In my last post, I took you through my adventures in the wild. There were pictures and everything. This week, I encountered an entirely different, but no less, shall we say, unique experience. Don't ask me how it happened, but this week I have found myself arriving every morning to the OB/GYN ward to do rounds with the doctors. There will be no pictures to accompany this post.
I'm a bit embarrassed by my reaction to this. First off, I'm 25, which by all metrics qualifies me as an adult and implies at least a modicum of maturity. And then there is the fact that I want to go into medicine. So I'm supposed to be cool, unfazed, scientific when it comes to every orifice, every fluid, every smell. On the surface, I think I pulled it off this week. I think that if you watched a video of my face as I made rounds, you would agree that I was successful in affecting an interested-but-not-terrified demeanor.
But inside my weird-shaped head, it was just bonkers, at least on the first day. Maybe by day three you could say the situation was downgraded from "bonkers" to "panicked", and perhaps by next week I might even reach "resigned terror." Given this projection, by the time I graduate medical school, I should have things down to a manageable "holy shit" level.
What really gets me is that, fundamentally, I shouldn't be uncomfortable standing there in the aftermath of labor. No one should. After all, weren't we literally born into this? The first air any of us breathed was saturated with those distinct aromas that accompany birth. In fact we were downright covered in the stuff. Maybe that's what all the crying was about. The point is, it doesn't make much sense that I was more apprehensive to enter the labor ward than I was to step onto a plane bound for the other side of the world. But I guess life's just weird like that.
Anyway, it's actually been very interesting. I've witnessed several surgical procedures including two Caesarean sections and a hysterectomy. The doctors have been amazingly helpful and informative. I know it's slowing them down to explain everything to me as we go from patient to patient, but they haven't uttered a word of complaint and seem to understand how beneficial this experience is for me. Though I'm just scratching the surface, I've learned a lot about the field.
Most interesting is seeing how cultural norms affect the way that the doctors approach patients. For example, a woman who bears ten children is highly celebrated within her village, so getting to that mark is a legitimate goal for many women in the area. However, if a woman has given three Caesarean births she puts herself and her baby at serious risk if she falls pregnant again. The doctors strongly urge women to cut their tubes following the Caesarean birth of their third child. Therefore they are presented with the monumental task of navigating the waters between cultural influence and medical interests for women who often have such a low level of education that they can barely understand the implications of their decisions. Things like this have served to open my eyes to the enormous scope of the challenge of medicine, particularly in the developing world.
Speaking of the challenge, a few words about the hospital itself:
Tshilidzini is the largest hospital in the area with 530 beds. The hospital grounds are actually quite picturesque. The sprawiling one-story brick buildings of the hospital are surrounded by trees and green grass. In the mornings, monkeys climb the branches near the main doors.
Inside, however, is a very different picture. Wards are over-crowded with beds and even more so with patients, who often have to find room on the floor. If you've spent any amount of time in an American hospital, the differences jump out at you in various forms. After close contact with patients, I found myself instinctively searching the walls for hand-sanitizer dispensers, which are virtually ubiquitous in a standard US hospital. Here, I located a sink after a short search, but it had neither soap nor paper towels. When helping a doctor insert a urinary catheter, the lighting behind the drawn curtain was so dim that the doctor asked if my phone had a flashlight. A patient admitted to the emergency room with chest pains will not get an ECG here, because to get an ECG, you need a working machine.
It's things like that... things that don't even cross your mind at home. They seem obvious, as though it is in the very nature of hospitals to be well stocked and well lit. You notice a deficiency in a hospital at home, a malfunctioning piece of equipment, a leak in the ceiling, and you assume that by the next time you visit, some authority will have acted to resolve the problem. That assumption here would be viewed, at best, as fantastical thinking.
Woah, things got a little grim there for a minute. My apologies, but I figured I'd be remiss if this entire blog contained nothing other than smartassmanship punctuated by photos. So that's been what's going on in my life this week.
Anyway, how are you? Good, glad to hear it! You're looking great, have you been working out?
-Gates
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