There are some things I am starting to just accept. Mainly that nothing happens quickly. Labs constantly need to be followed up to actually get a result. Trying to get a consultant to see a patient can take days. Figuring out where to even send certain tests can also take forever. I was talking to someone from home and getting frustrated for really no reason when I realized underlying all of this was the fact that I had a child this week die because they had a brain tumor (pineal gland diagnosed on outside CT) that was likely operable, but the neurosurgery team took days to see her and then wouldn't take her on their unit because she was starting to seize. They sent her back with plans to biopsy sometime this week but given she already had signs of increased pressure in her brain and nothing had been done, she died over the weekend. Some cases I am not happy with but figure there probably wasn't much that could be done in the first place, but this one made me more upset. This was a lot of political drama between peds and neurosurgery (as they are supposed to be trained to manage seizures as it is a NEUROSURGICAL unit and they have their own HDU) and the more senior pediatric consultants were all appropriately angry and went to discuss this with the neurosurgeons. There have been some problems recently with patients getting transferred for neurosurgery who then are not seen for days, which is really difficult for everyone. I got the contact info now for pretty much every consultant in the hospital so that I can now go up the chain of command quicker. I'm not sure if this will help but at least I can feel like I've done as much as I can short of becoming a brain surgeon.
The HDU where I spend a million hours rounding per day.
There are about 5-7 of these little box beds per side, each with 1-2 patients in them.
There are tiny cockroaches all over the walls (not pictured haha)
The left wall of the HDU where CPAP happens. Usually has 3 babies in that one bed.
It goes back to the serenity prayer I suppose. God grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference. Our first few months here are all about finding that wisdom. In any health facility there are places for improvement, it is just figuring out what will actually be helpful and create lasting change.
Jacaranda tree on the hospital grounds seen from where we do sign out each morning. They are all blooming now and are sooo beautiful.
To keep myself sane, I have been trying to accept the inevitable (e.g. if you are a 1 kg baby born here, you probably won't survive no matter what we do) and not think about the hospital too much when I am outside the hospital. I also routinely vent to the rest of the GHSP peds team, my fellow consultants here, and residency friends back home about difficult cases, probably to an annoying extent, but the support has been tremendous. It helps to have people corroborate what I'm thinking or suggest things that I wasn't even starting to think about. My counterpart here is awesome and is always available to look at difficult cases (not just for me but is consulted by everyone which makes me feel a little bit better haha) and then just picks up an xray or looks at the patient and in 2 seconds goes, "This is TB." Or, "This is KS (Kaposi Sarcoma)." Such confidence.
Besides traveling around the area, I've found some close by activities to keep me sane. I played basketball this weekend which was crazy but fun. Lots of elbows and more netball style than I am used to, and I am definitely a little rusty, but had a good time. I tripped and ate it doing my first lay up in warm ups because the hoop has 2 metal poles directly underneath (like right on the baseline) that I for sure was not used to. So that was an embarrassing start. It is a little scary they aren't padded or anything so I'm hoping that was the worst of the iron pole encounters.
Some dudes ballin' it up in the game before ours (which started 2 hours late unsurprisingly). The bottom of the offending pole can be seen at the far left.
I've also continued my grandmotherly activities like yogurt- and bread-making, cooking mass quantities of food, shopping for fabric... My next goals are jam making/canning (seriously), cross stitch (not as seriously), and mass consumption of cottage cheese with canned peaches. I am also honing my skills as a cockroach assassin and in-air mosquito killer (currently working on the one-handed mid-air grab, the cockroach technique is just gallons of Raid which is already pretty advanced I think).
Last weekend we didn't take any shortcuts and went Lilongwe (ahahaha gets me every time) to see the rest of our crew and pick up my passport. There were 4 volunteers who just came last week (who had other commitments at home so couldn't start when we did). So we welcomed them and then reunited with the some of the other girls from our crew. Lilongwe is definitely an experience in how the other half lives. There are tons of rich ex-pats there because of all the government officials and embassies around. Everything is soooo spread out and suburbic (I just made up that word) and I have no idea how people know where stuff is. We went to a lovely outdoor garden restaurant called "Brunch" that is next door to a salon that does pedicures, so enough said. We had a great time, did some hard core chitenje shopping, ate tons of good (but expensive food), and talked about non-hospital things (plus some hospital things like comparing numbers/sizes of things like beds, nursing staff and cockroaches in our units).
Lilongwe chitenje market finds. A couple will prob be used for house decor (like the little people one) but the rest I need to figure out what article of clothing they should be made into...
My new fave! Found this one at the fabric store here. Was on a mission to find it after I saw a lady at the hospital with it. I am not sure what the random little clocks are but I love the bikes. I think it's going to be a dress in the near future.
Otherwise, mostly have been thrilled to have pretty consistent electricity for the past few days (right when I started fighting for Peace Corps to buy us gas stoves). Probably thanks to this:Malawi: Minister Msaka announces new electricity company.
High fives for this week:
- Asking for help on a malnutrition lecture to a visiting expert and having him offer happily to just give a lecture he already has prepared on the topic (which, for the students is a huge win given I am prob the least qualified for this topic).
- Letting this chronically ill kid that we can't figure out what is going wrong with him use my phone to take selfies. He was smiling ear to ear (I'd post it but I didn't ask permission). We also discussed him in rounds and basically no one knows what is going on with him but at least he got to take some happy selfies using my stethoscope.
- Going to the 1 grocery store that has amazing, amazing things like curry paste, sesame oil, cheap coconut oil, and (gasp!) chocolate chips.
- Buying keys to the peds department so I don't get locked out again (no one told me we needed to get a key and doors lock at 5:30 pm)
- Meeting pretty much every ex-pat in Blantyre at the Fri night hang out spot this weekend and staying up past midnight (I know, I know, goes against my grandmotherly aspirations).
- Electricity!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
This week is going to be busy with some ultrasound training, a lecture (that I actually have to give and couldn't find someone to pawn it off on hahaha), and then the visit by the Peace Corps director, ahhhhhhhhh! Then I fly back to the states next Sunday! So exciting. I might try and post something when I'm home but it probably won't be as exciting (if you consider roach killing and yogurt-making exciting, then my blog is pretty thrilling).
Thanks for reading!!
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