High fives and heartache: adventures in pediatric global health: shake the dust

Awhile back, my brother sent me the link to Anis Mojgani's performance of his poem, "Shake the Dust" which is amazing to watch if you haven't seen it.

The poem ends:
"Make sure you live, shaking the dust
So when the world knocks at your front door
Clutch the knob tightly and open on up
And run forward and far into its widespread, greeting arms
With your hands outstretched before you
Fingertips trembling, though they may be"

I have been thinking about this poem a lot this week. Trying to focus on the positive when there have been so many negatives. When dust is being showered on some of the most vulnerable, marginalized members of our society. I thought about what it means if the dust is too thick. If the dust is beyond dust and more like clouds of black flies, toxic and alive. I think at that point we can't try and shake the dust from ourselves alone. We need to shake it from each other. And right now there is a lot of shaking to be done.

I have focused a lot on the negatives of being here so the past couple weeks I tried to take note of the positives. I had a good couple of weeks. I went home a few days bursting with pride in the interns and clinical officer students. We did resuscitation teaching for several them a couple weeks ago and they were eager to learn more and practice their skills on the dummies that we have, asking tons of questions about what equipment to use and how to perform procedures properly, concerned about being able to treat children in the most effective and safe way possible. Some of them care so much. One of the clinical officer students told me, "We are always eager for more teaching."

We spent some time going over fluid management in the emergency room with our crew of dudes who have been rotating through there the past 2 weeks. We somehow managed to have an all male group of med students, interns, and clinical officer students. It was both endearing and hilarious to see them all huddle together and concentrate when we asked them to calculate fluids for some example cases.

Post-call the other morning, we needed to do a lumbar puncture on a patient, and our wonderful intern (after spending a night in the hospital) was already done with her morning rounds and did the procedure with plenty of time to spare before we signed out. Our awesome pediatric clinical officer did a paracentesis and ultrasound with me during a busy afternoon and did a perfect job, teaching me a lot along the way (as he stuck a giant needle into a child's abdomen I was mostly excited I gave IV sedation and the right medication to keep the kid from barfing during the procedure).

It has been nice not to have to round on 30+ patients each morning and actually have time to teach and work directly with trainees in their initial assessment and management of sick patients. Though I've been on call a lot this month because we were short-handed, I've felt less drained and burned out because I've had time to think and teach, which has been my favorite part about being here.

Last week I also went up to Mount Mulanje, which is a really beautiful and peaceful place. I have also been watercoloring (I will spare you any pictures of my terrible art, but the therapeutic value is incredible) and reading a lot of poems which has helped me de-stress and come back to things my introverted self used to enjoy before medicine ate my soul (ok, ok, a little dramatic, I still have part of a soul left). Here are some pictures of stuff.