A Tale of Two Sisters (and Grief and Mental Health)

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Two little sisters had an extended stay in the small rural hospital. They were the stars of the Paeds ward. The little one was absolutely shining and brightened up the whole ward. I spent ward rounds with her in my arms, on my hips, and eventually falling asleep on my back. She was loved. The older one was a regular little mother-figure. No nurse was allowed to clean or feed her sister: SHE did it.

They were no longer ill, but had lost their parents in quick succession, followed by neglect and abuse by the relatives who took over their care. So, as they lived in a region with a single over-worked social worker, they were staying at hospital until placement could be arranged.

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For Mother’s Day: A Rural Story of a Mother’s Love

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I have amazing women in my life – a wonderful mother, grandmother and aunts. I have written about them before, so this Mother’s Day I am sharing a story I have told them, and I know they won’t mind it as a tribute to all mothers.

My rural Family Medicine rotation earlier this year was not just rural – it was classified as DEEP rural. The majority of the people living in the area had no water or electricity. Many of them had pulmonary disease, despite never having smoked – the so-called hut-lung disease. The nearest referral hospital was more than two hours away and was reached by traveling roads with near-dongas as potholes.

Most of our patients were unemployed, or otherwise self-employed as subsistence farmers who struggled to subsist. Almost none of them had cars, and so when we did refer them to the “nearby” hospital they were sent with patient transport vehicles that were chronically overfilled. Patients who had to go to even larger hospitals with more specialised abilities had to find their own way – although the doctors often helped them out with bus fair using their personal income. Continue reading

The Time I Got Injured On Duty

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It was hot summer afternoon and I was on my rural Family Medicine rotation; the Friday leading up to my birthday weekend. I was looking forward to an off-weekend, and I’d be going home to spend my birthday with my family for the first time since 2008. I had dressed up in a new skirt, a pretty pink top, and had even worn my contact lenses to work. I wanted to look “pretty” for going home.

A very, very sick man was brought into our clinic by his mother and sister. He was emaciated, shivering and delirious. Because I had been in the area for two weeks and the area has an incredibly high rate of HIV, I knew, or at least very strongly suspected, that he was a patient with the virus. I also strongly suspected that he was suffering from cryptococcal meningitis, because I’ve seen so many cases of it.

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“Water, Water, Every Where”

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I live in a water-scarce country on a water-scarce continent. I grew up with a little ditty, “Kinders moenie in die water mors nie, die ou mense wil dit drink” – “Children, don’t mess with water, the old people want to drink it”. Parts of my country has had water restrictions in the years that I have lived.

And yet, I have never really wanted for water. When I open a tap, there it is. Cold and ready to drink, albeit chlorinated. Cape Town has some of the cleanest drinking water in the world. I could run through sprinklers as a child. I could swim in swimming pools.

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IV Lines: You’re Doin’ It Wrong

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A quick contribution to this month’s Medical Monday. I am in the last week of Family Medicine and trying to finish of the mass of projects we have to present this week. Additionally I have just realised that my first set of exams (the B.Ch-part, a.k.a. Surgery) is in two months. I am not feeling prepared for that and will definitely need to focus more intently on studying.

Anyway, here is an incident that made me laugh. The rural hospital where I am working is relatively small and sometimes, patients sleep over at Outpatients’ Department while awaiting a bed. We start their treatment in the meanwhile, run tests and set up IV-infusions. The next morning, OPD essentially as its own “ward round”.

We were scratching our heads as to why a certain patient had not received her treatment overnight. Then we saw her IV line.

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(As you can see, that IV isn’t going anywhere but down the drain.) As we are fairly certain that no nurse or doctor would have done this, the only conclusion we could reach was that the IV came out and the patient or a relative tried to “put it back.”

Regardless, we had a good laugh. This has got to be even funnier than when this happened.

On ComServe, and the Desroches Case

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My friends and I have this joke among ourselves. We say that medical school is like slavery. But then we say, it’s actually WORSE than slavery, because we PAY to work ridiculous hours in ridiculous conditions. As you can see it’s kind of more of a tragedy, but we’ve chosen to make it a joke. For our sanity’s sake.

So in light of that you might be surprised to find that my overwhelming feeling towards the Miguel Desroches case is not a good one.

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Mobile Update: Weekend Trips

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One of the awesome things about rural rotations is the opportunity to explore the surrounds. This weekend we went to quite a few surrounding villages (and today we hiked for the better part of the day and my muscles are cursing me).

This is a photo I took on the way. I really hope it looks half as good on your computer screen as it does on this phone!

Isn’t it wonderful? I spoke to someone who has been at the hospital here for many years about how awesome the vibe here is.

He said that it is because the place attracts “missionaries, maniacs and misfits.” Hah!