Real Medicine

Working in the Land of Milk and Honey

By some kind of dumb luck, I am doing my Community Service posting at an incredible children’s hospital in Cape Town, rather than the archetypal middle-of-nowhere clinic post we all expect for ComServe.

And it’s incredible.

#lucky to work with this view; less lucky to be #oncall Friday and Sunday. #weekend #capetown

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This hospital is just something else. It’s public, but has so much private funding that it might as well be a private hospital. It gets a lot of private patients so clearly I’m not alone in my perception.

Some things that continue to blow my mind:

1. Pain management team

Absolutely essential, of course, but not something we had access to in the Eastern Cape. As part of pain management, our kiddies have access to aromatherapy and music therapy. How cool is that?!

2. Psycho-social services

When adults bring kids to hospital and they have witnessed violent events, the adults get debriefing practically before the kid even leaves the emergency unit. When a kid gets hit by a stray bullet, he gets trauma debriefing. There are support groups for kids with any number of conditions. All of these things should be a given, should’t they? But again, it’s something I’ve never seen.

3. Palliative Care Team

Last year, I often had to decide on my own whether a patient was for active resuscitation or not. It was a horrible responsibility, but not that I’ve learned just how much is involved within the practice of palliative care, I realise how WRONG it is for a clinician to have to make such decisions without an entire palliative care team.

My entire view of palliation has changed.

4. Gorgeous Operating Theaters

There are theaters with views of Table Mountain, and I just… wow. (The on-call room also has a view of the mountain.)

5. Clinicians who love their jobs

I can’t begin to tell you how amazing it is to be surrounded by senior doctors who are still passionate about their work. It gives me hope.

 * * *

One thing that is not available in the land of milk and honey is small-size theater scrubs. I still have to use a whole host of improvisations to prevent my pants from falling down when I scrub in for theater.

Oh well.

Real Medicine

Does It Have To End?

c4e635ecb89b5ed4844f087dca6580b1My four-month stint on the paediatric service comes to an end this week.

I enjoyed paediatrics in medical school, but never as much as this. How wonderful it was to be excited about work, to enjoy it so much that I willingly and eagerly read up more about all my cases.

It may have been one of the most challenging rotations – and it was good to see myself growing in confidence and ability.

There is so much work to do in paediatric healthcare, especially because you inadvertently treat the caregivers as well. And women are another group so sorely neglected in our environment.  Continue reading “Does It Have To End?”

Getting to know me, Real Medicine

Paediatrics: How Do I Love Thee

I noticed that four out of my last five posts here were sad posts. With good reason too: some scary things have happened.

But guys: I’ve had a fantastic two months. I’m on a four-month paediatric service and it makes me so… happy?

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Continue reading “Paediatrics: How Do I Love Thee”

Real Medicine

Baby-CPR: Full Circle

The first time I partook in a baby’s resuscitation was during my fourth year of medical school. It was a disaster: the wall-suction malfunctioned, the nursing staff were in the precarious business of changing shifts, and all algorithms flew out of the window.

I vowed optimistically that when I was a doctor, I would not let a baby die that way.

I had a lot of criticisms, which is so easy for a student to do; but I did learn from it. I learned to prepare myself mentally for any scenario where a life may need to be saved, so that I could give that life a fighting chance.

Last night it was my turn. I was called to the ward for a desaturating baby with pneumocystis carinii pneumonia (PCP). It was my call to start bag-mask ventilation, and then to start compressions when his heart rate dropped below 60.

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Chest X-ray of a child with PCP. European Respiratory Journal. Click for link.

Continue reading “Baby-CPR: Full Circle”

Bookishness, Real Medicine, Studying Medicine

What If Everything You Knew About Breastfeeding Was Wrong?

24612267How does one react to seeing a book cover that claims breast feeding is “big business and bad policy”?

If you’re me, you request a review copy of that book, fully intending to expose how wrong it is.

As a medical student, one of the important things I was taught again and again is this: BREAST IS BEST. We were given a nearly 100-page document to study about infant feeding during second year. We were expected to know the constituents of human milk and be able to compare it to cow’s milk and formula. We had to memorise tables of the various formulas on offer and their indications. In fourth year, an entire oral OSCE station was dedicated to breastfeeding.

Breast was best and formula-feeding was undesirable, and it all made perfect sense to me; and of course I never read up the literature because our professors had surely done that FOR us. Continue reading “What If Everything You Knew About Breastfeeding Was Wrong?”

Bookishness

Everything, Everything | SCID, Snark and Sweetness

I have a habit of requesting fictional books that address real-life diseases. I can’t help it. But I requested Everything, Everything because of that (“a girl who’s allergic to everything”) and because it sounded kind of awesome. And the COVER. Guys.

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“I’ve read many more books than you.”

What a first sentence! I liked Madeline immediately. She obviously liked books, and she’s mouthy. She has a tumblr and she reviews her books. Books remain an integral part of the whole story! Booknerd alert: I basically love her. Sometimes she re-reads her favourite books from back to front, and she writes things in the front of her books, like this: Continue reading “Everything, Everything | SCID, Snark and Sweetness”