Today I leave for a two week family medicine rotation in a small rural town in the Western Cape.
This year, family medicine will supposedly be a lot more fun than in third year. Calls will be a mish-mash of every rotation. Lady in labour? We catch it (yay!). Stitches, we do it (uh-oh…).
At a recent community volunteer clinic, I had my first proper psych patient. I have dealt before with suicide attempts, but those were unconscious patients in casualty and thus did not present the opportunity for a consultation.
This patient came for help herself – something I though was a good sign. Her affect was blunted and she was clearly depressed. There was a positive history too.
As part of Infectious Diseases, we must learn about Syndromic Management. It is not the best approach for a qualified doctor, but it is important to understand – especially in a primary health care setup.
During one of these tutorials, the doctor in charge made us close our books and asked us about our approaches to the full waiting room and the possibly accute patient.
We answered well.
Reuters reports that antibiotics are not useful for most sinus infections. Excessive prescription of antibiotics has lead to large-scale resistant organisms.
Okay, this I know.
But now what? Antibiotics make patients feel better. A frequent sufferer of sinusitis, I know this. So now my patients walk away from a consultation feeling that their doctor doesn’t care about their suffering. I don’t see many doctors being happy with that.
It’s STI/Condom awareness week in South Africa! I find it mildly amusing that this takes place during Valentine’s Week – whether that was intended as a buzz-kill is debatable.
STIs and especially HIV is huge in South Africa. If you’re new to this blog, click here for more of my related posts.
The inspiration for this document came during my second year while studying for an end-of-block test. At the same time, the then-first years were studying for Pathology, aided by “Le Document”. Somewhere in this time period I looked at a fellow second year, threw my hands in the air rather dramatically and exclaimed,
“I wish I had a Le Document for Second Year!”
Le Document pour MB.ChB.II can be found here. It focussed mostly on holistic wellness during a tough theoretical year. Third year is a whole new ballgame, with students finally set wild in the clinical environment. Theory modules are unfortunately still a reality and at my school, third years are haunted by Neurosciences and Musculoskeletal System.
I’m a bit of a Grinch. Or a grump, or maybe just a cynic.
Anyway, I read this article about how poor dental health can lead to pneumonia, therefore you must brush your teeth twice a day and floss once a day. The research was done by the Yale University School of Medicine, so I don’t for a moment doubt its legitimacy. They were also open-minded enough to mention that the precise relationship between oral bacteria and pneumonia must still be determined.
However, I fail to see the importance of such research in the context of health in the 21st century.
The countries where the general standard of living is high enough to worry about regular teeth brushing also happen to be the countries where health care is of such quality that pneumonia need no longer be a death sentence.