New Frontiers

This week was just one of those weeks where I realised that no matter how hard I try to put it into words,it just won't be possible at all...but I'll try anyway/how! The background as how I got myself into an "sticky" situation, is as follows; I am busy with my very first obstetric/neonatology rotatione that is not purely clinical as such,but does it comprise a chunk of the work/exposure we have to get through/experience.

Now Tembisa hospital is a very SPECIAL place; it's a medium-sized secondary hospital that is very,very busy(really just like Kalafong,just not as academic and student-friendly per se) and with more than ample opportunity to learn a great deal,even if you have to bribe the sisters with chocolates to do the basics. For people that has never been a busy state-hopsital in South Africa this post will be really difficult to imagine, but will shock no doctor in the good 'ol RSA.

Labour ward 8:00-Some day I will record the sounds of an African Labour Ward, make a pleasant CD and make millions for the horror it enstills into the hearts of young,starry-eyed med-students!!!HAHAHA.....or NOT! Now the labour ward is something that I can and most probably will devote a whole entire post to. To say the least I got to deliver two babies that day, suture a 1st degree tear etc.

At about 13-ish we had to prep a patient to go to theatre(the OR) for an emergency C-section so I asked the sista if I could put in a Foley's. After she agreed and getting everything ready, I saw the biggest vulva I have ever seen. Now for me, this doesn't really mean anything as I have zilch/nothing/nada/no experience in OBGYN and the rest of the day really relied pretty much on primal instinct. So I don the gloves very professionally and swab very nicely. Now to see the urethra is not easy, but I saw it(or so I thought) and swabbed one last time to make sure it's nice and clean, I asked the patient(who was had a failed induction) to cough to just gently ease the lubricated foley's catheter into the bladder.

By the 3rd time I failed to put it in and with the mother making funny noises(still moaning,but a slightly different tone), I stood back a reassessed. I went in there again and explored the area again(which I'm now an expert on) when I realized that the catheter will never go in there and that thing was meant for something else...I then realized,admist all the confusion, why she moaned all along.

And so I will carry this name that has been passed unwillingly unto me till the day I graduate...Mr. Nicey-nice.

Blood,sweat and tears...

“When one does not understand death, life can be very confusing.” - Ajahn Chah

Recently I started a new job in a huge private hospital as a phlebotomist. At first I was a bit hesitant as to where I am going to fit a 2nd job in between my other job and (more than) full-time studies. But, I can say, the three weeks I have been busy with my training/induction, it has been more than interesting and meant so much more than just the job at hand. Yes, I have worked very long hours for lower than minimum-wage, but soon I'll be rewarded fairly...

Once again I realised;

-How precious life is

-How different people are

-How "naked" all the patients are

-How vulnerable people are

-How untimely death is

-How a simple smile can make all the difference

-etc, etc, etc.

Ciao

PS:It's simple;you behave-I behave...you don't behave-I know you know...hAhAhAhAhAhA

Crunch time...

Once again I am on the advent of a very important exam. My first ever surgery exam is happening on friday and I cannot help but wonder if this time I am truly going to fail an exam. I have felt like this before, but this time it really seems like a possibility. All I can do now is to study like there is no tomorrow and hope that everything I find important, the examiners will ask.

But speaking about a big test, I often find myself wanting to do other things or not be totally focused as the exam-time nears. I believe this is a coping mechanism to make it seem that it is not really happening, almost like a denial-zombie state. And to top it off, it is the freakin' World Cup...only the biggest sporting event to hit South African shores.By the way, I am very impressed about everything is going so far! To admit, I was a bit skeptical when Fifa announced the World Cup is going to be hosted in RSA. So, while everybody is out celebrating and having an awesome time, I will be sitting behind my books......oh, self-pity, how I missed you!

Over and out
PS: My vuvuzela already has a number of pictures taken of it...

SCREAM!!!!!

Two things...
1)There is just something in the scream of an innocent child in pain that seems to get to me everytime.
2)Alcohol seems to be involved quite frequently.

Look I'm not the one saying that there should be a test to allow one to become a parent, but it will help in most cases I have seen. I may just be prejudicious, but let me explain.
The car stops at the practice with screeching tires and hazard lights. The mother jumps out crying with her 2-year old clenched in her arms. I take them to the emergency room to quickly have a peek at what the problem is. The child obviously in a great deal of pain and distress, screams like hell with a burnt belly that is clearly not just superficial,nice partial to full-thickness burn right across the abdomen of the little one. I ask as to how the injury occured as I apply Burnshield(nice soothing burn-lotion impregnated in gauze). I could clearly see the hair round the face also being burnt, which means RED LIGHT!!! Ugly blisters on the soft-palate!!!
The dad goes on to explain that the child was playing with some sort of device that exploded. I still don't know what he was talking about.
Now this is exactly where I have great inner conflict. 1) A child of that age should be in bed by that time!?! 2) How can parents let something like this happens. I mean if something has the potential to explode, then a 2-year old shouldn't be playing with it! 3) Is it really necessary for them to reek of alcohol.

While I enjoy a couple of drinks myself now and then and knowing stupid accidents can happen.(Especially when one of my friends surfed on the roof of a Tazz and only fell when they pulled into a parking space after clinging for +-2km,hahahaha) Surely one is more cautious and conscientious when children are involved?!

Maybe I don't understand these things as I am not a parent yet, but one thing is for sure...I will never be the one looking the doctor in the eye and trying to explain how something happened to my child(caused either directly or indirectly by EtOH) with my breath reeking of Whiskey,Brannas etc. That raw-scream ensured that!!!

Visitor

As I mentioned in my first posting, I work part-time at very busy private GP practice. It also happens that this practice is open 24 hours a day and there is at least one doctor present during the night with the so-called student. I normally don't work the night shift unless I really have to or help one of the fellow employees out. Well, this particular night I arrived my usual time, which is about 19, then the shift only ends the next morning 08:00. As soon as I arrived the people I was taking over from informed me, that there was a "visitor" in one of the procedure rooms. I inquired to what they meant by "visitor". They told me that it was an elderly gentleman, without a medical-aid relying and on a state pension,who was brought in by his employers. He suddenly collapsed as the doctor on duty was busy examining him, they tried to resus him but was to no avail. The paramedics(we always call the paramedics out in cases where resus is in progress-as not all of our doctors have their ACLS and the paramedics resus on a daily basis) which were called out declared him dead and told the doctor on duty they would organize for his body
to be collected by the state coroner. No questions asked.

At about 11 the practice has become quite silent and I could finally sit down to eat my supper. About an hour later a guy came crashing and screaming in pain through the door. He had a towel wrapped around his arm. Now any doctor would know that this is usually not a good sign, but I really didn't take too much notice as I've seen very small lacerations been wrapped in huge towels etc. I took him through to our allocated emergency room/stitch room with his mother in tears short on our heals to assess how bad his arm was. The guy was really in distress so I tried to calm him down just bit. As I removed the towel I had to jump back as bright-red blood squirted out. He had made a make-shift tourniquet from his belt to control the bleeding a bit, so pulled it tighter when he saw the blood squirting. I told him we must remove the tourniquet but before my sentence was completed he yelled at me and cursed in true Cape-flats fashion. I ripped of the towel and saw a very deep laceration extending through the muscle layer with the median nerve flowering like a daisy. I ran to the doctor who was busy stitching up a minor laceration on the fore-head from another patient who enjoyed a bit too much of juice, of the fermented kind, that we had a situation on hand and that he'd better hurry up. The doctor soon went as I offered to do the wound-dressing and filling his prescription of pain-medication and anti-septic ointment.(The practice has quite a big dispensary and I have been trained to dispense meds etc.) I went back to the room where the doctor was taking a look at the major gash and told me I must go and fetch a stitch-pack stat. I went to nearest procedure room where the stitch packs are kept, forgetting a little bit about the "visitor" who still hasn't been fetched by the state coroner. I'm not scared of dead bodies as we dissected our cadavers recently and this dead-guy was certainly not the first one I had to deal with. He was draped by a space-blanket(the shiny type paramedics use). I went in and turned my back to him to find the appropriate pack when a heard the space blanket moving!!!!! I almost soiled myself, gave a giant leap for mankind and yelled "wat die f*k?". As I jumped around I saw the blanket was really moving------but the freakin' aircon was not turned off and had blown onto the space blanket!

Needless to say I didn't sleep on duty that night,partly due to my fright and after I phoned the whole city red at 2'am asking who the hell is supposed to collect the guy? The coroner denying that any call-out was made and making it clear they were not going to be called out by me or anyone else at that time, except the SAPS.
Turned out the paramedic making the promises didn't keep them and so I phoned trusty ol' AVBOB.

The guy with the gash was referred to the ortho-pod. He was apparently having a fight with his mother and had somehow managed to get/bash/ram/moer his arm through the glass door of a built-in oven.......ssssttttuuuuuupppppiiiiiidddddd!!!!!!!

A night to remember!
Over and out
Zamalek

Innocence

I still remember that fateful day in the my 1st year of medicine. If I think back to it now,I think it has had bigger impact on me than I initially though.

It was halfway through the year when we had our orientation on a new campus, which included a quick-visit to one of the clinical departments to experience day to day life in the hospital as to kick-start our interest in medicine in general. As is per usual with our class, everyone rushed,kicked,screamed,pushed and cursed as soon as the lists went up to allocate us to a specific department. Almost everyone wanted to go to OR/theater(after all, this is exactly what we signed up for; blood and guts). Needless to say, I got stuck to visit the psychiatric hospital which is one the other side of the city, with one of my friends joining me. Bleh, I though!!! It is the same hospital as described by Bongi here and here It turned out to be a very interesting visit which included a informal ward round. To be quite honest, I can't be believe I was so ignorant to think that weird,crazy and just plain nutty people like that existed.

But after hearing the stories of all the people that actually went to theater/OR, I decided I just had to go. Luckily for me,studying in South Africa, I soon found out that this wasn't too difficult. After I encouraged some friends(we were about 5) to join me to sneak into the theater complex of the huge academic hospital across the road, we just went into the changing room and put on some scrubs while trying to look like we knew what we did. Surprisingly and shockingly easy I thought,just for any person to gain access to the complex. So off we went to see what surgeries where about to start so that we can have a peek of what real guts look like. The next moment we I can remember, we are in theater after asking the theater's scrub nurse if we may watch. The patient is an average looking middle-aged guy that has not yet been anaesthetized but we enter anyway as we are overly excited to see every happening. I mean here we now have the chance to see what lay before us, the reason why most of us is starting on this incredible journey. While the rest of the group carries on with laughter and discussing over-excitedly about how awesome this surgery is going to be, I noticed the patient is quite in distress. So I move on closer to make small talk to him in an attempt to ease his nerves, because it's clearly shot. I go on to ask him where his from etc, then I ask him what procedure they were planning to do today.

This is where I heard those dreaded words slowly from his mouth, almost in slow-motion; "They are going to amputate my other leg as well today." I don't know what facial expression I showed there-after as my whole face went numb. Now I clearly understood why this man was in such great distress. The surgeons were going to freakin cut off his only leg!!! His was laying there all exposed, all vulnerable, then we burst in a cheerful chatter as if his horror wasn't bad enough and making him feeling even worse.

I just said "Good luck" and stormed out of the theater as the moment I just found myself in was just to great, I was no longer so sure that I wanted to study medicine as I believed that I would be better prepared for the situation when I was at that specific moment.

That day I lost my innocence(so to speak) and the baptism-by-fire for the real life had done quite its job.

Over and out
Zamalek


PS:Needless the say, I joined the orthopod's in the adjacent OR for a spectacularly messy total hip replacement...mission=blood and gore---accomplished.

Welcome

Hey there!
Nice to meet you and welcome to my blog. For some time now, I've been wondering if I should start blogging my doings, but after reading bongi's blog I decided to start a blog of my own. I can only hope to be such a great writer with such awesome stories in the future, I also hope that this blog serves like some kind of memoir down the long winding road in on( not to sound too like I'm sorry for myself now).

First of all, let me introduce you to myself. I'm an average 20-something year old studying medicine,MBChB, at a "prestigious" university in South Africa's official capital.(The only University I might also say-t*ks of niks). I lead quite an ordinary life(ordinary?) but I do have the odd patient(person-to-person) interaction (my part-time job working as receptionist, cashier, nurse, cleaner and pharmacist at a very busy private GP's practice) that has lead to quite some interesting stories over the past almost-two-years.

Well,that's all for now, but let me thank you for reading this and once again welcome to my life. A life that I hope you will find interesting and full of great and not-so-great times.

Over and out
Zamalek

PS:People who know me personally--Yes, I started to blog,wow,but keep reading, you will maybe just recognize yourself in some of the blogs to come.
PSS: I will try my utmost best not to name anyone and not to embarrass or speak about anyone directly,but I can not promise anything.