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.

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.