The past few weeks have been exciting, inspiring, trying, frustrating, and depressing all at once. And now we only have 2 days left at Kitale District Hospital.
It has been an eye-opening experience, and has made me realize how much we take for granted and how much we have to be thankful for, living and working in the United States. I have seen and done so much here that I probably would not have, had I stayed close to home this summer. My first week, I watched several births and even assisted during a routine cesarian section. During week two, on my first day rotating in pediatrics, I witnessed CPR and resuscitation efforts fail on a severely malnourished one year old patient after he began losing consciousness and gasping for breath just as we were rounding. And then watched, speechless, tearing up, and at a loss, as the medical officer and intern pulled the sheet up over his face and moved on to round on the next patient. And watched as the mother of that child looked away and moved over to next bed to sit next to her 3 year old who was also a patient admitted because of malnutrition. Then, later that week, I learned how to perform a physical exam of the newborn. Though one of the six babies in the new born unit that day had been abandoned by his mother, they were all healthy, and cried lustily. I later got some experience in making babies and young children kick and scream and cry, also known as placing IV lines. I also got to apply what I'd learned in school about sickle cell anemia (here those patients are routinely referred to as "sicklers") and learned a lot about the features and treatments for malaria, dehydration, and malnutrition, very common diagnoses of pediatric patients here. I've seen that type II diabetes, while a much larger problem at home, does not leave patients here untouched. That has been apparent in the odors that emanate from the feet awaiting debridement in the surgical wards. I've also seen that doctors, nurses, and patients alike are willing and able to not only make do with the limited resources available to them, but get good results and outcomes--even with many patients waiting until their disease has progressed far past the point that most westerners would find tolerable, before coming to the hospital for medical care.
I have seen much that is frustrating and saddening, but even more that is heartening, encouraging, and inspiring. I think that in a harsher environment, only those that are not only smart but also adaptable and teachable will flourish--that is so here, where resources are limited, time is short, lab tests are few, there are many many patients, and many patients are very very sick. Doctors and nurses here rely on their clinical expertise and judgment, rather than the battery of tests an American doctor might run in order to get a sometimes quick but almost always expensive answer. Even the baby with mixed-degree burns nearly covering his torso, back and front, has a huge grin for anyone who looks in his direction--you'll invariably fall into those dark brown pools that are his eyes, rimmed with the longest and curliest eyelashes you've ever seen. And he gleefully toddles around the ward, clad only in silver-sulfadiazine burn ointment and butterfly-decorated sandals that squeak whenever he takes a step. I've seen many patients here stoically bear what I've seen many patients home cry and moan about--I know I'd likely cry and scream, myself!
It's been a different world, in many ways, but in a lot of ways it's much the same. I think though, at the very least, it has afforded me new and educational experiences, and a different perspective. I've learned more about myself, but I've also just become more grounded in why I am here and why I've chosen medicine as a profession. I hope that I will always remember this experience, and that it will aid me to approach my future practice and patients with the knowledge and expertise, but also the open mind and humility that is so necessary to be effective in this field.
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