Lessons learned in the past nine days:
I'm really bad at keeping up a regularly updated blog.
Forgiveness is truly divine. We had a patient on our team last
week who was poisoned by a "friend." Apparently, she forgave her
so-called friend before she was even discharged. I'm sure they'll
have a great time reminiscing about that in the future …
"HIV positive" is not to be said out loud, especially in a space
where others can hear. I made the mistake of asking how long a
patient had been HIV positive and the fourth year Moi student
translating for me shot me a bit of a look and later explained that
the correct term is ISS (immune-suppressed). Luckily it wasn't a
On to other things! It's funny to me how quickly I've adapted to
being on the wards. Last week I had to go to the new cardiac care
unit, which is a very nice part of the hospital. It's quiet and not
at all crowded; patients each have their own hospital beds; there
are monitors and crash carts and all kinds of fancy equipment.
Essentially, it looks like a standard American hospital ward. I was
surprised, however, to find that it felt so weird to be there after
getting used to the chaos of the general medicine wards. Returning
to "The Wards"- teeming with patients, nurses, social workers,
medical students, pharmacists, residents, even cockroaches-was
almost a relief. I can't say I will ever be totally comfortable
there but it's oddly come to be my "new normal." My team-thanks to
Friday afternoon lunch and drinks last week-has officially bonded.
Of course, there are daily frustrations, like taking an entire week
to obtain a chest X-Ray for a very sick patient. That can be taxing
and sometimes overwhelming. But I've also come to enjoy seeing some
of the ingenuity of my Kenyan colleagues. Things like actually
calculating how much hypertonic saline is needed to correct a
sodium level (in the US, one has the luxury of checking serum
chemistries every few hours) and controlling the rate of an IV drip
by adjusting the length of the wire hanging the bag from the
ceiling. Real science at work!
It's funny how in the US, we often romanticize physical
diagnosis skills. Stories of professors diagnosing neurosyphillis
after simply observing a patient's limp are legendary. Much of my
nerdy medical excitement for this rotation was getting the chance
to really hone my physical exam skills. And while this is
(thankfully) happening and I do still hold these skills in high
regard, I am also realizing how annoying it is to not have a CT
scanner to back up your suspicions. Last week we had a patient with
severe anemia-to the point that her conjunctivae where white. But
you still cannot safely transfuse blood products in a non-emergent
setting without doing a type and cross, which at MTHR can take days
to get back.
On to more fun things!
On Friday we visited the Tumaini Center-a really neat
shelter/rehab center for street youth in Eldoret that currently
houses 14 boys who are former street youth
Friday afternoons are reserved for soccer and often times, a group
from IU House will go out to play with them. I would describe my
own soccer skills by saying that it's clear I have spent a sizeable
chunk of my life on a soccer pitch, but I am certainly nothing to
write home about. I simply enjoy playing whenever I have the
chance. In the past few years, however, I have often found myself
playing soccer with a group of non-American, non-English speaking
males who initially find my enthusiasm for the sport cute at best.
The notion of an actually athletic and coordinated female does not
always occur to them. And while the Tumaini boys have been primed
by some of the more long-term soccer-playing female pharmacy
students, I could tell they were still a little hesitant about my
ability to not totally fail on the field. But as this story arc
always goes, it took 15 minutes of me playing with solid mediocrity
before a boy remarked to my friend on the sideline, "Maria is good!
Is she training for something?" As much as my pro-Title IX,
feminist self hates the double standard, I always find it amusing
to be accepted onto a field full of males not by actually playing
well, but just by not being the absolute worst player ever.
Saturday we went to Umbrella Falls, a waterfall near Eldoret
that actually generates enough waterpower to provide half the
city's electricity. It was quite a serene and beautiful
On Sunday we hosted "Blood Croquet" at IU House and invited many
of our Kenyan medical student friends. As it turns out, none of us
actually know how to play croquet but we didn't let that stop us.
We essentially set up a putt-putt course throughout the yards,
gutter system and gardens of the IU House compound. I'm sure our
version is much more entertaining than real croquet. When everyone
got tired of croquet, we moved on to a game called "Head's Up"
where someone puts a word on his/her forehead and the rest of the
group tries to get them to guess that word. We encountered a
cultural exchange moment when the word "ping pong" came up. Many of
the Kenyans immediately went the route of trying to describe the
skull of a baby born with Rickets, which will be so weakened by the
calcium deficiency that pushing on it is reminiscent of a ping pong
ball. That's a bit more morbid than table tennis …
In lighter news, I've grown accustomed to being greeted at the
main gate of IU House by the guard, Michael, who refers to me as
"Mother of Jesus." All of you who see me on a regular basis in the
US, please plan accordingly.
I'll finish with a short anecdote about the ever-impressive Joe
Mamlin. Last week, the US ambassador to Kenya visited Eldoret and
met with Dr. Mamlin at 10am on Friday. He and I sat down for lunch
after the meeting and he went on to say that while he appreciated
meeting the ambassador, he was ultimately disappointed to have to
miss his 9am-11am HIV clinic. I responded by saying that important
people want to know him. In his true humble form, he replied
simply, "Nobody needs to know me … they should all just meet Sarah
Ellen." (Sarah Ellen is his equally as impressive wife.)
That's it for now! Enjoy the snow. I'll continue to suffer
through the 80 degrees and sunny weather in Eldoret.