Tuesday week 3
Lots of readers but no discussion :( Maybe you want more medical stuff? Ok.
The general clinics run here are great places for learning. We see and manage conditions from every speciality, like a cross between A+E (but necessitating a longer term, holistic approach) and General Practice (but in a hospital setting and requiring more specialised care), where the out-patients doctor is general physician, dietician, counsellor, and secretary. Here are a few stories from today.
We saw a 5-year-old who had been ill all his life but was only brought to medical attention today. He was very pale, had swollen hands, a distended abdomen and lung crackles; he was having a sickle cell crisis so was rushed in for urgent admission.
There is no facility for heart valve surgery in The Gambia, so people with rheumatic heart disease die. Death is precipitated by cardiac stress, particularly childbirth. We saw a lady with the diagnosis today. Her husband had required her to have more children and she was not excused from heavy housework.
A man walked in unaided, but careful questionning revealed he was mildly confused, and led the doctor to guess he might have cerebral malaria, which, if untreated, can cause death within a few hours.
I really hope I can learn that skill of instinctively pooling all the info about a patient that is available at first glance, to know whether he is essentially well or ill.
I'll try to find some happier stories for next time!
After out-patients I had to present a case and literature review at the clinical meeting. I was asked loads of questions but it went well and I'd like to do it again.
The general clinics run here are great places for learning. We see and manage conditions from every speciality, like a cross between A+E (but necessitating a longer term, holistic approach) and General Practice (but in a hospital setting and requiring more specialised care), where the out-patients doctor is general physician, dietician, counsellor, and secretary. Here are a few stories from today.
We saw a 5-year-old who had been ill all his life but was only brought to medical attention today. He was very pale, had swollen hands, a distended abdomen and lung crackles; he was having a sickle cell crisis so was rushed in for urgent admission.
There is no facility for heart valve surgery in The Gambia, so people with rheumatic heart disease die. Death is precipitated by cardiac stress, particularly childbirth. We saw a lady with the diagnosis today. Her husband had required her to have more children and she was not excused from heavy housework.
A man walked in unaided, but careful questionning revealed he was mildly confused, and led the doctor to guess he might have cerebral malaria, which, if untreated, can cause death within a few hours.
I really hope I can learn that skill of instinctively pooling all the info about a patient that is available at first glance, to know whether he is essentially well or ill.
I'll try to find some happier stories for next time!
After out-patients I had to present a case and literature review at the clinical meeting. I was asked loads of questions but it went well and I'd like to do it again.
Comments
I haven't listened to the music I brought with me yet- seems that last minute scramble to get a MP3 player was for nothing. I want to try to catch Yossou D'Nour singing at the Independence Stadium which is not far from where I'm staying.
More about photos in a minute...
Thanks for writing. I had to think laterally to guess your identity(especially due to the reference to kids- I can't think of any friends who are parents who also use smileys!)- are you S.M.? :))
I think it is important to know from a young age be aware of the complexity of problems of 'rich' and 'poor' (including the hidden poor in industrialised countries).
The 'poor' don't need special treatment, just humanity and justice. And just like blind or deaf people, they compensate for what they don't have, so we can all learn from each other.