June 20th Hlebsia

June 20th, 2007This morning Regina and I walked almost the entire 8km from our home stay to the hospital. It is very hilly but absolutely gorgeous. We got to see the sunrise again and it was wonderful to get some good exercise in.

Maya and I got to shadow Tom, a doctor from London who wants to specialize in Infectious Disease. We went on ward rounds with him in the TB ward and it was very interesting. There was a patient who was 15 years old with advanced HIV (stage 4 AIDS) with a CD4 count of 4 (normal is between 500-1500). Her chart read that she was sexually active for several years with an older boyfriend. She said this was consensual sex. For her to have such a low CD4 count and symptoms of advanced AIDS you would think she would show at least a glimmer of anger towards her boyfriend.The odd thing is she doesn't. Even when the counselor (according to the notes) interviewed her and asked her if she considered charging her boyfriend with abuse for infecting her she said she didn't think of it as abuse.

Maya and my x-ray reading skills were put to the test in the TB ward. It was amazing to both of us how much we have learned since our first week at St.Mary's when an abnormal and normal x-ray pretty much looked the same to me. The x-rays and the diseases we get to see here are out of the textbook (in other words, we would never get to see them in the states other than in a textbook).

There was one male patient in the TB ward who was suffering from renal failure and at the end of his life in pain and quite agitated. Tom said at this point he was more focused on palliative care for the patient and was treating him much like the patients at Chatsworth Hospice. It's amazing how so many of my experiences here are coming full circle.

Arthur, Raj, Regina and I were the on-call medical students tonight and stayed in the doctor's quarters. We ran into one of the doctors from Hlebsia in the grocery store and invited him to dinner. Before we knew it we were making dinner for 7 people! With only two pots and very limited cooking supplies we worked as a team and made a fabulous dinner for ourselves and three of the other doctors. It was great being able to talk to them about what they thought of Hlebsia (they are all here studying different specialties for one year). It also made all of us consider possibly coming back to do something similar.

We didn't get woken up until 5:30 am, which was nice considering we were waking up at 6am anyway. We got to see a C-section and Raj assisted and I didn't pass out. It was amazing.

More to come...love you all.