How the other half…

How the other half…

Shall I bore you with yet another description of Major Ward Rounds? Though I will say, the age of political correctness and constructive criticism has robbed senior residents and attending physicians in the United States from getting truly creative with their instructional methods with deficient interns. Though the sarcastic and selective emphasis of “daktari” is eerily similar to the familiar, “So what are you going to do… doctor?” heard by interns all over the US.

“D____, you tell me that M____ is in theatre, that R____ is in theatre, and that you are busy running the ward. But you don’t know these patients, what are you running? Are you patrolling the corridor? Maybe we should take your white coat and give you a security uniform. We have people to patrol the corridor. Don’t tell me you’re working when all you’re doing is running back and forth looking busy.”

“So, M____, you think this woman has PID, did you do a PV [per vagina, bimanual exam]?” “No, she is on her menses.” “And you cannot take care of her properly because she is on her menses? Are you a doctor or a Jewish rabbi? Do you think to yourself: ‘This lady is clean, I will examine her. This lady is unclean, I cannot touch her.’ How can you diagnose PID without a PV!” [I have no clue about the accuracy of his theology, but he’s pretty funny.]

Then when examining a baby who clearly has an umbilical hernia, but was being seen to r/o intussusception.
Intern: “The abdomen was soft with no abnormalities noted.”
Surgeon: “Did you examine this baby?”
Intern: “Yes”
Surgeon: “Is there something wrong with your eyes, do you need to get closer to the baby?”
Intern: “No”
Surgeon: “And there’s no abnormality with this baby’s belly?”
Intern: [stares blankly at the naked child on the bed in front of us all]
Surgeon: “Touch his belly.”
Intern: [gently brushes his finger over the top of the hernia]
Surgeon: “Don’t lie to me. I can tell you’ve never examined this baby. I can tell you don’t know what a hernia is. Don’t read to me what other people write. I know how to read.”
Intern: [stammers a bit]
Surgeon: “And what about the PR? Exactly. You didn’t do one. If you’re not going to put your finger up theirs, you may as well put your head up yours.”

And my favorite of the day: “There is supposed to be a difference between parrots talking and humans talking. You know that? Humans are supposed to realize that the sounds have meaning. You are a bunch of parrots!”

No operating for me today. Left early (after six hours of rounds!) to do some souvenir shopping and make arrangements for my weekend. But I have figured out that in the 12 days in theatre I have had, I have done 40 cases, 11 of them on my own. Not bad. Three theatre days left.

Tonight was a treat. Most of the time I have spent with Beldina has been in the village or doing her infamous “windshield tours” of some of the slums in and around Kisumu. She is so passionate about the work that needs to be done here that it’s infectious. That is to say, I didn’t mind a single minute of it, I can’t say I enjoyed – who can enjoy witnessing such poverty! – but I was enlightened by seeing some of the areas. In contrast to that, however, tonight we dined like the Kisumu elite do, in the relatively wealthy neighborhood of Milimani. The first clue was the cars in the parking lot. The simple fact that there were cars, not a bunch of Mzungus being dropped off by taxis and tuk-tuks. Secondly, the cars were of a certain class of German import. ;)

When we walked into the dining areas (inside, veranda and outside courtyard) it was like walking into my imagination. This was the linen-ensconced, lantern-lit Africa that I had been envisioning. Dark wicker chairs with deep burnt orange seats surrounded rich wood tables under draped canopies of tan fabric. Candles flickered from behind hurricane glass on each individual table. The courtyard was strewn with these private huts, just far enough away from each other to hear murmurings of conversations in the African rolling Rs of their vaguely British accented English, interspersed, as always, with Swahili.

And they weren’t out of steak.

Until tomorrow…