ELEPHANTS!!!

It’s Wednesday and it’s already been quite an eventful week, and I think the most important lesson I’ve learned is the importance of trusting your own clinical judgment. 

Monday, there was a lot of praying, as I started rounding by myself.  It turns out, I actually made a lot of good decisions and correct diagnoses based mostly on Physical exams.  My big win was this lady who came in with fever and abdominal pain and the admitting nurse (who is actually usually very good) had thought the patient had severe typhoid.  Let me tell you how much I know about typhoid and how willing I am to say someone doesn’t have it….yeah, not at all.

Anyway, after examining her, I really thought she had PID.  Not having very good ways of culturing here (and because there’s a huge amount of perforated gut from typhoid and they really take abdominal pain seriously here), I started her on Antibiotics for PID and I ordered an abdominal U/S, which showed…endometritis! I was kind of proud.  :)

Of course, I made my fair share of mistakes as well, but luckily nothing that made anyone sick/die.

I’m also surprised by how many common things people have here as well.  We always tend to want to diagnose crazy tropical diseases, but this week we’ve diagnosed a trochanteric bursitis, DKA, CHF, migraines, epilepsy, etc.  (Still no nodding disease). It’s funny because we have some sick students here who we’ve decided had cholera, some sort of worm, and TB.  In hindsight, it’s probably traveler’s diarrhea, lack of sleep, and the common cold.  Who knows?

Non medical things: Eric (a medical student from Temple, actually) left today, so Julia and I went with him on Safari yesterday.  We saw so many animals and we were very blessed that it didn’t rain like it has been all week.  No lions, but at the end, we saw this huge herd of elephants, just hanging out in the road.  It was awesome.  Our driver was also kind enough to take us by one of the many explosion craters here as well as by the equator!  It was a great way to spend a last day, if I do say so myself.  It was sad to say bye to him today, but I’m happy that he lives in Philly and we’re going to get to hang out when I get back. :)

 

There were 11 elephants!

 

 

Julia and I at the crater lake.  Then Eric, in a picture he doesn't know I'm posting. :)