A whole new type of medicine

By the end of intern year I think I was finally feeling like a doctor. If you gave me a “bread and butter” case- I could probably tell you how to manage it. or at least knew where to look to find the answer. It felt good to know a thing or two after 8 years of higher education and 1 year of training. . . . unfortunately I think you can throw all of that out the window in Lesotho.

I assumed that I would adjust easily. I know what illnesses to look out for with HIV patients- I mean, I could answer all the questions about it on my board exams. To my surprise it has not been that simple. I can’t think about anything the way I did in the U.S. I have to always remember that these kids are immuno-compromised- which means the door is open to a host of new illnesses. Did you know that Lesotho has the 4^th largest prevalence of tuberculosis (TB) in the world? . . yikes! Most of my patients have HIV and TB. . . which is then a whole lot more disease to consider!

Today I had an HIV positive kid come in with abdominal pain. After questioning mom, doing an exam, and evaluating his growth parameters and vitals, I chalked it up to some constipation. He was growing well, no fevers, looked fine, eating without a problem- at home this would have been a reasonable conclusion. When I discussed the patient with my supervisor she promptly said “Oh, we better de-worm him.” De-worm? I don’t think we even use that lingo in the U.S.. .. can you even imagine having your doctor tell you that!?!? In Lesotho, all the children are routinely de-wormed (we just give them a medicine that flushes the parasites out of their system) every 6 months.

In a lot of ways I just can’t believe how much more disease there is here compared to the U.S. . Props to the states for having such good infection control!!!

Tomorrow I will see patients on my own! =/ Hopefully I won’t have any crazy stories to tell you after that!

I guess that is all for now- I have just been busy working. OH- AND I hand washed my clothes today. . . ugh what a job! We will see how my clothes look when they are dry. . . this could turn out to be an interesting month for wardrobe.