Ah, Friday

It’s been a week indeed. The bad news: the service admitted 15 patients last night and now stands at 42! The good news is that I’m no longer on it (but in some strange way miss the chaos). The current Penn resident is simply fantastic, as are the Penn student and Batswana intern. Christine the MO has slid into an ill-defined funk wherein she will leave, state she’ll soon return and not be seen until the next day. Try as I might to help I get nowhere.

This week I visited Kanye and Mochudi.

Both are on Google Maps: (http/maps.google.com/maps) and are even better if viewed as the satellite image. Kanye was fun as we rounded in the peds ward again, then in the male and female wards. They really are a touch unsure about me as I am the first one with expertise in all ages and both genders to show up and offer help/instruction/guidance. Then I saw some patients in consultation with a great nurse who is herself disabled (some neuro-muscular degenerative disorder) but has a personality that fills the entire place. The cases were generally easy and addressed the fears of the M.O.s that this might be something more pathologic.
They are gifted clinicians and delightful individuals. Yet I undiagnosed CREST syndrome, undiagnosed pericardial effusion/pericarditis, and so on. I am amazed as I normally wouldn’t have thought of the diagnosises on my own. That this happens in this country is magnificent.

The part about this that is a little like having to bake a cake and then eat it is the drive. It will come as no surprise to those that know me that I love it. I of course find the most obscure way out to these sites so I get to see some amazing bird and mammal life. I see kites, osprey, herons, weaver birds, hornbills, egrets, and more I can’t even identify. I rounded a corner to find a troop of 50+ baboons galloping across the road. The females vaulted a 2m fence with one hand, using the other to hold a baby! Goats and cattle are everywhere, donkeys and horses as well. The terrain is green, flat, interrupted by table top hills and rocky bluffs, and would remind one of sage country in the West. The flora and fauna is quite distinct however and that’s what makes it more fun!

I get lunch at the local grocery stores and get stares as I am the only non-African there, let alone in the town.

Mochudi was a hoot as morning report is run by a gentleman of my era, from Uganda, who graduated med school in the same year as I did. He is undoubtedly 5+yrs younger than I am and is very paternal as he sits at the head of a 7m table lined by the docs (a few) and nurses (a lot) and holds forth. I love his style as he in very inclusive of all disciplines there. I gave my first talks at these places, discussing the emergency treatment of seizures and was impressed with the depth of ability (but lack of resources) in the resultant conversations.

Next week I try to establish outreach in Gabs (I know, weird that we have leap-frogged over it) and try to solidify a schedule. Tomorrow Lynne and I climb the same local hill I discussed in the last entry. Tonight we say good-bye and God-speed to Daniel and his family as they prepare to leave to Australia and the next chapter in his training.

That’s probably enough for now, take care.