Back at it

We’re home and in one piece. I dove back into my work here and find myself seriously jet- lagged at this writing: I’m grouchy (to our kids: NO EYE ROLLING) and when I get a chance to nap I awaken from what feels like an unconscious state.

I find myself day dreaming on the road about how weird and other worldly the last month has been. A delightful trip to the Cape of Good Hope area followed by an out of body experience wherein I became a patient, was with the ones we love, was fairly sure I had a brain tumor (a low grade glioma to be specific), then reassured that my brain was not tumorous, just asymmetric and in a weird shaped vessel (my skull). Oooohkaay, how the hell do I put all THAT in perspective? How does a guy who has pursued health his whole life, not unlike a lot of my generation, process this bleep? Just God’s way of introducing some humility in my life I suppose, and never a bad thing as painful and annoying as it might be.

So thanks to all of you for being there for me/us. Interaction at that level, at any level, doesn’t come easy to me, just ask my sibs. Never the less I am at once humbled and blessed, and grateful.

I continue to be amazed that I have anything to offer the medical officers at the neighboring hospitals here. They are just like the FP’s familiar to me who see a patient in the out- patient setting, admit them to the hospital, treat them, discharge them, and see them in follow-up. Today I saw a woman with HIV, on HAART (highly active anti-retroviral therapy) with a month long history of fever on at least five different antibiotics and still febrile. What did I suggest they do? Well, harkening back to my training a million years ago, I said lets stop all meds and see what develops!

The nurses who always accompany me and the doc on rounds immediately chimed in that that was abandoning the patient, a 30+ year old woman with a family to care for. We had an animated conversation during which I invoked all the ID docs I know/knew and assured them that they would agree with me (I deeply hoped) and since we had a good idea of what DOESN’T work, let’s start from the beginning. The harried MO, a guy becoming a close friend, was post call and NOT the least bit interested in another lengthy workup. I demonstrated how it took less than 5 minutes to reinvestigate, via history and physical, what to test and treat, and how, and with what. He was grateful, the patient was grateful, the nurses were convinced, now if the patient’s immune system would just cooperate and improve.…

The drive out and back to these areas continues to amaze; troops of baboons and monkeys, wild jackasses (I know, I know me included), goats, and cattle. Everything is green now and the temp is now humane. I feel like we are where we’re supposed to be for the foreseeable future. We are expats successfully living in Botswana! A new med school, a new family medicine residency, and I get to go way off the beaten track top some remote clinics to teach. All in all, seizure disorder aside, I’m a lucky dude.