One for the books

What an extraordinary day! Friday is Kanye, my favorite drive through the back country of the southwestern part of the country. It is about 120km from here. The medical staff is largely Moslem or very evangelically Christian with five countries represented on a staff of eight docs, including Ethiopia, DRC, Zimbabwe, Argentina, and Philippines.

 I led a discussion about chest pain and how all you really need is a good history and physical, but that you really NEED a good H&P and can’t short cut around it. After that an EKG and chest X-ray would be nice but not absolutely essential. Then it was down the hill to the civic center (read district offices) for a two hour discussion with the outpatient MOs about medically unexplained symptoms, chest pain, and the like. 

Here all hypertensive patients are seen every month.  Because this is a relationship based society and because health care is free all the returning hypertension patients have virtually the same 6 complaints of somatic pain. All in order to get your attention and some medication which indicates to them that you; a) care, b) take them seriously, and c) that they got the currency of health care in a developing nation- meds.  Whether they truly need it or not. So we discussed how to ask, “How are you feeling?” instead of “What is the matter?” and how seeing returning hypertension patients with stable blood pressure can be done every 6 mos rather than more frequently and thence clogging up the queue.

 I then returned to the hospital to join a dear friend and colleague, Mohamed from Ethiopia, for Friday prayers in the mosque and lunch at his home. He has three kids, an 8mo old, a 3yr old, both girls, and a 5yr old son with birth associate brain injury. His wife is a gem and an amazing cook. We had the usual staple of rice with potatoes and lentils, and chicken. Wow….

 The drive home was beautiful and Fall-like, and culminated in the best part of the week/2months in that Lynne is home!!!!! She came in on Wednesday and has been getting her feet under her and looking forward to some adventures out there with yours truly. Man did I ever miss her.

 So a great couple of talks, a moving prayer service shared with men who I am convinced worship the same God as I do, a magnificent meal, and, best of all, my wife of going on 35yrs is  home….a great day indeed.