This week has been a little bit of a watershed for me and the program.

Tuesday- It began in a local clinic where I was to mentor an MO there but beat him to the office. I was in the exam room, door closed, to await the MO when a nurse stuck her head in and said she needed me next door.

“Ohhhhkay, why?”

“A little girl is in status”

“Uh, status what?” Hoping she meant asthmaticus.

“Epilepticus, she’s fitting Naka!”

“Bleep!”

So in I walk only to be handed a premeasured syringe with diazepam for rectal administration! She is a chubby three year old with epilepsy since birth secondary to birth injury fitting away for the last hour with no IV sites. In went the diazepam and in five minutes off went the seizures. We piled her into a car and off she went to PMH. The nurse was exceptional and acted like having things THIS much under control was no big deal. Would love to clone her!

Wednesday-I have been giving talks at Deborah Retief Memorial Hospital in Mochudi to the entire staff (about 30 professional from across the spectrum) and have made an annoying arss of myself trying to get the outpatient docs to join. Yesterday 6 showed up and stayed for an hour as we discussed innumerable issues that were shared and at times contentious. A great episode in medical staff intercourse and huge for quality of patient care. A true first.

Today-For the last several months I have struggled with the outpatient medical staff in Lobatse. They and I worked to come to some agreement about how best to participate with them. One of them lined up a bunch of patients about whom he had questions and away we went. Then I gave the same talk in the afternoon to them and it was received well. I, again, gave them my info and encouraged them to call anytime, and was before I had left town.

Its freaking cold here, just like you might expect from a high desert in the early spring. But the wards aren't heated so all the kids in peds are under 50 blankets and are just bumps on the bed. We have a diabetic in DKA here at Athlone Hospital in Lobatse. I swear that adolescents are the same the world over. He is sweet, too sweet literally, but is experimenting with controlling his own life, disease, meds, and, like all of us, his first foray into this arena was a little rough. We discussed how to treat this without lab back up, just with a glucometer and urine dipsticks. It was all very reminiscent of Frenchburg in the winter when I would treat two brothers with DKA, at the clinic as outpatients, as their mother was afraid of travel in the snow and ice.