Lynne's Home, and I Passed!

Lynne’s here and life is good, or did I mention that? She was happily up to her neck in twins and now is home, soon to be up to her neck at SOS. She got home on Monday and is slowly recovering from jet lag. The fare has definitely picked up and I have filled out. Last night we had roasted vegetables; delicious. Apparently I had forgotten about that whole category of the food pyramid.

P=MD(BC). Make that Pass=MD(Board Certified). And I’m old enough, yep I’m 57, that I think this is the last time I have to/get to/have the privilege of sitting in front of a computer screen for the better part of a day, sweating. The medicine here is so very different. I have definitely lost the edge to practice in the US and the style of family medicine that I left there. And I’m old, or did I mention that?

Yesterday we were in Kanye where I had Matt, the newly minted and gifted Internal Medicine outreach dude, and married to Premal (see below), Jessie; a third time visitor and this time as a Infectious Disease Fellow, Premal; a newly minted IM doc working for Baylor and married to Matt, and me, an aging and aged family medicine doc with a seizure disorder (that, by-the-way, is under better control with a new med). Matt drove and led the discussion on TB, that I had led at other venues, to try on his chops and did fantastic. We then rounded on a patient with Multiple Drug Resistant TB (MDR-TB) who was being managed admirably by the docs at Kanye SDAH. ID is not my strong point, and TB is the weakest link in that chain thus far. Actually based on my score on the board exam it would seem I no longer have a strong point (P=MD(BC), I just gotta keep saying that to myself). The Kanye docs were doing great.

We then went to a local clinic where we saw some amazing infectious disease. This is not even close to the stuff I saw in South Sudan but we shouldn’t be seeing that in this nation, as often or severe. What we see here is HIV/TB co-infection and it complications with a little medication side effect (mostly hepatitis) thrown in. The disease spectrum here is more narrow but deeper. And for a mono-neuronal family doc it is a touch easier to get a purchase on so as to move the patient towards health.

We of course had to weed out the truly sick from the “wanna-be-sick-so-as-to-get-sick-leave-on- a-Friday” folks. I came across a way to cynical to these guys I fear but I wanted to demonstrate the MOs that you need to dissuade patients with multiple somatic pains and an agenda from taking up your time so you can attend to the truly sick and needy. The sick leave situation here is a great exercise in abdication of employer responsibility. All the waiting rooms from the smallest outpost to the downtown clinics are crammed with anyone from the truly sick to the majority “wanna be’s” all wanting medically sanctioned time off on a Monday or Friday, absurd and a total waste of time. Yet we give them meds, sometimes five of them (acetaminophen, and four types of vitamins and a mineral or two) so they truly think they are sick and show their friends on the way out how they were treated so well that they got all these meds. We have created this monster and only we can fix it.

Did I mention Lynne is home? Wahoo!!!!