Friday, April 23, 2010

Male..49..vaginal discharge

April 19th. 2010: Back to work :( However, this week would be a tad different. I told our medical director, Dr. Khan, about my thesis on week 1. He offered me to go with him to his office so I could look through all of his files so I can compile some raw data. Hailey decided to join in on the act so we got picked up as usual and were taken to the City Centre of Durban. As we were driving through the City Centre, we noticed a TON of trash everywhere. There had been a strategically planned strike by the municipality of Durban. Right in time for World Cup, the municipality went on strike probably to ask for higher wages. As a result, no trash collectors, no maintenance workers, nobody. Imagine downtown L.A. without a day of trash pickup and how much gets generated everyday. There are no dumpsters so all the trash has been accumulating on the side of the road either in bags or just floating around in loose piles. But of course, T.I.A., and there must be some sort of twist. Most likely in order to speed negotiations, the workers took sledge hammers and smashed and/or turned over all the garbage bins in the area just to add to the mess. There is literally trash in every gutter, every sidewalk, and inside every building. It has been pretty windy here so when it blows all the trash blows up in the air. More than likely you’ll get a KFC box blown into your face.
We arrived at Dr. Khan’s office that is in a private hospital. This is an opportunity that no other intern has yet to see. All previous plans are with public institutions. I wasn’t expecting to see anything special this week but at least I get to compare. The building smelled like smoke but there were no long lines, not under staffed, no feeling of helplessness. We got into the office where we get put to work going through the files. We sit in a tiny table right behind the receptionist, Abigail. Patients would come in occasionally but never anything like the overload we’ve seen at the hospitals and clinics. Dr. Khan checks on us frequently which is nice and answers all of our questions. He proceeded to ask us if we wanted to witness a surgical procedure. Thinking it was an abscess; I was ready to take it on. Noooope, it was something new again. It was an adult circumcision. I was happy we were in a private hospital for this because I wouldn’t be surprised if the pubic sector bludgeoned the foreskin off with a butter knife from the upstairs cafĂ©. The patient was taken back into a room and was prepped for this procedure. As a guy, it was alarming to see what was going to happen. Hailey seemed fascinated. Dr. Khan outlined the procedure to the patient and to us. He gave the patient a couple shots in some unfamiliar places (yes it looked like it hurt) and apparently he was numb. The procedure was quite simple… simply pull and slice 3 different times and stitch back up. He asked if I wanted to help suture up. The last part of the body I thought I would do my first alive suture would be a freshly circumcised penis but hey I’ll take anything. Unfortunately, I wasn’t technically “properly scrubbed in” so maybe next time. After that, Dr. Khan gave me a sex talk that I wasn't sure I was ready for...or anticipating. Obviously, 98% of the information was uninformative for me.
Going through the files was quite cumbersome at first. It was hard to locate the information I actually wanted and how to actually sort it out so it became easier to read. I took down CD4 counts, viral loads, age, coinfections, if they disclosed to their partner about their status, and their partner’s status. Some of the files had some major booboos. For example, I found a man with vaginal discharge. That one left my head scratching. Also, there are missing pages and some mix-ups in patient names.

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