April 14th: Reaching the halfway point of the week seemed somewhat daunting. I really didn’t think I could handle another nausea episode, another anal abscess, or just being sent on another wild goose chase around the hospital. After the morning ritual, we headed to the same SOPD clinic expecting to be deported out of there. Sure enough, we did get deported. We found ourselves at another surgical unit and flagged down some random doctor through a glass window. He took us to a consultant where we tried to explain who we are for about a good 20 minutes. Eventually, he took us over to the surgery theatre where another surgery consultant was confused by our presence. Suddenly, some man stumbles in and starts talking to the consultants. He looked at us and asked who we were. For the third time, we explained who we are and situation. He goes “Oh, are your last names Li and Yang?” Double checking my reflection in the window to see if I was Asian, I responded no. He continued, “aren’t you supposed to be here on the 11th of May?” Completely confused, he explained he is the head of surgery here and that he receives all the emails from the program coordinator notifying that interns are coming. Evidently, he never received them for us but has for the interns coming after us. This is where the communication issue we had been experiencing had reached its boiling point. We had spent 2 days wandering around and being sent away from clinics because the program had not informed anybody of our arrival in surgery this week. He rushed us to the ward upstairs where we were warmly greeted by a doctor and a group of interns doing their daily rounds. I couldn’t believe it, I felt like I had landed at the Four Seasons. They asked about our school and what we have been doing, they understood we were pre-medical students (which is rare here because pre-medical is only a U.S. thing). Suddenly (!! This is where it gets gross, potentially brace yourself. Put down your lunch if need be!!), my attention diverts to the patient they were examining. It was definitely not my first choice patient.
It was this man with something wrapped around his leg. They had just unveiled it and it was pretty horrifying. His leg was essentially rotting away and skin had been sloughing off. I immediately asked what happened and the intern said, “he got attacked by a lion”. My jaw dropped. I completely believed him because it definitely could pass for a lion attack. The leg was obviously infected; there was exposed flesh from knee to ankle and pus was oozing down his leg (getting queasy yet? I was hiding behind an intern). It looked like…really marbalized meat. There was a towel that had been soaking up all the fluid from the affected area. Smirking, the intern turned to me and said, “just kidding, he has diabetes”. Somewhat disappointed, I was still shocked that diabetes was the result of this. The reason is because he had obviously not been taking care of himself. A possibility is that he could have a condition called osteomyelitis that went untreated. Consequently, he legs became necrotic, developed gangrene, and now is in serious danger. They were going to try and debride it (remove the dead tissue. I have no idea if they knock him out for it but that’s about how much my mind could handle at that point). Most likely, they will have to amputate the leg, which is not uncommon here. Thankfully, I made it out alive without passing out on the floor. There was this frail man who kept pointing at me but I just directed him to a nurse.
After that, we went over to the gynie ward (that’s actually what they call it, I think I’ll take it back with me). I was relieved that we were going there because I figured gynie cases aren’t tooooo bad right? Except for maybe a septic uterus… and yes they occur. We get to the gynie ward and surround the bed of this one woman. I don’t think it could get any better than this. Our next case would be… drumroll… a severe case of prolapsed hemorrhoids. C’mon man!! Coming right off of a necrotic leg, prolapsed hemorrhoids were not what I was anticipating or desiring. Sigh… but the gruesome train must continue its path I guess. She was turned over and wow it was a hemorrhoid. I mean WOW. To give an awful descriptor that’s been haunting me all day, size for size it looked a strawberry frosted donut…with white sprinkles. She was obviously in a lot of pain, the hemorrhoid had made a bigger and better encore appearance after she had just given birth. The doctors were talking about pushing them back in. Wondering why they just remove them instead of reinserting them, they said they just needed to do something right away and “just for comfort reasons”. Waiting for hemorrhoid operation could take weeks. I asked if she’ll be knocked out for this operation (since their track record has been almost no anesthesia), and they said yea. Finally, somebody gets relief without having to go through even more excruciating pain for it. Funny enough, this operation did not happen in an operating room. It was a bedside operation. They knocked her out and did it with everyone of her bedmates watching. The procedure was quite primitive, she literally just turned her over and shoved them all back into her rectum. It wasn’t the prettiest procedure and should be very painful it she was awake. Once they were forced back inside of her, they started to come right back out. I started feeling a little queasy at this point because the woman started to move and scream in pain. But I held myself a little better than the first time even though I had to walk away at one point. Still, it was somewhat frustrating.
I began thinking to myself, “why is this still happening?” I mean to come so far in my college career and all the volunteering and other extracurricular activities… can I not do medicine simply because I am getting queasy with almost everything? I am not really getting used to anything it seems like. It feels quite defeating. So that has become my biggest problem here in SA. I am now taking on some internal battles on whether I’m truly cut out for this. Am I wasting my time? What am I going to do when I get back home and have to apply for medical school? I know I shouldn’t be making decisions like that right now but it’s definitely lingering in the back of my head.