Paradise

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.

Bluffin' about my muffin

April 13th: We arrived at work hoping that today will be more productive. After completing our morning ritual of checking our email, we ventured over to the hospital hoping that the day will be more productive. We immediately headed over to the Personal Relations lady, she was very snappy and said that we should just walk back to SOPD (after telling us were pretty much stupid for wandering the halls) and observe there. Ironically, that’s the same place we just were. It was like dejavu, we walked in and felt in the way and nobody knew who we were. Within 15 minutes some doctors approached us told us that. “this is really boring, and we won’t be offended if you went somewhere else.” Again, this program was letting me down. The only “shocking” thing I saw was this man who needed medication for a liver problem, they simply didn’t have the medication and sent him away not to come back for 4 months when they’ll hopefully have it in stock. After that, we left and ended up in the scopes department where they should be doing colonoscopies and endoscopies. When we got there, we see the same doctors as yesterday in this clinic. They were performing an endoscopy on a man with esophageal cancer and we just watched. It was somewhat interesting, especially when we looked over and saw he was completely awake! They did not knock him out! All they do is spray a little chloroseptic in the back of his throat to numb it a little bit and down goes an old, thick, and somewhat broken black and white endoscope. He seemed to take it quite well. When they were done he just hopped out of the bed and went back to the waiting room. Next was a lady getting an endoscope to look for stomach ulcers. She had a harder time… she was gagging the entiiiire time. Hearing somebody gag for 20 minutes isn’t the most pleasing thing, luckily I held my ground.

I got back home to my homestay and was pretty hungry. I knew exactly what I wanted to eat, I had bought a muffin from the casino from my favorite place, Mugg and Bean. It was a HUGE blueberry muffin, perfectly cooked. I brought it home after my day at the beach and was saving it for breakfast or when I was hungry. But I was so tired that I took a tiny 30 minute nap. After my nap, Sibongile walked in with her big smile on her face and said the following, “Hi Miles! Oh you know something? I saw this muffin in the pantry and said to myself ‘this muffin has Miles’s, so you know what I did? I grabbed some coffee and ate the entire thing!’” as she clapped her hands joyfully. My eyes must’ve tripled in size but I kept my composure. I don’t think she had a clue that I was saving that for myself but I definitely can’t get mad. I put on this smile and replied cheerfully, “oh was it good?” She insisted it was a fantastic muffin and she was so full from it that she was going to skip dinner. Sigh… lesson learned.

I got a lot of ass today

April 12th: Hailey and I arrived at King Edwards for another action packed week (slight sarcasm). This time we were supposed to take on the surgery unit. The question was, where the hell is it? This hospital is completely scattered and the layout makes no sense. We found three different surgical units and just decided to pick one. This became so frustrating since we were just dropped off and expected to just find our way magically. The personal relations woman we saw the first day at paediatrics was MIA. Randomly, we just picked the SOPD unit. We walked in and asked to speak to the doctor and we were thrown around to different doctors. Eventually they just said to pick an intern and stick with him. Luckily, we picked a good one, he was able to tell us what was going on and asked us questions (most of them we didn’t know).
Although the first procedure didn’t leave the greatest impression (digital rectal exam), the few other ones after that proved to be worthwhile. Enjoying myself, I took the chart for the next patient and read it. Written in big block letters on the front was something left to be desired. ANAL ABSCESS. “Eff this” I thought. I mustered up the guts to go investigate this and found this gigantic woman lying on the table, pants down and ready to be checked up. The weird thing was that I started feeling light headed before I even saw her. I didn’t last too long as the doctor probed around the affected area. The abscess had already been removed and I was still not feeling too hot. Following my usual protocol, I stepped outside and tried to catch some fresh air. I felt lightheaded, narrow vision, nauseous, hot, sweating profusely, clammy, thirsty, and really tired. Since this was the first time it happened, I forgave myself for letting my mind get the best of me. I stepped back inside was fine for the time being. I later found out that the procedure was a complete waste and they could have just looked it at superficially to determine what kind of abscess it was. Oops? Soon enough, the clinic just magically emptied and we were the only ones in it. Doctors were nowhere to be seen and we were just deserted. Eventually we were escorted to this other part of the clinic where we were put with some doctor who did not say a word to us. He just sat there and said I am busy sorry. He continued to help patients after that. Frustrated we just left to go find surgeries…which we ended up not ever doing. That day I felt like I was completely in the way the entire time. Nobody seemed to know our purpose or why we were there. The program had begun to let me down because this was not the first time we felt ostracized. We walked away from that day hoping that the next day would be a little better.

Hippo mania!!

April 10th : You know since I have arrived in Durban, the weather had been fantastic. It’s been humid and hot as hell, but still ideal and sub-tropical. We woke up ready to go to the beach and relax and what do you know… just our luck… its pouring. And its not just pouring for an hour… it poured from morning until we went to bed. Complete FAIL. However, we tried to make the best of it by doing some indoor derived activites. We shopped around for a while and went to the fresh fruit market across the street. It was just a half block of fresh fruit and African crafts made by these owners who seemed to sleep in little cubbies towards the back of their stall. There were probably 15 or so vendors and as I walked through the various ones, they all had their awesome punchlines, “hello, today special price” “for you today, I make you deal” “shop with me and save” to sample a few. As annoying as it was, it was fun to walk around and look at everything and barter for some nifty objects that I can’t disclose :) We became hungry and went to the ski club for some lunch. There were hippos doing their thing in the estuary behind us. We sat in the bar area since outside was too windy and rainy. We watched a rugby game as we ate and that is one weird sport.
We arranged a hippo and croc tour at 4 pm where we would go on a boat in the estuary. We grabbed some lunch and took off for the boat. The best decision would be to bring blankets just in case. The entire cruise was rainy, windy, and freezing. We would have been miserable in our shorts, t-shirt, and sandals. The tour guide pointed out countless hippos but never any crocs since it was raining. We were even graced to witness a hippo mating, probably the last thing I was expecting. It was pretty sadistic since the male essentially drowns the female. The kids also watch on as the horror takes place. After two hours of being on a rainy and windy boat, we were happy to be back on shore.
When we got home we made dinner using what we bought from the fruit market and the local market. We made pasta, green beans with feta, braai garlic bread, (braai is a famous South African traditional barbecue that I am determined to experience before I come back), and a side of avocado. It was a compilation of things we miss back home + some new foods.

Me vs African driving- St. Lucia

April 9th: The weekend was fast approaching and Hailey and I had extreme difficulties trying to rent a car and arrange a place to stay. We decided St. Lucia would be a great place. It has a beach, wildlife, restaurants, everything we wanted to see and do. We planned to book everything on Friday morning before showing up for our rotation. Since we had access to computers all week, this should have gone without a hitch. But of course, there must be complications. When we got to the medical school we couldn’t get into the computer lab because a test was being administered. Tests would take up the entire computer lab until 1 pm apparently. Its ok though, there was another computer lab downstairs. After inputting our log in numbers and passwords, the computers were not allowing us to log on. Confused we asked why this isn’t working. This was our answer: “there is a test being administered upstairs in the computer lab and as a result we have to shut our entire network down”. WHAT?! How in the world does that make sense? The entire medical school is internetless for more than half the day and they’re still able to function efficiently without it? Frustrated, we went to our rotation hoping to get over to the internet café nearby. The day at work was pretty smooth, we just checked in on the babies and kids to make sure they were improving. We slipped out the door after seeing a 2 week infant with hydrocephalus. Hydrocephalus is essentially water in the head. This happened during pregnancy and the mother could have opted for treatment while the baby was in utero. For some unexplained reason, she did not. The baby was consequently born with this massive head filled with water. Surgeons inserted a shunt that runs from the head into the abdomen so it could drain. It looked way too bizarre so we just left.
We arrived at the mall only to find the internet café broken for the fifth day in a row. For some reason, we managed to find another café in a video rental store. Now the problem was a 25 minute wait. Fast forwarding, we eventually got online and managed to book a place.
After work, Hailey and I bolted home and packed and left for St. Lucia. Everybody said it takes 3 hours to get to St. Lucia…. and of course you can’t check in past 7 pm. (the number of setbacks can be quite grueling sometimes). We forked over some extra money for an automatic because since I just learned, and since they drive on the other side of the road, plus being at night in an unfamiliar place… we figured it was a good investment. We asked Roy for some directions to the highway and they consisted of, “turn left out of the neighborhood onto that main road and make a u-turn at the sign where it says you can’t u-turn” or “when you smell bread, then go across the road and turn right”. Eventually, we made it to the highway. The drive was pretty easy and very pretty. There were many villages interspersed throughout the drive, they were filled with clay huts and traditional Zulu homes. However, things get a little crazy once the sun sets. All the sudden I see cars driving on the emergency shoulder, driving a little faster, everybody is flashing their brights and emergency blinkers. This became so chaotic and hectic. I was so confused as to why people became so uninhibited when the sun goes down. Turns out the emergency shoulder becomes an actual lane so that people can pass in the actual lane. Problem with this is that the shoulder is narrower than the actual lane so it causes all the cars passing to stick out into opposing traffic a little bit. I was trying to keep with the flow of traffic and would pass occasionally. I tried to pass this semi with plenty of room to spare (I thought so at least). I then realized I am not driving my VW Passat…. I am driving a Chevy Aveo that has about half the power of the Passat. It was a close call to say the least. Good thing is that we got there in two hours flat :)
We got the keys from some random person and headed to our villa. We had our own garage and two bedrooms. However, we did not expect the sheer size of it! It was huuuge. We both had our own bedroom, a nice kitchen, living room and dining room. Plus, we screamed when we saw SHOWERS! We have been taking baths since we arrived here since that’s most common here in South Africa. We about passed out when we saw there was fast internet available with no filters, or out dated computers. I finally got to upload my photos to Facebook and truly update everyone. Most of all, I was able to see Jayson for the first time on Skype. It made me feel really giddy inside and we acted like we had just met. Before I knew it, it was time for bed since we were waking up to go to beach the next day.

Easter Weekend addition

This blog has serious issues posting, but here is a picture of bunny chow


but as of right now, I am in St. Lucia (after a crazy drive which I'll elaborate later) and plan on going on some safaris, beaches, and probably some other stuff. There is a map showing where I am in relation to Durban and what I am hoping to expect

Update later :)

Easter Weekend

This week so far has been much milder than the previous roller coaster. Monday was a holiday and I just spent it hanging out with the family. We went to the beach for a little bit and had a good time just hanging out. For this week, we are at King Edwards Hospital, which is a little more urban. I like it better because it is a teaching hospital therefore there are other interns in medical school floating around. We also have access to Internet (cha chiiiing). I uploaded my flash drive with pictures to put on Facebook. Again, I was struck down when I found out Facebook is banned from the server! But don’t worry; you can still play Warcraft and all those other games. So more delays for updating everything. This week we are in paediatrics hanging out with the doctors and interns. We floated around the HIV paediatric clinic for Tuesday. It was pretty mellow, just patients coming in and out and beginning their treatment. There was one sexual abuse case where the father gave his 4-year-old daughter HIV and an STD. It was pretty sickening to hear, but I’m being accustomed to it.

I then switched rooms and went with another doctor who was doing the samething. She had to do some blood work and asked if I wanted to help. Eager to do something, I popped on some gloves and prepared to learn or do something. The girl came in and sat down on the patient table. She was totally content through the physical examination and immediately when the doctor put on gloves, she went into hysterics. At such a young age, she already had so many blood tests that she knew what was coming. I tried to settle her down, but we continued onward anyway. Then something took me by surprise. I am used to blood draws consisting of a needle going into a vein and a small narrow tube connecting to a larger collection tube. Oh no, not here. The doctor inserted the needle and well.... that was it. Blood started to pour out of the needle and she held the collection tube underneath the free flowing drip. In shock, she told me to open the next tube and hold it next to the one that was collecting blood. Upon the tube filling, she quickly removed her hand and I had to continue to shift my tube into the blood flow. No way in hell this was going to be clean. Praying to God she doesn’t go into some arm throwing hysterics, I kept a steady hand. Some blood spilt on the floor and on my hands (with gloves) but I figured this was ok. When we had filled three tubes she told me to decant some of the blood into some smaller tubes. Like trying to pour a gallon of milk through a straw, some more blood was obviously spilt. After I was done, I had HIV positive bloody tubes, HIV positive blood on my gloves and a screaming baby. Job well done. No really, it was a decent job.

Wednesday (April 7^th) we went back into the paediatric resuscitation unit and were expecting to do rounds with the doctor. Hailey and I got there around 8 and waited to for 15 minutes. Nobody had a clue where the doctor was or where the interns were. We left and went to the computer lab for a little bit and came back around 8:45. Still, no doctor and no interns. We would do this until about 10 AM and finally asked, “do you know where we can find anybody?” None of the nurses knew where anybody was or when they would return. This has been a recurring theme in SA, time is absolutely non-essential. The doctor never really came and rounds were never done until later on the day when Hailey and I gave up. We peaced out in search of some authentic KwaZulu Natal cuisine- Bunny Chow. Before you animal lovers have a cow (so clever), this is not cute bunnies that are served for lunch. Bunny chow is an Indian/African dish where a loaf of bread is hollowed out and filled with chicken/beef/mutton curry. It was a very nice meal but damn it was spicy. With a spicy meal, one would usually drink milk or water. I asked for some basic tap water and out came the most absurd answer I have heard since my arrival here “We don’t have water, just coke”. WHAT!? This was not a joke as I asked like 4 more times. Small problem sista, I don’t drink coke. Hailey and I suffered for some quite time until some other employee came out and we explained our dilemma. 33 Celsius (91 F) + insane humidity + hot ass curry+ no AC+ no H20= crisis. Magically, water was made its appearance and was greeted with great applause. Let’s just say it’ll be BYOW next time.

I got home still reeling from that experience and just had to take a chill pill and relax. Eventually, I made my way outside to the kitchen where the family was about to make some fresh juice. They had bought all this fruit that was about to go bad and now they were going to liquefy it into a juice. We combined mangoes (which rival Costa Rica’s, sorry Mom), bananas, plums, oranges, and pineapples into this awesome juice cocktail. Since then, I’ve been drinking it non-stop. The boys and I played another 3 hours of Sorry, this time gambling the candy I had received before I left.

Thursday (April 8^th) was another attempt in pediatrics. This time with a successful encounter with the doctor. We rounded with him and the interns. Ironically, this was the best doctor I had encountered. He was so helpful and even took the time to tell us some things. Finally, I busted out that stethoscope that had been collecting dust in my pocket. Now I had played with stethoscopes before… real ones. But I always had a hard time trying to recognize heartbeats and breathing patterns. I flat out told him that I really have no idea where/how to listen to a steth. He took the time and showed me and it looked pretty basic. I put my steth up to the boy’s chest and listened for his heart. Nothing. I tried again and listened carefully. I then tried on the boy’s sides and even on his back for his lungs. Nothing. Double checking the poor boy wasn’t dead, I was trying for quite some time it felt like. I don’t know what it is, am I deaf? Am I on the wrong spot? Is my brand new Littman stethoscope dysfunctional? I felt like even the baby was looking at me like I had no idea what I was doing. Defeated, I just said I heard the murmur and moved on. The rest of the day was filled with the usual sick children, HIV, malnutrition, and dehydration. I did learn a lot though.

Hailey and I ran up to the computer lab before we had our weekly meeting with Dr. Khan (he is our medical director for the Durban portion. He has like 4 or 5 clinics). We made a push for trying to find a car to rent that’s automatic. (I’m obviously not confident in myself or in South Africa that I can drive a stick). Luckily, we found something at the last minute and we finally have a car! Now we have to find reservations somewhere by tomorrow. We are thinking of going to St. Lucia, a town 3 hours north of here. They have a national park that has the Big 5 (rhino, lion, cheetah, hippo, and elephant), beaches, and other sweet things. Hopefully I don’t get swallowed alive by a hippo and have a good time.