6-8-13: Change of Pace

Today was much better than yesterday. We actually got to rotate physicians today, so I was working with Dr. Patrick (no idea on his last name), the deputy commander of the hospital, in the internal medicine consult room. Meanwhile, Dr. Mann, our infectious disease pediatrician, worked with the doctor I had been working with. She said that he tried the same stuff with her as with me, the “this is how we see a patient…”, “this is how you do a physical exam…” stuff, but she put an end to it by repeatedly insisting that she had been a doctor for ten years, she knew that stuff, etc, etc. So because she was being aggressive, he finally started to treat her like an equal, and at the end he said, “I guess one of the American doctors knows something.”

                

Thanks, guy.

                

Meanwhile, I was over in internal medicine consults, where Dr. Patrick was going through patients at a much quicker (and more reasonable) pace, and for each, asking me about my differential diagnosis and how we would make the diagnosis in the States. It was so nice to be treated as somebody who actually knows something about medicine. I discovered in the course of conversation that they use the word “malaria” the way we use the word “flu”. It’s not so much a medical word to describe a particular diagnosis, but a general word to describe any illness. They call real malaria Paludisme (for Plasmodium), like we would call the real flu Influenza.

Yellow Fever and Malaria signs

Now that that has been explained to me, things make a lot more sense.

                

We finished the day with academics, which was to finish the malaria lectures (there was one we didn’t get to) and then onto TB. The DRC physicians explained their programs, program objectives, and their numbers, and I’m actually really impressed with how robust the program is. Kitona was apparently the pilot health zone for the new program, and comparing numbers to historical numbers, it’s looking like it’s making a difference.

                

Their goal is make TB “not a problem” by 2050. Guess we’ll have to wait and see.

TB treatment regiments (yes, I needed a translator for this, too). 

Tomorrow is Cultural Day, since there’s nothing going on at the hospital. Should be fun.