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afreakforjc
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Name: anDrew
Gender: Male
Interests: Currently I'm interested in not becoming jaded, embittered and generally dissatisfied with my life as an surgical resident. Many times I fail. Once in awhile, I appear marginally compassionate. Oh, the heights I've fallen.
Expertise: Discharge summaries, electrolyte replacement.
Occupation: Scut-recipient
Industry: Medical
Message: message me
AIM:  jcfreakout
Member Since:
7/16/2006
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| Off for a yearMy flight is about to leave. Minneapolis, New York, London, Nairobi. Then I take a small jet to the city of Eldoret, and a private vehicle up to Kapsowar Hospital. I'll arrive Saturday, July 11th.
Let it begin.
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| Things to missSomeone asked me what I'll miss most when I'm gone from the U.S. I'm not really sure, but I've been thinking about it a lot as the time for departure nears.
Here are some things I've experienced in the past few days that I doubt I'll get with any frequency in rural Kenya:
High-speed internet
Newspaper comics
Sushi
Thai food
Chinese food
Ethnic food in general
Movies in a movie theater (I saw Transformers 2 the other day)
Long conversations with my friends on a cell phone with unlimited nights and weekends
So these things I'll miss. What will I gain in return? Some wonderful culture exchange and experience? I'm not so sure. Part of the reason I wanted to spend more than just a few weeks abroad is that I want to fully experience the culture shock when moving to a foreign country. Sure, going to another country is fun for vacation, or fun for a few weeks. But is it so fun after two months? Four months? Ten months?
The culture shock awaits me. The real challenge lies just beyond that.
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| IntersectionIn the remaining few days I have in the US, I've been meeting up with friends, calling old roommates, and taking short trips.
Well, one short trip, to see my godson, EKG.
He's real cute. 
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| Swine fluSome things I don't really get about the so-called "swine" flu: it's a H1N1 influenza virus. Thus, the major antigens, hemagglutinin and neuraminidase, are not really any different from the usual serotypes of run-of-the-mill seasonal flu. (Somebody correct me if I'm wrong, but most human influenza is H1N1, correct?)
This being said, the novel 2009 H1N1 "swine" flu is gripping the country and the world. I could have cared less -- until my little sister began having high fevers, myalgias, a cough, sore throat, and headache.
No big deal, I thought. I'm a doctor. I see this stuff all the time. Viral syndrome. Self-limiting. She'll get better.
When my mom called me to tell me that my sister's temperature was 105.5 F (40.8 C), then I started to get concerned. I've seen fevers that high in surgical patients, but they're usually due to post-operative intraabdominal abscesses -- something that I'm pretty sure my sister didn't have.
After a quick call to my pediatrician friend, we sent her to Urgent Care to get a rapid nasopharyngeal flu swab -- which was positive. Thus, my sister has type A influenza. Further subtyping is being performed by the county's public health department, so we won't know if it's true "swine" flu for another few days. Not that it really matters. It's likely swine flu. Still likely self-limiting. She'd probably get better on her own.
She'll also probably get better (quicker) with Tamiflu.
What can I say? I'm a doctor. I believe in medication. It's what I do.
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| Another stage completeIt's July. The beginning of a new academic year.
But not for me. 
On the first of the month, I turned over the service to the newly-minted PGY-3's. Then I escaped the hospital.
I have now completed the general surgery portion of my residency. Three years as a general surgery resident -- learning all about trauma, oncology, thoracic, vascular, hepatobiliary, colorectal. Three years, laying my hands on people's bellies and telling them, "I think you have appendicitis," or "You're a drug-seeking ER frequent flier who already had your appendix taken out!"
Even though my formal general surgery training is over, in another sense it has only begun. The real general surgery starts in a week. There is so much I don't know about surgery. Orthopaedics, obstetrics, gynecology, neurosurgery, urology -- and let's not forget plastic surgery.
The case mix and operative load in Kenya will be so vastly different from anything I'm used to the States that I can't help but already gasp and gulp for air. Supracondylar fractures, prostatectomies, ventriculoperitoneal shunts -- all things I've never managed before. All things that are done at Kapsowar Hospital in Kenya.
Internship begins again. | | |
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