4/11/2017 In the NICU

April 11th, 2017 by Isaac Billings
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Currently on NICU. Started covering last Saturday. An infant passed away within 10 minutes of starting my first day, which was a reality check. The infant was an ~1-week-old, born at home with what sounds like was meconium fluid. He had come in overnight because of lethargy and pore feeding for the last several days. Unfortunately, the infant’s percent oxygen saturations were running in the 50s at admission, with bradycardia and hypothermia. Broad spectrum antibiotics were started and the patient placed on CPAP (they don’t have ventilators here). According to nursing staff the infant’s oxygen saturations never exceeded the 70s overnight. Dr. Becca made the decision to discontinue the CPAP as the infant very unlikely to recover (oxygen saturations still running in the 50s-60s and bradycardic) and if it did would most likely have a serious anoxic brain injury, which would be a sentence to a prolonged and miserable death in this setting.
Typical patient load is 25-30 neonates. About 1/3 are truly critical. Lots of malnutrition, dehydration, sepsis, hyperbilirubinemia, and congenital malformations/weird syndromes.

04/03/2017 “Thoughts while flying”

April 11th, 2017 by Isaac Billings
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Note: Please forgive the fact that the date at which I am writing these posts does not necessarily match the dates they are posted. Internet can be a little tricky.

Currently at 37,000ish feet somewhere over central Egypt. I am wrapping up the school year, and effectively bringing medical school to a close, with a six-week rotation at Kiwoko Hospital in Uganda. This rotation is following on the coattails of a rotation with the Indian Health Service, in which I worked at the Whiteriver Service Hospital located on the Whiteriver Apache reservation in Arizona. Desiring to gain more experience with truly impoverished populations both in the U.S. and internationally, I have been endeavoring to determine if I am cut out for this kind of work and all the commitment, effort, and frustrations that come with it. I have always had a passion for the rural medically underserved of the U.S. but over the last several years, the idea of practicing international medicine full-time has been steadily growing. However, I am certain that I have a rose-tint covering the lenses through which I view international medicine, and I want to know if this is something that can do for a decade or two of my life and still draw joy from my work. So many who go into this field are simply sulfur matchsticks – a brilliant flash of blue and smoke that dissipates a few moments later, leaving a pungent smell in their wake. If I’m going to do this, I’m going to do it right. That means commitment to a focused region or people for a long enough time that positive and lasting change can be affected.
The trip has been smooth thus far. Flew from Denver, CO to Fort Worth, TX last Wednesday for the in-classroom training section of INMED. Earlier yesterday I flew from Fort Worth to Newark, NJ. Caught a flight from Newark to Brussels, and now I have ~4 more hours left before landing in Entebbe, Uganda where I will stay the night. Tomorrow, I will catch a taxi to Kiwoko.

Introducing Myself

March 4th, 2017 by INMED
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Hello! My name is Issac Billings. I am a Medical Student at Rocky Vista University. I’m starting my INMED service-learning experience at Kiwoko Hospital in Uganda beginning in April 2017- May 2017.