So you might think that medicine would be different in the developing world than it is in the US. Which in some sense is true. In another sense, it might be the way we should all strive to practice a little more! Sometimes patients show up with a multitude of complaints, and they really only have a viral Upper Respiratory Infection or are constipated and need reassurance or maybe something simple over the counter. All history is done via an interpreter, and similar to some patients I’ve met, the patient may or may not answer your actual question, or understand it, and there may be a long discussion followed by the interpreter turning to you and saying “yes.” It can be frustrating. I’m learning to really work on physical exam and trust those findings, learning to ask before every test “how will this change what I do” and have a significant differential in mind before proceeding anywhere. Every test I order costs the patient something that might seem trivial to us, but is significant to them when the daily wage here is roughly equivalent to $1.50. Prenatal care is roughly similar, except trying to determine the correct dates can be a bit of a challenge, UltraSound is done whenever it is convenient for the patient (and they can self-refer for that), and breech vs cephalic presentation is confirmed either manually or by fetal position xray.
And I’ve never had so much fun. It is challenging to the utmost degree, heartbreaking when tragedies that could be prevented or resolved with quicker access (some of our patients travel days out of the hill tracks to get here), and joyous when recovery happens that only God can bring against all hope. The best and worst moments sometimes happen back to back. I’ll try and post a case soon also for you medically inclined folks 🙂
And hopefully someday soon I’ll post some pictures, at the moment I cannot get them to upload.
PS for those who really want to know, I matched to Duluth Family Medicine Residency in Duluth, MN last week. Yahoo!