This past Wednesday Ryan came with me to the hospital for the day to see more of what my life is like. I think he enjoyed his time and more importantly, it means we have pictures. : ) So welcome to B ward, the medical unit where my day started with rounds at 8:00.
Here is a picture of my half of the ward where I worked with Dr. Erin to see somewhere around 15 patients. If Ryan had turned around 180 degrees and taken another picture it looks basically the same on the other end of the ward. In the middle is the nurses’ station.
So one by one we made our way around the room talking to each patient, asking how they were doing, ordering labs and making adjustments to their medications as necessary. It is not uncommon to pull the ultrasound machine up to the ward to scan someone along the way as well.
After we finish rounds, all the doctors head towards OPD, the outpatient department to start seeing patients. Patients line up outside the building where they are first screened by nurses who take their history and vitals. Simple problems the nurses will treat and send the patients home, but if they decide it is too complicated the patient continues on to the line to see the doctor.
I’ve spent some time in OPD seeing patients, but I generally check the ER first and take care of any patients that need to be seen there. That’s where I am in this picture. My patient is laying on a hard metal bed covered by a sheet of plastic. The book down by his feet is his scale book. Every patient has a book that they take to any medical facility they go to. That is where we leave notes on the patient’s visit, prescriptions, and follow-up appointments. Theoretically you can see a patient’s whole medical history by looking through this book. Theoretically…
We stop seeing patients around noon and head off for lunch. Ryan and I actually ventured off the station this day for lunch (instead of our typical PB&J). We skipped on the betel nuts and cigarettes and went for flour balls and Coke.
Now flour balls are something like doughnuts holes, but not really. They’re deep fried dough but much denser than doughnut holes and not coated in sugar. They’re actually really filling. And anyone who knows me knows I really can’t stand Coke, but it actually tastes different here! I like the stuff! All I can come up with is that it doesn’t have high fructose corn syrup in it.
Anyway, after lunch it’s back to more of the same. We keep seeing patients in OPD and the ER usually until about 4:30 or 5. For the next pictures in order – First is me talking to the son of a patient whose prognosis was not very good. Next is me doing a paracentesis on a man with extremely bad ascites. I had taken 3 L off his belly the previous Saturday. This Wednesday he was still short of breath so I took off 3 more liters. After that is me doing a lumbar puncture on a boy with a febrile illness of some sort. Then me ultrasounding another patient’s belly in an attempt to figure out what his problem was. (Where’s a CT scanner when you need one…) And of course, there is always plenty of paperwork to be done. Although it is substantially less here compared to in the States. But that is how the afternoon continued until all the patients had been seen.