This final week in Kijabe has been all about the OPD, and OMG, what an experience! I was operating as a consultant, which is pretty similar to being an attending physician back in the States. The Clinical Officers and Medical Officers would handle the initial patient encounters. If it was a straightforward case, they’d complete their assessment and plan and discharge the patient. But if it was a complex case or time-sensitive situation, they’d bring it to me. They’d present the case, and if the story made sense and I could nail down a diagnosis, I’d help guide them toward the right diagnosis or the best diagnostic approach.
It’s wild because literally anything can walk through that door. It’s like an urgent care on steroids, with a mix of rare conditions and emergency room-level patients. My brain got a serious workout! I’ve seen diagnoses this week that I feel like I’ve only ever encountered on “House, M.D.” I’m talking pheochromocytoma, TB, secondary syphilis, traumatic brain injuries, metastatic cancer, empyema, and a whole laundry list of other things I can barely remember. It’s definitely a bit scary to be the one people are looking to for answers, but it’s also been incredibly rewarding. I realized that a lot of those treatments we memorized for exams, read about in textbooks, and researched actually stuck with me. Even though I hadn’t seen some of these conditions firsthand, I was able to recommend appropriate management (which I totally double-checked with my medical resources after the Clinical Officer left, haha!). And having a solid grasp of physiology really comes in clutch – if you know what’s normal, you’re in a much better position to understand pathology.
This last week was also fantastic for bonding with the other US-based students and residents. We’d hang out after work, watch movies, grab lunch and dinner together. It definitely made the time feel more familiar and homey. I even picked up some Swahili from the OPD workers and gained a whole new level of appreciation for them. Plus, we had some pretty decent pizza delivered for lunch on our second-to-last day, and let’s be honest, good food is always a bonding experience. Another skill I started developing here (though I’m still very much a novice) was how to wet-read diagnostic images. I’m still pretty terrible at ultrasounds, but I’m getting better with CT scans and X-rays.
I’m writing this in the taxi on my way to the airport on my last night in Kenya, and it’s hitting me just how surreal this whole experience has been. I got to practice medicine in a remote, mission-oriented setting, which is something I’ve dreamed of doing since 2007. And here I am, almost 20 years later, taking the first step on that career path. I traveled to a completely different hemisphere of the world by myself and lived here for four weeks. I made connections that will last a lifetime and might even be pivotal in shaping my future. It’s been wild, challenging, and incredibly fulfilling. I’m leaving Kenya with a full heart and a renewed sense of purpose.
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