Hospital Adventures (in pictures)

 

 

 

 

 

 

 

 

 

 

My fellow intern (Nicole) doing some paperwork in the nurse's station. Notice the TV on the right. Don't even THINK about bothering the nurses at noon when their favorite soap opera comes on.

Me in the radiology ward

Me and Nicole chillin next to the MRI machine.

Here we're facing the hospital and behind us is the entrance to the hospital (see the car coming in on the right side?)

Me and Giscard, another intern, near the exit of the hospital grounds.

Being a happy fool. (For those of you who don't speak French, "Urgences" means "Emergency") Every day I enter the hospital from the Urgences door.

"Interdit de stationner sur la pelouse" (translation: parking on the grass is prohibited)...and yet everyone parks on the grass lol

All it Takes is a Smile

It’s already been 2 weeks since I’ve been in the surgical ward, which means tomorrow I’m starting in the internal medicine A (infectious diseases) ward. At the end of my first week in surgery I went to the basement of the hospital with two other interns and the head nurse of the ward. He’s the type of guy (the head nurse) who LOOOOOVES to talk your ear off, so naturally he was giving us advice and telling stories during the entire trip. The other interns are all second years from nursing schools in Yaoundé. At one point the head nurse asked the other interns what makes me different from the rest of the interns (besides my skin tone and my American accent) and they were clueless…as was I. Finally, he told us that what sets me apart is the fact that I smile. He said it makes all the difference for the patients and the staff we work with. After he said that, I started noticing that the nurses here don’t really smile and that every time I smile at a patient, two things happen: 1) he/she has an incredibly surprised look on his/her face and then, 2) he/she smiles back, relaxes and his/her demeanor softens. That’s literally all it takes. I hadn’t noticed it before, probably because I smile all the time, but it all made sense to me because whenever I run into a patient or his/her family in the hallway, they always stop and talk to me. The head nurse made me realize that it’s simply because of my positive attitude that the patients feel comfortable telling me about themselves. For example, here it’s common for patients to give a little tip to nurses they like or feel are deserving of a reward. One morning I was changing one patient’s sheets as he was standing by the window. As I was working I said, “Bonjour, Monsieur Mahamat! Comment allez-vous ce matin?” (And of course I smiled). He turned to face me, smiled (was shocked that I was talking to him) and replied, “Bonjour, ca va très bien”. Ten minutes later, his brother came to the nurse’s station and gave me 1000 francs (about 2 bucks). He said that his brother was so pleased with the way I was with him that he wanted to give me a little something. It’s crazy how subtle culture differences can have such a huge influence on day-to-day life.

Livin The (Hospital) Life

First things first: I successfully killed my first roach! HUGE step for me and one of the tangible signs that I, in fact, have grown since I’ve been here :) 

For the past two weeks, I have been working in the General Hospital of Yaoundé in the internal medicine (cardiology, nephrology and psychiatry…I’ll explain the psych part later) ward with the nursing staff. I have learned an unbelievable amount about nursing, medicine and how public hospitals work in Cameroon. Every day I get to the hospital around 7:45am in time to start the 8 am rounds. There have been from 17 to 25 patients in the ward and there are only 2 nurses each shift (2 shifts: 7:30am-5:30pm and 5:30pm-7:30am). I’ve discovered that having only 2 nurses makes it extremely difficult to give each patient the time, attention and care they need. Luckily because two nursing students and I are here, the nurses have a slightly lighter load. An advantage to this is that I have the opportunity to learn everything from the nurses here. I’m getting used to doing EKGs (electrocardiograms) on my own, reading patient charts and administering the appropriate drugs.

Here’s the reason the psych ward is combined with the cardiology and nephrology ward: Awhile ago, there used to be an entire hospital devoted to psych patients. However, all of these patients are children of the richest and most powerful people in Cameroon -- who in turn get their way because all it takes is a little financial incentive – and they weren’t happy that their children were outcasts in the medical and social world. So, since the General Hospital is the best public hospital in Yaounde, the parents of such patients pay lots and lots of money to have their children (teens and young adults) hospitalized there. The problem is, there isn’t any room to have a completely separate psych ward, so they had to add it on to the cardiology and nephrology ward. Most, if not all, of these patients were at one point in Europe and then started using drugs or developing mental health issues and were sent back to Cameroon to the General Hospital. It’s sad because they end up spending most of their lives in and out of the hospital.

One of the major challenges in the ward is dealing with families that use traditional medicine in addition to (or in lieu of) modern/Western medicine. This causes even more problems with a patient who already has a severe renal insufficiency. There was a teenage boy in the ward last week that had already been hospitalized once before. He has a congenital kidney problem and has to monitor his food intake extremely closely otherwise his whole body swells with fluid and he becomes really, really tired because his kidneys can’t efficiently filter out waste. His parents had started giving him his meds but resorted to traditional medicine after awhile, which made his situation even worse, to the point where he almost died. So since he was in the hospital again, when all he initially needed was maintenance, he was in the worse condition possible and the nurses begged his parents to not give him traditional potions or lotions because they will not help him get better. Unfortunately, we have no way of following up with the family (there’s no time to properly care for the patients in the ward)…hopefully he won’t end up in the hospital again under the same conditions.

I had an “aha moment” the other day. I think I looked pretty stupid because I was smiling to myself in the ward. Anyway, I realized how useful I feel in the ward (especially with a shortage of personnel). I don’t feel like I’m doing much but every time I get a “merci beaucoup” from a patient, I can hear and see their sincerity. Even though I have seen a few people die in the ward, getting a thank you and/or a smile from a patient makes what I’m working towards completely worth it. Like I said, I don’t do a lot, but when someone (patient or family) feels like you care and are helping him or her get better, it brings about an indescribable feeling. This is the driving force behind what I think medicine should be about: seeing healthy, smiling people leave a ward who were at one point really sick, and knowing that you played a role in this improvement. Now that I’ve seen patients recover and others pass away, I have come to realize that although death is very sad, having patients recover and give you their thanks for helping them do so is absolutely worth it.

I’ll be working in surgery starting tomorrow so look out for another post next week!