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!