Casualty and See & Treat

My first three days at GF Jooste District Hospital have been a thrill. It has been an eye-opening educational experience thus far. Casualty is what we would call the ER back home. They have many many beds in a large open room with simple curtain sheets to draw around for privacy when needed. There are other students from the University of Cape Town in their 4th year of medical school getting practice. In addition, there is a full staff of nurses, doctors, and support staff. I have been following rounds in the mornings and then seeking out interesting patients and events throughout the day. They see a high load of "medical" patients during the day. This means they see an array of issues from HIV/TB complications, high blood pressure, DVT's, abcesses, stroke, TB, MDR-TB, and meningitis to name just a few. I got to observe two lumbar punctures (taking a sample of cerebrospinal fluid), blood draws, IV inserts, and many other small procedures. It has been most interesting to listen to the doctors line of inquiry and history taking with patients. I feel like I have learned so much in just a few days about how physicians go about reaching a diagnosis or a plan of attack to rule out possibilities. I also spent a great deal of time in the See & Treat section shadowing Dr. Isaacs a general practitioner. She sees patients on referral from the local day hospital. She will take a brief history and look at prior tests if it is their second time back. They see a great variety of issues in this section of hospital. I have really enjoyed learning from her over the past few days. Many things are drastically different here but the process of making a good diagnosis and treating patients effectively is quite similar. The kinds of complications are highly related to the poor sanitation, cramped living situations, and high rates of HIV/AIDS and TB in this region. The number of patients I have seen with TB and HIV is overwhelming. I didn't quite expect such a high percentage. I will be spending some more time in Casualty next week. Hopefully I will be able to post another blog on Monday about my weekend for all of you readers!