Howdy friends and fam!
Turns out I think there is something fun about sleeping under a mosquito
net every night. Now I equate it to building forts as a kid, but that was
not the case the first few years I was here. In the beginning, I was more
focused on the creepy, crawly, buzzing, biting, nightmare bugs that were
undoubtedly trying to get in. In fact, I have found myself more relaxed
regarding just about everything. The people, the language, the culture, the
insane traffic speeding through the winding streets; none of those things seem
as foreign to me now. Now it is comfortable, and I am again imagining I
could live here for quite some time.
It's hot and humid. Around 60 degrees at night, the days are
heating up to over 80 degrees with around 95-100% humidity (that's Bama hot,
ya'll ;). After work yesterday Cynthia (the Stanford anesthesia resident
I am mentoring) and I headed to the Serena Hotel so I could join their gym and
spa and we could lounge around on their big comfortable chairs and couches
siphoning off their wifi. I attempted a pathetic workout but was really
short of breath just walking around. I am clearly still jet lagged and affected
by the altitude. We ate dinner at the hotel, one of the only places I trust
eating a salad without getting sick.
Monday was our first academic/lectures day which might have been the
best yet. Every year there are huge improvements in the teaching methods
and this year is no different. I supervised a Rwandan anesthesia resident
but he did such an excellent job preparing and leading the discussion, my
contributions were confined to writing the pertinent information on a white
board. Most impressive was that he didn't use a single powerpoint
slide. Two years ago we would have all been put to sleep by the
monotonous tone of some resident reading from their slides.
We had an hour and a half for lunch which is pretty standard here. We
went to the Camelia Tea House with my friend Paulin who is the residency
director here. Some of you may recall he stayed in my apartment in
Sausalito this past summer during is first visit to the US for a
conference. He raved about his stay when he was introducing me to the new
residents. Paulin remembers my big brother, Gregor and his big
truck. He always laughs and says he is a "real American man."
In the afternoon Cynthia and I led two stations in the simulation
center. One station Cynthia simulated a patient with airway problems and
the other station I gave a chalk talk on mechanical ventilators. It's
thrilling every time you see comprehension spread across the students
faces. I miss teaching.
Today was a clinical teaching day. Cynthia went to the operating
room to work with some residents there, and I spent the day rounding with a
team of residents and medical students. We had 7 patients in the ICU and
3 patients in a step-down, or lower acuity unit. All of the patients
except two had brain damage after being in a motor vehicle accident. That
is actually most dangerous thing about being in Rwanda, and most low-income
countries actually. The lack of organized traffic flow and laws puts cars
and busses and bicycles and pedestrians and mototaxis all in a big pot together
to fend for themselves. I have even seen the mototaxis come up on the
sidewalks. Pedestrians definitely do not have the right of way. One
of the patients coded and died while we were rounding which is more rare in the
US, but unfortunately all too common here. The ICU is the one place which
sees only minimal improvements over the years, and where I will be spending
most of my time these next two weeks.
Last night I went to bed early, but woke up at 2am. Tonight's plan
is dinner at the Serena followed by a yoga class with Cynthia at the gym.
I hoping for better sleep tonight.
I miss and love you all, but am enjoying my team here as always.
XO
Ana
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