I would like to apologize in advance for this post. I made some new friends who are horrible influences. So this post is coming at you with one eye closed and the other squinting:
Morning report today was interesting as usual. There was a possible leiomyosarcoma who is going to the OR today, and another abdominal hysterectomy for fibroids. There was also a maternal death overnight. A 23 year old patient who had a cesarean section for fetal reasons. She began to get hypotensive and was transferred here for further management. On arrival she coded and never regained consciousness. She had a belly filled with blood on ultrasound done post mortem. I think that is the hardest part about Obstetrics and Gynecology in a setting like this. These deliveries and procedures are performed by these “General Practitioners” who could be physicians who just graduated medical school and entered the work force (no residency training). I cannot think of a logical reason why this patient had to die. It was very upsetting to everyone.
Next I met up with Blaise, the administrative chief of the residency. I came here to formulate a curriculum and have been having the hardest time mostly because the residents are EVERYWHERE and NOWHERE all at the same time. No two days are the same and it’s rare I work with the same person twice even though I’ve stayed in the same wards most of the time I’ve been here.
He’s always running around and said he needed to go to the ER to see a consult but that’s he be back- yeah right. I’ve been chasing him all week. I propose I go with him to see the consult and we walk and talk. He agreed and told me it’s a pregnant patient with TB. Cool. We get there only to find out, it’s a pregnant patient with TBI! Traumatic brain injury. Big difference. It was interesting seeing the emergency ward. It was like a vast wasteland initially with little nooks with tons of beds and patients. Ambulances. Screaming. Ok, we go find our patient. She is intubated and sedated. We get collateral information from the consulting ER physician and do an US. She was supposedly 8 weeks pregnant but was having a miscarriage. Blaise examined her and we did a sono. The uterus looked very thin and like there was no pregnancy. We gave some cytotec and left the ER.
Blaise suggested that we go to breakfast. So we went to the restaurant in the hospital and ironed out what would be a worthwhile rotation for future residents coming from Stony Brook. It was very productive. He has very high expectations. We also talked about research and how that can be carried out during the rotation too. We talked about when the IRB needs to be submitted to their hospital and even talked about resident help on the Rwanda side for American collaborative projects. It was awesome!
Next I went back to the labor ward. The Belgian student Maxim was there. As promised we reviewed Electronic fetal monitoring. We probably spoke for about 2 hours and even found a white board. We reviewed ectopic pregnancies, antenatal testing, abortions, STDs, GTN, and cervical cancer. I looked at my watch and it was already 2 pm. There were 2 active patients so we decided we would eat a quick lunch to get him back for the deliveries. Yeah right. At lunch we met up with some of the other Belgian students as well as Arjun, a 3rd year internal medicine resident from Yale doing a rotation. He’s so awesome! I wish I met him sooner. We joked about home, mutual acquaintances, and pop culture. It was also nice using English slang and getting an appropriate reaction. So after all this chatting as you can imagine we missed both deliveries- SORRY MAXIM!
Afterwards my new friends invited me out this evening to Inema Arts Center. I didn’t have plans but to be in bed by 9:30 and read more of For Whom The Bell Tolls By Ernest Hemingway. I asked Maxim how they were getting there, he proclaimed, ” Were taking motos!” And proceeded to show me a video of about 10 students riding on the back on 10 motos like a motorcycle gang. I’m such a wuss! Whatever. I messaged Alphonse that I would need a ride at 8:30 PM.
I met them there, and was severely underdressed. Here I was thinking we were going to an art gallery- NOPE. This was a full on outdoors night club. OY. I wore a frompy romper and a target sweater. Thankfully, I had my red lipstick in my purse which I threw on really quick so I could look somewhat descent. In any case, apparently this is the place to be on Thursday night in Rwanda. We definitely had the club turnt up, on a Tuesday~. Me and my new friends danced all night to East African, American, Indian, and Carribean music. It was awesome!! I felt like I was in the “Unforgettable.” Music video! The beer was cheap (~2 USD, hence the squinting) and the dancing was amazing!! I was so concerned about my dress code but I frequently found myself fighting the men off me. Rwandan men are VERY forward.
So some new characters in the mix. I already mentioned Arjun, he’s a character in himself. He’s very cultured and knows all about Carribean music and Jamaican culture. He’s Indian and someone I very much enjoy spending time with. He showed me Mars and is a huge astrology fan (although if you ask to many questions he is unable to answer hah). He’s very fluent in Carribean culture and must have a lot of Jamaican friends as he knows all the music and dances.Next is Hazel, she’s Belgian and dating Maxim. I’ve made her an honorary American (fall back trump) . She was very taken aback by the dancing style and asked me if this is how we dance in the US. I explained ” yes, but with much less clothes and a lot more gyrating.” She was intrigued. She quickly became the queen of the dancehall and was the center of the dance floor. That’s why she’s an honorary American. She takes no bullshit from no one! I love it! I try to explain to her she’s an OB/GYN but she’s stuck on this pediatrics thing. Next was Brendan. He’s an American Med student from Dartmouth. He’s been here forever and knows everyone. He’s awesome. My only regret is I haven’t gotten to know these people sooner!! They’ve become so special to me in just a few days. To my Belgian friends- you always have a place to visit if you come to the U.S! And to my new American friends- just name a time and place and we can meet up and continue what we’ve started!
Ok guys- goodnight. Last day of work tomorrow 💔