Thursday, June 16, 2011

Wrapping up

So, today is my last full day in Kenya. I can pretty easily say that I'm not ready to leave. While it's been challenging at times it's overall been a fantastic experience.

I haven't been that great lately about keeping my blog updated, part of that is related to the intermittent internet and part to sheer busy-ness. I've been spending the last 3 weeks rounding on the pediatric side, and found it difficult to blog about for several reasons. It's harder for me to see children with chronic diseases (rheumatic heart disease, malnutrition, etc) and know how disparate the care is between here and the US.

There were certainly kids who came in sick with acute illnesses (pneumonia, gastroenteritis, dehydration) who we were able to manage and send home after just a day or two. However, they aren't the ones who will haunt me when I go home.

One of the Kenyan pulmonary fellows commented today about the chronically ill patients (after rounding today on a 27 year old with HIV, dilated cardiomyopathy and presented with a STEMI) - "Patients like this, you know you see them in clinic over and over, and then when you don't see them anymore and you wonder, but you are afraid to ask. You know what happened, but you just don't want to ask."

However for this patient, a young mother, being able to receive ICU level care, anticoagulants and inotropes, may buy her at least a few more months than she would have otherwise. It's easy to get so overwhelmed that you lose sight of the person right in front of you that you can help, and the diffrence that it makes to them.

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