Wednesday, November 25, 2015

Had to Comment on the Healthcare Here - November 24, 2015

Today a mystery was solved!

In the brief phone conversation I had with the Selamta Executive Director right before I boarded my plane in DC (here), I failed to mention her true sign off line: “Oh…we learned last night that Yohannes is in the hospital. It says it was for ‘stomach surgery’…so we assume that means appendicitis – but could you check once you arrive?”

Considering I went straight from the Kigali airport to a wedding when I first moved to Rwanda (check it out here), the request to go to the hospital right when I landed wasn’t too far out of the ordinary. So, after the initial money exchange and errands, down I walked to the Bethel Teaching Hospital with Abel.

[Side note to mention that the hospital was in better shape than I had expected. I didn’t want to take any pictures there – so sorry, but it was a 5-story building with a winding ramp up the center atrium – all pristine white and reasonably organized. Inpatient was on the 5th floor (well – I was misled – they said it was on the “4th floor” but then my post-plane, sea-level altitude acclimated self almost cried when we walked up one flight and I saw a sign that said “Floor 1”.)]

In the inpatient unit, there was a chalkboard with the patients’ room numbers, names, diagnoses, DOB, etc. It seemed very similar to a US hospital (I’m not sure they need Hospital IQ yet) – Yohannes was listed in room 404 (LIES – really 504) and with a “Perforated PUD”.

STOP. Put yourself in my shoes and do not Google the answer. Because Google was not available to me at the time. Does a “PUD” in a foreign country that doesn’t even use the Roman alphabet for its native language look similar enough to “aPPenDix” that you’d agree with what you’ve been told? That the patient had appendicitis?

Med school students – I feel your judgment. I don’t care. You’re the profession that's most likely to suffer from #confirmationbias

Yohannes was unsurprisingly holding court from his hospital bed (maybe this is surprising since you have no idea who Yohannes is – but let me tell you – it’s not surprising). He had about 5 visitors when we arrived and there was a steady flow of visitors throughout the miserable 1.5 hours that I was there.

Why were those 1.5 hours miserable? Because I had arrived at 8am (midnight EST) after ~no sleep during my 16 hour flight and I was sitting on a hard chair in an Ethiopian hospital surrounded by people who didn’t really know English and whose focus was the kid recovering from surgery in an Ethiopian hospital – not the white girl sitting on the side.

At one point, this very confident woman showed up. She walked right in, pulled his chart off his bed and started flipping through it. Then she inspected his IV drip and drainage bag (stuffed into a black plastic bag, tied to the side of the bed), felt for a fever, and started saying something to his mother. Of note – she was also dressed up all nice and had her nails done and hair styled perfectly. I figured she was a Selamta kid who was in nursing school – and looked down at my dirt-laden nails and travel outfit with shame – and started regretting my career path – why do I have such useless skills? How will I ever be able to help anybody with Excel shortcuts and “leadership”??

Okay – let’s bring this back from my existential crisis – I also figured that if she was in nursing school she probably knew English – so I went for it and asked her the diagnosis.

Boy, did she know English. She rattled off her response. I again caught “perforated” and a word that had some P and D sounds. It wasn’t appendix but I wasn’t exactly sure what it was. I decided it was a fancier word for “spleen” because – that’s in that part of the body – and also has a P.

DON’T GOOGLE! Do you remember from 7th grade biology what the spleen does? Yeah, I didn’t think so.

Anyways, I nodded along and pretended I understood everything she was saying. Especially after we exchanged some greetings and I learned she’s the actual nurse for Selamta and I told her that I work at “a pharmacy” in the US (no introduction has ever been more misleading – she probably assumed I knew exactly what she was talking about).

When I remembered to Google it later, I searched for “ruptured PED” – which isn’t what he has but returned enough search results about a medical thing (a pipeline embolization device) that I #confirmed my assumption that “PED” was just some inexplicable Amharic-to-English acronym translation for spleen or appendix.

My mother was very concerned when she arrived today and asked me what the diagnosis is. Apparently a “ruptured spleen I think” is a VERY BIG deal. She went straight to the source of the nurse, where we got MYSTERY SOLVED: the patient had had a ruptured ulcer in his stomach (peptic ulcer disease)!

Unfortunately, this wasn’t actually joyous news – because like a ruptured PUD is a much, much worse diagnosis. But at least…now we know?

PS – Wonder if my time spent in a hospital allows me to bill this as a “work trip”?

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