To Africa: Last Things

Our trip has nearly come to an end. We could not have asked for a better experience. We saw so much in a short period of time, patients that presented as textbook perfect cases of diseases, some of which we have only read about. We also developed some basic McGuyver skills, creatively fashioning solutions out of next to nothing. We learned to be conservative in how we practice medicine, not by ordering a battery of tests to protect ourselves, but by using only what is necessary for diagnosis and treatment and nothing more. We had to think more about our resource utilization, which made us think more about our physical exam, bedside ultrasound, and our differential diagnosis before we planned our work up and disposition. We are better doctors because we had this opportunity.

While the medical experience was extremely rewarding, our experience would not have been the same without the people who helped us each and every day. Our Ethiopian nursing staff in the ER made each shift a joy. They tirelessly translated for us 'ferengis', proficiently navigating some difficult cultural and ethical situations and kindly but firmly redirecting patients who strayed from the questions we asked. Sometimes we asked them to do something differently than they are accustomed to, or we wanted to do something that was brand new for them in the ER, and each time they were eager to learn and happy to help. The GPs that we worked alongside were also invaluable resources -- we taught them a few things about airway management, central lines, ultrasound, and chronic diseases like AMI and stroke, but we learned so much from them in return-- they are experts in tropical diseases, they helped us broaden our differentials to take into consideration the disease processes that are common to this particular area, and they showed us daily how to make the best use of the system we had available. They work extremely hard and they do not complain. They were thankful for our help in the ER, but we were equally thankful for everything they did for us and for the work they do each and every day for these patients.

Finally, the Gabrysch family and all of the other missionaries at SCH were wonderful hosts. Everyone was welcoming and generous, and it was nice to both live and work among them as part of their community for short time. Jeremy especially was instrumental in making this a successful and rewarding trip. He helped us immensely in the ER, we learned together as a team on some complicated cases, and more often than not if we called him to ask a question he dropped whatever else he was doing to come see the patient alongside us. He even let us babysit his amazing kids for a few hours, but after keeping them up way past their bedtime playing games, I'm not sure we'll be invited to do that again! Christina and Jeremy also let us crash their short vacation to Lake Langamo on the way to Addis before we all leave for the United States, which was relaxing and fun. Plus, we got to spend some more time with the kids, both of whom are full of energy, very entertaining, and a joy to be around!

We will miss this place. It will be quite a shock to be back at county in just a few days compared to our lives for the past month, but this was a welcome and refreshing interlude before the home stretch in our final year of residency. Thank you again to everyone at home who made this possible for us, we love you all and we will see you soon!

New Airway Cart in the ER. We finally completed this during our last shift!