I'm too lazy to go back and see where I left off in my last post (plus, I'm running out of precious internet time.) So, I will just start where I feel like it. Deal.
Having Kenji here is amazing, I'm not gonna lie. I'd like to say that I'm one of those people that can go anywhere and do anything without familiarity around me and be just fine. But, I don't think so. I was trying to remember back to my year and a half in Japan when I was just starting the English school and living with a Japanese family in a tiny house with very little hot water and abusive in-laws all while barely speaking Japanese and having no-one familiar near. I don't remember being totally miserable. I must have blocked it out, right?
For those of you wondering my current mental state, here it is broken down in timeline fashion:
1) Week one sucks. No way around it. It will get better, no matter how much you think it won't. Expectations make a huge difference here--> whatever you expect, it will be the opposite.
2) Week two is much better simply because you are familiar with the unfamiliar and you start to figure out the gaps of care where you can insert yourself-- having a purpose always improves your mood.
3) Week three is the real adjustment period-- you know what you can do and what you can't, how you can help and somehow, you think you get it. Then you get kicked in the butt on-call but you get back up on your feet more quickly each time it happens. This is where you can start to feel good about what you are doing-- finally!! Hopefully this continues until the end, no matter how far away that may seem :)
4) And finally, the most important revelation: worry about what is in front of you RIGHT NOW and what you can do to fix it. Don't fixate on what COULD have been done had someone called you earlier. It is HARD to directly tell a medical student/clinical officer/intern who doesn't necessarily listen to you anyway that you think they permanently hurt/killed a patient. But, you gotta do it. It will probably keep happening whether you say it or not but if you vocalize it, there is a better chance they will finally get it. (P.S. for those of you coming after me, it helps if there is a Kenyan attending backing up your words of wisdom!)
all of that being said, the night before I picked up Kenji from Nairobi was rough but not intolerable; I think I got a few hours of sleep. But, once he was here, it all seemed to melt away. It also helped that two days after he got here, I finally got almost a full weekend off and we went to Lake Nakuru. Amazing! We stayed at the Sarova Lion Hill Lodge for almost half the price (we got hooked up with the non-kenyan resident rate instead of the tourist rate) and saw lots of animals and birds in the park. Then yesterday after delivering a breech 25 week fetal demise with a head entrapment, I left work right after Rounds and spent the day with John Njane, the Kenyan man who is starting a non-profit for orphaned boys and whom many of us have worked with before. It was Kenji's first day working with him so it was really nice doing things together. We saw John's house, met his family, and then went to the widow's house where Kenji and John are going to build a new roof for her and the orphans she is raising. We spent almost the entire day measuring, buying supplies, and then transporting the supplies up to the house. The cars here are less than ideal and so we spent a lot of time securing the muffler back onto the truck, pushing several trucks without starters that were loaded down with supplies, trying to fix a broken wheel that got stuck in a deep rut and even riding on the back bumper of a truck when there was no other room. Question of the day: Is it better to be locked in the car without a seatbelt and possibly get stuck inside with some horrible injury when you crash or to be thrown clear of the whole mess but possibly smack your head on the road or tree? Hmmmm.... tough one. We re-confirmed the location of the phone number for our medi-vac travelers' insurance about mid-way through the bumpy trips back and forth. You can never be too careful ;)
One thing for sure is that if you just spend your whole time in the hospital, you will not get the true Kenyan experience. The hours and days that I have learned and witnessed the most were when I was out in community clinics and/or just in villages helping regular people. There is a lot of good to be done in the hospital trying to teach the clinical officers and interns to give patients the best care possible with the resources they have. And I knew that the patients that I was treating were the poorest people I had probably ever come across. But, I didn't REALLY understand until I saw with my own eyes where and how they live. Yet, they are happy and it makes me feel slightly better about all that I have in my life when I can help them in some small way.