i’m in kenya now, and have been kept very busy at the kijabe hospital! i’m staying with a pediatric neurosurgeon who is a old friend of my mom, and it has been great! i’ll be here for the next three months, learning as much as i can about medicine. every day we head down to the hospital at 6:30 am, and do the rounds of the patients he will be operating on that day (often about ten patients – he’s an extremely busy man!). most of the kids have spina bifida, hydrocephalus or both. spina bifida is when the neural tube fails to properly close during fetal development, allowing the spinal cord to grow abnormally and often outside of the body, often resulting in some or a lot of paralysis. and hydrocephalus is when the cerebrospinal fluid that lubricates the brain and spinal cord is blocked from circulating properly, putting a lot of pressure on the brain, which causes problems. and because baby’s cranial bones are so soft, this pressure causes their entire skull to expand, often to extreme extremes, especially if they aren’t brought for help soon enough. very sad. so, the doctor i am with does surgeries to deal with these problems, although when the presentation is late, often damage control is the best outcome that can be hoped for. i have been in the operating room watching a lot of these and helping out when i can. also, thankfully the hospital is rather relaxed in terms of letting me get involved where i can, so i have watched some other surgeries and with cleaning some gnarly wounds, abscesses and burns, etc. their are about a trillion acronyms or more in the medical world, so it has obviously been a huge learning curve sometimes even following what is going on for me as a mere undergrad. but it is very gratifying when one of the acronyms, disorders, procedures or drugs that i have managed to remember is used in conversation. i’m really looking forward to learning more and eventually becoming a doctor who knows what he is doing.
the hospital is a training hospital – both for kenyan medical students and a few fourth year american medical students who are doing an international rotation. so i have spent considerable time with them as well, lately on the pediatric (kids) team. they do rounds of their ward every morning with an attending doctor, looking at each of their patients and talking out the latest information on the status of the kids and treatment plans, and they have been kind enough to let me join them. it is nice because even though they are obviously a lot further along than i am they are still learning. they also share some interesting info (they are all really nice people). for example, i just learned that rickets (soft bones in kids) never used to be a problem in kenya, though now it is. it has finally been discovered that the cause of this is that the government has been promoting a type of mixed grain flour that actually reacts with breastmilk in such a way that kids don’t get enough calcium, which can cause rickets. in this context the moral of the story is to make sure to tell the mothers with kids with stunted development who come into this maternal care clinic which is onsite (another place i have been hanging out with some of the interns) that they should avoid this type of flour even though the government tells them it is the healthiest (it actually is once the kid is done breastfeeding). fascinating. all the kenyans (at the hospital) speak english, although sometimes their accents are so foreign to me that i think they are speaking swahili, which is always a little embarrassing if they happened to be talking to me. just takes some getting used to. there is also a free kenyan lunch four days a week for the interns that i have been going to, followed by a technical lecture on a medical issue of note. needless to say my brain hurts a little from all the stimulus, as well as my feet from being on them all day basically without ever sitting down. but i’m getting used to it, and enjoying it thoroughly. honestly its like i’ve landed on a totally different planet, and have to learn a new language and way of doing things. but such is the beauty of life!
