Wednesday, May 26, 2010
Back Home
After all of the adventure making sure we had a flight back to the US, the actual traveling went quite smoothly. We arrived in Philly yesterday afternoon where Lisa's family picked us up. While we miss our friends in Africa, we are also excited about spending some time with family before graduation. Thank you so much for your prayers.
Sunday, May 23, 2010
Last update from Africa!
So... our second flight was cancelled, but we are now on a third to Philadelphia! I'm determined to get Stephen home for his graduation even if we have to swim ;-) Seriously though, please pray that this flight won't be cancelled and we will make all our connection etc. We leave in the morning to drive to Ghana, and our flight to London leaves tomorrow night. Lord willing we will be in the US around 3:00pm on Tuesday.
We had always intended to write one or two more blog posts, just to tell about our last week here and reflect a little bit on what we've learned. But those will have to be done from home now - so watch for that if you're still interested! Also, we'll post a link to our pictures once we put them up on a web album.
Thank you to all of you for your birthday wishes - I had a very special birthday here. I had mango pie for my birthday cake, and I had the happy birthday song sung to me in 3 languages - French, English, and Ewe. I will never forget that.
Well, I'm signing off from Africa for the last time... (for this trip, that is!). That is sad in some ways, but we are excited about seeing people at home and what is ahead of us there. We are even more excited about what God has done in our hearts while we have been here, and to see where He will take us next! We are so thankful and full of praise to the God who made us, redeemed us, and called us - the same One who is at work in this place and in these people. What an awesome God, and what a privilege to play a part in what He is doing in the world!
We had always intended to write one or two more blog posts, just to tell about our last week here and reflect a little bit on what we've learned. But those will have to be done from home now - so watch for that if you're still interested! Also, we'll post a link to our pictures once we put them up on a web album.
Thank you to all of you for your birthday wishes - I had a very special birthday here. I had mango pie for my birthday cake, and I had the happy birthday song sung to me in 3 languages - French, English, and Ewe. I will never forget that.
Well, I'm signing off from Africa for the last time... (for this trip, that is!). That is sad in some ways, but we are excited about seeing people at home and what is ahead of us there. We are even more excited about what God has done in our hearts while we have been here, and to see where He will take us next! We are so thankful and full of praise to the God who made us, redeemed us, and called us - the same One who is at work in this place and in these people. What an awesome God, and what a privilege to play a part in what He is doing in the world!
Friday, May 21, 2010
Answer to Prayer
Just got word that we are now on a flight to DC. Thanks for all of you who prayed. God is always good, but we are thankful He choose to do this for us.
Prayer Request
We just found out that our flight from London to BWI has been cancelled because of the British Airways strike, and we are unclear as to when or how we will get home. We are working with our travel agent to figure this situation out, but as you can imagine, many around the world have been affected by this. Please pray that we would trust God in the midst of the uncertainty, that if it is His will we would be able to get home by graduation, and that we would have wisdom as to any decisions that we need to make. Thank you so much.
Btw, we are still having fun.
Btw, we are still having fun.
Hospital Work
I've realized that in all of our blogging, I haven't devoted a whole post to describing my work in the hospital. It would be a shame to never do so, since not only has it been my primary responsibility, but there have been a host of fun experiences that deserve to be shared.
Hospital rounds start at 7:30-8 each morning, during which time we discuss patients who have been admitted to the hospital and decide upon their course of care. Sometimes decisions are fairly straightforward, and at other times the cases are bizarre, such as a snakebite or tetanus. I find it funny, though, as to what may be considered straightforward – for example, I've seen so much pediatric malaria, that I can basically recite the care to be given in a variety of clinical situations, as well as how to deal with various complications. Something that is a novelty in the states has now become very routine, and I'll probably have more experience treating it than all of my attendings in residency (so if a case ever comes in, I'll have a chance to look like an all star). Another few crazy facts on malaria in Togo – it's so common that you have to consider it for anyone with a fever, and will often treat without running tests. Also, it can cause such severe anemia, that single digit hematocrits are common upon admission. My personal record is 8, though patients with hematocrits as low as 4.5 have survived. (For the non-medical people, this is a measure of how anemic a person is...doctors usually transfuse a patient when their hemoglobin is less than 7, which is the equivalent of a hematocrit of 21.)
Being a family medicine (almost) doctor, I've tried to spend time helping with all types of patients – OB, medicine, pediatrics, and surgical. OB cases are some of my favorite. It's been exciting to deliver babies here in Togo. I've also gotten to get a significant amount of C-section experience. A lot of this consists of assisting the surgeons here, but I've gotten to deliver several of the babies in the OR after we have opened the uterus. Additionally, there have been 3 C-sections where I have done a majority of the operation, which has been one of the medical highlights of the trip. Many family medicine residents have never done a C-section, and I've already gotten to do 3!
After rounds, I usually go up to the clinic to see patients. It's been a new experience to have to interview patients through a translator. It works for the most part, though there are many times where I've felt I'm not getting the full picture. Sometimes this is frustrating, because knowing the language really would allow me to provide better care at times. Still, we manage to consistently help people, and it's been fun to have more responsibility in treating patients.
I'll also take call every 3-4 nights, which consists of taking phone calls when there are questions about patients and going down to the hospital when someone needs to be admitted. Fortunately, most people don't come in late at night so I would usually get at least 6 hours of sleep. The responsibility of admitting patients and having to make more decisions has been invaluable, and I feel much better prepared for residency after my 6 weeks here. I don't want it to sound like my responsibilities have meant I have little oversight. I have worked with some great doctors who have watched me make decisions and taught me a wealth of knowledge. Michael Gayle is a family medicine doctor who has been a wealth of information both in clinic and treating adult medicine patients. Russ Ebersole is a pediatrician who does an incredible job of what basically amounts to running a partial peds ICU with limited resources and monitoring, yet he saves innumerable lives. He taught me much of what I know about malaria. Todd DeKryger is a surgical PA, and he was one of the main people working on my surgical skills to train me to perform C-sections. Mary Jo is our midwife, and she has walked me through deliveries. And our short term surgeons have taught me about post-op care and allowed me to assist in the OR. All of these people have served to sharpen my skills, and I think I will only realize how much they contributed to my education once I start residency.
Some other medical highlights have included:
• getting my first intubation on a pediatric patient
• giving spinal anesthesia
• seeing a child survive a severe tetanus attack (the docs here have learned that giving antibodies into the fluid around the spinal cord and brain increases survival from 15% to 85% over conventional treatment, and while a few people had recommended this before, only in the last year is it becoming recommended practice by the experts)
• getting to practice medicine alongside Lisa...and getting to hand off the first baby I delivered by C-section to her (by the way, getting the baby after a C-section is Lisa's favorite thing to do medically)
• seeing a patient with a snake bite
• pulling out a twin during a C-section
In addition to the medical aspect, it has been a blessing to also be free to address patient's spiritual needs. And God in His grace is doing a mighty work in Togo. I have seen many people pray to accept Christ in the hospital and clinic, and it is exciting to know that our love and service is playing a role in bringing these people to salvation. It is probably true that some commitments are not genuine...after all Christ tells us in the parable of the sower that many who accept the gospel initially will fall away. But He also promises that many will go onto bear fruit, so we can trust that if the true gospel is given many confessions of faith will bear great fruit. I have already seen a picture of that as many of the Togolese serving in the hospital became believers through its ministry. One chaplain shared how his mother came to the hospital, was saved, and later led him to Christ. Now he serves sharing Christ's gospel and taking part in the work of salvation God is accomplishing at HBB. One of the PA's who is also a pastor was saved after working on the construction of the hospital 25 years ago. I had the privilege of seeing a women in clinic whose chart went back to the first year in the hospital, and she shared how during her first hospitalization she accepted Christ. A quarter century later she is faithfully serving Him. To take part in caring for these patient's as full humans – body and spirit – has been the greatest blessing of this trip. Sharing the gospel or watching others share the gospel and see patients respond to Christ's mercy is and incredible thrill. Jesus told us the angels rejoice over one who is saved, so I am certain there is a large party that keeps going on for the people of Togo. Praise God that He is making Himself known and that He lets us be a part of His work.
Hospital rounds start at 7:30-8 each morning, during which time we discuss patients who have been admitted to the hospital and decide upon their course of care. Sometimes decisions are fairly straightforward, and at other times the cases are bizarre, such as a snakebite or tetanus. I find it funny, though, as to what may be considered straightforward – for example, I've seen so much pediatric malaria, that I can basically recite the care to be given in a variety of clinical situations, as well as how to deal with various complications. Something that is a novelty in the states has now become very routine, and I'll probably have more experience treating it than all of my attendings in residency (so if a case ever comes in, I'll have a chance to look like an all star). Another few crazy facts on malaria in Togo – it's so common that you have to consider it for anyone with a fever, and will often treat without running tests. Also, it can cause such severe anemia, that single digit hematocrits are common upon admission. My personal record is 8, though patients with hematocrits as low as 4.5 have survived. (For the non-medical people, this is a measure of how anemic a person is...doctors usually transfuse a patient when their hemoglobin is less than 7, which is the equivalent of a hematocrit of 21.)
Being a family medicine (almost) doctor, I've tried to spend time helping with all types of patients – OB, medicine, pediatrics, and surgical. OB cases are some of my favorite. It's been exciting to deliver babies here in Togo. I've also gotten to get a significant amount of C-section experience. A lot of this consists of assisting the surgeons here, but I've gotten to deliver several of the babies in the OR after we have opened the uterus. Additionally, there have been 3 C-sections where I have done a majority of the operation, which has been one of the medical highlights of the trip. Many family medicine residents have never done a C-section, and I've already gotten to do 3!
After rounds, I usually go up to the clinic to see patients. It's been a new experience to have to interview patients through a translator. It works for the most part, though there are many times where I've felt I'm not getting the full picture. Sometimes this is frustrating, because knowing the language really would allow me to provide better care at times. Still, we manage to consistently help people, and it's been fun to have more responsibility in treating patients.
I'll also take call every 3-4 nights, which consists of taking phone calls when there are questions about patients and going down to the hospital when someone needs to be admitted. Fortunately, most people don't come in late at night so I would usually get at least 6 hours of sleep. The responsibility of admitting patients and having to make more decisions has been invaluable, and I feel much better prepared for residency after my 6 weeks here. I don't want it to sound like my responsibilities have meant I have little oversight. I have worked with some great doctors who have watched me make decisions and taught me a wealth of knowledge. Michael Gayle is a family medicine doctor who has been a wealth of information both in clinic and treating adult medicine patients. Russ Ebersole is a pediatrician who does an incredible job of what basically amounts to running a partial peds ICU with limited resources and monitoring, yet he saves innumerable lives. He taught me much of what I know about malaria. Todd DeKryger is a surgical PA, and he was one of the main people working on my surgical skills to train me to perform C-sections. Mary Jo is our midwife, and she has walked me through deliveries. And our short term surgeons have taught me about post-op care and allowed me to assist in the OR. All of these people have served to sharpen my skills, and I think I will only realize how much they contributed to my education once I start residency.
Some other medical highlights have included:
• getting my first intubation on a pediatric patient
• giving spinal anesthesia
• seeing a child survive a severe tetanus attack (the docs here have learned that giving antibodies into the fluid around the spinal cord and brain increases survival from 15% to 85% over conventional treatment, and while a few people had recommended this before, only in the last year is it becoming recommended practice by the experts)
• getting to practice medicine alongside Lisa...and getting to hand off the first baby I delivered by C-section to her (by the way, getting the baby after a C-section is Lisa's favorite thing to do medically)
• seeing a patient with a snake bite
• pulling out a twin during a C-section
In addition to the medical aspect, it has been a blessing to also be free to address patient's spiritual needs. And God in His grace is doing a mighty work in Togo. I have seen many people pray to accept Christ in the hospital and clinic, and it is exciting to know that our love and service is playing a role in bringing these people to salvation. It is probably true that some commitments are not genuine...after all Christ tells us in the parable of the sower that many who accept the gospel initially will fall away. But He also promises that many will go onto bear fruit, so we can trust that if the true gospel is given many confessions of faith will bear great fruit. I have already seen a picture of that as many of the Togolese serving in the hospital became believers through its ministry. One chaplain shared how his mother came to the hospital, was saved, and later led him to Christ. Now he serves sharing Christ's gospel and taking part in the work of salvation God is accomplishing at HBB. One of the PA's who is also a pastor was saved after working on the construction of the hospital 25 years ago. I had the privilege of seeing a women in clinic whose chart went back to the first year in the hospital, and she shared how during her first hospitalization she accepted Christ. A quarter century later she is faithfully serving Him. To take part in caring for these patient's as full humans – body and spirit – has been the greatest blessing of this trip. Sharing the gospel or watching others share the gospel and see patients respond to Christ's mercy is and incredible thrill. Jesus told us the angels rejoice over one who is saved, so I am certain there is a large party that keeps going on for the people of Togo. Praise God that He is making Himself known and that He lets us be a part of His work.
Tuesday, May 18, 2010
Things I miss, things I don't!
What I miss about America:
•Wal-mart
•Ice-cream!! (especially mint chocolate chip)
•Going to church and worshiping in a language I can understand
•The bathrooms (enough said)
•Taking care of my own house – yes, even cooking and cleaning!
•Driving down the road without feeling bruised from all the bumps
•The food, and how easy it is to get it
•My cell phone... oh yes, and the people I talk to on it! (so I guess really what I miss is talking to my far away friends and family)
•Getting together with friends... no translators necessary
•Wearing shorts!!!
•Being able to invite people over to my house
•Um, did I mention ice cream?
What I don't miss about America:
•Work (ok, maybe I do miss it a little bit...)
•Doing my own laundry
•Rude, unfriendly people
•Being so busy it's hard to fit in the really important stuff, like people
•The news – I haven't seen a headline since I've been here
•Traffic and commuting (a 3 minute walk to the hospital is nice)
•The obsession with stuff and entertainment
What I will miss about Africa:
•The huge smiles on people's faces just from saying hello
•The bright colors people wear
•The little babies tied to their mother's backs
•Being awestruck every time I see the enormous loads women carry on their heads, and feeling small that I couldn't even carry that much in my arms
•Afternoon siestas! Seriously, how can they manage a 2 hr afternoon break in the hospital here and some days at work I can't even manage a 5 minute one?
•The beautiful harmony and rhythms in church
•The fruit! Pineapples, mangos, bananas...
•The sweet, friendly people
•Being with my best friend (Stephen, in case you couldn't figure it out) all day long
What I won't miss about Africa:
•The potholes big enough to lose half your car in (I finally found a place with worse roads than Baltimore city)
•Sweating
•The smell of sweating
•Bugs – little ones, big ones, slimy ones, crawling ones, flying ones...
•Bargaining for everything I buy (Stephen would put this in the “what I'll miss” category, but not me!)
•Never being able to just blend in and be normal
•Feeling filthy rich
•My new best friend, Cipro (only fellow medical people or fellow travelers will understand this one, but I don't think I want to elaborate...)
•Malaria pills
•Wal-mart
•Ice-cream!! (especially mint chocolate chip)
•Going to church and worshiping in a language I can understand
•The bathrooms (enough said)
•Taking care of my own house – yes, even cooking and cleaning!
•Driving down the road without feeling bruised from all the bumps
•The food, and how easy it is to get it
•My cell phone... oh yes, and the people I talk to on it! (so I guess really what I miss is talking to my far away friends and family)
•Getting together with friends... no translators necessary
•Wearing shorts!!!
•Being able to invite people over to my house
•Um, did I mention ice cream?
What I don't miss about America:
•Work (ok, maybe I do miss it a little bit...)
•Doing my own laundry
•Rude, unfriendly people
•Being so busy it's hard to fit in the really important stuff, like people
•The news – I haven't seen a headline since I've been here
•Traffic and commuting (a 3 minute walk to the hospital is nice)
•The obsession with stuff and entertainment
What I will miss about Africa:
•The huge smiles on people's faces just from saying hello
•The bright colors people wear
•The little babies tied to their mother's backs
•Being awestruck every time I see the enormous loads women carry on their heads, and feeling small that I couldn't even carry that much in my arms
•Afternoon siestas! Seriously, how can they manage a 2 hr afternoon break in the hospital here and some days at work I can't even manage a 5 minute one?
•The beautiful harmony and rhythms in church
•The fruit! Pineapples, mangos, bananas...
•The sweet, friendly people
•Being with my best friend (Stephen, in case you couldn't figure it out) all day long
What I won't miss about Africa:
•The potholes big enough to lose half your car in (I finally found a place with worse roads than Baltimore city)
•Sweating
•The smell of sweating
•Bugs – little ones, big ones, slimy ones, crawling ones, flying ones...
•Bargaining for everything I buy (Stephen would put this in the “what I'll miss” category, but not me!)
•Never being able to just blend in and be normal
•Feeling filthy rich
•My new best friend, Cipro (only fellow medical people or fellow travelers will understand this one, but I don't think I want to elaborate...)
•Malaria pills
Saturday, May 15, 2010
You know you're in Africa/Togo when...
* There are more military personnel at the TV station than the border (because coups are the greater threat)
* You're excited to have a lizard roaming your walls because the bugs are worse than the reptiles
* A good machete is half the price of a small jar of peanut butter
* Kids love talking with you because you're a stranger
* A good road equals only a couple potholes every ¼ mile
* The woman carry more weight on their head than you could in your arms
* Your attempts at kicking a soccer ball are great entertainment to the local children
* 85 degrees with 85 percent humidity is one of your more comfortable days
* You're happy the electricity was out ½ an hour (instead of ½ a day)
* Your church service has more rhythm and harmony than most of your CDs
* Someone you'd consider anemic in the US is a candidate to donate blood
* Modesty (for women) means not showing any of your thighs, but clothing above the waist is optional
* You know people who never graduated high school, but speak 4 languages.
* Cats are a delicacy (no, I did not eat one)
* You are bored with diagnosing malaria, but your professors back in the states are stoked to make the diagnosis
* You've seen twins delivered by C-section without an MD in the operating room
* A shopkeeper insists he's not ripping you off because his sandals are made with “Italian plastic”
* A nine passenger van carrying 12 people is considered below capacity
* People run alongside a semi-truck going up a hill with cement blocks so they can stop the truck if it starts rolling backwards
* A simple greeting brings out a huge smile
* Your pictures of medical conditions are better than the textbooks
* You can buy Barack Obama boxers in the market (a few booths over from the fish)
* A shopkeeper knocks 20% off his “very-final price” (as opposed to his first “final price”)
* Dancing and drums are normal in a Baptist church
* You've been far more blessed than you have served, and “sacrificing” time and comforts to come is a great misnomer, because your joy is far greater than anything given up
* You're excited to have a lizard roaming your walls because the bugs are worse than the reptiles
* A good machete is half the price of a small jar of peanut butter
* Kids love talking with you because you're a stranger
* A good road equals only a couple potholes every ¼ mile
* The woman carry more weight on their head than you could in your arms
* Your attempts at kicking a soccer ball are great entertainment to the local children
* 85 degrees with 85 percent humidity is one of your more comfortable days
* You're happy the electricity was out ½ an hour (instead of ½ a day)
* Your church service has more rhythm and harmony than most of your CDs
* Someone you'd consider anemic in the US is a candidate to donate blood
* Modesty (for women) means not showing any of your thighs, but clothing above the waist is optional
* You know people who never graduated high school, but speak 4 languages.
* Cats are a delicacy (no, I did not eat one)
* You are bored with diagnosing malaria, but your professors back in the states are stoked to make the diagnosis
* You've seen twins delivered by C-section without an MD in the operating room
* A shopkeeper insists he's not ripping you off because his sandals are made with “Italian plastic”
* A nine passenger van carrying 12 people is considered below capacity
* People run alongside a semi-truck going up a hill with cement blocks so they can stop the truck if it starts rolling backwards
* A simple greeting brings out a huge smile
* Your pictures of medical conditions are better than the textbooks
* You can buy Barack Obama boxers in the market (a few booths over from the fish)
* A shopkeeper knocks 20% off his “very-final price” (as opposed to his first “final price”)
* Dancing and drums are normal in a Baptist church
* You've been far more blessed than you have served, and “sacrificing” time and comforts to come is a great misnomer, because your joy is far greater than anything given up
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