Remember your first day of school? Upon my last week here, sitting here recalling my first week on this assignment

I was excited and anxious. Excited about diving in, doing some clinical work, about doing what I have come here to do. Also a bit worried…what if I am double-crossed by all these cases I have never seen before…the cases that have been eradicated from our memory in the western world, so much so that after medical school we tend to forget about them. I am talking about the –asis and –osis diseases…leishmaniasis, donovanosis, shigellosis, amoebiasis, borreliosis.

The first 10 minutes I see a woman stabbed in the chest by  her lover causing a collapsed lung, a severe pre-eclamptic woman (a condition in pregnant women that, unless treated, can lead to seizures and death), and an overdose in a woman beaten by her husband. That was the first 10 minutes. For the medical people reading this…3 cases of cerebral malaria, 2 cases of meningitis, 1 Ludwigs angina, a woman in shock slouched in a chair, a status asthmaticus sitting in a chair, a severe head injury where there is no neurosurgical backup, a splenic rupture in a man beaten by the police, resistant TB, typhoid fever, a sucking chest wound in a 5 year old. All those on top of the usual gamut of broken bones, lacerations, vaginal bleeding, pneumonias etc…without the usual comforts like an ophthalmoscope, otoscope, ECG machine, blood-work, a glucometer…gauze!

Add an emergency department that I do not know, that has no formal triage system, staff that don’t know me, a hospital system that I cannot figure out, nurses that have to clone themselves to get anything done, a language that I do not speak and….oy!!!!!! 

That was one day. 

At the end of the day, I am not the child who cannot keep his eyes open because he is using all his energy to breath. I am not the woman whose leg was sliced open and dislocated by her husband, who could not get to see a health professional due to the remote area she lives in, and who will walk with crutches for the rest of her life. I am not one of the medical officers that struggle to learn medical skills while staying afloat in the tsunami of under-resourced shifts. 

At the end of the day, I get to leave back home to the comfort of my life. I could've left at any point of time if I wanted to.

At the end of the day, all I can do is fight back the sheer sadness and insanity of it all and ask the universe for the resolve to do what I have come here to do. 

All those back in the western hemiphere, miss you. Internet and time have been a blessing…I do get to read your comments…they make me smile.