Nov 17, 2009

Bronchitis, conjunctivitis, sinusitis, appendicitis…any other ‘itis’s?

I’ve been excited about helping at the clinic for a year now, ever since helping Danny and Nancy Smelser with a few mobile clinics they did in the bush, and now I’m very happy to be able to work at the newly built Tanzania Christian Clinic once or twice a week.

The days are fairly similar…the patients come in, get their histories and vital signs taken by Mrs. Stephanie Stafford, then are seen by Mr. Danny (ER doctor).  Then they’re sent to wait for whatever medicine that’s been prescribed, and Mrs. Nancy (aka, “Queen of the Pharmacy”) gives them their medicine, and instructs them how to take it.  My job usually consists of counting and bagging pills, or doing whatever happens to need doing at that moment.  It’s always interesting to hear Danny, Nancy and Stephanie talk back and forth about different maladies, using technical terms and hoopla; most of which goes straight over my head!  To give you one example, Nancy comes up giving me all the details about that “poor little boy that had Cardioshajfjjfdkdaskdjflslitis.”  Now, my poor little brain is busy trying to sort this out. “Cardio…oh, heart!…um…itis…” when Nancy (undoubtedly seeing my blank face and glassy eyes) kindly explains it to me in normal person language.  “You see, a healthy person’s heart will pump like ‘lub-lub…lub-lub…’, but a person’s heart with that disease will pump like ‘lubLUB-lubLUB’”.

This particular Monday, I sit nearby Stephanie to learn how to do her job of taking histories and vital signs.  I scribble down the questions she asks the patients on a scrap of paper.  “Wow, this lady has had 18 pregnancies?!"  

After we finished with that lady, Nancy calls me and asks me to transfer diagnoses into their log book.  Since I hadn’t been to the clinic in several days, there were plenty of files built up for me to transfer.  First, I look in the patient’s chart to the “Assessment” section, and then copy the diagnosis to a column in the log book along with the patient’s name.  This sounds like an incredibly easy job, but it can take forever and be quite tedious, because I have to decipher Mr. Danny’s handwriting.  Starting with the first letter seems like a good idea, so I look at it.  I stare harder.  I bend closer.  Finally, I end up with my nose practically touching the paper and my eyes feeling like they’re spinning around in circles.  Is that a “g”, “y”, or an “f?”  Or is it a “b” or a capital “l?”  Thankfully, it’s much easier now than at first and I can recognize “Bronchitis”, “Conjunctivitis”, and “Gastro Esophageal Reflux” at barely even a glance.  

Once I’m finished with transferring the diagnoses, I start recording the medicines and strengths used, and total the cost of the medicine and lab work.  I’ve been working quite a while, and the stack of files are almost gone.  Only one left.  Horrors! It’s the one I put on the bottom of the stack for a reason.  Even with being able to read almost all the writing fairly easily now, I just can’t make this one out.  I pull myself together, and concentrate on making out the scratches of pen marks.  S…I…O…U…X.  Hooray, I’ve done it!  Wait, Sioux?!  That’s an Indian tribe, not a medicine!  I decide to wait until Nancy comes back into the pharmacy, then I ask her, not even daring to mention what I had thought it was at first.  She glances at it for a moment and says “Sioux”.  Suddenly, she looks puzzled and goes back for a second look, while I’m trying to keep my bubbles of mirth under control.  “Oooooh, it’s not Sioux, that’s Lasix…the medicine for high blood pressure…I use it myself!  And here I was thinking it was a name like those Indians!”

 After I’m finished recording all the necessary information into the log books, I go back out to see if I can help Stephanie.  She said I could take a patient’s history and vital signs to practice.  There’s a mother in the nurse’s station holding a little boy, with a man sitting beside both of them.  Stephanie was in a different room at that moment giving an injection, so we were all waiting for her.  I gave the little boy a stuffed bear, and the woman holding him told me he was her son.  “How nice, you both look alike”, I told her.  After making polite conversation about the little boy’s name, age, etc, I held out my arms and asked the boy to come.  He looked very scared, and unsure of what I would do.  But he came, and just sat in my lap, so I started playfully bopping him in the face with his bear.  He started laughing, and started to have too good a time to remember he was scared anymore.  As we played with the bear, his mother looked at her husband next to her and said, “She’s a very good mama!”  I looked up, and laughed a little.  “Do you have any children?” she asked.  “No, I don’t.”  Looking a bit shocked, she replied, “Well why not?!”  Okay, great…. ”I don’t have any husband” I said, “I’m only 16”.  “Ah, yes…not yet then” she answered back to me.  I start playing with the boy on my lap again, while the lady sat back in her chair, with an expression on her face that looked like she was trying to solve a problem.  “Here’s what you do” she suddenly said, “Go get a husband, then you’ll get the children!”  Smiling triumphantly, she repeated “Then you will get!” a few more times.  I just smiled, and agreed with her, and started taking the boy’s temperature.  After finishing that, I put the stethoscope in my ears about to take his pulse and respirations.  I put it on his chest when he started crying.  I told him not to be afraid, and gave him the stethoscope so he could see it was nothing to be scared of.  He calmed down a little bit, and I put it in his ears so he could listen to his own heart.  Unfortunately, I had to go help Nancy again in the pharmacy with more patient files, and so Stephanie had to finish.  When the mother and boy were waiting for their medicine outside the pharmacy door where I was working, she saw me and told the boy he should give me a kiss.  She blew a few kisses to me to show him how, and then when he was too shy, I just leaned in, and he gave me a little peck on the cheek!

Being able to help is a great experience, and I’m really enjoying it!!  :)

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