Designated Wrangler

We are officially beyond the halfway point! It’s hard to believe that the training is almost over and we are well on our way to celebrating a successful week! This morning Dr. Goedken was nice enough to invite me to a Medical Education Writing Workshop at the Sheraton Hotel sponsored by MEPI (Medical Education Partnership Initiative) before heading into training this morning. It actually was very useful and really broke down how to take an aim or question and translate it into a publishable work. Both Dr. Goedken and I agreed that the course would be a great addition to Socrates, our medical research weeklong course at Emory, which definitely left something to be desired. While I was thinking about future medical research and how useful this information was, the course also made me think about my own personal writing and how to move forward with it in the future. My goal has always been to write a novel and I’m hoping that my time here gives me the experience and the opportunity to pursue that! I keep telling my roommates that if surgery doesn’t work out, maybe I’ll just go with my original idea to be a writer. Sounds a lot easier these days especially as I work on my residency applications and begin to face the reality of moving on from the safety of school and into life as an intern.

            After the workshop, we were picked up by Dr. Dawit and headed to Black Lion. On the agenda this morning was a debriefing session from yesterday’s clinical experience and then more practice with cryotherapy and VIA images. Also worked in there was my lecture about infection prevention practices in the healthcare setting and in the VIA clinic. It was a pretty bland lecture, but I think it went well! I also showed a video from MAF or Medical Aid Films which showed the necessary steps for decontamination and disinfection in the VIA clinic. It was actually a really clear and useful video, even though it took a bit to load given the tricky internet situation in the hospital.

Me giving my lecture. Everyone is obviously riveted. I tried to make a joke and heard crickets. 

            Right before lunch, the chief resident Samson kindly let us know that none of the residents would be able to attend tomorrow or Friday due to having to administer medical student exams. It seems like the medical students have exams every other week and the whole hospital literally shuts down when they do. No one rounds because the medical student is the one who collects the patient history and no operations are done because all of the residents and attendings are administering exams. I understand that everyone needs to be a little more patient in teaching hospitals but the idea that the hospital slows to a halt during exams is a little odd to me. Anyway, luckily we rearranged the schedule so the residents can complete the training and attend the testing, but that little hiccup almost gave me an ulcer.

            The afternoon was again spent in the clinics having the residents practicing VIA on participating patients. We finished around noon so I took my time with lunch as I figured most of the residents would. At around 12:45 I looked around for my group and they were all gone! I was supposed to pay for the residents to take a taxi cab to St.Paul’s, but apparently they left without me. So Alisa and I made our way over. On the way, my cab driver quizzed me in my Amharic knowledge and I am now proud to say that my vocabulary has greatly expanded. I can now count to 30, ask a man or a woman their name, how they are, etc, and know various other words. Anytime we stopped talking, he would take it upon himself to ensure my understanding and randomly test me on a number or phrase. It was hysterical. I can’t say I did very well, but I tried!

            When we arrived at St. Paul’s, the residents were nowhere in sight and I began to get a little panicked. I also was unable to get in touch with Dr. Abdulfetah who was supposed to be overseeing the clinic. Finally, the residents strolled in already to go and started setting up the clinic. The patient charts started stacking up and it looked like it was going to be a very productive day! Unfortunately we were beginning to run low on consent forms, the VIA exam forms, and the surveys so I ran across the street to make copies, which worked surprisingly well, and hurried back. Initially the residents were doing so well—counseling the women, ensuring they had filled out the forms, and doing thorough exams, but about an hour into the day everything just fell apart. The charts piled way high and women were literally trying to push their way into the exam room while I pushed back to barricade the door. In their attempts to move things along quickly, the residents shuffled all of the charts and all of the paperwork I had organized by patient number. They forgot to go over the consent forms before the patient got undressed and up on the exam table and didn’t have the patient leave the room to fill out the surveys. The surveys are supposed to have the patient rating the services they received so if filled out in front of the residents, there is a huge potential for bias. Plus, the patients don’t even understand the first question because the Amharic translation is off and makes it a double negative, which not surprisingly patients find very confusing. My data may be totally bogus, but oh well!

            Finally the day wrapped up and we got ready to head home. We had to send away 4 patients and tell them to come tomorrow because we were so swamped. When all was said and done, I headed over to Desalegn hotel to meet with Dr. Goedken and make some changes to the forms we are using and our schedule. Both of us were slumped in our chairs, barely forming sentences out of pure exhaustion. She had to head to a MEPI dinner at Yod Abyssinia right after while I thankfully got to go home. At home, we started to clean the house and get organized as Karen, Chris, and I are all leaving this weekend. As much as I miss home, my family and friends, I am unbelievably sad to be leaving. This place, as loud and chaotic and often frustrating as it is, has become to feel like a second home and I will be really heartbroken to leave it. But there is hope that I will be coming back in December to see how the clinics are running and to collect more data, so maybe my Ethiopia and I will be reunited again.