Totally worth it

I'm sitting on the couch, listening to Taylor Swift with Ashish, full from a Pick N' Pay grocery dinner, super content and so happy I came.  I went to bed pretty early last night since we'd had a few later nights in a row, and after decidedly getting hooked on Downton Abbey, called it a night. Woke up, did a little ab ripper, had my sesame butter and banana on toast to tide me over until lunch, which is traditionally one pm here instead of noon, which means it's often 2pm because clinic runs long sometimes.

I worked today with Makhalamele (kh is like a hebrew ch-) and also Victor. Both are young male physicians , I think Makhalamele is Basotho and Victor is Zimbabwean. Victor actually wants to do neurosurgery and almost did the NRMP this year for medicine, but pulled out at the last minute. Prob for the better, since a neurosurgery residency is only 5 years in Zimbabwe. But the sad part is he doesn't really enjoy what he's doing here, it's just a job to him.

I had a GREAT day today at clinic. First it's always fantastically beautiful weather, blue blue skies, mountains all around and perfect weather from 55F-82F. And then the first thing we do every day is sing an amazing hymn with like 90 other people. The quality of the music produced by the staff and waiting room patients is astounding!!!! Literally every day someone randomly starts a hymn, and everybody else in the room just knows the harmony (it's definitely a 4 part harmony every day...)  to it. I finally have the swing of things in clinic, managing the EMR, the bukana and the patient interview/exam. The meds are still a bit of a challenge since we're in a different country (paracetamol for acetominophen, benadry is allergex, diphenhydramine is used as a cough suppressant? ) Both my preceptors today pretty much let me run the visits, stepping in when I needed help with Sesotho and definitely advising on the sicker children. We had one poor girl with a fecal impaction, an infant that needed Resomal (a diluted oral rehydration solution for infants) ...and everyone is malnourished. It is astounding, mostly we see children who are stunted, which means they have been malnourished long enough to be short for their age, but they are not too skinny for their height. As opposed to wasting where they are their normal height, but too skinny. I've seen 12 month olds that look 3 months, 18 months that can barely sit up, 12 year olds that look 8...Some if it is HIV, which is known to delay growth, and a lot of it is food insecurity, which is heart breaking.

But my great day...I felt pretty independent seeing patients are finally ready to see patients on my own next week, just signing them out. (The first day I was highly skeptical of being able to see patients on my own...ever) And I think I'm starting to acclimate to the Basotho culture. Now that I know I can just  grab any child I want to cuddle, and cuddle them, I have free reign every time I go out into the waiting room to pull more patients. The kids and babies that are not acutely ill, are just the cutest and most pleasant children...and very accepting of a Mahoa swinging them around.

After work, I went for a short jog up the road and pretty much went until the sidewalk ran out. The drivers here are not so reassuring, so running on the side of the road didn't seem like a good idea. It's the kind of place where you greet (Dumela-me/n'tate!) every single person you run by, and then there are cows too. It was a pretty challenging jog, I'm hoping to blame the altitude, and not my rapid deconditioning!