1) Falling Into Place
Before we left for Africa, we had a million questions: what to expect at the hospital, what clothes and books to bring, where can we lock up our valuables, which hotels should we stay at, how to book bus tickets ahead of time, etc etc. It was hard to get straight answers to a lot of these questions, and now that we’re here, we understand why. Things just have a way of working themselves out in Africa. For example, last weekend we were planning to take the long bus ride from Mzuzu to Lilongwe, and had been told that it was not necessary to buy bus tickets ahead of time. We were skeptical considering we got stuck on the local bus that made TONS of stops at the beginning of the trip, but decided to wing it. This worked out in the best way possible: Dr. Colin, a missionary doctor based out of Lilongwe who had been working in Ekwendeni last week overheard that we were heading to Lilongwe and offered us a ride in his comfy Nissan Pathfinder… he picked us up at our guesthouse and dropped us off at Cool Runnings – and even stopped at a pharmacy on the way to pick up some antibiotics for my sinus infection! Another example: an American med student and her boyfriend recommended an Italian restaurant called Mamma Mia’s. It was off the beaten path in Lilongwe and we were having trouble finding it, but when we asked the first mzungu we saw (middle-aged guy with 2 daughters our age, not creepy, don’t worry Mom) if he knew where it was, he was heading there himself. Not only that, but when he picked up his take-out and left, he also paid for our ENTIRE DINNER without ever even mentioning it to us. The waiter just said that it had been taken care of… talk about paying it forward, Woody Hayes would be proud!
2) In A DIFFERENT Bubble, But Still In A Bubble
Med students often get stuck in their own little bubble. I don’t want to speak for everyone, but I myself am usually woefully behind on current events… for example, while studying for Step 1 I Nick and I didn’t know there was an oil spill in the Gulf of Mexico for over a week after it happened… very embarrassing. When Stevie and I came to Africa, we thought it would expand our view of the world. We would see things that shocked and surprised us, and leave as more culturally aware young adults. This expectation got completely turned around a few days ago when a man from South Africa who we met walking down the street to Mamma Mia’s was the first person to tell us that there had been a high school shooting in Ohio. We were surprised and sad to hear it, but he didn’t know many details and thought that it had been in the same city as Ohio State. When I found out in an email from my friend Emmy a few hours later that the shooting had taken place at Chardon High School – ten minutes from my own high school, the place where I substitute taught in my year off after undergrad, and the place where one of my favorite middle school teachers is now the principal – it felt like being punched in the stomach. To be so far removed from our home lives that we would not even know about such a tragedy was really scary. We’re so happy to be here, but the world is a big place and you can’t really be fully present both at home and here simultaneously.
3) Getting Too Comfortable?
Our first day in Malawi, I tried to buy a postcard at the market and was swarmed by about 10 men trying to shove their postcards in my face….it was terrifying, and I pretty much ran away empty-handed. This week, I returned to the same market to buy postcards as a seasoned haggling veteran, and when they swarmed me I firmly told them to wait their turn and then let them line up and hand them to me one by one…. didn’t phase me a bit. Similarly, a couple weeks ago we were appalled to be sharing a taxi to Nkhata Bay with a live chicken. This weekend, Stevie and I shared a rainy ride in the back of a short-bed pickup truck with 11 other passengers, all of our luggage, 2 bicycles, and several baskets full of bananas… and laughed about it. It’s strange how quickly people can adapt to their surroundings, but it’s also frightening when the same principle applies to sick patients. When we saw our first child who was very sick with cerebral malaria – seizing and with labored breathing - we were thinking of him all day, wondering if he was OK and thinking of the medical interventions that could be made in the United States. However, it became a pattern to us that all of the cerebral malaria patients recovered, and we got used to seeing it that way. When we came back from lunch last week and learned that one of these children had died while we were gone, it was somehow shocking – this wasn’t what we’ve been seeing, and we had already forgotten how scared we were with that first patient. Although we have adapted in small ways to life in Africa, Dr. Colin told us something that rings true… the poverty and sickness that exists here should ALWAYS shock and upset us, no matter how much of it we have seen.
4) Delivering Bad News
An interesting discussion came up last week at the hospital, when one of the Malawian nurses approached one of the missionary physicians regarding a patient who was terminally ill. The patient’s family had been told that his condition was incurable, and that although the doctors would do everything they could to keep him comfortable, he would not get better. According to the nurse, this had upset the patient’s family tremendously, and she said that in Malawi culture it would be enough to tell the family that “the patient is very sick.” The nurse’s perspective is that the family understands when a doctor uses the term “very sick” that the patient is ultimately dying, but it is up to God whether the patient recovers or not. The physician’s perspective (like ours in America) is that telling a terminally ill patient’s family that he is “very sick” is not enough – lots of people who are “very sick” get better, but terminally ill patients do not and withholding that information is hiding the truth. We found the discussion remarkable, and can see how it can be very difficult for physicians who have been trained a certain way to work in such a different environment. Ultimately, we think that the physician handled the situation flawlessly – holding strong to a personal code of ethics while still being receptive to the nuances of the Malawian culture.
5) Quality Over Quantity
In previous posts, I’ve touched on how “connected” the town of Ekwendeni is – seeing the same people in church, on the street, at work, etc. This same feeling of personal connection is especially true regarding the relationships Stevie and I have made with our attending physicians at Ekwendeni Hospital. In three weeks, we have come to know these women on a deeper level than almost all of the physicians we have met in our four years of medical school. We have been invited into their homes for dinner, played with their children, gone on weekend excursions, discussed our spiritual beliefs at Bible Study, and learned about the life experiences that have shaped them and brought them to Malawi. We have been blown away by the warm reception we received in the hospital, and have felt that we were truly allowed to carry a little of the workload. It is remarkable how much a work experience can be enriched by learning about the lives of your colleagues, and we’re just grateful that we were able to make such deep connections in such a short time.
No comments:
Post a Comment