Nearing the End.

I am currently in the last section that I will be a part of here at Bara: the medical/surgical section which includes trauma, burns, amputations, and any medical problems not falling into another section (mostly HIV or TB related problems). I am really enjoying it as most of this I have not seen in previous clinicals so I am really learning a lot. This also makes me feel much less confident in my skills/treatments than I did in my last neuro section. I really felt like I mostly knew what I was doing in neuro (most likely due to my previous clinical) and could really work along side these people. Now I totally feel like a student again, rethinking my decisions and taking my time considering what to do next. Let me tell you this is a hard transition! I really miss neuro, but I am trying to look to the fact that I am gaining so much invaluable experience here and increased time taking is not so bad. I have already learned so much here and will still be sad to go (although maybe a little less sad to leave this section than I was to leave neuro).

Speaking of learning things, I got to view a skin graft surgery on Tuesday. It was so cool to see how it is done, when they choose to do it, and reasons for graft failure (common problem). It was also kind of gruesome! But it turns out that if you dissociate the process from happening to an actual person and focus on the awesome science it's  really great to see. (I would like to report that I was a trooper and did not faint, puke, or have to sit down during the surgery even though the OR was small and about 90 degrees F). Skip to the next paragraph if you don't want details: I don't really know how I thought they harvested the skin, but I was not expecting an electric shaver type thing. All I could think of was how much that would have to hurt! Good thing the patient was put under. I had to help turn the patient once she was out and then they harvested skin from the side of her thigh. Crazy how thin skin is. I could see through the pieces they harvested. Harvested skin got put onto hard plastic boards according to how finely you wanted to mesh the skin which then went through a compressing type of machine that reminded me of the thing you squish the noodles through when you make homemade noodles. Then meshed skin was stapled onto her chest which was the most granulous part of the burn that was not healing well. Crazy, but so interesting.

After all that excitement, Emily and I were waiting for the bus and talking about our day when a guys sits down next to us on the bench. We didn't think much of it and continued talking. After a while, he grabbed Emily's arm. He looked like he was in pain or something was wrong, but he wouldn't answer any of our questions and his eyes were closed. After several minutes of trying to get any information out of him, we looked at his outpatient file he had with him. At this point his eyes were slightly open and we could see that his eyes were fluttering, so we decided that he definitely needed medical attention. While trying to convince this eyes closed man who may or may not understand English to go down to trauma, he started trying to lay down. We were like no standing is the way to get to trauma. He than began to have full on a tonic-clonic seizure. So Emily held his arms down and kept him from falling off of the bench and I held his head so he didn't give himself a concussion and kept it rotated so that he didn't choke/aspirate on the copious amounts of saliva that was pouring out of his mouth. He only seized for about a minute, but in that time a hospital employee stopped by and asked if we needed a stretcher after several people just passed us by. Several minutes later she returned with the stretcher. At that point, this gentlemen was less confused, his eyes were open, he was speaking (not in a language we understood), and his distressed breathing had returned to normal. We loaded him onto the stretcher, gave our report to the trauma nurse, and caught our bus home. At least this wasn't another boring wait for the bus!

Needless to say, Tuesday was a very eventful day! Wednesday we again helped our friend Nici with the mobile soup kitchen. It always amazes me at how open and talkative the people are who come to the kitchen. Also a fun/interesting time! We are now down to 5 days of clinical left, and if they continue to be this eventful I am really going to need that week in Cape Town!