Lepto can wait

Dr. Bill likes to give me various topics to investigate on my own that relates to illnesses we see at the hospital. This happens in the States all the time but it's usually, "Does an ultrasound to rule out DVT help decide whether to not to use medicine for a clot." Here, it's more like, "Find out what the heck Leptospirosis is." But today (/yesterday) was Anna's birthday so, as Uncle Bill said, "Lepto can wait."

What a great turnout at her birthday party. Everyone here has welcomed us with open arms, which is an absolute joy when you are thousands of miles from home and your little one has a birthday. We enjoyed "hobo dinners" around the fire before heading to Uncle Bill and Aunt Marsha's for cake, games and presents. Anna's new best friends the Goossens kids were there, as well as at least a dozen other people who celebrated with her. We're grateful that Anna has so quickly got an extended family to make the day memorable.

Anna, Lexi and Mama around the campfire (it was a little rainy)

I'm sure Esther will put up a list of her presents. She got her own bilam and a highland traditional hat ... though she doesn't look all that Papua New Guinean to me yet.

Anna's highland hat

Some interesting work in the hospital yesterday as well. One patient, Paul, has been sick for a couple weeks now. It seems like he has an infection and he hasn't been able to communicate or walk and is totally disoriented. We are not sure what illness is causing it and I can only imagine how challenging it is for his family right now. Dr. Bill and I did a spinal tap in an effort to find some culprit but as of now we are at a loss.

Trying to find a reason for a patient's illness on the ward

I've also been really happy with the progress of one of our patients who has pericardial TB (TB fluid around the heart). She is improving with medical treatment and probably won't need surgery - which would be very involved and dangerous. She has been a joy on the wards and has a smile every time we see her. I'm amazed because I had a very similar patient (an immigrant from Africa) during my Intern year at Hillcrest. That patient was in a negative pressure cardiovascular intensive care unit and had serial echocardiograms, a pericardial window guided by Xray, a cardiologist, cardiovascular surgeon, intensive care physician, infectious disease specialist and a family practice resident taking care of him. This patient has prednisone, lasix, anti-TB drugs and a family practice resident taking care of her. And she may be close to going home. I don't wonder any longer why our care in the US is so expensive. Obviously, we would love to have those things for this patient - but she is healing well, I think, because of a very positive attitude.

Me, Nursing students and my smiley TB patient

Next week I switch to Pediatrics and will start to work a little more in the OB department when I'm not in the ER. I'm really looking forward to working in OB and getting some additional C-section exposure. It is a little intimidating with the different techniques used here and, like most things in PNG, I'm sure it will be a quick learning curve.