Produce

Dr Bill pulls in the day's haul of bananas

Apparently Monday is the day of plenty in Papua New Guinea. Today we were given: berries, lemons, bananas, pineapple and got a chance to buy asparagus (a treat around here). Our kitchen looked like a grocery store. We are definitely eating more and more fresh fruit, and some vegetables. Sometimes I find myself craving a bag of potato chips, though.

I found the hospital a little less daunting today. Some nursing students came on hospital rounds in the morning. A large number of them gravitated toward Becky, but two came with me. Apparently we are expected to teach them, which is fine with me, though I have no idea how to do that cross-culturally and cross-language. Rounds were much faster, though, and I got to the outpatient department by 10.

3 or 4 of my patients spoke English remarkably well. They complained of symptoms a little more along my usual clinic patients also. Stress, back pain (x2), arm pain from an old fracture. I think it helped me to feel less daunted by the OPD.

In the ER, I admitted 2 infants with pneumonia. Sick children are becoming the most intimidating thing to me here. I handle the trauma, broken bones, cuts / stab wounds alright because I need no interpreter for those, in general. I find it very difficult to tease out a diagnosis in a child when I can't speak the language. It doesn't help that Papua New Guineans are ridiculously poor historians when it comes to illness. "I think she was in the hospital last year. I can't remember why. No, maybe that was last month. Was that my other child?" (Sigh)

I did treat an elderly man with cough for 4 years and weight loss. In this place, I now know, that represents TB unless you have a great reason for something else. He looked somewhat frail and came to the ER with his nephew. The nephew was adamant that it couldn't be TB, "It's probably just his winbox (lungs)." I remember seeing a very strong sense of denial towards diseases like HIV and TB in Africa, and I wonder if the same is true here.

Last night Esther and I spent time contemplating our plans after residency. There are several options that we've been looking at, and we wanted to see this place before we started to make that decision. Working at Kudjip is exactly the kind of medicine I went into my training thinking I would do. I spend 95% of my time taking care of patients here. I spend 0% of my time worrying about billing or malpractice. I see broad pathology and have the responsibility of treating it all. Yet the past 2 years at IMAGE exposed me to several other templates for medical missions, and I enjoy all of them. Village clinics and community health, public health, disaster relief medicine, medical education. All of them represent serious needs and have big answers for some of the neediest places in the world. Figuring out where I fit in that puzzle will likely take longer than a week working in a rural mission hospital. But I wouldn't trade our experience here thus far for anything else. I hope and pray that God will use the rest of our time to crystallize some of our goals, our heart and our path down the road.