Friendly Face

A visiting surgeon from Ottawa was at the hospital today teaching some of the local surgeons some laproscopic techniques.  We were able to watch and despite the fact that there were over 12 people in the small OR room, he took time to teach us a few things too.  He was really nice and I think he liked us too as we shared a few stories (coincidently he had also studied in Australia for a few months during an elective).  

We were off quite early again (3ish) and decided to drive to a local beach which had the reputation of having a few good surfable waves.  Sure enough, we got a good hour of surfing in, it was no Australia but for sufficed nonetheless for us amateurs.   We definitely plan on returning sometime soon.

We also organized a scuba diving trip for the weekend, should be fun.  Rumour has it there are a few tourists also signed up for the trip, which I'm actually looking forward to because the island has been pretty dead in regards to visitors.

It is Stef's birthday tomorrow, I think I just wrote that mainly as a reminder to myself, she'd kill us if we'd forget.  We might go out for a few drinks at night, the trinidadian rum is calling.  Tomorrow is the last day is OB/G and I am very pleased with the way things unfolded.  More of a conclusion in my next post.  Until later.

Two days

I missed an entry yesterday but it's not too important as nothing new really happened.  During the last two days I assisted in some more deliveries (gave shots and took blood from the cord) and saw more some c-sections.  I did get to witness a below the knee amputation which was quite exciting but seemed so strangely simple; it reminded me of deer hunting when we had the cut the legs off the deer.  Of course there's a lot more too it, just seemed rather "savage" as Dean so eloquently put it.  We were all four done at about 4ish on both days so we seized the opportunity to go to the nearby beach for a swim.  We met some pretty cool Norwegian guys and we will probably meet up with them sometime on the weekend.  Besides that, did a little bit of reading, watched a movie and went to bed nice and early.

Oh yeah, I almost forgot, this morning was a little awkward as there was a little bit of a power struggle in our unit between the consultant, the registrar and the junior medical officers.  There were a few surprising comments made and it was got a little feisty.  Afterwards, both parties of the battle vented to Lucas and I, but we simply said we didn't want to get involved.  I'm starting to realize that medicine also involves a lot of politics.  

I'm off to watch a movie/doing some reading.  Until later.

Hands On Monday

Before I start talking about the intense day that it was, I have to add that on Sat on our boating trip I swam with two sting rays.  We saw one while snorkeling about 10 feet down while this other huge one (significantly bigger than my wing span), swan amongst us for about 10 mins.  His name was Trent and he normally comes around this bay because he gets fed by the guides.  Pretty cool stuff.

Anyway on to today... To make a few long stories short I took blood from two people, gave three shots including 50 mg I/M of pethidine (strong morphine like opioid, and assisted in THREE vaginal deliveries.  The last one, which happened at about 630pmish, was intense.  The baby's head came out with the umbilical cord wrapped pretty tightly around the neck.  It was just the midwife, Lucas and myself and she immediately cut the cord and rushed through the rest of the delivery.  The baby was unresponsive for about 30secs and the nurse had pushed the emergency response button while we tried to stimulate the baby (I was suctioning the fluid from the airway).  Eventually, thankfully, to our great relief, we heard a little whimper and then a cry.  The nurse was saying "Thank you Jesus" and we all breathed a huge sigh of relief.   Pretty intense to say the least, but it was a pretty incredible feeling because Lucas and I actually felt like we helped out.  It's a lot different than just standing around observing.

On a lighter note, here's a little story to illustrate the sometimes old fashioned  way of thinking at the hospital.  One of the docs was taking blood and Lucas handed her a tourniquet.  Slightly bewildered, she took it and tried to attach it around the patient's arm, but  to no avail.  She looked over to the other doc who simply said, "I don't even know how these work, just tie it in a knot".  Sure enough, she ended up tying a perfectly good tourniquet around the patient's arm using a simple knot.  Later, without being patronising/condescending, we showed them the simple click and pull.  I don't know if anyone else will find this funny but it's the equivalent of tying your fully functioning seat belt into a knot instead of clipping it in.

Well that's it for me, another tiring day means I need another good sleep tonight.  Until later.

Great Weekend

I don't really remember what I included in my last entry, but I think it was on Friday before we went to the resort for a few drinks.  It nice a relaxing Friday night as the entire resort bar was empty except for one young couple and two elderly couples (the newly weds and nearly deads syndrome).  Yummy Tobagan rum and cokes.  Since it's the rainy season (hardly actually raining, maybe once a day for 5 mins) and considering the world's economic situation, there's a lull in the tourism.  I quite like it though, I truly dislike areas swarmed by tourists.  Despite only having few drinks, we ended up leaving the car at the resort and cabbing home, I know you'd be proud about that mom. As the cabbie dropped us off, I asked him if he had a number we could ever reach him, and he handed me his business card, which hilariously was for his plumbing service.  Making a buck anyway he can I guess.  We then got up at about 830ish Saturday morning and jogged to the resort to retrieve the car and be back at about 10ish to be picked up for our boating trip.  The trip was great, all you can drink beer and rum punch, snorkeling, fishing, beach bbq, beach soccer against the locals and great weather, nevermind singing a few Bob Marley songs with our guides.  All four of us got quite burnt but it was well worth the $80 for the day.  Since we had such a great day, one of the guides offered to drive us around for the night and show us some of the Tobagian night life.  Lucas wasn't feeling that well (sunstroke) so only the three of us went. Dean and I were the only white guys in the club but it was still pretty fun.  I bet mom is freaking out about going out but we had a little escort and the the atmosphere was really SAFE, I promise.  We all slept in this morning and went to the newly opened movie theatre for a matinee.  We needed to do something indoors to let our skin recover.  Now I'm back at home, going to watch some football, do some reading for tomorrow and probably go to bed nice and early.  The objective of the week is to get better at taking blood, assist is more surgeries and deliver me a baby.  Until later.

FRIDAY

I apologize to anyone for the last post if it seemed a bit graphic, maybe I should include a disclaimer.  Today was a great day!  Along with the usual rounds/interesting patients I had the opportunity to scrub in and assist in two cesarian-sections.  It was amazing, I was swabbing, holding sutures, holding instruments, pushing out the baby.  It may not seem like much, but it was just the surgeon and I working on the patient (except for the anaesthetist).  I'll say it again, it was amazing, I formally scrubbed in, got all suited up, and asked for instruments and was the right hand (okay maybe more left hand) man to the surgeon.  Like the last couple days, no lunch and stayed until 6pm but it was totally worth it.  It is now 840pm and we are heading out to a nearby resort to hit up the bar for a few relaxing drinks.  Then tomorrow we are being picked up at 10am for a fishing, snorkelling, beach rum party trip.  Should be entertaining, looking forward to seeing the sun again.  I'll write again soon whenever I get the chance.  Until later.

Tired but Productive

An exhausting but again very interesting 8am-7pm day.   Rounds in the morning were followed by a three procedure experience in the OR:  another c-section, a womb cleaning after an incomplete miscarriage, and a cervical biopsy for cancer (we had the opportunity to feel the cervix was so brittle and crumbling).  It was bleeding so much which was not good because she was already severely anemic.  We then rushed to the maternity ward but were too late to witness the delivery from a woman who had been in the ward since we had been there.  It was actually quite disappointing because we had really felt like we had gotten to know her, this may be a hint for me to become a GP because of my interest in continuity of care.  Anyway, she had had an episiotomy and I was fortunate enough to assist in the suturing.   Since we missed lunch again, the surgical ward gave us a little bit of food.  Since we were still a little disappointed for missing the aforementioned delivery, Lucas and I stuck around the maternity ward for the next women to go into labour.  After about two hours, our diligence paid off and we witnessed another vaginal delivery.  The mother was HIV+, but still insisted on a vaginal delivery despite the fact that a c-section would decrease the risk of transmission.  An interesting day, tomorrow should be a little more relaxed with some rounds and one scheduled c-section.  We're thinking we'll be done by 2-3ish and then hopefully relax on the beach for the afternoon.  I'm off to bed, I'm exhausted.  Until later.

Obama Fever

All the morning's action was overshadowed by everyone's excitement over Obama's victory, it was incredible to see how such an event affected the entire world.  The doctors discussed it with patients and there were shouts of YES WE CAN.  On a comical note, some of the people kept asking us how we felt about it, like we were a little upset or something. 

On a medical note, it was another very exciting day.  Rounds gave me opportunity to see a suspected ectopic pregnancy, a distraught woman following a spontaneous miscarriage (quite sad) and an assault involving a potential miscarriage.  Things were so busy we didn't get time for lunch and went straight into taking blood from many of the woman in the ward.  My first attempt was not successful, but in my defence it was a small vein and the doctor even ended up needing three tries.  My next try was more fruitful and I filled a nice 8 mL into the syringe.   Despite the lack of supplies/pretty  relaxed standard precautions, I was being quite careful considering the high prevalence of HIV.  We then rushed to the OR (got a piece of cake on the way) to watch a caesarian section. I had seen one before in Canada but it was still an exciting and shocking procedure.  The large baby (macrosomal) came out healthy and I'm curious to find out the weight tomorrow.   Tomorrow I'm hoping to witness another vaginal delivery, Lucas and I have bugged the nurses so much that as soon as there's talk of a delivery, we're hoping our nagging voices pop into their heads.  Until later.