Chris pics!

More pics from Chris........

Pics from Africa...

Chris is having trouble posting on his blog and asked me to load these pictures. I emailed him and asked him to explain the pictures and/or update us. Stay tuned....

Work at Tenwek Hospital

I've been here for a little over a week now, but it feels like a month.. Work is fun, but extremely challenging. My schedule is as follows. Sometime b/w 7 and 745 morning report begans. The time varies based on the day. It lasts until 9am. After morning report, the interns round on all of the Medicine patients. We usually have about 35, and these patients are divided between 4 interns and a US medical student. From 9-11am I see consults and the ICU patients. I then meet the interns at 11 for chai. The hospital shuts down during chai time, and chai is brought to the doctors while on the wards. Because the ward smells like a combination of really bad BO and death, I have trouble drinking my chai. Because I don't want to offend the Kenyan's, I either show up conveniently late or flush mine down the drain while nobody is looking. Chai ends at 1130am and we start teaching rounds. We have 2 attendings on service, myself and a general medicine doctor from Michigan. I take 2 of the attendings and the medical student and we see the patients. They present while I listen, then examine and offer advice. Most of the medical issues are things I deal with at Duke, but there are times where I have to defer to the Kenyan interns on the correct form of therapy. We see tons of TB meningitis, HIV, malaria, and typhoid. The lab here is bad, so we really have to rely on taking a good history and doing a good exam. Because most of my patients speak swahili, my history suffers a little, but I can usually find an interpreter. We round until 1pm and then break for lunch. After lunch I do more consults. Most of my consults are from the pediatric or surgery department requesting I perform an ultrasound of their patients' hearts. This is fun, but also challenging. There is a ton of patients with heart failure from rheumatic heart disease, which is easy enough to diagnose, but I have trouble interpreting the ultrasounds of kids with congenital heart defects. After I finish consults, I check in on my team to see how things are going. At 6pm I leave the hospital exhausted. I am on call about every 3rd night, and call is pretty tough. The patients who get admitted to my service are very sick, and I usually spend most of the night helping the interns at the hospital. Most doctors here are not familiar with vent management, so I try my best to help out with any patient who is ventilated. The vents are much different then the ones in the US, so it is not easy to manage these patients. I try not to put someone on a vent unless I am sure it will save their life. There are ony 3 vents here, so you don't want to give the vent to someone who would not recover and then not be able to save the next person who probably would. After work I have dinner at the guesthouse where I stay. Sometimes it is leftovers, and sometimes a meal is prepared. There is also a pantry with things I can cook if I feel up to it (not yet). After dinner I try to do some reading, but usually fall asleep before I get very far. I hope things are going well in the states. I'll tell you about my free time in a future email.

kwa heri (swahili for good-bye),
Chris

Getting to Tenwek Hospital

Wow! What a trip. I left Durham at 12:30pm on 2/24 and arrived at Tenwek Hospital on 2/26 at around 2pm. I'll mention a couple of highlights. First, from Detroit to Amsterdam I indulged in a lot of movie watching. Each seat was equipped with its own monitor and I was allowed to choose my viewing preference from a large selection of new, old, classic movies. I watched the new James Bond movie (which was bad) and followed that with Twilight and Slumdog Millionaire. Twilight was a great movie, wish I'd seen it in the theater. Slumdog Millionaire I'd seen. It was just as good the second time. And yes Dave, you do look like the main character. The three hours I spent in Amsterdam was a blur with except the very end, when I was standing in line to board the plane. There was a guy about my age, with whom I struck up a conversation. Turns out he was from Kenya, and had been in the US for several years, first running track at Arkansas State, then studying biomedical engineering at Johns Hopkins. Even more interesting was that he was born and raised in Bomet, Kenya, the city that holds Tenwek Hospital, and was on his way back to see his family. I used the next 15 minutes to throw at him a rather fierce onslaught of questions. He answered graciously, and as I boarded the plane, I considered how lucky I was for having had such an encounter. What I thought was luck turned out to be devine intervention. Of all the seats on that massive Boeing Jet, his happened to be right next to mine. For 7 hrs, we talked about almost everything, and as we exited the plane into the Nairobi airport, he told me to stick close to him and he would help me get through customs quickly. Anderson is a man of his word, I bypassed the long line to get a VISA as he directed me to a hidden booth around the corner. Then Anderson and his family (2 of them being police officers) told the guard to let me through customs without a hassle, and I passed through with a hand wave. Without a doubt, God was watching over me. As I walked out of the airport, I saw a man holding a sign that said Dr. Huff. I could only assume he was waiting for me as I didn't see my dad anywhere, so I jumped in his van. After 15 minutes of several near head on collisions, we arrived at a guest house, where I stayed for the night. Above is a picture of the room. The next morning I ate an awkward breakfast where I couldn't get anyone to pass me the toast. So I drank 2 cups of coffee and went back to my room. Gerald (my driver) picked me up at 0900 and we headed on a 2.5hr drive to Tenwek Hospital. Nairobi is very busy in the daytime. There were cars and people everywhere. I swear we should have wrecked like 10 times, but Gerald was as cool as a cucumber, and just kept asking me questions about myself. These are hard to answer when you think you're going to die. We made it out of the city and then I got my first look at the terrain. I'll attch some pictures in the next couple of days. Around Nairobi it is very dry and hot. We pulled over so I could get some pictures and I saw a few spider monkeys. Kept trying to get a picture, but this is hard when they are jumping in and out of bushes. I was screaming at those monkeys like a mad man trying to get them to look at me, but I don't think they speak English. Speaking of English, it is the primary language here, so communication is not a problem. After the monkey incident we headed west towards Bomet. The scenary became much greener as we headed west. I guess it's because as you get closer to Lake Victoria there is more rain. Anyway, I made it to Tenwek hospital safe and sound at 2pm on 2/26.