So.....I may be addicted to surgery

Holy crap! The first time I see a birth and it's an emergency C-section done because the mother was eclampsic! And this time in the operating theatre I actually helped, albeit just a little. I held down one of the woman's arms when she was starting to convulse and sometimes I had to hold her gas mask on, and then I helped an orderly open her legs so he could change her cathater (because the maternity nurse put a pediatric-size cathater in and the bladder was too full for the doctor to get a good grasp on the baby's head). At the time it didn't feel like anything special, except maybe when I was holding the gas mask and I could feel her short, shallow breaths, but now when I think about it I get a rush. During the surgery it seemed very surreal, as if the doctor was just performing a dissection like biology majors do in various labs, except the specimen was bleeding and warm to the touch. And Dr. Spencer was very calm about it all--it's all old hat to him I suppose. I mostly stood out of the way, but whenever I was called over to hold something I was very calm as well. It's only looking back on it that I think it's amazing. Maybe this means I have the needed distance for becoming a good doctor: empathetic but not losing myself in the problem of the patient. Anyway, it was really frickin' cool to watch Dr. Spencer pull the baby out of the womb. At first I didn't think it was alive because it was all grayish (remember, we're talking about an African baby here, not a wrinkly white one) and not moving or breathing. But a midwife and an orderly took the baby aside, used a suction machine powered by a foot pump, and sucked out the mucus in the baby's throat and mouth. Eventually it woke up and there is now a very healthy baby boy with a larger-than-average head. The mother's BP had dropped once the baby and placenta was removed but she was still twitching a bit when she was wheeled out to the maternity ward.

And earlier this week I walked with Dr. Spencer to see a patient with severe lower abdominal pain in her right side. The first (and only) thing I thought of was appendicitis, but Dr. Spencer said it could also be an ovarian cyst or ectopic pregnancy. Anyway, he did emergency surgery and it turned out to be appendicitis (Total points for me: 1). There was actually a seed, maybe baobob, that had become trapped in the appendix and caused the inflammation. It was ready to rupture by the time we did surgery, so Dr. Spencer saved the patient's life. How cool must that be?!? I used to say that I can cut up dead things but I wouldn't trust myself to cut something that's living, but now I think I could do the cutting. It's the suturing that would get to me. Definitely something needed, but the interesting part of the surgery is over by that point. Ah well. I'm just a toubab trying to play doctor with insufficient knowledge and my personal first aid kit (not the one given by Peace Corps, the one I brought with me).

One thing that struck me today though is how similar patients are when they come to the doctor, whether in the states or here. They have a pain, and they want the miracle drug that will make it go away. End of story. They don't want to have to change their lifestyle to improve their helath; they want a pill to make everything better. And the doctors eventually give way and prescribe some sort of antibiotic (today it was mostly doxycycline, which is the anti-malaria medication I had been on that gave me stomach ulcers, so at least the women are safe from malaria for a week or so), which leads to antibiotic-resistance among some of the disease-causing microorganisms, and then things get worse.

When I was in the scanning room watching ultrasounds the orderlies were talking about how some women want the ultrasound (even though it costs 100 dalasis) because they think the scanning wand will actually heal them. That kind of blind faith in medicine and the doctors and nurses who practice it can be scary sometimes. Like when people in village come to me with a health problem, and I have no idea what it is and tell them to go to the hospital, but they think if they sit and stare at me long enough I'll change my mind and give them some aspirin and everything will magicly be better. It's a sort of transfer of the old animist beliefs into medicine, but the "magic" is still there. That's why if people are given medicine to take for ten days, and after two days they don't feel any better, they stop taking the medicine and go to the local marabout for traditional healing. What to do? What to do?