Thursday, October 11, 2007

Sicko !

Wow, brilliant film this...

If you’ve not watched this movie, you must. Michael Moore is a brilliant cinematographer and he certainly didn’t let up in this ironic angle on the American health care system, with comparisons with erstwhile looked down upon states like Cuba. It’s remarkable how big business has taken hold of such an important and basic element of American life.

In one scene in the film one woman, unconscious when she is put into an ambulance, is billed for the trip because her insurer says it was not pre-authorized. Now you wonder how could she get authorization for the ambulance ride when she was out cold on the pavement? Yeah, that bad.

Towards the film's end, he discovers that Jim Keneflick, proprietor of the web's largest anti-Moore website, is going to be forced to shut down his site after his wife becomes ill and he can't afford the $12,000 needed to pay for her care. So, keen to protect Keneflick's right to free speech, or so he says, he sends the money to him. Jim is especially grateful for the anonymous contribution. It is only revealed that it was from Michael Moore, when the film is released.

The movie as described by some movie reviewers and critics..

“acidic new documentary about healthcare”

“Michael Moore's litany of horrors about the American health care system, which is run for profit,”

“It's those personal stories, of ordinary lives destroyed one form letter at a time, that make "Sicko" so powerful.”

"It's not impossible that this bitterly funny, bitterly sad call to alms could move reform back up the political agenda. For that reason alone, you owe it to yourself to see this movie."

“It’s a really brilliant movie this, and surreal”

A must watch.

tHE mEDiCinEmAn.

Tuesday, September 11, 2007

like i said, "Interns don't blog!"

September? Is that the month already? I have to say, I must have been amazingly lazy or incredibly busy these couple of months.

And which is it? Well, a bit of both actually, and so much has been happening. .

For one, I got done with maternity..
Praise God? (Did I hear an Amen?) 3 months of sleepless calls and tonnes of work. I would describe maternity, for lack of stronger adjectives, as laborious and painstaking. Not to mention the kind of pressure everyone puts on you. If anything so much as goes wrong, then you’ll have to explain why 10 minutes after being called, you were still trying to find the bearings out of your bed..

Weekends lost meaning, because more often than not, I’d be on the maternity floor, or theatre working as usual. More of my tales of terror with pregnant women later though.

I’ve now done 2 months of Internal Medicine and have one more to go. This is probably the most relaxing department ever! The calls are light, no emergency surgeries at night and I mustn’t forget the free afternoons…

Then got my internet connection (finally!) and now I’m on the information superhighway like a fish to water. So much to read and learn on the net, that even sparing a moment for my blog has been difficult. But I’m confident that this is the first of many more posts to come.

tHE mEDiCinEmAn.

Friday, June 01, 2007

So many firsts..

First, let's start off with why i've not blogged for, well... such a long time. Simple really. It's the department i moved to from Paediatrics. The good people in KNH call it Obs & Gynae, we, on the other hand, prefer to call it Maternity, Mat in short.

The first first, was me doing my first caeserian section, alone, yipee.. Oh, and that was before i delivered my first baby. hehe..

Another first, the number of hits on my blog pita'd the 1,000 mark. I was always looking forward to that.. now if only 1 of every 10 of those peeps left comments.. hmm..

Then i almost hit another first. I almost got internet in my room, save for a couple of 'gentlemen' that couldn't admit that they couldn't do the job.. story for another day by the way.

Got my first salo'... Making friends became so easy suddenly. Humans!

... i'll add a few more firsts in my next blog, for sure. Keep it locked. And also tonnes of storo's from the Realms of Thika Maternity..

Oh, and guys, props to your mothers. I swear! The kind of sh*t (literal shit and otherwise), pain etc that they went thru' to bear you, is to put it mildly, excruciating. So, big up for my mum!

& i'm back!
tHE mEDiCinEmAn.

Thursday, April 05, 2007

in the business of saving lives..

I've only got one more week to finish my internship weeks in Paediatrics, and boy i'm i glad!
The other day, i was in our acute room... (that's like the Paediatric E.R. at this here district hospital) and i was thinking..

"hmm we must have gotten really good at this."

Gotten good at this, you see, since, it had been more than a week since a child passed away! A personal record, that i felt quite proud of. So there i was, happily remembering that i had only slightly more than a week b4 i was done with screaming babies and endless ward rounds every single morning!

I don't know if i imagine the headache, lakini, i suddenly felt like a pile of bricks had dropped squarely on my head. The nurse i was working with announced that "the child there in the corner doesn't look too good", and as i glanced at the said corner, i could see the mother sobbing and this one dedicated father holding the oxygen prongs on the child's nostrils.

"Oh dear!" My worst moments in the ward usually start this way. Well, actually they start something like... "Daktari, mgonjwa hapumui!" And right there, u've to jump on your feet and do something, anything... usually heroic, heroic-like or somewhere in between.

Back to the story. So this particular kid was gasping at every breathe it could muster, and after 11 weeks in that ward, you can almost tell how long one has to live. A very unnerving skill, and for this kid it wasn't very long. The child's dad didn't make it any better when he confided in me that this was his only kid, and only 1 year after he was born, it would be cruel for him to join his maker.

Time was of the essence, and i proceeded to fix a line. As expected, the kids veins could just not be seen. But we did not give up. Pricked and poked his arms, his hand, his scalp, his neck.. yet nothing. Things seemed to get frantic, the mothers sobbing only got louder, and everyone else held a deathly silence. (deathly, how apt!) .. strapped his leg to look for a vein there. Don't know if it was luck or 11 weeks of experience, but we got it. Felt like time for a war cry just there.

Victory was ours! Having given starting doses of some acute drugs to help the child breathe better i left, felt a bit like i was walking on air. Another young soul saved.

The evening was young and we had been invited for a dinner organised by a drug company to launch a new product.. (more like bribing us with food.. but that's a story for another day.) And we ate and made merry.

I wasn't on call that night, but i really wanted to know how the child i had left earlier in the acute room was doing. When they say life isn't fair, they really mean it. Being a resource poor setting, our 'mortuary' (prior to a body getting to the actual hospital mortuary), is an isolated bed,(or is it cot) placed near the door to the acute room, just as one gets in. And like a really bad movie, was the body of that kid, wrapped in a leso and labelled with his name, well in sight for me to read.

Uuuh!! It's a nasty feeling that. Yo' only consolation is that you did the best for the patient, and many others have survived, thanks in large part to yo' efforts. But ooh! it ain't consoling.. ..not one bit.

aNGuiShEd mEDiCinEmAn.

Sunday, March 11, 2007

The mighty shilling..

Warren G's hit, "I want it all.." had it's chorus going like so
I want it all; money, fast cars
Diamond rings, gold chains and champagne
Shit, everydamn thing
I want it all; houses, expenses
My own business, a truck, hmm, and a couple o' Benz's..

I’ve never thought doctors earn enough. Ok, so almost every working Kenyan thinks they don’t get as much as they deserve, for all the nation building they are involved in, kaaaazi hio yote. (Well, MPs still want to earn more, despite not working at all.. Lakini that's a for another day.)

Caller No. 1: My doctor drives a Merc, he bought 2 months ago. And how does one sleep at night after charging you 2,000 shs to ask you a couple of questions and spend another 5 minutes listing a remarkable assortment of drugs worth another 3,000 shillings? Kwanza wakatwe mshahara! Shindwe kabisa!

Hehe… I think I already know which doctor this must be. The difference is this dude and myself is that he's a consultant, and a specialist in his field, and for sure, he’s gonna charge an arm and a leg for his years of hittin’ the books.

At the bottom of the food chain, however, is the eager, i-use-a-matatu-but-look-i’m-a-doctor, kind of chap, who, for the first few months at least, is excited and happy enough to have a new title and shiny badge to prove it.

That’s kinna us.. the medical interns. Enyewe, if there were ever misused persons, we would be them. My consultant visits the wards maybe 2wice a week and barely spends an hour or two, to review difficult cases, or just complain about this or the other. And for this, grosses around 150K from Sirikal every month. I wouldn’t want to imagine how much more she makes from her clinic and hospital consultations. My colleagues and I who slog away the whole day and night, weekends and public holidays, (did I say weekends?) earn 20K basic salo. Well, it’s not that bad, coz with my house and non-practice allowances it fikaz more than 30. Not bad for a recent campo graduate. So why am I complaining?

Caller No. 2: My doctor drives a Bima and lives in Runda. In fact, I want my son to do Medicine…

Me: wololo! Poor son.

Caller No. 2: I know he’ll be guaranteed a job once he finishes...

While I wouldn’t want to discourage any “neurosurgeon wannabe’s”, tread carefully. First, it’s confirmed that starting this year, interns finishing their internship are not guaranteed jobs with the govt. And just to make sure we don’t get any funny ideas in our minds, (u know, like a guaranteed job), they got us to sign contracts indicating that our 12 months employment was temporary with no bearing on future employment.

The other day, I was going through pay slips that had been carelessly dropped in the doctors’ room. I noticed something rather amusing. Most of the doctors were getting a non-practice allowance of 15,000 shillings. Amusing because, I can’t see how that amount will dissuade these doctors from not engaging in private work. Sample this, for part time work at a private institution, one can make that amount in less than a week, and that’s in one’s free time. So what makes the govt. think 15K will make these doctors focus their energies in the public hospitals? It’s not hard for one to rationalize on why he’s left work early to get to head off in search of more money.

Now if I was a neurosurgeon, I’d probably make 15K in a few minutes. And I can see why every top student in Kenya wants to be one. It’s challenging, And would certainly make for a captivating topic at those social events.

This-one-Thinks-Amefika: … so I had to call my agent in Dubai otherwise the cars were not going to be let thru’ the port. That’s when I realized that calling via satellite is so expensive. (laughter..) And what do you do..

Top-Student-Now-N’surgeon: I’m a brain surgeon. There are only 10 of us in Kenya you know. I was the ninth. So you were saying you import cars? From Dubai? Fascinating..

It’s interesting how many of these dreams slowly fade away during the first few weeks of 1st year, and focus shifts to passing the next CAT…

Anyhow, since I’m not a neurosurgeon, and I don’t think 30K+ a month is enough for saving lives (and that includes nights and weekends) I concluded that I was some what short-changed and I’ve been thinking about several options I could have next year, now that I’m not even guaranteed a job! (Not that I would have taken it up, but that’s beside the point.)

Any ideas? Drop a comment.

5 years? I think i'm getting a headache...
tHE mEdiCinEmAn.