Bidii Yangu (5 years worth...)

I think it must be all the time that i've spent during the last month partying that has kept me from my beloved blog this long! Yep, partying mbaya!!
Nilimaliza shule... Must have been that Surgery MCQ paper.. rumour has it ati only 3 people pita'd the 50% threshold mark, (aka: a pass, yo-ok-since-u'll-only-kill-half-yo'-patients mark... etc) ps: MCQ - multiple choice question. I've not sat for a harder paper than that in, well a very long time...

Some questions went like.. "the number of successful laparascopic procedures in specialist clinics in Guatemala was 85% ... True or False?" (ok, i'm kiddin about the Guatemala part.. lakini still!) I must have been the first person to finish the paper, coz enyewe, there's no need to try thinkin about stuff you've never read.. really. Everyone was complaining, ok, maybe not, coz i probably never got to talk to those 3 nut jobs that actually passed!

So when during my clinical exams, my confidence seemed to unfold, i felt a bit exposed... u know, shaken that i might not pass that exam..
It started with the long case. So i take a history from this dude. H was like 45 if i recall...

1 month history of yellowing of the eyes, similar period of pale stools and pruritus (med speak for itching..), and an tender hepatomegally (.. that's an enlarged liver that is painful to the touch.)

"Great!", i thought. "Surgical jaundice, secondary to gall stones..". Had read on it a while ago. Tho't it will be a walk in the park, this. Surgical jaundice simply means that the yellowing of his eyes (jaundice) has been caused by some sort of obstruction that requires surgical intervention to relieve it - hence the often other used term, obstructive jaundice. But enough with all this medical lingo.

I proceeded verify my diagnosis and the easiest thing to do, was simply to ask the patient what he had been told he has. Indeed, i was spot on. They were "mawe fulani. Walisema watatoa next week." Fabulous. Now i just had to have my story straight, do a proper system examination of the patient, and i'll be D.R in no time...

To cut a long story short, the examiners came and they insisted that this dude had cancer! Head of Pancreas cancer or Biliary tree (gall bladder) cancer. Which were actually on my list of differentials but further down than the stones. Apparently, the patient had lost weight during this time, but i tho't it was coz of the poor appetite he had developed. He had no abdominal masses, that would have pointed more to a tumor cozing the obstruction, or enlarged lymph nodes...

Any way, i gave in and admitted that that was wat he might be havin, altho' in my mind, i believed my line of thought was more consistent with findings on the patient. In med school, however, one thing you learn early on, is not to imagine that you know more than your consultants., or ever let them know that you think so... Saves you a lot of trouble.. and pain.

One week later, we camped for 5 hours (yes, 5!) outside the dean's office waiting for our results, to know whether we have been recommended to be awarded the degree, given the power to read, whether we were now doctors...

To say the wait was nerve-racking wouldn't come anywhere close to describing the feeling! It was terrifying... This was it. The last wait for results.. 5 years of work was coming to an end. The tension was palpable (i read that in a book, or was it someone's essay back in school? hmm...)

Hayawi hayawi huwa. After hours of waiting, the verdict was out...

Yes folks, it was then that i become a doctor!

Happy holidayz,
The latest mEDiCinEmAn in the hut.

tHE mEDiCinEmAn aka The WebDoc

hmm...
This blogging thing, this. So busy so little time. It's been dog years since i last wrote a post. Enyewe, doesn't feel nice letting down ma-fans, so i thot i should spare a few minutes of my eve' and confirm that i'm still alive and well. And the post on my trip to Paris will be coming very soon, papa hapa.

The break i've taken is actually from the books. Leo we started our end of year exams, yawa! Aii, kumbe hayawi hayawi huwa... the last leg is here with us. It's such a pity i have tonnes and tonnes of readin to do, and it just doesn't seem to end. It was a cold morning as i sat down to do my Internal Medicine essay paper. Management of thyrotoxicosis, anaemia in chronic renal failure... I mustn't bore u, but it was ok. 10 compulsory questions, 3 long hours and one tired med student.

Right now, niko juu ya mbuku (books by the way) mbaya. Head trauma and jejunojejunostomies. Crazy stuff. Kesho is Surgery essay. Na pia there is an ortho question humo.. all that readin for one question? Med school!

Oh, and one last thing..
Got tired with the alias 'The WebDoc', now i'm fondly known as 'tHe mEDiCinEmAn'. Forgive the camel text, but i thought it's sort of "different" and unique.

Otherwise, keep it blogged.
Adios amigos,
tHE mEDiCinEmAn aka The WebDoc.

Students In Free Enterprise

So much seems to be happening, keepin me so busy, away from my blog and all!! That's more or less the reason why i've not posted in ages. Today, however, i've decided to push aside a few things... to share the exciting... (ok, maybe not quite) , happeninings since i last wrote.

Well for one, i did pass the Ortho CAT i was telling you about. 53% was the score, being in med sch., i'm told gettin over 50 is enough for yo' patients (sic). We were quite a number of us who didn't make it all the way to 60, the bookworms, and the not so bookworms. Enough rationalising.

Back to wat's kept me so quite. Ever heard of SIFE? That's Students In Free Enterprise. What's it's all about is summarised by this extract from their site.

..SIFE team members leverage their personal educational experiences, the expertise of their faculty advisors, the support of their local business advisory boards, and the resources of their institutions to implement programs that create real economic opportunities for members of their communities. The effectiveness of their programs is judged at competition. Each national SIFE organization conducts a national competition, which is judged by leaders from its business community. At competition, SIFE teams present the results of their educational outreach projects and compete to determine which team was most successful at creating economic opportunity for others. SIFE National Champion teams advance to the top level of competition, the SIFE World Cup...

Being the business-minded fellow that i am, i promptly joined. I can't think of any other person from med sch. who felt this was worth their time.. boring lot! So indeed we went forth and "leveraged our personal educational experiences" and changed the world, took part in the National SIFE exposition with top business leaders in Kenya as judges. This is where we put together all our projects with a nice audiovisual presentation runnin in the bk ground (read powerpt presentation), and try and convince the judges that ours had the most impact to our communities.

Hours later, we got to the finals against USIU and Africa Nazarene University. Sadly for them, we were definitely better and UoN-SIFE was declared the winner of the 2006 Kenya National SIFE exposition!

Hurrah! We had a month and a half to put our passports in order, coz we were on our way to Paris, France, for the World Cup...

Keep it here, because when we return we find out,
.. shall i actually make it to France?
.. the university is broke.. again!
.. that'll be 3k for your visa..
.. then cough 20K if u want to survive in Europe!


and many more trials and tribulations that is my life..

Keep it blogged people,
Baadayez,
The WebDoc.

now the Ortho CAT

wow...
how time flies, (and how lazy i've become).
The surg CAT went ok.. to put it mildly. My essay had lots of cancer questions, esophageal, colorectal, breast... some of which i'd not prepared for, but my 3rd yr pathology kicked in to save me quite a few blushes.

The clinical was worrisome though. Took a good history and made a not too bad examination. Question time was however a bit rocky, especially when i couldn't recall they called an incision made during an appendectomy (appendicectomy)! Not very impressed, the good doctor asked me to read harder! That's not something you want 2 hear just after your exam, u know. Thankfully, i seem to have made a good enough impression for him to award me 59% (--applause--) remembering that not too many of my classmates got 60's let alone 70's, i think i was doin ok.


Anyhow, it's been so long since then, mpaka, i'm now just about to do my ortho exam (we have 6 weeks of each(surg and ortho) promptly followed by an essay and clinical assessment). So right now, i've hit the books again. I should actually be in theatre right now, but the reading doesn't allow me such pleasures.(unless some irate consultant summons us!). And as i read on Weber's classification of Ankle fractures, i thot i should post one more time, seeing that i haven't for such a long while.


Otherwise,
Keep it blogged.

My Surg CAT..

Here i am, writin this post, when i know all too well that i should be hitting the books like no one's business. I have this surg(that's surgery BTW..) exam next week and i just can't seem to get myself to read!! It's totally frustrating! And when i say exam i mean the full maneno's. A long-case, where we get to take history from a patient, take a full physical exam, and come up with a management plan for the same. And that's the day after we do our essay paper. Five essay questions and 3 hrs to knock ourselves out answering them.

Anyhow, looks like i really should be reading... ama? Things could go awry come Wednesday. I'll definitely tell how the clinical went.

I almost forgot. Jana, while i was 'not in the mood for reading' - again - i went to shoot a TV ad! Yep! One of those. It should be hitting Kenyan tv in a month or so. I'll keep this wire live, 4 sure.

Baadayez,
The WebDoc.

Revenge by any other name..

More than one year ago, i designed this website for a local band musician right here in Nairobi. I never actually got to meet him, in fact, the plan was that i'd probably never need to. What happened was this.

I had this 'friend' in college who's doin dental surg. and we are both into comps and stuff. So one day he approaches me and tells me about an entertainment portal that some band musician that he knew wanted designed. He had all my attention at this point. We talked about it at length (at least i thot' we did) and it was agreed that i would do the job for a paltry 10k, but i would then get 10k every month for updating the site. Now that sounded almost like a small salary to me! And i was in, hook, line and sinker.

A few weeks later, after being called, hustled and rushed, the site was finally done. Looked good, better than work i had b4, and i couldn't wait for the cash to start flowing in. I had been given 4k before starting with promises of more to come.

Days turned into weeks, weeks into months. The remainin 6k for the site was not 'currently' available, and the site owner had decided to go slow on the project and so there would be no further updating for a long while to come. The whole story was soundin all so Kenyan! You work, someone sits on your dues and the effort you put in doesn't seem to be appreciated that much. And as fate would have it, the months turned into years; almost 2 years to be precise. I had only 4,000 shillings to show for my efforts. My college-mate contact told me that the idea had been abandoned and i had to wait to get the remaining 6,000 shillings.

I figured, this was just one of those bad things that happen to u as you live and learn, in this classroom that is life. I just forgot about it. So, u can only imagine my surprise when one cold sunday afternoon i pass by Kenya cinema and spot a huge, triumphant banner announcing the greatest 'Entertainment portal in East africa'!! Yes, the very site that i had worked my ass off dzn'ing. A visit to the site and an email exchange later, i was in touch with the elusive local band musician whom i'd only heard about.

According to him, he'd never heard about some 3rd party that had dzn'd the site and only knew of my cunning college-mate as the "greatly skilled" webdesigner that had come up with his website. Back in college a heated exchange was 2 follow, during which, my hitherto trusted contact was slingin mud in the direction of the said local artist.

"He knew about u designing the site! He gave someone else the job of updating it! Do you think i would lie to you?? How long have i known you??"

The spirited defense was soundin very convincing. Someone was screwing me proper. The site was littered with ads, and @ the rates he was renting this virtual real estate, i'd say i was being screwed over. My efforts at recovering some money from the whole deal started floundering. Non-replied text messages, "u will get your money.." reponses, and for sure i was fed up.

That was when i remembered that i had been given the password to the site's FTP logon just after i finished the site design! That was just 2 days ago now. I thought of just deleting everything, maybe leaving a horrible message on the home page...

Now it was my turn to have them by the balls! i won't even tell them what i just did. I'll just wait for 'em to come crawling back, when advertisers on the site realise that it is no longer running!

As i write this post, they haven't yet, but it'll be soon!

www.showbizeastafrica.com

The initial site: http://www.showbizeastafrica.com/index_old.php

Aah, the wrath of God. It spares none.

Any tips from you guyz out there? Maybe i should never pick their calls and texts like they did mine? The look on their faces will be priceless. Just priceless.

The WebDoc.

Wired!

Yep, finally! I'm wired, right here in my room in the med school hostels. That might sound rather mundane 4 yo' all in the states and stuff, lakini, over here, we are over the moon.

What makes it even sweeter is that it was all the efforts of a group of us web savvy med students, who put in the extra effort... against all odds. And quite some odds they were. We had tried to get the sch admin to do it, but it sounded like..

"we've not even wired offices in the deans office, nani nyinyi?"

"we haven't thought about the hostels you live in yet, but maybe in the next few years!"

Ha! I've only a few months in this joint and this was the crap they were telling me? Any how, we already had all our comps connected to a local area network and i had got a wireless router when i was in the states, so then we thot' how do we do this? hmm?

Easy, there are internet points in the lib, and the lib's just across the fence, across the road, across another fence...

So a few connections here and a bit of reading there, and b4 we knew it, we were off into cyberspace!

So akina Clemo, Gacheru 'n everyone out there that checks out me blog, i'll do my best to keep the posts coming..

Baadayez,

A hero’s dossier…

Kenya is one amazing country and in the last few weeks it has not disappointed, not one bit. Those who’ve got their hands on John Githongo’s dossier are not doubt amazed by how rotten the corridors of power are. If you believe all that John tells us (and I haven’t any reason not to), then you’ll know that, like a fish, the rot starts at the head. Apparently, on several occasions, the president was told about the fishy goings on in some of his ministers’ dockets. He didn’t do a thing, despite clear evidence that his Ethics PS insisted he had on the matter.

Personally, I don’t believe this was just part of Kibaki’s laid back style of leadership, but in fact a personal effort at defrauding the country he swore to protect. Many times in the dossier, Kiraitu Murungi talks about the funds being needed to fund Narc activities. Dr. Murungaru is on record saying that the President himself personally sanctioned the 4.1Billion shilling (57M dollars) deal to buy naval ships from Spain. A deal that was part of the many struck with the non-existent entity, Anglo-Leasing. All those Githongo’s dossier points at are what the press refer to as Kibaki’s political pillars.


It was his Vice President that made a statement in parliament claiming that Anglo-Leasing was a clean and reputable company. Only to later claim that he read was a statement written by technocrats in his ministry. It had been revealed that the cost of the project had been inflated almost 3 and a half times, and awarded to a company that did not in fact exist. Just showing how little respect politicians have for Kenyans’ intellect. The same man, according to John’s dossier, who set up a meeting at his residence to ask John, why he was investigating the issue yet the monies paid out had been returned to the Treasury.

That said, perhaps the understatement of the century must have been from one Minister for Justice, Kiraitu Murungi. At the height of the revelations about the dubious companies making deals with the govt., he chose to refer to the whole saga as a ‘scandal that never was !’ questioning the reasons for the press giving the issue such extensive coverage. It is the same ‘scandal that never was’ that led to his dismissal from the cabinet, albeit belated.

Another crack head must be one David Mwiraria. Questioned on why he signed a document that would have seen Kenya lose billions of shillings to the ghost company, he proceeded to blame it on his Permanent Secretary, who had handed the said document to him to sign and he went ahead and did just that, without reading it! Yeah, he expects us to swallow that pile of utter garbage. And since he’d explained away the problem so eloquently, he didn’t see any reason to resign !! He must think we are a mob of illiterate, naïve idiots, if we are to believe a word he said. He’s no longer the Minister for Finance, but I’ll not smile until I see his short, thieving self behind bars.


Back to the Head of State. Now that things have come full circle, I don’t believe there is an ounce of sincerity in anything he does. It was only after lots of sustained pressure that he got rid of 3 ministers, although his VP is still in place, probably hoping to read another statement in parliament whose accuracy he’d careless about.

I can’t wait for 2007. Certainly a red card for this govt.

Next time, more on the tapes that John Githongo made of Cabinet ministers behaving badly.

Peace,
The WebDoc.

Hungry? Have some dog-food.

Only in Kenya, will a drought occur every 7 or so years, without the govt. putting in place any measures to make sure that it's citizens do not succumb to the eventual famine. And so as it has happened again this year. The President sent out appeals for food donations to sort out another of our problems, that we never seem to be able to solve.

So the other day, a New Zealand lady, Ms Christine Drummond, offered Kenya's starving masses 42 tonnes of dog food. Yep, Dog Food. At first glance, it sounds like a vicious joke...

"You look very hungry, here, have this. I'd made for my doggy, but u seem to need it more."

Ok, so maybe i'm being a bit colorful with my illustrations, but disgust was a common first reaction. It did not look good on the surface by any means. It was all over the FM station talk shows and letters to the editor. What many might not have been obvious, was that this food is actually very nutritious and loaded with proteins and vitamins, especially critical for children who are at highest risk of malnutrition.

Many questioned whether being hungry and poor is reason enough to eat what is fit for dogs. On the other hand, what is in a name? Ok, so it's "dog food". Should that stop us from accepting the offer and save thousands lives? The food is hygienically packaged, highly nutritious and has been generously offered to our famine-stricken victims. The lady owns the company donating the food, and i trust, she had the best of intentions when she made the offer.

Hmm? I don't know, what do you think? Drop a comment.
Is this another case of ignorant ideas about how to help 3rd world countries out of their problems, or a genuine and considerate offer of help from a kind lady, who tried to help in the best way she could?
I'll let it go at that.

Next time, i tell you about the resignation of our Minister for Finance. Easily the most powerful portfolio in government after the Presidency. No one resigns here, even against the most damning of evidence. Certainly a first for Kenya, as we continue the fight against official corruption.

Laterz,
The WebDoc,
seeking dog-food recipes.

Back in Nairobi..

Yes, yes, i know that i've been a bit slow and lazy on my blog, lakini it's with reason.You know internet is not as freely available here as many like myself would like. So it's not often that i get online.
Anyway, now that i've done away with a chunk of guilt, i've to say how lovely the weather here is. Everybody's saying that it's got too hot, but i disagree. I would have been saying the same thing had i not spent a couple of months of fall and winter in America. At least i dont need three layers of warm clothes... (lol). I'd even almost forgotten that the sun doesn't have to set by 4pm.
Nairobi is not doin too bad, other than the half constructed building that collapsed somewhere in "3rd world" parts of town, where less financially abled people frequent. Blame is going all round. Most of it to the City Council of Nairobi, that approved and failed to oversee the construction. Such a pity that we end up learning from our mistakes.
Speaking of mistakes, the weekend papers had been awash with stories linking very senior ministers in Kibaki's government to graft. Payment of billions of shillings to a company that did not exist!! The media have baptised it the Anglo-Leasing scandal. Only in Kenya, will a whole Minister of Justice, say that a crime was not committed since the stolen money was promptly wired back when the story first broke last year! Yep, Hon. Kiraitu is famously quoted for calling it "The scandal that never happened."!But now those ghost are coming back to haunt them, as the former anti-corruption 'czar'releases dossier documenting how his investigations were hampered and obstructed by the very people we put into power. Sadly, he has to do it from exile in Britain, after alleged threats to his life were made. Now, who would want this man dead? I certainly have a few names in mind.
Let me let off on the politics issue. I get heated sometimes! Med school is off to slow start. Just finished a rotation in Anaesthesia and i've just started another one in Dermatology, for another 2 weeks.

Keep it posted. I'll definitely be updating the blog more often from now on. A lot more stories, corruption, med school, weather updates... the usual.

The WebDoc ,blogged out, somewhere in the hot sun.

thank you people...

This blog is dedicated to all the people, i met, wrote to, talked to, laughed with, groaned about.. etc, durin my sojourn in Stato. It's been quite an experience, now that i'm on my way home. (sob..)

And i packed this post with pics, being my last from this side of the world.

First up, my bro David.. who sorted out my ticket. I probably wouldn't have come here otherwise. Thanks a tonne.

Thanks Brigid and Carole, my sis's, dropped me at the airport and helped to perk up my financial 'short-comings'.

The Germans we lived with at International house, you guyz are awesome. Martin, Sandra and Christian, aside from the PhD's etc(myself not even having a degree to talk of yet!), u really helped me out in those first cold, blurry days.

Thanks Martin, for wakin me at 5 in the morn and not gettin mad when, against my better judgement, it took me another hour to get out of bed and into the hospital. Oh' those early mornings.. biting cold, driving wind, drowsy mind..
Remember the annoying little green notices, on the wall and on top of the toilet. "make sure you flush all the way!" - coz we don't flash in our home countries? haha...



<--- A section of the KU Med. Center.







Thanks Dr. Jones, for the patience you had with me when i new not what to do, or where to go. And Dr. Hermreck, Selim and Delcore, for the opportunity to assist in your theatres. "..Retract!!" haha..

Thanks to Natt. For paging me one hundred and forty five times, when i was late or lost, and explaining things when the abbreviations sounded like an alien dialect of English.

Thanks Thad. A very good friend indeed. Always ready to help out a confused international student. The Guessture's game at Jeremy's, that was somethin' else!! haha.. Didn't think i'd meet an American who knew so much about Kenya. Hope you'll visit one day. It's a beautiful place this.

Thanks Clemo', small world, isn't it? The barbeque was deadly, the book as well, no doubt. I might finally decide what to do after med school... I'm waiting to read the headline, "Computers Save Humanity - The HIV breakthrough" hmm.. That angle of science unasoma, iz noma. Holla, when you check into Nai.

Last but certainly not least, thanks to my sis Di and her hubby John. They kept me in the basement away from the neighbours.. haha.. no, just kiddin. They fed and kept me warm for the whole time i was in stato. I couldn't thank you enough. Did i mention the free internet?

And thanks to anyone else i might not have mentioned here, but who made my experience a worthwhile one.

..and i'm expectin' yo'all to write a comment, just unload a thought or 2 that you might have. That's what a blog's all about. The comments link is just after the pics i put below.

Peace,
The WebDoc,
somewhere over the Atlantic.

-------------------------------------------------------------------------

... here are a few more my Kansas experiences. Enjoy


International Hse.
The posh diggz where we were accomodated.

..what it looks like inside.

And this is me, trying to look intelligent :-), in the Dyke's Library.
Pretty sleek joint!!

me again, on the www. Ever browsed @ speeds of 3mbps+ ? I have!

This is part of the hospital. Didn't take too many pics, long story..

ahh.. the game! Off the wire kabisa. TV does no justice, i'm telling you..

The mascot, like the team, is a 'JayHawk'

The Crowd.. and no, they were not in worship.

.. and of course the ballers. The KU JayHawks are in white.
they did win the game btw!

----------------------------------------------------------------------------------

I guess that's it from me. More blogs will be coming but from Nairobi this time. Yeah, i'll be waiting 4 your comments..

The Biggest Loser..

There's a new danger in the states. No, not Bin Laden and his suicidal fanatics, it's morbid obesity. U've probably heard about it in Kenya, lakini this you have to see to believe! Guyz are big!

There's this show on NBC, which has been quite a hit over here in the States, "The Biggest Loser" "hmm?.." you wonder, "whatever do u mean?" Well, it's really simple. A bunch of 14 larger than life Americans (literally) are tracked in a kind of 'Big Brother without the drama' arrangement. (well there's a tear here and sneer there, the usual.)

They live together at this joint where they are put thru' the paces, weight training, jogging, endurance missions, u know, the full 'i'm training for the Olympics' energy.

Each week one of them is fire.. oops, kicked off the show, shown the door etc. They work in 2 different teams and the team that has lost the least % in weight gets to vote out one of their own (soundz familiar). At the end of the show, the person that has lost the greatest percentage in weight is declared the winner and walks away with 250,000 US!

How about this. It's the only one of it's kind in the world, a boarding high school for obese and overweight teenagers. you have to be above a certain weight,i'm not sure what, to have any chance to get in. The school has recorded great success with its students, so much so that, it's opening a new school in New York. It will cost you however. About 5,000 dollars a month!! If u kenyans can quickly convert that 2 vernacular,(ok i'll do it for you..) 380,000 KShs/month! Oh.. but they'll be giving some scholarships soon as well.. to cater for everyone.

Once while i was at KUMC someone told me, "..sometimez they can't even fit in the CT scan machine.."

"hmm...", i wonder, "what happens then? they do without a scan?"

"oh no.", he replies, "we have to take them to the zoo, to use the animal one that's bigger!"

Yeah, i was also laughin my head off. But it wasn't funny. He was dead serious. Such is the agony some people have to go thru'. Fast food, many times is cheaper than kawaida food, and since it tastes so good, and it's alwayz available just around the corner..

For many people the only solution has come in the form of stomach stapling. Slowly developing into a subspeciality field known as bariatric surgery. They even have an association, etc http://www.asbs.org/.
They say 2/3's of American adults are overweight or obese! That's more than half. And needless to say, some doctors are making a killing, cardiologists, endocrinologists, the staplers (bariatric surgeons). It costs upwards of 25,000USD for a single operation!

Blame has been thrown all around, from farmers - whose methods of improving yields though not illegal, is raising eyebrows - to coperate fast food businesses like MacDonald's, who were actually sued by 2 teenagers, but won.
In my humble opinion, however, it mostly has to do with the way life goes on here.. move around in a car, get into a lift, sit in your office for hours, drive back home, sit infront of the tv and that's it. I even see people using shoppin carts that you can sit in to shop!

I don't know where this thread was headed, but i thot' i should bring out the stark contrast between America and Kenya.. kids could be dying of malnutrition in Makueni, but here, guyz are dying because of having too much to eat. Makes you wonder..

Keep it blogged,
The WebDoc.