Re-entry

Most of you loyal readers know that we are back Stateside now.  As Brooke alluded to on Facebook, one good part about traveling abroad as a resident is that we’re accustomed to flipping our days and nights, and a few hours of sleep is now enough for us to function somewhat normally.  Two days after returning home, I was mostly back to normal.  Well, maybe my time zone is still somewhere over the Atlantic.

It’s strange coming back to Medicine as I knew it.  During M&M at the VA, we had a lengthy discussion about TIPS in end stage liver disease.  I remember that very few places in India even have the capabilities to do that.  We’re also back to a point where we get indignant if we don’t get chemistries back in hours, where we can get a C-reactive protein faster than a renal panel, and where CT scans are the norm.

Our ID statements on HIV inpatients include most recent CD4 counts (usually done last week), and we entertain the possibility of micafungin in chemotherapy patients.

In my physical exams, I was much more careful to palpate for nodes, tried to identify the heart lesion causing the murmur, and yes, even looked for peripheral nerve inflammation.

I’m definitely feeling the burden of whitewashing the experiences.  People don’t want to hear every single detail, but everyone wants to know “how was it?!”

And life goes on…

T-5 (T-7 for most everyone else)

Thanks to Dr. Armitage, I have added a couple of extremely relevant (and in one case, timely) links to the Readings section. We have had our final CIT2 prep meeting 2 days ago. We discussed what to bring, more travel precautions, and the agenda as it stands now. The only thing left to do is to see if we can take some surgical supplies to be donated to SRH, courtesy of Medwish International. The butterflies are going full force for this writer. Mostly excitement, but some trepidation. My travel plans within India are about 80% complete. It looks like, in addition to my side trip to Nellore, I may be making a trip to Pune as well, home of the National AIDS Research Institute. Since my friends at YourManInIndia – Rahul, Sandeep, and others – came through for me, I guess they will get this contract also.

From Brooke….

I think that it would be good to post the checklist of items that you all discussed at the meeting today…. so here it is!

Checklist:

– Got your hep a, cipro, malaria prophy, typhoid

– lock for suitcase

– photocopy of passport to you and loved one (who is able to fax if needed)

– obtain an ipod/update with your latest tunes.

– pack at least 2 weeks worth of underwears

– obtain Deet

– get medical stuff from Dr. Yadavalli for transport (?bag from Glynn)

– travel insurance

– brooke will join team CIT2 in Dulles on 8/13/08

– plan for wed sept 10th coverage with chiefs

Sign of the times

I just bought a ticket to go see my aging grandmother in November.

CLE-IAD-FRA-MAA and back–18,000 miles, $1700 ticket=9 cents per mile

CLE-IAH-YVR and back—6000 miles, $1000 ticket= 17 cents per mile

Time between purchasing tickets: 2 months.

Now the question: 2 smaller bags that are easier to take on the train, or 1 large bag? I guess it depends how much United is going to charge.

The time is approaching…sooner than some would think

I think that all of us are realizing now how quickly the trip comes upon us. It is less than 2 weeks away and then we will be whisked off to another country to see a whole other side of medicine. Where examining the patient is the central part in making a diagnosis and where exotic illnesses are a simple fact of life. It will be amazing to see these things.

I am really impressed to see how excited everyone is for this travel. Unfortuantely, I am not there yet. I am still in the process of interviewing for fellowships and I need to get through this hurdle before I can even think about the prospect of going to india. Lucky for me, I have one interview left on 8/6 and then I can have a whole week to get mentally prepared and excited!

Until then, though, there is still a lot of work to do for all of us. I know that most of us have clinical responsibilities to fulfill and some of us even have moonlighting shift(s) to do to help shoulder the load of the trip at hand. Fun times to be had by all!!!