Cozy bus ride.

We are back at the official CIT2 hangout, Coffee.com and enjoying ourselves once again. I’m amazed that Desiree remembered all of our names, except for mine, which is understandable- I am quite forgettable. Paras is happy that she recalled his as he thinks she is kind of cute. She also added a note on the menu that their ice is made with water that is filtered by reverse osmosis to avoid further annoying questions such as Gopal’s yesterday. We took the bus into town again and this trip was not as pleasant as our last. I think the bus route is much more popular on Mondays than over the weekend. It was a bit hot, crowded and without the festive music. Unfortunately, it seems to be very difficult to get the rickshaws to take us into town so I don’t think we have much of a choice but to chance the bus again.

Today was our first day on the wards as the others have mentioned. Brian summed up our experiences on the peds side well. I also was very impressed with the federally-funded immunization program and the technology of the NICU. I am excited to spend more time there tomorrow. As Brooke mentioned, shoes have to be removed before entering all ICU’s and interesting enough, we had to put on a gown before entering the NICU. It is a very strange feeling to walk around the NICU in barefeet. I’m going to spend some time in the theatre with the pediatric surgeon on Wednesday which should be interesting. I’m hoping the scrub techs wear fancy scrub dresses as they do down under.

I think we are going to finish our coffee and find a restaurant on the beach for dinner. Then another ride on the rickshaws back to the hospital.

Dr. Kern, what do you think of this?

Today was our first day on the wards as Tim mentioned. We got to see a handful of interesting cases and I am certain our physical exam skills are going to improve on this trip – they are very precise about physical exam here, I think we gloss over it a little and just order imaging studies. (I do like to look at imaging studies.) When we were at the bedside and a 4th year medical student was presenting her patient to the team (in front of the patient, but I don’t think the patient speaks english) the attending grilled everybody pretty hard (including us) but then broke down the murmur the patient had very very carefully. It was a mid-diastolic grade 3 murmur, turns out, secondary to rheumatic fever and she had a heart failure exacerbation. Man, I think I am lucky to hear diastolic murmurs at all sometimes. I am going to resolve to listen more carefully in the future, Dr. Packer style… Oh, and when we were talking about her lab values and found an iron-deficiency anemia he asked “And what is the most likely cause of her iron deficiency?” I was certainly thinking GYN losses but it turns out in India it is actual hookworm infection – they treat empiricly. Hmm.

Tim and I took pictures of the front of the ICU where you are expected to take your shoes off before entering. Yes, dear readers, I was barefoot in the ICU!!! I got a good picture of Tim taking his shoes off so we can send it to our MICU back home… From what they’ve told me they haven’t had any acinetobacter outbreaks here… Maybe it works?