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?
CaseIndiaTrips 2 