My pediatric rotation

I just finished my pediatric rotation and thought that I should write a little about my experience.

Pediatrics was great. It was so cool to go to deliveries and see how the babies turn from blue to pink and to be able to warm them up. It was sad to see babies going to bad situations and feeling helpless. Watching circumcisions was a little traumatic though. Out patient peds was fun besides having malaria at the time. I think that it would be pretty cool to see kids grow up. A lot of the visits were healthy kids and making sure they were alright which was good. I spent a couple of days with oncology and got to do some lumbar punctures which was pretty fun also. I was nervous but I think that procedures could be good to do. I really liked inpatient pediatrics and following families day after day and seeing the progression of their health.

Embarrassing moments:
My attending physician has a reputation for being strict and giving poor evaluations to both students and residents. I actually really enjoyed his teaching. When I went in for my evaluation I tried to convey this. I said "I really like that you tell us what we did wrong after every presentation....you are not like those nice doctors that say you did a good job." He immediately replied asking me if I thought that he didn't give any positive feed back. I told him that we were all happy with him. Never the less, the next day he brought a bowl full of candy for us.

Our last day, because our attending only wears bow ties, we all dressed up with bow ties. It was pretty funny and quite a sight to see us following him around dressed like him and we received plenty of comments.

Irony of malaria

After a week of well baby nursery and starting out patient clinic during my pediatric rotation, I noticed that I had a high fever. My first thoughts were that I had gotten a virus from one of the kids or that I had malaria from my trip to Africa this summer. The next night, however, the truth came out as I woke up with my bedsheets and clothes were soaked to the skin. I had to change everything so that I could go back to sleep. At that point I knew I had malaria because I didn't think that I had cancer or tuberculosis which can also give you night sweats.

Because the fevers would spike and then I would feel alright, I went to the clinic to talk to the pediatricians about what I had. I followed one of the interns for a while until I was shivering so bad that he told me that I needed to go a doctor. I drove with my windows up on a hot July day so that I wouldn't feel so cold. I went to the student health center because of my horrible health insurance deductible of $2500. They took my blood and cleaned up my vomit and told me they would contact me when my results were in.

I figured that they would want to treat me and that it was better to be near a hospital than at my home alone if something went wrong, so I went to class. I had to leave because I had another fever spike. I went to Dr.Hale's office, my research mentor and infectious disease doctor, who was in Ghana. I laid down on the floor as his secretary got his PA to come see me. She had to call the lab twice to get my results because they weren't going to read them for two days. From my experience in Africa and studies on malaria I knew the dangers of cerebral malaria and was shocked that I wasn't going to get treatment. Luckily, I got some Malarone pills from someone who didn't need them and under Terry, Dr. Hale's PA , I took them. I threw up the first dose (which each dose costs $32 and there were a total of 3, and I had to get another dose). I only took one because I felt that I had absorbed some...not good. Then after my medication finished and I had another episode of night sweats I self treated with expired doxycycline (my prophlyaxis from a year previous.) I called the pharmacists and she said that by doing that I made my medication 40% less effective (she also told my mom about how stupid that was when she picked up my meds for me and got her worried.) I got one more dose.

And after a week of symptoms I felt better. I was pretty scared through the whole thing though because I was peeing blood and could feel my spleen and liver were enlarged. Dr. Hale returned from Africa they day I felt better and said that I should have been hospitalized. I had P. falciporum the most deadly species, but only 1% parasitemia.

The people at the public health department laughed at me because I was supposed to be studying about malaria prevention and ended up getting it. My excuse was that my deet in my backpack ate through my medication on the way home from Africa and I took the risk because I was already home. I lost, but now I have a funny story to tell. The health department did contact me and said there are mosquitoes in Utah that can carry malaria. I went camping in the windrivers right after getting home. I feel that if there is an outbreak of malaria in Wyoming it is my revenge for that stupid speeding ticket!

Wind Rivers and Rainbows

Two days after getting home from Africa, Brent and I went to the wind rivers to explore the vast wilderness of Wyoming. On my way there, I recieved my first speeding ticket which was awesome. We found out at a diner from a weird gray haired waitress that had the blank stare of a serial killer that the "Rainbows" were having their convention up where we were going to be. Driving up there, we saw a couple of people hitch hiking and when we got into the mountains we discovered the school buses turned homes, pirate flags, and naked people. It was pretty great. We ended up getting up to Big Sandy at 10 at night to be pretty much the only group at the lake. We put our food in the bear box and slept to the sounds of the river rushing a hundred yards away...beautiful. I woke up and played my harmonica waiting for Brent to wake up which he did at 900 and then we went and hiked the cirque of the towers. The hike was through snow up to our thighs at sometimes. It was quite an adrenaline rush as we walked on the frozen snow through the boulder field because you never knew if the next step you would stay on top of the frozen snow or a fall to an unknown depth. When we got to the cirque and had lunch, there was a marmot that was watching us. I was stupid and gave it part of my bagel. We tried to take a nap but the marmot would get on the different boulders that we would be sleeping on and steal things. We would throw rocks and try to scare him, but he had a short memory and would keep coming back. I finally hit him twice in the face and he left us alone. (It was from lots of good practice from throwing rocks at Paul and Spencer on hikes. I knew those skills would come in handy one day.) The cirque was pretty cool. The next day, we went and hiked to the top of East Temple Peak. The hike was intense as it consisted of hiking through a river and ice on top of the river, snow that you couldn't stay on top of, and the edges of frozen lakes (which sometimes broke.) We were beat already when we got to the steep boulder fields of the peak. I thought that I was going to throw up. We finally got to the top and rested and saw an incredible view. We then came down the mountain part of which consisted up sliding on our butts down one of the steep slopes that we had to climb up. Coming down was much better than going up and I finally didn't care about getting my feet wet so I walked through the river on the way down. We were beat that night and I burned off my shoe laces trying to dry them by our fire. We got down the next day when 3 huge groups were going up. They probably waited for Monday because they went to church. I figured I prayed so much more hiking to East Temple Peak that I would survive than I normally do that I was justified in hiking on the Sabbath. On the way home, because of Brent's beard and my neck beard people thought we were Rainbows and would be pretty angry when we wouldn't pick them up when they were hitch hiking. I felt a little guilty especially because I have always wanted to hitchhike for the experience and never dared to. Especially because I don't really feel hippies are dangerous. I just had a bunch of clothes that David had given me for rotations in the back seat and wanted to get home in a hurry. I am not the hippie that I would like to be, but at least I survived and felt the efforts of my hiking in the wind rivers for the next week.

Beaching it in Ghana, back to the USA, lessons learned in Africa

We got back to Ghana and it was sooo good to hear English again. We had to barter for a taxi. Janine was so fed up with the bartering system at this time she lost it. She said that she knew how "these people" were because she had worked in Katrina. Both Julia and I tried to explain to her that this is just how the system works and she was sick and tired of feeling ripped off. We went to the bus station to go to the beach and we finally had cell phone service. She walked away from us and just cried on the phone. She was probably expressing her frustration about Africa and Julia and I to her parents. She was entitled to this given that this was her first trip out of the country and it was so dang intense. We got on the bus and made it to the closest town to the resort. We had to arrange another taxi to take us to the resort and they told us $20. Janine wasn't going to take it. After about a half and hour of negociating with other taxis we finally took it. She felt insulted by the driver and was crying again. We finally realized how out of the way and how horrible the road was that we realized that it was a fair price. The resort was full and so we ended up sleeping in tents on the beach. It was a perfect place to de-stress and relax. Janine met a lot of knew friends and I read my book on the beach. We went swimming and got sun burned...it was what we needed. It was so romantic on the beach that Julia asked me what I thought about two friends making out if that would be awkward afterwards. A little shocked because I think that kissing causes emotions to flow just like saliva told her that it was probably better that we didn't. Ironically Julia and I been kind of physical throughout the end of the trip and the idea of kissing her went through my head before she brought it up. We stayed 2 nights at the beach with all of the other Europeans who were in Ghana. We went home and I called my parents on the way back to Accra. They had recieved sporatic emails and I knew they were probably worried as they usually do. It had been an adventure of a trip. I was sad to leave but it always feels good to come home.

These are just a couple of thoughts that I learned while I was in Africa that I wrote along the journey:
You can't control everything in life, sometimes you have to go with the flow if you are powerless in the situation.
It is better to have less expectations and treat every good thing in life as a gift.
It is important to greet people
Making friends is a good survival tool. People you can trust will help you through difficult situations
Everyone should be vulnerable sometimes to see who you really are and know what it is like when you have no control
It is scary to be in situations where you if you get hurt and there is no way to get help
It is easy to judge and make you feel better than others, but it makes you unhappy. it is just as easy to laugh at the situation and relax. Realize we are all human

Crazy Burkina!

We got to the border and we went through with little problems. The Burkina border control were so nice and friendly. In order to try to get a better transport to Ouagadougou, we told the tro tro that we wanted the extra money that we paid to get to Ouaga back. We went to the "bus" station were a line went...to our surprise it was a nicer tro tro but not the buses that we were still expecting. We waited another couple of of hours for the tro tro to fill up. We got the front seat with the driver. I think it was because we were white because we were the last in line and the told us to go to the front. We were so tired at that point that we took it and I didn't realize the special treatment until we were driving. We had our lunch which consisted of tuna on a baguette which was so good. On the way the driver got in an arguement with one of the passengers and he actually stopped the tro tro to fight with him. Luckily one of the other passengers calmed them down. The driver through out the drive was cursing under his breath at these guys. He tried to hit them while he was driving. He tried to get me on his side but I had no idea what he was saying. We finally got to Ouaga and our stop was the same tro tro stop where we caught the tro tro to leave Ouaga to Mali. We then took a taxi to the Catholic Cathedral and stayed in the nunery that night. I met up with my friend Rasmane that I met the time before. I was so happy to see him because he was a familiar face that I knew I could trust. I spoke to him in French. He told me that our other friend had left for Spain to work and that he was hoping to go to the US. I told him to keep practicing his English and to let me know what happened. We then went to dinner Julia, Rasmane, and two guys that we met on the street on the way to ATM at the cathedral. We then went on the back of the motos to an out door concert. Rasmane told me that the guy with Julia was known as a "bad boy." I thought this was ironic that we felt more comfortable with our muslim friend Rasmane than the Christian who was with Julia. I told Julia, she still insisted on riding back with him and we went back to our hostel. I was pretty disappointed at that point that we only had one night in Ouaga and I couldn't take the girls to the crocodile pools and that I couldn't hang out with Rasmane, but the next morning we had to take off to the airport. I bought a batik from the nuns for my parents. The Christian guys brought their stuff to sell us the next morning. I specifically wanted to buy from Rasmane as I know that he worked part time in a shop and bread store. He went along with the Christians as I knew that he had to be loyal to his country men before the Americans. I refused to buy because I wanted to wait for Rasmane. We went to the airport and Rasmane was waiting there for us. I bought a big batik of an elephant from him with couble the money than it was worth. He told me he didn't have change, and I told him that I didn't care about the money. I think that he understood that it was more about our friendship than money. We continue to email once every couple of months short messages and he wished me a Merry Christmas which I thought was ironic and great. We left Burkina and headed back to Ghana.

from Mopti Mali and on the road to Burkina Faso

We went back to the hostel Sevare got cleaned up and went to see Sek. We had Sek buy us tickets to go a longer route to Bobodialasso Ouagadougo because the girls didn't want to be on anymore horrible tro tro rides. He promised that it was going to be a good bus. We then went to the Bisap cafe one more time and invited our friends from the hostel to come. The bill ended up being $70. Julia paid for it which was very nice of her. We then went on a hike to get to our bus. It wasn't the air con buses or even ones with personal seats. It was an old bus with a wooden bench in the back and rusted holes in the floor. Janine broke down this time given that it was going to be another night sleeping in the bus. She just sat down and cried. We had already paid our money and there was nothing we could do. I went to go buy water and I had to go all over town to find cold water because I had a feeling that if these girls didn't get cold water that bad things were going to happen. I felt bad for them. After going and feeling water bottles in 5 different shops I chose the coldest and came back. Things were better when they came back. They were very sweet but still pretty frustrated. I chose a window seat in the back and the girls sat by the windows also. We rode for a while and the bus was not too full thank goodness. At sun down we got out and prayed. And during the trip we stopped because of bus problems and i would pray that the bus would run. I slept some on the bus ride. Julia came back and slept and cuddled with me. The large Malian woman in colorful balck green and yellow and red sitting on the bench would push Julia if she got too close. We didn't sleep so well. We got to the Burkina border and had to wait for 3 hours. So I got out and slept in the dirt next to the families that were traveling with us who had their mats and the girls slept on the bus.

Stranded in the Sahara with the Tuareg Family and back from Timbuktu

We headed out to the Sahara from Timbuktu. I had my turban that I had bought from the Fulani nomad in Mopti that had saved me and the 5 others on the wooden benches in the landcruiser on our 24 hour journey to Timbuktu and now I was finally putting it to use as the Tuareg used their turbans: protection from sun and sand. Julia, Janine, the French couple, their guide, Alkedi, and I headed out on camels into the desert with our Tuareg guide. We had a blast making jokes and singing Bob Marley on our way. We went through the sand dunes at sunset to finally the encampment were there were 2 huts: one for Tuareg family that we stayed with to sleep and another for food preparation. They laid out a blanket and we ate dates and drank African sweet tea (I should say that we made Janine drink our tea because we weren't supposed to drink the tea as mormons.) The french couple went off to do what couples do. And the girls and I and the two guides from Timbuktu went out into the desert to look at the moon. I brought my harmonica and we danced and played in the sand. The French couple's guide kept touching Julia inappropriately and I had to explain to him that was not right. He apologized when he saw that she was angry. However, I don't think that he understood that this was inappropriate behavior the way he acted that night. We went back to the encampment and rested on the mat outside when all of a sudden a dust storm came. Sand was everywhere and you couldn't see anything. We ran into the hut. They put up the walls to change the canapy of a hut to an enclosed dwelling. Sand still got in so we went under the blanket. It started raining. Under the hut, we had spagetti with camel meat in a big common bowl because the Tuareg food always made even the locals sick. It was pretty good. After we had finished eating, they gave the rest to the 5 kids of the Tuareg family. If we would have known that they were going to eat, we would haven't eaten as much. However, there was still a lot left. The storm finally stopped and we took a mat outside to sleep under the stars. The two guides came with us. During the night there wasn't a lot of sleeping as one of the guides kept putting his hand on the girls stomaches and touching their breasts. They would wake me up and I would switch places with them. He would then switch places also. Finally we told our guide who yelled at him, then our guide slept by the girls and started touching them. Finally everyone went to sleep at about 2am. The french couple slept on their own mat and had to wake up at 5am to catch their bus. We were thankful that their guide would be gone, but to our surprise when we woke up to the sun at 6am our guide had left also. We were left stranded with a Tuareg family in the desert with no idea how to communicate with them or how to get back. We noticed the father was still asleep in the hut. We watched as the mother and the children pounded the millet that the father had brought back from Timbuktu. We made friends with them and Julia had toys for them. Which they loved:plastic frogs, an eraser, a bouncy ball. The children looked like their ages ranged from 10 to 18 months. The 3 year old that we gave the eraser to started eating it. We took it a way and I gave him a plastic spoon from our MRE which he thought was the best thing on earth. We played catch with them with their toys. The little boys ran naked in the sand and we all laughed and had a good time. Julia swung one of the boys around and the parents became concerned and told the children to go away. Finally the father woke up and we had breakfast of bread and coffee for Janine. he then sold Janine and Julia jewelry and we went back on the camels which had huge ticks in their ears. The tuareg father tried to chase away some goats that were eating the follage in the desert, and the goats trotted away with their tails in the air. We finally got back to Timbuktu and we met a guy who was waiting to take us back to our place that we were staying. We then met up with Abdulye who gave us a tour of Timbuktu. The sun was blazing hot, but we saw the university that had been built in the 1200's and a library that housed books still from that era. He then took us to the houses of the Europeans that somehow had gotten into Timbuktu during this time by pretending they were muslims. Most of them were killed when they were found out, but some were kicked out or escaped back to Europe. Their families had bought their houses centuries after and put up plaques. We went to one more tent where one of the university students who was Tuareg to visit his family was selling things to help provide for his family. His family still made the 72 day trip from the salt mines to Morocco to sell salt. It was pretty impressive and it would be pretty cool to make that trip, but it is pretty dangerous also. I had some tea at that point because I was dehydrated and tired of making excuses to have Janine drink all of our tea. It was a herby sugar that heated your throut as it went down. It was pretty good. I was also happy for the caffiene at that point. We came back to the house and our friend was making dinner. There were two men from Algeria that were in the house. I was a little afraid because of reports that Al Qaida had infiltrated parts of Mali north of timbuktu. However these guys turned out to be great guys. One of my happiest moments was sitting out under the stars and talking to the guy from Algeria and our friend from Mali in conversation completely in French and understanding about 85 % of the conversation for about an hour. (Most of the conversation was about food which was easy vocab) Algerian made food for US oil companies and loved the US. He made us an amazing dish with mayo, vineager oil, melon, beans and fries. It was great. We also listened to Malian jazz and had a dance party with the girls and did some yoga. It felt so good to be able to finally communicate some. That night we slept under the stars and we were so tired from the past couple of days that we slept great! We woke up the next morning to go to the airport. We got there before it opened because our tickets had too eary of a time on them. It was good because feeling guilty that I hadn't gotten anything to remember this awesome visit to Timbuktu I got a bottle of Sahara sand that I smuggled into the US for my dad and bought my mom a Tuareg bracelette and got a camel skin bag for me. We flew back to Mopti on a flight that took 45 minutes. We were shocked because it took 24 hours to drive and was so crazy. And we sat in air conditioning for the first time in weeks. It felt so good. However, I appreciated the crazy experience to get to Timbuktu and thought that it was worth it for the memories. The girls thought that I was crazy. I just felt that it made getting to the legendary Timbuktu more real.