Bara Dora, potato potaato…?

My entire experience as a medical doctor thus far is coloured by the fact that I spent the last 2 years working at Chris Hani Baragwanath hospital (Bara), in Soweto. Asides from the short stints we did as students at the other public hospitals in and around Johannesburg, Bara is where I learnt how to function as a medic and it is almost all I know of the inner workings of a hospital. So I wasn’t surprised, just a little amused, when a few days ago, I found myself telling a patient to “…take your script to the pharmacy here at Bara…” I had to stop myself. “Sorry ma’am I meant Dora, the pharmacy here at Dora Nginza hospital…” Bara, Dora. The 2 almost sound the same in my head sometimes. The Dora experience thus far however, has been quite dissimilar…

 

I was on call for the first time out here a few days ago. From 8am on Monday to 8am on Tuesday morning I was the physician on call, or POC as they call it at my new hospital. During that time the intern and I saw about 35 patients and admitted 28. It was during this time in the admission area that my perception that my current place of work is so different from my previous hospital was most distinct. During my time on call I would clerk a patient, and while doing that I would start forming an idea in my head, of what I thought their diagnosis might be, and once I had finished the examination I would have a bit of a think about it, and maybe add to, or change something in my notes. Or perhaps I would come to the conclusion that what I had already written down was ok, and that I was happy with my working diagnosis.  I  was on call, and I had the time to think about what I was doing. I actually had time…

 

The first 4 months of my internship back at Bara hospital in 2012 were in internal medicine, the same department that I have chosen to work in now for my community service. On a day call, if it was a bad day I would  see the same number of patients (about 30) in a single afternoon. The best description I can come up with regarding those 4 months at Bara is that it was like being caught in a fast flowing river, going downhill. You just went with the current,  and you had very little control. Then you went home, invariably a lot later than you would have liked, slept, got up ridiculously early the next day and got swept up by the current again. Ward rounds, bookings, ward work, the odd meeting and next thing you know it’s way past 4.30pm in the arvo and you’re still at work. You finish up as much as you can, go home, sleep, and repeat the cycle on the morrow. I must admit that I speak only for myself. Although I know that there were other interns who felt the same way, there were those who were awesome, and thrived in that intense environment. Mostly I tried to manage the heavy workload as best as I could. Medical internship should ideally be a good balance between learning, and working like a slave. At Bara there were some days when I got that balance right and (or but? 😛 ) there were more days when I was just a workhorse (or a rat, yes more like a rat in a big warehouse). I learnt a very fast, instinctive type of medicine. Fast triage, a brief clerk getting the history and examination almost simultaneously, a provisional assessment, investigations and move on to see the next patient while awaiting the results of the tests you’ve requested. The pressure was such that very often the emphasis was on seeing and managing patients as quickly as you possibly could while being safe, because for every patient that you were seeing at a given moment there were invariably numerous more waiting to be helped. That was the typical situation when on call in the admission ward. Once a patient was admitted and in the wards it was the daily slog of seeing them and each of the 20something other patients you might have on your slate, making sure that they were well managed. You did this under the guidance of a registrar, and a specialist consultant, but as the intern you did shoulder a fair amount of responsibility. The number of patients one always had though, was such that all the time you remained conscious of how much there was to do, and how little time there was to do it all.

 

Dora Nginza hospital is less busy, and I feel somewhat more in control, I can be a little more deliberate in everything I do regarding patient management. I feel that it is a better pace that I can learn at and develop further. The physician in charge of the ward I work in keeps me and our 2 interns on our toes by asking very probing academic questions on the daily ward rounds, and there isn’t a day that goes by without his giving each of us a topic to read up on and present in a short sit-down discussion the following day. One of my fears after having left Bara, which is an academic hospital was that I would end up in a new work environment with doctors who hadn’t read anything new in years and I wouldn’t learn anything further than I had in my short career thus far. There doesn’t seem to be much danger of that happening, thankfully. Asides from being in a coastal town that is quite outdoorsy, catering to my sporting needs it seems that there will be no halting the learning curve. Along with my own studying towards hopefully writing SA College of Medicine exams sometime soonish (specialists don’t make themselves!) I’m having to squeeze in extra material every day that helps us better manage our ward patients too. Port Elizabeth was a good, lucky pick I think…

 

As I’m writing this it is late afternoon on Sunday. I just woke up, having slept since about 11am when I got back from the hospital where I was on call again since yesterday morning. We had a busy one for a weekend call, having again admitted about 30 patients. Some were seriously ill, others not so much. One gentleman that comes to mind is a 40something year old who was referred to us from casualty in a considerable degree of respiratory distress. We put him on oxygen by facemask but he just didn’t seem to get better, writhing and breathing laboriously. I ordered an X-ray of the chest, and while we were waiting to be able to view the film his girlfriend, who had escorted him in explained that he hadn’t been to the toilet in about 3 weeks. So we had a closer look and on further questioning he explained that most of his discomfort was in fact in the abdomen. He was given an enema, passed a little bit of stool and suddenly was much brighter, saying that he felt a lot better! His chest x-ray did show an extensive opacity in the left lung so we did admit him, but his story did provide for a fair giggle with the consultant on the ward round the next morning 🙂

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There comes a time in every man’s life…

I spent last Thursday afternoon frantically scouring Port Elizabeth’s malls (both of them! 😛 ) for a clothing shop that would have a french cufflink shirt. Having finally found it (Edgars, Walmer Park Shopping centre. They saved my life!), I spent Thursday evening ironing said shirt. Anyone who knows me knows I’m a T-shirt, shorts and slops kinda guy. Outside of work, it takes a lot to get me to wear closed shoes or anything resembling formal wear. This however, was a special occasion, Rodney my best friend was getting married the next day! I packed a bag for the weekend and having taken leave for that day, got on a plane to fly to Johannesburg early the next morning.

 

Friday morning was frantic,  8.15am landing time, getting into town, getting to the car rental company, and being very disappointed with the service-“What?! ’95 Ford Tracer, ok fine! You want it back by tomorrow morning?! Jeepers, I’m here for the whole weekend… fine then!” (Never using that company again!) then going to pick up my girlfriend, and date for the big event. While all of this was happening, 2 phone calls from the best man very calmly saying (while probably visciously swearing under his breath!) “Pascal, how far are you? …alright see you in a bit”, and a third phone call unbelievably, requesting that I drive to Melrose Arch and purchase 2 bouquets of flowers. All of this before having to get onto the road to Haartebeespoort,  for a 14.00 start of the ceremony at the venue! What I would give to be just slightly (read: a lot!) more organised (insert emotive AAARGH!!)… All of that sorted, I finally got us onto the R512 to Haarties,  arriving at Red Ivory Lodge, the venue for this much awaited event with barely an hour to go before the scheduled start of the ceremony.

 

I walked into the Alexandra suite to find a dazzling collection of groomsmen, all dappered up and putting the finishing touches to their outfits-a final polish of the shoe, an adjustment of the tie etc. Ngoni, Rodney’s brother and best man handed me my own groomsmen suit. I was dressed in a few minutes (my shirt did have to be re-ironed, having not quite survived the trip) and there we were, tailored suits, cufflinks and the distinct feeling in the air that a chapter was about to come to a close, and our friend was about to embark on a new journey… There comes a time in every man’s life when he must forgo the things of youth, the frivolousness and abandon. He must take the plunge, make a commitment and choose a partner for life. Rodney had done this a while ago (their relationship is about 6 years-strong), but this would make it official.

 

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Rodney and I first met when we were both first year students at Wits university, we stayed at the same residence. Our first few encounters consisted of heated arguments about rugby, specifically that year’s Tri-nations tournament. That was 12 years ago. I don’t have another friend that I have known for that long. Despite my somewhat selfish nature (I spent most of the time during our varsity years buried in my books trying to become a medical doctor, and although I have come out of my shell somewhat since qualifying, I’m still not really Mr Sociable and Out-going) when I wasn’t stressing out about the next exam or just the sheer workload of the course I could always go and see him, or during the tough times I could always count on him for an encouraging word. He’s a really good guy, of strong character and he places a high value in his friendships. I have never been part of a bridal party before, never been asked to be one of a few to stand next to someone as they tie the knot with their chosen one. So this event was quite special to me, almost overwhelmingly so. It’s a good thing he didn’t ask me to make a speech or anything as I would have gotten quite emotional!

 

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I first met Mandisa, Rodney’s girlfriend-now-wife not too long after they started seeing each other. Attractive,  intelligent, also of strong character I noticed that she quickly became very important to him. I felt she challenged him somehow.  All these years later here they were, about to be married. It absolutely warms my heart to see my friend so happy and about to take this big step. The ceremony was something quite special, Red Ivory has a chapel, the front of which is open and looks out over a picturesque veldt area that provided a beautiful backdrop to the scene of the blessing of their union. The reception afterwards was a good, fun party. I was horrified a few weeks previously when we had been informed that the groomsmen and bridesmaids would have to  do a procession, consisting of synchronized steps during the reception. This is because my coordination is somewhat lacking, tending towards non-existent! Thankfully though the steps were pretty simple, dumbed down I think quite possibly because I was part of the bridal party! 😛 That part of the evening went off relatively smoothly, I think (and I stand to be corrected) that I may have only missed a step or 2 during our 10 minute performance,  no more or less than any of the other guys…

 

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Rodney’s brother Brian, and also Rishon, a good friend of his each said a speech about the man of the moment, and Jacqui the bride’s best friend also had a turn at the podium. None of the speeches were as embarrassing for the groom and bride, as one would have liked for the sake of entertainment but there you go,  you can’t have everything in life! 🙂 Good times were had by all. Friends and family had come from far and wide, as people will do for such an event, and everytime the dance floor was opened there was no shortage of bodies moving and swaying in merriment.

 

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Let me not to the marriage of true minds, blah blah blah… I could go on, I am a hopeless romantic, but that weekend came and went, and what a great couple of days it was. Definately worth the trip! You haven’t travelled I think, until you’ve travelled for friends. Sunday evening came and I was on a plane back to PE, to have to face work at the hospital again the next morning. For my friend,  Sunday and Monday both came but he wasn’t the same. No longer a single man but now half of a newly married couple. Ain’t life (and love) grand? 😉

 

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Not unpredictably, I start off by describing a run I went on this morning, a slow 24km amble. Not unpredictably, it was in my new favourite place Seaview 🙂 and once again, not unpredictably it was absolutely beautiful, out and back along Maitland road follwing the shore, with that ever present ocean view to one side! I ran with my friend Dario, having driven from PE town to be at his house at 6am, to meet up with a bunch of other runners (about 50 or so) at 6.30am before setting off. During the run we linked up with Allister, another local. He has been running for about 20 years and was using this as a training run for the up coming Comerades marathon, his third. A lot of the others on the run this morning (runners from clubs all over PE) are building up (tapering down that is) for this year’s Comrades. We took it long, and slow.

 

Allister is a very talkative character and we were never short of conversation. This was quite different for me as I am usually a bit of a loner on the road. I’ve been running for just over 3 years now, and I almost always go it alone, on training runs and races alike. Just me, and my thoughts and ideas, and (mostly) my non-thoughts and non-ideas! I’m not antisocial or anything,  I just find it difficult to strike up convo with a stranger, with whom all I have in common is running. I’ve always wondered about chatty runners. Usually finding myself quietly overtaking them, or quitely being overtaken 😛 as it were! How fit does one have to be to be able to run, maintain pace, and swap random opinions about oh say the epic scenery, your partner threatening to leave you because you spend too much time out running,  politics, voting, not voting, the weather, work…? These are life’s big questions really, a philosopher’s delight.

We had a good one though, as long runs go. I quite enjoyed it. One of the advantages of constant chatter and banter, I discovered is that you don’t think about the distance too much. I also made a new running friend, in Allister. No amount of distraction can take away from the pain I was feeling in my legs over the last 3km though. That last bit is always the worst. Having cruised the previous 21km odd, all of your senses suddenly switch on, and you feel every step and every little niggle until the last step. Funny thing about running, that. Once we did stop I promptly forgot all of that, taking in the awe-inspiring scene around us.

 

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My afternoon on this public holiday, voting day,  was spent working on this post at a cool Greek joint called Yiayia’s on Stanley street in PE. They make a mean sandwich melt! Stanley street is a cool going out spot in an area called Richmond Hill, on the edge of town, repeatedly recommended to me since I moved here. I found it not dissimillar to 7th Street in Melville, or Gleneagles road in Greenside. When I’m not in Seaview I’ll probably be arb’ing somewhere on Stanley street… 😉

Running conversation. Voting, not voting…

Aside

Jozi my lover, I have left you for another…

I have just come back from an early morning 10km run along a road that runs parallel to the beach, and as I finish writing this I’m sitting on a balcony a couple of minutes walk away from said-beach, in Seaview, Port Elizabeth. I guess it’s real now, the move that is. I have left my Jozi, well and truly.  Not to be dramatic or anything…

 

  • The Road Trip: I love a long drive to somewhere interesting,  but it really isn’t much fun when you’re doing it on your own. Just me, in my little sedan packed with absolutely everything I own (excep for one or two relatively large pieces of furniture which I left behind) driving along, talking to myself, and managing to run through ALL the music I have. I did the trip in 2 parts, spending one night in a self catering in a little town called Colesberg. The scenery along the N10 is much more interesting (read: eye catching) than that of the N9, which in turn is more so than that of the N1 before it. There is definate gradual change of colour scheme from brown to green as one travels away from the highveldt, towards the Eastern Cape. Of note, there is a sign somewhere along the N9 for a turn-off to a place called Daggaboer. I kid you not. Chortle, chortle…

  • Seaview and it’s people: A friend of a friend of mine, Dario (with whom I went on the run this morning) and  his wife Jenelle are my only 2 connects in PE. We met for the first time when I arrived 3 nights ago (having spoken on the phone a couple times before I came down). They are very cool, super-friendly people and they introduced me to Kim and Bennie, an equally cool and super-friendly couple who have an awesome little self catering flat in Seaview, where I’ve been staying for the last couple of nights, hosted by Kim’s daughter Robyn, and her husband Conrad on my first night. I am absolutely in love with Seaview, with it’s houses built so close to the shore, and the smell and sound of the sea. I was at a braai at Dario and Jenelle’s last night where I met more friendly and interesting characters. It has been a very happy, sociable start…

  • First day at work: I read a book a little while ago by a British doctor. It was about his experiences during his medical internship. Describing his first day at work, he says he was very nervous. He walked in to his new ward for the first time and heard a nurse say “Oh good, there’s the doctor” and he sighed, relieved until he realised that she was referring to him! Now I’ve been qualified for 2 years already so I wasn’t that nervous on Friday, my first day at Dora Nginza hospital.  But there is still a small part of you that hopes that nothing hectic happens on day one, just so you have a chance to ease yourself in, find your bearings in the ward and hospital, meet and get to know your colleagues etc… Thankfully I did get the chance to do all that, and ended up having to take care of a lot of admin stuff. The internal medicine department, where I will be working for the first 6 months of my community service consists of 4 wards, 2 for male patients and the other 2 for female patients. I was in one of the female wards, I helped out with the ward round by seeing a few patients. There was a meeting with all the doctors present, to say goodbye to the interns, it was their last day in the department,  so I met everyone I’ll be working with. I also had a sit-down with the head of department.

 

I have moved into a block of flats in town, it is the doctors’ accomodation (yes that finally got sorted out!), the building is filled with doctors that work at the different hospitals in PE. It’s my official residence but I plan to spend alot of time in Seaview 🙂

One of the doctors I work with is a triathlete, she recently completed the Iron Man (Iron lady I suppose?) here in PE. Dario, and Kim and Bennie all cycle and run, and as I sit here on the balcony a group of cyclists have just ridden past on the road below. I was destined to come to this town, I love it here! 🙂

Somewhere along the N9

Somewhere along the N9

Somewhere along the N1

Somewhere along the N1

Dagga boer. I still laugh when I look at that! :-D

Dagga boer. I still laugh when I look at that! 😀

Seaview...

Seaview…

 

 

 

 

 

 

 

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