Words, words, words. It's always exciting to learn new words.
Flashing is a common occurrence in Sierra Leone. Nobody has flashed me yet, but I have already taught Rachel how to Flash. You know, just in case. I also told a patient's father today that I had diagnosed his 5 year old son with Malaria. I had a woman ask me if there was anything that needed Brooking. Rachel was asked, "Whosi de come?"
Waterloo has a very active and organized church. The hospital has a morning worship schedule that is out a month in advance (although no shows are not uncommon). I have expressed concern to some of the leaders that I wanted my first speaking engagements to be small, until I can learn Krio (the local English dialect). I was told that any physician in Sierra Leone is highly respected. Also, any white man is also highly respected. Since I apparently meet both criteria, even if I stood at the pulpit and preached in English using words nobody understood, they would say the sermon was a huge success. Although the thought of unconditional praise without any critique of my thoughts seems appealing, I have not yet taken a speaking engagement.
But I have been thinking more about the 'Gospel.' What is it exactly? Apparently, sometimes a white man speaking incomprehensible words from behind the pulpit is the gospel. Sometimes it is the disciples speaking in tongues at pentecost. Sometimes it's just a kind word or action across racial, ethnic, economic, or religious divides. What I have come to believe is that the gospel always has some form of human connection and not just some 'magic' words. But who knows, maybe me just blabbering behind a pulpit is enough?
To understand flashing, you have to understand how cell phones work in Sierra Leone. Everyone puts money on their account, then you pay by the minute. Only the person making the call has to pay. So when you're low on money, you dial the person you want to speak to. As soon as their contact 'flashes' on the screen you hang up. They have been "flashed" and know to call you back (at their expense).
I thought it was an open and shut case, when I diagnosed this child with malaria. But apparently it wasn't. The father thought about it for 45 minutes while lingering in the lobby. When I walked past again, he called me over again. "I don't understand. What type of malaria did you find in my son? Typhoid? Infection? Plain malaria?" Similar to how in my youth, all sodas were called 'Coke', apparently malaria is a host of infections.
When your best source of running water is the stream, that's where the washing is done. If something needs washed, you 'brook' it.
"Whosi de come?" When this is spoken extremely slowly, you can imagine 'Whose side did come?' Since this culture is much more focused on relationships rather than time or geography, the question would translate as "Where have you been?" But since my culture's language cares more about place than people, we don't often ask from whom we have just come.
Anyways, I wouldn't recommend returning any calls that you are flashed. There are not yet robocallers in Sierra Leone.
And to that I say, "Tel God tanki"
Monday, September 9, 2019
Friday, September 6, 2019
Childhood, again...
Tonight's thought is just going to quickly written and only lightly reviewed for errors. I'm tired, sweaty, and ready for bed.
We've been in Salome (Sierra Leone) for almost exactly a week.
I now know how to go to the market and buy eggs. I know a few greetings. The employee’s faces are starting to look familiar (although unfortunately their names are not yet...) I know how to use the internet. I know how to open the lock on my door. I know how to use the toilet. And only in the last few days have I started easing back into patient care. I almost know how to use the patient's chart. I know where to find gloves. But there is also so much I don't know how to do.
But even over this short time, I'm realizing how much of the 'real life' stuff that I know is based on where I learned it. I have felt more like a child in the last week, than any time in recent memory. Every single thing in the paragraph above, I had to learn either by asking or by struggling. Yep, you read that correctly. Apparently I didn't know how to use a toilet. There was a solid 5 hour period this week where everyone I met was asking if I had a plunger yet or not. Apparently there wasn't one in the entire hospital. I haven't started patient care until now because honestly, I'm 31 years old and still trying to figure out the mechanics of daily living.
All of the tools I've learned before seem to almost, but not quite work, here in Sierra Leone.
Today's experience that brought all of these ideas together was when I was trying to ultrasound a woman's thyroid. She's got hyperthyroidism and is suffering. Huge anxiety, rapid pounding heart beat, all for several weeks. "Great," I thought, "I specifically took a rotation and practiced this in residency. I'll just do a quick scan and see if she has an abnormal nodule." So I set up the equipment, darkened the room so I could see the screen, laid the patient down, and put the ultrasound gel on her neck. Nope. I put the ultrasound fluid on her neck. It ran everywhere.
To explain my struggle, let me back up and describe why gel is important. Air is the enemy of ultrasound. So without gel, the ultrasound can't see anything. Because she is laying on her back, her 'Adam's apple' and trachea form a high point and the rest of her neck slopes down and away. The thyroid is lateral to the midline structures. So if you are going to look straight down at the thyroid, the gel has to mound up to make a 'bridge' between the probe and location of the thyroid. So my river of gel meant I had to improvise (more likely compromise my images).
As I have reflected on this experience, medicine is filled with assumptions. Every book, lecture, course, and advice I have received about ultrasound has assumed that I have decent quality gel in an air conditioned room. Well, I can tell you that air conditioning can be about more than just comfort.
Everything I am re-learning about daily life is difficult because there is a core of assumptions that are being challenged. I anticipate medicine will continue be the same. There are so many areas of our lives that go unexamined, simply because our assumptions have always worked. These beliefs have moved into the subconscious and we don't think about or discuss them, unless they are challenged. Perhaps Christ's advice to become like children, in Matthew 18, is a more difficult process than I thought.
We've been in Salome (Sierra Leone) for almost exactly a week.
I now know how to go to the market and buy eggs. I know a few greetings. The employee’s faces are starting to look familiar (although unfortunately their names are not yet...) I know how to use the internet. I know how to open the lock on my door. I know how to use the toilet. And only in the last few days have I started easing back into patient care. I almost know how to use the patient's chart. I know where to find gloves. But there is also so much I don't know how to do.
But even over this short time, I'm realizing how much of the 'real life' stuff that I know is based on where I learned it. I have felt more like a child in the last week, than any time in recent memory. Every single thing in the paragraph above, I had to learn either by asking or by struggling. Yep, you read that correctly. Apparently I didn't know how to use a toilet. There was a solid 5 hour period this week where everyone I met was asking if I had a plunger yet or not. Apparently there wasn't one in the entire hospital. I haven't started patient care until now because honestly, I'm 31 years old and still trying to figure out the mechanics of daily living.
All of the tools I've learned before seem to almost, but not quite work, here in Sierra Leone.
Today's experience that brought all of these ideas together was when I was trying to ultrasound a woman's thyroid. She's got hyperthyroidism and is suffering. Huge anxiety, rapid pounding heart beat, all for several weeks. "Great," I thought, "I specifically took a rotation and practiced this in residency. I'll just do a quick scan and see if she has an abnormal nodule." So I set up the equipment, darkened the room so I could see the screen, laid the patient down, and put the ultrasound gel on her neck. Nope. I put the ultrasound fluid on her neck. It ran everywhere.
To explain my struggle, let me back up and describe why gel is important. Air is the enemy of ultrasound. So without gel, the ultrasound can't see anything. Because she is laying on her back, her 'Adam's apple' and trachea form a high point and the rest of her neck slopes down and away. The thyroid is lateral to the midline structures. So if you are going to look straight down at the thyroid, the gel has to mound up to make a 'bridge' between the probe and location of the thyroid. So my river of gel meant I had to improvise (more likely compromise my images).
As I have reflected on this experience, medicine is filled with assumptions. Every book, lecture, course, and advice I have received about ultrasound has assumed that I have decent quality gel in an air conditioned room. Well, I can tell you that air conditioning can be about more than just comfort.
Everything I am re-learning about daily life is difficult because there is a core of assumptions that are being challenged. I anticipate medicine will continue be the same. There are so many areas of our lives that go unexamined, simply because our assumptions have always worked. These beliefs have moved into the subconscious and we don't think about or discuss them, unless they are challenged. Perhaps Christ's advice to become like children, in Matthew 18, is a more difficult process than I thought.
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