Right-hand drive

Back in Houston, when we first met Kathy, we were asked what our
medical interests would be once we got to Maseru. Not having
specialists on staff, the new graduates were asked to pick a
particular role which they would like to fill in the clinic. There's
need across the board, but in the past, people have chosen to become
the resident expert on tuberculosis, outreach and suport staff
education, and epidemiology. I chose nutrition. I guess in my head,
I started romanticizing about what it would be like to "feed the
children"/tackle malnutrition in one the poorest parts of the world.
And of couse, I've started to realize that there's something
gratifying about feeding people.

So when we got our schedules a couple days ago, I guess I was kind of
expecting to have one loaded with time spent at QE2 (Queen Elizabeth
II Public Hospital). On the wards, PAC docs work hand in hand with a
local pediatrician, Dr. Pirri. Whereas hospitals in the states
are seen generally as the last stop when things get too bad to take
care of at home, it seems that QE2 has earned itself the opposite
reputation. Do everything you can to keep the kids out of there,
because if they end up on the wards, there's a decent chance that they
might not leave. Its also the last stop when malnourished kids are
unable to be treated at home or as an outpatient. After our intial
training is done, that's where I'll be headed next. Alone. It's got
me a little terrified, and as we sit here in the lecture room going
through current guidelines for everything from WHO Staging Criteria
for HIV infection to compliance training for the adolescent, I'm
scrambling to retain as much as I can. A lot of this material was
only mentioned peripherally in residency, if at all, and now as I
prepare to see it day in and day out, it makes me wonder how it'll
unfold. Time will tell I guess.

In the meantime we've been doing some shadowing with the vet PAC docs.
We follow them around as they pull patients into rooms and then try
to guess what we would do in that situation. I've been doing a lot of
guessing, and to be honest, I think I'm starting to get a handle on
some of it. Over the past couple weeks its been hard to keep things
in perspective, but I'm reassured by the fact that the fundamentals
for caring for a child in southern Africa are ultimately rooted in the
same foundation as caring for one back home.

Another surprise is how the days are filling themselves. Between
dinners and the weekly happy hour, most nights fly by. Last night
ended around 11:30 after 3 solid hours of South African Monopoly.
It's a little funny. All of the properties are listed in English and
Africans, and all of the currency has an extra pair of zeros to
accomodate for inflation. Tomorrow we head out to Bloemfontein where
we'll get a chance to pick up supplies in a South African chain
modeled after Target, and then we might get a chance to look for cars.
I myself had another big first today when Jeff, one of the vet docs,
tossed me the keys as we walked out of clinic. He's been trying to
sell his purple Volvo, and I guess I had coaxed him into a test drive.
Left hand drive on a manual transmission in the middle of rush hour
was entertaining to say the least, but we made it home safely, and
only after a handful of honks from other cars on the road. I kind of
felt like I was in driver's ed again. I was sitting straight up with
perfect posture and arms at 10 & 2, barely looking away from the road,
not even chancing a reach to turn off the heater which was getting
ready to lull me into submission.

In just a couple minutes we'll head out to Lesotho Sun for drinks,
then the chinese place Peace, (twice in less that two weeks!), and
then happy hour at a bar built into the big gym here. It's Jazz
poolside, or something like that.