Wednesday, May 30, 2012

Houseman on call; Life at the Regional Hospital, Cape Coast

Maybe I'll summarize earlier weeks and add it later but for now, I'm just itching to let this out in my third week as an intern at the Central Regional Hospital in Cape Coast. Here it goes...

Yesterday (Sunday, 27/05/2012) I did my first suturing! yay! I'm obviously excited about this cos' it gives me hope that I'll be justified in my decision not to stay in Korle Bu for my first year in House job. Having hid behind numbers most time (cos' we had a large class in Medical School), I decided it was time I stood on my own. A hard decision that has seen me even part ways with my best friend from school even though he also opted to stay outside Korle Bu for first year. 
Anyway, I have to get that off my mind and simply focus on gaining as much as I can gain from this experience.
It's now 1:48am on 28-05-2012 and I have a crazy schedule ahead of me;
- I'm the only house officer on call 24 Hours at the Department of Surgery here in CRH. That means I'm in charge of both male and female wards, I review cases on both wards every morning, I do OPD work, prepare patients for surgery and also assist in theatre, sometimes review surgical cases at the ER and in addition, do ER work almost every other day! That translates into about 15 hours of work/ day every other day and also means my short sleep hours can (and actually is) interrupted at any time of the day! 
So much for my personality which is the kind that wants to do things at its own pace, be in charge and control how events unfold. Not anymore! The times are set for me and I must follow through and come out clean if I am going to be a good doctor (or so I have come to believe).

As I realized, my day typically begins few minutes before 6am and by 7:30am, I should be by my patients side and reviewing cases already. By 9:30am/ 10am, ward work including reviews and taking samples and doing other procedures should be done. Then depending on the day, I set off for the OPD to see patients. 
By 2pm/ 3pm, I should be done here and really my day should end there if I don't have ER duties. But no! Theatre calls and I must answer. Emergency or elective cases, I must answer the call.
As I have realized also, there are good sides to being an overworked intern;
I get to do so many things that I would have otherwise missed. I get to be more responsible and also get more opportunities at practice.
But later today as I would realize, my responsibilities just got a little bit overboard! I will be running the department of surgery alone tomorrow the 29th of May 2012!
None of my 5 superiors will be around in the day and the onus lies on me to keep the department sane and running smoothly. God help me.

So it turned out I have worked for 20 hours non-stop! I had duties at the ER and my night started at 10pm on 28/05/2012 and ER duty ended next day at 7am. So much for the night already and I must get ready and move straight to the ward and review cases. Little did I know know I was going to be in the hospital premises for the next 11 hours or so! Hey! I don't even know if my new American friend was around. I simply didn't notice this. First year medical student from University of North Carolina here in Cape Coast. So much for the girl in my opinion. I had a good time at the ER with my colleague and classmate helping me out. The only problem I had with the night was this baby with Malaria and gastroenteritis with dehydration. I had a hard time finding an IV line for him to get the fluids in. He needed these IV fluids and his inexperienced doctor couldn't find his tiny little veins buried in his thick skin. Days you wish not all 14 months babies were not that well fed and dehydrated with collapsed veins. There was also this teenager who for strange reasons had drank some liquid soap and fallen unconscious! Thank God he was revived after a lot of IV fluids! I guess it was a good experience for me. I'm learning everyday and I count myslf blessed under these circumstances. Today itself would have been a good one if not for the emergency cases we had to operate on. I had anticipated it to be a crazy one cos' I was going to be alone but the H.O.D for surgery at the UCCSMS came around to do the emergency cases. So I reviewed all the ER cases, and the ward cases as well and did the labs for the patients whiles I waited for Prof. to prepare for the cases. He let me do my second skin suturing! The case we did in theatre included a 9 year old girl who was initially thought to have perforated her bowel from typhoid fever. It turned out to be a perforated gallbladder! Cholecystectomy it was then. The youngest Prof. had done in his many years of work both in the UK and in Ghana.

It's 12:33am on 31/05/2012- Awake and listening to good country music. I really should be sleeping but I simply can't! Not with the thoughts of the demise of my colleague and friend under bizarre circumstances at the Korle Bu Teaching Hospital. I'm starting to have thoughts of seeing a psychologist cos' I simply can't sleep with these thoughts. Sometimes just blank thoughts and at other times, memories of the many nights I walked the lonely dark road to my late colleague's room to play video games with him. I remember the excitement in his eyes, sometimes the shock at my incredible comebacks in FIFA12. Oh, I can remember one game he scored 3-0 in first half and I equalized in second half to 3-3. eventually, he had the last laugh when he won in extra time but he congratulated me all the same. He would really laugh loud and tease hard when he won against me. I had my revenge on some days but truth be told, he won more than I did. Now I remember also one time he had asked me to go for a ride with him in his brand new Nissan Primera. Just so much occupying my mind now. So young, so full of life and enjoying his new status as a medical doctor. Just murdered coldly in your own room at the doctors' flat without a clue. Desmond, Rest In Peace!