november....

another month gone by in africa.....wow. hard to believe it’s already been 4 months! as it goes, in some ways it feels like so much longer, in others it feels like yesterday that we got here with our 2 tons of luggage. the last month has definitely flown – i spent the first 2 weeks on wards and then went to serowe (smaller town 3 ½ hrs north of gabs) for 2 weeks. between the two i got to go to south africa for one of the most beautiful weddings ever. needless to say, it’s been a full month :)

so wards....yet again a difficult experience, yet better this time not being quite so fresh out of residency or quite so fresh to botswana. i think somewhere along the way i learned to let go of some things – i.e. getting labs in a timely fashion, or at all, same with xrays, even medicines sometimes. you have to pick your battles around here or you’ll go crazy! i find myself much saner picking a handful of things that i feel strongly about and focusing on those. little bit different than our do absolutely everything we can (sometimes to a fault) mentality in the states. the limitations are often frustrating, but now only really get to me when they affect my patients. the number of deaths is still overwhelming....this past month i had 2 that were particularly difficult. one, an 8 month old with HIV and pneumonia that i took care of for a week and a half before he died....he was very sick, but still it was the first child i’d had die that i’d been taking care of for a while and had had sole responsibility for. and again, with better respiratory support he probably would have lived. the second was my very favorite patient ever....just the most precious 3yr old boy with soulful eyes and a contagious sweetness that touched the whole pediatric ward. i admitted him my first month here with a disease called langerhan cell histiocytosis - which is a bad disease even for the states - but he’s been getting chemotherapy in the hospital since that time and has looked so well, then got worse quickly and died because we were out of blood transfusions. heartbreaking.

serowe....definitely a different experience than working in gabs. our role there is more of a mentoring role, which means we work with doctors in local clinics to help them learn pediatric HIV care. as you can imagine this gets a little tedious....there are so many patients that come to these clinics (sometimes over 100/day for 2 doctors) that they don’t have time to spend on details and understandably just try to crank through as fast as they can. another opportunity for picking battles. the town is much smaller with very little to do so life is quieter there, which is a nice break. one of our doctors is there full time so we’re not alone, and she has some cuban friends that make excellent food and provided free salsa lessons – definite bonus!

south african wedding....AMAZING. we were in a town called pietermaritzburg which is about an hr from durban (on the coast). our ex-neighbor and pyschologist at the clinic, lindsay, got married to one of the old PAC doctors and it was such a lovely wedding. very similar to a wedding in the states except that many of the rehearsal dinner speeches are given at the wedding (best man, father of bride & groom, and groom himself). it was neat cause everyone got to share in their story. oh and i forgot the best part - there was a trampoline. leigh and i spent a good amount of time with said trampoline, once again acting our age :)
















k, that’s definitely enough for one blog! hope all is well at home, will try to be more faithful with the blogs so they’re not always so long! lot’s of love :)