I walked with another doctor from Penn (a pediatric AIDs specialist who arrived last night and is 32 wks pregnant, luggage lost) to PMH, which is a conglomerate of one-storey buildings that house the patients and support services. I was directed to Morning Report, which reviewed the admissions of >35 patients from the weekend. The illnesses ranged from crytococcal meningitis to overwhelming TB(I saw an XRay with total RUL atelectasis and miliary disease throughout the rest of the lung fields). An older woman with poorly controlled htn was discussed; the drugs and compliance are limited. A chest pain patient with an XRay suggestive of pericardial effusion was presented, but the analysis by the resident failed to consider this possible diagnosis. I am not yet certified by the government of Botswana to practice, so I didn't say much, especially since I hadn't been introduced to the group.
The echo situation is ripe for improvement. The hospital has recently acquired a new compact GE model that I'll have to work with to learn how to operate. It has a TEE probe, and there may be the opportunity to introduce TEE to a community on 2 continents! The Philips distributor called with the good news that the HD11 will be arriving tomorrow, and we'll take delivery Wednesday. Great news.
Indian food tonight.
While you were inspecting the golf course, ruing the fact that you only brought nine golf balls (not the needed nine dozen) and trying hard not "to say much" (how hard would that be for PKSMD), I was stretching my back early and often removing the gentle white stuff (over a foot) from our front walks and driveway. I wonder if, after three months, you might be taciturn?
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