Hospital Monday

Like everywhere, Mondays are busy days at the hospital. At Princess Marina Hospital, morning report goes on for 1.25 hrs while residents and interns quietly recount the weekend's admissions, occurrences, and deaths. I was asked to do 4 consults and did 3 echoes, finishing in time to give the residents' lecture at 4PM.
Among the patients were a 20 year old primipara (HIV positive) with severe heart failure due to a peripartum cardiomyopathy. Another poor woman, 61 years old, had pulmonary hypertension and also severe heart failure on top of poorly controlled diabetes, hypertension, and kidney failure. She was caring for 2 small children (I presume grandchildren) alone, and was in bad shape. A 75 year-old woman from Lesotho (an island within South Africa) got sick while visiting family here and had advanced heart failure. Her country of origin is relevant in that the government supports the cost of citizens' health care, but not foreigners...they have to pay for everything up front. I'm cheap...no bill for my services or for the echoes I do. The ECG and chest Xray are another matter.
The talk was on Basic Life Support and we did a practical demonstration using the defibrillator. No one got shocked, despite my threats!
I walked home in 90 degree heat, and the Gibson (really, gin on the rocks) tasted great! Barbara, who had worked all day on her Muskie paper (it sounds like a lot of work!) cooked a great dinner and we had a long end-of-day conversation with our new housemate, Dr. Rob Roy MacGregor, from Penn.