Tales from Scot

"Another Day in Paradise" pretty well sums this place up. The weather is near perfect every day. The nights are cool and comfortable (just right for sleeping), and three or four nights a week it rains.

The practice of medicine is another story! I am very busy. They have put me in charge of the labor & delivery floor. Most days, there are 10-12 deliveries and a C-section or two. The nurses do most of the deliveries and repair the simple lacerations and episiotomies. They do a good job most of the time, but could stand some improvement. So far, I have had 8-10 C-sections, a breech delivery and have repaired a half dozen bad lacerations. The nursery does not have a ventilator and that is a great frustration to me. I have had an emergency C-section where the baby was resuscitated, but expired for lack of a way to provide any long term ventilator support. I am currently waiting on a delivery of a 28-29 weeker that I know we can't do anything for. Please pray for me; it is very difficult. I do miss all of the nice perks of qualified pediatricians, neonatologists and especially a high risk nursery. The nurses here are addressed as "Sister": Sister Sylvia, Margaret, Mary, etc.

As for Gyn, they do a nice job here. The surgery is well stocked and the personnel seems well trained. Cancers seem further advanced, but I have not seen anything I could not handle, yet. Ectopic pregnancy is a popular diagnosis. I have operated on 5 ectopic cases in the first three weeks. Most are caused by P.I.D. , which is also a popular diagnosis. Last night, I operated on a woman who had a ruptured ectopic for five days and had walked in from a distant village. Her hemoglobin in the emergency room was 3.7 grams. I was able to give her four units of blood and operate.  She had 2600cc of blood in her abdomen.

Aids, hepatitis, and tuberculosis are also very big around here. I have had one HIV positive vaginal delivery and one HIV positive C-section. Most days in the clinic I see fresh cases of tuberculosis, malaria, and hepatitis. My ultrasound machine is in use constantly. I have diagnosed several large pelvic tumors, three sets of twins and several cases of abdominal TB, so far.

Enough about me for now. I miss you guys. God bless you,

Dr. P

p.s. Thanks to Cindy R.'s mom for the hats. They are a big hit.