Medical experiences so far.

When I first started this blog about a month ago, I aniticipated I would update it almost every other day. For a couple of reasons it didn't play out like that, I guess it seemed somewhat unnatural. I have been learning incrementally in conversations with people what life is like here and now after the past 4 weeks I feel I am perhaps in a better position to discuss it. I should point out therefore that each subsequent post probably won't follow any set line or avenue of thought. This one will focus on some of my medical experiences.

Though having learned some information theoretically at the red crescent hospital, the fact that they require proof of some not inexpensive insurance to be presented limits signifcantly the number of patients visiting. Hence, though their specialists are good, it really wasn't the best place for a medical student to be placed. Having said that, I saw and got to help out with some pretty crazy stuff.
To give an example, I was doing an on call at roughly 4-5am about 2-3 weeks back whilst attached to gynae/obstetrics. A lady came into the ER after having just given birth to her kid in the car on the way. THe baby was delivered breech (feet first, a number of possible complications accompany that), and was totally grey and lifeless, no first cry, no breathing nothing. Apgar score of 0-1 at 1 minute and the same 10 mins later for you medics.
We took her up to the ward and for the next hour tried to resuscitate her. Some 30 mins went by with scarce improvement when we finally got her heart working again. Within half an hour she had stabalised though she did experience seizures some couple days afterwards. Learning the protocol for neonatal life support and resus in such a way made a huge impression on me and honest to God, it was one of the scariest experiences I had faced, mostly cause we barely touched on it during Paediatric rotation. About 5 mins into it, I felt the blood drain from my head and for the first time in my life I felt like I would pass out, whilst simultaneously feeling like I had to take a shit and vomit. Took every bit of resolve to stay on my feet and do what was asked of me. Thankfully that kid was for the most part ok, though I am unsure as to what long term sequelae may be faced by her.
Lord knows I went home that day and commited neonatal resus to my brain lest I ever be faced by it again before I receive formal paediatric training.

Experiences like that were very few and far between, and having gained as much experience as I could in the three weeks, I transferred to Ramallah General, the main port of call for the uninsured (almost 80% people) and people from the refugee camps. We do have quite modern equipment here as with most hospitals (this isn't Sierra Leone), although there isn't enough of it, and certain specialties lack essential facilites. I'm attached to the emergency and orthopaedic departments.
I have seen about 50 fracture cases in the 4 days here, mostly crazy kids getting too hyper and jumping around until they break something! Had to help out in a cardiac arrest/MI emergency (heart attack) and got to suture about 5 people with various cut wounds. I'm getting a lot more hands on here, but also am being challenged by doctors who would probably ace the USMLE theory exam.
After my sojorun here I still remain absolutely convinced about the necessity for a much more indepth approach to clinical teaching than what presently exists in most UK teaching hospitals, and of the need to impart a work ethic that sees the student challenging himself to no end (with due supervision of course). The few weeks working here have blown my impression of what I was capable off right out of the water. Hell I'm even considering doing the USMLE at the end of the 5th year!

I will discuss some of the limitations of the medical system in more detail in my next post.