Week 1: It was a Monday morning when the global health program coordinator at Danbury Hospital picked me up from a hotel where I had spent the night. It was freezing cold with currents of very cold dry air blowing at my face when we moved into the car to embark on our journey to Danbury. While at the hospital, I was struck by the enormous buck pavilion building with multi-colored fountains in front of it. I couldn’t wait to enter this beautiful building.
Week 2: I was astonished by the diversity of people at the hospital. For instance, I met the chief resident of internal medicine, Moses, who is of Kenyan background. I was then placed on the 8E Tower building teaching ward. Most strikingly, doctors on the floor walked so fast and all seemed so busy, all occupied on computers. Every patient was hooked to a machine with EKG monitors beeping– oh my goodness I thought I was in the intensive care unit. The wards were extremely big but I was surprised that most patients were elderly, above 70 years, and each team had no more than 14 patients. Deep in my heart I wished we in Uganda had only half of this equipment. During rounds, doctors mostly concentrated on the electronic medical records. I noticed a big difference; physical examination is very limited in this setting. Physicians hardly palpate the radial pulse, tell the position of the apex beat, feel for the precordium, percuss the chest and asses symmetry. These practices have been replaced by the enormous technological advancements. At least every patient has access to CT scan, MRI, ECG/ECHO and ultrasound scan. I may stand to be corrected, but I learned in my medical training that medicine is an apprenticeship in which the art is passed on from one doctor to another.
Week 3: It was a Wednesday when I prepared to catch my train to Norwalk for the Global Health presentation at the hospital. A doctor presented a patient he had managed back home in Uganda. Medical students, residents, fellows and faculty attended this talk. He presented an ethical dilemma of trying to help this 19-year-old boy with Tuberculosis and deteriorating levels of consciousness by getting him into the ICU, yet putting the whole family at a financial burden. It was really a tough call. Everyone was so touched by this story. There was a moment of silence in the conference room. I realized how emotional this experience turned out to be, a sentiment I never felt while managing this patient back home. Practicing medicine in Uganda, a low resource limited setting, seemed like a battlefield to many American doctors. I am used to seeing suffering patients in the ward.
Week 4: I had a chance to rotate in Norwalk Hospital’s intensive care unit. I entered this huge 20-bed ICU with computers scattered everywhere and machines beeping all over with clean ventilators in each room. Through the windows I peeped and saw a very beautiful and healing view across the streets of Norwalk with the red and yellow trees, a river, the ocean and a nice bright sky. This was the best experience ever! That evening I and a Russian resident, Tatiana, decided to walk to the beach. Unfortunately and surprisingly, it became very dark at 5 pm. It was unbelievable! I had never seen this in my entire life, the day getting darker so soon!
The medical crew from nurses to attendings was very lovely! I felt like home for the very first time. Bedside didactics from Dr. Winter were amazing! I witnessed bronchoscopy being performed, and attended a cardiology conference where I saw coronary angiography. This was the best experience ever! At this hospital, it was a different way of doing things. Residents present patients to the attending, and it was a beautiful learning experience where residents were asked to justify the decisions in management of patients. It is a system-by-system approach where almost everything is tackled.