Caring For One Patient, Serving an Entire Community

Written by Rafael Khalitov, M.D., Global Health Scholar from Russia

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“Anxious to bring both the year and New Year’s Day into line with the West, Peter decreed that the next new year would begin on January 1 and that the coming year would be numbered 1700… But to blunt the argument of those who said that God could not have made the earth in the depth of winter, Peter invited them “to view the map of the globe and gave them to understand that Russia was not all the world and that what was winter with them was, at the same time, always summer in those places beyond the equator.” -Robert K. Massie, Peter the Great: His Life and World

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As a graduate of Kazan State Medical University, I am proud that my Alma Mater was among the first Russian institutions to send graduates and residents to medical facilities in other countries. Global health is one of the most powerful tools with which professional horizons can be widened. It reminds us why we chose medicine in the first place.

The Qualities That Make a Surgeon Great

Written by Bryce Bludevich, M.D. '17

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He was a young man with a seemingly bright future ahead of him, a university student with a loving family. He was only twenty years old when he came to Mulago Hospital. He was skin and bones by the time he had arrived, his eyes sunken and blank as if he knew the end was in sight. Under his thin bedcovers lay the source of his malady: an open midline incision. The suture lay exposed, along with his spleen and small bowel. His tattered skin crisscrossed over his open abdomen, the edges of his incision well worn. He had multiple enterocutaneous fistulas.

Combating Medicine’s Hidden Curriculum

Written by Stefan Wheat, '18

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"But we had forgotten that alongside Orwell's dark vision, there was another - slightly older, slightly less well known, equally chilling: Aldous Huxley's Brave New World. Orwell warns that we will be overcome by an externally imposed oppression. But in Huxley's vision, no Big Brother is required to deprive people of their autonomy, maturity and history.” -Neil Postman

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My family reached the saddle of Thorung La pass on day fifteen of our twenty-one day trek of the Annapurna Circuit in Nepal, the 300 km trail encircling the Annapurna massif. On day sixteen I turned nine years old, and on day seventeen I developed appendicitis. That first night after I began to develop symptoms, I remember clearly when our sirdar, the leader of our expedition, entered the tent where I was screaming bloody murder—writhing in pain, but perfectly lucid. He sang a very tranquil song in Nepali and proceeded to inform my father—within clear earshot of myself—that he did not think I would survive to reach the nearest hospital. This marked my first experience with poor bedside manner.

This Week Brought the Strike

Written by Sarah King, M.D. '17

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This week brought the strike of the junior and senior resident medical officers (JRMO and SRMO).  They have gone on strike for a number of reasons, including salary, but also because there is no guaranteed job once they finish the first two years of post-graduate training.  Typically, after these two years doctors will work in a rural area for at least a year, a way of “giving back” to the government.  Unfortunately, although there are not enough open posts for the graduating SRMOs, the government will not issue permits to work in  private practice leave the country. As a result,  after seven years of training, a large proportion of them will not be able to find work.

Minutes Turn to Hours and Seconds Slow to Eternity

Written by Imelda Muller, M.D. '17

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Minutes turn to hours and seconds slow to eternity as we wait. Those once lining the walls have begun to indulge in the vertical support behind them, some sinking to the floor. We are all waiting for the man in the long white coat.

La Doctora Americana

Written by Jessica Huang, M.D. '17

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Among the sea of residents dressed in well-fitted white jackets, pressed white pants, and white shoes, I stood out like a sore thumb in my baggy light blue UVM scrubs, navy blue clogs, neon socks, and dirty white coat overstuffed with my stethoscope, Harriet Lane handbook, notebook, pens, hand sanitizer, and tissue paper. Unlike in the United States, the training level of medical residents in the Dominican Republic are identified by the color of their tops with green signifying first year resident, yellow for second year resident, blue for third year resident, black for first year fellow, etc. There are no specific colors for the interns (equivalent of fourth year medical students) while the pre-interns (equivalent of third year medical students) wear light brown scrubs.

Have You Ever Lived Like This?

Written by Katherine Wang, M.D. '17

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It’s hard to believe that it’s been less than a week since we arrived home. It simultaneously feels like I’ve been back for an eternity, Uganda a distant memory, and like I was just there yesterday. Home is such a vastly different place—from the weather and physical setting to the people and customs. On the flip side, it is so familiar that it has been easy to settle back into the routine, hopping back into a car to drive on the right side of the road, and working out on the treadmill. I almost wonder if it’s been too easy, given the prevalence of reverse culture shock. Maybe it just hasn’t set in yet, but I am certainly happy to be home as well.

Healthcare as Necessity

Written by Billy Tran, M.D. '17

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My time at Cho Ray hospital and Vietnam over the past six weeks has been filled with discovery, both of the world and of myself. I came to Vietnam with the hope of learning about a new healthcare system and improving my Vietnamese. As someone who grew up in a large Vietnamese community, I have always wanted to return to that community and provide healthcare to those with difficulty communicating with American physicians. Thus, improving my Vietnamese and increasing my cultural awareness was a big goal for my time here. While I did improve my Vietnamese language skills, I have gained so much more in my time here.

Noticeably Absent

Written by Erin Pichiotino, M.D. '17, M.P.H.

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Orthopedic Trauma rounds are every Monday morning. We visit each and every patient, take down dressings to look at wounds, review x-rays, and as a team come up with a plan for the week. Other than that, the orthopedic officers and nurses are responsible for following the plan, performing wound care, administering antibiotics and otherwise managing the patient, consulting the surgeons if and when necessary for proper patient care. The day-to-day needs of the patient including procuring implants and medications, bathing, feeding, and physical therapy if needed are taken care of by the caretaker, friends and family members who come to the hospital to help. Most of these caretakers sleep outside the hospital on the concrete, washing and cooking in the open space between wards.

Outrage As Impact

Written by Sarah King, '17

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I’ve been home now for just over a week. I was so excited to come home to see my friends and family and perhaps most of all my two dogs, that the realization that I am home didn’t sink until I had been home for a couple of days. I feel sad that I was not able to help more, that I am able to fly across the world back home to my comfy bed, my healthy family and friends, my car. I feel guilty realizing just how very privileged and lucky I am. We give my one of my 14 year old dogs a medication for her painful arthritis that many patients in Zimbabwe could not even afford. I’ve been struggling with feeling despair about the lives and suffering of so many people, of such profound poverty.