Update from Adam

I know that my addition to the blog is long overdue. We are at the end of our third week, and it is going to be difficult to encapsulate all that I have seen and done over these three weeks.

My main position is as an attending on the medicine ward at the hospital. Tenwek Hospital has 16 intern positions that rotate every 3 months through medicine, pediatrics, general surgery and obstetrics. They started the first of January, and therefore my first week here I caught the first group on their last week of medicine, and then got a new group of 4 interns these last two weeks. There is one family medicine attending who rounds, another resident and a Kenyan medical officer who all attend on the wards. I have been running rounds on the female ward (18 beds, always over capacity), and the family medicine attending runs rounds on the male wards. We also take care of patients in the ICU and do any medicine consults. I am on call with one of the interns roughly every 4th night, and was on all weekend the first weekend.

My position being what it is, my primary ministry is to the interns, who I work with very closely. I teach them on rounds, while admitting patients on call, during daily morning report, and have given them a formal lecture on heart failure management. On call I have had opportunities to sit and get to know them better. I have also been able to assist with their presentations at the various conferences they present at. I love teaching, and this has been a wonderful opportunity for me to use my skills as an educator to help them as they grow in their knowledge of medicine and how to take care of patients.

Tenwek is unashamedly a mission hospital, as evidenced by their motto, “We treat, Jesus heals.” This also plays a part of my many interactions, as we pray before each conference and before morning rounds. It also has played into many of our discussions on rounds, as we discuss how to care for patients and many of the ethical issues we face. We have even openly prayed together over patients, which has been a neat experience. For some of the interns, their faith is very vibrant and evident, and for others seems more of a formality, giving many opportunities for discussions. There are also morning devotions every Wednesday morning, and Bible studies every Wednesday night for the interns.

My next ministry is to the patients. I have seen an overwhelming amount of HIV/AIDS, TB, meningitis, typhoid fever, malaria, and esophageal cancer. More than I have ever seen in my life. I have spent a lot of time in the hospital library reading about the diagnosis and treatment of conditions I rarely see in the US. We do a lot of good here, but I have also seen death every day, and fight the urge to grow callous and cold. I have even shed tears for patients that would have lived had we had adequate resources to care for them. There is a lot that Tenwek has to offer compared to most of the other hospitals throughout Africa, but it is still very limited compared to what I am used to at Mayo. Sometimes I think it is a good thing, because it forces us to think about everything we do, justify it, and cut waste—a skill that is lacking in my practice in the US. But when people are dying because of lack of resources and public health, it is sad. Even with limited ability to communicate with language, I try to communicate compassion through smile or touch and through translators.

Well, it has been an eventful 3 weeks. I will try to blog more before the trip is up.

Adam