Easter weekend

Just completed our 3rd day at the BMC, and stole away to the schoolhouse for some brief internet and AC time. The schoolhouse is the only building witha working window unit, and since it rained today every other building is muggy and buggy right now. Every one of us had a dozen or more gnats stuck to our skin after returning from the hospital. So, ya know, basically Georgia in July. 

I honestly can't say I notice the heat much while I am in the hospital. Yesterday evening, we saw a fungating breast mass, which is the term for a breast cancer that has erupted through the skin (I would not recommend googling it). It occurs when a cancer goes neglected for a very long time. Typically, patients with terminal cancer here are taken home, but this woman and her family actually opted to be referred to a treatment center in the nearest large city. Our team spent a good deal of our time today trying to manually reduce the largest hernia I've ever seen (think grapefruit-sized). We were debating over whether he could wait until a surgeon is available to operate next month, or if he needed a more expedient repair, when the patient called us over to show us he had reduced it himself! It will definitely come back, but makes us feel a lot better about being able to wait for Dr. Faile to operate when he arrives in May.

The most memorable patient we saw yesterday evening. A pregnant woman with no detectable fetal heart rate, vaginal bleeding, and a hemoglobin of 2 (very severely anemic). On exam, she had a very irregularly shaped abdomen. They were concerned about uterine rupture, but she appeared relatively stable for such a severe diagnosis. Jeff and Brett scrubbed in for her surgery, in which they found what was likely a bicornate, or abnormally shaped uterus, that was weak in parts and close to rupture. Unfortunately, there are no blood products kept here, so a family member has to be available to give blood when it is needed. She had gotten less than one unit before she went into the OR, and did well during surgery, but died later that same morning. Definitely a sad experience. Jeff and Brett stayed late into the night assisting the physician with her surgery, and when we showed up for rounds she was just gone. 

Will try to post more tomorrow about our trip to the market yesterday.