(Almost) Total Eclipse of the Sun

It’s hard to believe I’ve finished my first full week of work. The time is going by very fast here, and I feel pretty settled into Kijabe life. There weren’t a lot of surgical cases this week, but rounding and clinic kept me busy. Gynecology clinic is on Fridays, and I think 90% of the patients I saw today came in complaining of fibroids. Most were asymptomatic, but the patients had been told that a hysterectomy would help their neck/bone/leg pain- doubtful. Many other patients complained of infertility. I saw one woman at the end of the day who was not well- hypotensive, tachycardic, and complaining of 6 weeks of vaginal bleeding. She wasn’t pregnant, and her exam was more consistent with pelvic inflammatory disease. I was a little alarmed that she had sat in the waiting room for several hours with such bad vital signs. I’m anxious to check on her in the morning.

They perform a lot of neurosurgery at Kijabe – particularly on kids with hydrocephalus and spina bifida. The lack of folic acid in women of child bearing age is a widespread problem. Currently, there are some visiting neurosurgeons from Wisconsin, so people are traveling very far for neurosurgery consultations. Yesterday a mother brought her newborn in who had anencephaly. The poor little guy had protruding brain tissue and a very small cranium. Not even the neurosurgeons could help him. Today we admitted a term mom who was told she might be having twins, but her baby actually had hydrocephalus. We ultrasounded her, and asked the neurosurgeon if there was enough normal brain tissue for the baby to live. He thought so, and we did her c-section tonight. The baby was breech with a very, very large head as well as a myelomeningocele. He will get a VP shunt within 24 hrs to relieve the pressure in his head, but will have a very difficult road. At least the mom has 3 healthy kids at home.

Everyone take several breaks during the work day to “take tea.” The head maternity nurse told Pauline yesterday that she should buy them all mondazis (fried doughnuts). It must be universal that to keep the nurses happy, you should bring them snacks. We figured out that we needed about 20 mondazis for everyone. (The Kenyan family medicine resident Tembu told us “better order 21, because I can take two.”) I am surprised by the fact that there are male OB nurses here as I have never met a male ob nurse in the States. The nurses here are all trained as midwives. You can spot all the nursing students becasue they women wear blue sweater vests and skirts and the guys wear short white lab coats.

Today there was an annular solar eclipse, and everyone was outside looking at the sun through x-ray films. The eclipse was awesome – also very funny to see all of Kenyans peering through random x-rays. I hope I didn’t burn my retinas!