Elsewhere and Otherwise: Fun at Work?

I was dressed up as a drunk, combative car accident victim for the final exam of the ATLS course... and had a great time!

Yeah, we have a lot of fun... or, I suppose, at least I do... lodged between the long hours, the chaos, the depressing stories and the violence, there's a lighter side to things (honestly, there is!). The trick to getting through the day - in fact, the secret to loving the days - is to find humor in every situation. Some days, things seem so ridiculous that I pretend I'm actually on "Candid Camera" and am being taped for a reality TV show... often, it's the only explanation that makes any sense. I remember walking through the trauma unit one morning, coffee cup in hand... there's a guy sleeping (and snoring very loudly) in a pool of blood (his own, I hope...) on the floor... a paramedic is holding a patient's amputated foot in a plastic bag near the door. There is a woman who was bitten by her boyfriend, a man who jumped off a train, and three police officers guarding a man who is so drunk that he's asleep, half on a chair/ half on the floor, butt straight up in the air. I mean... it must be some kind of dark comedy script, right? It's weird, it's funny, it's surreal... except that, of course, it's actually real, and so then you stop chuckling and get to work.

Saturday was my last shift at the Joberg Gen. In five weeks, I've done 23 12-14 hour shifts, plus a three-day ATLS course. In that time, I've placed 8 chest tubes, 3 central lines, and assisted with two DPLs. I don't even know how much I've sutured, or how many ABGs or IV's I have placed... I lost count a long time ago. I'm exhausted. In some ways, it's hard to believe that it has only been five weeks... I have become to comfortable here, in Joberg and the hospital; I've met so many people, made friends, traveled about... it almost feels like I live here. The shifts have sometimes flown by in a flurry of activity, and other times, when the patient flow slows to a manageable trickle, long conversations about politics or philosophy break out over weak coffee and cold Nando's chicken. I have loved all of it, every last bit; I say that honestly, acknowledging that each and every terrible thing, all of the inefficiencies, the preventable morbidities, the horror of the constant violence and underlying racial tensions - everything that I have experienced here has been more than worth it. Life here is exactly what I often feel is lacking back home: it is real, so very, very real, that it's impossible to deny or avoid. In the states, particularly in the more affluent communities, it feels that life is lived in a bubble of cars, fashion, and shopping malls... here, in the hallways of 163, the frivolous concerns of suburbia couldn't be further away. I don't find myself constantly rolling my eyes... i'm too busy caring for patients, too busy learning and feeling what is real as it ebbs all around me. I suppose this is part of the reason why I chose to become a doctor, why I'm going to specialize in emergency medicine, and why I insist on practicing it in the busiest, most chaotic conditions available. Maybe this desire will pass as I get older, more tired and jaded... but for now I'm more than happy to roll up my sleeves and get my hands dirty... thank you, Africa, for giving me this opportunity. I'll be back!

After relaxing on Sunday, I will start two weeks of trauma ICU at Chris Hani Baragwanath ('Bara') Hospital on Monday. Bara is the major "university" hospital serving Soweto, a poor, historic township just minutes from Johannesburg. It is home to an estimated 4-5 million people, mainly poor black families, and is one of the most violent areas in all of Joberg. Bara hospital is one of the largest hospitals in the world, with 3,500 beds, and runs one of the busiest trauma services in all of Africa. But, more on that in the next post... for now, I want to take you on a brief , illustrated tour of the Joberg Gen. Enjoy!

Welcome to the Trauma Unit! Enter at your own risk... :)

The entrance to 163 is a locked metal gate... enough said!!

Hanging out with Nick and Marius at the end of a 14 hour shift. It's 7am and we're exhausted... why are we smiling?!

Looking at an x-ray with Colin... I honestly don't think he's capable of looking serious in *any* photograph!

Mariana, me, and Colin in one of the trauma bays.

Kids, don't try this at home!! Especially because i'm doing it wrong (there's no mask on the end of that BVM!) But it's all for the photo anyway... :P