Intro to KCMC

   I just finished my third day here and I'm adjusting slowly. The pace is much different here, much slower than in the US, without the typical sense of urgency and impatience that we all experience everyday at home. In fact, people you've never met even stop to say hello and chat- although people do this some in the south, this is on a completely different scale. The same goes at the hospital- an 8 AM lecture usually starts somewhere around 8:15 or 8:20, for example.
   The days have become relatively predictable. The residents and students (most of which are European) usually start off at 7:30 or 8:00 with morning report, which usually consists of the person on call discussing the admissions and deliveries from the day before and then discussing the more complicated patients in detail. I don't know exactly how many residents there are, because it seems like I'm meeting new people everyday and there is a different mix of faces everyday. After morning report, everyone quickly scatters to their respective services... the theater (OR), labor and delivery, etc.
   So far, I've only gone to the OR. People are also much more creative and make due with much less than we do, which is not at all surprising. For example, they don't have automated blood pressure cuffs, so the anesthesiologist has to manually take the blood pressure every 10-15 minutes through the case. They also don't have access to advanced laparoscopic instruments, and they are just now starting to do diagnostic laparoscopies. If they find something that needs operative intervention, however, they still need to do an exploratory laparotomy.

A typical GYN OR set-up.

   After the cases are done (which recently has been by 4 at the latest), everyone scatters. In fact, today we finished with an abdominal hysterectomy and it went past 3, so the scrub nurse just scrubbed out and left. The surgeons just kept going and helped themselves to the instruments on the table, which I could never see happening without a fuss in the US.

I'll write about some of the interesting cases next time, hopefully with some pictures :-)