First off you all should be very proud that I caught myself before I posted my personal statement that I spent all evening thinking about and not working on up here.
Alright there is a lot of context here-I promise…So let’s jump into it why don’t we?
Thursday morning we had a clinical meeting at 7:30 A.M. Alright well it was supposed to start at 7 but that is when I got there and they hadn’t started. Most people honestly showed up later. Anyways, at the hospital every Thursday morning someone from a department presents on a relevant topic from their department. This morning was a female ward presenting on family planning. Apparently in Zambian culture it has long been seen to be a sign of wealth to have many children which leads to people having so many children that they can’t take care of them well. Zambia has gone into drought–some of the areas didn’t get any rain during the rainy season which in case you were wondering is a bad thing–so making sure there is food for the kids is even harder than if it was simply an economic thing. This is where she was coming from and then also pregnancy among 15-20 year olds is a huge thing.
So as you do at these meetings she talked about birth control, all the types from NFP to vasectomies and tubal ligations–pros and cons of each, side effects, etcetera. What was even better is she had brought some of each to pass around so we could look at them. So I’m not kidding. I passed every type of birth control available to the pastor. It was really interesting the different reactions. Everyone was dead serious but there were some like Dr. Shimunza who just passed things without even looking at them and then guys who would stare intently at like the depo injections packaging. It felt a little ludacris when we passed a condom around and then the nurse explained how to use it. It was dead serious as she was demonstrating.
“Now remember when teaching patients it is important to have a prop so they don’t put it on their finger like I have and then come back complaining of conceiving.” Again everyone was dead serious, some people were taking notes. It was almost too much for me to keep quiet but thankfully I hadn’t had my coffee and was feeling it. I won’t go into too much detail because who knows children might be reading this but at the end there was a time for questions and here is a funny story that killed me.
Random guy- “So I’ve heard from err friends that sometimes birth control decreases pleasure for the woman.”
Nurse presenter-”No, but as family planning counselors we can help teach the men about foreplay if need be. We have to hit the nail on the head.”
I felt a bit like I was in a twilight zone episode. After the meeting Dr. Shimunza told me to wait outside while he had a debrief. I was sitting in the sun when a cleaning guy started talking to me. I love how friendly people are here. The guy looked like he was about 40.
“Enjoying the sun?”
“Yes, it’s very nice out today.”
“Where are you from?”
“America.”
“And you came alone?”
“Yes, all alone.”
“Wow!”
“Do you have someone waiting for you back at home?”
“No.”
“How could you not? You are a beautiful young woman and there are so many guys.” I was still getting fatherly vibes although my alarm bells should have been going off.
“I’ve just been unlucky.”
“You’ve just been unlucky! Are there no men in America?”
“I just haven’t found the right one. One day!”
“Ah well perhaps we can exchange numbers and I can text you in America.”
I have never been so thankful to see Dr. Shimunza coming before. “Oh I have to go now to follow the doctor but thank you!”
Thank God! I thought I was safe talking to this guy. I guess Chris and I are married/engaged again! (How could I not miss my fake husband honestly!)
We went to the female ward first and I suppose you can never escape obstetrics because the first several patients had to do with that and female anatomy. I was with the first year nursing students today so I held my own a little better on the anatomy and none of us knew all the specifics. I did know all the layers between the abdomen and the uterus so I’m calling that a success–something like learning from experience.
We also visited a 99 year old woman and Dr. Shimunza posed us the question, “How long do you want to live?”
It’s funny how nervous the nurses get around the doctor. I wonder when I will have that effect if the power will go to my head or not? We all sat there nervously as if still in quiz mode–is there a right answer?”
“Sister, how long do you want to live?”
The nurse student shrugged her shoulders.
“Claire, how long do you want to live?”
Ah excellent, I have my fail safe answer, “As long as God wills it.”
“Yes but how long is that?”
“Ummm….until it’s my time?”
“Me I want to live 70-80 years and then it is good after that do you enjoy life? Is she enjoying life?”
To be fair the 99 year old woman was kind of laying on the bed staring vacantly into space so she could have been daydreaming.
“And yet she asks us to keep her alive? Are you ready to die?” He paused for a moment. “Anyways that is all class you may have a break.”
Of course I’m not part of the class, I'm part of the follow the doctor around and pay attention to everything he says in the group. I have no will but his. We saw a few more patients mostly with malaria–a very big problem that I know how to treat now. And then you’ll never guess where we got called! The obstetrics ward! Because there was a patient in need of a C-Section. 36 years old, sixth baby, failure to progress. The lady didn’t look super happy about it after six live births but she also wanted a bilateral tubal ligation which is apparently easy once the abdomen is already cut open.
So instead of eating lunch we went to the operating room! Becky wasn’t there today but the assistant nurse surgeon was Mary who is very confident in me learning things. Lazarus, the head of the theater, finally put his number on my phone. I hope he didn't expect me to text him but he did ask about seventy-seven times. But back to Mary and her unfounded confidence.
“Ah Claire, today you will be assisting the Doctor.”
“Oh okay.” Then my brain processed what she’d just said to me. “What?”
“Yes, you’ve watched now you will help. I will be there too but I don’t think I’ll even have to put on the boots (we wear galoshes for C-sections) because you will be there.”
“Great!” I think that is what came out of my mouth. In my head I was going. I haven’t eaten anything but a piece of bread because I had to rush to the weirdest meeting of my life, and oh I don’t think I’ve had coffee today either. I’m going to fall over during this C-Section and the patient is going to die and it’s going to be…”Oh it’s time to scrub up?”
There is something very methodical about scrubbing up. It feels a bit like putting on a superhero costume if superheroes regularly proceeded to cut people open and rip babies out. First you put on the C-Section Galoshes (That can also be used for other bloody surgeries) then you put on an apron. It’s assumed that you already have scrubs, a mask, and a cap on.
Then there is a certain way in which you wash your hands and a step by step process. I never understood why surgeons hold their hands the way they do. Now I know! (It’s so that the water always drips downward because the fingers need to be the cleanest part.) The unfortunate thing is the sinks are Dr. Ang's height so I have to wash my hands in a semi squat position.
You go into the operating room, hands still held up and get handed or grab a towel very carefully. Then you dry your hands drying from the tips down. You get your gown put on keeping your hands inside the sleeves. Then you put on the first pair of gloves–while someone ties your gown. You have to hold out the waist strings so that they don’t touch the front of the gown. Then you put the second pair of gloves on and you are all suited up.
Anyways after I did this I went and stood a little ways away from the patient. “What are you doing Claire?” Mary immediately asked. “Come here.”
Okay so she was serious.
I moved to the direct side of the patient and whispered more than one prayer under my breath while Dr. Shimunza checked the numbness of her abdomen.
“Alright we are starting.” It was a bit like tipping over the edge of a roller coaster.
“Okay Claire I just cut through the dermis–clean the blood with that gauze.”
-And I did. Not aggressively enough because I had to do it again.
“Now I am cutting through the sheath. Alright grab the muscle and pull.” (You don’t cut it because it bleeds so much.) “Brace yourself against the table and lean back.”
It took me a couple tries to get it right.
“Okay here is the peritoneum, is it the parietal or visceral.”
“Parietal.” Man I’m glad my brain still sort of works.
“Hold it open.” And then the baby was cut out and there was blood everywhere. I got the suction taken away from me when they realized I am bad at it but I had the gauze. Did you know you hand surgeons forceps and tools in a certain way? I did it wrong the first time and they paused their efforts to explain it to me. While the woman was still bleeding so they must not have been too concerned.
“Alright Claire, hold the uterus like this for me.” I won’t lie, I nearly dropped it. I know it’s part of a living body but I wasn’t expecting it to be warm and pulsating. I held it in the proper position and would grab the thread when he asked while the Doctor sewed it shut only hitting one artery in the process and taking care of it without batting an eye. “Mary, I'm going to need more gauze.”
Once the uterus is shut the process can slow down because the bleeding kind of dies out. We then took that time to look at the uterus’s anatomy and that of the fallopian tubes. “Don’t sew this instead of the tube” he said pointing to a ligament. “If you do, they will come back pregnant and sue you.”
That process all I had to do was hold the tubes with some forceps while he tied and cut them. As we were doing this and chit chatting the lady began to talk quite extensively about a certain guy. Everytime we asked if he was her husband she clammed up so perhaps there are secrets they are better left untalked about. What was more interesting is she did this in English which none of us had thought she spoke.
“Do you love me like you love him?” Dr. Shimunza asked.
“No.” Was a very decisive answer.
“Why not?”
“What are you doing?” Imagine everything she says very slowly and in a loopy way.
Later on when she was going on about him again and we asked her again if he was her husband she told us very emphatically to stop playing mind games on her. She then grabbed my arm very violently which I’m glad Dr. Shimunza was just finishing sewing the skin.
“Hey,” Juma said, “Stop touching the Mzungo.”
That was the end of the day at the hospital and I finally got to eat lunch at about 3:30 P.M. but I didn’t pass out in the operating room and I think I was sort of okay.
My walk that evening was very beautiful. The clouds were making the sun come through in rays and I walked a loop I hadn’t before. I think I am running out of new options but it was really pretty. I’d originally started by just going to the creek I found the other day which is already running low and filled with trash so not the most inspiring. People also kept walking by and asking what I was doing so I gave up on sitting there.
While walking by the church I noticed a guy who’d been walking behind me for some time and had kept running to get closer. Well this is how I get murdered is the first thought that went through my head. When he got up close to me he stopped running so he could appear to casually walk up to me. Hey at least he was trying.
“Hi, how are you?”
“Good, how are you?”
“I am good, I am Gift, can I walk with you?”
“Sure.” (It had taken me a second with the name. At first I thought he’d said, “I am a gift.” Which is very very forward.
He turned out to be a very nice, very devoted SDA who had noticed me in the hospital and had simply had to meet me. He sings in a choir–which is a red flag now–but my fake husband does? Do I just go for red flags? Who even knows.
But anyhow I went home and cooked dinner by candlelight because of load shedding. The drought is really really awful here so it is okay. I just hope I clean to Emmanuel's standards by candlelight–which I probably don’t. (That man does not talk much except to say good morning and to tell me to keep the kitchen clean–which the only time I don’t is when I’m actively cooking but we try.)
You would think Friday morning would be another late morning of 8 A.M. but now there is a prayer service at 7:15 in the morning to end the week and even though I’m not SDA like praying so I will go. I had gone to bed so early the night before that I got up really easily and in time to do some studying on Kidneys and Fallopian tubes. My knowledge of Anatomy is going to be so random by the time I get to medical school. I didn't, however, give myself time to eat a long breakfast so I once again ran down to the hospital with a piece of toast hanging out of my mouth. Where I discovered-nurses day, and that my friend deserves its own explanation.
Song of the Post: Hooked on a Feeling
Quote of the Post: “Oh Claire! You’re Catholic! I’m Catholic too! Well of a different sort.” The SDA Pastor
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