Pitching = showing up

Everyday we arrive at the hospital whenever our bus decides to drop us off. We get to the bus stop at approximately 6:50 am and hope for the best. Sometimes it gets there and leaves before 7:00 am rolls around, others we wait until about 7:20 am. We have officially discovered Africa time, which according to our registrars is very common. The bus could leave early or late, we just have to pitch to the hospital whenever we can. Our "bosses" are so worried about us making the bus in the afternoons, we actually leave about 20 minutes before its scheduled departure to wait for it. Needless to say, we do a lot of waiting every day.

Yesterday I officially saw my first patient on my own. Needless to say it was a little difficult. Not only was she the first person that I have met here that did not speak a word of English, but we could not find a room in the clinic for me to talk with her. After conquering these obstacles, I came to find out that she has had a deep cavitating lesion on her right thigh, which has been getting worse for the past 7 MONTHS! She had just been told to dress it, and eventually someone took a biopsy, which demonstrated lymphoma. She was unconcerned about it due to the fact that it was not painful for quite some time.

Another patient that I saw yesterday had 3 masses, which were visible from across the room, under his chin. He stated that he was unconcerned about the masses because, once again, they were not painful. My attending physician told me that this is extremely common here, especially in those who are uneducated and do not know that even and especially non-painful masses are something to go to the physician for.

So Ashley and I pitched (yes, that means showed up) to a "tut" (aka tutorial) today with the other South African medical students. We often feel significantly stupid in these sessions because everyone here seems to know so much more about physical diagnosis than in the US. At home, when we suspect something, we order the tests to discover what is wrong with the patients. Here, they narrow down the diagnosis much quicker and more efficiently just with their physical exam skills. They often discuss signs and symptoms that we have never heard before. It is amazing how much clinical teaching the students and the residents receive here. Several times a week, if not daily, an attending physician (consultant) takes time to teach a case including all of the physical diagnosis signs, which there are a LOT more abnormal findings here than in the US. It has been an amazing learning experience.

Cheers.