Do I walk funny?

So, it poured here last week. I mean, POURED!!! And since I mostly walk on dirt roads, it quickly became a quagmire of mud all around me -- and I didn't escape unscathed. Even though I thought I was being so smart wearing capris, my legs and pants were covered in mud. It seems like that should be par for the course, but much to my chagrin, everyone else looked like they had just walked in from a perfect 80 degree sunny day, even down their shining leather shoes. So clearly the only conclusion to draw is that I must walk funny -- I mean whose legs run into each other with such frequency!?! But anyway, on the bright side, at least I got a mud leg mask, right? :) And Kili came out in the morning, for the first time since I've been here!

Other happenings of the past week --

So there's a KCMC Wednesday morning clinical conference, essentially a hospital grand rounds. I've only been to a few so far because you have to introduce yourself in front of everyone so that one of the hospital directors knows who the newcomers are, and I kept postponing that dreadful day!! But I did it, and survived, although I spoke so fast I'm pretty sure no one understood me!! Well, except for the random Stanford undergrad who also happens to be at KCMC for a few weeks!!

Anyway, the quality of these conferences really varies, as you'll soon see from my story. This week was general surgery presenting conference on various syndromes of polyps in the colon. After their case presentations, they start reviewing the medicine behind the various syndromes, and start with FAP -- familial adenomatous polyposis, a syndrome of polyps that we ALL learn about in med school ad nauseam. Of course, their powerpoint lists it as the hereditary proctotypical polyposis syndrome !!!!!!!!!


I died laughing so hard and grabbed a picture on my conveniently located iPhone (yeah, I was definitely responding to emails during conference). If you squint you can totally see what I'm talking about. And no, that's not a typo -- procto means rectum. Talk about Freudian slip!!

Then, halfway through this review of polyposis syndromes, some lady comes in and writes on the blackboard, "Casuality doctors, emergence," underlines it, and walks out.


Now, there are about several comments to make about this --

(1) No one gets up!

(2) Everyone spells casualty (which is the emergency department) as casuality -- almost like they're talking about their attitude towards it -- casually

(3) There is no one covering casualty during conference!?!

On a more serious note, it's pretty sad. Casualty here has 4 beds and is run by AMOs -- assistant medical officers, who are mid-level providers, more than nurses but less than MDs. No one wants to go into ED medicine here, so the acute emergency care is sadly so inadequate.

But every week, these conferences do provide a more-than-anticipated level of amusement. This week I plan on sitting closer to the middle so my pictures are better :) I do wish I could offer my spellcheck/grammar services to all the presenters, but sometimes I think it's just a lack of attention to detail that results in poor formatting and editing -- this theme often pervades work in many different spheres.

I also hit one of my high and low points on the same day! Starting with the high...

We're resurrecting the practices of holding journal club, where one person presents an article, its methodology and strengths/weaknesses, and everyone discusses. Actually they are quite fun because you learn to critically read the literature. But in order to do that, the residents and interns need a basic epi/research design refresher course, and I had to present the first one -- an overview of clinical research designs and epidemiology/biostatistics metrics. It ended up going really well -- the consultants were very excited, said it was one of the first time all those messy definitions of case-control, cohort, cross-sectional studies made sense -- and they especially liked my crude chalkboard grabs and silly examples of fake research studies that would fulfill the different types of research.

I even got an intern to ask a question!! Amazing in a society that quietly sits through presentations without ever saying a word. Honestly, how can people not have questions!?!?

But the best part was an intern coming up to me and really wanting to get involved in our research group, participate in our journal club, and even present!! And, she also offered to take me shopping for better shoes for the muddy season :) Yup, it all comes full circle...

To the low -- actually, it started off as a great day, because after the presentation, I found out that my mom's package had finally arrived, 23 days later. So I recruited Shangwe, a guy who works with the Duke-KCMC project, to come with me to the post office. Of course, getting there requires riding the dala dala. What's a dala? These pictures say it all....

So basically it's an oversize van that should fit about 10 people but of course fits anywhere from 20-30 people. You're seriously packed in like a can of sardines, and though I'm sure it gets old, it's kind of fun! Locals have such a blaze attitudes about them -- look at this guy playing with his phone...

Of course, 20 second later, he lost his SIM card to the dala forever.... hakuna matata! But they range in class, from zebra print covered roofs, inside lights, and stereo, to a roof so low that even I am too tall for the dala (obviously couldn't take a picture in that one!). And the guy hanging out the window -- classic. He collects your 250 shillings (about 15 cents) and also adjusts the sliding door that always teetering on its rails and about to fall off.

Anyway, so we get to the post office, at 1pm; of course, customs went to lunch at 1259pm, so we had to wait until 2pm for them to return, at which point after my prolonged altercation with the lady because I didn't have my passport, I returned home dejected, parcel-less, and frustrated for the first time in Moshi. Lucky for me, Shangwe came with me to town the next day, and this time, many shikamoo's later and no bribe needed, I got my parcel, hamna shida!!! and, in time for my birthday :)

More to come on my birthday -- as usual, my personal motto for Tanzania says it all -- it's always an adventure...