Wednesday, March 11, 2015

Togo Week 4: Bringing it home

Last week, I stocked up on Vitamin D at the pool, did a lot of spinal blocks, saw a lot of patients in clinic, and said my goodbyes. One day, I saw thirty patients in six hours, which averages out to one patient every twelve minutes! I also performed two Caesarian deliveries and a tubal ligation, and helped on a hysterectomy and a couple inguinal herniorraphies. Finally being able to get in the OR my last couple of days felt like a reward for all the hard work I'd done the previous month.

I wanted to come away from my time in Togo with new tangible skills, and I did. I'm comfortable doing spinal blocks on my own now, and a lot more comfortable with Caesarians now than I was before I went. To reinforce what I've mentioned in prior posts, I also feel much better about taking care of sick or potentially sick newborns, as well as malaria, typhoid, TB, parasites, HIV, schistosomiasis, and snake envenomations.

I also had a lot of time to reflect over the past week on larger learning points from the trip. An important one is that it's basically impossible to meaningfully connect to people with whom you do not share a language. This motivates me to continue to learn French, but also to try more to learn the local language of whatever place or places I spend more time working in the future. My gains in French over 3.5 weeks were fairly good, but would have been much more if I had had the head-space available that was taken up by medicine. In the future, I would like some dedicated time for just language learning, 24/7 for at least a couple months. Right after residency or fellowship would be the best time to do this, though I'll have to see what my life looks like at that time.

A related musing was how we should approach everything in life as a challenge, a puzzle, a problem, a question to be answered, solved, and overcome. This perspective is so empowering. When I was hot, I did not succumb to the temptation to dwell on how I wasn't meant to be in Togo or how I could never work at a mission hospital in Africa; I borrowed some thinner pants from Brett and took short breaks in air-conditioned areas, and felt just fine after that. Similarly, when I didn't understand what people were saying in French, I decided to make more of an effort to study and try to speak what little of the language I knew, and could at least understand bits and pieces of what people were saying by the end of the trip. When I wasn't sure how to get something done in the hospital, I would try to ask more questions rather than resign to futility. The list goes on. I'm frequently struck by how so many people resign themselves to being bad at something rather than approaching their weaknesses as solvable problems. Sure, not all of us are wired to be math whizzes or golf champions or social butterflies, but unless you have a personality disorder, a physical disability, or a below-average IQ, you can become decent at just about anything. We should all strive to be Renaissance men or women, not only to increase our antifragility but also so that our lives may be enriched. That's been my goal for a long time, and it's made my life immeasurably richer. But I still have a long way to go!

In addition to medical experiences, I was also able to connect to most of the English-speaking staff members of the hospital. I really enjoyed getting to know the CRNA's in the OR, who were all my age and spoke decent English. One guy even gave me an invitation to his wedding! During my down time, I watched Frozen with some other short-termers and the first half of the expanded The Hobbit 1: An Unexpected Journey with my house parents Mark and Donna Thompson. Church also offered a chance to engage with Togolese culture in a different venue, and the dancing and music did not disappoint! I also got my first djembe lesson by the long-term surgeon, Eric Miller, and am excited to play more and maybe get some drum circles going in the future.

My trip to the airport in Lome on Friday was eventful, as our first driver drove away with the keys to our van after we switched drivers halfway. Brett took off down the road waving his hands in the air, but she didn't see him. I'm sure it was quite entertaining to all the locals. Fortunately, the driver picked up when our driver gave her a call on her cell phone. Thank God for cell phones. We had a good time chatting with Koffi, the second driver, as well as a neat guy named Serge we met at a pizza place where we ate before heading to the airport.

The twenty-four hour series of three flights home was about what you'd expect; a never-ending stream of customs agents and airline clerks, movies and podcasts, carb-heavy food and cramped seating, naps and attempted blog posts that got lost multiple times. I finally gave up on the blog post, but think the added few days of perspective has helped things.

I already posted my photos from last week on Facebook, but will put up a few of the same here for posterity. Another post is coming where I will reflect on how well I met February's goals and what March is looking like. Until then, stay on the rise.

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