New Smoking Laws

For those of you who don't know... Smoking laws are getting stricter. YES! Good on ya, South Africa. If only they'd extend it to alcohol (btw, when is SAB going to STOP making quarts in glass bottles? Have you SEEN Friday night at Bara??)



Although he pokes fun and says that smoking laws do nothing - this is not true. There have been large changes in the prevalence of smoking of the first set of laws were passed in South Africa. Same for you overseas? Another post on this soon.

More on iMod.

Stories from Internship: Elephantitis Man

I'm sure Bongi would agree with me that doctors are only human - and usually have many funny stories to tell from seeing hospital patients - especially during internship. You only have to watch an episode of Scrubs. And yes. Most of the time... Scrubs is true. A lot more realistic than Gray's Anatomy.

This reminds me of a competition that our unit ran for a couple of weeks (between four of us - we left out the two religious interns).

The prize: Lunch. Paid for while you sit and eat it quietly, the rest of the unit picking up the slack of your ward work. As you can understand, a rare gift as an intern.

The Task: Which of our patients had the largest penis?

Yes, it sounds cruel comparing private vital organs, but you all do it on the Net anyway... We weren't cruel or judging. In fact, you would have been disqualified if you laughed, gasped, or in anyway let the patient know what was going on. We became very inventive at showing skin blemishes in the inguinal area on ward rounds, or asking for a second opinion on a catheter insertion.

Needless to say after two weeks we thought we had a winner. Whilst congratulating him before a morning round, one of our religious interns came to ask about the commotion. We told her about the competition and our winner (and the size of the prize penis - "huge" is a good start).

"Can it be any penis, diseased or not?" she asked.

"Anything. This is a hospital of course".

"Well then you should have included me."

Thinking that there was no way our winner could have been surpassed - and also that we couldn't imagine this small, timid girl taking note of any man's penis, we followed...

She lead us down the long corridor and we gathered around a bed.

"Mr X, we need to see how the swelling is going," she said to the patient and removed the bed sheets.

If there has ever been a time that I have had to stifle a gasp it was then.

The man had elephantitis and the timid Intern got one HELL OF A LUNCH!

TLA's

TLA's (three letter acronyms) are the best. Both in clinical medicine and in the world of medical aids.

They sound intelligent. And mysterious. And that's what Doctors are, aren't they?

My favourite is FOS (full of shit - can be used in psych or gastroenterology).

I once had a patient who was well versed in TLA's and also liked to read files. After examining her and writing notes, I went off to collect some meds (this was in a polyclinic)...


She became all worried after reading her file. The acronym F.L.U stood out. What could it be? A fancy medical term? Fungating Lipo Ulcerations?

When I looked confused, she said that I had used an abbreviation and she was trying to think what it meant - it sounded serious...

I couldn't help but chuckle and tell her she had the FLU and I wasn't abbreviating.

Remembering the old days... Black Eyes & Baragwanath

Being in managed health care is just... not as dangerous.

For some reason, I thought of this old gem the other day...

It was a dark, stormy night. Aren't all the nights in Bara dark and stormy. Or at least dark. When the lights go out. That's another story.

Was working in Ward 20. Having seen the 1 000 00th TB patient, I got called to case where the patient was tired to a stretcher. This can only mean two things.

One, the patient is dangerous. Two, the patient is psychotic. Both aren’t preferable. And the combo package is even worse.

This particular patient had post-ictal psychosis (for the layman out there, translation: have fit, become psychotic). On trying to get close to her, the poor lady screamed like a banshee and struggled against the restraints. At one point, she managed to slip free of the bonds that held her, requiring two (big manly) doctors to hold her down. My job? Flank and approach armed with large dose of Benzo’s. Unfortunately, she got her arm free and took a nice big swing.


THWACK.

I’ve barely been in a catfight, but before I knew it – I was knocked flat back on my ass. 1 x Well connected shot to the jaw. I left. Ego and jaw bruised, and not particularly caring anymore.

On the ward round the next day, we came across the same patient, who was now lucid and no longer psychotic. She was, however, spoting a nice black eye. Eyes turned towards me. The consultant had heard about the punch.

“Did YOU do that?!” he said.

“No,” I replied. But I wish I had.

Goes to show. Always the bloody doctors who get blamed!?

The Culture of Health

Sometimes, when days at the private practice get a bit dull, I think back to the good ‘ol days at Baragwanath. Those 30 hour calls when all you ate was a Bar One. Those frantic trips, wheeling a patient over to X-Rays (Porters? What porters?) JUST to escape a whining aunty. Those blissful moments where you scream back at the psychotics. And those daydreams of actually having sex in the on-call room. Contrary to popular belief, and a horrible TV doctor culture – DOCTORS DON’T ACTUALLY SHAG ALL OVER THE HOSPITAL.

Back to the aunties. It gets me thinking about the culture of health. South Africa is such a racially and culturally diverse country, that you’re bound to encounter some gems.

As Doctors, believe it or not, we've got our favourites. Here's the rundown:

WHITE PATIENTS: White patients believe the world owes them a favour. Why? I don’t know. If you aren't doing moving the earth for them (and they will check that by getting 3 consults) - there MUST be something wrong with you.

In fact, if I a white person dared to walk into Bara - THE WORLD MUST. COME. TO. A. STANDSTILL.

They are the only patients in the room. White doctors, of course (didn't you know?) should give preferential treatment to their white brothers.

The consequence of this entitlement complex - I have many doctor friends who are too afraid to go work in private practice, in white suburbia heaven, because of the perceived special treatment that has to take place. Agh!

INDIAN PATIENTS: Ah, aunties and their hubbies. They are PAINFUL. More painful to us than anything that might be afflicting them (excuse the sarcasm, but this applies to the ones that actually aren’t dying – which is most of them!).

Indian patients believe that every pain, every feeling and every thought that had crossed their minds in the LAST 10 YEARS... are all interlinked. These patients will proceed to tell you how the itch in their left ear, is related to the pain in their right groin, which is OBVIOUSLY going to give them a heart attack. In the next 48 hours.

And no matter how you tell them otherwise, the talking just does noooooot stop (cue Perry Cox extended syllables). Add to this, by the end of the conversation, you'll know the entire family history, eating habits and lengthy diagnosis of daughter's boyfriends's mother's uncle's skin condition. And WHY it’s just such a damaging relationship. Which one you ask? My point exactly.

BLACK PATIENTS: Perhaps it’s just because of demographics, that we happened to see more black patients, working in a government hospital. Perhaps it’s a cultural issue I just don’t understand – but black patients seem to have a more inherent trust and understanding of the pace and pressure of a health environment. These patients will will tend to tell you exactly what's wrong, and nothing more.

There have of course been those wonderful examples of:

"Noooo... I can't be pregnant."

“Have you been having sex?”

“Yes.”

"Then you can be pregnant".

But then again, that pretty much happens with everyone.

Give me our black bruvvas. They are certainly a lot more appreciative! To this day... Not a single courtesy curry. Or even an invite to meet the daughter's boyfriend over a mango lassie. And definitely no invitation to Sandton kitchen tea.

Ah, patience, patients.

"Jozi - H" Puts South African Spin on Medical Dramas

Thanks to Champs for this info.

Reuters, UK
17/12/2006

The Canadian-South African co-production follows the same format as primetime U.S. dramas like "ER,'' with breakneck editing, punchy dialogue and overlapping story lines that play out over several episodes.

But it also deals with South Africa's specific problems.

The country has some of the world's highest levels of violent crime, a crushing AIDS epidemic as well as millions of people suffering diseases associated with poverty and need: its busy emergency rooms bear witness to these scourges.

"Jozi-H'' draws inspiration from two of Johannesburg's most pressured trauma wards -- Johannesburg General and Chris Hani Baragwanath Hospital in the sprawling Soweto township.

Finally, someone's going to talk about it. Yes! I just hope it really is a CO-production - or would get some otherworldy views creeping in. Funny, but I seem to remember SA Doc getting consulted in varsity over some kind of potential TV Show. Wonder if this is it?



You can check out the official website here. It's even on IMDB. Is it just me, or are those some ex-Soapie stars? Hmmm.

Joburg Hospitals reduce intubation weight of babies to 900 grams

More Ubuntu stuff soon... Keep reading! Some important news though... just in.

It happened the other day. Anything 900g or less must breathe by itself or die. There are reasons of course, like not enough staff or intubators. Studies have also shown poor prognoses in lower grammages. Therefore those with a higher chance of surviving - will get the intubators.






This one is 3500 grams. Makes you think. Doesn't it?

The largest hospital in the world!

So, Google Maps just opened its warm capitalist arms to South Africa. We took a quick trip to show the world of blogging... Baragwanath Hospital. Old Bara is apparently the biggest hospital in the world by bed count. It's also the most multi-cultural Doctor-fest around. SA Doc had a Russian, Yugoslavian, Pakistanian, Congonese, Indian and 4 South Africans... just in one unit!


Feast your eyes ladies and gents. Note size of shacks bottom left and houses middle top. Just under 2km in diameter - no wonder the porters laze off.