Luck & Skill

"ARE YOU trying to make me more sicker?"

I alluded to what we actually do as fifth semesters as medical students here in Dominica in my last entry. Four out of five days of the week, we come out to Princess Margaret Hospital (PMH), which is the core hospital of Dominica, located right outside the capital city of Roseau. From now on, completely disregard what you think hospitals are like based on what you see in the states. Airconditioned, multi-floored buildings, well-sanitized with just about everything glistening in white... One of the most defining scenes is as you enter in after the giant painted-on "Welcome to Princess Margaret Hospital" sign... its a big diamond window where I see shelves of patient files stored. Some of the files are falling over into the gap behind the shelving and the window. Talk about care for patient records and ultimately, privacy. Nope, there's no huge cafeteria... Just a simple kitchen that's across from our teaching facility called The Canteen. You grab a seat in a plastic patio chair, pop open a glass-bottle of coke, and enjoy burgers and some other fried Dominican dishes. However, in the end, with what they have, I know the Dominicans make the best of it... and 50 medical students - including myself - are placed into the midst of it all.

Fifth semester for my program at Ross University - the name of my school - involves 12 intense weeks of observation and training in various Hospital wards. My first ward rotation took place in the ICU. We were about to observe a patient admitted for Heart Failure, after experiencing symptoms on one of the cruise ships that come into Dominica. The only doctor in care of the ICU told us, "The department's [and the patient's] yours." And there we went for it, asking for the patient's history (a download of how they ended up at the hospital) and started physically examining his/her body. Well, go figure, our patient started grumbling and he/she said to us the statement that started this entry...

I'll admit we're still new to this clinical deal. However, we were doing things by the book with what we had, our stethoscopes, our hands, and our knowledge. By the way our patient was asking, I figured he/she didn't like his/her time at the hospital. After all, the patient was crowded into a single isolation room without a window, the equipment cramped up much free space in the room. However, I had to think... "Our patient's lucky." No, no, no... not lucky that we're in a hospital that doesn't have all the resources... This guy/gal is lucky to be not only in good hands, but anyone's hands. Some people in the world can't even take care of their sickness because they don't have the money to get sent to a hospital, much less just see a physician.

See, at the end of our findings, it seemed that our patient was stabilizing... No signs were there to show progression of any decline of the patient's status. I believe if it wasn't for the dedication and knowledge of the sole ICU doctor in Dominica, then the lack of resources would have been a bigger issue. Instead, from what we observed, our observing doctor made the best of what he had, and that, my friends, is true skill. No matter where you go, its not just the technology that will define your bill of health when you leave the hospital... it is still the knowledge, flexibility and industriousness of the doctor that will make the difference. And it is these three qualities I aim to acquire as I move forward in my medical education.

Oh yeah, did I tell you? Jo's Chicken Surprise was absolutely amazing. She should start competing against The Canteen.