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Monday, May 6, 2013

Mi a Go

I finished my last day of work, and it was bittersweet. According to my patient logs, I have helped many children here in Jamaica (135 to be exact), while enjoying the beauty of lush rainforest and gorgeous beaches.

The view from the bridge of Annotto Bay

On the way between Ochos Rios and Annotto Bay

Typical bar in Jamaica

On my last day, I saw a patient for the second time at Port Antonio Hospital.  She was a 12 year old girl who had come last week  concerned because she was always thirsty, and always urinating, even at night.  In fact, mom was concerned because this wonderful, active 12 year old had never had a dry night in her life.  The mother had brought up this issue in the past with previous doctors, but no one had quite figured it out.  I had them obtain some basic labwork and a urine sample.  She had normal kidney function, her urine was negative for protein or blood or sugar, and she could properly concentrate her urine (ruling out a hormonal problem that could cause this issue).  The last test that we did was to check her hemoglobin A1c, which reflects the amount of sugar in the blood present over the past three months.  Normal is less than 6.3%.  Hers was 8.1%, indicating that she had diabetes (likely type 1).  I explained what happens in diabetes, warning signs to look out for, and referred her to an endocrinology specialist at Bastamante Bay. 

What I will remember most is the gratitude on the mother's face because she finally knew what was wrong with her daughter.  The relief on my patient's face was even more gratifying.  When I first saw her last week, she was so embarrassed because she was twelve and was still wetting the bed at night.  She wouldn't make eye contact, and she barely said a word.  After she knew that it wasn't her fault, that a disease was why she couldn't keep dry at night, and that this problem was fixable once her diabetes was under control, she started smiling.

I have learned so much over this past month here in Jamaica, and am so sad that I will be leaving tomorrow. I have learned to be very self reliant, and this experience has shown me that I am ready (even if I didn't think I was) to take up the mantle of being a full time pediatrician starting in July.  I am comfortable with procedures, and managing sick and not so sick patients at the same time.  I realized how adaptable I can be, and I am able to utilize limited resources to coordinate care of a patient.  I am so much more comfortable now with the idea of striking out on my own. 

Of course, I had wonderful nursing and physician support to help me all along the way.  As I said before, the people here in Jamaica are amazing...especially the parents and patients themselves.  They are so respectful of doctors (everyone takes off heir shoes when laying down on the exam table), and very patient.  They will wait hours to see a doctor in the heat.

Waiting area at PMH in the morning
The waiting area at PMH in the afternoon

Here in Jamaica, they speak both Patois, which is a very lyrical language of shorthand English, slang, and French, and regular English.  During my time here, many parents would speak with thick accents in Patois.  Sometimes I would struggle with understanding them, other times they would struggle with understanding me.  However, they never became frustrated. One of the physicians at PAH (Port Antonio Hospital) even gave me a short half hour lecture on Patois, and some of the rules. Like, never say I, just mi.  Th is pronounced "da", and er becomes "a" like in "It ova dere".  Each region of Jamaica has their own dialect of Patois, which makes it even more fun. It was like a puzzle sometimes, as I would do my best to figure out what was said.

So, mi a go home. However, I will always carry this experience with me.   Heading outside to enjoy my last bit of sunshine before I go!

Waving goodbye!

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