Day 08 - Usher and Shaggy are in Jamaica!

A hearty breakfast every morning. A great cup of coffee. Amazing view. Yeah, I can get used to this.

I was eager to get to Port Maria today so I could check in on the one-year-old boy we saw last week who had been scalded by boiling water. Stacy and I were worried about his pain management and the adequacy of monitoring such a young child's fluid balance. I'm happy to report that he is doing much better. In fact, I couldn't find him in his bed because he was out and playing around. He was scheduled to be discharged today. Dr. Fazul had followed our recommendations for pain management using morphine and he reports that the baby was very comfortable during the last week. He has been eating well, and his skin looks very healthy. His mother came and gave me a hug saying, "thank you for loving my child". That's it. That's all the compensation I need.

Dr. Fazul and I rounded on another 8 patients. The pediatric ward here has the luxury of being split into three zones, so the four children admitted with gastroenteritis were physically separated from three newborns and another one-year-old girl who had been admitted two days ago with a burn eerily similar to the first boy's burn. I learned an interesting tidbit of information when I asked if the babies were receiving expressed breastmilk and if the hospital provided mothers with breast pumps. Apparently, the mothers actually express their breast milk manually, using their hands (this is how). I didn't know this was possible, and I'm happy to hear that it is, but a part of me wonders how many more mothers would provide expressed breast milk if they had the manual breast pumps that many US hospital provide free of charge to new mothers.

I saw five patients in the clinic after rounds: two were follow-ups for asthma, one was a well child visit for a month old newborn (yes, they do well child visits here), one was case of pretty bad tinea capitis that had failed management with shampoo that a private doctor had prescribed, and one was a child with occasional dizziness spells that I sent off for some tests and asked to follow-up next week.

I had a little time to speak with the folks at the registration and scheduling office. They are now offering parents who call for a pediatric appointment the choice of a Tuesday clinic (when Dr. Ramos is here) and a Friday clinic (when one of us will be here, hopefully regularly). They've integrated us, and I love it!

Before heading back to the resort one last time, Steve and I went to Scotchy's, which has the reputation of being the absolute best place to have jerk bbq in Jamaica. I came here last week with Diane, Stacy, and Alex and I couldn't bear to go home without pigging out again.

Today is my last day here and I'll be happy to get back to my family. But I've had a tremendous experience here. Having a regular schedule, and actually filling in a gap in each clinic is very gratifying. Working with the hospitals rather than in parallel to them is beneficial to the long-term well-being of child care in Jamaica. I've gotten to know the pharmacists, the lab technicians, the attendants, and the other physicians and I feel that we are now a unified force. Great things are coming. We are learning new lessons every day, and the "orientation manual" that Stacy and Diane are writing is being updated on an almost daily basis. There will be kinks, but that's the best way to learn and to improve. And being able to come home to the luxuries of a beautiful resort and rest in a great bed is nice icing on the cake.

This blog will be open to posts from the future physicians and nurses who take part in this mission. I'm looking forward to reading about others' experience here. Thank you all for following my journey with me. The emails you sent me and the comments you posted were very inspiring.