Monday, August 20, 2007

Dinner with the big wigs

So intake this morning was a little surprising – my team had 3 patients die over the weekend – one 77 year-old with metastatic adenocarcinoma, which wasn’t too surprising. But the other two were young, 30 and 42, with mental status changes, that I thought were going to live! It was a little difficult to take – I was not expecting it, and I had poured so much work into them to try and make them better. Some of these patients you know are going to die, so it’s not worth 3 hours of your time to try and diagnose or treat them. But these two I thought were going to make it. I guess that’s the way it is here… Nothing much happened today though. I thought we might pick up a huge number of patients since Boipelo was on call Saturday, but we only picked up 3 or 4.

Tonight we went out for dinner again, this time at Tendani’s house – she used to be an MO, and was leaps and bounds better than the other MO’s, so got recruited to run IDCC, which is the Infection Disease Clinic at Princess Marina Hospital – it mostly takes care of patients with HIV and AIDS. However, she is rarely ever there anymore as she now is very involved in PEPFAR (the U.S. President’s Emergency Plan for AIDS Relief). Her dad is the Minister of Finance in Botswana, arguably the 3rd most important person in Botswana, so she comes from what seems like a line of administrators. Interestingly, her husband is an artist, and seemed to be a very cool guy – although I didn’t really get to talk to him.

There were some very interesting people at the dinner. The entire Penn team had been invited, and she had invited a lot of PEPFAR people as well. I had very interesting conversations with a few different people – one was the son of a prior president and he told us a lot of stuff about Botswana politics. I met a few PEPFAR people too, and they explained to me what PEPFAR does – it helps set up HIV/AIDS clinics in small towns in Botswana so that eventually, hopefully all citizens will be able to receive treatment. HIV is such a huge problem here – I would say that 75% of my patients come in knowing they are HIV positive. And who knows how many of the other 25% are HIV positive. We offer the testing to everyone, but not everybody wants it. Boipelo says it’s because most of them are in denial or are afraid, but they have really good accessible treatment now, so it’s starting to become a little more openly talked about.

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