The Riverwalk Mall

Nothing too crazy happened at the hospital – I did two LP’s and a blood draw. Got both LP’s, the first one was after a few tries. This patient is a 30 year-old with HIV and altered mental status and we have no idea what’s wrong with him. The head CT was normal, so we decided to do an LP (lumbar puncture), but he’s out of it, so he kept moving and it was pretty hard to get. Even Boipelo tried and she couldn’t do it, and then I tried one more time and finally got it – it was a very traumatic (bloody) tap, but at least I got some CSF. I’m sure it’s a matter of being obstinate, but I’m still pretty proud that Boipelo couldn’t do it and I got it. The other guy was someone that needs to be tapped every day. This week, sometimes Boipelo has done it, and sometimes I do it – he likes me better. The first time I ever tried it (on Tuesday), I hit it on the first try, and Boipelo apparently took a bunch of tries on Wednesday. And today, I sorta had a first try, but I didn’t put the needle very far in. And the 2^nd time, I got it easily. So he says he likes it when I do it. But I don’t know how long I can keep it up. I guess we’ll see – I have to keep doing it until his intracranial pressure (the LP opening pressure) goes down. And this was the first day that it was lower than the day before, so I hope that this means he’s getting better – he has Crytococcal meningitis. We may have to put in some sort of shunt because we can’t keep tapping him every day. Boipelo says to not get my hopes up about him because she has seen pressures that got lower, then went back up the next day, but I don’t care! I’m getting my hopes up! He’s on Amphotericin right now, which is an awful drug. We have to give him 4L IV fluids (IVFs) every day because this drug seriously dehydrates you.

And tonight, we finally got out a little earlier! Like 6pm! It’s the earliest so far. This is my and Phil’s easy week – only on call Monday and that’s it. Our teams are on call Saturday but as Penn students we don’t have to come in on weekends. Next week will be super hard though. We pick up all the patients on Monday that our teams admitted over the weekend, and then we’re on call Wednesday and Friday.

Anyways, so because we got out early, we all went to the Riverwalk Mall (one of 3 malls in Gabs) and there’s a big grocery store there! Sort of like an American supermarket! And the mall is indoors, and has clothes shops, a food court, something like a Walmart – very similar to an American mall but with Botswana flavor. So I bought some groceries, and then we went to the Italian restaurant there called Primi’s. There were a lot of Americans there – apparently it’s a very nice restaurant by Botswana standards. I got a big pasta entrée (more than enough to take home) and a glass of wine for like P80, or $14. Not too shabby.