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My Elective - Blog 1

By James Lee

My Elective - Blog 1

Elective 101. The sick don't wait for you to graduate.

Day 1 of elective. Wake up at... Oh wait, no sleep for me. Off to the airport at 2am for a 6:20 flight. Not that I'd have gotten any sleep last night: With finals over, it's been a long wait to hear results. Today is results day. Flight number 1 is eventless- the dread that some medical emergency will occur en route, as if I'm not already feeling inadequate.

Results at 9am we're told. Standing in the boarding queue at 9am, refreshing my emails frantically, I find no results... The suspense is killing me! Through the gate. Boarding the plane. 9:07- it's happened, the decision to unleash me on patients this August has been made. I PASSED FINALS! Now the holiday can really begin.

I decided a few months ago to kick off my elective with a road trip of Southern Africa. A few days in, I encounter an interesting pit stop as we pass through the border control into Botswana. We'd been warned to keep our shoes separate from our luggage as we'd need to disinfect them before passing into Botswana.

A precautionary measure to prevent the spread of foot and mouth disease. Anticipating a gruelling scrub of each pair of shoes I already regretted bringing, I was surprised by a mere dab on a welcome mat doused in what smelled like chlorinated water.

Off we went. The stark difference to the rigorous cleaning processes I have seen in the UK, I am already wondering what other differences there might be in the approach to healthcare in this country.

En route, someone in the background is wheezing heavily, the recognisable sound of an inhaler and bouts of coughing. My tour guide tells me that he is an asthmatic and has been taking his salbutamol inhaler multiple times a day for months. He had considered a trip to the doctor but was waiting for pay day. Still not technically qualified, am I in a place to offer medical advice? Pharmacies here don't require a prescription... Shouldn't he be taking an inhaled corticosteroid?

A few days later, a fellow tour goer arrives to breakfast with a swollen red eye and she asks for my opinion. It's watery but not painful with no reduction in acuity. Not wanting to give unqualified medical advice, I suggest she rinse with sterile water and avoid contaminating the other eye. Throughout medical school we're told common is common, therefore this is probably a viral conjunctivitis right?

Fast forward to the end of the tour and it's still there. She sees a doctor back home and is given a long list of medication and a stat dose of prednisone after a preliminary diagnosis of orbital cellulitis. After being told repeatedly "common is common", I learnt from this that the rarer things still exist and there is still much more learning to do.

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