My last trip to Roseau and the Dominican hospital.

I had my second trip to the hospital last Tuesday and boy it was a heck of a day. As usual, the day started with a dose of dramamine for the long winding road to Roseau. Midway though the drive, I realized that this stretch of highway looks a bit like California Highway 1. The Dominican Road (which, I cannot find a name for other than, "the road to Roseau"), is so windy, barley two lanes and plunges into the mountains and then plunges out toward the ocean before taking a hair pen turn back into the safety of land. There is one strip of the two way lane is straight (about 1/4 of a mile) that looks shockingly similar to the picture below from Highway 1 in California--and I heard Tom Cochran's "Life Is A Highway" for the rest of the day. The main difference between California and Dominica is that Dominica has huge mountains just inland of sea and it is much greener. In fact, Dominica is so green that it is almost intoxicating.

But alas, we are no where near the United States, let alone California (or Washington!). There is a sign outside of the library that states we are 3,818.42 miles from California and that California is 34°26'N and 119°50'W. The funny thing is that the sign is facing Southwest rather than Northwest. I'm not exactly where you would be if you went 3,818.42 miles southwest of Dominica, but I think it is somewhere in the Atlantic ocean or on the Atlantic coast of Africa.

Now onto the hospital, I was assigned to the OB/GYN unit for the morning of shadowing a physician. The first three patients we saw where all hospitalized for intense morning sickness. They were all between 11-16 weeks and overall doing well. Honestly, it wasn't too exciting because there isn't anything to see and basically they just give these women antacids, anti-emetics and IV fluids. I don't want to say that any patient isn't exciting, but I guess since three of them had the same thing wrong it wasn't as interesting by the third time through.

Sometimes you don't always get what you wish for because my next patient was exciting, but I'd never wish anyone to be in so much pain: a young woman who had a primary outbreak of herpes. I won't describe the lesions in too much detail because I know that most people don't want to hear the details of infections. I feel so horrible for this young woman as you never can get rid of herpes simplex virus. For those that don't know, herpes is an extremely painful infection and my patent's infection was so extensive that she couldn't comfortably sit down as she was in so much pain. On the other hand, medical students don't usually get to see such extensive infections so early in their career so I'm grateful that I was able to see this infection--it looked like something from a pathology or microbiology book. I was also able to see the vagina and cervix, which I have not done yet in medical school (they only let us practice pelvic exams on mannequins at this point in our education).

After finishing up with that poor patient, we headed upstairs to the delivery floor. Our next patient was 44 weeks pregnant! 44 week!!! For those of you who don't know, 40 weeks is the general length of pregnancy and a baby is considered full term at 38 weeks. In the U.S. (and Dominica), babies are not allowed to hang out in utero for 44 weeks (babies get big and can get stuck during delivery amongst other problems). However, that involves the mother coming in for prenatal care! This Mom had come in once before and then came in because she thought it was time that she had the baby. Upon ultrasound and a good history (I'm not sure how they got a good history out of this lady), they determined that the baby was 44 weeks along. The most exciting thing about seeing his patient was that the doctor showed us how to feel for the position of the baby and we got to listen to the heartbeat. I even found the heartbeat all by myself! It was SO exciting!! Babies have quick heart beats (if I remember correctly a normal fetal heart beat is 120-140 bpm) and they sound a bit like a choo-choo train.

After that patient, we went out to lunch. Again, I have no idea why we needed a two hour lunch. We went to a different restaurant this time and it wasn't that good; but I didn't get food poisoning, which in a third world country means that that it was a GREAT restaurant.

After lunch, I was assigned to the pre-surgical unit. My patient had two gunshot wounds and his hallicus (big toe) on his left foot lost all movement. The working theory is that his sciatic nerve was injured either from the bullet (less likely based upon his history) or the due to the healing process (more likely based upon history). He was going to have an exploratory surgery at the end of last week, but I don't know what they found out. At least the interview was interesting.

The ride home was, as usual, rather tipsy turny--thank goodness that I had time to take my dramamine before we left Roseau for the 20 mile, 60 minute drive back to school. That was my probably last trip to Roseau ever. Speaking of things coming to an end, I've got to enjoy these Caribbean sunsets while I can because I have less than 30 days left in Dominica. But that also means I have less than 30 days of cold showers left too!!