Today we saw our list of patients and did a few small cases. Two of our patients had oral mucosal cancer. It is very common here, perhaps because paan and other chewing tobacco are so popular.... One patient had his bottom lip and part of his mandible resected, and the other had nearly his entire right mandible, bottom lip, and front of his jaw removed. Because this cancer had invaded his lower and right face, he was left with a huge gaping area missing. With the reconstructive surgery, a flap was taken from his thigh and sutured in to replace the open gap of his right and lower face. We check on him every morning to make sure the flap is still getting adequate blood supply from the anastomosed vessels. (another reason not to chew tobacco....). We also have little kids with congenital malformations, burns, a little boy with necrotizing fasciitis of his lower leg (treated before I came here), and one little 3 year old with lymphoma. She is not a surgical case, but we were consulted because they thought it might be small intestinal or colonic TB. It is something they always have to rule out here. I have only read briefly of these other presentations of TB (not the typical cough, night sweats, fevers, chills, weight loss, etc). Today I learned about all the different TB presentations they see here- brain abscesses, lung, intestinal, bladder, liver, and others. They also see leprosy, malaria, dengue fever, and many many more. I'm sure my friend over in Infectious Disease has been learning a lot! Our patients are all surgical, but I still get to learn about those cases from the attendings and residents. (apologies to the non-medical people who don't really care....). Anyway, after we saw our patients, I enjoyed a little paneer and dal for lunch and got to go home at 3pm!
As a side note- I am still learning to walk on the left side of the hallways and staircases... Have had quite a few near-collisions as I run up the steps on the wrong side : / A good reminder that I should never attempt to drive here. I'm also learning that our floor 1 is floor 0, and 1 is 2, etc. Seems like it wouldn't be that confusing, but for some reason I can't seem to get it right when I'm using the stairs. In the new hospital they actually have the floors labeled (to help the foreigners...). Makes my life a little easier :)
At home I am finally able to sit down and relax :) ..something that I can enjoy now before residency begins... I read, did yoga, and am now trying to learn the Hindi alphabet. As I draw out their beautiful characters, I can hear the people gathered at the Mosque right across the street. They chant together in their low toned melody, shifting subtly from one note to the other. The sound echos through the city as they do their daily prayers- the Salah. Tonight it is the Isha- the prayer done at night time. I am still learning these things..so hopefully I got that right... I am intrigued by the calligraphy of the Hindi alphabet and listening the low chanting prayer of my Muslim neighbors. My curiosity kicks in and I am fascinated by the many things I have yet to learn.
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