Wednesday, August 31, 2011

My Morning

So, ya wanna know what I did between ward rounds and lunch today?  Today was my "half-day", which is one day per week when each doctor has some time away from the hospital to do non patient care work, or catch up from times on call.  Whether is is really half of the day, or more or less depends on how many doctors are here, and how busy things are.  Sometimes there are enough doctors that we can leave the hospital right after ward rounds.  Sometimes we work in outpatient until lunch time.  If we are particularly short-handed, we don't take the half-day at all.  But this week we tried out a new system; after ward rounds, we see eight patients in outpatient, and then go.

Patient number 5.  With his mother.
So, I thought you might like to know about the eight patients I saw.  They represented a good selection of the patients we see.

1.  A young adult woman with a bladder infection.  She had taken medicine for a week, but didn't get better.  I was pretty sure that it was really a bladder infection, so I prescribed a different antibiotic.

2.  A young woman with a couple of lumps on her arm.  I told her that these were lipomas, and were harmless, that they didn't need to be removed.  She was quite uncertain, and asked several time if they should be removed.  Finally she asked if they were cancer.  I assured her that they weren't, and she finally seemed relieved.

3.  A man in his early thirties who had recently completed treatment for abdominal TB.  He was feeling well, his exam was normal.  Those meds really work!  And, yes, TB can infect areas other than the lungs.

4.  An elderly lady with a chronic cough.  She has been treated for both pneumonia and chronic obstructive pulmonary disease, but has recently started coughing up blood.  I got her most recent chest x-ray from the x-ray room to review.  I then sent her to the TB nurse to start TB treatment.

5.  Baby boy with several days of diarrhea.  Not sick enough to need to be admitted to the hospital (he was laughing and smiling, for goodness' sake--a sure way for a baby to disqualify himself from admission to our hospital!) I prescribed some meds, and asked his mom to bring him back on Friday, sooner if he should get worse.  See photo above.

6.  A young woman with chronic pelvic pain.  She had been treated several times for pelvic inflammatory disease, without any improvement.  When I examined her, I noted that her uterus was enlarged.  In fact, it was about the size of a uterus with a 12-week pregnancy.  Yeah, yeah, I should have asked her about menstrual periods earlier, but I asked then, and she said that she hadn't had any for at least 2 months.  An ultrasound revealed a healthy 14-week pregnancy (2 weeks error ain't too bad in this situation).  I gave her vitamins, iron tablets and paracetamol to take for her pain.

7.  Young man with a severe cough, fever and a sore in a location that suggested a venereal disease.  I sent him to the lab for a test called a VDRL, and to the x-ray room for a chest film.  Because I thought he was number 8, and I didn't want to wait around, I asked Dr. Imelda to review his results and write for meds when he got back.

So now I realize that I only saw 7.  Wait!  There was an old man who wandered into outpatient who thought that when the doctor told him to come back in 2 weeks that meant he could skip paying fees and waiting his turn in the long discouraging line.  I had sent him to go pay and wait.  I wasn't going to count him, but without him, I only saw 7, so now I think I should count him.  He has benign prostatic hypertrophy, by the way, with complete urinary outlet obstruction.  He was being treated with a catheter and medicines.

There.  That's 8.  Good variety, but not fully representative of what we see.  There was no trauma in the group, no fractures, no arthritis, no abscesses, no malaria, and no AIDS, which are all pretty common in our work.

Sunday, August 21, 2011

Saturday in Kudjip

What do we do on a Saturday on a tropical island?

Some of us sleep.

Some of us long to eat small children.

Some of us work on refinishing the tennis/basketball court.

And some of us watch.

Some of us make dog and cat food.

Some of us keep working and working.

And some work in different ways.

Newly engaged couples take romantic walks - not holding hands of course.

And we knit!


Saturday, August 6, 2011

Catching Up

Yes, we're back in Kudjip after a wonderful 3-month home assignment and 4 weeks of vacation in the US.  We had wonderful times with our kids extended family, friends and hundreds of Nazarene supporters.  Here are a few photos to catch up on the trip back and the first few days here.

In the morning of our departure day we stopped by to see my dad at Karcher Estates, where he has lived for the last 15 years or so, first in Independent Living with Mom, then in Assisted Living, and now in "Health Care".  Dad had a stroke in December, and is now unable to walk.  It was hard to see him so dependent, but wonderful to see how his spirit, his love for Jesus, and his indomitable humor are still fully intact.  We hope to see him again here on earth, but if that is not in God's timing we will plan on a big reunion in heaven.

My sister Cammi and bro-in-law Denny Ellis took us to the airport, along with Sam and Amy.  Here Cammi is showing the info sheet on their new sponsoree in the Nazarene Child Sponsorship Program.  He is Josiah John, the son of one of the pastors near Kudjip.  His family have been our friends from our earliest days in PNG.  He has a little brother who is my namesake.

Our return route took us through Fiji.  Because the Pacific Air did not check our bags through to PNG, we had to claim them in Fiji, wait in the very long lines for Fiji Customs and for Immigration, and then take them a distance to the arrival lounge to the Air Niugini counter and check them again. It took a long time, but went OK, and Air Niugini did not charge us for excess baggage, as Pacific Air had done (we're not feeling like recommending Pacific Air right now).

When we finally made it through to the departure lounge, we only had about an hour to wait for our flight.  In typical Fiji fashion, they had this group of musicians performing for the waiting passengers.

The big surprise was who we encountered among our fellow passengers: Harmon and Quinton Schmelzenbach.  Harmon is our Field Strategy Coordinator (fancy language for "boss").  They were booked on the same Air Niugini flight from Fiji, but only as far as the Solomon Islands (Fiji and the Solomons are both part of the territory that Harmon is responsible for).  They were actually in the flights immediately behind us on the plane, so we managed to have a good visit as we traveled.  (That's Quinton in the middle of the photo, using the free internet.)

We arrived back in Kudjip, 36 1/2 hours after leaving Boise.  It just took 6 flights (Boise-Phoenix-Nadi-Honiara-Moresby-Hagen).  The ride from Hagen to Kudjip was provided by Tim and Karla Deuel, new missionaries who arrived in Kudjip just a couple of weeks before we left.  At the house were the usual welcome signs.  It took a while to locate the keys to our house, but eventually we got in for quick showers before proceeding to supper with Randy, Joani, Emma, Alexia and Ethan Goosen.  They are new missionaries who arrived just days after we left for home assignment.  We met Joani's parents in the US, but this was our first meeting with them.

Emma and Alexia                                              Ethan              

Simon, Esther and Ishigel Tausi came by the next day.  Here they are looking at our album of photos of Baby Andy.

Our "old friend" Bobby is doing well!  He's now living with the Tausis.  He got some lollies from the bag of candy that Sam sent for his PNG brothers, sisters and friends.  Bobby's new favorite words are "choc", "o" and "late".  "Late is pronounced like "late at night".

We're now settled back into our Kudjip routine.  Each departure from the US is different than the others.  This time we were affected by the fact that we were leaving a new little grandson behind, as well as our kids, Dad and the rest of the family.  The veteran missionaries told us early-on that the departures don't get any easier as time goes on, and they were right.  But we love PNG, we love Kudjip, we love our family here, both missionary and PNG, and we love being in God's will.  We know that, for now at least, this is where He wants us, and we are happy serving him here to the best of our abilities.