So Saturday night another contingent of Muzungo's arrived from Montefiore. Five more medical students, in addition to the 3 who were already here who I haven't mentioned yet. Jerry Paccione who is one of the founders and leaders of the social medicine program at Montefiore for the past 25 years and Jerry's niece who is our age and also wanted to work in Uganda.
Jerry is a brilliant physician, a master of physical diagnosis, and very experienced working in developing countries. He also works very hard and is very demanding. So Sunday morning he wanted everyone to go in early to meet all the patients. So Sara and I led the med students to the wards and instead of 2 muzungos it was a group of 10 all walking together. People were just staring at us. As soon as we got there Sara went to check on her girl with status epilepticus and she was seizing again. Jerry walked in the room and in one second he said "this isn't a seizure it is hysteria". I guess it made sense since she wasn't dead yet and she had been in this condition for 3 days. Apparently hysteria is common here and we aren't used to seeing it. In the States it is something we would call conversion disorder.
There is a phenomenon of patients "escaping". That is leaving without being discharged. There was a very interesting patient I had admitted on Friday who I wanted to present who had escaped overnight Saturday night. He had developed swelling throughout his body over the past 2 weeks including his arms legs belly and face. After closely examining him and doing a urine dip stick I came to the conclusion that he had nephrotic syndrome. Patients escape once in a while in the States we call it eloping. But it happens here much more often. When a patient feels better he just leaves without a discharge or medications to take with him.
Sunday evening after the wards we went on a hike up a hill. It was just one hour up and one hour down. It was with all the new students who had come. We began hiking up the hill through all the hill side agriculture. Then we began to get a great view of the town from above and all the surrounding mountains. The village kids were chasing us as we climbed up and actually running circles around us and they were very cute. When we got to the top of the hill we could see the nearby Lake Mutanda and the sunset. It was beautiful and I got some good pictures. So our outpost of muzungos has grown and we would have a lot of extra help now on the wards for the upcoming weeks.
here is a link to the pictures of the hike up the hillside: http://picasaweb.google.com/rafiki/UgandaHikeUpTheHillside