I never expected that I would miss medicine the way I do here. I am not yet a doctor, but I feel that with every day of medical training, I become closer to something I was born to be. The reasons I first gave to the admissions committee about why I wanted to be a physician have evolved and become so ingrained, that now I couldn’t separate out these reasons from my own life story.
Here in Zambia, I float around medicine like a bee around a particularly scrumptious flower. I help design clinical tools, I perform chart reviews on patients, I occasionally am lucky enough to observe in the clinic. But the hands-on, nitty-gritty of patient care is neither my right nor my expectation while I am here. A big part of the reason I was so attracted to global health was the incredible health disparity between the first and third worlds, and I dove into the global health opportunities that were available to me. Yet, the more I experience, the more I begin to realize that what have always been advantages in the past are obstacles to providing care here; my skin color, my strange accent, my gender are disadvantages despite the prestige of my education. It hardly helps to know the intimacies of anatomy of a human heart, or to have six antibiotics for pneumonia on the tip of the tongue, when you are at a clinic where cardiac echoes are unavailable, or the only drug in the pharmacy is penicillin.
After a few months here, I know now that while some could adapt, I will never be able to learn the blend of fatalism and practicality that is so necessary. A few weeks ago, I was helping a clinical officer in one of our most rural clinics. A patient came in for fatigue, heart palpitations, episodic chest pain, and headache. She had been having these symptoms for months. Diagnoses flitted through my head incessantly; valve prolapse, cardiomegaly, variant angina, panic attacks, hyperthyroidism. For each, though, I only knew how to reach an answer through tests or medications. The clinical officer, pressured by the long queue of patients, finally provided her with analgesics, recommended light activity for a few days, and asked her to come back if the episodes continued. I was frustrated that we didn’t have the luxury of time for an adequate patient history, that we had no tools at our disposal (without significant effort to refer the patient or costs for lab tests that were prohibitive) other than our stethoscopes and our hands, and that my clinical knowledge was insufficient to help her.
I was disconcerted that I offered so little, but at the end of the visit, she looked both of us in the eyes and warmly thanked us for hearing her story and said she felt much better already. In a few months, I will return to the States, to a cornucopia of designer drugs and 3D images, and I will once again be able to immerse myself in medicine full time. However, I hope that I remember that medicine comes in many forms, including the ability to listen.
I never expected that I would miss medicine the way I do here. I am not yet a doctor, but I feel that with every day of medical training, I become closer to something I was born to be. The reasons I first gave to the admissions committee about why I wanted to be a physician have evolved and become so ingrained, that now I couldn’t separate out these reasons from my own life story. Here in Zambia, I float around medicine like a bee around a particularly scrumptious flower. I help design clinical tools, I perform chart reviews on patients, I occasionally am lucky enough to observe in the clinic. But the hands-on, nitty-gritty of patient care is neither my right nor my expectation while I am here. A big part of the reason I was so attracted to global health was the incredible health disparity between the first and third worlds, and I dove into the global health opportunities that were available to me. Yet, the more I experience, the more I begin to realize that what have always been advantages in the past are obstacles to providing care here; my skin color, my strange accent, my gender are disadvantages despite the prestige of my education. It hardly helps to know the intimacies of anatomy of a human heart, or to have six antibiotics for pneumonia on the tip of the tongue, when you are at a clinic where cardiac echoes are unavailable, or the only drug in the pharmacy is penicillin. After a few months here, I know now that while some could adapt, I will never be able to learn the blend of fatalism and practicality that is so necessary. A few weeks ago, I was helping a clinical officer in one of our most rural clinics. A patient came in for fatigue, heart palpitations, episodic chest pain, and headache. She had been having these symptoms for months. Diagnoses flitted through my head incessantly; valve prolapse, cardiomegaly, variant angina, panic attacks, hyperthyroidism. For each, though, I only knew how to reach an answer through tests or medications. The clinical officer, pressured by the long queue of patients, finally provided her with analgesics, recommended light activity for a few days, and asked her to come back if the episodes continued. I was frustrated that we didn’t have the luxury of time for an adequate patient history, that we had no tools at our disposal (without significant effort to refer the patient or costs for lab tests that were prohibitive) other than our stethoscopes and our hands, and that my clinical knowledge was insufficient to help her. 
I was disconcerted that I offered so little, but at the end of the visit, she looked both of us in the eyes and warmly thanked us for hearing her story and said she felt much better already. In a few months, I will return to the States, to a cornucopia of designer drugs and 3D images, and I will once again be able to immerse myself in medicine full time. However, I hope that I remember that medicine comes in many forms, including the ability to listen. 
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