On the subject of Sex Ed...

Let's keep going with this sex-ed theme:

Last year, when I was a lowly intern, I worked in a similar, though much less busy community health care centre in the middle of Cape Town.

On my first day there, I was presented with my consulting room ( the tiniest one as I was way down at the bottom of the medical heirarchy.)

I wondered who I had inherited this room from - it was pretty shabby which was to be expected, but it seemed like it was equipped with the basics.

However, it turned out it was WAY more equipped than necessary, as while rummaging around on the back shelf for gloves, I came across an interesting package.

The package was long, and phallus shaped with a picture of a sexy girl in a bunny outfit on the front. I wondered where this package came from , but then it told me itself of its origins when I read the words "Adult World" printed on the front.

Curious, I opened the package, but my keen doctor's detective brain was already pretty sure of what I was going to find inside...and lo and behold, there was a large pink fleshy dildo complete with suction base just chilling out in the bottom of the box.

I suddenly felt very naughty. "Is this why the doctor's here are all so relaxed?", I wondered. How kinky! How inappropriate. I decided to report this matter to the senior doctor, who simply showed me the dildo on his back shelf which was much bigger and had testicles to go with it.

Typical, I thought, the intern always get's the short dildo, I mean straw.

Turns out they were bought as hospital aids to show patients how to put condoms on correctly!

How progressive! How innovative! I loved it! I pulled that dildo out in as many consultations as I deemed was appropriate. The scary thing was that most of my patients were really grateful as they honestly were clueless about condom application.

Now whenever I work in a new clinic I make sure I have a good rummage on the back shelf - who knows what one will find! So far it's just been dead cockroaches and mice droppings. That dildo was the first, and probably the last back shelf treasure I'll ever discover.

Sex Ed

Gonorrhoea.
Syphyllis.
Chlamydia.
HPV.
HIV.

These are all nasty nasty genital diseases tramsmitted when doing the nasty nasty dance of love. They even sound nasty when you say them.

I know that when I say them it feels like I have yellow green pus dripping out my mouth instead of words. Eeeugh! I think the words affect me in this way because I've actually seen these things up close. ( And no, my darling hubby, while diagnosing patients, not myself I assure you!)

The awesome awesome thing is though...that they can all be prevented by that simple invention - the condom!

Apparently condom use is being taught in schools as part of sex education or life skills or guidance class or whatever it's being called nowadays.

Apparently, it's even being taught in preschool. Yes, preschool.

How do I know this? Because during the clinic, one of my hypertensive diabetic patients brought her 4 year old grandchild into the consulting room with her.
This child, petrified that I might bring out a long needle to inject into its bum, sat very still and did not say a word. That is, until the end of the consultation, when he walked past a box full of government issue prophylactics, turned around beaming, and gleefully shouted, "Condoms! Yay!"

Granny was very proud as she marched him out of the room.

What?!?!?! Is this normal? For a four year old to know what a condom is? Should I be happy that our kids are so well educated about sex or should I be sad that they have a very small chance at innocence before reality blows that out the water.

I don't know, I'm very confused right now. To take my mind off it I googled the different names for condoms and this is what I found, it's too hilarious:




Bob - (why Bob?)

Cock Sock (apt)

Condominium (hee hee)

Condomus Maximus ( oh yeah sure buddy, it's the biggest we've EVER seen)

Dick-Sock

Dinger

Dobber

Franger

French Letter ( so elegant)

Gentleman's Jerkin

The Goalie ( ha ha! I love this one, can you see the goalie frantically trying to prevent millions of soccer ball sized spermatazoa from entering the cervix? I love it.)

Hats

Hazmat Suit

Jimmie Hatz

Jimmy

Johnnies

Johnny Bag

Love Glove

Love Sock

Mr. Prevention

Nodding Sock

Poshie

Prophylactic

Raincoat

Robber

Robber Johnnies

Rubber

Rubber Magic

Rubber Straitjacket

Rubber

Salami Sling

Sex Shark Warmer ( what?)

Sheaths

Snake Charmer

The Tour Guide

Willie Hat

Willie Warmer

"English Riding Coat."

Denmark - Gummimand­ "Rubberman,"

Hungary - Ovsver "Safety Tool,"

Hong Kong - Pei Dang Vi "Bulletproof Vest,"

Portugal - Camisa De Venus "Venus Shirt,"

Nigeria - Okpuamu "Penis Hat,"

Indonesia - Koteca "Penis Gourd,"

Spain - globo "Balloon."

courtesy of: http://inventorspot.com/condom_many_other_names

Hardcore Chicks

Goodness Gracious Golly Gosh!

Has it really been ten days since my last post?

My humble apologies.

I'm back, this time with an embarrassing story about me.

I like to think of myself as a pretty independant chick. My parents like to remind us of the blood sweat and tears they lost while raising us to be in charge of our own destinies , to rely on ourselves and to be educated enough to be financially independant. They also raised us to take no shit from any man, ( to my dad's dismay, he forgot that that included himself).


So there I was, living that dream they had for me, when I was on call in the trauma unit last Thursday.

It was rough, I had the usual severe and life-threatening asthma attacks, fitting children, heart attacks etc. I also had the interesting case of two brothers who stabbed each other in the chest after drinking too much. The one had a particularly vicious stab that resulted in me having to cut through his chest wall and insert a drain into the space around his lungs to drain off the 300ml of blood that was impairing his breathing.

I was exhausted and bloodstained by morning, yet I was starting to think that maybe I could start calling myself hardcore.
Hardcore and cool like the doctors on TV (see earlier blog posts).
Awesome and strong like WonderWoman who can kick the ass of any man she meets.

Except that I wasn't because as I got to my car I saw that my tyre was flat and was mortified when I realised that I DID NOT KNOW HOW TO CHANGE IT!

How could I not know how to do something as simple as change a tyre? Why was this not part of my practical skills training? I was flabbergasted that I knew how to drain blood off a dying man's chest but couldn't even change a tyre!?

So I did what we women do in these situations,
I reverted back to my silly feminine self and fluttered my eyelids helplessly while attracting the help of the closest manly man to help me.

Turned out Dr R was my unsuspecting victim. Luckily for me as in my smelly, post-call state I doubt I could have elicited the help of a man other than a friend. He said not a word, and changed my tyre in about ten minutes. Sweet guy, Dr R.

I went home and demanded that my husband teach me how to change a tyre like a real man. My goal is now to be able to do it in five minutes with a blindfold and one hand tied behind my back.

Then I'll be on my way to being tough.
I just have to learn to to fly a helicopter, change a plug and kill a spider without screaming.
Then I can really earn the title of Hardcore Chick.

Miracles happen TWICE at Easter

All I have to say is, that there was no leftover Easter carnage.

I had a fantastic peaceful day in the "trauma unit" with only the usual MI's, asthma attacks etc to deal with.

So what does this mean?

Did god decide to show up this weekend?

I'm not convinced.

I reckon that most likely it has to do with the recession and people not having enough money for alcohol.

Then again, I'm pretty cynical.

Miracles do happen at Easter!

A miracle happened this Easter.

Unfortunately nobody rose from the dead.

(Did that offend some of you? Its just that I am still trying to teach patients to do that but they just don't want to learn. So far I've been unsuccessful at waking them once they've passed on...Sister C says it's because only Jesus is allowed to do that. I told Sister C that if that's so then Jesus is selfish. She was too mortified to respond and ignored me for the rest of my last trauma shift.)

No, the miracle was that for the first time in 5 years I have not been on call over the Easter weekend. FIVE BLOODY YEARS!

This meant that starting from Thursday afternoon I had exactly four whole days free. FOR FREE! I didn't even have to ask for special leave.

So the hubby and I packed our bags and drove like two tortured bats out of hell down the N1 to the peaceful town of McGregor. A sleepy charming village in the Breede River Valley, where the green and white houses are neatly arranged and the gardens are full of blooming bouganvilla and luscious iceberg rose bushes. There is one main road, two cafe's and a dam. There is no hospital or clinic. There isn't even a pharmacy. What bliss!

We stayed in a luxury self-catering cottage. And that's all we did. We stayed there. We never left it. It was even better than our honeymoon in Vietnam because we didn't feel compelled to sight-see. In fact, we could sight-see the whole of McGregor while sitting on the front porch in our underwear chewing braaivleis.

For four days I experienced what the rest of South Africa looks forward to every April. And there are people out there who get to do this EVERY year? Lucky bastards.
There are also those people who get to do this every year, who go completely overboard.

These people celebrate by getting drunk, doing drugs, raping, shooting and stabbing. They usually come and tell us about it in the trauma unit.
This is a holy weekend after all, someone's gotta give us something to pray for right!?

I'm back in Cape Town now and I'm getting that nervous pre-work feeling.

My lovely facility manager has put me in trauma tomorrow from 7am to 5pm.
It will be the first day after the Easter weekend carnage.
I'm trying hard not to think about it.
I'm going to go to work with positivity and enthusiasm.
I'm going to defend myself from the work stress it took four days of doing nothing to get rid of.
I hope it lasts the whole day.
It probably won't and tomorrow evening you'll most likely read about how to have the joy sucked out of you by the government health system.

Sweet dreams!

Mind your language (1)

I just thought I'd share this with you.

I consulted a diabetic patient today who had a septic wound on his toe. I couldn't see it under the masses of bandage so I asked him to describe it before I released that purulent festering wound from its swathy prison.

He began thus: "Well doctor, you know I has a pasta in my foot."

This man did not look like an Italian.

Pasta foot? What the hell?

Hmmm...I suppose that would be graded in terms of severity by its al dente'ness?


What would I find when I opened this wound?

Linguine? Hopefully that's all it is as that's the mildest most non-fatal form of pasta foot.

Fettucine? Severe, but still treatable with garlic and sundried tomatoes.

Panzerotti!? Oh god no, please let it not be panzerotti! There's no coming back from panzerotti!


"No man Doctor, a pasta, like when it is having an infection."


Then I got it. He meant like pus. A pus-like infection. A yummy pus-filled pasta sauce.

I forgave this man his mishap because English is his 4th language.

They always did compare certain pathologies to food at medschool:

TB necrosis - cottage cheese

Meckel's diverticulum - red currant jelly

Bleeding gastric ulcer - coffee grounds

Bon appetit!

coMEDIC. (get it?)

In the last hour of our shift yesterday I tried to make things FUN! for the poor peoples and their childrens who had been waiting so long to see me.Fun fun fun! I must have been delirious after twelve hours of non-stop work.

There were a few X-ray waiting to be reviewed that belonged to patients with possible fractures.

I picked up the first folder and was about to put the X-ray film up on the lightbox...X-ray FILM...!!! Suddenly I had a bright idea

I went out to the waiting room and called for the owner of the X-ray.

"Would Mrs XYZ please be so kind as to join me at the premiere of her right leg's debut show?"

Mrs XYZ looked at me like I was on crack, but said nothing, as I wheeled her into our unit.

I positioned her nicely in front of the lightbox and began the show.

"As you can see madam, I have procured fantastic front row seats for you to this spectacular moment in your right leg's history. The title of this show, 'Does Mrs XYZ have a broken tibia?' "

I hummed the theme tune to 20th Century Fox as I placed the radiograph on the lightbox.


Her tibia was completely intact.


"Oh dear Mrs XYZ, " I said, ( her face fell, expecting bad news)

"Unfortunately this is a very boring movie as your bone is not actually broken! Hoorah!"

Mrs XYZ didn't get it and was looking around the unit nervously for someone normal to explain to her whether her bone was broken or not.

I thought I was being awesome. The patient thought I needed admission to the psych ward. Oh well. Seems I failed at bringing joy and laughter into the unit. Turns out it wasn't that hilarious. Clearly I need to work on my material.


:)

Dr R gone bad.

Let me tell you about my community service colleague, Dr R.

Dr R and I have been working together for three years. We did our two years of internship together at the same hospital and are now both based on the cape flats at this community health centre.

We have been nicknamed the "A-team" by the trauma staff purely because we are both always working in trauma on days when things get particularly crazy.

Dr R is possibly one of the nicest doctors I know. Soft-spoken and gentle. Non-confrontational. The opposite of me.
He wants to be a psychiatrist once our compulsory government service is finished, so you can imagine the amount of patience he has.

However, I have noticed that after only three months in this place he is beginning to develop a bit of a nasty, frustrated edge...

It's happened to all of us, it's unavoidable. We are working in shocking conditions, it's dangerous, it's unhealthy. We live with the threat of developing tuberculosis as we are on the front lines diagnosing it on a daily basis. Some of our colleagues have had to have lobectomies after contracting the disease. The patients are poor and uneducated. This particular community can be incredibly violent and rude in the trauma unit. We are constanty working under the pressure of a jam packed waiting room full of patients. We have ancient equipment. We are dealing with unimaginable tragedy every day. No matter how hard we try we can't help everyone but despite that we are constantly having to field complaints that we are not working hard enough. We see about 100 patients a day in the trauma unit.

It takes its toll, we have to develop souls of steel and try as we might to remain empathetic, sometimes we snap. It doesn't happen often. But it does happen. It even happened to someone as sweet as Dr R.

Dr R was consulting with a recent geriatric stroke victim. The stroke left him paralysed on one side. However, he was in our unit for the problem of a two month cough that was productive of blood-stained sputum. (the TB bell clangs loudly when these symptoms are expressed.) The man was coughing violently in Dr R's face and made no effort to turn his head away.

"Please sir, could you put your hand in front of your mouth when you cough." Dr R asked politely.

The man responded with another sputum-spraying coughing attack. He did not use his hand to prevent infecting everyone with the disease, as so nicely asked by Dr R.

Dr R wiped some goo off his face and then lost his temper.

"I TOLD YOU TO PUT YOUR HAND IN FRONT OF YOUR MOUTH! YES, YOU HAD A STROKE, BUT SO WHAT?"

He picks up the paralysed hand and lets it drop limply,

"This hand may not work but your are NOT paralysed on the other side! your other hand is still functioning so PUT YOUR FUNCTIONING HAND IN FRONT OF YOUR MOUTH WHEN YOU COUGH!!"

Oh dear, Dr R. I see not even you are immune to the personality changing effects of this place.

Three more months to go...Good God, what kind of people will we be like then?


.

Nought to chaos in 15 minutes.

In the space of fifteen minutes, and with a waiting room already jam-packed with patients waiting to be seen by myself and my colleague, these patients rocked up at the trauma unit yesterday. Some brought by the ambulance, some from the street. All pretty serious.

1: A man who had been stabbed in the neck "for no reason" by his brother.

2: An unconscious man found in the road by the police with a large bleeding wound from his head.

3: A lady who was sad that she had had a miscarriage so tried to kill herself by dousing her house and herself in paraffin. she survived but had 50 percent burns to the front part of her body including her face.

4: Another man stabbed in the neck and pouring blood from the wound.

5: A lady having a ?heart attack/?asthma attack/? pulmonary oedema

6: An unresponsive fifteen year old boy found in the bath by his mom and brother.


Six emergencies in 15 minutes, 2 young doctors with only three years experience each, and four nursing sisters. Does this make mathematical sense to you? And this is supposed to be an urban setting. I'm not even based in the middle of the Eastern Cape, or somewhere South of the Mozambiquan border.


The worst of them all was the 15 year old boy. He was carried in by his mom and brother after they found him sitting in the bath, completely unresponsive. They placed him on the bed and we assessed the situation. He was small for his age. He had no known medical history. Was not abusing drugs. No pills found lying around the the bathroom indicating an overdose.

He had no pulse and no respiration. His pupils were fixed and dilated. He had a flat line on the heart monitor. He had cold peripheries. In short, he was a DOA. (dead on arrival).

I had to go and tell the family who was waiting outside. There's no easy way to do this. One just has to say it. This was not the first time I've had to tell someone that they've lost their son, but the mother's screams always rip right through me and I have to try really hard not to burst out crying as well.

I'm 27 for God's sake! How the hell did I end up here dealing with all of this tragedy? This was not part of the plan. The plan involved me being fabulous, being famous and having people remove the green M & M's from my constant supply of sweeties.

African Acupuncture

She was standing at the door of the trauma unit.

Just standing there.

A 20 year old Xhosa girl she was, beautiful, except for the damage done to her face.

I'd never seen anything like it before. Her face and neck were covered with hundreds of tiny superficial scratches. The scratches were all perfectly evenly spaced and only ran vertically. They were about 5mm in length and looked very fresh as some of them were oozing blood slightly.

What on Earth was this? This was certainly not in the dermatology handbook of skin diseases.

"My dear," I asked "what happened to you?"

She just stared at me blankly and then said that she didn't know.

"What do you mean you don't know? Did somebody hurt you?" Negative response.

"Did you do this to yourself?" Exasperated negative response.

"I told you doctor I don't know! I went to sleep and when I woke up this was on my face! I was asleep for a long time, nobody was in my house and I didn't feel anything.It was just there"

I could sense a distinct change in the trauma unit atmopshere after that statement. Creepy...sinister...fear of the unknown...what the hell was going on here?

Then a Xhosa nursing student clears my confusion.

"It is the evil force, doctor. We must not make play with these matters. She is a cursed. You must help her with her spirit."


Oh for God's sake, I was most certainly NOT equipped to provide spiritual counsel to this woman. And besides that, I didn't believe any of it. Evil spiritual forces, my ass! One thing was certain, a most non-spiritual REAL human being was behind this facial vandalism.

At this point, the Sister in charge got fed up and fired off a terrifying tirade in Xhosa. You didn't need to understand it to realise that she was asking the girl to cut the crap and tell the truth.

Turns out, the patient had been suffering from headaches and had gone to a sangoma (traditional healer) for help. He put her to sleep with a magic muti and then while she was out, decorated her face with these pretty scratches.

Problem was though, that she still had the headache. I felt sorry for her and was about to examine her properly, but the Xhosa sister in charge refused, gave the girl a box of panados and chased her home with a warning that if she came back telling lies again we would not see her.

Homeopathy, naturopathy, aromatherapy. They're all very popular alternate healing therapies nowadays, particularly amongst the middle to upper class variety of our nation.

Somehow though, I don't think we'll see the superwealthy 4X4 driving excessive brunching mommies booking sessions with the sangoma before fetching Darling Girl from private school for this form of African Acupuncture.

SNVL (1)

Now, not much shocks me anymore. However, every so often one of my patients manages to elevate themselves to stellar plateaus of indecency.

So this is episode one of SNVL. If you are a sensitive reader...abort this blog post immediately.


The police brought this particular gentleman into the unit one morning. He was a known Schizophrenic who had defaulted on his meds. Did I mention that he was also self-medicating with TIK ( crystal meth) and was completely cooked when he came in.

He was impossible to interview as he was psychotic and screaming at the top of his lungs. Not an unusual occurrence, however, the content of his speech was something like aural rape.

What he said was in Afrikaans slang, so the shock factor is slightly depleted upon English translation. I'm going to enlighten you anyway...this is what he was saying...don't say I didn't warn you...


"Ek naai net die wit vrouens! Ek naai net die wit vrouens"

I only fuck white women. I only fuck white women.

"Ek naai hulle in hulle bekke in"

I fuck them in their mouths

"Dan lag ek as hulle will opgooi"

Then I laugh when they want to throw up

"ek likes it as my saad agter in hulle bekke slat"

I love it when my seed hits the backs of their throats.

"dan trek ek my piel uit en ek mors op hulle gevriete."

Then I pull out my dick and mess on their faces.


At this point, the policeman decided that he'd heard enough and apologised to me for the patient's behaviour. I watched him take that guy outside the unit. I'm not sure I want to know what happened after that, but when he returned the patient was no longer an aural irritation and behaved quite decently. For five minutes. Then it started again....

"ek naai net die wit vrouens..."