Wednesday, March 08, 2006

Men are from Mars, etc. etc.

It's interesting to see the natural ebb & flow of admissions here at Princess Marina Hospital. For instance, the Male Medical Ward (where I am) when I started was getting hit hard--lots of admissions, even on days when we weren't on call somehow, thanks to the highly confusing schedule here. Now it's the Female Medical Ward which is getting killed--they have probably about 3 times as many patients as the Male side. However, due to cultural differences, it's probably about the same amount of total work: I've found that in general here, men wait until they are pretty damn sick before they'll come into the hospital--which often means that because their HIV has gone unchecked for many years, they'll likely have some big-ass pleural effusion which needs to be tapped. The Male side has had fewer patients overall, but lots more procedures--which in general I like, so I"m glad I ended up on the Male side.

Another common admission on the female side is the "parasuicide". They use this term here to refer to anything ranging from a half-hearted suicidal gesture all the way to a frank suicide attempt. It always happens afte r a "misunderstanding" between the patient (who is nearly always a young female, it seems to me) and their boyfriend/husband/mother. Fortunately, most of the time it's not successful--they'll take something completely benign like trying to O.D. on their HIV meds (which won't really do much except perhaps reduce your viral load) or 5 tablets of ibuprofen or something like that. However we have seen a few more serious ones like paracetamol (their equivalent of Tylenol--which can definitely cause fulminant liver failure that can be lethal), insecticide (the only male suicide attempt I saw was with insecticide--and it was sadly successful even after a brief bout in the ICU here), and something called "Jeye's fluid", some type of cleaning fluid that for whatever reason seems to be the beverage of choice for Motswana looking to off themselves quickly.

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