Today I shadowed in Hematology Oncology in the Clinic – this was wildly different from the In-patient ward and so, so very chaotic. The rest of the hospital is disorganized in its own subtle way, but this was pure insanity. Dr. Yasser Wali (who didn’t know I was coming, but welcomed me anyways) sat in an office as patients were brought in and out. After several moments of him trying to ask me questions to things I hadn’t learned yet, he realized I was just finishing first year and actually began teaching me. It was simply incredible. I saw a day filled with Alpha and Beta thalassemia, a boy with a fistula that caused an abscess in his perianal region, hypospadias, and sickle cell with gall stones etc. Most interestingly, perhaps, was this baby with osteopetrosis. Called “bone in bone” disease, a malfunction of osteoclasts causes bones to keep growing into the marrow, causing severe anemia because all the space that was supposed to be making red and white blood cells is filled with hard bone. The infants appear with the “Bat man” sign in their x-rays – meaning that the bones in their faces are so dense that it looks like the children are wearing batman masks. They also have dysmorphic facies (AKA – FLK children: funny lookin’ kids), and rickets to the point that you can see the bone-cartilage junction in their ribs. Their ribs, speaking of which, are misshapened and tiny you can also see Harrison Sulci where the ribs indent before the last set of ribs and the abdomen. They have pigeon shaped bodies where their chest is tiny and their bellies are distended and huge. His liver came below his umbilicus (belly button) and his spleen was probably 5-7 centimeters past his rib cage – it was phenomenal. He was hypotonic – had low muscle tone, and had Marfan’s sign where there is a notch in the medial malleolus of his ankle. Etc etc etc. It was incredible. And it was rare, so I felt so very honored to see it. I got to know so many families and their children with these crazy blood disorders. I also got to take histories, write up patient reports, and learn so much. Thalassemic facies are so adorable (facies is a real word J). They have these big cheeks because the body is trying to compensate for the low blood by maxing out the areas where blood is made – our cheek bones and foreheads are one area. It was a really, really good day. Didn’t get lunch, but the doctor gave me his apple and I had a candy, so I didn’t get to hypoglycemic. Came home – made an awesome hummus and am now watching Iron man with Claire as we both journal. Today is our first calm day in a week…. It’s so insanely glorious. No plans, just sitting, only resting. I’m on hour 2 of journaling… ridiculous. Trevor plans on getting Domino’s tonight. Lol. When in Rome, right?
Oh, also wanted to mention that Claire needs to write on here about meeting woman in full veil that was sassy and gorgeous and educated. That side of the issue needs to be put in here, it complicated my feelings about the issue and I want to meet more women like that.
Secondly, I am finding myself deliberately just turning my gaze slightly when I notice people staring. I don’t back look at them like I would in the US sometimes or when I first came here, but I don’t really move much, just don’t focus on them. It allows them to keep staring. And I know that sounds odd, but I don’t mind the staring. I know it’s curiosity and interest. When I was in Africa, one of my favorite things to do was to sit on the sun-beaten earth with children all around me- climbing on me or sitting quietly, and we would just touch each other’s faces, hair, hands, skin. They’d play with my blonde hair, I’d kiss their beautiful black faces. We’d simply touch. It was so binding, so innocent, so soulful. They had lost everything and often had no families except each other. They had no parents, due to AIDS, disease or accident, and they had no real time to simply be held. These children cry and there is no one there to comfort them. They freeze at night and they have no blanket and no person to tuck them in. They suffer, their heart breaks and they have no one to heal or mend them. It’s so tragic. It’s one of my favorite life experiences – sitting on the dirt, simply giving them all the love I had, feeling so very loved in response… That is what I’m talking about here though. I’ve had no moments here that are quite the same, but the opportunity to observe, to study and to appreciate our differences is critical to appreciation and growth. I don’t mind their curious glances, I hope that by my turning my gaze, they can learn a face from half a world away.
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