by Work the World

Day 2

Today we went to the Hospital, a beautiful and impressively huge building on the mountain. We spent the morning looking around, visiting all the departments, including Forensics, which was really really interesting and I took loads of photos of the curios on display (eg the preserved body parts and informational posters).

So anyway I got to the x-ray department and met with the radiologist, who took me into CT to meet the rad tech, and the nurse there. They were all really nice and let me get settled and watch their procedures. The CT scanner is a 5th generation GE single slice which has to be tilted manually rather than remotely. I’m going to admit that what I saw today was difficult to watch, but I’m not here to judge, I’m here to learn and this is going to be one hell of a learning experience! The first OMG moment was when the rad tech did a scout view while the nurse was still in the room, with the second following shortly after when he started the actual scan while she was injecting the contrast . The nurses don’t get dose badges, and don't seem bothered about radiation. Aside from that though, they really know their stuff, especially when it comes to neuro anatomy- I really showed my ignorance (I’m writing this on my laptop having not had a net connection since Saturday, so my exam results probably echo this lack of knowledge too but I haven’t found out yet).

One of the afternoon’s patients had a massive unidentified lung mass, about the size of a tennis ball in his upper right lobe so they performed a CT guided biopsy, something I’ve never seen before. An initial chest scan was done, and measurements were taken to ascertain where the needle should be inserted. Once a fair guess had been made a small piece of lead was taped to this area and another scan was done. During the entire process the patient’s son was stood in the room wearing a battered old lead coat- 5 scans were done in total. The pathologist arrived to perform the biopsy, complete with two students carrying slides and equipment. He inserted the needle without anaesthetic into the patient’s axilla to a depth of about 2cm, then another scan was done to make sure it wasn’t puncturing the lung. It was pushed to about 5cm, another scan, then it was wiggled about until some tissue was drawn into the syringe. The needle was withdrawn and then dabbed onto about 15 slides. Once the pathologist left, the patient was scanned again to make sure he hadn’t had a pneumothorax during the procedure. He remained silent and cooperative the entire time, as did his son. The next UK patient to moan about having to hold their poorly hand in a lateral position will probably get an earful from me after this!

There were also a fair few brain scans for suspected infarcts, all of which were confirmed by the scans.

The daily monsoon rains hit at about 4pm, apparently they occur at the same time every day and last for about 2-3 hours or so. The hospital is right on the edge of the mountains and every thunderclap sounds like a bullet while lightning illuminates the whole valley. Imagine the heaviest rain you’ve ever seen in England and double it- that’s pretty much what falls from the sky during this 2 hour period. Then, as quickly as it started the sun returned and the rain reduced to patchy showers. I’ll have to film it at some point, it’s rather impressive.

During this rain, Anna and I attempted to get the bus home. I say attempted because it actually took two busses and we still didn’t get anywhere near the house! Once we finally got back, it was time for our first Nepali lesson, which was very useful, but I don’t know how much has actually stuck. We’ve just had dinner and I’m being unsociable, avoiding the other 16 students in order to write this before my brain completely gives up for the day. Hopefully tomorrow I’ll have internet access so I can post these ramblings.

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