Woke up in the middle of the night- dreamed about my mother attempting suicide again. I didn't jot down my visions at the time, but I recalled being angry and wondering why she was trying to do it again after promising she wouldn't.
The water is VERY hot in the shower- expect your skin to be burned off every time. I had to start squatting in the shower so the temperature would cool down before it reached my body =(. Someday I'll find a stool in the place to adjust the dial on the water boiler. Also, laundry days here are on Tuesdays and Fridays. You wouldn't think it, but the dirty clothes seem to pile on quicker here compared to the U.S. for some reason.
Rochelle relayed a message via Ginger for me to go ahead to the hospital without her if I want to start work early. I misunderstood or didn't understand the meaning initially because what she wanted to convey is that I can go to the lab, preview and writeup cases before she gets there so that she can review them while I gross with Ginger. That makes SO much more sense!
Last day of the week, and we are finally all caught up! At this hospital, reviewing the path records, they have 3712 surgical pathology cases, 1344 Paps, and 262 non-GYN cytology for the 2023 year. That seems about what we probably get individually during our two AP years at UW. It would be nice if this hospital could open up a residency spot for pathology, but then we have to deal with all this bureaucratic headache, in addition to finding pathology attendings willing to teach/train someone on the job.
Things that also differ here in pathology: formalin goes down the sink?! What about their water supply?? We reuse the same protective gown. It is surprising how far one can go with a sturdy gown. I don't know how long the one I'm using has been hanging in the gross room, but I ended up using that same one all week and probably will for the remainder of my rotation. Another difference is that lead pencil is used for writing on cassettes rather than having a fancy label printer. The caveat of using pencil is that it dissolves in formalin, so you better be sure your labels are etched well onto the block. The ink here is also watered down, as we have been reusing the same bottles for our surgical specimens. Thankfully the volume isn't as high here compared to UW, so it will most likely last them all year long. It also seems that we don't really need our margins inked that often to finalize diagnoses on our cases. So long as you cut and submit the tissue appropriately, you should be able to tell microscopically how close the lesion is to the margin. The ink does help though =).
All week I was putting the finally figured out what to do with this blue strip for the headset, turns out it it a compressed surgical cap to cover my hair haha...
Previewing cases- we finally caught up! The hospital had a total of 3712 surgical pathology cases (excluding cytology), which seems good for one resident to train here. When we've been chatting with each other leading up to boards applications, everyone we asked just guesstimated ~3000 cases total from both AP years of training.
Rochelle left around 3PM, whereas I continued previewing cases (chondroid syringoma was interesting to see- it presented as a firm mobile scalp mass in young patient) until Ginger came by, and pretty much finished all cases not pending consultation or slides. By the time I was done previewing, the new cases from the OR (one colon, one MOAR thyroid) were not accessioned so the both of us decided to go home.
Laundry came FRESH and hot out the presses. They wash and dry your clothes for you. It was raining today (you can tell from just outside the grossing window, which is something I appreciate more here compared to our closed artificially lit gross rooms in Seattle), so I was worried they were hanging in the drizzling rain all day.
Ginger wears nightgowns, nightshirts if you will (of which I have 3, 2 from Christmas gifts). If I had known she was going to wear them I would've brought my own as well.
Changes occurring by the end of the week: I was no longer spraying my scrubs with permethrin, nor myself with picaridin. I will pretty much save those sprays for when I'm traveling in Nairobi or on safari. There really aren't any mosquitoes here!
Things I appreciate during this tenure in Africa: talking to Rochelle and Ginger about their interests and learning more about them, getting advice on my future career path in path (ha), and spilling the tea (lips are sealed).
Dinner was everyone for themself (again)! I had ramen with canned tuna and a whole can of corn, plus yogurt, juice, wine, and diced mango. At the dining table while eating my mango, Rochelle teased me, asking if I was planning on eating all the fruit in my tray (a reference to my possibility of having diarrhea while hiking tomorrow).
Laying in bed around 9PM is when you start receiving work emails from UW. Reminder that PST is 11 hours behind Kenya's time zone. Happy weekend all!
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