Diagnosis

July 20^th: This morning we awoke with the same enthusiasm for a day watching neurosurgeries. The surgeries scheduled were pretty similar to the day before (several laminectomies). In addition, there was a shunt removal on a 4 month old scheduled.

This poor little boy had hydrocephalus and his frontal lobe was bulging outwards. I got to hold his little hand as the anesthesiologist set up for intubation and anesthetics. Jose explained that the tubing equipment that they have here in Kenya is not the best and this little guy’s was faulty. Therefore they were going to try to replace the faulty segment rather than removing the whole thing. Sure enough, once exploring they found the problem and were able to replace it.

After watching the surgeries of the day we were waiting in front of the hospital for our ride back to the compound when this man approached us but didn’t say anything right away. My first instinct was to reach for my pockets to protect the contents as I thought he was trying to pickpocket us. A minute later he found an opening in the conversation and began to ask for our help. (I hate those moments when you feel guilty for questioning a person’s intentions, for judging right away.)

This was my first taste of trying to determine a diagnosis on my own and it was SO GREAT! He described the strange symptoms his daughter was experiencing and he was so sweetly concerned. He was frustrated because they had come once before and the doctors just gave her headache relief meds but the symptoms were worsening. It was Whitney, Maggie (an Irish medical school student) and me. We unanimously concluded that it sounded an awful lot like epilepsy. We followed the man back to the waiting room where his daughter was seated and we had her describe her symptoms as well. More and more signs were pointing towards epilepsy (Maggie had a pocket-sized medical reference book that emphasized that we were on the right track). We all felt the satisfaction of being able to give her feedback. It may not have ended up being the correct diagnosis, but it will give them a discussion point with the doctor. To try and solidify the evidence/conclusions we made our very first (informal but equally exciting) dictation. We wrote the important symptoms, the symptoms that were missing, a potential course of treatment, potential tests to run and our tentative diagnosis. We gave it to the family. We probably had relatively no impact on that girl’s future but we were happy to give her even just a bit of our time and our feedback.

Later that night we went to the highly anticipated 9:15 pm 3D showing of the legendary Harry Potter. This was past our usual bedtime (I just may have dozed off for a bit :/)!