Back in business...

the attitude, that is. This is just a quick note to say that I'm in a good mood. I don't know what happened the last few days but I'm glad it's over. Sometimes you just have to ride out your own crappy brain waves and remind yourself that it will pass.

I slept really hard last night and woke up to my alarm in the middle of a dream in which one of my future co-interns (whom I happen to know from my post-bacc premed program in Vermont) was explaining --in the knick of time-- that climbing trees was the best way to avoid a moose attack. As it turned out, this particular charging moose knew how to climb trees too, so I spent several exhausting minutes swinging on vines and pumping with my feet like the little kids on the hospital swing here to become a moving target for the lumbering beast. It turned out ok in the end, you'll be relieved to know.

This morning I had a couple new admissions, a death certificate to fill out for someone I hadn't met, several blood draws to do (though the liver function machine is down again: boo-hiss!), sputums to collect, some debating and consulting on anti-convulsants for a patient with an unknown "aggressive and violent psychiatric history" on unknown medications for an unknown period of time prescribed by an unknown clinic where his Bukana (medical record book) is now sitting, a chest x-ray to organize, and Gilder to frame for it. Oh jeez, the guessing games are remarkable here.

There's a sad scene in the ward today: two handsome boys in their mid-twenties are in beds side-by-side and both very, very sick. One is moaning with every breath, drooling, his right hand writhing, and an enormous fungating and ulcerated mass growing from his testes. He's had this for five months and was brought in by family yesterday because he could no longer talk and was losing weight. The fellow next to him is 26, has a CD4 of just over 100, and is nearly fully unresponsive from meningitis. I just did his lumbar puncture and hope to know what kind of culprit we're treating by tomorrow. For tonight we'll cover him for everthing: TB, crypto, bacterial, toxo, and hope he starts to come around a little. Joe just went up to the ward to admit a third young man with AIDS, TB, and pneumonia. I'm hoping to go home soon to change out of these scrub pants which have now-dried samples of several fluids which aren't mine. Why is it that I love doing this? I totally do.

It turns out that Friday is "Workers' Day" so nobody works... including us. So we're going to try to get to Semonkong to hike and do the big rappel (sorry Mom; I'll be careful but I can no longer shade you from the truth). I'm also getting excited about a few-day trip to Kruger, likely leaving with a group from Jo-burg and spending three days in the park. I'm hoping to find a company that will allow me some flexibility of schedule, the saved money of not renting a car on my own for a few days and driving eight hours alone, and some guided goodness including sight-seeing on the way to and from and info on grrrrranimals. My other big hope is that I'll be able to catch a rugby match somewhere sort of close by. Soccer would be a totally tolerable second place sport to see, but I'd love to see some good rugby. I've hardly seen any live (that wasn't part of a tournament I was in) and really miss the sport.

Aahh! The other big project I have going is making sure I graduate. I have a National Health Service Corps scholarship which pays my tuition (3rd and 4th years) in exchange for my service as a primary care physician after residency in a federally designated "underserved" area. Cool. Very cool. BUT they're really slow to pay the tuition and I have a "bursar's hold" on my diploma until they cough it up. I managed to skype to the Comm Ave Barnes and Noble and make sure I had a cap and gown to march in, but I'd love for the dean to hand me an actual diploma on the 17th.

Finally: tonight I shall make a carrot cake. Expect pictures and reports of happy tummies.