The commute

Here's a little taste of the walk to work:

This photo doesn't do it justice, but this is the walk down from the convent to the hospital. The mist burns off the mountains by late morning (this is taken around 7:15). There are some nice typical players here: kids in shcool uniforms, a combi van (group taxi with established routes) likely honking and yelling "Maputsoe!" or "Butha-Buthe!", and a healthy-looking funeral home.
This is our little short-cut trail from the main road down to the hospital. In the morning it is slippery with dew and I keep waiting for one of us to bite it. There's quite a bit of litter, often chickens, sometimes sheep, cows, or donkeys. At the bottom in the Leribe Craft Store that I haven't managed to get to yet during business hours. They sell shawls, guide books, traditional Lesotho hats, and weavings.
Lots of things have barbed wire around them here and I'm not sure why. This is the hospital compound. In the foreground a new building is going up to house kids cared for by the Elizabeth Glazer Pediatric AIDS Foundation.
It would really take a load off my nasal worries. I've actually never seen leprosy. Behind the banner is the hospital. You can see the administrative building on the left and the male medical ward on the right, where I spend half my time.
And here we are at the driveway. We'll take a right at the sign, pass some plastic jewelry, a booth for cell phone minutes, two stands selling small cellophane bags of cheese puffs, and a grill preparing to make chicken feet for lunch. Mmm... we gotta try that before we leave.

I put in my first nasogastric tube yesterday. Joe and I decided it was simple enough and we had seen it done a good handful of times. The nurse knew which tubes to use and so, curling the flexible thing around my finger to give it a little curve like an endotracheal tube without a stylette, I slipped it into the left nostril and down the esophagus of the poor wretching and abdominally-bloated woman as she dutifully swallowed and ignored the tears running down her cheeks. She was a trooper and, when we got to our estimated insertion depth and gastric contents started pulsing up the tube, I taped it as well as I could to her sweaty, febrile face, doing my best to avoid covering her eyes, nostrils, or ears. You’d think it would be easy, but I also didn’t want to cover the entire non-orifice-containing surface of her head. Anyway, it seemed to work so we left.

I stopped back through the ward later to borrow a chart to photocopy for a case presentation tomorrow (we’re trying to knock the socks off someone from the National University of Lesotho who may be interested in incorporating the residency into the Health Sciences program there) and the mother of another patient caught my eye. She beckoned me into the room and pointed towards the woman with the NG tube with urgency that flipped my switch into “calm, efficient response to emergency” mode. I thought, “Oh sh*t; what did I do?” But then I saw that the woman was smiling, as were the delightfully festive-spirited family members who board in the hospital with their patients. The beckoning woman –clearly the designated English speaker in the 8-bed room-- said, “It slips out”. I took a look at the NG tube and noted that the tape was exactly where it had been, the depth of the tube was unchanged, and the stomach contents were slowly moving out towards the collecting bag. The whole room was looking at me like it was my turn to hit the piñata and wasn’t that fun, so I decided to humor the crowd who, hungry for candy, could trample me in the name of the Last Rolo at any moment. I untaped the tube, pushed it in one more gentle half-centimeter, retaped it more elegantly, and made my escape. The Beckoner, in carefully chosen English, took my elbow and said, “You are a Florence Nightingale”. Now that’s cool.