Monday, July 22, 2013

Elephants, Lions, Gerstles and Kenya


At the age of 29, married, and a father myself, I never figured on being adopted. There are no papers to prove it, but I’ve shared enough water bottles, coffee cups, many meals, and almost a hotel room with Roger so I think it’s nearly official. I always knew I liked the Rich-Gerstle family, but this trip has given me even more reasons to enjoy their company. From day one, they made me feel very welcome, and we have laughed a lot together.

Traveling abroad can be very straining on relationships. It’s always risky to keep close quarters with friends while abroad, but the Gerstle’s adventurous spirit, desire to meld with the culture, and relaxed attitude has made living here fun and our relationship has deepened. In the evening when we sit around the table, talking and processing the day it is always interesting to hear the perspectives of everyone here and how they perceive the people, culture and traditions. Everyone seems to be adjusting well, and I’m even getting used to picking the stray blonde hairs out of my food, off my white coat, and off pretty much any horizontal surfaceJ

A little bit about me, my name is Nate Sailor, I am married to Trinet, who is my heartthrob and foxy lady ;) We have two handsome little boys; Hudson (3 ½) and Benaiah (2) and another boy due December 1ST (Marji has suggested “Roger” as a namesake, but I’m just not sure the world is ready for more “Roger”s). I am in my final year of residency at the Munson Family Medicine Residency Program in Traverse City, Michigan. “Rogers” (as they call him here) or “Dr. Gerstle” as I am so used to calling him, is one of the faculty preceptors/attending physicians for the program and thus the connection to traveling together. We are working together and also independently in Chogoria on a few different projects from implementation of treatment protocols for the hospital, to working on an electronic medical record to augmenting the training of the interns. I couldn’t have asked for a better partner and mentor to do a trip with. We have had a lot of fun times and it is exciting to compare notes and discuss what we saw and learned from a medical perspective. My learning is doubled by him being here too.

Most of my days…ok pretty much all of them are spent in the hospital internal medicine wards. I have had the privilege of working alongside the Kenyan interns. We have very different knowledge bases, and it is great to share in the patients. I have seen more malaria, HIV (here it is called ISS “Immune Suppressive Syndrome” to prevent patient embarrassment.), tuberculosis, meningitis, and cryptococcal infections in one week here than I have in my entire medical school and residency combined. Then again we round on 40-60 patients every morning and then are in clinics in the afternoon so seeing “a lot” is not difficult here. The intern’s knowledge of infectious diseases exceeds mine, and it is fun to broaden my knowledge base. However, I am able to have some input when it comes to treating hypertension, heart failure, pneumonia and general medicine and emergency medicine topics.

The interns here have been so welcoming, they even invited me to travel with them on a trip to a town about 40 kilometers from here (Meru) for a dinner and lecture, and some shopping. (The prices seem to be much lower when I am with interns then when I am alone). At night we decompress with bad-mitten, some light jogging and lots of laughter.

During the day we deal with some pretty serious cases, last week we had a case of an 8 year old boy who was struck by a car causing a severe head injury. Despite hours of management and even having the general surgeon perform a craniotomy to relieve the pressure from the bleeding on the brain, the child did not survive the surgery. It is one thing to deal with adults who die because of trauma or illness but it is always tough to deal with the death of children. As a parent, my heart just breaks for the parents and families of those children. However, despite feeling quite melancholy after that case, I was called back to the operating room about an hour later (“Theater” as they call it here) for a pregnant mother in labor with twins. In Kenya having a multiple gestation pregnancy is an indication for cesarean section so I was able to take part in the birth of two beautiful, brown, pudgy African boys. Both boys came out crying and healthy, and it was just such good medicine for our hearts. In fact the same OR team that previously worked on the boy with the brain bleed, was present for the delivery and the male surgical tech sang and danced with the babies in his arms while some traditional African music played from a nearby radio. The interns here see a lot of death and end stage diseases and they are so strong because of it, so it was fun to celebrate life and vitality in light of the sad cases we dealt with during the day.

At the end of the week we drove to Samburo National Park for a car safari. We saw the lions, elephants, a zebra, crocodiles and even 2 lions chasing a giraffe. We were amazed at how the giraffe ran so gracefully. The lions never had a chance. I think the real reason the Gerstles wanted me to come on safari with them was because they knew I’m a slow runner, and if it came down to a chase I’d be much easier lion bait, and probably more of a “meaty meal”;) as those Gerstles are all so lean and sinewy;). Ok well I’ve yammered on long enough, “Asante Sena” or “thanks very much” for reading.  Signing off for now, 

 -Nate

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