This was a busier week than the previous few despite the fact that the hospital strike continues and we've seen very few patients in the clinic this week. Having the Grubers around has been a treat, although we have reorganized the same shelves in the clinic several times since they arrived. Alice has kept me busy reorganizing the filing cabinets, the computer, and all of the medications and medical supplies. I also worked on updating her physician orientation guide with current information about the hospital and the island. I have been meeting with technicians from Paradise Computers to try to install some new internet connections in the hospital and repair the old ones that aren't working, and that has given me the opportunity to meet more hospital employees and explore a bit.
The most interesting cases we saw this week were a child with hydrocephaly and a cleft lip and palette and another child with a congenital skin/eye/hair condition that thusfar defies diagnosis. The child with hydrocephaly came to the hospital (referred from Ms. Peggy's) to receive pre-surgery testing because Peggy wanted to send him to the mainland to meet an American surgical brigade to repair his cleft palette. The child came to the clinic to receive an ultrasound (by one of Peggy's volunteers, an ER resident) and then to get all the necessary labs. I spent a full morning walking with the mother and child between offices to get the necessary paperwork and labs, and in the end they did not go to the mainland to get the surgery because of a paperwork hang-up. Dr. Breslin and all the other folks in the clinic have been working hard to resurrect our patient follow-up system (the patient list you sent me was from 2005), and we already have several patients entered into the new database.
The other interesting case was an 11-month old girl with a mysterious icthyosiform erythroderma and congenital cataracts. The doctors sent some photos to a pediatric dermatologist at Boston Children's Hospital and came up with a differential diagnosis, but the patient had already been sent home. A social service doc referred the patient to a dermatologist who was visiting Woods Medical Center on Saturday, so I spent several hours waiting for the dermatologist to try and intercept the patient yesterday. I was doubtful that the patient was going to show, so I spoke with the dermatologist and exchanged contact information with her in case she did see the patient later in the day. I am still hoping to track down the patient to give her mother more information and resources to visit an ophthalmologist on the mainland and possibly get cataract surgery by a medical brigade in November.
In the afternoons Peggy has kept me busy with odd jobs and errands and I spent three days tutoring high schoolers at a bilingual school in French Harbour with one of Peggy's volunteers and Christine. Hopefully this week I'll make it over to the day care and hopefully develop some more regular projects. Also, in a few weeks the tutoring should turn into at least a two-afternoon per week job.
