We're slowly starting to get to grips with how everything works in the trauma unit. Sick people get sent to the cubicle area (lovingly referred to as "The Pit"), sicker people get sent to Resus, most 'walking wounded' get fobbed off to a local clinic, anyone with a confirmed simple fracture gets sent round to Ortho - from the number of these patients that end up wandering back round after we've sent them on their way I get the feeling that trauma may not be Ortho's favourite department....
After some minor mishaps which saw Riki jab himself when filling a blood tube via a needle (Klaud's worst nightmare and something you would ideally never have to do in the UK - praise Jebus the patient was negative for everything) and me prick myself taking the cap off a sterile needle (Ok I can't really make any excuses for that one, I was just dumb) we have both decided that double gloving might be wise for the future... Some things though to us do just seem inexcusable. For example, this is allegedly the biggest trauma unit in the world and there is a grand total of ONE 12-lead ECG machine. Actually, more accurately half a machine as it's shared with the neighbouring medical emergency unit... you come in to a UK emergency department with a bruised pinky toe and you'll get a full ECG! Then when it comes to suturing some of the equipment they're having to use is simply not really fit for purpose. In one case we saw what resembled a blacksmith's set of pliers that would be more at home around a kiln of molten metal than around a 1cm fine needle being used for a pretty delicate suture.
So this is a little false because I didn't take this photo, but apparently this is what The Pit looks like on a Saturday night, guess we'll find out soon enough!
This is the next door 12 bed Resus area - again the picture is a lie, it DEFINITELY does not look this clean.
The nurses appear to have a complete monopoly over all the equipment in the department. They've banned doctors from the store room so lots of things you need you have to ask for. If I was being generous, I would say that this only triples the time that it would normally take to get things ready. Adrenaline stat! (more like in 15 minutes)
Found this event card lying on the trauma reception desk - Not sure this would be allowed in the UK
So as we've banged on about enough already we're working in the Trauma department. People get bashed about a bit, things may or may not be broken or bleeding. Scans are a fab way to identify these injuries and thankfully there are multiple CT scanners a short walk away from the unit. Ideal. The problem comes in getting the patients to these scanners. Riki and I have spent a total of approximately 30 hours in the department so far. I kid you not in that time I have not seen a SINGLE porter. Apparently they are here, but these etherial beings appear to reside on an entirely different plane of existence to the rest of the Hospital. There doesn't appear to be any way of communicating that a porter is needed. We're beginning to suspect that the porters don't wear any kind of uniform - a 'plain clothes' porter if you will - presumably to avoid having to actually do any portering.
Thursday morning saw us return to Wits Uni to pay for our elective. This is a fairly hefty fee that goes to the University. I honestly have no idea what we're paying for because there appears to be zero admin on the University side, after a couple of days we are definitely going to be contributing more than we are detracting from the department, and no one was expecting us at the hospital so we could have just showed up without paying and no one would have been the wiser. Pheeeww rant over. I shouldn't really complain, all the interns here (equivalent F1s) are fab and the international Visiting Doctors are also super helpful. We collected our ID cards and then headed in to their clinical school - approximately 10 times the size of our clinical school and somehow 10 times as ugly - to pick up some scrubs. The cynicism here may just be coming from a place of jealousy because their facilities actually seemed a lot better than ours.....
The concrete obelisk that is the Wits Uni Medical school
Half the day already gone we headed over to the Hospital and spent a few fairly uneventful hours helping out. Just as it was about time to leave, Riki (nearly) reached the peak of his Clinical career. He'd been asked to see a patient that none of the Doctors were worried about because she'd already been seen a few days ago and discharged. All kinds of distractors were chucked in to the history but being the obnoxiously thorough person he is a full history gave him some concerns. Going back through the X rays he had been told were clear he saw some fairly obvious SIX rib fractures. Whoops. He also noticed that he couldn't hear the lady's left lung, also not ideal. The case was escalated, more X rays were taken and after glancing at them I commented to Riki 'Oh great job in picking up that pneumothorax!' - (for non-medics air inside the chest compressing the lung). The numpty responded 'What pneumothorax?!?'. So close yet so far Riki.
After an intense few days and with Manu's return from his Safari we had a touristy day and visited the Apartheid museum which Riki still knew NOTHING about. When buying your tickets you are randomly allocated white or non-white status and enter through separate gateways.
Oooohhhh much artsy, much symbolism. Due to Riki's Asian status he had to climb in through the garbage chute.
Turns out that I didn't actually know anything about Apartheid either so we had a few very educational hours learning about the atrocities of Apartheid and wandered through a temporary exhibit detailing Nelson Mandela's life, which it turns out we also knew nothing about. Some pre-reading before this elective might have been a good idea.
Riki and Manu enjoying some of Mandela's top quotes. #TopLadMandela
We finished our wandering when the sounds of Manu's hungry rumbling stomach could be heard across the museum and after he was satiated headed to the number 7 thing to do in Johannesburg on tripadvisor - Constitutional Hill. This place was weird. There were no obvious signs on how to get in, when we did get in, half of it seemed to be closed off or derelict and there were hardly any tourists wandering around. We did get some great views over central Joburg though.
The view from Constitutional Hill - as far as we can tell the weird glass towers serve absolutely zero purpose
Exploring done for the day we headed to our new favourite shopping centre to go to the cinema when I had to again contend with the administrative dung heap that is South Africa. When trying to get a sim card for my phone I was told that I would need proof of permanent residence. After eventually questioning how on earth any international travellers get sim cards if that was actually the case the guy caved and I got my sim card. VICTORY.
Manu sharing in my pain at the South Africa admin problems when he was told by a machine he would have a 171 minute wait.
Plans for today include more market visiting (hopefully with significantly less difficulty parking) and our first night shift tonight! Wish us luck, I think we're gonna need it.
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