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Kenya Clerkship Journal Entries - Nithya Gopal

12/17/12

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RUSM
: What type of experience did you expect to get out of this clinical rotation?

GOPAL: The rotation truly exceeded all of my expectations. It was very well organized by the Chamberlain College of Nursing that accompanied us. We had six clinic days total, two at each of the three slums in Nairobi: Korogocho, Mitumba, and Kibera. Our days usually started at 8 am and went until 5 pm, during which we had the option of working in one of several treatment rooms with a nursing student (supervised by a physician), working in the dental room with the Kenya dentists, or working in the pharmacy. In addition the educational component of the trip, we were required to pair up with a nursing student and conduct seminars to patients about various topics ranging from nutrition to sexual health. Each mini rotation was exciting and challenging in its own right, especially Pharmacy since we were working with extremely limited supplies (most were donations or purchased by individuals) in difficult conditions.


RUSM: After having participated in this rotation, has your perspective changed about medical education, your role in the profession or healthcare in general?

GOPAL: I can't say enough about how life-changing this experience was for myself and the other students. Going through medical school, it's easy to get lost in the monotonous patterns of studying, test taking, and days spent at the hospital. In just six days, my clinical skills became stronger than in six weeks in any core rotation, as I was forced to rely exclusively on my eyes and my stethoscope. This trip taught me the true value of the doctor-patient relationship and renewed my faith in medicine and its ability to change lives.


RUSM: What was your most memorable experience during this clinical rotation?

GOPAL: My most memorable experience was also my most personally challenging one. My last patient of the day on day one at Korogocho was a timid young woman that worked as a sex worker inside of the slum. Clinical signs indicated that she had contracted an STI, but we didn't have any diagnostic tools to narrow it down. After my insisting that she get an HIV test, she said it doesn't matter to her because she would die soon anyway from starvation. She was filled with immeasurable despair; as I found after 15 minutes of talking with her, she was not interested in any treatment - all she wanted was someone to talk to about all of her worries. I did as much as I could to listen and educate her about all of the opportunities available to start anew, and she walked away with a gracious smile, though I don't know how long it would last.

RUSM: How did you like participating in an integrated clinical rotation with nursing students?

GOPAL: I was apprehensive at first at the thought of working with nursing students, simply because of my personal tendencies to micromanage and take control of team exercises. Also, I think there are natural prejudices that are formed in the hospital setting between nurses and doctors that ultimately trickle down to the student level. However, I could not have been more pleasantly surprised by the dynamics between our two groups of students. The enthusiasm and mutual respect that we all shared made working in tandem a really great experience. The nursing students all had many strengths that I think are not stressed as heavily in medical school: for example, their natural tendencies to counsel patients in a non-medicinal way (sometimes med students get caught up in the prescriptions and the plans of action) and to create a very comfortable environment for the patients to discuss personal matters.