Weekend: part one.

Q: Do I use to many exclamation points? Not sure. Anyway.

The next few posts may contain a fair amount of sappiness and love goo. (and other types of goo of course, I did have clinic in the AM)

So on Friday I had antenatal clinic in the morning. And that afternoon, at approximately 12:40pm, Jon touched down in Jamaica. I would like to say that I sensed the moment he landed, the moment he physically was on the island, that something magical happened and I had the tingles and that is when I knew. However, I was too busy sweating at 12:40pm but I knew he landed at that time because the computer at Alicia's apartment told me so.

Anyway, back to antenatal clinic. Again, time here is flexible and it seems that the assigned times for clinic are merely suggestions but it does not matter. Things work out. When my assigned teaching consultant was late the nurse made sure I got to work with the senior resident Dr. Chand.

It was a wonderful morning! I had a lot of hands on education! Dr. Chand is a wonderful teacher and allowed me to ask him a million questions! So we were here


just to refresh your memory. I was mistaken in my original post about the two curtains. I thought one was a changing room and one was a doorway into the hall. Nope. They are both doorways into the hall. While one patient is being seen by the doctor the other patient waits her turn in the little space behind the curtain. That way when the one patient is finished the next one can come right in and another person fills in her spot. There is little concern here about patient confidentiality. The patient waiting can hear EVERYTHING about the other patient being seen!

Anyway, the clinic is very busy. Dr. Chand basically stands there as the patients shuffle (waddle) in and out of the room. Of note: no attending oversees the residents work. They work and function independently deciding how to manage the patients themselves. This differs from the US as the resident almost always has to clear all decisions with the attending. Nothing is done without the attending agreeing to it.

The women do not change in to paper gowns or cloth gowns. Rather they change out of their bottoms and put on a black slip that they bring with them. Then they come into the examining area and spread out a sheet or towel they brought with them over the examining table. There is nothing disposable here so that white paper sheet we are all used to does not exist here. The patient then uses the step stool to get onto the table and lays down. The entire interview is conducted while the patient is laying down and the doctor standing over her. Then we commence the physical exam which consists of a focused abdominal exam. We measure the fundal height, perform Leopold's maneuvers and then auscultate the heart rate! I had a slightly embarrassing moment when Dr. Chand asked me to measure the fundal height. I asked him where the tape measures were kept. He gave me a funny look and told me that it was the students responsibility to have a tape measure on him/her. It turns out that they use real tape measures and not the disposable ones like we do. I felt a bit foolish telling him that each patient gets their own disposable tape measure and then it is discarded afterwards. It may not seem like an awkward moment but when you are faced with a place that has such limited resources it is a bit embarrassing to tell them how callous and carefree we are with our endless endless supplies.

Anyway, back to the exam!


Ta-da! It actually works! It is hard to get the rate because it is so fast but you can generally hear that it is in the right range. (PS: the patient said it was okay to use her picture)


We had a woman that needed a culture taken because she had some abnormal discharge. So we go to the culture cooler.
The culture media is kept in this small cooler with ice packs.


The media is in small glass jars that can be re-used again after they have been sterilized.
After the culture is place the lab order is wrapped around the culture and sent to the lab. I think it is a miracle that the actual results end up in the right chart later!


This is a prescription pad! No DEA number, no stamp, no licensing number!

After a busy morning we were done for the day. I got dropped off at Alicia's to head out to Ocho Rios where Jon was meeting us.( (yay! yay! yay! My love!) Long crazy story short--we got there a bit late but that is okay because we got to do one of the coolest things ever!

But first some pictures of the journey there.

Trench town. Where Bob Marley is from.


Trying once again to capture the scenery.

The pum pum rock. This is on the way to Ocho Rios and it resembles, ah.... you can use your imagination but it has to do with the field I am entering.
We traveled through a place called Fern Gully. (yep, like the movie) It was so green and lush! It was amazing! Below is a video. The roads twist and turn like crazy here. This was not even half that bad. The ones up on the mountains are stomach churning!