Flexion and Extension Views

October 6, 2009 

Slow mornings seem to be more difficult for me than busy ones. I don’t know why, but times like this morning, where I only did two films in the first one and half hours is kind of hard for me. Its not what I’m used to, or prefer to do. Luckily, today it picked up. Though it seemed to all happen at once.

I had to repeat films on a patient because the orders had been ignored. The patient’s requisition said to do flexion and extension views of the lumbar spine. I had noticed it when I took the paper to record the name, but however did the film failed to read that part, so they did AP and lateral views. The patient came back, handed me the requisition, pointed at it, and i knew what was wrong. I apologized and told him I would retake his films. When I got the patient in and positioned I tried to have him do the extension position, which he just needed to arch his back for, however, the language barrier proved to be pretty big for this particular exam. Normally I can sort of just move the patient and then grunt in agreement or correction, but it was NOT working for this exam. I asked Atim (who is pictured with her baby, Angel) to come in and interpret for me. She has helped me a lot in the past few weeks, but in this case, it proved to be a little more challenging. She had to translate from English to Acholi for the patient to understand, but first I had to translate from medical terms to layman's terms for her. What normally would have only taken a few minutes to explain in America took Atim and I probably twenty minutes. Twenty minutes of going back and forth, correcting the misunderstandings and incorrect movements. It was trying, to say the least. We finally got the films done and I allowed the patient to go. So many things have taught me patient here, I can’t even begin to explain them all.

When I said that it picked up a bit later, I meant it. In fact, my supervisor, Morris, came in at one point to greet me and I was barely able to talk with him. Not only did I have a patient on the table, but also had many more waiting in line. I felt rude, but at the same time I felt like it was ok. So much gets set aside when it comes to patient care here because of ideas or cultural norms and its something I sometimes struggle to balance. I’m learning though. Always learning...

I had one patient come who actually sort of ended up bothering me. He works at the hospital and was an all right guy, except that he expected special treatment because of it. He explained why his orders were dated for a few weeks ago, and ended up taking a lot of time to tell the story. However, then he seemed perturbed that we could not do his films right away. I asked him to wait because we needed to process some films. I understand that he was in pain also, however, the fact that he expected preferential treatment because of his status bothered me. It seems to happen here quite a bit. A title causes them to consider themselves above the rest of the patients sitting outside waiting. I have been challenged lately with this idea of entitlement. It happens everywhere, and I am beginning to realize the root of it. I am trying to make sure I do not operate from that sort of place. It gets to me. Though I really am still loving this, I am also being challenged a lot. Growing, growing, growing...