Internal medicine, begging, and cooking dinner

Monday 27th August
Today I started médecine internale, which I had assumed would be the equivalent of general medicine in the UK. How wrong I was. In fact, it seems to be shorthand for neurology / cardiology / whateverthehellshowsupology. Which is fun - and it's quite a relief seeing signs again which aren't just you pinching their tummies and watching the skin fold staying up for about forty minutes because they're so dehydrated. You will be relieved to hear that I pinched not one adult's tummy during today's proceedings.

They have a lot of stroke patients, oddly enough - one tetraplegic who cheerily responded "very well" to the three doctors who asked how he was - and a woman who was in the middle of what I will bet good money was a pretty hefty pulmonary embolism; I will find out tomorrow, I suppose. The head honcho here being a cardiologist, there were also lots of ECGs and a doctor on the ward round who was great at teaching me as we want round, and I think my ECG expertise impressed him at least a bit. It certainly impressed me - I successfully spotted the reverse tick sign of digoxin therapy. Although I was only able to explain this with the aid of diagrams, as I wasn't sure of the French for anything needed to explain it bar 'digoxin' and 'ECG'.

Today was also the day I finally had it with the people here. I've got used to the kids whose only English is "Donne-moi un cadeau!"; I now just go for a curt "non" and then walk briskly off swearing to myself in English and wondering why they feel that tu-toyer-ing me is a good idea in this situation. This afternoon, though, some guy wanders up to me and asks if I remember him. Thinking he might be some shopkeeper I hadn't recalled talking to, I admitted I didn't, and he said oh, I work with you at the hospital! So this is fine, and we get chatting as I'm walking home. Then he drops in that his bike is broken and is at the workshop - and could he borrow 1,000 Central African Francs (CFA) to pay the mechanic. There follows a long and involved discussion of how he lives a long way away and will bring the money to the hospital tomorrow; I show him that I'm only carrying 2000 CFA and say I need them tonight, blah blah blah. I'm obviously reluctant to lend him the money, so he gets a bit shrill - "ah, if you need all this money to eat tonight, then you can't help me now I've broken down". I get a bit pissed off at this point and suggest he ask the mechanic if he can bring the money back to him. He says he doesn't think so. I say, well let's go and see the mechanic. He says, okay.

But then we get ten yards down the road and he changes his mind - perhaps he can borrow a motorbike from one of his friends and go home for the money.

Perhaps you can, sunshine.

The kids are one thing - they've grown up in an environment where looking sweet and asking for presents is, by and large, financially rewarding. They don't, by and large, know any better, and actually the Western governments which pour money into aid work which doesn't attempt to help them work - and probably I'm including a lot of medical aid work in this category - and the tourists who hand out pens and books and candy, are at least as blameworthy as the kids. Adults who lie to you, though, are a different breed.

So still not all sweetness and light, but I had four of Peace Corps lot round for dinner on saturday which was fun. Not exactly haute cuisine, but an interesting bunch - an Iraq vet who's off to NYC to talk about agriculture at a veterans' convention, two vegetarians who'd been living on a commune in Virginia before coming out here, and the last called Lulu - and cooking made the place feel quite homely. And I think the medicine's going to be easier and more varied from here on in...