CPM Summer 2018 - 21

daup h i n c m s .o rg

While I advocated for the patient to be to the U.S. is large, and one of the pediatric throughout his abdomen. Between the history
sent to the operating theatre, it was not safe patients truly illustrated this obvious gap in of the unknown testicular mass, cirrhosis,
for the surgeon or the patient without proper medical care.
multiple abdominal masses, and weight loss,
staff. I went to bed that night not knowing if
we unfortunately came to the diagnosis of
I would still see this patient in the morning,
An 11-year-old child came to the hospital for metastatic testicular cancer. The only hospital
but to my amazement, she was still alive the abdominal pain and distension. His abdomen in all of Zambia that had any cancer treatment
next day. An above the knee amputation was resembled the size of a 9-month pregnant was in Lusaka, the same hospital that neglected
performed that day with four of the local woman, yet he only weighed 40 pounds. the child a year prior.
doctors. I wish I could say this operation helped, You could see his distended veins coursing
but her infection was too widespread by the over his entre abdomen, and I saw my first
As physicians, we will always advocate
time the operation was performed. It was very fluid wave on physical exam. His ultrasound for and support our patients. We take for
possible the infection settled into other parts showed cirrhosis, and he tested negative for granted the incredible medical care the U.S.
of her body, including her brain. We will never any infectious causes that could have led to possesses because of some of the nuisances
know because CT scans, cultures, or extensive this. It was a very strange presentation for a that come with a developed healthcare system.
blood work were not available for a definitive child of any background, and so we needed While we perceive daily notes, insurance claims,
diagnosis. I will wonder what her outcome to find out more.
and the need to place numerous, minute
would have been if she was born in a different
orders as inconveniences in the medical system,
place. A place with adequate resources where
While interviewing the child's family, we they provide checks and balances throughout
her infection would have been caught sooner, discovered that, a year prior, he was seen at patient care. But they can also blind us from
and her diabetes treated earlier, preventing her the hospital in Zambia's capital, Lusaka. When the reasons we were attracted to medicine in
from developing the infection in the first place. he was admitted to the hospital in Lusaka, the first place. My time in Zambia reminded
he wasn't seen by a physician for over a week. me of my reasons for choosing medicine,
In the U.S., we cannot imagine a hospital Eventually, a medical team removed a mass and these reasons don't have to be lost in
without a CT scanner, without access to che- from his testicle, and informed the family the the technologies of Western Medicine. We
motherapy, with limitations to blood work, or team would provide results to the biopsy. But must always advocate and investigate for our
with unreliable electricity. In Zambia, patients after a month of neglect from the physicians patients, as well as remember the humanistic
don't always go back to the operating theatre in at the hospital, his family never learned if the side of medicine. I cannot wait to return to
a timely manner, burn victims only receive large mass was benign or malignant. A year later, in Zambia as an independent physician where
skin grafts when an outside physician flies his Macha's hospital, we removed liters of fluid I will provide more for those who need the
plane into the area, and cancer patients must from his abdomen in an attempt to make extra (wo)man-power in rural Africa.
travel far to get any form of cancer treatment. him comfortable. After the loss of fluid, the
The gap in medical care in Zambia compared doctor was able to palpate multiple masses

Central PA Medicine Summer 2018 21


Table of Contents for the Digital Edition of CPM Summer 2018

CPM Summer 2018 - 1
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