Imagine BYOB healthcare. If you want to have a c-section, you gotta bring your own iv supplies, food, water, bedside gloves (for the drs and nurses), and extra money for any medications you may need. Left your cash under the dresser at home? Or, more realistically, gave your little cash to your kids to manage while you’re away? Tough luck. You’ll be holding up a hospital bed until you can pay up…or until you can phone a friend to bail you out of the hospital. I wonder what it would be like if my entire residency program were suddenly transplanted into the Rwandan healthcare system. How would we fare? Would we look like rockstars? Or would our weaknesses and vulnerabilities quickly be exposed? Running water? Just hope it rains because you can gather it in a bucket. Blood on hold for that contracting previa? If you’re lucky you’ll have a blood type. Continuous monitoring for that twin-twin transfusion? Impossible, since you only have one monitor for the entire hospital. Epidural anesthesia for vaginal deliveries? We can’t waste like that. A list of medications your patient has received? You’re funny. Cytotec stat for that impending postpartum hemorrhage? Hang on, the patient needs to go pay for it at the pharmacy first. A transfer that’s not already lost 3 liters of blood and is DIC? She’s in the morgue. Your own copy of Creasy? You can only dream. A patient that’s had more than two prenatal visits? Well, maybe we can count the one with the traditional healer. A call room? What the heck is that? Retractors for your vag hyst? Ask Santa to stuff your stocking. Blood cultures for your septic patient? I’m sorry, we don’t know what those are. Sterile surgical gowns? These cloth ones were washed this morning. The latest practice bulletin to guide your management? Never heard of ACOG. A car to get to work? You don’t know anyone with a car except foreigners. Just walk 3 miles or fight for a bus seat. Being able to give report in your native tongue? Let’s try the third language you’ve had to learn. A room in the entire hospital that doesn’t have a cockroach? Doesn’t exist. Career mentorship meetings with your attendings to help you be all you can be? Clearly, you’re on crack. Attendings to scrub with you on that 2am case? Better just say a prayer and make it a good one. A psychologist to help you process at least one maternal death per week? Bahaha suck it up. OK, at least some family to hang out with or call? Sorry, most of them were killed in the 1994 genocide. A clean apartment with a fuzzy cat, gym, pool, hot shower, bed, clean clothes, air conditioning, cable tv, wireless internet, nail polish, hairdryer, curling iron, takeout pizza, boxed wine, and scented candles to return to after your long week? Now where in the world do you think you are…America?
Posted on: Wed, 06 Nov 2013 08:23:15 +0000
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