Madikwe and My Final Day on the Wards

I'm sitting at Sanitas, a quaint and pretty garden in Gabarone where we just finished a tasty brunch. We're all enjoying the free hour of internet. And while I digest I'm enjoying my last full day in Botswana. I realized with the shaky internet situation I wasn't able to write about our trip to Madikwe...

Last weekend a group of us took a luxurious trip to Tau Lodge in Madikwe. It's a South African game reserve just across the border from Botswana, only about 40 minutes from where we stay in Gabarone. We arrived to glasses of fresh lemonade and a very nice staff. The lodge was extremely well-decorated with trendy modern art and pictures of game. We almost felt guilty for being there (seeing as the majority of us were still in med school and had not seen a paycheck in many years) -  they had a fully stocked bar, a pool, multiple places to eat where they had buffet style meals, a spa, and incredible bed rooms with outdoor showers and balconies up against a watering hole where we saw zebra, wildebeast, elephants, impala and other animals playing by and drinking from the water.

We had two game drives - after arriving Saturday afternoon and early Sunday morning, where we saw amazing exotic birds, including the lilacbreasted roller, the national birds that boasts brilliant bright colors. We also saw a pride of lions - my personal favorite - and watched three sisters and two brothers napping with the mother bathing herself not too far away. They are such powerful creatures. We also saw a herd of ~ 100 buffalo, families of elephants with some sleeping and some snapping trees, rhino, giraffe, kudu, steenbok, the list goes on. I love game drives, there's so much time to just sit and think, covered in fluffy blankets and warmed by tea and coffee and wine, while taking in the nature all around. We also had a solid group. Anant and I shared a room which was actually slightly bigger than the others. The beds were pre-warmed to ensure comfort, and I actually had to turn the heat down a bit. I had a neck and back massage for amazing value. And we ate like kings and queens. The buffet lunch and dinner on Saturday, and breakfast on Sunday can only be described as criminal in terms of the amount of food I ate. And it was all tasty and delicious and quite healthy. Our final lunch was ostrich carpaccio and impala steak - pretty good actually. In the evening, we all hung out, played a game of pool while drinking Pinotage, sat by the fire and played two truths and a lie. The stars were incredible overhead. It was one of those trips that reminds you how lucky you are to be alive.

Fast forward to my last day at BLH this past Friday...it was actually tough to say good bye to the medical officer staff at the hospital. They are wonderful people and they were such a pleasure to get to know. I made some carrot cake for them on the last day which they really enjoyed. And then we said our goodbyes before rounds. The patients on the male medical ward have actually been fascinating this past week, many I will leave unresolved for the next medical student, but I felt good about us moving towards a diagnosis. One patient in particular that I've been thinking about all weekend - he's not a local Batswana so he's paying for each day that he's in the hospital. He has impressive swelling on one side of his body, lymphadenopathy, unexplained kidney failure, as well as a DVT. He also has other lab abnormalities. And none of this fit into an easy diagnosis. We're treating him empirically for some things, and I'm just hoping it's not a malignancy. He asked me if I could fly back soon to finish treating him. I certainly wish I could.

All in all, it's certainly been a challenge thinking about the meaning of giving good care in a place like Botswana. The range of patients I have seen has been extremely varied, and the ability to get imaging or send off certain tests seemingly depends on the day, but one constant thing that remained was the rapport one could build with the patients, as well as their endless gratitude. There's such an emphasis on doing the best you can with what you have, which I think really challenged me to rely less on the fancy tests and more on my confidence in my own training and collaboration with the families and other doctors to bring about good outcomes for the patients. I can easily see myself returning one day - it was an easy place to be despite how difficult it was to see patients suffer and the many frustrations of the system. And that's saying a lot in favor of the spirit of the amazing people who I met.