Lost in Translation

Today was PBF, which I think means something like Performance Based Evaluation in French.  Everyone has been running around like crazy for the past two days, and I'm glad I have not had to do anything with it.  Caleb and Louise were in Kigali this morning, dropping off her parents, so I was pretty much left to my own devices today, and for the most part decided to lay low.

I came to the hospital at 7:15 and ran into Richard, who said, "I have to go to Kigali today.  I've already rounded on all the patients.  Why don't you just follow Dr. Joly around on Medicine today?"

Dr. Joly's idea of me following him around was to split the women's ward in half, and to meet him in the middle.  When I tried to report my patients to him, he didn't really pay attention, and certainly didn't stop to sign after me on my notes.  I was pretty much the only "doctor" half of the women saw today.  

One of my patients had come in with malaria, and had received almost all of her Coartem, just needing one more dose.  I asked her, through a translator, how she was doing today.   She complained of vaginal bleeding and cramps.  I looked at her age, and on the chart it said 41.  However, she said she was 50.  I asked if she had been through menopause yet, and she (through a translator) said, "my last period was in 2003."  Well, that's crazy because any vaginal bleeding after menopause is uterine cancer until proven otherwise.  

I wrote on the note that we would have to do a full pelvic exam, and I'd have to wait until I could get the surgeon, Dr. Thierry, to come by and look with me to see if he would need to do a hysterectomy.  I finished my half of the women's ward, and then began to wait for him between c-sections.  He came over with me to see her, and then, between him and a different nurse/translator, she says, "my last period was in December.  I haven't been through menopause yet.  I think I'm just on my period."  

Of course, I felt terrible that I had just dragged Dr. Thierry over for a mistake in history taking.  I kept saying, "Elle m'a dit qu'elle a deja eu la menopause!"  (she told me that she already had menopause!) Thankfully, Dr. Thierry was very understanding and kept saying, "it's okay, probably just a bad translator."  If only Kinyarwanda wasn't such a difficult language to learn.  Or maybe if my French was better.

When Louise came back later today, I told her about it, and she said, "that's called a migrating history and we get it all the time here."  

I actually finished rounds really early today, and since the PBF thing was going on, I decided to hide in Shyira Chalet instead of getting in the way.  I've been working on a presentation for tomorrow.  Thankfully, I get to give it in English and get to have a translator.  I'm not ready to give a presentation in French yet.

So that is all for today.  I pretty much hid from the evaluators today.  But thankfully, the evaluation went well and now everyone is very much relieved.  I think it's the equivalent of JAHCO (not sure if that's the right acronym) coming in to a hospital in the US.

Ni ah'ejo!