R.I.P. Hard Drive

"True knowledge exists in knowing that you know nothing. And in knowing that you know nothing, that makes you the smartest of all."

-Socrates

My computer died on me earlier today. I will need to get a whole new hard drive. All of my music and photos are gone. I will just have to continue on undeterred.

The housekeeper said that the people that were getting married did not want him taking photos at the wedding. So instead he gave me a photo taken at one of his relative's wedding.

Today we had a peaceful protest near our base. I was told by one of the interpreters that they were the widows of men that had died from war related causes. They were protesting the UN building for more widow's rights.

Today at the clinic I spent some time with the OB/GYN doctor. I think that I will dedicate a lot of my time with her. It is like I am starting from scratch. She does not do any of the basic assessments that are normally done in the states. From the measurements of the abdomen of 2 of her patients today I am not even sure she knows how to accurately predict due dates.

Although I was really impressed by something that she did. Like I said yesterday, one of her patients tested positive for something called Toxoplasmosis. Just to give you an example of how rare it is in the states, one of the nurses over here is married to an OB doctor that has been practicing in the states for over 20 years. She asked him what to do to treat Toxoplasmosis and he said that he had only one patient 20 years ago with it and he is not quite sure what he used. I did a little reading yesterday and I found that Spiramicin can be used to limit the transmission to the fetus. Here is the article.

http://www.aafp.org/afp/20030515/2131.html

I have never heard of this drug and in the article it says that Spiramycin can only be obtained through the manufacturer (Aventis Pharmaceuticals, Bridgewater, N.J.) with approval from the U.S. Food and Drug Administration. I thought to myself there was no way I was going to get a hold of this drug. Earlier today I was going over how to do a OB history and physical. When we got to the part where we list the current medications the patient pulled out a plastic bag and took out boxes of Spiramicin. I was shocked and thrilled to see it. My faith in the OB doctor was renewed.

The G.I. doctor came down to the ER to get my opinion on a abdominal CT result on a 30 year-old patient of his. The report said that there was an abdominal tumor that from the appearance most likely looked like a sarcoma which is a type of cancer. He asked me for my opinion and I told him that he should get a biopsy and then the patient should be referred to an Oncologist. The G.I. doctor replied that they do not have any oncologist in all of Afghanistan. I asked him how do they give chemotherapy or radiation to people with cancer and he said that they don't. I found it to be so strange. It really makes you think twice about trying to institute any screening measures for cancer if you do not even have any way of treating it once they get identified.

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One last interesting thing. Today a husband brought his wife into the ER who was having problems with headaches, dizziness, and episodes of fainting. The ER doctor was doing a great job obtaining a history and then doing a physical exam. He moved the patient's head scarf just slightly over to the side and started to palpate the side of her head. 999 times out of 1,000, when someone comes in with a headache and you actually feel their head, you will not find anything. Well when he did it, with his hands deep under her headscarf, he said with a big surprise, "Oh, there is an abnormality!" I looked at him somewhat skeptical. He pulled back the head scarf to reveal a golf ball sized mass over the upper part of her head. You think that she would have mentioned it before we examined her. It was a good catch by the ER doc.

The VCR program did their sorting tonight. There was a lot of donations. It obviously had to do with Christmas. Take a look.

Thanks for reading.