Vangaurd Drive Community Health Centre

Last night I did not sleep too well. I woke up feeling tired, but not bad. I woke up, at a leisurely pace, had breakfast and then got on my merry way to Vangaurd CHC.

It was a quick drive through to Vangaurd, which is located on the highway between the suburbs of Bonteheuvel and Langa, both of which are incredible low SES areas riddled with extreme violence and crime. I felt just a little worried blindly trying to navigate through Bonteheuwel in the general direction of the CHC.

Upon arrival I parked and decided to immediately submerge myself in the chaotic writhing mass of sickened humanity that is treated by the centre. Walking through the door is breathtaking. Hundreds of people sit dejectly on wooden benches waiting as an integral part of some unseen process which results in them eventually getting treated by a health professional or referred. The sheer amount of people; old and young, fat and thin, healthy and sickly, with injuries clearly seen or looking completely healthy, pregnant woman, young children and the ancient aged all waiting around in a loud chaotic mess that makes me feel overwhelmed, scared, helpless, guilty, disempowered and quite honestly awestruck.

In 1 second my senses absorb the sight described above, as well as the associated sound and inevitable smell. I see, know and accept that there is nothing that I can do, besides smiling at people, that will make even the slightest difference in the sate of this facility. My mind focuses and gears towards my objective – Find the nurse who knows what we need to do in this boil of the cape flats.

It does need to be said that Vangaurd Drive Community Health Centre is a well maintained structure. It is clean, organised, painted and well kept. There is also a very nice UCT student’s area which is a little disgusting. The reason why I find it disgusting is that in the greater scheme of things that money and effort might have been invested in improving more important facets of the hospital. It feels like when you take out an expensive meal and start eating it in a room full of people who don’t even know where their next meal is coming from…

So, anyway, I found the Sr and spent some time on the high speed internet and reading while I awaited the arrival of the rest of my quintet. Once they arrived we spent a lot of time sitting / standing/ crouching / pacing around outside the family planning room. Eventually a Sr let us in and spoke to us about contraception – obviously we know absolutely nothing about contraception and it is completely cost, time and effort economical for this nursing sister to speak to us on the topic instead of us all seeing patients.

After that completely enlighting session we went to the voluntary testing and counselling room in the midwife obstetric unit. We would have gone to either of the two voluntary testing and counselling centres in the actual CHC but BOTH rooms were closed due to the staff not being “in” today.

The woman who spoke to us and then 3 patients about HIV, sex, STIs, breast feeding, childbirth and numerous other topics was absolutely fucked. She had a BMI of like 35 or 40. Her upper arms were MASSIVE and flabby, not just massive but completely huge like September 11th or the Rwandan Genocide. Her ass could and very probably was hiding weapons of mass destruction somewhere in their infinite folds and weight.

She spoke 50% truth and 70% absolute crap. She was vague, technically incorrect and a born-again Christian who decided to use her position of power to indoctrinate frightened women. Besides slating the government’s possible idea of legalising prostitution she also said something along the lines of “You get many kinds of yogurts: Strawberry, fruit, mixed fruit and berry – these are for the mouth, but the white plain yogurt is for the lips down bellow.”

After learning how appalling our VCT services at Vangaurd CHC was I saw an incredibly irritating patient. She was a 48 year old Gravida 3 Partum 3 woman with a long list of conditions including being quite hearing impaired and numerous psychological conditions. She was presenting with intermenstrual bleeding on a higher dose combined oral contraceptive pill. Taking the history from her was excruciating, she did not hear what I asked her and then spoke about what she thought I said until I was forced to interrupt her. The process took quite a long time, but was a good learning experience.

After seeing her I waited a while and then we had to present our patient to a doctor. The two foreigners I was working with did a decent presentation, but pseudo-jew was very unconfident and I felt irritated by how slowly he presented. My presentation went ok, but not as well as I had hoped. I did a PV and passed a speculum on my patient.

I went home via Canal Walk where I purchased Age of Mythology which I’ve been playing since.

I’m feeling quite tired and ready for my weekend. I’m feeling in quite a strong anti-women place again, which is good. I didn’t do Yoga today, but I should have. My dad seems to be in a better mood.

Hold Back!

On Tuesday morning we had a teaching ward round which was quite good. Afterwards we had to see pre-operation patients to take a full history and do a full examination, plus take bloods and do special investigation. The problem was that here were very few patients and many students, so I went down to the emergency room and clerked a new gynae patient. She was a 23 year old gravida 2 partum 1 (2 previous pregnancies, 1 previous birth) lady from DRC who spoke only friends and is currently pregnant and complaining of lower abdominal pain and headaches. She was later diagnosed with a urinary tract infection and discharged on antibiotics and paracetemol. The process took a long long time because I had to go fetch the intern on the 6 floor then walk down 7 flights of stairs with the intern in tow, after I had to help her with some wardwork, then the intern saw the patient with me and had to go up to the 6th floor to discuss the patient with registrar before she could discharge her. After that we chilled a bit outside then went back to medical school where my clinical partner and I chilled and smoked a quick nag. We had a gynae pathology tutorial with the very interesting, dignified and slightly geriatric retired consultant After the tut I went through to Vernan where I did a bit of leisure and varsity reading as well as sent an email to Rachel. My homey came over and we sat and watched tv while Vernan showed us various combinations of clothing. I gave vernan a lift through to the shnat farewellcome. It was really amazing to see some of the people from camp. The one girl is so absolutely incredible, she makes my blood boil and my knees fail. Fuck! I hung out there until about 19h10 when I sped through to canal walk to meet Foamy for supper. I had a decent Pizza and it was really great to hang out with him. I got home after 9 and struggled to get to bed. I’m taking Alergex every night at the moment because I have quite bad allergies. I had a hectic dream about Lolita. I woke up with difficulty today. I mission through to uni and arrived at the same time as the pseudo-jew in my class. He and I walked up to the hospital together. We had a disgusting amount of lectures today. First up we had a lecture on GPH which was a bit boring and repetitive. After that we had TWO 1 hour contraception lectures back to back by the 80 year old contraception chick. I died, then a died again. Daria and I were discussing things we’d rather do than be in the lecture. These things included inoculating ourselves with RVD and inhaling TB positive sputum. After that we had a 20 minute break followed by an excellent lecture by the cynical, sarcastic and brilliant course convener. After that lecture we had another gynae path tut followed by a 30 minutes break and then 2 forensic lectures, one of lectures was about anoxia as a cause of death, the next was about anaesthetic deaths. I heard an amazing story where a woman was found dead at a club. On autopsy they found that she had received a lovebite over her one carotid sinus and had gone into neurogenic cardiac arrest from excess vagal stimulation. Amazing. I arrived late for aftercare. Some guy before me wasn’t admitted yet and was quite unpleasant. Everybody else had had quite a good week, which was nice. I was disappointed when my two friends had to leave early. I spent some time with an friend from longer ago then went through for my weekly nag meeting. On the way through I bought some food as well as some chocolate for a girl in my class whose birthday I had to stop off at on the way home. The guy was hung over and his brother sick, so we did not smoke nag. I watched him play a cool Xbox game. I stopped for half an hour at this chick from my classes birthday at hemisphere. I felt sweaty and disgusting. At the moment I feel quite good. I’m going to give Lolita much much more space. I feel lonely and very tired.

A shitti start to an ok day

I woke up at 6 this morning after a decent sleep. I had struggled falling asleep initially but eventually slept well.

I arrived at the microwave after getting dressed and doing my ablutions to found, to my dismay and horror that my wheetbix had been made with milk that was no longer usable so I had to throw them in the bin and have sandwiches for breakfast. I should have taken this as a sign and gone straight back to bed.

I arrived at New Summerst Hospital and struggled to find the gynaecology ward. It had been moved from the first floor to the sixth floor. The button to call the lift on the first flood did not work.

I arrived at the gynaecology ward to find that I had absolutely nothing to do until 14h30. I went down to the emergency room where there were also no gynaecology patients so I went home.

I arrived home, socialised with my parents then went back to bed where I did not sleep for a while. I read quite a substantial part of the Oxford handbook of Obstetrics and Gynaecology. I’ve decided that Obs and Gynae are quite a limited and boring field. Then dad and I decided to go shopping for more clothes for me.

We arrived at value centre – part of N1 city and looked at 2 shoe shops. We then left and went to N1 city proper. I found a decent new pair of jeans, a decent pair of casual pants as well as a new pair of takkies. I also bought a new pair of smarter pants. We then went to a shoe shop in voortrekker road where I got my first pair of smart shoes in a long time.

I arrived home, did some yoga and then read more text book. I showered early, had supper with my folks and spent some time on the internet.

I ran scandisk, defragmentor, spyware and virus scans on my computer today.

When I go to sleep I think of Lolita and sms her sometimes. She never replies which makes me feel anxious and shitty.

Tomorrow I will hopefully have a more productive day at NSH. I am also attending the shnat farewellcome and going out for supper with Ranti.

I’m feeling quite calm and well. I’m looking forward to relaxing with my cup of milk chai tea and my book for a while and then going to bed early.

Another Weekend

On Friday I was lucky to only have to go into uni at 10. I, however, woke up at 7h30 after a superb nights sleep after taking alergex. I had taken the alergex the night before because I was feeling a little anxious about Lolita and uni and decided a good night’s sleep would be in order.

I arrived early at GSH gynae triage to find my partner there already, as I expected. We immediately starting seeing our first patient: a 50yo G3P3 postmenopausal woman with 2 x previous pulmonary TB now presenting with pelvic organ prolapsed. It was a good learning experience seeing her.

After that my colleagues went to go watch an evacuation. I stayed and saw another woman – a 27 G4P3 now pregnant with an STI.

A while woman came in with retained products of conception after a miss-carriage. I took care of her, but wasn’t allowed in the room while they did the pelvic exam. I went with her to x-ray, then went with her to day theatre to get her uterus evacuated, which was quite disturbing.

I came home at around 14h30, slept a bit, read a bit and played some Civ IV.

Supper at my usual family was great. I filled my car on the way through, then stopped off at my usual spar to buy fruit juice then went through to the family. We had a decent night. It was very familiar to every other Friday of my life, which was good.

I wanted to stop by and visit Lolita, but we had had an sms conversation earlier where she first said she had to write an essay, so I pushed a bit, then she said she didn’t feel like visitors. I felt bad and anxious, so I wrote her a message on facebook.

On Saturday morning at fucking 7h30 I had to get up in order to attend the funeral of a guy I knew from Kaya. He was an 18 year old recovering drug addict with 10 months clean time now dead with a myocardial infarction.

I arrived early at the same time as two of my kaya friends. The third and fourth joined later. It was quite sombre and sad for them. I felt very ok about him dying. The church was one of those hectic born again churches which have a way of making me feel like leaving. They had a 4 piece band, a full on mixing desk, 30 stage lights and seating for about 5000 people. They sung rock songs worshiping jesus and the priest spoke for about an hour on how, if we don’t ask jesus to be our own personal saviour we can never go to heaven and see the departed again. I read about evangelical Christianity on Wikipedia on my phone during a large part of the service.

I felt out of place so I left quite quickly afterwards. My lunch plans Ranty my computer friend was cancelled, so I played a long game of Civ IV. I went to my oldest friend’s house for dinner with some cronies. 3 I hadn’t seen in a long time and the fourth I hadn’t seen in 2 year because he’s studying in Australia. I had quite a decent night and got to bed at 12.

I slept till 9h30 today, woke up, had breakfast, fucked around with my computer again and then I had a reassuring chat with Lolita on MSN for a little bit. I did some yoga for the first time since my art of living course. I had to look up one of the asana.

I read a bit of uni stuff and typed up two patients.

I went out for supper with Muscle. We smoked nag first and we were joined by two guys we’d met previously at Primi. I confided in him about Lolita and he was reassuring again.

I’m feeling quite well rested and ready for the week.

Fear, Anxiety and… hope

Wednesday was a long day. I had a lecture on Auditing death rate which was very dry. I read a bit during the lecture. After the lecture I had to borrow a coat from one of my peers because I had a tutorial with a doctor my dad knows that I had forgotten about. The tutorial was excellent. I got to do my first PV of the year and also passed my first speculum. The woman had a while unoffensive discharge and her cervix was pathologically anterior and superior, and also distorted.

I spent some time with some of my peers then we had two gynae lectures that were quite good, though I nearly fell asleep in one of them and struggled to concentrate in both. After a brief lunch we had a horrendous, disgusting, dehumanising lecture on forensics which was quite long and quite interesting.

I hung out with a closet homosexual friend of mine for a while, then went through to aftercare.

I felt very concerned about talking about Lolita in aftercare. I didn’t want to go, which was a clear sign to me that I had to go. I didn’t want to speak about her for fear of the group’s reaction and the associated shame that it would bring back from my early days. I arrived at aftercare determined to speak about Lolita.

The mood in the room was frightening. My two kaya friends that I hung out with last week were either very sad or very angry. Because of the anxious frame of mind I arrived in I interpreted their feeling as anger and decided that it was directed towards me. I was brought right back to my days as an inpatient there. I was racked with fear the likes of which I haven’t felt since Alia, and long long before her.

My turn, however, came and went without anything. I found out that a friend of mine that I had met at Kaya died of a heart attack on the weekend. He had died clean and he had died happy. He had also died, which meant he suffers no more. It felt strange, but I was ok with his passing.

I chose not to speak about Lolita considering the mood in the group. I still half-feared the coming confrontation that never came.

After the session I waited and spoke to the main counsellor there, a man who I love and respect very much. After I describe the situation with Lolita he said he was happy for me and that I wasn’t doing anything wrong. I felt so much better.

I went to visit the Pepperman. We smoked nag and chilled. The nag made me feel sick.

I went home and wrote a long letter to Lolita. I would have liked to have spoken to her, but it’s sometimes good to write down what you feel. I sent to her over facebook for lack of a better choice. She replied with a tremendously heart warming letter which made me feel happy. It was good to know she cared to and also had feelings for me at one stage, though she had pushed them away.

I have to give her space now, which is not what I am good at.

I took my usual sleeping tables plus an alergex and slept well last night.

Today I had to wake up fucking early. I had a 7h30 ward round at Groote Schuur. The senior consultant and our course convener was so fucking excellent. After the ward round we clerked pre-op patient with the 6th years. I left at about 12h30 after dropping off bloods and x-ray forms.

I went home, only to find that the power was off. I went to canal walk, bought some supplies then had a shwarma which was great.

My supper plans with my computer friend got cancelled. I spent quite a bit of time trying to nap.

I am feeling hot and uncomfortable today. My time and space feels empty. I feel a mixture of anxiety and exciting about Lolita. I am happy the weekend is near. My dad and step mother have been away. I don’t think that I miss them, but it’s not the same without them.

Gareth cliff makes me laugh every morning.

I have come up with a new series of jokes: “Shedding jokes”

My radio sometimes cannot tune to 88.2 so its frequency or station shedding
My computer friend and I experienced arrangement shedding today

Of hopes and shattered dreams

Today I woke up early feeling quite well.

I went through to surgery. I got into my scrubs, which I enjoy doing because it’s a clean meticulous process.

After missioning for a while I found the gynae theatre. The patient was on the table, so I introduced myself to her, then the anaesthetists because I feel familiar with them, then the gynaecologists. The consultant was a really great guy, very challenging and stimulating, but a good teacher. The registrar was quiet yet friendly and there were 2 six years who were also quite friendly.

The first patient had ovarian CA. She had had a bowel resection with a colostomy and had endured a previous hysterectomy and 4 rounds of chemotherapy. They opened her up with great difficulty owing to adhesions from the previous operations. Once inside the explored and found that she had a very large metastesis which was ran from the transverse colon, up to the liver and under the stomach extending to the spleen – inoperable and therefore terminal. She also had a few other smaller mets.

A death sentence had been pronounced before my eyes and she was then stitched up quickly to make room for the next case. It was quite a profound thing, something final and sad. She had entered the operation with the hope of cure, but had found pain and death waiting for her in the months ahead.

The next patient to be brought in was an old woman who looked likely to throw a DVT. She was there for a radical hysterectomy because she had cervical cancer grade 1 B 1. I could not see clearly what was going on during the surgery and the HOD had arrived so the operation was crowded by 4 people being involved, so I read a bit then went to the com labs

I downloaded drivers for my computer, emailed Profs Burch and Blockman about the generic treatment guidelines from last year, surfed a bit, then rushed back to the museum in the obstetric and gynae department in the old main building for an excellent tut on gynae pathology by a really excellent doctor who preached humility which I really like!

After the tut I went to canal walk where I found out there’s something wrong with my cars suspension and not the wheel alignment. I then bought airtime and went virgin mobile to find out about a new deal on my cell phone. I then went to my motor mechanic who said my car can wait until its next service.

I went home, read and got ready for the next day.

I’ve thought about Lolita a lot today, not too much, nothing troublesome or unwholesome, just a little nag at the back of my mind.

One of my colleagues said that she was intimidated by me because I always leave the exams early. I was quite flattered by her comment, but explained to her that I was not competitive and did not do amazingly well. I told her that leaving the exams early was the one small victory that I could still glean in the shadow of my superb school results.

I’ve chatted a little to Lolita tonight over the internet. She does / did not feel the same way as me, but I don’t think it’s uncomfortable or awkward. I feel like a bit of a toss, and a bit venerable, that’s ok.

cold comfort for shame

Today I woke up after a good night’s sleep feeling healthy and refreshed.

I went to uni where we had a 3 hour tutorial on gynae patients by an excellent doctor who was a misogynist and a bigot, but a good teacher. It was an excellent tut where I learned a lot.

I left my phone at home, so I had to go back to Edgemead then back to camps bay to repair a computer. The computer had a few simple problems which required 2 hours to repair and got me paid R300.

After waiting outside my clients house for a while I went to Lolita’s house to visit her sick sister. After spending most of my time with the sister I went to visit Lolita and had a bizarre, exciting experience that I am worried about.

We didn’t speak. She was sleeping. I woke her. We hugged and held each other a while. We then communicated non-verbally for a very long time. We looked at each other, touched each other fairly innocently, she listened to my heart while looking at my watch, and I felt her pulse. We held each other some more. I said a few things to her, and then left. I found the experience very comforting but also sexual.

At any point I felt that I could have kissed her and that she wanted me to. I would have loved to have kissed her. I care about her and she cares about me. She is 15 turning 16 and I am 23 turning 24. I would feel ok kissing her, but I could never explain to her parents, her family (who are friends of mine) and my friends and peers.

I had supper with my family and soon I will go to bed where I will think about her and drift off to sleep.

As far as weekends go…

Friday I woke up early and went through to Victoria Hospital for Gynae Surgery… I arrived on time, unlike my colleagues and the doctor, so I got into scrubs and wondered around like an idiot for half an hour. When I eventually went back to the change rooms to check I found the senior surgical consultant giving the others an impromptu tut, which was annoying.

Once the gynae surgeon arrived we went to theatre. The first two patients on the list were hysterectomies, then there was a hysteroscopy and an exploratory laperotomy. ‘

Both procedures were fairly interesting, pretty straight forward and gross. Vaginas are not particularly attractive organs to start off with, but when you add the fact that the woman is overweight and unattractive with a big wart on her thigh you just cannot help but shudder when you actually think about at what you are looking.

After a while the power tripped thanks to eskom so we had to cancel the two final procedures.

I went home, had a nap, and then, while playing Civ IV the power tripped at home, so I missioned down to Canal walk to buy a new book. I finished reading the black magician series, and thoroughly enjoyed it. I am now reading the Age of the Five series also by Trudy Canavan. I’m enjoying it as well.

On Saturday I spent most of the day at home relaxing. I read quite a bit and played computer games. I shaved my pubic hair for the hell or it. I went out for supper with Badger, his fiancé and one of their friends from Joburg. We had quite an decent night, then went back to Badger’s flat for nag.

Today I slept late, watched 5 or 6 episodes of Heroes 2. I got the series from badger and enjoyed watching them. I missed vanilla and would have loved to watch them with her, but I cannot keep running after her.

I went out for a relaxed supper with JetPlane. It was ok to see her; I was much colder and calmer with her than I have ever been before. We had a decent time though.

I am feeling well rested and ready for the week ahead. I still feel quite loney and empty. I am the least sexual that I can remember being. I’m just disinterested in women. I feel generally turned off. I am still lonely and miss Vanilla, but not sexually.

The Roof

The day started off by a tut from a doctor that looked quite scary. He was direct, to the point and gave us an incredibly good overview of gynaecology. He finished an hour early – at 9h30 which gave us 3 hours to do nothing, so we did what all good medical students do:

My partner, this awesome Injan and I tried to get onto the roof of groote schuur. We went up the orange stairwell then climbed up between the spiral of the stair case to avoid the door. When we eventually got to the roof door it was locked.

We then tried to catch the lift up to GT floor but the lift wouldn’t go there.

Then went to the old main building and immediately found some very friendly painters who showed us exactly how to get on the roof. We played around a bit and then chilled there for a good 2 hours. It was beautiful and awesome.

We eventually went down from the roof and went to F12 for a ward round. We asked a 6th year medic where the ward round was and she said she didn’t know. Much later, after I had seen a patient with LAP during micturition and couldn’t find the file the nurse told me that its was probably with all the doctors in their meeting in the seminar room. I felt like such an idiot as I walked in 45 minutes later.

After that we went to K floor of the out patient building for the infertility clinic. After waiting a while, during which I finished the black magician series by Trudy Canavan, I attended an excellent Dr while she saw two patients, one of whom had fallen pregnant and the other who was unlikely to.

After that I called up two of my Kaya friends and went there for a while. I had a good time. The one girl’s really awesome

I nearly had a car accident while giving the other a lift home, then I went home, then went out again to buy some food from the supermarket.

Tomorrow I am doing gynae surgery and have the afternoon off!

I’m feeling a little tired, but well and happy.

Long, Lecture-filled day

I struggled again to fall asleep last night. I was more vigulent about the problem so took my medicine sooner and it helped. It was still rough waking up at 6 this morning!

Traffic was much better than I had expected.

I arrived at uni at the same time as Dariah, which was decent. It reminded me of 3rd year when I stilled lived in town and often used to arrive and leave at the same time as her. We walked together up  to the Obs and Gynae department museum of dead babies and woman parts for 4 lectures, two on Obs and 2 on Gynae.

We had an excellent lecture on obstetric emergencies but then the lecture on contraception was painful and I read my book during it.

After lectures Dariah and I went to the café in Groote Schuur and chilled. It was really enjoyable to spend time with her.

The next two lectures were amenorrhoea and menorrhagia. They were both good.

After a brief lunch we went to LT2 in groote schuur for lectures on forensics. I really enjoyed having a chat with Dariah and Dangerous and jojo. The lecture was very very dry.

I went through to aftercare. It was cool to see two old friends there. They’re great. The session went quite quickly, but then one of the other oldies was back with the same issues and we spent a long time on her. It was not pleasant at all. We had a confrontation eventually, and then moved on.

After aftercare I gave one of the two friends a lift to thoroughgay aftercare then drove home. I got my car washed and gave this beautiful botasig girl her shoes from camp back, then got home, made lunch, got ready for tomorrow.

I was a bit annoyed by a brief power failure.

I’m feeling ok. A little tired and numb, but ok