What renal physiology, the global TB epidemic, and esophageal varices have in common

Stumped? Well, I won't keep you in suspense any longer: renal physiology, the global TB epidemic, and esophageal varices are all related in that I spent a very long day yesterday dealing with them. I started off with two hours of Dr. Hanss' physio lectures, and then rushed over to Columbia for the TB Alliance Reversing the Tide of Tuberculosis symposium. The symposium was held in Low Library, which was kind of exciting since I had never actually been inside the building while I was studying at Columbia. Jeff Sachs opened the conference, and then a host of familiar faces were either involved in the presentations (i.e. Josh Ruxin, one of my readers for my Master's Thesis, was a moderator) or as audience members. There were talks from drug and diagnostic development companies, the Vice-Minister of Health for Mexico, as well as many others. On the whole the presentations were interesting, though the symposium was running late so they constantly had to cut people short, and there wasn't as much discussion and I would have liked. Still, the TB Alliance is a group I am interested in working with, so this was a good look at what the group does. I had wanted to stick around after the symposium to try and talk to some of the people who work there, but I had to run off to the train so I could get across town to Elmhurst.

I got to the ER at Elmhurst around 6pm, and things were relatively slow. There was a patient dying of COPD with a DNR in the trauma room, and the whole family was around and emotional. The wife actually was making suicidal comments, and wouldn't let go of a bottle of morphine that she threatened to drink, so psych had to be called down to evaluate her state. The husband was sent off to hospice care upstairs so he could be more comfortable. Dr. Okuda was extremely helpful and willing to talk through some of the cases, and offer a perspective of what life is like in the ER. I really enjoyed the time we had to just talk about how things are run down there. I also got a chance to spend some time with Dr. Clint Masterson, who is an ER resident that is coming on the Belize trip to OrangeWalk. He was also extremely nice, and let me hang around while he was taking care of some patients. When the ER finally got busy around 7:30pm, we saw a woman with a GI bleed (probably from esophageal varices), a 98 year old man who fell down 15 steps (he was called in as a red trauma, but ultimately he ended up being perfectly fine, not a single bone broken), another man who was drunk and fell down a flight of stairs (and was massively bleeding from his scalp-- I had to apply pressure to try to stop the bleeding), a 27 year old man who dislocated his shoulder playing soccer, a elderly woman with COPD who got excited when her son was in an argument with his neighbor, and stopped breathing, and a 80 year old man who was suspected of having a stroke. Dr. Okuda said that there wasn't any case that was tremendously spectacular, but I thought on the whole there was a lot of excitement. Truthfully, when I left at 11pm, it had felt more like 15 minutes had gone by, not 5 hours.

So today is the 8th of March, which means that we are leaving for Belize in less than a month. This is really starting to stress me out, because I really don't think we are where we need to be in the planning stages of the trip-- at least I don't feel comfortable with all the information I have from Peacework to feel that the trip would run smoothly at this point. And there is so much that still needs to happen in the next four weeks that I'm sure is going to go by in a blur: I have to finish preparing for Belize, we have to take 3 exams (two finals and a midterm), I have to take my trip to Chicago for the AMSA Convention, I'm going to have a number of phone calls for the Global Scholars Program, I have to be clinic manager at EHHOP, we are starting two new courses, and I have to pretty much figure out my plans for the summer, since the funding deadline is while I'm going to be away. All of this is quite depressing, actually, because I know I'm not ready for any of it. I guess it has to happen though.

Also, not sure how long it'll be on the web, but the AMSA Global Health Scholars website for this year is up. There is something satisfying to having your life summarized in approximately 200 words.