I have found it hard this week, mainly because the clinics
were full and that meant a lot of work. I don’t mind the work, in fact I am
very grateful for the experience, but it does leave me knackered.
As I said last time, this week was when I intended to
practice pacing my case-taking better and I have to say that it worked. Each clinic,
instead of rushing headlong into it, I sat and took ten deep breaths and
remembered what I was there for. On Monday I rearranged the seating (Patience, our
translator, seemed to think I was mad but went along with it – thank you!) This
meant that now the laptop & table were to one side and I was more directly
facing the patient, making better contact and being able to observe more. For
this clinic I also worked with Lorraine which reduced the writing load and thus
eased the pressure. And finally, when I felt that I needed to, I stopped, drew breath and
reminded myself of what I was doing. All this helped and by the end of
Monday I felt like I was dealing with cases far better than last week.
On Tuesday we drove off towards the Pare mountains, and this
time I noticed what wonderful scenery there was. Before we started I took a few minutes to draw inspiration from the beautiful hills around. This time I was
working on my own, with input from Cynthia, but was now feeling more comfortable
with my method. Things flowed better, even when Roger, the translator, and I
moved into the second chicken coop there – the first one now being occupied by
a rag-tag bunch of chickens. This again was a very busy day.
Wednesday proved to be busier still, with about 12 patients
at a clinic, followed by a sad home visit. Then driving off back to another
clinic where Michelle had been working flat out and still had eight patients
waiting when I arrived (I could take some lessons in stamina from Michelle!!)
So, knackered but knowing that we are a team, I settled down to take as many
cases as I could. Here I have to say I was blessed with good fortune, as the
three new cases I saw all had at least one very clear or unusual symptom,
making prescribing much easier. For example, this was the first time I had met
someone who was eating Pica (unusual substances) – in her case earth. She had
some problems with heavy menses and when I got home and read about it, it seems
that people who want to eat Pica usually have low iron levels. Interesting!
However the biggest lesson for the day was my final patient.
She entered the room with a very miserable face and just looked like she was
saying ‘poor me’. Normally I feel sympathy for most people I see, but at this
point all I could think was how much she was complaining. Looking back I can
see that I was at, or beyond, my limit. I am not sure how good a prescription I
gave, with the hindsight of fresher eyes I suspect Pulsatilla would have been
good. So – what is good is, that I have learned that I have my limits and there
is a time to say ‘enough’ for if I stay longer, I am not giving as much help as
I might.
We have been told to take a break when we need to, so that
is what I did. Good advice.
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