Setting the standard

For weeks her little boy had cried out in pain every time he had tried to walk. He clinically looked healthy and studies and imaging available wouldn't point to an obvious culprit. Dr. Gerardo was quite "stumped" and sought consultation with the other doctors as well as myself to think outside the box. They considered the complete gamut from worms/parasites to slipped capital femoral epiphysis (SCFE) and everything in between.

We took him to the OR this morning for exploration and found infection deep in his leg surrounding his bone. Talking to mom after the case she couldn't keep back tears as weeks of worry were finally replaced with a sliver of hope.

It's hard with the limited resources here in Honduras sometimes. In the US this little boy would not have had to limp around with infection in his leg for a month. The imaging capability is better, the antibiotics are better, and even the ability to obtain cultures and tailor antibiotics to treat the specific bacteria... such a luxury. Chatting with Dr. Shafick the other day, he mentioned a recent trip the US where he learned that there are five generations of Cephalosporins (a class of antibiotic). In medical school here they are only taught the first three generations because 4 and 5 are not available in country and so considered useless knowledge. I of course have my opinions on this, but when I am also here treating infection without cultures to guide that treatment, how can I hold myself let alone the medical education system of an entire nation to the standard that is in my head. Maybe we need to just start with education here at Loma de Luz and see where it takes these Honduran docs. Add it to the list of things to do.

It's been over a month without rain. It's interesting how our perspectives have changed being here through the seasons. Jake and I commented to each other the other day how brown everything was looking.

Much Love.