Clinical rotation, campus guards, boat rides down the Buriganga River and the busride of near death

I know, my postings are becoming increasingly lengthy, yet you keep coming back! Welcome back, friends.

Since my last posting, I have gone on my first clinical rotation to United Hospital near the Gulshan area, right outside of Uttara (I live in Uttara, near Dhaka, the capital of Bangladesh)! Last Thursday was honestly the best full day I’ve had in Bangladesh. That’s a bold statement, hey? Haha. So I woke up and we were at the hospital around 0730. Clinical starts around 0800, but the students still have to get changed when they arrive (there’s a school van that leaves at 0700 but some students arrange for transport independently). I found it really frustrating at first. The students have around the same skills set as I do, if not more, and many of them have yet to give PO meds. That baffled me, honestly. At first, I was so disappointed with it, I thought, ‘how is that even possible?’ The possibility for me to do skills was but a distant dream, if the students weren’t even able to. Why is this the case, you ask? Apparently it’s a part of the culture over here – the nurses are not very receptive to students doing the tasks and would rather do it themselves. It was frustrating for me as well, because I didn’t see the students GOING OUT THERE and being assertive and saying what they wanted to do. I even went to the nurse to ask if she needed help with anything and if she needed help with anything to not hesitate to let me know. She said ‘no’ and then didn’t even bother looking at me after that. It didn’t bother me too much, I just let it roll right off my back. What also saddened me was that the students didn’t take their own learning into their own hands. BUTTTTT I am well aware that it’s a different culture here, the ppl here are taught to listen to their elders, not to challenge the status quo. Interestingly enough, I had a flashing image of Family Theory go through my mind, about challenging status quo, and I guess I really just take advantage of being able to do so freely.

Rest assured, friends, I did not just sit back and wallow in my frustrations. I took the opportunity to go over pharmacology with the students on my floor (cardiac floor)! I felt so alive. I can’t even begin to explain how thrilled I was to see Arif, one of the students, put two and two together after I had pointed out the pharmacokinetics of calcium channel blockers. I had to clap out of glee when he made the connection between the –prazole drugs. We looked up proton pump inhibitors at the back of the book where it listed a number of them (esomeprazole, pantoprazole, lansoprazole etc) and he mumbles, “oh, all –prazole) and you have no idea how wide my eyes were when I was staring at the top of his head. Eyes wide, face full of hope and he goes, “oh!” and it clicked. I loved it.

Next was Tanjina. I went over some drugs with her, but what I love is how I have been able to adapt things I’ve liked from all my previous levels and show it here. For example, the drug tips were from level 1 and from level 2, I remember explicitly on the first day that my instructor said, “You can usually get a pretty good glean of your pt’s condition by looking at their drugs” (ex. They might be in pain if they’re on morphine and have taken it regularly) So I’ve poached it and worked with that concept here with Tanjina. I have also been able to talk about post-op complications (ex. Why would a post-op pt be on domperidone?) in relation to their meds, so to really try and get her to understand why things are ordered and to ask questions when things don’t make sense. She seemed quite receptive and excited to make her own connections. I’m also trying to foster confidence in the students here and I do that by offering positive reinforcement and really just letting them know that they really DO know the answers, but that I just guide them there. It’s really exciting to see them smile when they get the right answer. Knowing that they’re smiling because of you is…..so heart-warming.

After I came back to school, I had 30 minutes before my first round of first aid classes to the campus security guards. Can I just say that I have never had so much fun teaching first aid in my life? These men (ages ranged from my age-50’s) were so full of life and were so captivated by the content. They loved the practical component and were so engaged in the conversation. Thank god for Shahed and Asha (senior nursing students) for coming as my translators! I laughed so hard with them and found them very endearing, actually. The second class was also fun, I had two trouble makers. You guys, they were THE cutest!! When they were checking breathing, one of them would be blowing into the other person’s ear and they would both be giggling. SOOO cute! But of course, I had to split them up cuz they were being counter-productive. I wouldn’t even let them face each other with different partners cuz they were getting each other all riled up. I took pictures, so I’ll def post some up, now that my pics are on my USB key!

On Friday, I went on a boat ride down the Buriganga River with Rhodina, hit up Hindu Street in search of Deepak’s wedding cake topper, and walked around a bunch of Bazars in old Dhaka. The boat ride was so much fun, though the boat guide made me a bit uncomfortable. He kept on saying I reminded him of his wife (no resemblance at all). We got a tour of the social housing area where he lives with his family and his neighbors. It was quite fun and I got henna done on my hand! It was fun, but also very overwhelming. The boatride was definitely a highlight of the trip, though! I’m glad I went, despite there being huge freights that wouldn’t hesitate to trample over our smalltime boat.

Busride of death. It says it all. I’ve never been on a bus SO full in my life, where I’ve been so afraid of falling out a window and been rubbed up against so much. It was both upsetting and a learning experience. I was more upset about my submissiveness than about the act. Instead of verbally telling him to stop and get away, I just moved. And he followed. And I moved again. Lather, rinse, and repeat until I finally managed to get a seat. I was just more disappointed with myself than anything. I think it was more a matter of me not knowing how to react and how others would react. I did hit him in the face with my bun multiple times. Not painful by any means, but unpleasant, especially considering how sweaty I was after that day. HAHA, sucker. Also, he’s lucky he isn’t a student at IUBAT, otherwise he’d be in for it. I’m good friends with the security guards now, you know! Haha.
Oh!! One last note, I’ve assigned the students lab values to look up and we will be going over them at the hospital instead of in class. I was very firm with them and said that I expected them to be in on time and that two days was plenty of time to look up 2 lab values (which I think is true!). I also offered them my help in any way possible and invited questions. Here’s the exciting part! This morning, three students came to me with questions! And I said I would help them as long as they had SOME work done, but I wasn’t going to do their work for them, and they came with questions ABOUT what they had already done!!! I felt so triumphant. I have high hopes for them and I know they can do it. I hope they know they can, too.

Love you all,
Cass Ma