Wax and Cannon (Kernel) aka lymph nodes

The time has certainly passed swiftly even as I am becoming more familiar with the practice of pediatrics in rural Ja. I have seen some interesting cases: branchial cysts, diabetes inspidus etc. This past tuesday I experienced the ride of a lifetime in transporting a 30wkr in respiratory distress from Port Maria to St. Anns Bay hospital which had better capabilities. It was a harrowing 20 minutes (normally 40-45min ride) driving at an average of 95km/hr on the curvy narrow roads in a…taxi! The baby was in the backseat receiving O2 via mask. I was so scared!! But baby and us made it safely and it was a familiar scene of incubators and cpap devices once we arrived.
But still these and otheres are reminders that I am in a developing nation. There was the cutest little 2mth old boy who was hospitalized in respiratory distress, known to have transposition of the great vessels, thriving but still in need of surgical intervention. Unfortunately, there is not a dedicated cardiac team in Jamaica so I was told that he would be sent home to die eventually UNLESS the visiting cardiac teams (from US or Great Britain) gets to him in time. Ughhh..Stark reality of life in Jamaica.
Or how about no new born screening in JA (but to be fair this was only been in vogue for the last 20-30yrs in the US). Waiting a day or two or three for CBC, inflammatory markers, urine analysis. No abgs available in certain rural hospitals of Ja…arrgghhh.
The parents and patients are so much more appreciative and respectful than what I am used to in NYC. I cannot forget counseling this young man re asthma and his humble “Yes miss, no miss, yes miss” responses. The general population honor the doctors AND nurses. It is a tremendous, tremendous opportunity to educate and they WILL listen and improve. Knowledge is indeed power.
Case in point: A pair of premature twins were foremost in my mind because they were 4 pds, barely, and not gaining weight. They also had very bad diaper dermatitis, formula was mixed incorrectly etc. So I educated the parents, gave them some A&D along with Rx and advised a return. The parents were extremely grateful and thanked me profusely. Today they returned for weight check and while the rash was much improved, formula and breasfeeding was appropriate, Twin A was gaining weight beautifully, Twin B was actually losing weight so I had to admit her. I know she will be well taken care of. But I was so glad that I was able to help as a doctor and educator. I love, love, love to help them.
I promised to talk more about Couples in my last blog. It is simply paradise! The food is divine, the ambiance is the best of island life, and the staff is EXCEPTIONAL. They have, without a doubt, made my stay so very comfortable, and I will miss them so much!!!
Water sports, pools, blue and bluer beaches, trips to Dunn’s river falls (a must), Mystic Mountain, horseback riding, plus daily in house entertainment are just some of the activities available. But my personal favorite is tennis! I absolutely love tennis, and the pro instructor, Colin, is the best! I played tennis almost everyday after work and on weekends ( I prefer this to the gym).
Is there a more genuine set of people than Jamaicans (no bias here.lol).Shout-out to all the medical staff at the various hospitals/clinics who held my hand and instructed me on the proper medications and procedures; Dr. Ramos, Ravi, Cleary, Dr. Fisher, Dr. San San, the nurses and Mina (previous volunteer). Love you all.

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