Last Week in Cape Town and Looking Back on the Experience

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I haven’t really had a chance to blog over the past week because I was busy finishing up my internship and checking out a few last things in Cape Town. I finally got a chance to hike Table Mountain and decided to take the long route starting from the Kirstenbosch botanical gardens and coming up the backside of the mountain. It took about 4 hours and we decided to take the cable car down which only took about 5 minutes. It was so cool to hike one of the seven natural wonders of the world and the views of the Cape Flats and Atlantic Ocean were unbelievable.

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Looking down on the Atlantic Ocean and about 3 million people

Most of our crew left on Saturday while I left on Sunday, but two girls from Stanford were sticking around for another two weeks so I had some people left to hang out with. We decided in my last day to check out the Franschhoek wine area and do another wine tasting, which was a lot of fun. It was different than my experience in Stellenbosch (the first wine tasting that I blogged about) because Franschhoek is a more “upper class” area so instead of wine tasting with a bunch of college kids, we were the youngest people on the tour by about 10 or 20 years. It was fun to act classy and get tipsy with older people though, and was a nice activity for me as a last hurrah in South Africa. We traveled to five different wineries on a train driving between the mountains, so it was a really picturesque tour as well.

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The Franschhoek Winelands

I finished up my rotations this week and mainly hung out in the Orthopedic department because I felt the most comfortable there and they allowed me to be more hands on then other departments. I took a few pictures of the workplace and said my goodbyes, and although it was sad that this chapter of my life was closing, I was ready to come home and be a normal college kid again. After a while, just being able to follow and watch without all of the background knowledge that would come from a medical degree can get a bit dry, and by the end the internship had definitely run its course for me.

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Removing a Cast

I am so happy I got to have this amazing experience this summer. I will never forget bungee jumping, going on a safari, diving with Great Whites, or what I learned culturally and medically about South Africa. I have left with much more confidence that I want to pursue medicine in the future, as well as more confidence that I can do a lot of things on my own, because hell I just spent 10 weeks in a foreign country where I knew no one going in and had an unbelievable time.  I don’t think I can ever see America in quite the same way that I used to, but I’m glad for that and I think it makes me more of a cultured person. Some people told me that I would look down on America when I came back, but I really don’t think that’s true. We have our own problems and perhaps some unneeded luxuries, but yet we are so fortunate for the little things that we take for granted. We might perform too many unnecessary MRI’s or be a little too addicted to technology and the internet, but as far as medicine goes, we give our patients a great fighting chance that can’t be rivaled by many underprivileged countries throughout the world. I’ve missed college football and the NFL, country music, a heated home, and even the American accent. As I lay in my bed in Grafton, WI writing this final blog about my trip, I couldn’t be happier to be back in America and although this trip was incredibly memorable and even bordering on life changing (could be a stretch but only time will tell), I’m ready to go back to living with a bunch of college kids, cheering for the Huskies on Saturdays, and watching Packer games on Sundays. I hope this blog was interesting for everyone that read it, I sure enjoyed writing it and reading the comments that everyone left. If you are ever wanting to travel to South Africa and are looking for someone to show you around, keep me in mind!

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The Orthopedics team plus 3 of us interns

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Myself and Avril, the Medical Director for the program and an awesome lady

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Finally some good Mexican food in Milwaukee!!

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A view of Cape Town from Robben Island with Table Mountain in the background

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From our Table Mountain hike

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Nelson Mandela’s cell on Robben Island

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My Cape Town host mom Barbara and I during the meal we made the family

 

Shark Diving and Working in the Emergency Room

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When I decided I wanted to go to South Africa this summer, there were a lot of sights, activities, and experiences that I was really excited for. Diving with Great White Sharks has always been on the top of this list, and this weekend I finally got my chance. Seven of us travelled to Kleinsbaai, about a 2 hour trek from Cape Town, in order to dive in False Bay with these beasts of the ocean. Our tour left at noon, and after getting some lunch and gearing up for the trip, we boarded the “Apex Predator” boat that took the 28 divers to the coast of Dyer Island. Our guide had been out on the water earlier that day, so he knew exactly where the sharks were and after a few minutes of chumming (a mixture of tuna and blood), the sharks started to arrive. The cage that we used fit 8 people at a time, and I didn’t go until the third group. The cage floats right next to the boat, and when a shark comes close, the divers can go under water to a viewing area in the cage to see the sharks face to face. At one point, a shark even started biting the cage and I could have touched his nose if I wanted to (which I didn’t!). We spent about a half hour in the cage and saw 8 or so sharks up close and personal. I really felt like I was a diver for a Shark Week show because the sharks were so close and were biting the bait right in front of me! Half of our group got terribly seasick and unfortunately didn’t have a great time, but I had a strong stomach and really enjoyed my time out on the water with the sharks. I bought the 15 minute video summarizing our trip, but below is a link to a short Youtube video from our day. I also visited Cape Point and the Cape of Good Hope on Saturday, which is the South Eastern most point of Africa and where the Indian and Atlantic Oceans meet. I stopped at Boulder’s beach on the way as well and hung out with some penguins.

http://youtu.be/Xhfx3LjiePA

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As for work, I am in the Emergency room this week. The amount of stabbings and other crazy trauma that I’ve seen is really amazing, especially because I only work the day shift. I had my first experience with a patient dying on the table, which was very sad to see. She died of TB; the infection filled up her lungs with fluid and the doctors could not drain it because her lungs had essentially stuck to her ribs and there was no space for the doctors to put a drain in. After trying to save this woman for a few hours, the doctors had to turn around and tell the family what had happened to their loved one, and that had she come in weeks earlier they most likely would have been able to save her. I have a lot of crazy stories from both this week and the rest of my experience that I can’t really post online, but being here in South Africa has exposed me to things that trauma surgeons in America haven’t even seen. One of the interns here was in Boston a few months ago and spoke with a trauma surgeon involved with the Boston bombings. He said that the surgeon felt unprepared and that he had only seen 10% of the trauma that the South African resident had seen in his career. This is why I think it is important for doctors to see the health issues in other countries, to prepare themselves for rare situations within the U.S.

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The point where the Indian Ocean meets the Atlantic

Call me crazy, but I think that if I had to decide a specialty right now I would choose Emergency Medicine. I like the constant action, the teamwork required to really be successful, and having the ability to make a real life, instantaneous difference in people’s lives. Also, when a patient comes in, there is usually one problem to deal with, and once it is dealt with they can be referred to other departments for more chronic problems. I have a lot of time to decide what I want to do, but the exposure that I’ve gotten here has really begun to steer me toward trauma.

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I have another week and a half here in SA. I am going to see the famous Robben Island where Mandela was imprisoned, hike Table Mountain, go whale watching, and try to enjoy the nice weather now that spring has finally come to Cape Town. Lots still to do but before I know it this whole experience will be over and I’ll be back to being a normal college kid who has to go to class, study for tests, and try to prove to medical schools why I’m capable of doing the work I’ve been doing here for the past 9 weeks.

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Leaving the Harbor for Shark Diving

 

The Garden Route: A Bucket List Checking Weekend

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As I mentioned in my previous post, this past weekend I went on the “Garden Route”. This is an area full of mountains and right on the Indian Ocean with tons of activities about 5 hours from Cape Town. Our 2 coordinators drove the ten of us in a mini bus all over the place for the weekend. They do this trip 11 times a year on average with students, so they are basically professional tour guides but way more fun. We stayed at a really nice hotel right on the Indian Ocean and paid $60 a night for a room. Gotta love South African tourism. It was a wild weekend and I checked a bunch of things off my bucket list, and even did some things that I never thought in a million years that I would do.

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On Friday, we left at 5 a.m. from Cape Town and went to the Cango Caves and did an adventure tour through the caves. It was really cool and I’m pretty shocked that I squeezed through some of the spaces that I did on the tour. After that, we went to an Ostrich farm and I rode an Ostrich. When would I have ever thought I would ride an Ostrich? It’s actually not too hard but I was about 15 kg’s over the weight limit but didn’t tell the instructor, so the Ostrich bucked me off pretty quick because it was probably pretty pissed. After a great dinner with the crew, we went back to the hotel to rest up for the crazy Saturday ahead of us.

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After grabbing an awesome breakfast buffet at the hotel, we were off to a zip lining canopy tour. There were 10 different “zips” and it was so cool to just go flying through the trees like Tarzan. I’m kind of scared of heights, so I was surprised how much I enjoyed the zip lining. This euphoria gave me the confidence to participate in our next activity which I told myself I would never, ever, ever do. I bungee jumped on the highest bungee in the world!! It was 216 meters, which is 709 feet for those of you struggling with the metric conversion. I went first in the group and was glad that I did because then I could just relax and watch the other 4 interns go. It was one of the craziest experiences of my life and I still can’t believe that I did it, but I figured I couldn’t let the opportunity go. I will tell you though that the celebratory beer afterwards tasted a hell of a lot better than a Windhoek lager should. Fresh off our adrenaline highs, we went to an Elephant reserve where we got to feed the Elephants and walk with them. There is something almost majestic about walking between 2 huge Elephants and touching these amazing animals. After the Elephant farm, we went on a sunset cruise on the Indian Ocean, which was stunning but also relaxing after such a crazy day. After a stop at a little pizza place and a dip in the Indian Ocean, I was off to bed exhausted and a little terrified that I had swan dived off a 700 ft. bridge just hours earlier.

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On Sunday we did a game drive at a really nice game reserve. We saw giraffes, rhinos, wildebeest, water buffalo, water buck, kudu, springbok, but the coolest animal was definitely the lions. I had seen most of these animals before on the safari that I did in Durban, but the property that we were on was awesome with rolling hills and mountains all around including a view of the ocean and Mussel Bay. After lunch at the reserve, we made the 5 hour trek back to Cape Town, exhausted but definitely satisfied with our weekend.

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This past weekend was the best that I’ve had since I’ve been here. The activities were awesome, the camaraderie between the interns and the coordinators was really great, and I checked a bunch of things off my bucket list. I have three more weeks here and I feel like I have so much more to do. There is a ton to see in Cape Town and with my work schedule I really only have the weekends to see the area. This week I’m starting my internal medicine rotation at the hospital. Next weekend is the event I’ve been looking forward to the most this trip: cage diving with Great White Sharks!

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Proof that I did it

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On the way down

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My buddy

 

Wine Tasting, Hiking, and Adjusting to Cape Town

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Busy, busy, busy describes my first week in Cape Town. We work an extra 2 hours a day compared to Durban and all of the interns and I joined a gym where we can get wifi as well as a much appreciated work out after work, making it so that we can’t really do a whole lot during the week besides work. I finished up my Orthopedics rotation last week and even got to take out some stitches! The patient was a trooper and was ok with me pulling a little bit on the stitches since I wasn’t quite sure what I was doing, but the doctors trusted me and left me alone with the patient to take the stitches out. I’m starting to feel a lot more comfortable in the hospital/medical setting, and with the right attitude the days can actually be a lot of fun while also being extremely interesting. The doctors here take more time to explain everything to us than they did in Durban, so that has been very nice. I start Surgery this week and I’m sure I will see some crazy stuff such as amputations. Today was really crazy because I had to stay about an hour and a half late for work because I was scrubbed in for a 4 hour surgery and the other surgeon left, leaving me with an actual role in the surgery. Since I don’t actually know what I’m doing, I was just an extra hand for the surgeon but it was still a pretty cool experience.

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We went to the wine lands in Stellenbosch on Saturday, which is only about 30 minutes away from where we live. We took a van taxi called the Vine Hopper that took us to 5 different wineries throughout the day for tastings, which turned out to be too many for most of the group. I learned a lot about wine and really liked Stellenbosch’s 2 unique, flagship wines: the Chenin Blanc (white) and the Pinotage (red). After a full day of tours and tastings, we were exhausted (intoxicated?) and just spent the night in instead of going out in Cape Town like our plan had originally been. I’ve also been spending some more time with my host family and really starting to like them. Once again, I lucked out and got with one of the best families, as the other interns have a lot of complaints about their living situations here.

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One of the Wineries

On Sunday, a few of us went to the Kirstenbosch botanical gardens, which was very scenic due to the 4 mountains of Cape Town in the backdrop. The 4 mountains here are: Table Mountain (one of the 7 natural wonders of the world), Lion’s Head, Signal Hill, and Devil’s Peak. We then did a sunset hike up Lion’s Head Mountain, which turned out to be a little more challenging than we expected. The views on the way up and especially on top made it totally worth it though, as you could see all of the mountains, downtown, and even another bay on the opposite side of the mountain. It’s very popular for locals to take wine up to the top and watch the sun set, but I’m glad we didn’t do that because getting down the mountain in the dark after a few glasses of wine would have been quite the challenge.

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Sunset from the summit

This weekend I am going on the famed Garden Route through the mountains with the program coordinators and 10 of the interns. It’s going to be a great time and we leave early Friday morning and don’t return until late Sunday. I’ll have a post all about the trip but I’m really looking forward to it. Also, it’s starting to warm up here so everyone has been in a better mood. It rained every day last week and none of the houses have heating systems, so we are all welcoming some warmer, nicer weather.

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The Kristenbosch Botanical Gardens

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Lion’s Head Mountain

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The view from on top

Saying Goodbye to Durban and Beginning a New Adventure In Cape Town

I left for Cape Town on Saturday, and while I was sad that I was leaving my great home stay in Durban, I was excited to begin a new experience in Cape Town. Thus far, I have gotten along very well with the 5 new students that are stationed here in Cape Town for the next few weeks, so I think I have a lot of fun ahead of me. The program coordinators here are a lot of fun as well, and are willing to help us or give advice on anything from which hike to take on a nice day (rare in Cape Town this time of the year) or which bar to go to on a Saturday night. My new host family parents here are named Cedric and Barbara, and I am living with Priya, one of the girls that was in Durban with me (just to get it out of the way because I know what you are thinking, we sleep in separate rooms and she has a boyfriend, so don’t try to read between the lines on this one). I have already gone to a Rugby game here and even met some of the players at a pub on Sunday and we had a great time. Needless to say I’m glad I grew up in Wisconsin because no one else in my group could keep up with these 250 lb. guys and how fast/much they drink (sorry mom and dad, it’s better than me having a terrible tolerance…). They were fascinated that I was a Packers fan and I might even be taking some of them to a game at Lambeau in the future if they end up coming to the states.

As for the work side of things, I am in GH Jooste hospital only about 5 minutes away from my house. The hospital is in between 2 townships so we see a lot of stab and gunshot victims, as well as a lot of very poor patients. This week, I am in the Orthopedic department working in the clinic. I have been able to do a lot more here in Cape Town than I did in Durban, and even did 3 Cortisone-like injections for patients, 2 in the knee and 1 in the shoulder. The doctors have all been very nice to me but since it is not a teaching hospital there are no students around to talk to. This weekend we are planning some wine tours and then going to hike Table Mountain, a must if you come to Cape Town.  

I am really excited for a new adventure starting here in Cape Town. The surrounding area is beautiful and the culture feels much more European than Durban. There is so much that I want to do here in the next 5 weeks and I will try to keep this blog updated since wifi is a bit easier to get here. I apologize for the lack of pictures but I haven’t had a chance to move my pictures over to my computer yet. Stay posted because I’m going to be moving nonstop until mid-September!

South African Slang

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I figured it would be pretty cool if I just posted a few of the South African “slang” terms or common phrases that I’ve learned since being here:

Howzit? – How are you doing? Hello

Lekker – cool, good, sweet

cooldrink – soda

that side – over there (ex. When asking about America: How is the food that side?)

Shame – insert this for anything disappointing. Just the one word.

Robots – traffic lights

Yaybo! – Yes, also used to break up general conversation pauses

tuck shop – A small store that is owned and run by 1 person

serviette – napkin

napkin – diaper (made this mistake before)

Chips – french fries

Crisps – potato chips

draw – to party

braai – barbeque

dop – an alcoholic drink

just now – some time in the near future. Haven’t quite figured this one out yet.

boss – used for someone in authority. (When I’m in the hospital, patients might say “Howzit boss?”

Also, if I ever use the word dude its a dead giveaway that I’m American. I’m sure I’m leaving some out but that’s all that I can remember right now.

 

Rotating Through Clinics Then Traveling Down South Coast

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My last post covered up until Tuesday of last week and only my experience at the hospice. I went to the Malagazy clinic on Wednesday which was located in a pretty bad area of the Umlaze township. It is a one room clinic where patients with minor problems can go. I didn’t really enjoy my time there because every patient that came in walked out with the same thing: antibiotics and some multivitamins. It never really felt like this sister-run clinic (meaning no doctors work there) ever practiced medicine, they just followed a formula and didn’t really seem to listen to the patients. That is pretty typical of a primary clinic here though. If they can’t help you, they’ll send you on to the next level which is usually a smaller hospital, from there to a big hospital, and so you will climb the healthcare ladder until hopefully somewhere can treat you before your disease progresses. So sometimes patients will wait days or even a week to get treated, all the while not going to work and sitting in waiting rooms. As one nurse put it though this is a good sign because it means that the people of South Africa are using their healthcare system and getting treatment, but I still wouldn’t want to wait a week to get my condition looked at.

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My gift to my host family is already in use at the kitchen table!

On Thursday and Friday I was at the Blue Roof ARV clinic. Blue Roof is what they like to call a “model clinic” here in Durban. The system is very efficient, the facility is great, the staff is friendly, and every patient even gets served a hot meal before they leave. Blue Roof is supported by Alicia Keys and the Keep a Child Alive foundation, so they are very fortunate to not have funding issues. I spent most of my time with sister Tessa, a very outspoken, passionate lady that I really got along with. She had many questions about the American healthcare system, and I talked to her for hours about Mandela, the apartheid, and South Africa’s political situation. I never thought I would hear someone refer to the apartheid as the good ol’ days, but here was sister Tessa saying that she wishes she could have it back. Sister Tessa is colored, which is not a derogatory term here and means that she is mixed race. Crime was very low during the apartheid due to the communities that were formed, while the healthcare and education systems were far better in her opinion. I have heard pretty often since I’ve been here that South Africans are happy Mandela ended the racial segregation, but they disagree with many of his policies. Mandela introduced abortion to South Africa and did away with capital punishment. The crime rate has skyrocketed and girls can get abortions here at the age of 12 without consent from a parent. In a country in which the vast majority of the residents are Christian, abortion is a very controversial issue. South Africa has had a huge problem with immigrants from Zimbabwe, Namibia, and other neighboring countries taking a lot of jobs away from citizens. The catch is though that many people here are used to getting taken care of by the government (food subsidy, free housing, and a subsidy for each kid) so they don’t want to work. It’s a bad sign when 25% of the country isn’t even looking for work! Many of the people who do work start at 8, take a half hour tea break, an hour lunch, and then leave work early around 3 or 3:30. Now what kind of productivity is that? Sister Tessa is very disappointed with where her country has gone in the last 20 years and thinks that laziness will ultimately ruin this country. She goes to businesses and discusses these issues every Friday while also checking blood pressure, blood sugar, and free HIV tests for all of the employees. I got to go along with her on Friday and was fascinated with what the South African people think about where their country is going. Some are very well informed, some are not, and some can’t even drink water without adding 3 scoops of sugar to it (sister Tessa predicted Type 2 Diabetes in that one). I really enjoyed my time in the clinics and while not learning a lot of medicine, I learned a lot about South Africa, HIV, and the politics and attitudes since the apartheid that I can’t even begin to explain on here but would love to discuss with people when I get home.

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See how this doesn’t really look like Africa?

Over the weekend, our group drove down the South Coast to different beaches and such. It was nice and relaxing and I actually felt like I left Africa for 2 days. On Saturday we went to “The Gorge” where they have bungee jumping, rock climbing, and some hiking. I walked across a suspended bridge which was a lot for me considering my fear of heights. Our hostel that we stayed at was at someone’s house, and while cleaning up breakfast Sunday morning we were bombarded by monkeys! Our host feeds them every day and he even let me feed them some bread and apples which was quite the experience.

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Its not as scary as it looks until they come through the windows

I only have a few days left in Durban as I leave for Cape Town on Saturday. I’m excited for a new city, to meet the 5 new interns that will be there (6 of us from Durban are going, so 11 interns in total), but am sad to be leaving Durban as well. My host family here has been absolutely phenomenal, and I don’t think I could have possibly enjoyed my trip as much without them. The weather in Cape Town will be much colder, so I’ll miss sitting in the sun after work and reading a little (for anyone looking for a good South African read, pick up “Spud”, it’s hilarious and is a best seller here so I’m sure you can find it in the states). This week I’ll spend 2 days back in surgery at King Edward and 2 days at St. Mary’s. After work, I’m planning on just relaxing by the beach, taking a brewery tour, and of course getting one more Bunny Chow before I leave. 

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The treacherous suspension bridge