Shalini’s Guyana Blog – Week 4

End of work week 4 – August 24th

It is unbelievable that 4 weeks have gone by, so quickly. Beth will be leaving this Sunday and I am staying for another week.

Work week was very good, we had so many things to do, learn and teach. The showpiece of the entire teaching month was the first journal club that we organized this Thursday. The 4 final year residents presented 2 papers that we had selected for them, early in August. The residents were excited albeit a bit apprehensive and I must say, appeared scared, initially. They had never spoken to an audience or presented an article. Beth is a great teacher and together, we helped them refine their presentations and finally, they pulled it off, and wonderfully so. Well done Maxine, Tiffany, Shellon and Smolana, we are proud of you! There was good discussion and all residents participated, asking relevant questions. They also arranged for a little pizza party during the half time break between the presentations. Well planned and executed! I hope the oncoming visiting team keeps up this journal club activity.

Cases during this week were very interesting as well. We had a 92 year old patient with Hansen’s disease for fracture femur. Beth had never seen a case of Hansen’s disease so that was a learning experience for her. There was another very elderly woman who supposedly had a hip fracture but Xray could not be done due to pain. A femoral block (planned and guided by me, supervised by Beth and done by the Guyanese resident) allowed the C-arm to be used and it turned out that there was no fracture! I have been going around with the US machine demonstrating its uses wherever needed; a-lines, peripheral lines in kids, blocks in adults/kids, teaching spinal scanning. It has been a useful thing to bring, I must say.

We have been going to the pain clinic every Tuesday. We have done 2 epidural steroids. One patient returned, very happy. The second one will return next Tuesday, hopefully with good results.

Today was the last day for Beth with the residents. They gathered together and organized a little farewell speech and a going away present for both of us. Such a lovely and thoughtful gesture!

I bought a pumpkin for teaching epidural needle and catheter insertion as there is no other way residents could experience the ‘loss of resistance’ feeling especially as there are not many occasions to do an epidural. This turned out to be an excellent idea and residents practiced their LOR to air as well as saline and catheter threading skills in the pumpkin. Necessity is indeed, the mother of invention. I plan to bake the pumpkin next week, before returning home!

Demerara and the Eldorado rum – August 25th

Did you know that Demerara sugar comes from the sugarcanes in Guyana?

I have always enjoyed the golden yellow/brown crystals of the sugar in my coffee but did not know that it came from the molasses of the sugarcanes that are grown in the Demerara region of Guyana! We are staying in the Demerara-Mahaica region here in Guyana and the big bridge that connects Georgetown to rest of the country is also called Demerara so the sugar in my coffee back home becomes more important. Does it not? The remarkable Eldorado rum also comes from Guyana and is considered one of the best rums in the world and since 1992, it has repeatedly won awards in its category. It is called the true gold of Guyana. I can personally vouch for its smoothness and velvety taste. Though I am a wine drinker, I think Eldorado has the power to convert me!

Shawn, an Guyanese doctor who was an ENT fellow in London, Ontario took us over the Demerara bridge one night. It is the 4th longest pontoon bridge in the world and is 1.8 km long. Pontoon bridge is a floating bridge and barges/boats/pontoons support the bridge deck. Pretty neat, isn’t it? The deck moved a lot when we drove over it and then when we were on the walkway, it shook a lot when cars/trucks went by. A passing car slowed down to enquire if we were planning to jump in the (crocodile and snake infested) river! The river is also called Demerara, is nearly 350 km long, has powerful current and drains in the Atlantic ocean. The bridge opens at scheduled times to allow ships (5000 tons) to go through! There is a network of large rivers all over Guyana that are the drainage basins for this very fertile land. No wonder the fruits taste so good here.

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