Today was our first day on the job. I have many things I could write as I took a full history on each child, pretty much. The day started early and we set out to find the crowded wards. The hospital is on a campus with a few gates, security in place. However, there are mass crowds inside and I'm not sure why they are there. People wait in "lobbies" for hours and hours to sign in to then wait in a clinic. Of course, some have traveled for days.
Interestingly, the first thing we did was go to a weekly chaplain-led Bible study and discussion. The hospital is Christian and ostensibly so are the residents as we met with an 60-something English lady who organized the discussion. The hospital publishes weekly guides for all residents and each department participates separately. At the bottom of the weekly Bible verses and discussion questions are prayers specifically for departments like "Dr. Kumar and staff in Pathology."
While I thought it was pretty wonderful, I could tell the residents were kind of apathetic- sitting there quietly just like they do in the US during Discharge Planning Painful Meetings. As soon as she left, they burst into conversation over new admits.
The residents were female heavy as in Peds in the US nowadays. The attendings commanded a great deal of respect and were cheerful and eager to ask questions- pimping for the residents and curiousity "Is sweat chloride the first-line testing in the US for CF?" for Ileana and me.
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What is the hierarchy of medical staff at CMC? Do they share our model (intern-resident-attending), the British system (house officer, consultant, senior consultant etc.), or the Indian system (pre- and post-intern in an outlying clinic, specialist, etc.)?
I was curious to read about people waiting to sign in to clinic: what is the intake process like, and how different are the criteria for inpatient admission than in the U.S.?
Do patients at CMC self-pay (with or without adjustment for financial need), or are they covered by the state? How much of a role does charity play?
And did you explain that sweat chloride is not first-line testing for anything, that in the U.S. we test for everything initially with full-body CT or MR scans?
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