10 Into the wild The life of a community service medical officer


Dr Hellen Georgakis and Dr Michelle Pentecost discuss the unique challenges posed by the community service year


one. After two long, hard and occasionally soul- destroying years of internship, young South African doctors face another year of “parole” to be served under the supervision of the Department of Health. Whilst a lot of my fellow colleagues expressed resentment at having to do this year, I was quite excited. This year offered me the opportunity to leave the tertiary hospital setting, move to a new part of the country and hopefully rediscover the magic that is medicine. After being second-


T


rounded for places, I ended up getting my ninth choice and that’s how I ended up in this small, beautiful town in between the mountains. There was some trauma around organising a move, leaving loved ones and familiar surroundings. On the plus side, I brought a good friend and a good sense of humour along for the ride. As it turns out there have been times when I needed both. After arriving on my


first day at work, meeting the rest of the staff and attending the obligatory Monday meetings (which soon extended into Tuesdays and Wednesdays and have become the bane of my mornings) I set off to the male surgical ward. This ward is where I met amazing staff and learned a number of lessons in humility. This is where I met Mr S, who is


Dr Hellen Georgakis, Mpumalanga


he issue of community service is a contentious


a long-term resident of the hospital. Not because he is sick but simply because he prefers to live there than to go home. Therefore, the staff reserved a bed for him and made sure food was set aside for him. The nursing staff seemed quite fond of him and were very accepting of his position at the hospital, making no attempt to discharge him as would most certainly be the case in a larger hospital. On one of my first days in casualty, a father came running in doing CPR on his three-year-old daughter. She had been electrocuted after touching an exposed wire in their shack that


had been hooked up to an illegal electricity connection. Despite the father being careful to turn off the switch when he went out, she had somehow switched on


while her dad was outside. Not wanting to risk the inevitable delay in waiting for an ambulance he had picked her up and run


barefoot to the hospital, all the while trying to keep her alive by blowing air into her


lungs. The sight of him coming through those casualty doors will stay with me forever. We tried to resuscitate her despite the fact that she was essentially dead by the time she was put on our resus stretcher. We did this largely for her father’s sake and because it is painfully difficult to look at the body of a healthy three-year-old who paid the ultimate price for being curious and imitating adults by flicking a switch. Of the many other incidents that I have experienced, some have been incredibly heartbreaking, others have been happy and some are hysterical. Despite personal, political and general working-in-a-small- town problems, when it comes to practising medicine I am most certainly enjoying this ride.


Dr Michelle Pentecost, Cape Town


For many of us, we chose to study medicine for the very reason that we will never have a “typical” day.


Each day brings with it new challenges and learning opportunities, especially in the community service year. My year is split into two


rotations: six months of neonatology at a maternity hospital, and six months working in casualty – an exciting mix of ICU and newborn care, and adult medicine. My current days are filled with caring for sick newborns in our ICU, following up on well babies in the postnatal wards, and attending high risk deliveries. I do seven night calls


per month. On a typical call I arrive in theatre just before 8am; I prepare the resuscitation bay, checking my equipment and preparing emergency drugs. I assess each baby after delivery: cases range from infants requiring some additional oxygen to lengthy resuscitations requiring intubation and ventilation. Infants who are preterm, have respiratory distress or other clinical problems require admission,


FEATURE


JUNIOR DOCTOR | VOLUME 2 | ISSUE 1 | 2011 | SOUTH AFRICA www.medicalprotection.org


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