apartment in Guyana

My first few days in Guyana have been a flurry of new experiences. I am staying with a colleague from Vanderbilt in an apartment that is walking distance to the hospital. It has been a nice walk every day - warm and sunny. On my first day at Georgetown Public Hospital, I felt out of place and not very helpful. I knew the medical information required to care for patients, but that will only get you so far in any clinical environment. It took several days for me to learn the basics of patient flow in the Accident and Emergency Department (A+E): which lab testing, imaging, and medications were available, and how to manage patient disposition and follow-up planning. Most of the patients I have cared for have the same medical conditions so commonly seen in the United States - asthma, COPD, liver disease, heart failure, diabetes, trauma, etc. Mixed amongst them are patients with problems less commonly encountered in the United States - malaria, TB, dengue, or the occasional snake bite. The emergency medicine residents and graduates have been eager to help me get oriented, to discuss interesting cases, and hear about the differences in practice between Guyana and the United States. Now, after few days of on the job experience, I am much more comfortable in this environment and excited for the weeks ahead of me, to provide both patient care and teaching to the local doctors.