I've grossed my sister out for years when I mention the names of basic organs within my field of practice. It has always seemed funny to talk about a "hoo-hoo" or "wee-wee" when I am a doctor. During residency I have used "boo-boo" slang many times when my more ghetto-saavy patients didn't know what I meant by bowel movement. That stopped when I found "poop" to be a universally understood term in the english language. It seemed more honorable than the other. I thought I had heard them all...
But that was before I came to Mbingo. Here, as the gynecologist, I am constantly asking questions about "de woman-skin". And I giggle a little inside each time I use a crude term for urinating (the p--s word) or defecating (the s one), but I'm just using the words they understand. It's not distasteful at all to them, in fact, they don't understand it said any other way. And it gives me a funny laugh in my heart as I ask about the different things they are passing. Now, blogging as a missionary doctor I can't bear to put them on the paper in full, it feels like some sort of turn against pure speech. But not when I'm talking to my patients, then it is their norm.
The odd changes are more than mere words. Today two men came to my clinic. The first sat down and I immediately said, "I think there is a problem. I am a gynecologist, and you are a man." He wanted some STD testing. I looked at the swab I should use. Then I looked back at him. It's not that I don't know where it should go, I mean the options are sort of limited. Yet, I haven't had anything to do with "de man-skin" since required to in medical school. Maybe I've gotten immature as I've gotten older, but I thought I might bust out laughing during the practicalities of getting that testing completed. I mean, I don't remember how far the q-tip has to go up there. And then, he gave me a way out. He described some additional pain in the upper abdomen. I told him that the internal medicine doctor down the way was very good at taking care of the upper abdomen, and all that I knew was the low pelvis. And then I wrote on his medical book "see internal medicine doctor for probable gastritis. and please do a chlamydia and gonorrhea swab to evaluate for STDs." Done. One down. I don't remember what the other one wanted, but it was probably gastritis too. :) I'm not sure how they got triaged to me in the first place.
There are some funny things that are new and different. But there are also a thousand things that aren't funny. They are frustrating and stressful. A new environment is always a bit trying. But then feeling like I don't know my place and responsibilities and function between the OR, the obstetric ward, the gynecology clinic. Big masses that I don't know what to do with, infertility that you will keep coming to me for even though I have nothing more to offer, questions about chemotherapy regimens for weird cancer scenarios. And the never ending line of patients. I mean never ending. In the morning, they are there waiting when I finish my obstetric rounds. And their eyes look at me as I walk by to go by the house to grab something to eat, wondering why they are waiting and I still find the need for food. And then some of those same stares again in the evening as I walk past, having had to shut the door and turn people away. They've waited all day just for me to walk by. But I have to walk away sometime. I can't have a 24 hour ob/gyn clinic with just me. None the less, it feels like I am letting them down and turning away from their need. I am trying to imagine ideas to improve the system, but I don't even know where to start. I've gotta make appropriate boundaries, but knowing what that looks like practically isn't in some manual they give you before you step on the plane.
But in the midst of all of that stress that can leave me burdened, sometimes I see the funny things around me and laugh. Sometimes in the midst of rainy season, the sun comes out from behind the clouds and makes me lift my eyes to the beautiful green, rolling hills surrounding me. Sometimes in the middle of what feels like floundering in ignorance I will have a grand thought that will actually change someones life for the better. There are really a thousand "sometimes" to be thankful for. But all the times, the best and worst, happy and sad, broken or triumphant, I can rest in the One who holds it all together.