Limitations

Everyone has their limitations, and i guess that knowing where yours are is pretty important.

If you don't push your limits, you stay in your comfort zone, but ultimately stay in the same place as you started.

Sometimes limitations are put upon you by the circumstances.

This x-ray defines a few limitations

The poor girl is about 12 and is very very underweight. For some reason she appears to be malabsorbing. She also has a consolidated right lower lung, clinical signs show it to be pretty much solid.

What's going on with her is still any body's guess, at home you could run her through a CT or MRI, you could scope her bowel to look for a cause of the malabsorption, you could run blood tests for SLE, Coeliac or tumour markers, biopsies could be taken and histology reports would be written and treatment plans devised by the MDT.

Unfortunately the limitations of the hospital mean none of these things can be done, she creates the same amount of concern and interest as she would at home, but the prospect of getting to the bottom of her problem may take much longer.

Fortunately we have managed to send some bloods to Australia to rule in/out SLE and Coeliac, but we are still waiting for the results. It could be TB and a treatment trial has been started but there are a few other clinical things that don't fit TB being the only problem.

We are all limited by our experience (or lack there of), our knowledge, our skill and the available medical technology. Unfortunately this may end up limiting this girls chance of seeing old age.

Who am I?.....Where am I?

Two questions usually reserved for Saturday morning, but on this occasion they are rhetorical.

I'm a mature medical student at Peninsula Medical School. My hairline is retreating faster than the French infantry, needless to say i now require more sunblock to cover my face, and less shampoo in the shower. What I used to declare as laughter lines around my eyes have now taken up permanent residence regardless of my mood and my fellow students often ask me what it was like to live through the sixties, I'm in my 30's (the wrong side of 35) but they seem to find it hilarious!

Four years ago I embarked on my lifetime ambition to study medicine, and I'm now just 12 months from graduating (exams permitting). The journey has cost me my life savings, massive debt, one relationship, one car, hundreds of hours of lost sleep and a second mortgage............however it has been worth it (well sort of, but it could have been a little less painful to be honest).

I'm about to embark on my 4th year elective to Vila Central Hospital, Vanuatu, South Pacific, I'll save you the time of digging out a dusty Atlas and describe it as half way between Fiji and Papua New Guinea .

My selection process for an elective destination involved the following criteria;

Somewhere it wasn't Winter. (rule out Aus+NZ)

Somewhere that was marginally English speaking. (rule out South America, China, Japan etc)

Somewhere with surf. (rule out anywhere without a coastline)

Somewhere that wasn't America (rule out America)

Somewhere remote.

Somewhere non Westernised

That left me with either the Isle of Lewis or Vanuatu (and I've been to Lewis)

Decision made, Vanuatu here i come, I fly out on July 31st.

Come along on the journey, It could be interesting.