19 September 2008

You Are Not a Real Saffa Doctor Until You Have :

  • filled out a thousand J88's
  • filled out two thousand disability grants
  • seen worms exiting the human body via anus, nose, mouth & laparotomy
  • cauterised warts the size of cauliflowers
  • done a caesar because of warts
  • stopped wearing a mask around TB patients (pregrad)
  • inserted 3 ICD's in 10 minutes (on family members who had an argument)
  • treated hysteria with ethyl chloride
  • been handed a Checkers packet containing the fruits of the TOP clinic
  • done a caesar in under 15 minutes
  • had your fingers in a stab neck whilst rushing to theatre
  • given a BCo & Voltaren injections in a cash practice locum
  • earned more abroad in 2 months, than a year in SA
  • been shocked to see a negative HIV result
  • diagnosed marasmic kwashiorkor
  • had a prescription for paracetamol, amoxycillin & insulin returned as "Out of Stock" x3
  • wiped & wiped & wiped with an alcohol swab, but the skin won't come clean
  • been referred a patient with "multiple electrolyte derangements"
  • heard : "the patient is having a change in condition"
  • survived two 24 hour trauma calls on a pay-day weekend
  • had your first (second & third) needlestick injury and/not completed the ensuing course of ARV's
  • been convinced you are seroconverting
  • washed vaseline and/or zambuk off your hands after an examination
  • gotten a laryngoscope blade stuck in a passion gap
  • medschool friends living in 5 continents
  • witnessed the spoils of initiation school
  • been in the 3rd round of allocations for internship/community service
  • seen sangoma cuts & scratches
  • cut off abdominal, wrist, ankle & neck sangoma strings
  • retrieved a matchstick head from a middle ear
  • been 4th in the queue on the line to the HPCSA - for the past 2 hours
  • recognised the winter aroma of Yardleys You're the Khaya*
  • waited for months for your first pay cheque
  • taken your own toilet paper on call with you
  • heard a patient presented as FUBAR BUNDY
  • scanned through the files waiting in casualties & left the wishy-washy ones for a colleague
  • marveled at what the ID photo looks like when filling out a death certificate for an AIDS victim
  • met a 16yr Grav 3 Para 2
  • achieved the most amazing feats in casualties with the help of pethidine & valium
  • been laughed at by an entire clinic after trying to pronounce the name of the next patient
  • had the phone amicably put down in your ear before you are finished talking with a sister
  • been blamed for poor assisting when the scissors won't cut or suction doesn't suction
  • watched patients picking their nose (+/- eating it)/scratching their privates/hocking lurgies on grand ward rounds
  • been amazed when a 2 minute conversation between patient & translator comes back as a monosyllabic "No"
  • cried with a patient because there is no state funded treatment for a potentially manageable condition
  • cried because a patient has received such poor care
  • cried after seeing what a violent society is capable of doing to people
  • cried whilst treating a child who has been raped
  • cried to see human neglect

*a delicate blend of matured perspiration, with a hint of paraffin and a mystical swirl of wood-fire smoke


Bongi said...

fubar bundy slmfyoyo

Karen Little said...

That's hilarious! Although I must say, it usually takes a lot more than 10 minutes to assemble the equipment to insert an ICD... Finding the ligno, the blade, the sutures... You know how it goes... Unless I'm very much mistaken (which i occaisionally am), that's a photo of a certain polish obstetric PMO named Adam C - am I right?

Amanzi Down Under said...

Hilarious post!

The pic certainly does look like 7 min Caesar Ah-Dam C.... Although we used to refer to him as Calvin (as in Calvin & Hobbes)because of his hairstyle.

P.S> I've used 15 alcohol wipes on a patient here in Oz after he'd just been "Out bush" before I discovered he was actually white not aboriginal

Anonymous said...

Thanks so much for this post - I can smell and feel Kalafong and Bara with this post and the guilt of having left and living in a country full of spoilt eerstewereldes is strong.
I WAS a real saffa doctor and I salute and pray for you guys who still are.

the annester said...

you are hilarious! your blog has made my day... you have a new fan.

can i add one or two?
- until you've developed a strange constant scratching tic from the numerous flea bites all over your body from the tea room couch/on call bed
- until you've run a resus, complete with cpr, on your own because all the other "hinderers" were on "tea"
- until you've attempted (or at least watched) a front room thoracotomy (outcome is irrelevant!)
- until youve sutured a patient without any local (usually because it was out of stock), without them noticing, due to massive amounts of alcohol.
- consoled a patient with a potentially treatable condition who can only get a clinic date at a tertiary institution in about 7 years time
- called the emergency services to arrange a transfer for critically ill patient, only to discover that its changeover time, and the phone will not be answered for approximately the next hour or so.

keep up the blog and good luck:)

Dragonfly said...

Awesome post. It captures the developing world insanity so well...(from someone who has also been there)

Anonymous said...

Come on.. what`s up.
we need some more material to choke on!

Anonymous said...

I dnt know how many times ive read this post, mostly coz i view ur blog alot hoping u've posted anotha 1 and obviously coz its jus 2 funny,lmao. Plsplspls dnt stop blogging!!

Bongi said...

post dammit, post!!!

Jade said...

Im with Dr Bongi. I made one of my friends read one of your posts @ 3am while preparing 4 exams and she almost died of laughter.
We waiting, pretty please with a cherry on top :-)

Bernard Linde said...


Don't forget having the sister phone you at some ungodly hour to say "Eh docta, the patient is gasping" too many times to count!

Anonymous said...

So true... So sad

Anonymous said...

A telephone conversation I will never forget goes as follows whilst I am scrubbed in theatre:
"Docta, the patient she (a male) is gasping"
"Sister, is the patient already dead or must I send someone?"
"Yoyo Docta, the patient she is in the final stages of gasping, you can come later" meaning rigor mortis has already set in!

Anonymous said...


futureuncertain said...

Used a piece of medical equipment for a purpose for which i was definitely not designed to do. "boer maak n plan" style

futureuncertain said...

I recently had a patient come to see me in the clinic. A typical E Cape refugee escaping the ravages of the collapsing health system there by seeking help in the Western Cape.

"Hello Tata" i say, "How can I help you, what is wrong?". "I have an appointment" he replies. "Yes I see that but how are you unwell? What is troubling you?" "The doctor at the other clinic sent me here."

After this conversation went around in circles for some time it was clear that A. he had no idea that he had hypertension, glomerulonephritis or a perforated eardrum. Which were all long standing problems that he had had multiple previous appointments for.

B. In addition he hadn't noticed or complained about his cachexia, dysphagia and least of all stridor. For which I am now busy investigating and treating.

It never fails to amaze me that patients wont openly describe their symptoms straight up.

Anonymous said...

On morning ward round: "Eh, blood pressure and pulse normal" with the patient already dead !

Anonymous said...

Only the doctors find this funny. The rest of us find it very, very sad.

Anonymous said...

FUBAR BUNDY........F@@@@@ up beyond all repair But unfortunately not dead yet

Unknown said...

Story of my life!

More additions... needing the bathroom & going 30hrs later. Prerenal UKE picture due to on call dehydration...and sometimes drinking injection water out of desperation. Wishing some chronic MOs would bugger off so u can give proper care. Crying cos u lost a really friendly patient. Crying cos some patients just wont die. Wanting to cry but being to tired for the effort. Spending your youth suffering. Wanting to help but being unable to...

But despite it all we go back everyday. We lie awake at night thinking of patients. We try to be better everyday.

Anonymous said...

Loving it! Woke up in a terrible mood but i'm ready for more of the above mentioned today.
Have to love it when you present a FUBAR BUNDY to a consultatnt and he just nods, as if "we can on now"!
I have drank water from "water from injection" vials.I have also removed a samsung cellphone from a patient's ass.
I have treated a bow and arrow (complete with feathers,steel point and the works) in casualties.
I have changed my signature and neglected to stamp government forms in order to avoid possibly going to court

The list goes on...

Jacqui said...

They should add:
1. Been harrassed at least once a day by a security guard in search of a laptop in your carboot.
2. Have patients with non-sensical names like 'Simcard' & 'Dewdrop'.
3. You have put 'Generalised body weakness' as your diagnosis on an admission form
4. A question on a travel visa application form says, "Have you ever been in contact with a person who has TB in the last year?" & you spend half an hour trying to decide what to say.
5. You steal supplies from other wards / clinics / hospitals & keep them in a bag for call.
6. You've certified a patient without a stethoscope.
7. Fabricate symptoms to get a CT scan for a patient.
8. At least one patient has pointed from the top of their head to the tips of their toes when asked where the pain is.

Dr Guinevere said...

Ooh yes, its all true.

The photo is of Dr 7-minute-caesar Adam. What a legend!

Laughing at this sad, sad state of affairs may seem harsh to a non-medical person, sure. But if you don't laugh, you might not stop crying, and we've all been there too.

Jenny said...

My definitive Bara description has to be the refrain of the ward sister to the ward call: "Doctor, the patient is gasping". (usually indicating that rigor mortis has set in a while ago)

Jenny said...

Apologies! I see I am not the first to mention that!

CWJ said...

Excellent blog. Brings back some fond memories although I now work in the first world system of the NHS which is plagued by its own problems!

Unknown said...

Using masking tape to secure a iv line. Having brought the tape from home for that exact purpose

Anonymous said...

Or the never ending search for strapping after you'd been called by the sisters for a drip in the ward...realizing they'd never even attempted to gather the drips et and continued sleeping at the nursing station...and then points in the general direction of the locked storage room when you're looking for anything remotely useful

Dr. Thando said...

Sometimes I think they're so used to suffering that they don't know how to separate suffering due to poverty from suffering due to illness.

Anonymous said...

Marvellously true.the truth at the end just kills the humour as we realize how sick society is

Unknown said...

I'm a Saffa Dr!!! 😂😂😂😂

testing said...

This is classic. All over the country we all are in the same boat. Does anyone have a hastag-SOMETHING-must-fall-idea? Seems to be working for tertiary education.

Unknown said...

Many of these things are SO True...

Someone asked me (in my first year in the UK) "why are you here" and the response came out of the absolute core of my being: "I shouldn't be here but I'm not a fucking saint".

Interestingly, having spent 15 years in the UK, and even though I'ma consultant in a fancy-pants teaching hospital, I recognise many of the things said about Saffa hospitals. Just recently I've:

Done three laparotomies for stabbings in 4 hours. Same incident.

Witnessed the ten minute conversation between patient and Polish interpreter, only for the answer to be "she no know".

Used oh so many wipes to get through the years of grime and dogshit on someone's skin.

Phoned for an ICU bed only to be told "it's handover - maybe after". Then nursed the patient myself until the NEXT handover 6 hours later.

The difference is this: in SA the patients are usually grateful. Here? Some complain and say "it's me RIGHTS, I knows me RIGHTS!". Then they sue you with legal aid that your own taxes paid for. They didn't pay any taxes of course. Because welfare is their right....

But calling patients Grandfather? Or calling the young pissed-up lads with holes in them "brother"? In the strangest way, I miss those interactions so very, very much. Typing this, I can't quite stop the tears.

But 15 minutes for a Caesar? Wow. I never got below 20. Mind you, I was only a houseman. ..

testing said...

Removing an above knee back slab with a stitch cutter- can't find a scissor anywhere! Alwyn, really enjoyed your comment!

testing said...

Removing an above knee back slab with a stitch cutter- can't find a scissor anywhere! Alwyn, really enjoyed your comment!

Anonymous said...

This is excellent and so true!
May I add:
Being called out from home at night to reinsert a urinary catheter that could easily have been done by nursing staff.

Being called to certify a body in the ward (staff skipped the part of phoning at the gasping stages), check the chart, last vitals recorded 10min ago. On exam: already rigor mortis.

Anonymous said...

-Admitting the same patient for DKA more than three times.
-Hanging a patients IV fluids yourself to ensure he actually gets it.
-Seeing 'D/W Dr. X' on a referral or admission note when you know no one ever called you
-Being told a patient is stable only to find him gasping when you arrive
-Stabilising a patients COPD exacerbation only for them to sneak out for a cigarette

Anonymous said...

F$#*ed Up Beyond All Repair
But Unfortunately Not Dead Yet

Roguean said...

Avoiding a stab to your juguluar from an acutely psychotic patient using a thermometer as a knife...

Suturing the same patient within 12hrs for another stab wound...

Physically assuming the position to demonstrate 'please lie on your back'

Anonymous said...

And then there were the FITH and healthy - F@#ked In The Head. Common at JHB Gen... usually former advantaged, now fallen on hard times - aggro complainers with imagined or minor maladies who can't wait their turn in a 1 Reg to 60 patient OPD.

Tiger Lily said...

Completely agree. Have often thought that too.

Unknown said...

It shouldn't be funny but it is. Maybe seeing the funny is how we cope. During the State of Emergency I inserted 16 under water drains in patients with gunshot wounds, in one night. I was a sixth year student. The intern showed one and left for theatre. I was crying like a baby but I did it and they lived. That was only the first time I was scared to death by what I had to do with almost no experience, minimal assistance, not enough meds and instruments and backlogs in support services (labs, X-rays, etc)