I’m Not a Doctor – I Just Play One in Mbale

Dog Science

Just so we’re clear: that title is totally facetious. I haven’t pretended that I’m a doctor here.

But it’s like the start of a bad joke: A muzungu walks into a hospital…

And everyone assumes you’re a doctor. This is completely rational – most of the foreigners who come to hospitals here are doctors. It’s just that I am decidedly not; clinically, my major accomplishment thus far has been to not pass out during the first c-section I scrubbed in to observe.*

Not being a doctor is usually OK; if there are clinical issues, we have doctors working with my organization, and my project partner is a doctor from the UK. They are hyper-proficient clinicians and I trust them to, well, keep me alive if I’m unable to do it myself.

But, if they are all out of town or otherwise unavailable – as they were this weekend – within the organization I’m affiliated with, I am perhaps the least bad choice to speak with other doctors (thanks, care coordination!), or to otherwise attend to clinical issues. Playing doctor, without the “helping patients” part. And, for reasons that elude me, the people I live and work with seem to trust me and my judgment.

Which is how it came to pass that, after a very fun, very late evening at Thatch Gardens (incidentally, a place bereft of gardens but chock full of Tusker and African rap), I was up at the crack of dawn and at the private hospital down the road, trying to get the doctors to tell me why a child was scheduled to undergo major stomach surgery.

As an aside: I think a shared experience between all expat aid workers is the moment – moments, really; it happens all the time – when the question “what string of events in my life led to this?” pops into one’s head. It’s the realization that you are, at least temporarily, living a moment that past-you, friends, family, whomever, could rightly consider bizarre – well out of the sphere of what you or they would previously have considered possible. It arrives during moments of bewilderment and beauty, stress and strangeness.

This was one of those moments.

Anyway, some background is useful: how the child got to the hospital is a long story that, if you’re interested in hearing, I’ll tell you ad nauseum, but privately. For now, suffice it to say that a child became associated with the NGO I’m affiliated with, and was in the hospital.

Before she left for the weekend, my doctor friend and I went to see the kid, and while there, his doctor indicated to us that he would not need surgery and would be discharged within a day or two. Which was good news – the NG tube seemed pretty uncomfortable and he didn’t have much to do at the hospital – and we left satisfied with his prognosis. So, it was surprising to hear later that evening – through a game of telephone, by way of someone not versed in medical terminology – that he was scheduled for surgery early the next morning. We decided that I would go in and discuss the diagnosis and plan of care with his surgeon, if for no other reason than to understand what was going on.

Surgery is a significant risk, whether done in America or Uganda, so implicitly the goal was to ensure it was absolutely necessary and the best thing for the patient. The surgeon seemed nice and patiently gave me a crash course in gastroenterology; the short version was that surgery may be necessary, but the diagnostic tool to confirm this – a pediatric endoscope – isn’t available in east Uganda. If surgery is chosen as the best option, it’ll likely be later this week; for now, the NG tube is out, and hopefully the kid will tolerate some food that’s a bit more substantial than ice cream, which I bought for him yesterday.

The story goes on, of course, but it makes more sense to finish when all is said and done. And I don’t really have a particular point I want to make, other than to fill in friends and family about the strange goings-on that occasionally crop up – more here than in America, I’m finding – when the least bad option is, well, the best option.


*Almost, though; the room faded to black, as it’s wont to do in such situations, and I had to step into the sterilization room for a minute. A minute during which I saw the baby pulled out, feet first, directly into the air. Stepping out was a good choice.

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