Take Courage – Ryan Lafollette

Tuesday
   There are many signs in Ho, but Jes and I found one that caught our
eye. “Dr. DZ. M.D.” What we found was not, as you might expect, the
medical version of the Discovery Zone beloved in our youth, but
instead we arrive at a white picket fence one house off the main
street. I brushed aside a dust-filled white and blue patterned curtain
and greeted two nurses no older than 20. Explaining my place as a
fourth-year medical student from America they responded by pointing
behind us. We turned to find a man in the dark corner of the house,
slouched comfortably in the ubiquitous plastic chairs which appear
anywhere and anytime in Ghana. His smile first cracked at the corners
broke to reveal teeth that would make the Cheshire cat swoon. Dr. DZ,
as we learned, trained as a surgeon in Poland, moved back near his
home town in Ghana to practice and now runs this road-side clinic we
have happened across. We spent nearly an hour with him as he told us
his herbal cures for malaria, dehydration, wellness, etc. When asked
what Ghana needs for better health care he replied, “Doctors, more
than resources… Doctors” He goes on to tell us that the Volta
Region, all of which refers to one hospital, has one orthopedist, one
dermatologist, and one ophthalmologist. Before we left I asked for
advice as I start a career in medicine and he said “have courage…
know your limits but when there is decision and you have to make it…
HAVE COURAGE.” I will take that forward to every patient I see.

Wednesday    
   “Doc…. DOC…” Not something a fourth-year medical student is
trained to hear yet. This is yesterday, in Hli Have, and one of the
villagers led us to a 98 year old woman they said was having chest
pain. Stat troponins, Nitrates, Morphine, EKG, Chest Xray, Aspirin,
O2… None of them? How about an ambulance. No ambulance? Hmm… taxi?
Ken and I probably consumed half a liter of dust on our taxi ride
in… An autobike? A 98 year old on a motorcycle?! My mind raced and
was already humbled by a lack of options. I approached my first
Ghanaian patient and met a frail woman, wrapped in blue. It was
amazing to think when I placed my stethoscope on her it was one of few
to ever do so, if not the only one. Crackles, small breaths, normal
heart. This is what I imagine 98 years of breathing dust sounds like.
There is nothing I can do but it doesn’t change the smile and thanks
in her eyes and I feel that gut check of knowing a 5 minute visit will
never replace a lifetime without health care, and take a new respect
for medical personnel who have the courage to live their lives with
this struggle. I have seen great adaptation and most importantly
unquenchable happiness here. In America we often get caught up in a
battle to be flawless. Here they accept health as a part of life, and
though there is much to be done to better the health standard,
adaptation is my lesson today. At the municipal hospital we saw how to
give pitocin, not by measuring, but by counting drops per minute, and
four beds in each isolation room. Yet when talking to the pharmacist,
he quoted me number of malaria rates, the sensitivity and specificity
of HIV testing, and the extent of their electronic medical record. The
adaptation speaks for itself.

Today:
   “How many years do you have?”
   “At least 55,” Johnny translates.
   He explains that the man remembers the independence so he’s at least that old.
   “He is the oldest of six… At least 60.”
   That’s as close as we got to discovering about this man the elders of
Kunyowu took us to because he is coughing up green for 2 months. Not
allowed to go for a week in the U.S., this man’s pneumonia is a fact
of life. Disparity may describe the difference between our cultures,
but it does not describe theirs. And being a part of their culture if
only for a week fills me with gratitude to know the difference.

Ryan Lafollette

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