Surgery/ Internal Medicine Service

I have included some photos of my time here and wanted to provide a warning before you proceed: Some of the photos may be quite graphic.

In addition to the public health and community health clinic work, I spent a few days working in the surgery and internal medicine wards. The chest x-rays shown are actually a success story. The patient was a 35 year old female diagnosed with tuberculosis. The x-ray on the L is the one taken on her first visit approximately 6 months ago. Notice the L side of her chest (your R) is completely white. This infection has spread throughout her L lung field. The patient initially presented with the typical symptoms…weight loss, anorexia, fever, and night sweats. The patient was placed on multi-drug therapy for 6 months. Upon return to the clinic for her 6 month check-up the patient had the x-ray on the R taken. The infection had completely resolved and the patient had a healthy recovery.

Working on the surgery ward was one of the most eye opening experiences I have had in medicine. The patients were of various ages but almost all had severely debilitating diseases. What was most unsettling was the fact that many of the patients had come to the hospital long after their disease process began. One of the most impressive diseases commonly found in tropical hospitals is the buruli ulcer. Buruli ulcers are chronic necrotizing skin infections caused by the bacteria Mycobacterium ulcerans. The ulcers usually begin as painless nodules that can sometimes itch. Some spontaneously resolve but many times the ulcers will grow in size and begin to spread rapidly. They can become quite large and disfiguring. The best way to treat these ulcers is by early detection and surgical excision of the ulcer. Without treatment or with a late diagnosis the lesion may slowly heal after a few years.