It is perhaps a rite of passage here in Tanzania that most travelers are hit with at least one episode of intestinal distress of some sort and unfortunately it was Kelley’s this morning. Hours after having eaten at the Happy Days Pub in town, she had developed severe nausea, was white as a ghost the next morning and very light headed. The decision was “probably giardiasis” given how quickly it affected her, but Laura had eaten the same thing for dinner so it wasn’t entirely clear. Kelley remained in bed at home as we had decided to visit her midday, so Frank gave us his secret concoction of medications that he swore would take care of her. More on that later.

Laura learning to use the portable ophthalmoscope

Everyone participates in the exam

With Kelley on the disabled list, it was Laura’s chance to step up to the plate and that she did. Since it wasn’t yet an “advertised” neuro clinic with didn’t have the onslaught of patients expected for the coming week, so it gave me plenty of time to orient her on seeing patients here in Tanzania. Salina, who had been working with me as interpreter for the past two days, joined the two of us while seeing patient and continued the excellent job she had been doing. She is a new nurse here at FAME and is from the Rift Valley Children’s Village where she had spent a year living there before going away to school. Seeing patients here at FAME isn’t just about the language differences or even the cultural differences, which so impact our ability to obtain accurate histories on patients. It’s also about the medications that are available here and how to write prescriptions, simple things that we take for granted at home and which can now become easily disorienting. And the common medications we use at home all come in new flavors of names here just to confuse things. Though almost exclusively use generic names here at FAME, that isn’t totally true at other healthcare facilities so patients come with lists of medications that often require further research just to know what they’re taking. It was a busy, but not crazy day on Saturday and a good way for Laura to get comfortable here. We worked until lunch at 2pm and then brought a plate of rice and beans home for Kelley. She was pretty much comatose thanks to Frank’s special cocktail, but finally awakened later in the afternoon when she was improved enough to eat some of the reheated rice and beans and managed to keep it all down.

Laura working on her pediatric neurology

Laura and Salina doing a mental status exam

For dinner that night we had planned to have grilled cheese sandwiches and Alex was making mashed cauliflower to have with it. Unbeknownst to Laura and I, though, he also made some fried risotto balls that had cheese and veggies mixed in along with some incredible hot sauce. Dinner was delicious. Kelley eventually made it out of bed and came over to have some homemade chicken noodle soup that Alex made for her (definitely not in my repertoire) and she seemed to be on her way to an excellent recovery as we had planned to head to Tarangire very early the next morning for a day of safari – their first as well as Alex’s first despite his having been here for two months. That meant lots of pressure for me to put on a good show and do my best safari guide imitation possible. Though I’ve had lots of experience over the last several years, it can always be a bit stressful as you want to make sure everyone has a great time and sees everything they expect to see.