It took a while for me to realize how spoiled I am back at my home hospital, as compared to GPHC. Of course I immediately realized that that had different medications, fewer medications, and access to fewer labs and imaging tests, but I had expected and was prepared for most of that. But then one day it hit me: individually wrapped alcohol prep pads. There are at least a hundred of them in every patient room back home. In my haste to grab one, I probably drop about 3 on the floor and never pick them up. They don’t exist at GPHC. Here, there is a large container of cotton (like a giant cotton ball), over which someone pours alcohol and then you pull off a piece of cotton.
After that, I began to notice more and more how spoiled I had been. One patient had accidentally ingested a bit of formalin. What would have been a 5 minute call to the poison center became over an hour of research and calculations to figure out if she had ingested a lethal amount. A 6-year-old child with an unrepaired congenital heart lesion arrived cyanotic (blue), with dangerously low oxygen levels. Though I had just given the residents a lecture on the topic a week prior, this was the first patient I had actually seen with the condition, as most patients in the US with this lesion have had it repaired very early in life. We gave the appropriate treatment within the bounds of available medications, but what I really wanted was a conversation with a pediatric cardiologist.
I will come home appreciating all of these experiences when I had to figure it out on my own, and I think I am a better physician because of it. Now, though, I have a new appreciation for the vast resources that are just a phone call away.