I haven't posted in a while. But today something happened that surprised me enough that I wanted to write about it. So here it is.

A few months ago a cop stopped me at a busy intersection here in Montreal and gave me a ticket for having run a red light. I was turning right at the intersection and I agree, it was close. But I didn't think I ran the red light. So I fought the ticket, partially for the principle, but mostly for the demerit points it would have put on my license. I pled not guilty. The city sent me a second notice, urging me to plead guilty to avoid further expenses. No thanks.

So then I got a notice with my court date, which was today. In the leadup to this, I tried to research ways to plea-bargain - I knew I could lose the case, so I would have been OK paying a fine and avoiding the demerit points. I couldn't find a way to do this very easily, so I went to court today.

I showed up before my time, they opened the room. I talked to the city lawyer there after he showed me his evidence, which consisted of the cop's written testimony that I crossed the line after the light on his side of the street, ninety degrees from mine, had turned green. I asked the city lawyer if I could plea-bargain. He said that given the testimony of the cop, no, the best thing I could do was plead guilty now, and avoid the charges that go with having my case go before the judge. Again, no thanks.

So the judge comes in, my case is first. I raise my right hand, swear I'm me, that I live where I do, that I was born when I was, and that I'll tell the truth. They didn't even give me a Koran to swear on or anything.

The judge asked for my version of events after the city lawyer gave him the deposition from the cop. Let me tell you, I was kinda nervous. Actually, pretty nervous. Very nervous? OK. I mean, I'd never been in court before, here I was by myself, defending myself, with no clue what I was doing. In French.

After trying various ways of saying it, I finally communicated to the judge that the light had turned yellow, that I didn't think I could stop in time, and that the light had turned red after I had crossed the stop line, so I continued my turn. He asked several questions about when the light changed etc. Then he said my version of events seemed plausible, and that it is the right course of action to continue if one can't stop in time, and then he pounded his gavel and acquitted me.

I was sorta dumbfounded. I mean, it's not like I was acquitted of a crime for which I would have to serve time or the death penalty. But hey, I won! No fine for me...

Anyway, I wanted to post this because I was surprised that in some municipal traffic court, on a regular weekday, a judge actually listened and thought about what I said. And believed me. Weird. But inspiring. At least to me. I mean, this might be a boring and inane story. But I had a pretty good day after that.

I hate the emergency room

I know, most people hate the emergency room. But not like me. See, they come in, wait several hours, and then get substandard care. So they hate it. Me, I'm the one who makes them wait several hours. I don't think I give substandard care, but that's not for me to judge.

But how many fevers can one person see in a night before he gets jaded? Kids get fevers. It's what they do. You give them a cold, and instead of the sniffles, they get a fever. But parents get scared and bring their kids in at 11 pm. At which time there are no rooms in the ER to see kids, since the place is packed with adults with various equally unsatisfying complaints, like back pain. It may sound callous to some, but I just get fed up with counseling parents about their child's viral illness. Keep fever down, make sure he/she is drinking ok, it's ok not to eat when they're sick, make sure he/she pees once in a while. Call if he/she still has a fever in 3 days. At which time I'll give you the same advice again.

So in 1 month, I'm going to be in the ICU for good, and I won't have to deal with any viruses, except maybe my own kids' one day. I can guarantee I won't show up in the ER with my kid at 11 at night.

Sick of SF weather

So I'm no longer sick, as I was last week. It was neither swine flu nor malaria, so that's boring. But I am sick of the weather here. It was teasingly warm for one weekend, and then back to regular - highs in the mid-teens (Celsius), lows around 10, maybe some sun sometimes, otherwise foggy. It's just so boring. AMT blogged about weather in Edmonton, and I can see her getting sick of that too (snow in May - well, it's not as bad as snow in June. Or July), but at least it's weather. We lack that here. So in 38 (!!!) days I'm going to a place where it cannot be argued there's no weather. And hopefully I won't do anything bad to my patients there. But they scare me.

Sick

OK, so it's not so much fun to be sick. I've been sick for a week now, and every day, it gets less fun. Except for that one day when I thought I wasn't sick any more, that was pretty good. On that day (Sunday) I felt so good I went to the gym. Hey, I was even able to lift pretty decent weight for a while. But then I started noticing that whenever I stood up, I got a bit of a headache, which died down. Then I noticed that whenever I changed position, I got a bit of a headache, and when I stood up, I got a bit more of a headache. And then I started feeling tired. So, being smart, I left.

Being smart, but not that smart, I didn't go home, but I went biking and shopping. Then I went home, really not feeling so hot. Er, good. And as the afternoon wore on, I got a headache the likes of which I cannot recall. Ever. Both my temples pulsing with pain, a band over my head between them made of throbbing... lighting. I don't know. Something big and destructive. And every time I moved, the throbbing went up. It was unbelievable. And it took 2 hours of this (during which I refused to take anything because I needed to see if I would still get a fever) before I finally got a fever. Then I took Tylenol, then ibuprofen, then felt somewhat better. I even slept OK.

So this am I went to the doctor (urgent care at UCSF, not my useless GP here), where they ran some tests. Everything so far is negative. My white blood cell count is as normal as possible, I'm not anemic, my kidneys seem to work, my liver is OK. Even my malaria smear (so far) is normal. Stupid lab tests. What do they know?

Flying

It seems airports are my favourite, or maybe only, places to blog. In any case, I've been getting sick for several hours after Stephanie came down with something and left already, and it's getting worse. Fevers, chills, aches and pains. Hopefully they won't quarantine me. Anyway, a few advil did the trick, and things are looking up. I hope I can sleep on this plane, 'cause I feel like shit.

Israel

I've been in Israel for over a week now, just so you know in case you haven't been able to find me. As far as I'm concerned, there isn't a better vacation place. Although it appears the pope has just landed here, so that might put a damper on things. But never mind that, I still love it. The beaches are fantastic, the water is still cool in May instead of the pee-temperature (and probably pee-filled) water in the summer, the food is still amazing. I don't know why people eat anything else. Except maybe the occasional French or Italian meal. Maybe Thai and Indian occasionally. OK, there's other good food out there, but seriously, I prefer this. Vegetables as tasty as you can imagine, hummus and falafel that's mouth-watering, fresh-squeezed juice at the beach... Sigh.

But I'm leaving tomorrow, back to San Francisco for my last six weeks of residency. And then on to Montreal. Love it! But first, I think I need more hummus.

Last blog from Kenya

01/05/09

Jomo Kenyatta

I’m typing this at the airport, having arrived at Nairobi (Jomo Kenyatta) airport a while ago from Kisumu. I still have 5 hours until my flight to Istanbul, and then 8 hours or so there before I go to Israel. So I have time to blog. Or at least to type, since I can’t connect to the internet here.
Que dire? I spent a month in Kenya, going on safari, treating HIV, seeing kids on the inpatient side with tuberculosis, malaria, cholera, typhoid, marasmus, kwashiorkor – diseases that, in my world, only exist in books. Diseases that should exist only in books. All of them, except maybe HIV, can be easily prevented. When caught in time, they also can be fairly easily treated. But so many forces here have conspired to allow these diseases to flourish.
Poverty is of course chief among them. But the poverty is complex, and I’d need to spend much more time in Kenya figuring it out. The legacy of colonialism is, to me, strongly felt. Hundreds of years of oppression, followed by rapid independence based on map lines that have, or had at the time, nothing to do with Kenyans’ (if we can call them that) lives. And then somehow we expect them to have a flourishing democracy. Just like Iraq has.
I also think centuries of white oppression has divorced people from their culture, and therefore from their land. Not only do people not have the means to feed their children, they don’t know how. I am sure, before colonialism, there was no such hunger and malnutrition. People farmed, hunted, fished to eat, and though there were general problems (wars, floods, famines, etc), there was local knowledge and wisdom about how to farm without raping the land, about what constitutes a good diet. Now all people have is Ugali, which has the texture and likely the nutritional value of wet sawdust. I don’t think I’m romanticizing here. Whatever was here before white people was better than what is here now. “Progress” has only made the majority of people poorer, unable to feed themselves and their families.
Incompetent government is easily seen in the papers here every day. I thought Stevie was something, but we’re talking orders of magnitude here. And the corruption the incompetence engenders is also palpable. Government money simply disappears. As if there was enough to begin with, the government spirits it away. Much of the population has nothing to eat but maize, and the MP’s are raking it in. Families lose half their children to malnutrition and related diseases, but the government is more interested in power-grabbing than in solving socio-economic problems. Recently the Ugandans planted a flag on a small island in Lake Victoria that is also claimed by Kenya. Luckily the Kenyan government decided not to go to war over this, but the amount of energy devoted to this in politics and on the streets is unbelievable. As if a tiny fishing island has any effect on the majority of the population.
But similarly what they do with their free time. In general, men here are obsessed with one thing, and that’s Champions League Football. In Kenya, you’re either a Man United fan or an Arsenal fan. As if some game played on another continent has any bearing on anything here. But it does, because that’s where people’s emotions are invested. Which I find difficult to swallow. I do understand the wish to escape from the daily life, but this is crazy. In Sindo, for example, which goes without power for much of the day and night, some people have their own gasoline generators. And what do they do with the gas they buy? They watch TV, of course, and mostly it’s football.
Kenya is an economic success in sub-Saharan Africa. I can’t imagine what countries like Angola look like, let alone Zimbabwe. One reason people at the clinic were sad to see me go was that they could see how a paediatrician was so important. And they don’t usually have access to one. As they said, my services are more needed here. And they’re right. There is an abundance of people to take care of the preemies at UCSF for the next month. But for the rural population of Suba, there is no paediatrician.
So I’ll be back. Maybe not exactly here, but somewhere where they need me more than at tertiary-care centres in the developed world. I’ll probably come as part of something organized rather than on my own. I’m not sure what form that will take. Maybe as part of the MCH’s cardiac team, but that’s not what I feel is really needed. What’s needed is fairly basic care. Not like kids with cardiac disease don’t deserve to live, but the resources that need to be invested in them are huge, and with that money, you could make Sindo District Hospital into a place that could actually be conducive to healing, rather than death.
OK. That’s a downer. And this is long again. Not blog-like. I’m sure I’ll soon find good things to write about. Like this mosquito I’m hunting right now…