When you hear hoof beats think horses, not zebras. That is often repeated advise when trying to arrive at a medical diagnosis...common diseases are common, and while your patient may have some incredibly rare infectious disease, it is way more likely they have the flu. Throughout residency interviews the horse vs. zebra issue was a frequently asked question from students because ideally you want to train in a hospital where you see both bread and butter pediatrics so you know how to handle the most common things but in order to expand your knowledge base and keep things interesting it's always good to see a fair number of unusual diagnoses too. I think CHOP has a great balance.
Of course, in Africa there are a lot more zebras. Malaria, meningitis, TB, leprosy...it's all here. In combination with seeing more serious diseases because people wait longer before seeking medical attention, the variety of diseases encountered makes training in a developing country very rewarding when it's not totally chaotic. I really enjoyed my time in Eldoret and will carry this experience with me in my training to come.
Zebras are definitely exciting, but unfortunately for the course of African history, apparently they are hard to domesticate (they bite and don't let go). Fortunately there are some domesticatable animals here, including the Arabian Camel. I'm on the Kenyan coast for my last few days of vacation and visited the amazing town of Lamu. There's a large Swahili presence there and the town is like nothing else. On a secluded beach outside of the village I stumbled upon a camel and got to go for a ride. Incredible! Now I'm relaxing in the tropical paradise of Watamu before making my way further south to Mombasa, taking the train back to Nairobi, and heading home. I can't believe this adventure is almost at an end but I've certainly enjoyed the safari.
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