Buy This Book

Sexy cover, sexy author, sexy book! Nothing to do with Africa! It won the Lambda Literary Award for Lesbian Debut Fiction, but you don't have to be a lesbian to love it. The Washington Post called it “post-gay” and The New York Times called it “engaging” and “delightfully lyric.”

Buy it from your nearest independent bookstore, or simply by clicking on this link.

Doctors Dysphoric

There's a decent article in the New York Times about discontent with clinical practice in the USA. Nothing new there-- but it is gratifying to hear somebody else describe the same discontent that you've struggled with. The article quotes a doctor on Long Island:

I’d write a prescription,” he told me, “and then insurance companies would put restrictions on almost every medication. I’d get a call: ‘Drug not covered. Write a different prescription or get preauthorization.’ If I ordered an M.R.I., I’d have to explain to a clerk why I wanted to do the test. I felt handcuffed. It was a big, big headache.”

When he decided to work in a hospital, he figured that there would be more freedom to practice his specialty.

“But managed care is like a magnet attached to you,” he said.

He continues to be frustrated by payment denials. “Thirty percent of my hospital admissions are being denied. There’s a 45-day limit on the appeal. You don’t bill in time, you lose everything. You’re discussing this with a managed-care rep on the phone and you think: ‘You’re sitting there, I’m sitting here. How do you know anything about this patient?’ ”

Recently, he confessed, he has been thinking about quitting medicine altogether and opening a convenience store. “Ninety percent of doctors I know are fed up with medicine,” he said.

I am not working in a convenience store, but negotiating with Kenyan bureaucrats is not exactly clinical medicine either. If American doctors choose to work in convenience stores or the developing world rather than primary care practice, isn't it time to reform the American health care system?

Liverpool School of Tropical Medicine

We are facing some major challenges to our research study. However, rather than dwell on the pain, I will try to look to the future. Specifically, I am getting excited about the 3-month Diploma in Tropical Medicine and Hygiene course that I am going to take September-December 2008.

Liverpool is a major center of tropical medicine. According to the website:

the school was founded in 1898, becoming the World's first institution devoted primarily to tropical health. It has extensive links with UN organizations, health ministries, universities, non-governmental organizations and research institutions worldwide and is involved in numerous programmes to control diseases of poverty and to develop more effective systems for health care. The School prides itself on its links with developing countries and is committed to increasing such partnerships.

Sounds right up my alley. Back in medical school, believe it or not, I was one of the most gifted students at looking for ova & parasites in stool samples under the microscope! Ro can vouch.

Forkless

I was in Busia town earlier today, about 3 km away from home, when my bike fell over and hit the ground. The rusty old fork split right in half. I started walking home, carrying my bike, when a fundi (skilled worker) appeared out of nowhere. He pulled a new fork out of his tool box, and proceeded to replace my fork, adjust my spokes, and tune my breaks. I felt like a bicycle racer with my own team of professional mechanics. After a half-hour overhaul of my bicycle, he gave me the bill: 250 shillings (4 USD) for the new fork, and 40 shillings (65 cents) for the labor. This seemed absurdly underpriced, given that he provided the exact service I needed at my desperate moment of need (5pm on a Sunday afternoon, no less!). When did I become so lucky? Has an albino crossed my path?

Albino Body Parts

I just read a grisly article in the New York Times online about a wave of Albino murders in Tanzania. Apparently, witch doctors have been spreading the word that Albinos are good luck. A market for Albino body parts has grown in the area around Dar Es Salaam. The article reports 19 albinos have been killed in recent weeks. Why are Albinos suddenly good luck? The article also mentions that albino-killing is spreading to Kenya. I will be especially careful, as mzungu could easily be mistaken for albino, I would think.

Tourists Without Borders

I visited the Maasai Mara game park in Southwestern Kenya with Rebecca last weekend. Maasai Mara is famous for the diversity of wildlife in the park, as well as the yearly wildebeest migration, where 1.6 million beasts trudge back and forth from Serengeti to Maasai Mara and back again. The wildebeests come to the Mara in July and August, so we missed the spectacle. However, we saw some unforgettable sights. This bunch of zebra crossed the Mara river right in front of a hungry croc. There was also a lioness waiting on the far shore! Also, two cheetahs jumped onto our safari-mobile. This pic isn't even zoom! She was that close....