Bonnie Wong's Experience

Perspectives of an NYU Neurology Resident

 

It was the quietness of our wards that struck me the most.; Each held at least 10 hospital beds with patients, with usually more in the corridor between beds. Because bedside care was provided by family, they stayed during the day and night on colorful woven mats on the floor, with food and belongings tucked into bags and baskets nearby.There was a toddler who wandered in an out, her soft giggles audible. Sometimes, entire families stayed during the day and yet you could hear your thoughts. We leaned in close to hear rounds, review scans, and make plans at just above a whisper.

In order to modernize the central national hospital facilities, hospital services were divided and relocated 4 smaller community hospitals with surgical services and radiology remaining on the main campus. Patients were transported from the ED in Mulago to the neurology wards 40 minutes away at Kirrudu. Hospital CT scans were also a 40 minute ambulance ride away. The transition meant that we were actually practicing neurology as if there were only one CT scanner. In Kirrudu, I saw neuropathology of every kind, in all stages of development - neurotuberculosis, neurocystercercosis, PML, myasthenia, a multitude of large hemorrhagic strokes from uncontrolled hypertension, epilepsy.Above all, the neurologic exam and history drove decision making.

The experience offered a multitude of lessons in neurology, but also in improvisation, in making do with less rather than more. It has profoundly influenced my perspective on neurology, global health, health systems, and on my present and future role as a physician within these systems. I am incredibly thankful for the opportunity.

Bonnie Wong, MD - Neurology Resident PGY-3