Differences

Everyone is different. That's a pretty exciting thing about life; some differences are pretty big and some are tiny and virtually inconsequential. There are a few differences that I thought I'd mention today, for no particular reason, other than they happen to be rumbling round my head.

I had a long conversation with a patient today about his treatment for diabetes. He was rather frustrated, and was requesting that I refer him to a more advanced hospital in a neighbouring country because, after a whole month of medication, we hadn't cured him. I don't know how things were explained to him a month ago when he was diagnosed, but somewhere along the line, the concept of a chronic disease has been lost. Back in the UK, most of the patients I see have at least one ongoing disease, which is highly unlikely to ever be cured; I spend a significant amount of time dealing with complications of treatment for chronic conditions. Here, things are different; far fewer people are diagnosed with chronic diseases (I'm not sure why, maybe because they have a better lifestyle, maybe because the life expectancy is less due to acute illness - it's probably too complex a question for me to answer) and several times over the last month or so, I've had patients who are very suprised that their diabetes or epilepsy hasn't been cured after the first month of medication. Like many problems in healthcare, good communication can go a long way; explaining that even if I referred my patient to the best hospital in the world, he still wouldn't have his diabetes cured and that all we can do is control it the best we can with daily medication and try and avoid the complications. I'm sure as things continue to change in South Sudan that this and many other differences may be addressed by doctors and patients alike.

That example was of a difference, which is more towards the negative end of the spectrum. Lots of differences are much more positive, and lots are just different. Everywhere you look at lunchtime, people are eating together and chatting - often if I'm out running in the evening, the pavement is blocked by groups of men sitting round and drinking tea. There seems to be, in some respects, more of a community than there is back home.

Some differences are completely trivial, but for some reason happen to stick with you. Almost without fail, whenever I ask a patient to lie on the examination bed in clinic they put their hands behind their head - I'm sure people don't naturally do this in the UK. It doesn't matter at all, I just find it odd that everyone does it. I imagine they find it odd that I drink my tea black and without sugar (powdered milk makes it taste of cheese) when the average is about 4 sugars in each cup.

All in all, differences are what make going new places and meeting new people so interesting - it lets you see that there isn't just one way to think about something or do something. We all have a lot to learn from our differences. Who knows, maybe I'll start expecting diabetes to be cured, I know for sure I won't have sugar in my tea though...