Coastal Maine Global Health Fellowship

This patient presented from Burma after not being able to move the right side of her body OR speak for one week . She'd been hospitalized in Burma for 5 days, recieving who knows what for treatment, when they decided to refer her to our tiny little satellite clinic on the Burmese border today. From there, Dr. Mark sent her to KRCH for a head CT, which revealed the obvious hemorrhage in the above image. It's amazing she is even alive. Unfortunately her family is very poor, but they have agreed to transfer her to a higher level of care for neurosurgical evaluation and treatment.  She was overall stable while here with intermittent bradycardia and borderline hypertension (likely Cushing reflex). We emergently stabilized her starting her on mannitol and transferred her to Sangkhla Buri hospital.  This is an amazing example of how lucky we are in the United States to have access to medical care in emergency situations. Yes, it's true that we have a convoluted and ex

Thailand has the cutest kids. It's a fact. They're cute, even with their snotty noses and coughs that don't need cough medicine. This is one of the many benefits of working in Thailand- the kids are just too darn cute. Most of the girls show up in Disney princess outfits, and the boys show up in superman capes. I can't talk to them all that much, besides making goofy faces at them and trying to make them laugh, but usually that's all they can do anyway, so we get along well.  Most of the pediatric illnesses that I've seen here in Thailand have been viral gastroenteritis and upper respiratory infections, which is not much different than at home. The majority of these cases have been benign illnesss, but I've seen a handful of sick kids. My time here has definitely given me the opportunity to improve my sick vs not sick radar, which is an indespensible skill when it comes to our littlest patients. I am thankful to all the children and their families f

Case: A 23 year old male presented on February 16 with two months of dyspnea. On arrival is oxygen saturation was 77% on room air. Josh and I were called to the bedside for evaluation. On further questioning he admits to two months of this progressively worsening difficulty breathing and also 2-3 loose stools daily. He's had significant weight loss as well, approximately 5kg over the last couple of weeks. He has had a poor appetite. He denies any drug or alcohol use. He is not a smoker. He has no lung problems. On exam the patient is very thin and in obvious respiratory distress with 2-3 word dyspnea. His oxygen saturation improved with oxygen via nasal cannula and he was around 96% on 3 liters via nasal cannula. His lungs were remarkably clear, with slightly decreased lung sounds in the left lower lung. He had no lymphadenopathy, no jaundice, no oral or skin lesions, and no abdominal distension or tenderness. He had no lower extremity swelling. He was febrile to 39 degrees c