So I began my rotation down in the ED mid-last-week. Chatting with the physician one afternoon, I mentioned my interest in tropical medicine and infectious diseases. "Is there anything you're hoping to see while you're here?" he asked.
"Well, I've been here three weeks and I still haven't seen a case of Dengue yet."
The doctor laughed for what felt like 47 minutes, nearly fell out of his chair. Catching his breath, he glanced out the window at the non-stop drizzle (so apparently it rains a fair amount in the rainforest), glanced at his watch and said: "wait 40 seconds."
Sure enough in the next five days I would see literally over 200+ cases of Dengue. Luckily, few are hemorrhagic, and even those are much less dramatic than the textbooks and Discovery Health specials had led me to believe.
It's absolutely endless. I can spot them from a mile off now. The shuffle, the index finger and thumb squeezing the bridge of the nose, eyes covered with a towel or bandana. We do a brief workup: check the urine for blood, check hematocrit, listen the lungs, and take a blood smear for malaria. But most leave with just a painkiller and reassurance.
Many of the patients refuse a workup, simply marching into the triage area and announcing "I have Dengue again." We thank them for letting us know, tell them to take some tylenol, and off they go.
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