My internship year began after successful applications and placements.I got well equipped with the requirements before beginning my internship at the coast referral hospital that was not that far from my childhood home.Leaving home at dawn,then returning back as late as eight p.m became a norm ,with time.. Responsibilities of the Intern:
Patient Care:
Interns are expected to take histories, perform physical examinations, assist in diagnosis, and initiate treatment under supervision. They are directly involved in patient care but have limited autonomy.
Documentation:
Accurate documentation of medical records, patient notes, and prescriptions is critical. Interns must keep detailed records for every patient they manage.
Performing Procedures:
Interns are often given the opportunity to assist with or perform minor medical procedures, such as suturing wounds, venipuncture (inserting IV lines), and other basic clinical tasks under supervision.
Attendance:
Interns are required to attend daily rounds, departmental meetings, and other training sessions to deepen their understanding of different medical disciplines.
Assessment and Evaluation
Daily/Weekly Assessments:
Interns are regularly assessed by their supervising consultants or medical officers. These evaluations may involve observing their clinical decision-making, communication skills, technical skills, and ability to work in teams.
Logbook:
Interns must maintain a logbook where they document all their rotations, procedures, and experiences. The logbook serves as a record of their hands-on learning and is used for certification at the end of the internship.
Final Evaluation:
At the end of the internship, a final evaluation is carried out by the supervising consultants or medical officers, assessing the intern's competency and readiness to practice medicine independently.
. Professional Development
Medical Ethics and Professionalism:
Interns are trained to uphold high standards of medical ethics, including confidentiality, respect for patients, and professional conduct. They are also exposed to medical law, ethics in practice, and the responsibilities of healthcare professionals.
Continued Education:
Interns are encouraged to attend continuing medical education (CME) seminars, workshops, and other professional development activities to stay updated with the latest medical advancements.
Challenges Faced by Interns
Long Working Hours:
Medical internships are known for their demanding schedules. Interns may work long hours, including night shifts, weekends, and public holidays.
Emotional and Physical Stress:
Interns often deal with emotionally and physically draining situations, such as managing critically ill patients or handling trauma cases. The work can be stressful, especially in resource-limited settings.
Workload:
In many hospitals, the patient-to-doctor ratio is high, and interns may be responsible for a significant number of patients, which can be overwhelming at times.
Post-Internship Certification
Upon successful completion of the internship, the intern receives a certificate of completion from the Kenya Medical Practitioners and Dentists Council (KMPDC).
This certificate allows the graduate to register as a fully licensed medical practitioner and practice medicine independently in Kenya.
The first three months was characterized with general medicine practice and supervisions.I was able to diagnose, do prognosis,and recommend medications for Diabetes, hypertension and other tropical maladies.
The following three months I was then able to go through surgical rotations (performing minor,pre and post operative surgical cares) as well as managing surgical conditions.I was able to handle orthopedics,ear,nose and throat surgeries.
For the subsequent three months,I was taken through Obstetrics and Gynecology.We were then able to deal with pregnant women.(Birth processes) as well as manage child-birth related infections and diseases.
The last three months was characterized with dealing with paediatrics (infections and maladies affecting kids and teens).We were able to handle and manage communicable and non-communicable diseases,as well as provide vaccinations in proper measures.
As a Kenyan intern doctor, a wide range of medical cases will be encountered during the one-year internship. The nature of these cases is influenced by various factors, including the setting (rural or urban), the resources available in the healthcare facility, and the patient demographics. Kenya's healthcare system, especially in public hospitals, often deals with a combination of common conditions, infectious diseases, trauma, and chronic illnesses. Below are some medical cases an intern doctor in Kenya is likely to encounter during their internship:
1. Infectious Diseases
Malaria:
Malaria is still a leading cause of morbidity and mortality in Kenya, especially in rural and malaria-endemic areas. Interns will commonly diagnose and treat malaria, which presents with fever, chills, and other flu-like symptoms.
Tuberculosis (TB):
TB is another prevalent infectious disease in Kenya. Interns are likely to encounter both pulmonary TB and extra-pulmonary TB cases, often in patients presenting with chronic cough, night sweats, weight loss, and fatigue.
HIV/AIDS:
Given the high HIV prevalence in Kenya, interns will work with patients managing HIV, including those with opportunistic infections (e.g., Pneumocystis jirovecii pneumonia) and those receiving antiretroviral therapy (ART). Managing HIV-related complications, such as TB co-infection, is also common.
Typhoid Fever:
This is endemic in many parts of Kenya, especially in areas with poor sanitation. Patients typically present with fever, abdominal pain, and diarrhea.
Dengue Fever:
In some regions, especially coastal areas, dengue fever is common, with symptoms including high fever, rash, and joint pain.
Leprosy:
Though less common, leprosy still exists in Kenya, and interns may encounter patients with skin lesions, nerve damage, and deformities.
2. Tropical Diseases and Parasitic Infections
Schistosomiasis:
Common in areas with stagnant water, this parasitic infection presents with symptoms like abdominal pain, diarrhea, and in severe cases, liver damage.
Onchocerciasis (River Blindness):
This is caused by a parasitic worm and can lead to blindness. It is endemic in some parts of Kenya, especially in the Rift Valley and Western Kenya.
Hookworm Infection:
Interns may encounter patients with hookworm, especially in rural settings. Symptoms include anemia, abdominal pain, and fatigue.
3. Non-Communicable Diseases (NCDs)
Hypertension:
High blood pressure is a common chronic condition in Kenya. Interns will manage hypertensive patients, including those with complications like stroke, renal failure, and heart disease.
Diabetes Mellitus:
Type 2 diabetes is increasingly common in Kenya, especially among older adults. Interns will manage diabetic patients and their complications, such as diabetic ketoacidosis (DKA) and diabetic foot ulcers.
Chronic Kidney Disease (CKD):
CKD, often associated with uncontrolled hypertension and diabetes, is a major concern in Kenyan hospitals. Interns will help manage patients with kidney disease and may assist in the initiation of dialysis.
Asthma and Chronic Obstructive Pulmonary Disease (COPD):
Both asthma and COPD are common in Kenyan hospitals, with symptoms like wheezing, cough, and shortness of breath. Interns will treat acute exacerbations and manage ongoing treatment plans.
4. Obstetrics and Gynaecology
Pregnancy-Related Complications:
Interns in Kenya will likely encounter complications related to pregnancy, including pre-eclampsia, eclampsia, gestational diabetes, and placental abruption. Management often takes place in labor wards, where interns will be involved in the delivery process.
Labor and Delivery:
Assisting in vaginal deliveries and caesarean sections will be a key part of the internship. Interns will learn how to manage normal labor, as well as obstetric emergencies like obstructed labor, shoulder dystocia, and postpartum hemorrhage.
Sexually Transmitted Infections (STIs):
Interns will frequently diagnose and treat STIs like gonorrhea, syphilis, chlamydia, and trichomoniasis, which are prevalent in Kenya and have significant implications for reproductive health.
Cervical and Breast Cancer:
With rising awareness about cancer, interns may encounter patients presenting with symptoms like abnormal vaginal bleeding or breast lumps, requiring management and referral for further evaluation.
5. Paediatrics
Pneumonia and Respiratory Infections:
Pneumonia is a leading cause of mortality in children under 5 years old. Interns will encounter a high number of pediatric patients with respiratory distress and will manage pneumonia, asthma, and bronchiolitis.
Malnutrition:
Malnutrition, especially protein-energy malnutrition, remains a significant concern in Kenya, particularly in rural areas. Interns will treat children with severe malnutrition and complications like kwashiorkor and marasmus.
Diarrheal Diseases:
Diarrheal diseases are common in children, often due to poor sanitation. Interns will manage cases of acute gastroenteritis, often due to rotavirus or bacterial infections like E. coli and Salmonella.
Vaccination-Preventable Diseases:
Interns will manage children with diseases like measles, polio, and whooping cough, especially in areas with low vaccination rates.
Neonatal Conditions:
Interns may be involved in managing neonatal sepsis, birth asphyxia, and premature births. Management may include resuscitation, infection control, and supporting feeding in premature babies.
6. Surgical Cases
Trauma and Road Traffic Accidents (RTAs):
Trauma from road traffic accidents is a major issue in Kenya. Interns will be exposed to trauma cases, including fractures, head injuries, and abdominal trauma. They will assist in emergency management and surgical procedures.
Burns:
Burn injuries, often from domestic accidents or fires, are common, and interns will be involved in managing burn wounds, fluid resuscitation, and wound care.
Appendicitis:
Acute appendicitis is a frequent emergency requiring surgical intervention. Interns will learn to assist in appendectomy procedures and postoperative care.
Hernias:
Inguinal hernias and umbilical hernias are common surgical cases, especially in infants and older adults.
Obstetric Fistula:
Obstetric fistula remains a challenge in Kenya, especially among women who experience prolonged or obstructed labor without access to timely obstetric care. Interns will learn to recognize and assist in the treatment of these cases.
7. Trauma and Emergency Cases
Road Traffic Accidents (RTAs):
Kenya has a high incidence of road traffic accidents, and interns will encounter traumatic injuries, ranging from fractures to head injuries, internal bleeding, and spinal injuries. They will be involved in emergency management, stabilization, and referral.
Burns:
Interns may deal with significant burn cases, especially in areas where open flames, cooking accidents, and fires are common.
Acute Poisoning:
Cases of poisoning from household chemicals or pesticides can occur, especially in rural areas. Interns will manage the emergency care of poisoned patients.
8. Mental Health
Mental Health Disorders:
Mental health issues, including depression, anxiety, and schizophrenia, are common, and interns will likely encounter patients in the hospital with psychiatric concerns. Interns will be involved in both diagnosis and management, and they may work with psychiatry teams in the hospital.
Generally,my life year as an intern doctor,was no different from others.Transitioning from one place to the other,having little breaks and so forth.
The life of a Kenyan intern doctor for a year is a combination of intense work, learning, and personal growth, with moments of both professional fulfillment and challenge. After completing their medical degree (MBChB), interns embark on their mandatory one-year internship, where they get hands-on experience in various medical departments while being mentored by senior doctors. Here's a detailed description of a typical year in the life of a Kenyan intern doctor:
1. Transition from Student to Professional
Increased Responsibility:
After graduation, the intern doctor officially begins their medical practice, but with much less autonomy than a fully qualified doctor. They are expected to take on more responsibility than they did as students, but still under the supervision of senior medical officers and consultants.
Feeling of Responsibility:
The internship year is often a significant emotional shift. Interns feel the weight of their responsibility for patient care, though they know that they are supported by experienced doctors. The realization that they are making life-or-death decisions can be daunting at times.
2. Work Environment and Schedule
Long Hours and Shift Work:
Interns in Kenya typically work long hours, often extending to night shifts, weekends, and public holidays. A typical shift could range from 8-12 hours, and in some hospitals, interns may be on call for emergency cases.
A typical day starts early, with ward rounds often beginning at around 7:00 or 8:00 AM, where they present cases to the consultants and other senior doctors.
Interns are expected to assist with procedures, take patient histories, perform examinations, and assist in formulating treatment plans. They also spend a considerable amount of time documenting patient details and attending departmental meetings.
Rotations Across Specialties:
The internship year is structured into rotations, so interns experience different departments. The first few months may feel overwhelming as they switch between specialties like surgery, medicine, obstetrics and gynecology, paediatrics, and more. Each department brings new challenges and demands different skills, making each rotation unique and challenging.
3. Clinical Work and Patient Care
Hands-on Practice:
Interns are tasked with performing certain clinical tasks such as taking blood samples, doing physical exams, and assisting with minor surgeries. They also gain experience with medical procedures like suturing, inserting IV lines, and administering injections under supervision.
The level of involvement increases gradually, and in some cases, interns may get the chance to perform certain procedures independently once they are deemed competent.
Supervision:
Interns work under the guidance of senior medical officers and consultants. While they do a lot of the patient care and management themselves, they are regularly supervised, especially in the beginning. Consultants and senior doctors often guide them through complex cases, ensuring that decisions are sound.
Challenging Cases:
The internship year is marked by exposure to difficult cases, which could include trauma, complicated medical conditions, and emotional situations. The intern doctor is involved in managing patients in critical conditions, and the pressure to perform well can be high. Many Kenyan hospitals, especially in rural or underserved areas, are often overwhelmed with patients, and interns may have to manage high volumes of cases.
4. Emotional and Mental Strain
Stressful Situations:
The internship year can be emotionally and mentally taxing. Interns frequently face life-and-death situations, deal with traumatic injuries, and manage critical conditions. The workload can be heavy, and interns often feel responsible for the well-being of their patients, which can lead to stress.
The long working hours, combined with the emotional demands of the job, can lead to burnout, especially when dealing with patients in pain, suffering, or dying.
Coping with Emotional Strain:
Interns may experience feelings of self-doubt and anxiety, especially when dealing with the pressure of making important decisions. Sometimes, the emotional toll is compounded by the shortage of resources in public hospitals, where the intern is often forced to work with limited equipment and medications.
Support System:
Interns often rely on each other for emotional support. Fellow interns form a close-knit community where they share experiences, help each other through tough situations, and offer advice or comfort. Mentorship from senior doctors also plays a critical role in helping them manage emotional challenges.
5. Learning and Professional Development
Continuous Learning:
The internship year is essentially an extension of learning. Interns attend rounds, seminars, and conferences where they continue to deepen their knowledge and sharpen their skills. They are encouraged to engage in continuous medical education (CME) and may attend various in-hospital training programs.
In each department, interns are given practical exposure and are constantly learning from their mistakes and successes. Over the year, their diagnostic and treatment skills become more refined.
Feedback and Evaluation:
Interns receive regular feedback from senior doctors, which can range from formal evaluations to informal comments. They also keep logbooks where they document their cases and procedures. At the end of the internship, they are formally assessed to determine whether they are competent and ready to practice medicine independently.
6. Interpersonal Relationships and Challenges
Teamwork and Collaboration:
Interns work alongside nurses, pharmacists, laboratory technicians, and other healthcare professionals in multidisciplinary teams. Strong communication and teamwork skills are crucial for smooth operation in the hospital.
However, navigating workplace dynamics can be challenging, especially when interacting with senior doctors or consultants who may have different communication styles. Interns often learn how to balance assertiveness with humility and respect for authority.
Workplace Hierarchies:
Interns are at the bottom of the medical hierarchy and are expected to demonstrate humility, willingness to learn, and dedication. In some cases, interns may face challenges in gaining the respect of senior colleagues, but this often improves as they prove their competence and reliability.
7. Personal Life and Well-Being
Work-Life Balance:
Due to the demanding nature of the internship, it can be hard for interns to maintain a healthy work-life balance. Long shifts and being on call mean that free time is limited, and interns often sacrifice social activities and personal time.
However, some interns make time for short breaks or family visits during rare off days, though they remain conscious of the physical and mental exhaustion they may feel.
Financial Strain:
Interns in Kenya typically earn a stipend which is modest compared to the amount of work they put in. For many, this is their first salary as doctors, and while it provides some financial independence, it may not be sufficient to cover all their personal expenses, especially in urban centers where the cost of living can be high.
8. Transition to Full Practicing Doctor
End of Internship and Certification:
After successfully completing the internship year, an intern is required to pass final evaluations before being awarded a certificate of completion. This certificate is crucial for registration with the Kenya Medical Practitioners and Dentists Council (KMPDC) and enables them to become a fully registered and licensed medical practitioner.
This marks the end of the internship, and many interns are eager to begin their independent careers in the medical field, whether in private practice, public hospitals, or other health sectors.
The following year,after adding internship certificate to my file of certifications,I sought other certificates like good conduct,in order to begin my job hunting mission.I threw out applications to all advertising hospitals;from newspapers,to web adverts,I was keen.However,three months passed on and I didn't receive any replies.Checking my e-mail,chatbox,social medias;but no single reply came.This created anxiety at home.
My caring parents held me accountable,but then I had to be honest with them.My mum at one time mentioned,"Still no replies from all those hospital companies?" "Not yet mum,I'm still hopeful!" "Lad,we did our part to educate and care for you!Now,you must try your level best to take care of us as well as yourself!" "I understand mum!I will try as hard as possible.But then these rejections prove to be an obstruction!"
Tithings, flooding alter of God with tears,questioning God why my prayers were unheard then became a norm! However,at almost the end of the fourth month,there was a glimmer of hope!My mum,got connected to a family friend who worked at a private hospital as a receptionist.She then gave me an e-mail address where I was to apply for the job.The family friend often gave reassurancing hopes that I would be called for an interview in the long run.
80400 Stuff,
Mombasa,
Kenya.
18 May
The Director,
St.Pete Hospital,
Free area,
Mombasa.
Dear Sir,
I was interested to read your website that you require a medical doctor.
I am twenty five years old and have underwent successful KMPDU internship programs, necessary for employment.I specialized in ears,nose and throat surgeries operations.
I wish to apply for the mid-level doctor position at your private hospital.I'm free to attend interviews any day.
My Principal,vice chancellor and old headmaster have agreed to send information about me if you require it.
Yours faithfully,
Pete.
Two weeks went by, before being called for interviews at St.Pete Hospital which was religiously affiliated.After arrivals,I sat near the receptionist,in which my family friend turned out to be.She welcomed me around and then went ahead to book an appointment with the hospital's managing director.After a long while,I got invited to M.D's office.
MD:Welcome! Pete , have a seat
P: Thank you sir!
MD: Okay!Let me give you a brief introductions to this place.St.Pete is a religious -affliated private hospital.We treat,God heals is the motto.It's quite huge,having been structured: a categorized list of possible items and objects you'd find:
Medical Equipment & Supplies
Diagnostic Equipment: MRI machine, CT scanner, X-ray machine, ultrasound machine, ECG machine
Patient Monitoring Devices: Blood pressure monitors, pulse oximeters, heart rate monitors, bedside monitors
Treatment Equipment: Defibrillators, ventilators, infusion pumps, dialysis machines, anesthesia machines
Surgical Instruments: Scalpels, forceps, retractors, electrocautery machines, surgical lights
Emergency & ICU Equipment: Crash carts, oxygen tanks, suction machines, respirators
Pharmaceutical & Laboratory Items
Medications: Antibiotics, painkillers, IV fluids, vaccines, anesthetics
Laboratory Equipment: Microscopes, centrifuges, blood analyzers, urine test kits
Sterilization Equipment: Autoclaves, disinfectants, sterilization pouches
Furniture & Patient Comfort
Hospital Beds & Accessories: Adjustable hospital beds, stretchers, wheelchairs, bedside tables
Waiting Area & Rooms: Sofas, chairs, coffee tables, magazines, vending machines
Sanitation Items: Hand sanitizers, gloves, disposable masks, bedpans
Administrative & Operational Items
Computers & IT Systems: Electronic Health Record (EHR) systems, billing software, appointment scheduling software
Communication Devices: Intercoms, pagers, walkie-talkies, landline phones
Security & Safety: Fire extinguishers, emergency exit signs, surveillance cameras
Specialized Departments
Maternity Ward: Incubators, fetal monitors, birthing beds
Pediatrics: Child-sized medical beds, toys, nebulizers
Radiology: Lead aprons, contrast dyes, film viewers
Physical Therapy: Treadmills, resistance bands, therapy balls
Hierarchy of Doctors and Medical Staff in a Private Hospital
A private hospital employs various doctors and healthcare staff at different levels based on experience, specialization, and roles. Below is a structured hierarchy from senior-most to junior staff, including non-medical professionals.
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1. Senior Management & Administration
These are the highest-ranking officials overseeing hospital operations.
Medical Director – The top medical officer responsible for overall clinical governance.
Chief Executive Officer (CEO) – Manages hospital administration and business operations.
Chief Medical Officer (CMO) – Oversees medical staff and policy-making.
Hospital Administrator – Handles finances, HR, and facility management.
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2. Senior Medical Doctors & Specialists
These doctors have years of experience and handle complex cases.
Consultants (Specialists) – Highly experienced doctors specializing in specific fields, e.g.:
Cardiologist – Heart diseases
Neurosurgeon – Brain and spine surgery
Obstetrician & Gynecologist (OB/GYN) – Pregnancy & reproductive health
Pediatrician – Child health
Oncologist – Cancer treatment
Orthopedic Surgeon – Bone & joint issues
General Surgeon – Performs major surgeries
Senior Resident (Registrar) – A specialist-in-training who assists consultants in surgeries and critical cases.
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3. Mid-Level Doctors & Specialists in Training
These doctors have finished medical school and are either in residency or working as general practitioners.
Medical Officer (MO) – A licensed doctor (MBChB/MD) handling general cases, emergency care, and ward rounds.
Resident Doctor (Junior Registrar) – A doctor undergoing specialty training (e.g., surgery, internal medicine).
General Practitioner (GP) – Provides outpatient care and treats common illnesses.
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4. Junior Doctors & Trainees
These doctors are still gaining clinical experience.
Intern Doctor (House Officer) – A fresh medical graduate working under supervision.
Medical Student (Interns & Attachments) – Final-year students observing and assisting under supervision.
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5. Nursing Staff & Midwives
Nurses provide patient care, administer medications, and assist in surgeries.
Chief Nursing Officer (CNO) – Senior-most nurse overseeing all nursing staff.
Nurse Manager/Matron – Supervises nurses in different departments (ICU, maternity, wards).
Registered Nurse (RN) – Provides direct patient care in wards and ICU.
Enrolled Nurse (EN) – Assists registered nurses in basic patient care.
Midwife – Specializes in pregnancy and childbirth care.
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6. Specialized Allied Healthcare Staff
These professionals support doctors and nurses in diagnostics and therapy.
Pharmacist – Dispenses and manages medications.
Laboratory Technician – Conducts blood tests and diagnostics.
Radiologist & Radiology Technicians – Conduct and interpret X-rays, CT scans, MRIs.
Physiotherapist – Helps patients recover mobility post-surgery or injury.
Occupational Therapist – Assists in rehabilitation for disabled patients.
Dietitian/Nutritionist – Provides dietary plans for patients.
Psychologist/Psychiatrist – Handles mental health cases.
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7. Support & Emergency Medical Staff
These professionals ensure smooth hospital operations and patient support.
Emergency Medical Technician (EMT) – Works in ambulances, providing first aid.
Paramedic – A higher-level EMT handling advanced pre-hospital care.
Theater Technician – Assists in surgical operations.
Medical Records Officer – Manages patient files and hospital data.
Hospital Cleaners & Orderlies – Maintain hygiene and transport patients within the hospital.
We have ample parking spaces for our ambulances inside our bottom subsequent floors.We also provide scholarships opportunity for mid-level doctors who in the long run,do a nice job according to their performances contracts over a long period of time.These scholarships are specializations opportunities in different fields of surgery.We maintain a KEBS protocols implemented by their annual inspections around the facility then grading us later on.We usually have boardroom meetings after every quarter of the year;auditing our performances against the company's targets.Okay,now let's begin the interviews:
MD :1. General Background and Experience
:Tell us about your medical background and training.
P:I schooled at kemu,underwent successful attachments and internships using their hospital premises.Afterwards,I went for a one year internship program at Coast referral hospital under close supervisions.I got positive feedbacks,henceforth an internship certificate.During internship,I was taken through general medicine for the first three months where I was able to treat common illness like diabetes and hypertensions.The next three months I was able to specialize in ear,nose and throat pre and post operative cares.The subsequent three months I was thereafter taken through Obstetrics and gynecology where we were supervised in handling pregnant moms.The final three months,I thereafter got led to paediatrics where we handled childhood vaccinations,communicable and non-communicable diseases affecting kids and teens.
MD:Why did you choose to pursue medicine, and specifically this specialty?
P: I chose to pursue medicine because I encountered medical challenges as I grew up.From head concussions, orthopedic surgeries to weakened immune system against cholera,malaria.Those close to me also died of cancer.Such factors inspired me to pursue medicine so that I may positively impact the society.I chose ear,nose and throat speciality because I just love surgical procedures; undergoing through them left me thrilled with this sense of hope,that one day,I may save a life in such critical conditions.
MD:Can you describe your experience in handling a wide range of medical cases?
P:Case 1: Severe Malnutrition (Kwashiorkor/Marasmus)
Scenario:
A 2-year-old boy from a low-income rural area is brought to the clinic with severe weight loss, swollen feet, and irritability. The mother says he has been refusing food and has frequent diarrhea.
Examination & Diagnosis:
Kwashiorkor: Generalized edema (swollen feet, hands, face), thin limbs, distended abdomen, skin changes (peeling, dark patches).
Marasmus: Severe muscle wasting, sunken eyes, prominent ribs, no edema.
Mid-upper arm circumference (MUAC) < 11.5 cm (Severe Acute Malnutrition - SAM).
Management:
Admit to nutritional rehabilitation center (if available).
Rehydration with ReSoMal (not regular ORS to avoid sodium overload).
Slow refeeding (F-75 formula for stabilization, then F-100 for weight gain).
Treat underlying infections (IV antibiotics if needed).
Nutritional education for the caregiver.
Challenges:
Late presentation due to lack of awareness.
Food insecurity makes long-term recovery difficult.
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Case 2: Pneumonia in a Toddler
Scenario:
A 9-month-old baby is brought to the clinic with cough, fever, fast breathing, and chest in-drawing. The baby is not breastfeeding well and has had symptoms for 3 days.
Examination & Diagnosis:
Respiratory rate: 55 breaths/min (high for age).
Chest in-drawing and nasal flaring (signs of severe pneumonia).
Crackles heard on lung auscultation.
Oxygen saturation: 90% (mild hypoxia).
Management:
If mild pneumonia: Oral Amoxicillin at home.
If severe pneumonia: Admit and give IV Ampicillin + Gentamicin.
Oxygen therapy if SpO₂ < 92%.
Fluids and feeding support if the child is unable to drink.
Challenges:
Antibiotic resistance is increasing.
Parents delay coming to the hospital, mistaking symptoms for a cold.
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Case 3: Neonatal Jaundice (Severe Hyperbilirubinemia)
Scenario:
A 3-day-old baby is brought in because the mother noticed yellow skin and eyes. The baby is sleepy, not feeding well, and has mild fever.
Examination & Diagnosis:
Kramer's rule: Yellow discoloration up to the abdomen (moderate jaundice).
Total bilirubin: 18 mg/dL (high, risk of kernicterus).
Causes: Likely ABO incompatibility or G6PD deficiency.
Management:
Phototherapy for bilirubin breakdown.
Exchange transfusion if bilirubin > 25 mg/dL or signs of kernicterus.
Frequent feeding to enhance bilirubin excretion.
Treat any underlying infection (e.g., neonatal sepsis).
Challenges:
Many rural hospitals lack phototherapy units.
Parents may stop treatment early due to cultural belief
MD:Have you worked in a private healthcare setting before? If so, how did that experience differ from working in a public hospital?
P:No I haven't.
MD:What would you say is your greatest strength as a medical professional?
P: Handling and management of surgical conditions.I haven't yet experienced any medical errors in such field.(Ear,nose and throat).
MD:Can you walk us through a particularly challenging case you've managed and how you handled it?
P:Medical errors.Failure to Remove a Surgical Instrument Post-Operation(Obstetrics and gynecology field)
Case:
After a C-section, a surgical sponge was mistakenly left inside the patient's abdomen.
Error:
The surgical count was not verified before closing the incision.
Surgeons did not perform a final instrument check.
Outcome:
The patient develops severe infection and pain weeks later.
Requires another surgery to remove the sponge.
Prevention:
✅ Use counting protocols before closing surgical sites.
✅ Consider X-rays post-surgery in high-risk cases.
✅ Implement radio-frequency tagged surgical instruments..
MD:2. Patient Care and Communication
:How do you ensure effective communication with patients, especially those who may be anxious or in pain?
P:From my medical ethics lessons background,we ensure that they calm down,first ,then we try convince them when the mood is right that we as doctors are committed to do our level best to handle the situations.We however ,keep them out of the operating room,requesting them to wait outside so that the doctors have a tranquile focused moments in their line of duty.At some point,they may be required to sign a contract in life-threatening surgical procedures.Communicating with them,requires a co-ordinated efforts of various staff in a hospital in the long run.
MD:Describe a time when you had to deliver bad news to a patient or their family. How did you handle it?
P: I just approached the family at the waiting bay.I then tried to calm their anxieties.After such struggles,I then offered the bad news.However,I stipulated alternative ways of how the situation could be managed maybe against the medical errors.
MD:How do you manage patient expectations, particularly when treatment outcomes may be uncertain?
P:One of the ways that I had just mentioned was contract-signing.After we have assessed the probability of the outcomes,we elucidate it to the patients ,and his contingents.They then proceed to sign as witnesses and patient.Other ways is educating on the importances of medical insurances which covers uncertain situations.
MD:What strategies do you use to build trust and rapport with your patients?
P:Chart education.Our teams of other staff,present educative materials like booklets, pamphlets,bronchures about various maladies,and their management.Prospectus about the hospital also elucidates the services offered in the hospital.The various charts ,schedules around the hospital also guides them further.A receptionist is all together in charge of managing further inquiries from the patients. Follow ups through phone communications also ensures effective management,as well as trust building.
MD:In your opinion, what is the role of a doctor in patient education, and how do you incorporate it into your practice?
P:Making the patient aware of procedures in treating or managing his conditions in different scenarios prepares him, mentally.In such diagnostic dialogues,we try to convince them to give honest opinions as much as possible, because it will affect the doctor's decisions.I usually give insurance education, making them aware on the importance of medical covers in the face of uncertainties.
MD:3. Clinical Knowledge and Problem Solving
:Can you give an example of a clinical decision you made that required you to think critically and rapidly?
P:Fish bone stuck inside a throat for a patient at late nights.It made me think critically,and urgently, because of inaccessibility of surgical tools.I had to use other available tools that could be used alternatively,but in the most critical ways.I was glad to successfully operate the patient eventually.
MD:How do you stay updated with the latest medical research and advancements in your field?
P:Viewing various medical blogs at leisure time.Making use of social media to access further knowledge,keeps me updated.
MD:Describe a situation where you had to make a difficult diagnostic decision. What approach did you take to reach your conclusion?
P:A full-term baby is born through thick meconium-stained amniotic fluid. The baby has labored breathing and low oxygen saturation.
Examination & Diagnosis:
Grunting, nasal flaring, chest retractions.
X-ray: Patchy lung opacities, overinflated lungs.**
Blood gas analysis: Acidosis with low oxygen.**
Management:
Suctioning (if done immediately after birth).
Oxygen therapy or mechanical ventilation if severe.
Antibiotics if secondary pneumonia develops.
Challenges:
Severe cases lead to persistent lung problems (chronic lung disease).
Limited NICU resources for ventilator support.
MD:How do you handle situations where you don't have all the information you need to make a decision?
P:Tranquilizers and anaesthetic medications to stop further pains, bleeds are methods that I use beforehand.Being a junior doctor,I would just contact my supervisors(senior doctors) who would then handle such complex situations later on.
MD:What are your thoughts on the role of technology and electronic health records (EHR) in modern medicine?
P: Technologies like Artificial intelligence which have emerged recently have helped practitioners in making wiser decisions,hence reducing medical errors.Big data processes is vital for practitioners.Based on medical history,it becomes easy to diagnose and do prognosis about the trajectory of various medical conditions.
MD:4. Teamwork and Collaboration
:Describe a time when you had to work closely with a multidisciplinary team. How did you ensure effective collaboration?
P:Working with junior doctors was hectic.Everyone trying to showcase their knowledge,but I try to mediate beseeching the various individuals to play their part in order to make a good teamwork in the long run.
MD:How do you handle disagreements with colleagues or other healthcare professionals over a patient's treatment plan?
P:With everyone with their planned ideas at hand,it ends up chaotic,as everyone sees their pathways to be wiser.Concession voting, typically solves most contentious problems according to my proverbial devotions.I just request for brief votings,at extreme level,I involve the patient along with his group.
MD:What's your approach to working with support staff (nurses, pharmacists, medical assistants)?
P:Working with people below my level,seems challenging.I embrace humility and collaborations.It's challenging because a couple of them tend to be insolent,disobeying orders,.But then,I do personal follow -ups, try to calm them down before having critical conversations.
MD:In a private hospital, teamwork can be very important. Can you tell us how you would foster a cooperative working environment in the hospital?
P:Trying as much as possible to listen to them.Their arguments,convictions before I reason with them.Through the guided policy frameworks,I try to memorize and stipulate law codes and articles,in such spirit of cooperations,this in my opinion reminds them much faster in such oblivious dissents that may arise.
MD:5. Adaptability and Stress Management
:Private hospitals often have high expectations for patient care. How do you handle high-pressure situations or long working hours?
P:Taking frequent short breaks recharges my mental strength to handle various situations during the long periods.Taking a fresh breath of air,while listening to deep house relaxing music,while enjoying nature are my therapeutic methods of recharging.I used to study huge medical voluminous books at the library doing the same therapies which proved effective in the long run.
MD:Describe a time when you had to adapt to a change in procedure or protocol. How did you handle it?
P:I just made phone calls to an absentee paramedic in an ambulance emergency situation.We were to pick a critical patient,I was the available doctor who then was in touch with the paramedic.Through step by step guidances from the phone communications,I was able to eventually handle that patient.
MD:How do you prioritize your work when faced with multiple patients with urgent needs?
P:Low doctor to patient ratios at public hospitals was challenging. However,the queues are structured in accordance to urgent needs.If then,urgent patients line up,it becomes a situation of managing time.I try as much as possible to diagnose,treat,refer and manage their urgent needs in an ample time space,that is neither too lengthy nor too short .
MD:What do you think is the most stressful part of being a doctor, and how do you manage that stress?
P: Showing signs of irresponsiveness ,is really stressful.It makes you guess if there might be a medical error.Unprepared medical errors may lead to lawsuits.Resuscitating my patient becomes my primary goal thereafter.As I urgently contact other senior doctors in the long run.That's how I managed such stress.
MD:6. Ethical and Legal Considerations
:Can you describe a situation where you had to navigate an ethical dilemma in your practice? How did you approach it?
P:Sharing of private data.The impatient group of waiters became insolent with such helter-skelters around the waiting bays.They would incessantly bang the operating room,shout outside.I then had to by -pass my medical ethics and code of conduct in order to keep them updated ,hence calming them down in the long run.
MD:How do you ensure patient confidentiality, especially in a private healthcare setting where confidentiality is critical?
P:In a private setting which highly values medical ethics,I would then try to work with various staff in order to keep the waiting group calm and patient.Confidentiality can also be ensured through patient -doctor agreement signing.This will highly build such trusts.
MD:What would you do if you suspected a colleague was providing substandard care or was impaired in their ability to practice medicine?
P:In case of working along with quack doctors and practitioners,this would bring a lot of distrust,hence ruin the company's reputations.I would report them to the authorities as soon as possible,If I spot a suspected colleague.
MD:How do you balance the needs of the patient with the hospital's goals, especially when there are financial considerations involved?
P:In accordance to the policies in the hospital,I would try to elucidate them to the patient in order that they may understand.If the policies favor post-pay services,I would proceed to treat them, otherwise,I would priotize the company over the patient.
MD:7. Knowledge of Private Healthcare Setting
:What do you believe are the key differences between practicing in a private hospital and a public hospital?
P:Balanced patient to doctor ratio occurs in private hospital than in public hospitals.Avalanche of necessary miscallenous medical equipments, technologies and facilities are found frequently in private hospitals than public hospitals.However, majority of customers who happen to be middle- income earners prefer public hospitals more than private hospitals.
MD:In a private setting, patients often have more options for their care. How do you handle situations where a patient seeks alternative or non-traditional treatments?
P:If a patient requires technological form of treatment by choice,I would then arrange his transfer to a technical facility where I would then work hand in hand with the technical team,in managing the situation.
MD:How do you ensure that the care you provide is both evidence-based and aligns with the hospital's values and policies?
P:Making use of the cctv cameras around to hold myself accountable.In case of their unavailability,I would then film my treatment and care management procedures.
MD:Private hospitals sometimes have more flexibility in terms of treatment plans. How would you tailor your care for patients while respecting their personal preferences and the hospital's resources?
P:Handling sensitivities with care at the operating room or choice of facilities,requires a great deal of poignancies. I would lower myself to their demands as long as the expected outcomes comes to pass.
MD:8. Professional Development and Future Goals
:What are your short-term and long-term career goals in medicine?
P:My short term goals are to reduce medical errors,reach a level where I would supervise junior doctors by experiences.My long term goals are to be a specialist, especially a cardiologist.
MD:How do you plan to continue your education and training while working in this role?
P: Part-time classes would be suitable for this case.I attend evening and night classes under your special permissions.Then during the weekends,I also make myself unavailable under the same permissions.
MD:What are you looking for in a work environment, and what kind of support do you feel you need to succeed as a doctor in this private hospital?
P:Non-toxic environment is vital for me to operate soberly,in a cooperative manner.Instead of losing my mind in stressful environments,I prefer amicable colleagues around me,for me to succeed in the long run.
MD:9. Cultural Fit
:Why do you want to work at our hospital specifically?
P:Under guidances of my family friend,with time I can easily adjust to workflows in this place.I also feel private hospitals have equipments that reduce medical errors by far.
MD:What interests you about working in a private healthcare environment?
P: Technological advancement facinates me.Being a tech geek,I get enthusiastic about using medical technologies.
MD:How do you ensure that your approach to patient care is culturally sensitive and inclusive?
P:Embracing varieties of cultures reduces insensitivies.Using A.I powered tools for translations, in efforts of meeting their demands are just one of the ways that I would make them feel inclusive ,and embraced in the long run.
MD:What do you know about our hospital's mission, values, and patient care philosophy? How do you see yourself contributing to this?
P:Mission is to foster innovations for sustainable future.Values are honesty, transparency,patient care, confidentiality,trust, and creativity.Philosophy is observing the highest codes of medical ethics while providing highest standards of medical services.I see myself contributing to this by meditating the policy codes lest I forget them in my line of duty.Working closely with various staff and executives will also help me achieve their goals.
MD:10. Closing Questions
:Is there anything about your medical training or experiences that you haven't had a chance to mention, but that you think would make you a good fit for this position?
P:Nope!
MD:What is your availability, and when would you be able to start if hired?
P:I'm always available at home.Anytime,maybe this week I could familiarize myself with various departments,and workflows under the guidances of my family friend.Then,next week I begin.
MD:Ok as you wish!Do you have any questions for us about the hospital or the role?:
P:Nope!
MD:Fine!Our working hours are eight to sixteen depending on your levels.From eight a.m upto twelve a.m the following day.Be punctual,signing out and in is crucial for performances contracts.Well dressed accordingly, and always practice courteousy and hospitality around here!
P:Well understood sir!
MD:Fine,you may leave!
I greeted him, respectfully before leaving his presence.Immediately, I went to the receptionist where I elucidated everything to her before leaving the premises.It was not a long distance from home.Spending only a hundred a fifty shillings on fare,was cheap after all.For the remaining days,as agreed with receptionist,we oriented every departments, learning by observations the workflows,inspecting the ambulances, learning from the paramedics,I was as well as introduced to various staff around.I couldn't hide the joy,that I was finally a working medical doctor.I knew my role accordingly.Mid-levelDoctors-These doctors have completed medical school and are either in residency or general practice.
Medical Officer (MO) – A general doctor responsible for treating common illnesses, handling emergencies, and assisting in surgeries.
Role: Runs outpatient clinics, admits and manages patients, assists in surgeries.
Works in: Emergency Room (ER), Wards, Surgery, Maternity, ICU.
The following week,in my official attires,I arrived at the hospital premises exactly on time.Greeted everyone before being directed to my personal office space.All forms of urgent communications were present including the cctv cameras around.I meddled with the computers,read a couple of medical books around the mini-glassed shelves for a while ,before I reported to my first call of duty.
It was then I met Pavel Kane."Hi!I'm Pavel Kane,you must be new around here."He mentioned even as he was directing me in treating a malaria patient in that ward."Yes!I'm Pete!I just started working." "Pass me that!" "I'm sure you know procedures from your internships!" "Yes!I do have experience, working on various medical cases." "Maybe,you can handle the patient ,under my watch,I'm just curious, don't worry?" "Of course,no problem,now if you excuse me!"I mentioned even as I got an opportunity to successfully treat my patient."Wow!I'm impressed!" "Thanks for the compliment." "I can see fever has reduced,and the patient is showing recovery signs."Pavel then added."My pleasure!" Then Pavel continued,"Here!We have rare patient visits unlike public hospitals.Maybe,if you could just sit down and have conversations." He then suggested before I replied,"No problem!" We then proceeded to sit at his office space,having ordered tea with snacks from guards."Don't worry,you do take tea right!" "Yeah!I just took one this dawn!I'm not allergic." I then replied."I can see you are living the dream,at las!" "Yeah,it's just exciting to dream while you were a child.Then ,fulfill that dream later on! Against all odds,in life.I guess!" I tentatively said."Ok,do you plan to specialize in their scholarship programs?" "Yeah,I look forward to win the scholarship opportunity.That means ,I must show good grades in my performances contracts.I wanna specialize in being a cardiologist." "Awesome!Looks like we are in the same page!I also want to specialize in cardiology.I look forward then to work hand in hand with you.I came here four years ago, however ,the opportunity only falls to two guys.I have never won.I guess other guys were better,A pluses in their contracts.But I still hope." "Yeah ,let's hope together.Hope deferred makes the heart sick."I consoled him.
Later on, breakfast was brought forward,we took them as we furthered our colloquialism jabbering about the staff in the hospital.He kinda knew the individual attitudes of workers around there based on his experiences.I was glad to hear that the receptionist,was not a bad person to be around.I guess he was warning me about the good and bad associations around the hospital.I was still living at my parents' home,transitioning with my a hundred and fifty fare daily,for six days.I used to walk for a while traversing through various corner streets,avenues before I boarded a van.My bag in which I travelled along with,carried my official white overall and other doctor's apparels.I was able to then gradually work as patients got received in the hospital with time.
I encountered various medical cases at the beginning of my career-
Here are some common cases categorized by specialty:
1. Infectious Diseases
Malaria – One of the most common cases in Kenya, often presenting with fever, chills, headache, and body weakness.
Respiratory Infections (e.g., Pneumonia, Tuberculosis) – Common due to environmental factors and living conditions. TB is particularly significant in HIV patients.
HIV/AIDS-related Complications – Opportunistic infections such as cryptococcal meningitis, Kaposi's sarcoma, and tuberculosis.
Typhoid and Cholera – Often linked to poor sanitation and water contamination, causing severe diarrhea and dehydration.
Dengue Fever & Chikungunya – Increasingly reported due to climate change and mosquito prevalence.
2. Non-Communicable Diseases (NCDs)
Hypertension & Stroke – Often undiagnosed until complications arise. Many patients present with headaches, dizziness, or strokes.
Diabetes Mellitus – Increasingly common, with cases presenting with complications like diabetic foot ulcers, kidney disease, and neuropathy.
Asthma & Chronic Obstructive Pulmonary Disease (COPD) – Common in urban areas with poor air quality.
3. Obstetrics & Gynecology
Obstructed Labor & Birth Complications – A frequent emergency, especially in rural hospitals.
Postpartum Hemorrhage – A leading cause of maternal mortality.
Preeclampsia & Eclampsia – Hypertensive disorders in pregnancy requiring urgent intervention.
Unsafe Abortions & Complications – Often encountered in emergency rooms due to high rates of unsafe abortions.
4. Pediatric Cases
Malnutrition (Kwashiorkor & Marasmus) – Common in rural and impoverished areas.
Neonatal Sepsis & Jaundice – Requires prompt intervention.
Acute Diarrheal Diseases – Often caused by Rotavirus, E. coli, or contaminated water.
5. Trauma & Emergencies
Road Traffic Accidents (RTA) – A major public health issue, with cases involving fractures, head injuries, and internal bleeding.
Assault & Gender-Based Violence Cases – Often encountered in emergency departments.
Burn Injuries – Common among children and due to domestic accidents.
Poisoning Cases – Accidental ingestion (common in children) and pesticide poisoning (common in agricultural regions).
6. Surgical Cases
Appendicitis – A common surgical emergency requiring prompt intervention.
Hernias – Many cases present late due to lack of access to surgical services.
Gangrene & Infected Wounds – Often seen in diabetic patients or those with poor wound care.
7. Mental Health Cases
Depression & Anxiety Disorders – Increasingly recognized, especially in urban settings.
Substance Abuse (Alcohol, Khat, Marijuana, Hard Drugs) – A growing issue among young adults.
Schizophrenia & Bipolar Disorder – Often diagnosed late due to stigma and lack of awareness.
We had board meetings at the boardroom,after every three months,where the director plus other officials and auditors presented their reports.At the last end of year meeting,I was eager to hear who had won the scholarships.It was another pair of mid-level doctors(who had won), however ,I still consoled Pavel,who still waited for his time to come.I was grateful for that year.As recorded in my journal:
I'm grateful this year that I got a job.Didn't encounter any medical errors unlike my internship season.I didn't let my boss down.
I also got a chance to have Pavel as my friend.He warned me about various staff around.He also shared his scholarships aspirations in which also I got interested.We share the same cardiology aspirations.A few challenges here and there.Civil unrests that crippled the transport systems.I walked longer during such periods.Stubborn nurses,and cleaners that got into my way.I didn't have time to argue further with them.I just followed my proverbial advice,of leaving the presence of a fool.I was glad all the same,to still do my proverbs' devotions this year.God answered my prayers,after all.The patients were also stubborn.Not cooperating during injections;other violent kids pushed me away,in such anxieties,breaking my syringe needle.Other kids loudly screamed at the ward,we had to tie down other stubborn kids,in order to enforce medical procedures.However,that led me to be awarded A- in my p.c's.I got my first 70k monthly salary ,that in turn made my parents happy.From Carrefour supermarket,I used to do home shoppings.I also awarded the receptionist for 'connections' as well as perform my tithings obligations.I look forward to gaining more experiences with time, before making any further decisions.Happy new year!
The following year,6th January,I returned to my usual work premises.As awkward as it may sound,I was still using van taxi to commute.I still was not in a sound position to make financial decisions,remembering my extravagant experience with the student loans,back then in my college days.I soon interacted with Pavel after settling down.Pavel,"Happy new year Pete!" "Happy new year to you too Pavel!" I replied."I saw you alighting a van,as I came around.Are you still boarding van taxi?Do you need a lift, perhaps?" "No!It's not that what you think!I'm just saving for my future,you know.A new apartment,car and all that stuff as I grow in my career." Then Pavel understood,"Oh!I understand.Saving is good for beginners.But I can still offer lifts if you want?" "No problem!I won't refuse.Thanks in advance."I then thanked him."How is your family back home,if I may ask?"Pavel then inquired."My family is thrilled.I do shoppings for them.They are just tranquile.They proud of me,living out my childhood dreams.You could say,that they are a source of joy or motivations and inspirations for that matter!" I elucidated before inquiring him,"What about you?Do you have a family already?" Then Pavel answered,"I'm still unmarried at 29!But I do hope to find the right one this time.I have dated several times,but it didn't work out.My parents,are still surgeons.Both neurosurgeons for that case.They work together in a renowned public hospital around the country.They are the ones who led me,or inspired me to develop a taste in medicine since childhood.However, at one point they got divorced hence separated as they legally agreed, due to cheating suspicions.This led to a series of sibling rivalry, financial crisis after confiscation of properties.All along,being on my mum's side,I grew up with the little she left,since she was establishing herself all alone.Public schools upto the college level;you know how costly med.course is? That's basically my brief background.I'm still repaying my student loans,almost finishing."
Then I recalled,"You have a quite similar story in that case.I also got enrolled to public schools, depending on loans and scholarships in the long run.We do hope to finish with these loan stresses after all." Then Pavel aquiescented.
The second year was marred with challenges.But with Pavel's aid we were able to solve them.
However,one mistakened case by Pavel and I definitely led us to miss a scholarship opportunity that year:
A 2-year-old child with a respiratory infection is prescribed paracetamol. However, the doctor writes 500 mg instead of 120 mg due to a miscalculation based on weight.
Error:
Incorrect dose calculation for a child.
The pharmacist did not double-check the dosage.
Outcome:
The child develops acute liver failure due to paracetamol overdose.
Requires ICU admission and possible liver transplant.
Prevention:
✅ Always calculate pediatric doses by weight (mg/kg).
✅ Use electronic prescription systems with built-in dose checks.
✅ Pharmacists and nurses should double-check high-risk medications
After being advised accordingly at the end-year boardroom meeting,Pavel and I vowed to be more keen the following year.
Pavel ,"I'm still in the race of that scholarship opportunity.This year,we faced a lot of challenges,did medical errors but let's just be optimistic.Grade B is not bad." I agreed with him,"Yeah, we must fight the good fight of hope,faith and love!Love covers ,wins, the game!"
Knowing that iron sharpens iron,I knew then Pavel and I shared similarities based on our backgrounds and future aspirations.We were both unlucky in relationships pursuits historically,we grew up in public schools at one point,as well as with student loans.We both looked forward optimistically to win scholarships the following year after such an overwhelming year.
A little sleep,a little slumber and poverty attacks like a bandit.The following year,I was determined to be a diligent 'perfectionist',my aim was to score an A plus on my p.c. I worked on my attitudes, leadership,and other life skills in order to boost my performances.I used such influential approaches to patients,and people around me in that hospital,that made significant impacts in the long run.Patients also took part in the rating processes.Using counselling psychology approaches,I left them satisfied by just reading their reactions.Poignantly with Pavel,that year went on well.We also spent time together,researching,reading medical books,hanging around the garden parks as we 'restauranted' at such scenes at mid -day breaks.
Surrounded by several mosques,Mombasa town was dominantly Islamic.The ventriloquism mosques' noises were tolerable after all.On one occasion at the garden,Pavel then suddenly questioned my relationship life,"Pete?Can I ask you something?" "Sure,why not? You're my bestie!" "Do you have a girlfriend?" "No!Why ask?" "It's nothing!I was just wondering!" "Here at Mombasa ,I have a primary school crush!We rarely see each other.She is called Tina Ciku.We did the same medical course,graduated the same year,but then we lost contact.I guess that ,she perhaps changed her number!" "Oh!That's sad,but at least you had a lover!" "Yeah!You could say that!Obtaining favor from the Lord,is something lucky!" "Well,there are Arabs,Indians,and variety of women walking around the cosmopolitan streets of Mombasa,why don't you just one day decide to fall by one girl!" I laughed calmly before replying,"Nah!After all the heartbreaks I have been through,I think I'm in my healing season." "Heartbreaks!" "Yeah, During college I had several attempts of getting a lover,but they all were futile efforts." "Do you think maybe the girls were afraid of g.b.vs, thrown by their boyfriends?" "Perhaps ?Perhaps not!But if they were divided emotionally,they just couldn't have wasted my time at the first place?I'm the one who ended up more hurt!" Then a Busia bus passed by suddenly before he continued from such engine noises,"But you're still hopeful? Right,you know marriage is knocking at the door!" "Marriage pressures at this stage!Nah!I'll just wait on the Lord to direct my steps in building such a house!" "Okay as you say!For my case,It's not that they find me unattractive,in any way,it's just that perhaps I don't know how to give them time romantically or flirt with them.They just all of a sudden stealthily run away from me!" Then I saw his problems,"Now I see,your case is not giving them much romantic attentions.Women demand attentions.On the chatbox,dating,expressing romantic greetings frequently, talking romantically oftenly in all occasions.But the moment you show them signs of non-attentiveness,they run away from you secretly.You must find ways of balancing your demanding career and dating life,even if it means reaching a concession with them." Pavel then agreed,"Ok,thanks bestie for such advices." "Do you believe in having a type?" Pavel then asked."Judging a book by its cover based on tribe, backgrounds or anything else ,I actually don't believe in that.I mean everything is adjustable.The heart is what that matters.If your heart becomes innate to match ,and fall in love irregardless,then you found the right person.Otherwise,you heart must first be in agreements." Then Pavel commented,"Wow.You must be a good advisor.O.k let's finish meals,so that we don't become late for any emergency calls!"
My friendship with Pavel grew with time,spending leisure times at the entertainment room,playing pool,watching television,playing chess and other board games.At the end -year boardroom meetings,we anxiously entered the room.Pavel,"Ok,this is it.Knowing our scholarships fates!" Then I replied,"Yeah I know.But I think we did a good job,our patients attested to that by their reactions." We then proceeded to grab close seats as we waited for M.D to arrive.Anxious clamoring was going on in the meantime,others expected promotions,others scholarships,others trophies for the best team,worker,most improved in such annual rewarding moments.Winners were usually taken to fully -paid corporate vacays besides medals and cash prizes.Their picture winning portraits were also preserved at their individual offices.
The M.D suddenly entered the room.Him along with other superfluous officials in their harangues,presented various statistics before finally, the rewarding moment came."The scholarships awards after scoring impressive A pluses this year on their p.c's goes to..." He then went ahead to open the golden envelope , "Pavel and Pete!" We then reacted by clapping loudly.The rest followed their applauses later on ,in such appreciations.Afterwards,we had personal meetings with M.D to clarify the scholarships program.It was to start the following year in a neighbouring college,on part -time basis.We both chose cardiothoracic specializations.For the better part of the end -year vacay,we spent it as a corporate,the rewardees had a good time touring Dubai.
In such good moods,the following year we returned to work. We soon got enrolled for the residency programs along with Pavel at a nearby college.Scheduled units for :Year 1: Foundational Training
Basic Sciences and Principles of Surgery:
In depth understanding of Physiology, microbiology, anatomy and pathology in relation to surgical procedures.
Preoperative and Postoperative Care:
Emphasizing patient recovery and management.
Surgical Skills Development:
Hands-on training in fundamental surgical techniques and aseptic procedures.
Rotations in Various Surgical Subspecialties:
Exposures to various surgical fields to build such broad foundations.
It was then I met the rest of five members,who were my bestie at the college,also on part-time basis, specializing in the same cardiology course in the same class.Lara,Marina,Mars,Tina,and Victor.Coincidentally,only seven of us had enrolled for such part-time program.The rest were full time residents.On the first night, we then decided to stay behind for a while after class.Lara recalled,"This is pure! If not impeccable,learning along with my besties.Except a few that I may not know .Maybe we can introduce each other!" Brief introductions then began."Hi!I'm Lara!I know Marina,Pete,and Tina as long time allies!" "Hi!I'm Marina,I know Mars,Pete,Lara,and Tina as besties!" "Hi I'm Mars!I know Victor,Pete and Marina as allies." "Hi!I'm Victor.I know Mars and Pete as besties!" "Hi!I'm Pete,I know Mars,Victor,Lara,Marina,Tina,and Pavel my colleague as allies." "Hi!I'm Pavel!I only know Pete as my colleague and ally!" Then Lara continued,"Since we all look forward to be cardiothoracic surgeons,I'm sure we will have a fun time in our five years.Pete knows everyone.Pavel is your colleague.Is anyone else working along with the other?I forgot to mention Tina and Marina as my colleagues at the coast referral hospital where we got placed by government." Then Victor and Mars also recalled,"We are also colleagues at the Port public hospital.Those sides near airport.We also got placed by the government." Then I suddenly asked,"Are we all under scholarships?" "The Ministry of Health as per bargaining agreements with medical union ,agreed to sponsor best performing mid-level doctors to their specialities.I guess that's why we are here. Coincidentally,we all ended up after the same speciality ."Lara then elucidated.I then reiterated,"Oh!That's good news.As for Pavel and I ,we won scholarships from our St.Pete hospital,where we both work.Also based on our rates and performances,we kinda ended up aspiring the same speciality." Lara then added,"Awesome!Now we know each other,we can endeavor to know each other better."
Lara seemed desperate somehow from the first night,perhaps she was eager to hopefully get something out of our socializations.Suddenly ,she couldn't hide it anymore,"Ok guys!I'm single.Getting perhaps someone from this close associations would perhaps make me happier."The rest then laughed."What!I'm just being open and honest!" Then I came through as a mediator,"Maybe we can help Lara here!How many are currently dating or engaged for that matter!" Then Mars,Victor,and Marina raised their hands."I guess Pavel and I are your ideal candidates!"Then everyone chuckled.Then Lara turned to Tina,"Tina,you are seeing this too ,right!"Then Tina tried to change the topic,"Ok guys,Let's head out home,it's getting late,we have hospital duties don't forget that?" At her suggestions,we then duly dispersed home.We walked together for a while, jabbering our career lives as a group.It became hard to balance school and work.Having little time to rest.Handling tedious cases for the better part of my part-time debut.
After the first adapting year,the second year soon began.We all passed the foundational units,after such group studies.The subsequent Years 2 and 3: Intermediate Training
Advanced Surgical Techniques:
Training in complex procedures in cardiothoracic field.
Critical Care Management:
Managing intensive care unit victims.
Emergency and Trauma Surgery:
Preparations in handling acute surgical emergencies and trauma cases.
Research Methodology:
Engagement in clinical research projects to foster evidence -based practices.
Intermediate trainings appeared demanding and harder.We spent longer hours during the weekends.From morning till mid nights just trying to master the pragmatics of surgeries.Flirting or socializing during weekends became almost impossible.
Challenges in Dating for Medical Students:
Time Constraints: Medical school is incredibly time-consuming. The demanding schedules of medical students, with long hours of studying and attending classes or clinical rotations, leave little room for personal relationships. Finding time for each other can be difficult.
Emotional Exhaustion: Medical students often experience burnout due to the high-stress nature of their studies. This emotional exhaustion can negatively affect relationships, making it hard to invest emotionally in a partner.
Burnout and Work-Life Balance: It can be difficult for students to strike a balance between focusing on their academic career and maintaining a healthy personal life. Relationships can sometimes take a back seat during the stressful periods of exams, rotations, or major projects.
Academic Competition: Some students may experience stress or jealousy if they feel their partner is out-performing them academically, or conversely, if they feel the need to compete for attention and success in the medical field..
Despite the inculcating challenges,we still somehow, managed to date.
Below are a few possible dating scenarios involving medical students:
1. The Study Partner Romance
Scenario: Two medical students find themselves frequently paired up for study sessions due to similar schedules and mutual academic interests. Initially, their relationship is purely academic, focused on reviewing complex subjects like anatomy or pathology. Over time, however, they begin to develop personal feelings for each other, and their late-night study sessions turn into coffee dates and long conversations about life beyond medical school.
Challenges: Balancing professional and personal boundaries can become tricky. The pressure to maintain focus on studies while navigating a romantic relationship can create tension, especially during exam periods.
2. The Opposites-Attract Relationship
Scenario: One student is highly organized, always studying ahead and sticking to a strict schedule, while the other is more spontaneous and struggles to keep up with the rigorous academic demands. Despite their differences in study habits, they find common ground in their shared passion for medicine and mutual respect for each other's strengths. Over time, the differences become a source of intrigue, and they begin to help each other balance their personal and academic lives.
Challenges: The contrasting approaches to studying and time management can lead to misunderstandings or frustration, especially if one partner feels the other isn't taking their education seriously enough.
3. The Clinical Rotation Romance
Scenario: Two medical students are placed on the same clinical rotation in a hospital, spending long hours together with patients and healthcare teams. They bond over shared experiences with patients, difficult cases, and the pressures of working in a clinical setting. The intensity of their experiences brings them closer, leading to a romantic relationship.
Challenges: Navigating a relationship in a clinical setting can be complicated by professional boundaries, especially if one of the students is more senior or if the rotation involves patients who know both students personally. There's also the challenge of keeping the relationship professional, as hospital environments often emphasize the importance of maintaining boundaries.
4. The "High-Stress" Relationship
Scenario: During a particularly grueling exam period or clinical rotation, two students begin a relationship out of the need for emotional support. The intense pressure of exams and long hours lead them to lean on each other for comfort. Their relationship becomes a coping mechanism, providing relief from the academic stress, even though they both know the relationship is more about providing temporary support than long-term commitment.
Challenges: Once the exams are over, the dynamics may shift. What began as a short-term emotional relief can turn into a more serious relationship, leading to questions about whether it was truly based on genuine feelings or if it was just an emotional escape during a stressful period.
5. The "Professional" Relationship
Scenario: Two students begin dating after one helps the other with a challenging aspect of medical school, such as mastering a particular subject or passing a difficult exam. They admire each other's work ethic and dedication to medicine. Over time, they start going on dates, supporting each other's ambitions, and bonding over their shared career goals.
Challenges: The potential for conflict arises when their professional ambitions or future career paths take them in different directions. One might want to specialize in a particular field, while the other has different aspirations, creating tension in the relationship when they begin thinking about post-graduation plans.
6. The Peer Pressure Relationship
Scenario: In a tight-knit medical school cohort, two students start dating due to pressure from their friends or peers. Maybe they are the "perfect couple" in the eyes of their classmates, or perhaps they share similar backgrounds and have been paired together for clinical projects and group work. The relationship seems to follow expectations rather than natural chemistry.
Challenges: In this situation, the relationship may feel like more of a social obligation than a real connection. Over time, the lack of emotional depth can lead to dissatisfaction, and one or both partners may begin to question the authenticity of the relationship.
However,for Lara and Pavel,it was more of a peer pressure case scenario than the rest of the scenerios, generally speaking.Tina and I used only the first five scenerios to genuinely date romantically. At other times ,we went to :blue room ,KFC,pizza inn and other auspicious places as we grouped together (while others like Pavel and I dated.)
The final fourth year soon dawned.Afterwards(in the fifth year), we were to undergo a full -time one year fellowship under special permissions (one year off-leave) by our employers.
Year 4: Specialization and Leadership
Focused Subspecialty Training:
Opportunity to focus on Cardiac surgery involving procedures related to heart and
great vessels.
Leadership and Teaching Roles:
Monitoring junior residents and participating in education of medical students.
Independent Practice:
Perform surgeries under minimal supervision
Supervisions,and lecturing roles fascinated us.Based on my Sunday school,and primary school experiences,at least I could teach medical students like a lecturer.Unfortunately,I couldn't make it up to three hours of lecturing.From body sign languages,you could easily tell that students got bored or were less concentrating as time went by.
The off -year soon began.It was then that I took my dating experiences with Tina a little higher.
As a novice cardiothoracic surgeon undergoing training, practical skills are critical for mastering the complexities of the specialty. During simulated operations, trainees acquire essential skills in a controlled environment that mirrors real-world conditions. These simulations are designed to build competence, confidence, and precision before performing procedures on actual patients. Here are some of the key practical skills a novice cardiothoracic surgeon would typically acquire:
1. Basic Surgical Techniques
Aseptic Techniques: Proper preparation for surgery, including hand scrubbing, gowning, gloving, and sterilizing instruments.
Incision and Suturing: Learning how to make precise incisions and close them correctly, including basic suturing techniques (e.g., interrupted, continuous, subcuticular sutures).
After such basic surgical techniques for a while,flirtings crept in our conversations.Lara,"I know you guys mastered the steps.I'm just reiterating.Scrubbing, gowning,gloving then instruments sterilizations."Then Marina added,"Then we make incisions based on the situations at hand; interrupted in case of obstructed vessels.Continous :Incase of a critical vessel.Subcuticular sutures in deep cuts scenerios."Pavel then flirted,"If I could access your inner heart,Lara!" "I would be precise,warm and perfect with my cupid incisions." Then Lara chuckled,"Aww!How romantic of you!I won't mind my darling!"Then we all laughed.
Hemostasis: Mastering methods to control bleeding using various techniques such as cautery, ligature, or hemostatic agents.
In remembering Tina indirectly I then mentioned,"Don't forget the hemostasis procedures.Controlling bleeding.Like Tina,after my heart bled for long,she became my hemostasis agent!" Tina then chuckled,"Aww.Thanks bestie that is what true friends are for.In good and bad times!"Then the rest laughed for a while.
2. Cardiothoracic Procedures
Chest Opening (Thoracotomy): Learning to safely open the chest, whether through a median sternotomy (breastbone incision) or lateral thoracotomy (side chest incision).
The rest of the group also got a chance to elucidate the processes like :thoracotomy,cardiac valve surgery,coronary artery bypass grafting,cardiac arrest management,simulation ,handling instruments and so forth.
Cardiac Valve Surgery: Practicing the replacement or repair of heart valves, which involves both recognizing the pathology and performing the actual operation on a simulated heart.
Coronary Artery Bypass Grafting (CABG): Learning the techniques for bypassing blocked coronary arteries using grafts like the saphenous vein or internal mammary artery.
Cardiac Arrest Management: Practicing the steps involved in handling a heart that has stopped beating, including starting CPR, using defibrillators, and other resuscitation measures.
3. Simulation of Cardiac Anatomy
Virtual Reality or 3D Models: Trainees work with lifelike virtual simulations or 3D printed models of the heart to practice surgical interventions in an immersive environment.
Anatomical Landmark Recognition: Learning to identify key anatomical structures such as the aorta, pulmonary artery, coronary arteries, heart chambers, and valves to navigate during surgery safely.
4. Surgical Instrument Handling
Use of Specialized Tools: Practicing with specialized instruments such as heart-lung machines, forceps, clamps, and retractors, which are essential in cardiothoracic surgeries.
Precision in Instrument Handling: Developing dexterity and precision when handling instruments to avoid damage to delicate tissues and to ensure effective and safe surgery.
5. Simulated Cardiopulmonary Bypass (CPB)
Setting Up the Heart-Lung Machine: Understanding how to operate the heart-lung machine that temporarily takes over the functions of the heart and lungs during surgery.
Managing Blood Flow and Pressure: Learning to manage blood flow, pressure, and oxygenation while the heart-lung machine is in use.
6. Managing Complications
Recognizing and Treating Bleeding: Understanding how to manage excessive bleeding during surgery, including identifying major blood vessels and using hemostatic techniques.
Dealing with Arrhythmias: Practicing how to recognize and manage abnormal heart rhythms during surgery, including the use of defibrillators and other devices.
Postoperative Care: Learning to recognize signs of complications in the postoperative period such as infections, graft failure, or low cardiac output.
7. Decision-Making and Teamwork
Crisis Management: Practicing in simulated high-pressure scenarios, making quick decisions about surgical approaches or emergency interventions.
Multidisciplinary Collaboration: Working alongside anesthesiologists, surgical assistants, nurses, and other members of the team, honing communication and leadership skills during the surgery.
8. Ethical and Communication Skills
Informed Consent: Learning how to effectively communicate with patients and their families before surgery, ensuring they understand the risks and benefits.
Patient Safety: Practicing how to ensure the patient's safety throughout the surgical procedure by managing risks and minimizing errors.
9. Postoperative Monitoring
Monitoring Vital Signs: Simulating the postoperative care of a cardiothoracic patient, including vital sign monitoring, recognizing signs of shock, and ensuring effective recovery.
Pain Management: Understanding how to manage postoperative pain and prevent complications like infections or blood clots.
The romantic fellowships soon lapsed.We had fun time together with the group.
The following year, we were promoted as per the agreements.I still got in touch with the group, through :social media groups,calls,and sms.We rarely visited each other at respective workplaces;it wasn't a surprise but a planned visit after all.Benchmarking each other,consolations,while also motivating each other.Cardiothoracic surgery demanded keenness,(using various suggestive treatment plans,to reach the best probable solution safe and sound).This oftenly prolongs surgical procedures at the operating room.Cybernetics ,and probability played key roles.One of the frequent cases that Pavel and I faced was heart attack.
1. Acute Myocardial Infarction (Heart Attack)
What Happens: A blockage in one of the coronary arteries that supply blood to the heart muscle causes a heart attack. The heart muscle begins to die due to lack of oxygen.
Urgency: If the blockage is not relieved promptly, it can lead to permanent heart damage or death. Cardiothoracic surgeons may be required to perform urgent surgeries like coronary artery bypass grafting (CABG) or, in some cases, interventional procedures to restore blood flow.
We used to review procedures with Pavel.I then began,"Thrombosis; clotting of coronary artery is the main cause of these heart arrests cases.Graftings methods like saphenous vein or internal mamary to by pass passages has proved quite effective in a couple of cases."Then Pavel replied,"Yeah,if the conditions became worse,we could just use the electric c.p.r ,and defibrillators for resuscitation measures!"
The end year boardroom meetings came later on,we had debuted our cardiothoracic surgery career,we had few errors as doctors however that left both of us with grade A-'s.During the long vacations ( leaves),we then through our group chats, organized a group date on December later on.Every member was to bring along their partners at the Mama Ngina gardens.
The red letter day finally dawned.The dress codes were ; black tuxedos outfit for men,and liliac dresses for women.We hired a band,photographer,to then entertain us during our dinner date.At eight p.m entrances got witnessed,as the photographer snapped various individual photos at such moments.Two by two,besties arrived in style at the dinner table which was decorated meticulously with candles,bottles and glasses of wine ,a couple of cutleries,vased -flowers besides, petals scattered all over to set the scene on romantic moods.With background band music,sea lull and gales,ambient lights around, finally we were all able to settle down.
Lara,the appointed group secretary opened the sessions,"I would like to take this opportunity to welcome you all to this group date that we had organized.I know my besties but I don't know their girlfriends or boyfriends.Maybe,they can individually introduce themselves, kindly!" Then Lara through her hand -pointing gestures,she then directed the guests to introduce themselves."Ok,ah good evening guys!I'm Liss, Marina's cousin,and Mar's girlfriend!"She then awed all of us in murmurs for a while.Before Lara interjected,"Ok let's continue!" "Good evening everyone!I'm Ahmed, Marina's boyfriend. "Good evening guys!I'm Tiana, Victor's girlfriend." Then Lara continued,"For the sake of our guests ,I'm Lara currently dating Pavel Kane here.This is Pete currently dating Tina.Okay,we have ordered the cuisine spaghetti, sauce,salads, desserts along with meatballs.In a short while,we will be served .In the meantime,we can reflect on a couple of issues.Year review,dating lives maybe?"
Then Lara randomly pointed me."Ah ,my year review was not bad.I debuted my surgery career,had no errors in surgery;the errors only occured while working as a doctor.I also got a chance to visit all of you at your practicing premises.We had a good time together in the long run.I also had time for my cutie here,Tina.Enjoying the sunsets together,in those evening dates.I'm a nature lover.Whether be at top buildings-restaurants,clubs or at the beach,we kinda had a good time staring at the sunsets.We also did cycling, gymnastics,and brisk walks together.I'm glad to have Tina by my side." "Okay,thanks Pete for your reviews.Pavel you are next." Then everyone chuckled."I'm Pavel Kane, Lara's boyfriend.My year was basically similar to Pete.We frequently spent times together in our debut surgery careers.I was glad to brainstorm along with him.We solved problems together.We also paid visits together at some points to your various hospitals,where we had a good time with each other.I also couldn't forget my girl ,Lara.The love of my life.Always there for me.Visiting her place,and vice versa that was how we kinda date , oftenly.We rarely took each other out,due to our unfortunate busy tight schedules.We however,enjoyed the culinary arts together at home;baking birthday cakes,rare meals,blogging and vlogging.I think she is a socialist,social media lover; TikTok and other platforms.Being a gamer at my home,I enjoyed playing 'dimba' with her.She became good with time.Defeating me in some of the games.That's basically my fun time with Lara." Then Lara blushed,"Oh thanks Hun!Okay,I can see the waiters approaching.We will pause for a while.Eat while murmuring with each other while also enjoying the music!"
Malaika!Nakupenda Malaika!...
You are my African queen.The girl of my dreams.You make my heart go tinga galing...
Nice to nice to know you let's do it again ...
...
Those were some of the band's background music as we ate,while dining.Suddenly ,
'Uliza kiatu,ask my shoe ,...
Song 'played when Pavel and I decided to propose to our girlfriends.Pavel then stood up,hit the glass for a while,"Attention everyone!So, tonight Pete and I as we came along we secretly organized a proposal session to our respective girlfriends.In such honor,I would allow first my bestie to take it away."
With my fast beating heart,I then rubbed my hands,gave a sigh of relief before beginning,"Tina,you have been my best friend,a present help in times of need.I value our friendship,all the good and bad times we've been through together as primary school mates.Then, coincidentally as resident surgeons.We achieved such fetes,even as I recall those dreams we had as kids.I never saw you in college sports,however,in such anticipations.For this very reason and moments.Tina will you be my engaged girlfriend?" I said after opening the ring box,while kneeling down."Yes I will.Yes I will!" She hysterically replied.Then,I went ahead to put on the emarald-blue jeweled ring on her middle finger.The rest cheered on.From my coat also,I took out a golden necklace,went ahead to put it around her neck, joyously.
Then,we all settled down before Pavel continued,"Wow!We have just witnessed a successful,loving and cheerful proposal between Pete and Tina.May their relationship go well!" The rest then applauded."Now!I want also to take this opportunity to propose to Lara Scott." Pavel then soon went down on his knees to propose,with a ring box out of his coat,he went ahead,"Lara,you have been a source of joy.Your sense of humor,enlightens me is like you know my moods for the moments.Your extrovertness also awes me.I have never met a loving girl like you before.Unique,social,cute, adventurous,and a loving girl.Our friendship has been a rollercoaster of fun.That's why I would love to take it higher to another level.Lara Scott, would you be my engaged girlfriend?"With such ring presentations then Lara hysterically replied,"Yes I do!Yes I do!"Cheers then broke out.He also went ahead to wear Lara,a beautiful golden necklace around her neck."Now guys,thanks for your attention!We can continue dining!" The dining moments continued characterized with brisk jabbering,music listening,photo sessions,breezing ,witnessing ships passing by before it came to an end.The rest of the fellows then also got a chance to give their year reviews along with their dating lives narratives.The dating experience soon came to a halt.We dispersed to our respective homes,in such paired escorts.I looked forward to the good times,and perhaps to marriage with Tina Ciku after that unforgettable 27th date.