Many updates, end unit with privacy & beautiful landscaping, attached 2 car garage. Walking distance from Forest Park & Metrolink, perfect for residents. Check out pics at www.5587waterman.info & call 314.440.4663 for showing!
Share ThisI am currently in Eritrea on the away elective. I have been e-mailing my family and friends updates and here is the one I sent on Friday, 30 April, with reflections on my first week here:
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Hello All,
Greetings from Eritrea! I am finished with my first week of work (weekends off – it’s great!). It has been quite an experience so far. The following e-mail/update is long and written as stream of consciousness (sorry :)).
First, the country and life outside of work. The hotel I am staying at is nice and the food in the restaurant is good. The internet, like elsewhere, is shady – best late at night and early in the morning. In the room, I fight a battle between staying cool and getting annoyed by bugs/mosquitoes at night – either to leave the window open or closed. The roosters don’t seem to get that they are only supposed to crow in the morning when the sun comes up – they crow all day and all night long. There’s also a dog that likes to bark until midnight outside my window. I have to think like I am in Syria for the shower because I have to remember to turn on the hot water heater 30 minutes before I shower – it’s an adjustment or there’s always the option of a cold shower (sometimes plausible when I’m so hot from outside).
The weather is beautiful but hot, especially around lunch time. It’s cool enough in the evening that I wear a sweater. The hospital basically closes for 2 hours at lunch so I walk back to the hotel (and up 4 flights to my room) but I am usually drenched in sweat with that. The hospital wards are pretty cool (though no air conditioning). The “national” food is not to my liking unfortunately – it is grains, lentils, barley in some combination with meat (usually beef) but they tend to make it all very spicy. I am trying to be more adventurous but it’s hard with my wimpy palette. I ate with two of the interns at their cafeteria at the medical school and that was way too spicy but I tried – I ended up eating lots of bread. They always have other food on the menu – including Italian food (Eritrea was once an Italian colony) and regular stuff like sandwiches and grilled fish or beef. The fish is pretty good – we are going to the seaside this weekend so I should eat some pretty good fish there. The restaurants are nice but a little scattered (more walking). People don’t have a lot of money so you see people (especially the young couples and groups) just going to the restaurant for coffee or a drink and not ordering food. A full dinner at a restaurant costs about $15-20. The grocery stores are like in Syria – basic supplies and then people go to the downtown markets for fruits, grains, etc. Most people you pass in the street are nice and will smile back. Children will follow us, asking for chocolate or money, and one person approached Ahmad asking if he wanted to change money on the black market (illegal). The special things to buy seem to be leather products and ceramics. I found a shop 2 doors down from my hotel that sells hand-made leather handbags (I saw them in the back working) for <$40 (it is very tempting and I may save up for one myself). I can get to most anything on foot. There are taxis and buses but I don’t want to take a bus because they are crowded and everyone seems to have TB here. A lot of the culture is still caught up in the war with Ethiopia and many patients have wounds from battle. The military is the largest employer in the country. I haven’t explored the city much more than beyond the first day because I have been exhausted every evening when I get back from work (and sore feet) and I usually try to get some reading done before going to dinner.
For the weekend, Ahmad and I are going to Massawa, a town on the Red Sea coast. We had to apply for a travel permit to leave the city (this is how they keep track of people and especially those trying to flee the country) from the Interior Ministry. Our permit says specifically what roads we can take and how we are traveling. The dean at the medical school and the lab director (our contacts here – so nice!) have been helping arrange this. We will leave Saturday morning and drive 3 hours to there. We plan on sitting on the beach (maybe ride a camel!) and seeing the town and heading back on Sunday. There’s the Catholic church in Asmara but I haven’t figured out mass times yet – I don’t know if I will have time this weekend.
Last but certainly not least is the main reason I am here – work. It has been a bit of culture shock this week, working in a new hospital. As I said earlier, the patient population seems younger. The line between adult medicine and pediatrics is blurred – I have a 15 and 16 year old and Ahmad has a 13 year old type 1 diabetic. Like in the U.S., the surgeons like to dump their admissions on medicine and medicine has the same frustrations with surgery. The hospital I am at (Orotta) is the main referral hospital for the country. Patients are admitted to the ward through the emergency department or the outpatient department (OPD). The OPD sees cases sent from smaller regional hospitals and also citizens of Asmara. They may get seen several days in a row in the OPD for work up and then eventually admitted. Patients carry all their lab and radiology studies with them. The OPD is very busy in general – my attending saw 20 patients in a morning in the cardiology clinic – and chronically understaffed. The ER is similar to the U.S. but you can’t start regular drugs as easily and it’s harder to get labs/imaging done there than on the ward. People can stay in the ER for more than 24 hours before being admitted. There tends to be 1-3 deaths a night for the medicine service (about 60 patients on wards + 10 ICU + ER) and CPR seems non-existent. Every morning there is report where the intern who was on duty last night presents the new admissions, new ER presentations, and death reports. This is attended by the medicine interns and a smattering of attendings. After that, everyone disperses to their jobs. I go upstairs and with my intern and most of the time by attending we round on the service. Our ward is 35 patients and we see a hallway worth (half the ward each day formally. My intern and I will then see the sick people on the other hallway and quickly everyone else. We do the discharges. The ward work closes down every day from 12 to 2 pm. You can’t discharge anyone in the afternoon. Procedures are done in the afternoon usually – the interns have great skills at this because most have already done surgery. Bone marrow biopsies are done in the sternum (not hip – eecks!) and splenic aspirations are common. Thoracenteses and parcenteses are done by gravity drainage (IV tubing to an old IV fluid bottle). Foley catheters are also connected to old IV fluid bottles. Supplies are okay to find but sterile technique is not the best. I think ordering tests is the hardest thing to tolerate. You order a test and fill out a sheet for it and then you WAIT – e.g. 1 day for a CBC, 1-3 days for chest x-ray, 2-5 days for blood chemistries, 1-3 days for fluid studies, 1 week for cultures. It’s intensely frustrating and difficult to adapt to because you feel like you can’t alter management as well. I guess it also teaches you to go more by exam and history but GRR! All bone marrow biopsies are sent to the U.S. for examination and the date when the next set of specimens is sent is not exactly known so I have a gentleman with leukemia sitting on my ward who is awaiting a bone marrow biopsy but will probably go home and get called back when we can send the specimens to the U.S. The medicines available here are also different and not always there. There is crystalline penicillin, chloramphenicol, ampicillin, and occasionally ceftriaxone (not right now). Anti-parastitics, fluconazole, and anti-TB, and HAART are readily available. Furosemide, spirinolactone, and digoxin seems to be the standard CHF regimen. There are ACE inhibitors and beta blockers but the options aren’t great. No anti-depressants in the hospital but they are available as an outpatient (I’ve heard about amitriptyline only). I am still a little confused as to how patients get their medicines at discharge and about the discharge process and follow up. I have an Eritrean guy on my service who is living in the U.S. He got a DVT (leg blood clot) flying back here to see family. I started him on warfarin but I have no clue how his INR is going to be followed until he flies back to the U.S. As I said before, everyone has TB. The HIV is bad HIV that is diagnosed late and with many complications. There still needs to be informed consent and counseling by someone to get someone tested for HIV – a little frustrating because it doesn’t happen right away. There are things to think about in the differential that I would never think about in the states (schistosomiasis, leshminiasis, malaria, tropical splenomegaly syndrome) and I think the combination of my experience in medicine as a resident and my intern’s local knowledge, we do a fairly okay job. The interns are over-worked. Medical school here is 6 years after high school and only the best go to medical school. The medical school just graduated its first class last year. The medical students are eager to learn but there are a lot of them around. The “internship” is 10 weeks in different specialties (OB, peds, medicine, surgery, outpatient, etc.). The interns will then chose what they want to do – most are deciding whether to do general practice, specialize in a surgical specialty (more well-established here) or go abroad. There are formal OB, peds, and surgery residencies – they are trying to start a medicine residency program. The medical school is Eritrean run but staffed in most divisions by Cubans. Cubans, which I didn’t know, supposedly go on “missions” for 2 years at a time to establish medical schools all over the world. The medicine interns are on-call every 6th night but they don’t get to go home after being on call. They have to round alone on Saturday and then if they are not on call on Sunday, they get it off. They generally will admit 3-5 new patients a day and 1-2 overflow patients from the night before. They don’t write progress notes everyday – maybe every few days. I am trying to encourage them to write notes on especially sick or confusing patients or if they do a procedure. I am also encouraging/demonstrating better understanding by keeping track of patient data in a more organized fashion. The nurses are nice but a language barrier exists. My Arabic helps in some ways because I can pick up some words. It’s kind of frustrating when the intern or attending communicate with nursing and then I don’t know what’s going on. I am trying to learn simple words to speak with patients like “good morning”, “how are you”, “open your mouth”, “sit up” and “take a deep breath.” My attending thinks I will be fluent by the time I leave because I already speak 3 languages so this one shouldn’t be too hard to pick up. I am beginning to understand the concept of “brain drain” and why doctors (and regular people) want to leave the country because it is frustrating. Overall, I think I am helping and I think I am learning.
Well, that’s it.
Share ThisThis 2BR/1.5 Bath 2-story, 1,420 sq ft condo within a 4-unit brownstone building in the Central West End is literally across the street from Barnes-Jewish Hospital. Hardwood floors in the living/dining room, gas fireplace, built-in bookshelves, stackable washer/dryer included, beautiful balcony (great for a mini-garden or flower boxes/planters) accessible through 2 sets of French doors in a large master bedroom, deck in the back which is great for barbecuing, berber carpet on stairs and bedrooms. 1 carport space per unit, but you also get an additional free permit for street parking directly in front of the building. Plenty of storage plus additional space in shared basement.
I can’t say enough about the location! Literally across the street from the medical center/Forest Park parking lot (which most faculty/housestaff have to pay a hefty monthly fee to park in). Directly adjacent to Forest Park and everything it has to offer (awesome for those that like to run in the park). Seconds from the I-64/40 highway, amazing restaurants on the corner of Laclede and Euclid, short walk to the Metro, Chase Park Plaza/movie theater, bars/clubs, dry cleaners, and a public library.
I’ve been here for residency/fellowship and cannot stress enough how nice it is to be so close to work. It’s so easy to just come home during your downtime or for lunch. Plus if you take home call like I do, coming in for an emergency in the middle of the night is slightly less painful if you can just walk across the street.
*****OPEN HOUSE MAY 2, 1PM-2PM***********
FOR MORE INFO CONTACT AGENT SANDY WALLICK (314) 997-2401
Address: 4937 Laclede Ave, St Louis, MO 63108
Website: http://www.cbgundaker.com/PropertyDetail.jsp?mls_num=10023774&type=cnd
Share ThisVery nice 2 bedroom, 2 full bathroom condo (1324 sq. ft) located on the second floor tucked away in the safe and friendly Kenricke Manor subdivision in Shrewsbury. Roughly 15 minute drive from BJH. Close to I-44 and I-64/40 as well as to the Shrewsbury Metro Link(but traffic was never an issue). 2 Car detached garage. Great room with vaulted ceilings and main floor laundry with washer & dryer included. Neighbors are a nice mix of young professionals and retired/nearly retired . See the link below for pictures and more details. (5358 Somerworth Lane Zip Code: 63119)
Share This3 Bedroom apt, 3 bathrooms, kitchen, living room, and full basement with washer/dryer.
Rent $850 total, split among 2 or 3 people
Nice apt in central west end, 5 min to Barnes-Jewish Hospital
Call 847.630.1970 or e-mail me at cyohan1@gmail.com for more info. Thanks
Share ThisFlyer Hello! My wife and I are selling our 3BR, 2.5BA house in the Botanical Heights neighborhood. The house is 3 years old, and conveniently close to both the Washington University and SLU medical campuses. When taking home call, this house was perfectly located! The house is in excellent condition. The exterior includes an upgraded elevation with front sitting porch, a patio, a vinyl privacy fenced-in backyard with a remote controlled gate, and landscaped backyard with a vegetable garden. The interior includes upgraded kitchen appliances, upgraded window layout, central air/heat, 2 car garage, cable/DSL ready, large unfinished basement with 3/4 bathroom rough, master suite with separate bathtub/shower and walk in closet. We are moving to Honolulu, so we would also be happy to negotiate leaving several other pieces of our furniture and appliances, i.e. refrigerator, washer/dryer, upright piano, etc. to facilitate our move as well as yours. Our neighbors are fantastic, a diverse group of mostly young professionals and their families. The neighborhood is tax-abated, which also saves money. My wife and I both work at the WashU medical campus, and we have loved being able to bike, scoot, or drive to work all in 5-10 minutes while still being far enough away to not hear any sirens! Web links: http://www.realtor.com/realestateandhomes-detail/4029-Blaine-Ave_St-Louis_MO_63110_1116038126 http://tours.realspacetours.com/kschindler/4029-Blaine-Ave
Share This2 BR 2 Bath, updated kitchen & bathrooms, 2 car garage, washer/dryer, great neighborhood, end unit with privacy & fenced- in patio. Walking distance from Forest Park, metrolink. Check out website: www.5587waterman.info or call Larry at (314-440-4663).
Share ThisCongratulations at matching at Washington University! I completed my residency here and we are selling our loft. My husband and I loved living there and will miss it. We especially liked the pool and rooftop deck with downtown views. It is priced much less than what we paid due to the current real estate market. My commute to work was very quick using either 1-64-40 or off-highway routes. There is a link below with pictures.
Amy
******OPEN HOUSE: Sunday April 18th 1-3 pm. ******
Beautiful top floor 2 BR/1 bath loft for sale in popular Westgate Lofts building with expansive city views and lots of upgrades. Priced to sell at $165,000.
• High ceilings & huge picture windows with great views & bamboo shades.
• Quartz countertops, maple cabinets, stainless steel appliances stay.
• Extra kitchen cabinets & hallway storage units.
• Washer/dryer stay.
• Spectacular rooftop deck with pool, grills, panoramic downtown/Arch views.
• Rooftop community room with kitchen, TV area, large glass doors to deck.
• 1 parking spot assigned in attached garage plus 1 in secured parking lot.
• Secured entrances & elevators/24-hour video monitoring.
• Very quick access to I-64-40, quick access to I-44, I-55, I-70.
• Short drive to Washington University medical center.
• Walk to shops, restaurants, MetroLink.
For more information, please call Walt Coleman at (314)446-7542 or Coldwell Banker Premier Group at (314)647-0001, or see listing website
Address: 2323 Locust St., Apt. #503, St. Louis, MO 63103
*****OPEN HOUSE: Sunday April 18th 1-3 pm.******
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Available for rent for $1150 + utilities, is charming 2 bed, 2 bath condo in tree-lined, charming Debalivier, Central West End. Special features include:
>1200 square feet of space,
Spacious Kitchen,
Bonus Sunroom,
Gated Parking,
Central Heat and Air,
Quiet and Safe location,
Close to Metrolink (3 blocks), Wash U Hilltop Campus and Barnes-Jewish Hospital (1.5 miles each),
Three blocks to Forest Park
Updated Appliances,
In Home Washer and Dryer,
Optional: high quality furniture for rent/sale
Will consider PET with security deposit.
Additional pics available:
http://webpages.charter.net/samzilla/home
One year lease + security deposit REQUIRED. Will consider selling, now or after 1 year of lease.
Contact: Ahovanes@gmail.com
310-560-9823
Share This6218 Southwood - Demun area - Clayton schools - view of Forest Park!
http://stlouis.craigslist.org/reo/1656836983.html
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