When I hear somebody sigh, "Life is hard," I am always tempted to ask, "Compared to what?"
- Sydney J. Harris
I recently was privileged to hear Dr. Claire Wendland describe two groups of medical trainees.
The first was a group of medical students from the United States spending time in the sub-Saharan African country of Malawi. Each day, the students learned from their American professors and African colleagues. The students were surrounded by patients with diseases that they had previously encountered only in textbooks and lectures — malaria, untreated HIV/AIDS, the late stages of tuberculosis. Many patients had very advanced disease or long-neglected illness. The students were immersed in a medical system that relied heavily on improvisation. The medical facilities had inconsistent electricity, limited imaging studies and bare-bones laboratory testing. The students also noted that the Malawi hospital had none of the American obsessions with billing and record keeping.