Doctoring without technology

The lack of equipment in the developing world can make caring for patients difficult but it forces the clinician to rely on training, experience and intuition. When there are no simple lab tests or more complex diagnostic imaging, we must trust our oral history and physical exam.

Antonio is a near two year-old who was admitted for “tiredness”. He had diarrhea for five days but it had recently begun to resolve. He was drinking clean water at home and had no vomiting. On his exam, he was unable to hold his head up and could not sit without support. He seemed like a wet noodle. I guessed that since he had diarrhea and was now weak that his potassium was low. After 36 hours of potassium supplementation and a diet heavy in bananas, he was back to his normal self! No labs needed.

We then admitted George, an adorable seven year-old unable to walk for one week. His family did not speak Tetun, Portuguese, English or Spanish, so our patient history was fairly difficult. After multiple attempts to obtain an accurate story, it seemed the difficulty walking may be due to a neurologic issue. A complete exam demonstrated he had no signs of increased pressure on his brain (i.e. from a tumor), so we simply watched and waited. Today, he rose from bed and began to take his first few steps. No MRI needed.

Antonio after a little postassium

One Response to “Doctoring without technology”

  1. Francisco Acosta Says:

    I am not a big fan of doctors, as i visit a hospital or doctor only when required. Thank god, i never get sick as often. I have a strong belief some doctors are so dependent on equipment, they forget the basics and I see you guys know that from having to deal with lack of technology. Great job!

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