Réanimation

Soon after we arrived in Burundi, I was informed by the dean of the medical school that I am a “Réanimationist”.  I am still not sure exactly what a Réanimationist is, but I have to admit, the title is pretty cool.  In fact, I am considering having business cards and T shirts made up.  Greg Sund,Réanimationist, MD.  

As to what the practice of reanimation involves, the answers I have received have been mixed.  As I now understand it, it does NOT involve copying cartoon characters.  And I am not in fact expected to bring dead people back to life.  And after some clarification, it turns out that I am not expected to give the power of vision to children who have gone blind from meningitis (yes, I was asked to consult on a patient for this very reason).  

From what I now understand, it involves a combination of anesthesia and critical care medicine, with an emphasis on resuscitation.  The reason my new title is important is because all medical students in Burundi are required to rotate through one month of “Reanimation”.  Given that the medical school here has no reanimationist, this requirement has gone unable to be fulfilled for many of the medical students (apparently, there are 3 or 4 “Reanimationists” in the country, but they do not have enough availability to get all of the medical students through this rotation).

So, I was asked if, during my time here, I would lead a monthly Reanimation rotation, with 6 students each month, in the hopes of getting 30 or 40 students through this requirement while I am in Burundi.  I said yes, and this past week, we began.  

Mercifully, they chose 6 of their best English speakers to ease me into this new role.  Our schedule involves 2 lectures each week, mornings in the O.R. learning about anesthesia, then spending 3 afternoons each week rounding on critically ill patients, which we are asked to consult on by various services (Peds, Internal Medicine, Surgery).  To be certain, this afternoon portion is a role I am far removed from back in the U.S.  I did 3 months of critical care rotations during my residency, but since then, the only time I am invited into the ICU is when someone needs to be intubated or needs an invasive line.  So, I am hitting the books, and trying to dredge up all those critical care memories that have been suppressed for years.

The first week has gone surprisingly well.  And I have actually found myself enjoying my time on rounds.  There are plenty of moments that involve me stepping out of my comfort zone (eg. rounding on a patient in isolation with multi-drug resistant tuberculosis).  But the students are wonderful.  They are diligent, and compassionate, and they are learning so much with so few resources (no ipads, no computers, and the only books they read are a handful of medical books in English which are kept at the hospital … then they are required to present all this information in French).  

So, the next time you are feeling less than animated … feel free to call me … Greg Sund, Réanimationist ….. MD.