There are no paintings on the walls in the hospitals I have worked at in the capital of Liberia.  The bareness of the walls parallels the limited equipment I have on hand.   Listening to some of these patients, or looking at their X-rays without the benefit of modern technology, I get the feeling I am seeing pathology in its most extreme form – the way people saw it when the diseases we now treat routinely in the West were first discovered. Listening to the sandpaper sound of one man’s pericardial rub, caused by fluid moving around the heart muscle from an infection or cancer, I think, “Oh! That’s why we call it a ‘rub!’”  Sometimes the challenges of this work, such as helping a grandmother survive a simple asthma attack, are rewarding.   Other times my co-workers and I face the horror of losing a two year-old before we have even made a diagnosis. (more…)