Veteran Rheumatologist Takes Expedition Medicine Trip to Rural Nepal

Left: Home visit to assess Sangmo’s shoulder pain.

Right: Dr. Overman (center) with trail-side patient and his wife.

Returning Renewed

I visited meme Choesang for the last time four days after I found him with a ridge belly. My suspicions had been wrong—he didn’t die and, in fact, was awake and eating. Ceftriaxone IM, triple H. pylori therapy, and rehydration fluids may have helped, or maybe it was his karma. Either way, he won this battle to not to leave this world, and suckling Karsung was winning her battle to stay.

So, where have you always wanted to go? Do it. You will learn expedition medicine and third-world medicine easily, given your internal medicine foundation. As a rheumatologist, you deconstruct complex illness through patient stories, do comprehensive multisystem examinations, and think about the whole person. These skills will allow you to practice medicine anywhere, but it is your comfort dealing with the unknown, your ability to offer hope when all the answers aren’t known, and to hold your patient’s hand during any crisis that will assure your usefulness. Anywhere you go, there will be people in pain, with inflammation and disability, who will appreciate what you have to offer. Being so close to the challenges and joys of simple living will fill your heart and renew your soul.

Dr. Overman is a founding member of The Seattle Arthritis Clinic and chief of rheumatology at Northwest/University of Washington Medical Center. He has practiced rheumatology in Seattle for 30 years and co-authored You Don’t LOOK Sick! Living Well with Invisible Chronic Illness. He is currently clinical professor of medicine at the University of Washington School of Medicine.

References

1. Murray WH. The Scottish Himalayan Expedition. London: Dent; 1951.
2. Craig SR. Healing Elements: Efficacy and the Social Ecologies of Tibetan Medicine. Berkeley: University of California Press; 2012.
3. Furst DE, Venkatraman MM, Krishna Swamy BG, et al. Well controlled, double-blind, placebo-controlled trials of classical Ayurvedic treatment are possible in rheumatoid arthritis. Ann Rheum Dis. 2011;70:392-393.
4. Patan Academy of Health Sciences. Nepal at a Glance. Available at www.pahs.edu.np/about/about-nepal. Accessed August 29, 2013.