BPC blog

A kaleidoscope of cardiac pathology

admin — Tue, 14 Feb 2012 01:57:12 +0000

Australian cardiologist Dr Noel Bayley examining a local young patient with heart problems at Bairo Pite Clinic in Dili during his March 2011 visit. Photo © Basil Rolandsen (http://bouvetmedia.com)Final report: 48 cardiac echos… 1 normal, the other 47 represent a kaleidoscope of cardiac pathology including congenital like VSD and ASD, then large dose of rheumatic including balloon and several multi-valve replacement candidates, an infiltrative cardiomyopathy and a calcific aortic valve stenosis… and, oh, can't forget an about to fail right heart from chronic endocarditis… plus a myriad of post ops doing very well thank you… all in all an excellent harvest for the visiting team.

Thank you Dr Bayley et. al.

Dr Dan Murphy is the head physician at Bairo Pite Clinic

The Dili trip was terrific. Very busy, we saw almost 60 patients over two days.

Three young women with very severe rheumatic valve disease were identified, and we'll be striving to organise lifesaving surgery for them in the next few months.

The most moving part of the trip was the opportunity to see our patients from the last few years. Without exception, they are well and living normal lives, a dramatc change from their very ill and disabled preop state. The technical results are also better than I could have hoped for.

~ Dr Noel Bayley

Our reputation precedes us

admin — Sun, 12 Feb 2012 01:44:18 +0000

Suddenly the parking area just outside the consultation room was flooded with “official” automobiles… out jumped fully armed men everywhere…this is it I thought… the coup de tat…

But no, just a friendly pop in visit by Israeli Ambassador to Timor-Leste Amira Arnon… “had to see the Bairo Pite Clinic” she said.

Pleased to hear that our reputation precedes us in some quarters.

Dr Dan Murphy is the head physician at Bairo Pite Clinic

We will do all we can

admin — Thu, 09 Feb 2012 01:01:32 +0000

Australian cardiologist Dr Noel Bayley of East Timor Hearts Fund (right) again visits Bairo Pite Clinic to screen heart patients for possible medical treatment. Here with BPC Director Dr Dan Murphy. Photo © Basil Rolandsen (http://bouvetmedia.com)Big cardiology day yesterday with Dr Noel Bayley… a variety of challenging cases… several surgical candidates.

To everyone helping to search for help with what I believe are now 3 leukemia cases I am sad to report that Geraldo, age 25, succumbed to his disease yesterday. We still have 2 children left… one ALL and one AML. We will do all we can to get help for these patients with this very treatable diagnosis.

Dr Dan Murphy is the head physician at Bairo Pite Clinic

No fatalities yet

admin — Mon, 06 Feb 2012 00:47:14 +0000

4 dengue admissions yesterday… one critical… this thing is getting dangerously out of control… fortunately no fatalities as of yet… can only imagine the situation at Dili National.

Dr Dan Murphy is the head physician at Bairo Pite Clinic

An isolated life

admin — Fri, 03 Feb 2012 00:12:56 +0000

Urgent 3 am call from maternity… primip with abnormal presentation… on exam seemed vertex but lacking cranial vault… delivery confirmed suspicion… anencephaly with accompanying cleft lip and other anomalies… one in a thousand pregnancies… doubly tragic for mother who also has cleft lip… at risk for an isolated life as incapable of producing “normal” offspring… will do all we can to counsel and provide folic acid.

Dr Dan Murphy is the head physician at Bairo Pite Clinic

Now to save this child!

admin — Tue, 31 Jan 2012 05:35:41 +0000

The last patient of the day… this is the time when I battle with fatigue and near insanity…

WAIT! STOP EVERYTHING! One look and my attention was riveted… 4 year old carried in by his disheveled and gaunt father… pale, severely malnourished, and moderately dyspneic, this child was chronically ill and nearly moribund. My thoughts were, “What a massive effort for this man to come from deep in the mountains to BPC.”

The imploring look in his eyes nearly brought tears to mine. He was saying without words, “I love my son. I have done all I can. Please save him.” A poverty stricken subsistence farmer who now was taking advantage of TimorLeste’s independence to give his family a better chance.

The whole thing affects me profoundly. Now to save this child!

Dr Dan Murphy is the head physician at Bairo Pite Clinic

We don't need it

admin — Fri, 27 Jan 2012 00:38:53 +0000

Now I'm worried… yesterday called to the lab to see a smear on a 16 year old with fever and chills… 3+ Plasmodium falciparum… we've had an inexplicable lull in malaria cases for 3 months… but over the last week starting to pick up again… with intermittant pesticide fulmigation we could be turning a hyper-endemic area into an unstable one with inadequate background immunity for many adults making them susceptible to severe attacks of malaria. This on top of a rapid rise in dengue cases. We don't need it.

Dr Dan Murphy is the head physician at Bairo Pite Clinic

Amazing work

admin — Tue, 24 Jan 2012 23:31:06 +0000

This won't make any headlines or even the news… but for the people of Manusai things will never be the same. It was the initial visit of Dr Aida and Frontline.

Over 5,000 people live there, ceremony, pomp, and inspirational speeches. Consult for 240 patients. Beginnings of the process of choosing candidates for lay midwife training. Setting the groundwork.

This is the tried and true formula for transforming village dynamics for sustainable and meaningful improvement in health. Amazing work Dr Aida.

Dr Dan Murphy is the head physician at Bairo Pite Clinic

Dr Aida Goncalves examins patients at a mobile clinic in Betupu village (Hatulia sub district, Ermera). Photo © Basil Rolandsen (http://bouvetmedia.com)

Looks like thalassemia

admin — Tue, 24 Jan 2012 03:11:55 +0000

Six year old from Los Palos, Hgb 4, previously treated with prednisone. Smear looks like thalassemia.

Dr Dan Murphy is the head physician at Bairo Pite Clinic

Anyone's guess

admin — Sun, 22 Jan 2012 02:54:58 +0000

Yesterday’s work load brought new meaning to “insanity”… my favorite case: neither the poor girl or her mother had any idea of her age… we are just poor people she said… they come from Luana, somewhere behind Ramelau, the crown of Timorleste. She appeared pre-adolescent but it was anyone's guess with the body ravaged by chronic disease… speaking only simple Mumbai she told how tired she was as I examined the sores with purulence draining from her lymph nodes… she was dyspniec and febrile and cachectic… we dilated her right pupil searching for choroid tubercles and then started the treatment that will most assuredly improve her squalid existence.

And then:

Fernando off to NIH in US tomorrow
And the 3 MS's homecoming from Melbourne
Tuesday spinal fusion for Teresa in Tokyo

Fantastic multinational assault on disease in Timor-Leste.

Dr Dan Murphy is the head physician at Bairo Pite Clinic

New Dx is ALL

admin — Wed, 18 Jan 2012 00:25:55 +0000

Turns out the aplastic anemia isn’t after all… new Dx is ALL… saw one of the nasty “blasts” on periferal smear myself…

Now, who will treat this very treatable malady?

Dr Dan Murphy is the head physician at Bairo Pite Clinic

Gone in 3 hours

admin — Tue, 17 Jan 2012 00:21:17 +0000

Now we know how a grade 3 sarcoma can kill… yesterday at the clinic… 22 year old female with most of the upper back ravaged by an invasive angry fungating raw malignancy oozing serosanguinous material… pale as a ghost and barely able to whisper… gone in 3 hours… RIP.

Dr Dan Murphy is the head physician at Bairo Pite Clinic

New challenges abound

admin — Mon, 16 Jan 2012 00:18:34 +0000

TB dacryocystitis… yup, TB meningitis in 25 yr old college student… already resolving… CML improving nicely on imatinib…

Bone marrow biopsy on the way to Brisbane to delineate aplastic anemia…

Malnutrition ward overflowing…

3 MS's off to Melbourne tomorrow for balloons…

Acutely psychotic 17 yr old finally sedated with 300 mg chlorpromazine/d…

New challenges abound.

Dr Dan Murphy is the head physician at Bairo Pite Clinic

Hematology ward

admin — Thu, 12 Jan 2012 01:38:03 +0000

Two young guys admitted this week… one with HUGE spleen, WBC 368,000, mostly premature myeloid elements… blood off for translocation 9, 22 Philadelphia chromosome… imatinib already begun…

Guy next to him has chronic cough and pallor… hmm… WBC 1,000, Hgb 26, and platelets 18… either too much or too little… can't seem to win. Gotta start a hematology ward.

Dr Dan Murphy is the head physician at Bairo Pite Clinic

“Revolutionary Doctors”

admin — Mon, 09 Jan 2012 04:23:56 +0000

Just finished the book “Revolutionary Doctors” by Steve Brouwer. Very appropos to what we are trying to do in ET. Like most things the theory may be exemplary but results depend on practical application.

To me the key message is fundamental solidarity with those in need. This must be the pervasive mind set to achieve our goals.

We are all extremely fortunate to have the example of both Che Guevara and Cuba to illuminate our paths.

Dr Dan Murphy is the head physician at Bairo Pite Clinic