In Summer 2022, I traveled to Rabat, Morocco to participate in a 4-week medical internship. I interned at Clinique La Capitale, a private clinic in the heart of Rabat specializing in midwifery, surgery, and post-surgical care. My typical work week consisted of getting to the hospital at 9:00 am, checking in with our site lead, getting assigned to a unit (nursery, maternity ward/oncology/ICU, or operating room), and shadowing (assisting, if applicable) the medical staff until 5:00 pm. When shadowing, I observed the nurses and physicians as they performed routine checks and conducted patient consultations, watched surgeries, examined scans, and assisted in postnatal care for both the mothers and the infants.
Week #1 & 2: Nursery, Maternity Ward, and Oncology/ICU Units
When I arrived in Morocco in July, the local Moroccan and Islamic community was in the midst of celebrating Eid al-Adha, a national holiday that spans 3-4 days. Thus, I began my internship in the nursery where our assistance was needed. As the only two interns for the month of July, my peer and I spent the first day observing and conversing with the daily routine of the nurses. The nurses would organize the babies up in a line to be cared for, and attend to each. This care included a diaper change, a quick bath, a change of clothes, and a bottle. However, on the second day and going forth, it was all hands on deck. We were given a review of the instructions for how to dress the babies and how to make their bottles, and then were told to complete the post-natal care line up under their supervision. While this was a bit scary at first, as we were caring for hour-old babies, it got easier as went on. I was extremely excited to get this hands-on experience, and loved spending time with the newborns and working with the midwifery staff, who were all so friendly. For one and a half weeks, we had developed a routine with the midwifery nurses, and fell into a daily rhythm.
In Week 2, we were assigned to the patient-centered units which housed post-birth mothers and post-surgery patients. We toured the ICU, which was very similar to that of the ones I've observed in the US. However, there weren't many patients in the ICU, due to the clinic catering to mostly scheduled and/or elective surgeries, instead of critical and emergent cases. When on this unit, I got to observe more of the doctor-patient and nurse-patient interactions that took place at the bedside. I observed the friendly and communal nature that all of the staff had with their patients. The interactions resembled that of those with ones family member. With the main focus of this unit being post-surgery or post-procedure care, the nurses and doctors would review pre- and post- x-ray scans before seeing a patient, and would walk me through what type of scan was conducted and characteristics of the image that pointed to an issue that needed to be fixed surgically.
These two weeks were exciting, and I learned so much. However, one major downside to these two weeks was the language barrier I faced when interacting to some of the patients and staff. Since the two major language of Rabat, Morocco was Arabic and French, most of the medical staff spoke only Arabic and French, but a few spoke English in addition to these two language. Thus, there were moments when I would communicate using hand gestures and Google Translate. Moreover, this barrier also allowed me to practice what little French I knew before going to Morocco, and the Arabic phrases I learned in the weeks leading up to the trip.
Week 3 & 4: The Surgical Unit/ Operating Room
The last two weeks of this internship were by far the best and most exciting parts of my internship. In these two weeks, I shadowed Dr. El Azouzi, a neurosurgeon that completed his medical training in Boston and returned to Morocco to practice. Amazed with our enthusiasm and interest in medicine, Dr. El Azouzi had us sit in on his patient consultations, reviewed numerous scans and explained how they aided him in his diagnosis and treatment, and allowed us to observe his surgeries inside of the operating room. He taught us the difference between T1 and T2 MRI scans CT scans, and described in depth various techniques he used during his surgeries. After the second day, we had created a routine: I would meet Dr. El Azouzi in the operating room masked and prepped, he would then assess the scans with us and tell us the diagnosis and his treatment approach. Next, we would observe the surgery from the first cut to the last suture, and then we would debrief by conversing about things that went well during the surgery, and expectations for behaviors to be seen when the patient wakes and for recovery.
I remember one day distinctly that solidified my interest in science, the human body, and psychology in medicine. My friend and I had arrived in the operating room masked and prepped and had noticed Dr. El Azouzi in the midst of a surgery. Upon entering, we greeted him and the other members of the surgical team in the team. Then, Dr. El Azouzi had us to over the the board with the scans for the patient being operated on in the table in front of us, and told us about the symptoms that the patient had when they were admitted. As we looked over the scan (shown above), Dr. El Azouzi spoke jokingly, "If you cannot tell us what is wrong with this patient, you both owe everyone in this room lunch." Knowing he was only joking, we still took the challenge very seriously and began assessing things that looked out of place. After a few hints and about 5 minutes, we were able to guess that there was a massive leak of some fluid in the left side of the brain. Knowing that this was a T1 scan and blood did not appear as whiteish/grey on this kind of scan, we were able to determine that the mystery fluid was cerebral spinal fluid. Once we figured out the root of the problem and were correct, Dr. El Azouzi commented to the room, "Well everyone it seems that we won't be getting lunch today, but we do have two future neurosurgeons." It was in this moment that I realized in all of the surgeries (breast cancer removal, orthopedic leg alignment, caesarian section, brain tumor removal, lumber and cerebral hernias, hemorrhoids, and abdominal laparoscopy) I witnessed, I had the most fun assessing the scans of and observing the neurological surgeries. Becoming a neurologist was a possibility for my future specialty. It was an amazing area to allow me to put my combined major Biological Sciences and Psychology to use.
Disclaimer: The following content contains images and videos that contains blood and gorgy details, which may be disturbing to some. Proceed at your own caution.
