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dc.contributor.authorWind, A
dc.date.accessioned2020-01-08T15:41:54Z
dc.date.available2020-01-08T15:41:54Z
dc.date.issued2019-12-09
dc.date.submitted2019-12-23
dc.identifier.issn2053-8855
dc.identifier.doi10.1093/omcr/omz112
dc.identifier.urihttp://hdl.handle.net/10144/619565
dc.description.abstractIn 2015, I was in the Democratic Republic of the Congo (DRC), working as a pediatrician with Médecins Sans Frontières (MSF). As had been the case in my two previous assignments with MSF, I encountered many interesting and challenging cases—cases that I had never experienced prior to working in resource limited settings. Contrary to when I work in the USA and have access to extensive laboratory exams and diagnostic testing, in our hospital in the DRC, no such tools were available, and thus I needed to use a whole new level of clinical skills and deductive reasoning. To make clinical management even more challenging, I rarely saw these types of cases written about or published in the medical literature. I was discouraged that although these clinical examples were perfect fodder for medical case discussions, they did not have the ‘components’ required for a traditional case report. In frustration, I wrote the following: ‘The reason why we, those working in “resource limited settings”, do not often attempt to publish case reports is because we don’t often find an answer. We think that published articles and case reports should be neat and clean. That students or colleagues should be able to read a mystery case, try to solve the puzzle, and at the end be rewarded with an answer brought about by some obscure lab or radiology report. But that’s not what happens. The world of medicine in resource limited settings isn’t neat and clean. It’s frustrating and messy. Mystifying and sad. You can come up with a million differentials but ultimately the child, because of, or in despite of, your chosen treatment, makes it. Or doesn’t make it. And you never get an answer. You don’t learn. And you can try to look in the literature, but the research will talk about IGF1 and MRI and calcium. I can’t even get a cal.ci.um. And so, the mystery disease leads to a mystery death and you are left feeling powerless. And there is not even a take home message.’ I am excited that now with the Oxford Medical Case Reports collaboration, there is a platform to start regaining some power, to start creating a take-home message. There is a platform for collaboration amongst all of us medical professionals working in resource limited settings—a platform to share these unique cases to perhaps discover that they are not so unique at all. They are just not published.en_US
dc.language.isoenen_US
dc.publisherOxford University Press (OUP)en_US
dc.rightsWith thanks to Oxford Pressen_US
dc.titleA reflection on case reporting in resource-limited settingsen_US
dc.typejournal-article
dc.identifier.journalOxford Medical Journalen_US
dc.source.volume2019
dc.source.issue11
dc.source.beginpage469-469
refterms.dateFOA2020-01-08T15:41:54Z


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