Matthias Frischhut (General Medicine, fifth year) reflects on a medical internship and sends pictures. His 14-day stay at the Annapurna Neurological Institute in Katmandu was supported by the Second Faculty of Medicine's Internationalization Fund.
From OT to ABC
After two days of exploring the chaotic and lively streets of Thamel, a renowned district in Kathmandu, I found myself attending the morning meeting at the Annapurna Neurological Institute. Held daily before rounds, these meetings provided an opportunity to discuss complex new cases and update each other on patients in the ICUs and wards. Those first 20 minutes were enough to convince me that the long journey from my home country of Austria was worth every effort. Surgeons, nurses, and other doctors openly discussed challenging cases, with mutual respect for everyone present, despite the strong hierarchical system typical of any hospital. My questions were answered with expertise and patience, as if the constant time pressure of the hospital paused momentarily. After being introduced to the various departments that morning, I joined one of the neurosurgeons to assist in my first herniated disc decompression surgery.
In the following days, I spent most of my time in the operating theater, assisting with numerous neurological, orthopedic, and vascular procedures. These included disc decompressions, transsphenoidal pituitary macroadenoma resections, intramedullary nailing of the tibia, cruciate ligament reconstructions, and varicose vein corrections, to name the most common. When I wasn't assisting, I observed intricate open-skull surgeries. The sight of the head neurosurgeon delicately maneuvering the superior cerebellar artery to separate it from the trigeminal nerve, relieving a patient of trigeminal neuralgia, is an image that will stay with me forever. My late afternoons, once surgeries concluded, were spent in the emergency room placing urinary catheters, drawing blood, administering infusions, changing bandages, and assessing stroke cases. I took a particular interest in the MRIs, CTs, and X-rays of acute stroke, trauma, and TB patients.
During breaks, I bonded with doctors and nurses over the delicious food, rich culture, and stunning landscapes of Nepal. I received numerous recommendations for restaurants, traditional dishes, customs, and trekking routes in Kathmandu and beyond.
To ABC
Annapurna Base Camp (ABC) was our goal and mission after completing the two-week internship in Kathmandu. Starting from Pokhara, our views only improved with each passing day. Although we hiked at the tail end of the monsoon season and expected rain, we were incredibly fortunate to witness the peaks and the full beauty of the Annapurna region.
After a month in Nepal, I proudly look back at all the practical and theoretical knowledge I've gained, as well as the friendships I've made along the way. I also cherish the less obvious lessons taught by the doctors and nurses—about being mindful of patients' beliefs and religions, viewing cases holistically rather than focusing solely on obvious problems and solutions, and practicing pragmatism, where some countries must carefully consider their medical resources and avoid overtreatment.
