Saturday, June 7, 2008
Hands on
Thursday, May 29, 2008
Last call!
Last night was my last call of residency. Over the years, when I tell people that I'm on call, there are different interpretations. I've found myself having to explain over and over that call means staying in the hospital 24-30 hours at a stretch. Then I have to explain how that is possible and blah blah blah. After 4 years, I finally took my last call. I was sitting back in the call room thinking about how many calls I probably took over 4 years. If I say that on average I took about 4 calls a month over a 4 year period, then I probably took about 200 calls. That's 200 nights spent at the hospital, time that I'll never get back. But, it's 200 nights where my skills were tested to the max. Where I learned how to be a doctor, and how to take care of patients, how to talk to patients and their families. How to be realistic with them, give hope, or deliver the worst news possible. That's a lot of time.
When I was an intern, I remember feeling nervous everytime it was time for call. Every page I received would worry me, and I would worry about the patients endlessly. Somewhere, probably around year 3, I kind of lost that nervous feeling as I became more comfortable with my role. I still worried about the patients, but I was more confident in what was expected of me and my decision making skills. One of my old friends from residency used to get very wound up and nervous every call. Finally, around year 2 she stopped and said to me, "what is the worst thing that can happen. I'm not going to die, some of the patients might, but I'm not going to die." I think this about sums up how it feels to be an inexperienced resident on call. As I finished up this last call I began thinking about what the future holds. No more in house call, but I will still need to take home call. I know that I will be nervous again, as I was 4 years ago when it comes to call, but at least I will not die! What I really look forward to is a little more time outside the hosptal (maybe)!
Friday, March 21, 2008
Return to real life..
So I'm again trying to get the Sydney pictures posted. I can't figure it out, again. I'll keep trying, keep checking for an update.
Tuesday, February 26, 2008
Rough cut of pictures!
The home stretch
Saturday, February 23, 2008
The longest airplane ride in the world!
Tuesday, February 19, 2008
Goodbye to Bolivia
After our excitement, we went to a waterfall to go swimming. We had a picnic lunch packed by our hostel. Afterwards, we headed back to Santa Cruz. This morning we went on rounds at the public hospital. It just always amazes me there. I saw 2 patients on ventilators on the floor, not on any monitors. Their vents are the oldest vents I've ever seen. They only have 2 modes , CMV or IDV. But everyone's vent settings were the same, whether they weren't breathing over, or if they were breathing 50 BPM. Weird. They also assume that everyone has dengue and treat accordingly, and if it turns out they are wrong, oh well. Not the greatest examples. Today was scorching hot. It was oppressively hot. I'm glad to get a break. It will be a long flight, but I'm looking forward to Sydney!
Thursday, February 14, 2008
Breathtaking and breathless La Paz!
So, another adventure started this past weekend. I flew to La Paz with 2 of the medical students and the other attending. La Paz is the capitol of Bolivia, and I think is the highest capitol in the world at 14,000 feet. We had decided to fly the national airlines, aerosur. I had trouble getting my credit card accepted, so had to book through a travel agent (which is an important detail later on in this post!). So we thought our flight headed out at 8:30. Turns out that airlines schedules here are just loose suggestions. People show up for the flight about 5 minutes before scheduled take off. They also can´t fill their planes with people because the engines can´t handle the weight! Anyway, we finally arrived after midnight in La Paz. Because the airport is so high up, the runway needs to be extra long, 5km, because it takes planes longer to stop because the air is thin. It also takes a really long time to get enough wind speed to take off. Therefore, when I finally left La Paz, our take-off terrified me because you are speeding down the runway for 3 times the normal amount of time, and you barely lift off!
Anyway, La Paz is absolutely breathtaking! The whole city is built into a crater in the Andes mountains. I loved it! When I stepped off the plane, I wasn´t sure if I was going to feel altitude sickness right away. Luckily I started taking diamox (great stuff) and didn´t get sick at all. I was huffing and puffing much more than normal! Anyway, we made our way to the hostel, the world´s highest microbrew. Unfortunately, they were no longer serving beer by the time we got there :( The next morning we got up early and headed to the buses to Copacabana on Lake Titicaca. The public bus took 5 hours, but the scenary was breathtakingly beautiful! Mountains, Lakes, and rural Bolivia. It makes me really regret some times living in a really flat city!
In Copacabana on the edge of Lake Titicaca we found a nice hotel and explored the town. There was probably more gringos there than I´ve seen the entire trip! Most were German, man, those people get around! Ï´ve seen German tourists in every third world country that I´ve worked in, including Ghana Africa! Anyway, after enjoying the afternoon in Copacabana, (carnivale was still going on), we settled in. The following morning we headed out on a boat to Isla del Sol, an old Incan site. The boat ride took 1.5 hours, then we had only 1 hour on the island and had to return! It was fine with me, the boat ride was more beautiful. I got really burned on my face and arms, though! I forgot, it was cooler, but we were closer to the sun!
Next we headed back to La Paz. I loved La Paz. It was like being in a completely different country than Santa Cruz. The indiginous are closer to their roots. The women wear shawls, skirts, derby hats and carry their children on their backs. We walked around at some of the markets, including a witches market which sold really weird stuff like llama fetuses. Next we went down to the cosmopolitan area, which was like any other city. We visited the museum of contemparary art. To our surprise, all of the art was for sale, and affordably on sale. I fell in love with a painting of La Paz and bought it! I got a certificate of authenticity and everything!
We were suppose to leave that night. When we arrived at the airport, we found out that my flight supposedly left the day before, even though we had confirmed with the airlines. It was a whole debacle. There was moments when I thought that I was going to be staying by myself in La Paz, knowing very little spanish. Turns out the one of the students stayed with me. We flew back the next morning and made our way out to clinic, very late! I hope to get some pictures up so everyone can see how breathtaking it was, but time is tight now. I leave for Sydney next Wednesday. We plan on heading to Samipato this weekend, it is a dutch settlement in the middle of Bolivia. Should be interesting!
Saturday, February 9, 2008
Palacios, to many people in a small space!
Wednesday we headed out to the clinic. There was 12 of us headed to a house made for 6. Needless to say, space was tight! The road finally had dried out and we could make the extra half hour drive down a very bumpy dirt road. The clinic is pretty remote. I really felt cut off from the world out there, I was probably the most cut off that I´ll ever be. There was tons of bugs! But the stars were beautiful. The land around the house and clinic have a bunch of horses. They would come right up to the clinic door.
The first day, everyone split up. I headed out to one of the remote villages with a couple other doctors. The village was cute, but poor. We saw patients on someone´s front porch. Our waiting room was their front lawn. In that village, it was mostly young women and children. I saw some interesting stuff, though. Diagnosed a kid with pericarditis without an EKG. Since there are so many internist down here, I decided to just bang right through all of the kids. It was fun. But trying to decide who gets the amoxicillin and liquid tylenol when we only have 2 bottles was not fun! Afterwards we all gathered at the house for chicken curry and divided up the rooms/beds. I luckily ended up in a bedroom with 2 beds and a total of 3 girls. We pushed the beds together and slept pretty comfortably 3 across. In the other room, there was 2 bunk beds and 4 people, but apparantly, one person snores like no other so I was glad not to be in that room. Our bosses slept on the couch and on a spare mattress in the kitchen. 2 boys had to sleep in the clinic, which I imagine was pretty buggy!
The next morning we split up again. We headed out to another village that was pretty remote, but large. We saw a lot of people there at a ¨"hostel", if you could even call it that. Again, I tried to stick to the kiddies! Lots of rashes around here. I bunch I didn´t even know what I was looking at. There was one old guy with a raging STD. He was 68. Good for him.
Anyhow, the third day we all stayed at the clinic all day. The clinic is really nice. It´s big and spacious and like a full functioning clinic. There´s a room for eye exams, dental, and gyne. I saw lots of patients, but the one that sticks out was an 8 year old girl with some bony abnormalities from birth and severe scoliosis. At home she would have surgery on her back. We´re going to try and convince someone to come and do surgery on this girl. That night, half of the people left because they were flying home. I finally felt like we could breathe again. We found out that a cat had given birth under one of the bunk beds, and there was much excitement in pulling her out and looking at the kittens.
Today we saw a few patients in clinic and headed home. Since the main driver had left with the others the day before, I had to drive us home because I was the only one who knew how to drive stick shift. Unfortunately it had been raining all day. The road was really muddy and slippery, but I´m proud to say that we didn´t get stuck once. I drove the whole 2 hours back to Santa Cruz, even though all of the drivers are crazy. On the way back we saw a lady get on the back of a motorcycle in the rain carrying a cake, right out in the open, not even in a box. Everyone here is crazy. Right now I´m getting ready to head off to La Paz. I hope that I don´t get altitude sickness, the capitol is 14,000 feet up there.
Monday, February 4, 2008
Trying to add photos!!
Anyway, lots happens everyday and I fall behind in blogging. Time here seems endless! It makes a big difference not having distractions like phones and TV. We also are only working 4 days a week. I'm not used to so much time! When we returned from our rural adventure, I took a long wonderful shower. I felt so dirty from the hostel. That evening we went to eat dinner at Casa del Cambo, a traditional Bolivian restaurant. It would be equivalent to a fancy restaurant at home, but our entire meal with appetizers wine, beer, and dinner was $10 each. The restaurant itself was akin to Fogo de Chao, with the waiters all dressed up. They did have a cheesy background keyboard singer throwing out a mix between traditional bolivian music and cheesy 80's songs.
Saturday, my boss for this month and her husband arrived. That evening, Sharon (the canadian social worker), took usto a Bolivian baptism. She had befriended a Bolivian family during her last visit and they had asked her to serve as Godmother. We arrived at the church super early. But it was nice, different than at home. Only the mother and godparents were there for each of the families. Sharon was Godmother to 2 year old Jose Eduardo. A 3 year old girl named Sharon was also getting baptised. Afterward, we made our way to the family's house for the party. Their house was humble. They had set the party up in the front yard with the chickens and dogs. The BBQ pit was made with a chain linked fence. But the amount of food they bought must have cost them a years worth of salary (actually, I think Sharon bought a bunch of it). They were so excited to have the Americans at their party. The food was delicious, even though I knew that I would probably pay for it later! We played soccer with the kids. Later in the evening there was lots of dancing. It was great.
Sunday, we finally made it to a carnavale party. So, they had warned us to wear clothes that we wouldn't mind getting wet and dirty. I was thinking that we were going to this family's house and that maybe they would throw a few water balloons at us. Oh no, this is a city wide water balloon fight! Everyone from the very young to the very old get into it. We arrived at our host's aunt and uncle's house. After greeting everyone, his aunt, who is about 70 years old, walks over to a bucket of water, takes it and dumps it over our head! After that, it all broke loose! There's strategy involved. There is also lots of dye involved. I was drenched from head to toe and also covered in paint! If a gringo attempts to walk down the street, you are just pelted with dyed water, foam, waterballoon, hoses. There's so much coming at you that you can't tell where it's coming from! Everyone's is into it, I loved it!
When we came back to the house, a whole bunch more people arrived. Yuna, the 1st year NW student left and so did Sharon, the canadian SW. Now there is an OB attending from Wright state that brought a resident and a student. There is also a 4th year student from UCSF who has been traveling around central america and is staying for a month. There is an attending from UC Davis, and a college student who will be staying for 5 months as a volunteer! We are packed into the house now! It's still a lot of fun hearing of everyone's story!
Saturday, February 2, 2008
Jugo, clinica, y more
So this week it was just the 3 students and myself. Each day we also had a Bolivian doctor there as well. I sent 2 patients to the hospital this week. One woman had just been discharged after staying about a week and being treated for a UTI. She was dehydrated yet again, and looked terrible. Another man actually was receiving dialysis twice a week, and came to clinic with a blood pressure in the 70's/50's with tachycardia and fevers. I've seen some heart disease, DM, lots of arthritis, and one rheumatoid arthritis. The kids mostly had "beechos" which is there term for worms, parasites, etc. All in all it was similar to other trips I've taken in the past, but I felt that these patients had more continuity and follow up. And I could actually order tests on them if necessary. The saddest moment was when I saw this older man, who had sustained a large burn injury on the back of his leg about 1.5 years ago. It was still open and quite large, but fairly clean. I was trying to explain how he should dress the wound every day when I found out he couldn't afford soap. That sucks! We bought him some soap.
We stayed out at a small town near the outpost, at a village called Buena Vista. It was very cute. Every town has a plaza which is the focal point of the town. The plaza is like a park, with lots of trees, bushes, flowers, and also lots of benches. In the evenings, everyone comes here to hang out, talk, etc. It's really nice. Buena Vista had a nice plaza, surrounded by a church built in 1690. They are famous for their jugo or juice. It was delicious, a combo of orange, passion fruit, strawberry and other stuff. It was great. Our hostel, on the other hand, was bare bone basic. It cost $2 a night, and was worth only $2 a night. Pretty much we were camping outside. The outside toilets broke after 1 day. The showers had those electric shower heads that I hate, with lots of wires sticking out. I'm always freaked out that I'll get electrocuted! All in all, wasn't that bad, and not too many bugs except for a gigantic cockroach the size of my foot!
On Friday night we made our way back to Santa Cruz. Carnavale is going on from Saturday to Wednesday morning. Basically, it sounds like a large city wide water balloon fight with drinking and dancing! We'll see! Also, a couple people left the house and a whole boatload of people arrived, from Wright State, UCSF, and Loyola. Where are all these people going to fit! More on carnavale and hopefully pictures in the next post!
Tuesday, January 29, 2008
Car accidents, butterflies, and rounds
Today, we went to the public university hospital for rounds. It was interesting. I've worked at a hospital in Ghana and felt that this hospital was much better. It was similar to the hospital in Kingston, Jamaica. There were residents and students and we were on their teaching rounds. The wards were crowded with patients. Nobody washes their hands or talks to the patients. There's no such thing as HIPPA or hand sanitizer. If a test or medication is ordered, the patient or their family has to go across the street to get it done. The patients themselves were very interesting. Saw a lot of brain lesions, HIV, stoke, PCP pneumonia. I also saw a lot of management I didn't necessarily agree with, but I didn't really catch everything that was going on either. Maybe I'll catch more next week. I did notice that the male physicians there would talk only to the male students with me, and not to me or the other female student! Tomorrow we head to the rural clinic until Saturday. It should be an adventure, as the main road to the clinic is impassable!
Sunday, January 27, 2008
The Real World: Bolivia
So, I feel like I´m on an episode of "the Real World: Bolivia". We live in this gigantic, nice house. Most of the people in the house are between the ages of 22-33. There´s always people coming and going. Let´s see, there is me and the 3 4th year medical students. The volunteer coordinator is just out of college and is living here for 1 year. There is a girl who is taking a year off after 1st year of medical school to decide if she really wants to do medicine. She is staying down here for a few months. There is a canadian social worker who is down here for a few weeks on a project, and taking care of some personal business. My boss´s son is living here, being an "artist", but mostly hanging out with his bolivian girlfriend who lives in the house. And then there are 3 bolivian graduate students who live here, and our housekeeper and her daughter! That´s a lot of people coming and going! There´s a big mix of english and spanish being tossed around.
So in true real world style, most of us went out last night together to celebrate saturday night. Santa Cruz is in party mode right now as people are getting ready for carnaval! It´s a really nice city. We started the evening by going to a brazilian all you can eat pizza restaurant. They had some interesting pizza combos, including a stroganoff pizza with fries on top. They even had dessert pizza, chocolate, carmel, and fruit. Afterwards, we went to a place called Jose Cuervo´s, which lived up to its name. The street we were on was filled with bars and clubs. Everyone was hanging out on the street as well, almost like a large tailgait, partying in the street and in the bars. I felt like I was at some big college town after a football game. We did some dancing. Most of the music was Daddy Yankee style. All in all, a fun night and a lazy morning today!
Friday, January 25, 2008
I've arrived!
Sunday, January 13, 2008
Sunday, January 6, 2008
First time for everything
About Me
- wandering scrubs
- Chicago, IL, United States