Sunday, May 29, 2005

Natalie Chavez Journal 1

This week was very interesting, trying, and eventful. I feel that this journal may be a few pages long, since I have so many memories in my head I want to organize on paper. The plane ride was the most difficult part of this whole experience. I had to take off from four different airports in order to finally get to Roatan. I managed to pull it off well, taking in mind that this was my very first time traveling alone. I really had to grow up almost instantly and take care of myself in the real world. When I arrived to the airport Dr. Black found me. He says he knew it was me because I was the only American looking lost. I was trying to look for Krista the whole time, so I was a bit surprised when a larger man approached me. Dr. David Black is a real sweet guy, who speaks freely about how his kind (aka Gringos) are taking over the business in Roatan and exploiting the native population there. He also never hates to criticize the corruption in the U.S. field of medicine and the pay system ruled by insurance companies. He gave me a crude wake-up call to the reality of the medical system in the U.S. and how insurance companies determine how physicians attend their patients and how they get paid per patient, not taking into deep consideration the quality of health care.

Dr. Eli Sills was the attending I was going to be sharing a room with during my stay. He is a third generation Californian who was born in south California and raised in Oakland. We shared a lot of things in common because we were brought up with a lot of the same things that were unique to California, like local radio stations, for example. He was 29 years old and was to graduate from residency this July. He completed his undergraduate studies in UC Davis and went to medical school in both Tel Aviv, which is in Israel and in NYU in the USA. I didn’t know a medical student could go to two different medical schools. He said he was in a special program, but I forgot to ask what. I had never heard of that before. He also told me about all of the different things that have occurred to him throughout his life, like witnessing the suicide bombings in Iraq and also being in New York during 9/11. During 9/11 he was anticipating a swarm of injured people from the tragedy, so he discharged all patients who were not critically ill, which was about 90-95% of the patients in the ER. To his surprise, barely any people showed up for help and this was because they either escaped with minor scrapes, cuts, or bruises, or they were dead. He travels a lot. I believe he has also been to Vietnam, Thailand, and a few other countries. Traveling sounds like a wonderful thing I’d want to continue doing. He is very knowledgeable of different cultures, which is good to know especially in California where the population is so diverse. We shared many conversations about different universities and the importance or unimportance of prestige. He says that as long as a person is passionate and committed to what they are trying to achieve it does not matter where that person came from. He said that when patients come and see him they don’t ask what school he is from because they don’t care. They are there to see him because they like the care they receive. I got rid of a lot of assumptions that night. He reminded me a lot of Dr. McCullough when he said that there is no right way into medical school. I have heard that so many times it has become 100% internalized.

I also met a group of nurses from Alabama who were traveling and volunteering at Peggy’s clinic, as well as the Roatan hospital in Coxen Hole. They were much more different than Dr. Eli in that they liked to party hard after a long day of work. I went out with them a couple times and they made me wonder how they maintained fully functional the next morning. Those nights I spent with them were the most fun I have had ever. I have always been shy to dance around people I did not know, but their energy just rubbed off. They were spending the night in the two rooms next to ours, so we all became good friends.
I bonded more with a couple from Canada named Bobbie and Darron. They were both my age and had independently contacted Ms. Peggy to see if they could travel down here to volunteer. They have taught me so much about the Canadian government, medical system, school system, and overall culture. Bobbie kept telling me that I was deprived because I had never tasted Canadian ketchup chips. They are very motivated, passionate, and influential individuals that have inspired me to travel, take up different languages, and experience a different world outside my own. They will be leaving next Saturday, so hopefully we can hang out before then because I am seriously considering visiting them in Canada before I graduate. Their school system is so much different from that of California. It isn’t unusual for a student to graduate at the age of 21 and become a doctor in their mid-twenties. When I told them that usually students in California took a year off to do research or do internships abroad, they almost jumped out of their pants because the trend for them is to apply for medical school during their late third-year/early fourth-year. Darron says that medical schools in Canada focus on the marks (aka grades) more than anything else, while most medical schools in the U.S. focus on the well-roundedness of the applicant. That made sense to Bobbie and Darron, but they didn’t know why the medical schools in Canada did not think that way. Overall, they are friends I’ll never forget.

I have been reviewing the follow-up sign out sheet from the hospital and emailed the latest version to myself, so I could work on it from home. Dr. Raymond says that he wants me to focus on the children that need eye medical care because a group of optometrists and opthamologists will be coming in sometime in June or July and he wants to get a large group together so they can get the medical attention they need. Dr. Raymond was also going to go to La Ceiba this weekend to get in contact with a cardiologist he wanted to network with for the kids.
We had a small birthday party for Dr. Raymond after the clinic closed. He was turning thirty-three years old, so the clinic’s administrative staff members baked him a cake and appetizers for the guests. The food was delicious and Dr. Raymond looked really happy. I have a picture of him cutting his cake with a huge smile on his face. He showed me a picture of his young daughter, who has the most lively eyes.

I learned a lot from being in the clinic like how important it is to show a patient that you care about their health and getting them to care about their own. Emphasis on important information is key in order for the patient and his/her mother to leave the clinic with a clear understanding of what needs to be done for optimal health. The most extreme case I have seen in the clinic was a four month old baby who had trouble sucking on his mother’s nipple. The baby’s frenulum was too short making it difficult for the baby to suck properly. This would cause greater difficulty in speech and eating as the child grew older. Dr. Raymond decided to take a sterile razor blade and snip the baby’s frenulum in order to free it. Dr. Eli had to hold the baby’s head real steady or else there was a chance that Dr. Raymond could puncture something else in the baby’s mouth. Dr. Raymond snipped the baby’s frenulum and their was minimal bleeding, but a loud screech coming from the baby. I baby cried for a whole three minutes before he fell silently asleep. I had never seen that procedure done before, so this was a new experience for me. Later on, Dr. Eduardo joked by saying “would you like to go next, it’ll be fun”. The baby’s mother was very grateful towards the clinic staff and left home with a happy baby.

I really like it here in Roatan because of the potential this island has to become a clean and healthy environment for the children, as well as the adults. There have been many good and bad experiences here so far that has really opened my eyes to the innate goodness, as well as selfishness of the human population. Some tourists have no shame in taking advantage of the situation of the poor, while some natives come up with different ways to exploit their own. Overall, I have been greeted with smiling faces and have been treated with the utmost respect. The people of Roatan are willing to help out anyone in need of assistance, even if they have nothing. They are always smiling and full of energy, especially the children.

Next week I will administer the clinic survey, most likely on binder paper, to the patients waiting to be seen. Since it will be pretty busy this week because Dr. Raymond will be the only attending in the clinic for most of this week, I will administer the research survey questions to the remaining patients (women and children) after clinic hours. I plan to also walk around Coxen Hole asking random women the list of questions on my research handout, but I am not quite sure what the response will be. I am hoping most of them will be okay with answering a few questions about their nutrition, as long as I explain to them where I am from and what I am trying to accomplish. I will also try using the clinic phone to contact the follow up patients to see how they are doing and find out the progress of their situation in comparison to what was last recorded in the sign-out sheet. If the phone becomes a problem I will try to set up an appointment where I can meet with them in person to discuss their current situation. Hopefully I make some progress with each follow-up patient. This has been my experience so far and hopefully there is more to come.