My first week in clinic went more smoothly than I expected. It was a little overwhelming at first- all those mothers and their babies and their rapid-fire Spanish (and the fact that they seem to talk faster when we didn’t understand what they said the first time), the crazy multitude of names (and spellings) on all the charts, Global Healing volunteers coming in and out to use the phone and computer, hospital employees looking for Dr. Charles and the attendings, Dr. Charles’ illegible handwriting- but once I got used to the way things worked, it wasn’t all that bad. I already sort of knew some local medical terminology- like “calentura” for fever- after going with Audra to Peggy’s clinic the week before to help teach the weekly class for the Community Health Promoters Project in La Colonia. The week’s topic was diarrhea and respiratory illnesses and it was a good introduction to a lot of the common complaints I would be seeing in the clinic, as well as how they are approached medically on the island. Audra is making a lot of progress on the project with the volunteers and made sure to introduce me to Dr. Raymond and Peggy while I was there.
During our days of overlap while Ilena and I were waiting for the doctors to finish with their patients so we could enter their data, Ilena we through some of the books in the clinic’s “library,” including a book on Parasites and “Pediatric Dermatology.” I am convinced I am going to get scabies. No, seriously. I even had a dream about getting back to the States with scabies. Almost all the kids that first week had them. I’m sure it also helped that Dr. Charles showed me the rather large, cartoonish drawing of scabies that he points out to mothers to scare them into taking scabies seriously and making sure they treat their kids for it. Those bugs look like no fun. Ilena finds my paranoia incredibly amusing and proceeds to diagnose every bump and bite on my body as scabies. So much intern love.
When I first got here, Audra and Ilena were both sick with some kind of cold and sinus infection combo so we spent most nights that week indoors, watching “Desperate Housewives” Season 1 DVDs I had brought with me. Then it started raining for a week straight because of Hurricane Gamma so we stayed inside most of those nights, too. After that, it had become tradition. We mixed it up with some episodes of “House, MD” and “Grey’s Anatomy” that I had on my computer. “House” is especially great when we get to see some of the tropical diseases in clinic that they mention on the show. Like leishmaniasis. Fun! And “Grey’s” is about surgical interns at a hospital in Seattle so there’s lots of quotable goodness like, “You’re interns, grunts, nobodies, bottom of the food chain. Take orders, work every second of your life until you drop and don’t complain.” Yay intern abuse!
Eileen, the new attending and my roommate, arrived my second week in clinic. I think it is her 5th time volunteering on the island and in the clinic, so random people drop by all day to come and see her. Dr. Thomas, the resident from Chicago has really been enjoying some of the differences from back home. Last week, a mom came in with her daughter who had fallen out of a tree. He sent her to have an X-ray of her shoulder and she came back a few hours later holding a sopping wet x-ray of her daughter’s broken clavicle. Dr. Thomas kind of stared at it blankly like he didn’t know what to do with it.
“It’s wet,” he said. “It must have just been developed a few minutes ago,” he said more excitedly.
“Yeah, that’s what it looks like,” I said.
“That’s crazy!” he said then proceeded to clutch the x-ray for the next few minutes, not wanting to set it down and get everything all wet with x-ray developer or whatever liquid they dunk them in. I guess sometimes it’s just the little things.
Thanksgiving Day. Although I’d usually spend it scarfing down turkey and cranberry sauce at home, today was just not a good day for West End residents looking for a traditional American Thanksgiving meal. Fosters, the one restaurant that advertised an all-day Turkey Buffet, ran out of food before 4 pm. Drs. Eileen and Thomas, Nora, Ilena and I ended up eating rotisserie chicken- which is kind of like turkey, if you squint really hard- and a few days later I found a can of cranberry sauce at Warren’s (yes!).
I’ve gotten to see parts of the island I hadn’t really expected to from my crazy cab rides back from clinic. Somehow the cab drivers have all conspired to kill me. One time Ilena and I were nearly backed into by a truck and nearly ran off the road multiple times as the driver took the turns at 60 miles an hour. Not to mention the numerous bikers and pedestrians he nearly clipped. I was pretty sure that we weren’t going to make it. For the rest of the day after miraculously making it home alive, the colors seemed a little brighter, food tasted a little better. Nothing like a near-death experience to perk your day right up. Then there was just this ridiculous driver that detoured into La Colonia on the way back during the worst of the Gamma rains. We got about halfway up the hill when the car lost traction and started sliding backwards down the clay. He started cursing and thankfully abandoned the endeavor, managing to steer us backward down the hill to safety. Now you’d think after risking my life on this La Colonia adventure, the cab driver would be courteous enough to at least take me back to Casa Calico…but no. I was promptly ejected from the cab at the West End turn-around, left to trudge back home in a bonafide tropical storm. Funnily enough, while most cabs won’t think twice about going up the perilous, death-trap road to La Colonia, they refuse to go the last few feet to Casa Calico because “the road is too bad.” Craziness.
Then there are the random intense conversations I have with the drivers. One time I talked with this guy about how the island needs to invest more in the youth to keep them from getting into trouble and having problems as adults. He wanted to start a youth rehabilitation center on the island, which I thought was an interesting idea. Then he proceeded to talk to me about the importance of having Jesus in my life for the rest of the drive. Another time the driver launched into his whole life story, about how his daughter was killed when she was 10 and his wife left him and went to the mainland soon after. It was sad. And awkward. Apparently I am the only one blessed with all these taxi cab experiences as Audra and Ilena laugh at me every time I come home with a new one.
Last week Eileen was pretty sick with some stomach virus and Dr. Charles was on vacation so it was just me and Thomas in the clinic. Of there were more patients waiting to be seen on the day with only one doctor than I had seen on any other day thus far. It was ridiculously busy, but after I’d gotten through triaging everyone and was waiting for Thomas to finish with charts I did get to enjoy a warm and fuzzy moment with a little girl whose brother was being seen. I had changed the wallpaper on the computer earlier that week to fish and I guess she must have been in earlier because even though I had the spreadsheet open and you couldn’t see the desktop, the girl ran up and pointed to the screen and said “pescados.” When I minimized the window so the fish magically appeared she grinned and exclaimed, “there they are!” (in spanish of course) She then demanded that I put up a dog. Little did I know that by complying with her I request I would spend the next 10 minutes cycling through every wallpaper image that comes with Windows XP. When those were exhausted we started flipping through a picture book. It was in English, but no matter. Instead we went to work identifying the animals, doing pretty well between the two of us until we came upon a Hippopotamus. Neither of us knew the name in Spanish, but she was pretty amused when I explained how we say it in English. Then we moved on to colors, which was an interesting exercise as she knew the names of various colors, but apparently hadn’t learned to match them up with their respective shades. It was fun though, since we’d been so busy I hadn’t been able to spend much time talking to any one child.
In more recent news, Ilena, Audra, and I started our dive classes and went out on our 3rd open water dive today. The three of us were waiting about 15-20 feet down from the surface while the instructor was working on a skill with another guy. Out of nowhere this rather large fish swims straight at us and starts rubbing against our fins and legs. This wouldn’t have been problematic until it started heading towards my face and bared it’s evil little fish fangs. Let me explain that is was no ordinary fish. Despite what modern medical science may say to the contrary, it was clear that this fish had leprosy. It’s scales were flaking off in patches and it had sickly discolored splotches all over it. We’d had just about enough of leper fish when the instructor came back down and shoo-ed him away. She later informed us that it was a Dog Snapper trying to pass a leechy parasite fish to us, but he will always be Leper Fish to me.
