As I write this, I realize that this is my last weekend on the island – my final picture-perfect weekend in one of the most beautiful places in the world. It seems as though I just got here, yet in a week's time, my internship will come to a close. But a week is still plenty of time to learn and explore – and that is exactly what I intend to do.
Clinic was an enriching experience this week – in addition to my morning triage and screening duties, I was able to spend more time with the physicians as they rotated through the pediatric wards in the afternoons. Simply walking through the wards and seeing familiar faces – some that we had in fact referred here from our own outpatient clinic – provided me some sense of comfort, as though the children were now safe and would be constantly cared for until their departure from the hospital. Of course, it was even more rewarding when we saw a child's health improving dramatically over the course of just three days – and an empty bed the day after. Stories of success make the challenges of medicine worthwhile, I believe; without the challenges, there would be no rewarding recoveries. I also believe that it is this hope that makes the losses – like the tragic death of a convulsive febrile baby last week – just a little bit easier to bear. Medicine is not, after all, a field of magic or perfect certainties. It is, however, a reminder of the power of people helping people, and that is exactly where I want to be.
One simple but powerful observation I made this week was the effectiveness of positive reinforcement in the medical setting. I noticed that, when doctors praised mothers for their vigilance and determination in caring for their children, the same mothers were more likely to bring in lab tests the next day and obtain all necessary prescriptions from the pharmacy. When mothers were looked in the eye and thanked for their tireless efforts – waiting in long lines, taking time off from work or other pursuits, paying for medications despite an already tight budget – they would feel genuinely appreciated. The appreciation manifested itself through sincere attentiveness when our physician explained the causes and treatments for asthma. It manifested itself as a mother passing on her new knowledge to her sister and her niece, encouraging them both to come to our clinic the next day. And I find that absolutely incredible. It is about time that we appreciated the patient; because as difficult as a physician's job is, it is ultimately the patient who must be willing to take necessary steps to ensure success. If one simple “thank you” can convince a mother to provide her children a healthier home, then we have succeeded in our mission of providing sustainable patient care.
Outside of clinic, I have busy with my other pursuits – tutoring at the bilingual school, teaching English to Moises, and spending quality time with the other volunteers I've met here, especially those here in Sandy Bay. This weekend I was initially a bit disheartened when the last of the original friends I had made here left for the states – I felt very alone, all of a sudden; it struck me how easy it was to make friends here, but how difficult it was to let go of them. On the bright side, I met a whole new set of incoming medical students volunteering here in the community – thirteen of them! Indeed, the volunteer efforts on this island are best characterized by a state of constant flux, with people coming in and out as their schedule permits, but with the guarantee of finding incredible and diverse friends regardless of when one decides to come down. I hope I can keep in touch with those who have already left, as well as with those who are just arriving – a forum to reflect upon our experiences here and perhaps shape future journeys.
This next week will be my last on the island, but it is a crucial week nonetheless; the Grubers will be coming down, as well as Sarah (my replacement for the month of July), and lab technicians from the Bay Area. Hopefully with all of their help the clinic will see a host of improvements and efficiency in the coming days and months. As for me, I am simply ready to relish my final days here and do my best to pass on what I have learned to Sarah. I know that while the 'end' may be near for my internship, it is yet the beginning of better days to come.
