In 5 days, I return to the states. In some ways, my time on the island has flown by, as I’ve acclimated to the hot, humid weather, the frequent power outages, and laid-back island attitude. In other ways, the time has passed slowly as I have tried to take advantage of all Roatan has to offer. I really cannot believe how much I have learned and grown since I have been here. Before I came, I was terribly afraid of all sorts of bugs; now, a gecko on the wall is no big deal and creepy, crawly insects have become part of the experience. My rusty Spanish has improved substantially, and I have learned many medical words. I have learned to be more adventurous with food and have ever dared to eat the hospital cafeteria food. (Just imagine what the cafeteria food must be like here if people in the US even avoid eating hospital food!)
I think the most important lesson I will take away from this place is the realization that one person really can make a difference, whether it be in healthcare, education, or policy. The idea of philanthropy is widespread on this island, and although I’m sure I’ve talked about this before, it still amazes me that people like Miss Peggy and the owners of Bay Islands Beach Resort can touch so many lives on the island. A bunch of us went to the Tequila Downs Crab Races again this past Thursday, which is a fundraising event for the e-Learning Center. We raised $472, which is enough to put one child through one year of the educational program. It was so great to see so many people giving back to a community that isn’t their own. I guess crab races are pretty popular as a fundraising event, as there was another one that we went to in West Bay that raised money for families affected by HIV on the island.
This past week in clinic really flew by. We were lucky to have Dr. Howard with us the whole week as he prepared for the third annual Trauma Conference. On Friday, he took me to visit with a newborn in the pediatric ward. She was born full-term but low weight for gestational age; she looked very tiny and fragile. We examined her fully, finding that she had cleft lip and palate, a heart murmur, and an enlarged liver. As I have never really listened to hearts before, I wasn’t sure what to listen for when I held a stethoscope up to her chest. Dr. Howard said I would hear a shuffling sound after the first heart sound; thank goodness he told me, otherwise I wouldn’t have been able to tell what I was listening to! This baby was interesting because during the entire exam, she didn’t cry or flinch at all. She was unresponsive and lethargic. After returning to the clinic, we looked up chromosomal trisomies that could cause severe cleft lip and palate and found that many of the children don’t survive their childhood. I really hope this child does.
Dr. Howard taught me a good lesson on pediatrics this week. Patient care relies on trust between the patient and doctor and in the case of peds, also between the doctor and parent. With adults, trust can be established with some form of body language or kind words. With kids, it’s a bit harder. Dr. Howard told me to think about people as if they have an imaginary box around them; this is their space and others must be invited to invade their space. He discovered that peds patients respond much better to him (as in they don’t cry or squirm around) when the kids cross the imaginary line (between your space and theirs) themselves. The way to do this is to offer them a sticker or tongue depressor, but hold it on your side; this way, the child reaches over into your space and unconsciously invites you to enter theirs. I never thought to think about patient-physician trust and communication in this way, but it makes a lot of sense. I’m really going to try to do this with kids next week and see if they trust me more when I let them cross that imaginary line first.
Saturday I attended the Trauma Conference, which I thought was a success! Accomplished speakers were lined up the whole day to give lectures on pediatric trauma, advanced life support, abdominal injuries, and burns. Although the lectures were all in highly technical Spanish, I was able to understand a bit of it. I made a list of all the words I heard and saw on slides that I didn’t know; it’s a very long list! I especially enjoyed Dr. Janice’s talk on H1N1, not only because it was given in English, but also because it added to my knowledge of the pandemic. I had no idea that swine flu may present with diarrhea, which is a symptom not commonly seen in regular flu. It’s scary that swine flu only responds to a few medications, and those medications are in short supply around the world. The physicians at the conference joked that Roatan would be one of the last places to get the drugs; the sad fact is that it’s probably the truth.
In other news, I finished my last training dive today! We went to Overheat Reef out past Anthony’s Key towards West End. We followed the reef around to a wall of coral and swam along with the current. There was a ton of bright blue fish that swam in schools all around us. I really wish I knew the names of some of these fish because really all I can tell people about my dive is that I saw a blue fish, some black fishes, and fish with stripes. Our divemaster Shane pointed out fire coral, which looked like a large brownish red coral bush with white tips. It was interesting to try to interpret his shaking finger and subsequent touching of his arm to mean stay away from the coral. I guess this is where sign language would come in handy to communicate!
This afternoon, we’re heading to West Bay for beach time and Angelo’s gelato. We’ll probably do dinner at Banarama and then stay for the fire dance show. I’ve heard it’s really amazing with little kids flinging fire around.
Until next week,
Erin
