A week in the mountains

I was home this week in Waynesville shadowing at a family practice. Lessons from the week are these:
1) I have learned something in the last 2 years. BUT I have much more to learn. Especially that no one uses the generic names of drugs. And that drugs are VERY important to the arsenal of what doctors can do.

2) Saw some cool physical findings, which is exciting to me because most of the time we only see "normal" so, finding something good means it is worth it to try and examine every patient. Tough things were heart murmurs and some lung rales. However I got a good look at interesting eardrums-scarred, full of nasty pus etc. Also saw a couple cool procedures chopping off skin cancers and lancing a cyst.

3) Loved the variety of people we got to see. People with lots of education, people with only a little education, poor people, wealthy people. People I knew, people I didn't know. It was great to wade into every room and expect something different but also to get to talk to very different people.

4) Got to toughen up for a final push of studying for my Boards during the summer (June 15th)

Picture from Ecuador mountains looking over the jungle but enjoyed the mountains of WNC this week!

Off the Map? Off the Mark

Hey guys,

Dad encouraged me to keep writing on my blog here in case people are still interested in what people who look at power points 7 hours a day do with their lives.

I thought I would start with the new ABC Show


Off the Map

I watched the pilot and have refused to watch since. It presumably takes place in the jungle of South America. Having been there for awhile it is of course beautiful but I was so disappointed in how they portrayed American doctors.
A) NONE of the new american doctors spoke Spanish. Every doctor I interacted with in Ecuador spoke Spanish. You cannot be a doctor if you can't talk to people and at least understand a little bit about the culture. These people they brought in were idiots. We are taught to fit our medicine to the culture of our patients and that sometimes culture is a much stronger influence on health than we ever will be. Why are they not at least TRYING to learn Spanish?

B) They don't NEED to be there. The governments of these countries have outposts into the jungle. Far better than any Americans could decide to do it. There is a health system there. They don't have everything that we have but they don't have to chop down coconuts to make a saline solution. So while they do need supplies they most certainly do not need doctors who don't understand the language or the culture.

That is my rant on Off the Map. I do continue to watch Grey's Anatomy...I mean after this long I am just getting old and can't bear to let it go.

I also study...but more on cool diseases later.
Let me know if you want to keep hearing about medical school!

Back in the USA

Thanks so much for reading along. I made it back to the US and I am very glad that everything is in English and I can drink water from the tap. I had some delicious Mexican and Italian food already. I will update some blog posts with better pictures and video once I settle back in and start organizing.

Hopefully I will see most of you soon to let you know in person all of the amazing stories that happened along the way.

Mud Colors

I feel like today was Get Back Day up at trail. We went on a long hike into the jungle and did not have any amenities like showers or beds and then today we did a long hike back out. I could seriously taste the lunch chocolate chip cookies during the whole hike. It was a lot longer than our get back hikes usually are. Definitely took a triumphant mud splattered photo once we returned.

These people live literally a 5 hour HARD hike into the jungle. The trail isn't exactly maintained (there were a couple bridges) so it is just a giant mud slide basically. I learned a lot about mud this week. There are many many different kinds. First, there are different colors: white, orange, brown then more interesting like green, purple and pink. There is mud that supports your weight even when you step down hard. There is mud that sucks in your boot and doesn't let you out. (I often felt like the poor horse in the beginning of The Neverending Story...ATREYU!!!) There is mud that clings to your boot so that you have a cement block to drag behind you. Also a note about the jungle boots (they are knee high black rubber boots= do not breathe and smelly feet) but they are pretty much the national shoe of Ecuador everyone in the jungle has them.

So, the cool stuff I did in the jungle. Learned about medicinal plants. One flower numbed your tongue if you nibbled on it a little bit! Then others are poisonous and are used to kill fish for food or worms under the skin. Another poisonous one that is to be used only for emergencies is for like huge machete cuts or bites to stop bleeding but its leaves are very irritating to the skin. Then another if for snake bites and inside that one lives these lemon ants. And they taste just like little bits of lemon. They were really good. You kind of lick them out of this little pod you crack open on the plant. We also hiked to a waterfall. The kids there LOVED the bouncy balls I brought with me and I got to play Equavolley. Like volleyball but...better. Pictures will come eventually. I am packing to head back to Quito and then home. I will miss my host family very much here but I am excited for some food that does not involve rice or plantains/bananas.

Quilotoa and Bus Rides

Hello amigos!

So, I made it all the way to Quilotoa and back. It was an adventure throughout. First, we rode with our family for 3 hours (shuffling two children between laps). We watched How To Train Your Dragon (I loved it again in Spanish). Then we got on a bus and so the buses stop whenever people want and at assigned stops but they dont like make announcements or anything. So, my solution is to make sure everyone in the vicinity of my seat knows where I need to get off by asking loudly each time we stop if this is it. Luckily this plan worked and we got off. Also, the moon is completely full and it lit up the whole landscape. I can't even describe how hauntingly beautiful and lunar it looks because it is so dry and cold there isn't much vegetation.

Then we got in a truck to our hostel. Luckily they still had some food and the fire was going in the woodstove in the center of the common room. It had been hot that day so it was quite a shock to the system to go to the cold.

The next day we set out around the rim of the lake. It is such picturesque country just craggy hills with squares of grain. There were shepherds and sheep wandering the steep hills. One had a cell phone it was pretty ironic. Also, the lake is at like 12,500 feet. So the altitude made it difficult. Every time we went up an incline I had to catch my breath. The terrain changed from moment to moment. Sometimes craggy rocks and sometimes sand like literally sand you would find at the beach to beautiful wildflower lined path. The lake was green though it changed colors as the clouds skimmed over it.

And then, to get home. We took the truck this time riding in the back to the first bus. Then we transferred to another bus that took us part way until we had to get on yet another. So, on the buses they are always playing music and people are selling stuff so I am going to do a stream of conscious example of my typical bus ride.
Maybe I'll practice my Spanish as I ride....what can I get here...your eyes...never leave...always...panflute interlude (the universal language)...song change...ok maybe this time I'll understand..."have to change" (was that you or I, maybe it'll come up again)...your eyes (again!)...love..the words you must...looking out the window: That aloe plant was the size of a Christmas tree!!...And drowning out the words now "Empanada, empanada...helado,lado,helado,cola"

Now you have had the feeling of the bus in Ecuador. Pictures are taking too long to load, you will have to come back. I head to a 3 day stint with a community in the jungle. We have a 5 hour hike into the community! I am excited and a little nervous. Won't be updating until Wednesday because I don't think remote Jungle villages have wifi.

Strange Pets

Hello.

Today I went fumigating for the mosquitoes that carry Dengue and Yellow Fever. Did not find any but we did find some very strange pets...an alligator, a parrot, a huge tortoise and another team found a small version of the flying monkeys from the wizard of oz.

Today I head to Quilotoa. wish me luck on my transfers from car to bus to truck?!

Meters...why America why?

So I have been meaning to post about this problem for awhile. My first day taking height and weight in clinic I was rudely awakened to the fact that I have no idea what the metric system means. Like how many kilograms should a child weigh? So, I could never estimate a starting weight when wailing kids were pried away from their mothers and plunked down screaming every time I would have to start at 0 and work all the way up because I had no idea what 20 kg even was close to as the kids wailed for mom. Or centimeters for height? Why did America do this to us? I am getting a little better but when we were comparing how much we had gained from eating a plate of white rice every meal I was convinced that I had gained 20 pounds until I found a calculator and someone more informed. (It was only 4 pounds luckily). Don't even get me started on actual thermometers with like ...mercury? really? in them. I had to be shown like everything on how to use one of those. It doesnt even beep at you to let you know it is done! No one had a fever because I wasn't patient enough to let the mercury (seriously?) move all the way.

On a more recent subject today we drove a long way to find some bugs. We found like 6 bugs, more specifically Chimburi bugs (I think). We also found a scorpion and the largest cockroach I have seen in my life. It was the size of my hand. It was in a woodpile but oh my it was huge. We did some excellent gravel road driving. It is kind of nice here because like estimation of travel time never really depends on traffic...(double yellow line means wait until you are out of the blind curve to pass, por favor)...it depends on how quickly the driver wants to power slide in and out of curves on these gravel roads. There are also speed bumps on large roads between cities...that would not go over so well in the US I decided. But Dr. Torres liked to use those as a kind of green light for the drag race to pass other cars.

Doing very well overall, one more morning with the Infectious Disease Control.

This weekend I go to Quilotoa. To a volcano crater lake that locals say has no bottom. It is supposedly very cold so I might have some alpaca wool pictures in the future.