Today, instead of going to shadow at Clinica Madre de Cristo, we all went to Alta, Trujillo, where we volunteered as part of a health campaign for a very poor and apparently dangerous neighboorhood. All 4 of us went in the morning as it gets very dangerous in the afternoons/evening with like robberies? I think.
I was very
lucky blessed today, and FINALLY got to get my hands on
something someone. The doctor and the local Peruvian medical student in his last year and I allowed me to do all the physical exams on the patients and we worked like a well oiled machine, despite a HUGE language barrier; The medical student wrote the chart, while he and the doctor asked the patient questions, the doctor wrote the prescriptions, and I did the physical exams. Incase you were wondering, they did not repeat any exams (exception below), which I was kind of surprised about, but I made sure that if I did not completely understand what I was supposed to do, not because I didn't know how to do it, but because my spanish comprehension is horrendous, I made sure to say I didn't know. While I was confident in my findings for most of my physical exams, I was kind of hesitant when the medical student asked about a patient's lung sounds (the patient's chief complaint was some sort of respiratory issues) and whether or not they were normal. While I was quite certain it was normal (as I have also had prior experience), I was shocked that he just took my word for it instead of listen himself, for if they patient had any minute respiratory problems, a minimally experienced med student probably would not catch it (but Thank you EMT!). What I think happened was that after the doctor and medical student observed me perform the physical exam for the first 2 patients, they decided that I was somewhat competent and could trust me, so therefore, they could be a bit lazy! A WIN for all of us as I was pretty excited at the opportunity because we have not done much this trip, which I have been kind of disappointed about.
At one point during the patient interview, the doctor actually asked me if I had any questions to ask the patient. While I had questions to ask, I didn't want to sound like an idiot with my Spanish, so I admitted my Spanish was a bit lacking -_- I really need to learn. Someone give me some motivation and some language learning smarts PRONTO pls! Honestly though, seeing that most of my experiences with difficult doctor - patient encounters has been with Chinese speaking patients, and I strongly feel that is where my passion lies. However, I hope that one day I could become fluent in Spanish to help even more patients. But for now, one language (err... more like 3-4) at a time!
There was one patient who came in, who I took the blood pressure of and found that she had hypertension. Seeing that I had originally pumped the cuff to about 160 or so since most patient's don't have that high of a BP and I heard the first systolic in the 140s, I re-took her BP to make sure that I got it correctly (though I knew it was completely unnecessary as my EMT training has taught me to get the BP exactly on the spot every time, even during exams). When I reported the numbers with my
broken lack of spanish, I could tell that the doctor and med student was quite hesitant, deservingly so, for if they judged my intelligence based on my Spanish, I would be quite close to incompetent hahaha. The med student then proceeded to take the pt's BP on the other arm, and also found that the pt had hypertension. WHEW! Crisis averted (not that there was one to begin with)! It was very sad to see the patient begin to cry when she realized that she actually had hypertension and didn't know why. The med student then asked her what she eats, and the first thing she said was "papas fritas," meaning "fried potatoes" along with some other Peruvian foods/dishes that didn't sound like "veduras" or "frutas" (vegetables or fruits). She also admitted she likes to drink coffee. Well, go figures. I don't blame her for her poor diet though; although I hate potatoes usually, potatoes are prepared EXTREMELY well in this country.
Although my primary care physicians in the States have never percussed any part of my body during a physical exam, percussion is actually used, especially in a medical settings with very limited equipment, by that I mean like only pen, paper, desk, chair, bed, 1 stethoscope and 1 BP cuff. Good thing MSU was insistent on getting down that wrist action! Honestly, I kind of really like this bare-bones medicine without advance technology to get in the way, maybe I will work as a rural doc, who knows.
Avocado salad for lunch. My favorite salad/side that Mama Rosa has made.
Chicken and potatoes for lunch!
Group photo in front of the clinic
For dinner, we tried to go to a vegetarian restaurant, but after we walked over 1 hr (while starving) and got lost a couple of times, turns out the restaurant either doesn't exist anymore or moved locations. =( We ended up at Kevin's favorite restaurant and I "splurged" on a duck dish (S/19.90, or $7.65). It was pretty delicious, but maybe I have been "trained" to always prefer duck cooked the Chino way, roasted!
On our way home, I witnessed the first accident, a minor fender bender. I am very very surprised that I have been here for 2.5 weeks and it took THAT long for me to witness an accident, given how insane they drive in Peru. I am glad it wasn't a big accident though
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