Greetings listeners. This update is coming to you from a local internet cafe in the town of Archidona, Ecuador. I arrived here two days ago and moved in to my temporary home for the next 4 weeks or so. I´m staying in a cabana in Amupakin, a clinic just south of Archidona, which is staffed by midwives practicing traditional Ecuadorian medicine. I am currently rooming with my new buddy Danny, another medical student volunteer. The accomodations are pretty nice: we each have our own room wtih a bed, and we share a small bathroom with a shower (no hot water). The clinic has a generator, but they only turn it on in the evening (after dark) until about 9:30pm, and occasionally in the mornings as well. The region we are in has been great so far. The people are very friendly (I was greeted out of the blue by a young boy riding on the bus the other evening). It is pretty hot/humid; the first day we were here was practically unbearable, but it has since cooled down a bit. Sleeping can be a bit rough at night. Also, akin to my experience in Costa Rica, we have had a bit of a battle with the indigenous inhabitants of our canaba (namely, bugs). They started out strong, but in the end, our side seems to have won the war after having cleared out some of their rather nasty soldiers -- I had a giant spider on my wall and a sizeable cockroach in my bed; Danny bested a bullet ant in his room. Since then, they seem to have realized our superior tactics and resigned to a shameful defeat.
We have worked in clinics for two days so far, both times in Cotundo, a town just North of Achidona. So far it has been really great. Nothing too out of the ordinary yet, and a bit of standing around, but still a great experience overall. All of the staff are super nice, and the doctor there was great. Tomorrow we will be working at a clinic in San Pablo (Southeast of Archidona), and on Saturday we will spend a halfday at a clinic in Tena (for a presentation, I believe). We are taking Sunday off (possibly going to do some tubing down the Tena river in Misahualli).
So, in addition to seeing the country and working in clinics, I have another rationale for my desire to travel abroad: the food. So far, Ecuadorian food has been very appeasing, and certainly ample. Like Costa Rica, there is little diversity in the types of food; the flavors, however, are pleasantly variable. Lunch always consists of a soup (usually with vegetables and often some small portion of some meat) followed by the main dish, a big plate of rice, some sort of veggie/salad, and a meat (so far chicken or beef, often fried). Most restaurrants (where we typically eat lunch) serve a set almuerzo (read: lunch) which costs $1.25 - $2. Dinner often follows the same pattern (soup, rice, veggie, meat), but is a bit less rigid in its requirements. Since moving into Amupakin, the midwives have been cooking our breakfasts and lunches, and their meals are always exceptional. Last night we had a very interesting cut of fire-roasted chicken in which, as Danny pointed out, you could truly taste the flavor of the wood that we had been smelling. It was delicious. As in Costa Rica, plantains are used very frequently here, typically fried. Also like Costa Rica, they serve them both ripe (maduros, which were my absolute favorite food while in Costa Rica -- so far they haven´t been quite as good here), and unripe/green (patacones, which are also very delicious and more similar to a french fry). Plaintains are also used to make breads, though as of yet I haven´t had the opportunity to try this variant. It is pretty incredible the diversity of dishes they can prepare with plaintains, and bananas too, for that matter. So far for breakfast at Amupakin, we have had eggs (either fried or scrambled), along with friend bananas (a bit dry), and fried/mashed patacones (delicious!). Ah, one last point about the food, as I am sure you are all drooling by this point -- I know I am (blame any types on the slobbery keyboard). Often times the soup will be served with a bowl of popcorn, which is supposed to be put into the soup to give it a bit of texture (since the soups are usually pretty brothy and often not very substantial) -- Mom, I had you in mind while trying it this afternoon. New favorite, perhaps? I wasn´t quite sure how I felt about it personally, but then again, I´m not a huge fan of popcorn, so who am I to say? I very much look forward to trying more tasty local delicacies during the rest of my stay.
Thursday, June 30, 2011
Tuesday, June 28, 2011
A Quick Update
In my hurry to get to bed last night, I forgot to mention our plans for today (Tuesday the 28th, day 3). We are headed out early this morning to make the looong trek (about 6 hours by bus) down South where I will be spending most of my time for the next 4 weeks. I will be staying in a cabana in the Amupakin clinic in the town of Archidona (which is located in the Napo region of Ecuador in the Amazon basin). This isn´t one of the clinics we will be working in, but there are midwives who live there -- they will be preparing our breakfasts and dinners (yum!). Archidona is very near the larger town of Tena. After dropping off our bags, we are going to head to Tena this afternoon to get an introduction from the Direccion de Salud Area 1, which I believe is sort of like the local ministry of health in charge of all the clinics in the area (Subcentros). We will start working in a clinic in Tena the following morning, and then rotate through several others, as well as the local hospital, over the course of the next few days/weeks. I´m very excited for what´s to come, a little apprehensive, but mostly just thrilled to be down here.
The internet won´t be as readily accessible once I move down South, so I´ll likely be updating much less frequently, and when I do, much more briefly. Nevertheless, I hope you will continue to check back for some more wild stories. At the very least, I´ll try to make periodic updates to Facebook to let you all know how I am doing.
The internet won´t be as readily accessible once I move down South, so I´ll likely be updating much less frequently, and when I do, much more briefly. Nevertheless, I hope you will continue to check back for some more wild stories. At the very least, I´ll try to make periodic updates to Facebook to let you all know how I am doing.
Monday, June 27, 2011
Day 2: Parasites, Crafts and Disemboweled Rodents
Today was a fanstastic day filled with tourism, exploration, learning and bewilderment. After breakfast, we promptly hopped in a cab, headed to the bus station, and began our journey to the town of Otavalo. I had heard many positive things about this town prior to coming to Ecuador; it is pretty famous among tourists for its open-air markets -- and for very good reason. The town is largely dominated by two sizeable street markets, one consisting primarily of foods, while the other (more renowned) boasts hand-made local Ecuadorian crafts. We stopped by the food market first. It had pretty much everything you might expect (fruits, veggies, grains, spices, various types of corn, etc.), as well as many thing that you probably would not -- such as whole boar heads, plates of lard (both cooked and uncooked), and tables full of other various and sundry body parts and entrails. As I walked through the crowded aisles, I couldn´t help but see the booths not in terms of the meats they were selling, but instead as an arid breeding ground for the variety of parasites to which they were certainly the host. Ah look, that woman is selling taenia solium -- anyone up for some cysticercosis? Oh, and look over here! A plate full of Taenia saginatum! A round of beef tapeworms for everyone! Despite the diversity of meat products, there wasn´t any fish to be seen, so my personal favorite, Diphyllobothrium latum, was conspicuously absent from the mix. In retrospect, I can´t help but think the only way a person could possibly get me to eat meat from that market would be if they served it up with an Albendazole glaze. But in all seriousness, though the meat section was a bit questionable, there were many fine looking products. The veggies and fruit stands were particularly appealing. Some of them had grapes the size of...well, I can´t really think of anything to compare them to, so we´ll just say they were the size of several normal-sized grapes. Nevertheless, they were large and looked quite appealing.
Next we hit up the crafts market, which was an even cooler experience, if slightly less hygienically remarkable. I won´t go into too much detail, but there were tons of incredible hand-made products. I bought a couple of great gifts, and managed to get them at some pretty ridiculously low prices following a bout of fierce (and impressive, if I do say so myself) haggling.
Finally, we spent the remainder of the afternoon checking out Jambi Huasi, a local clinic which combines traditional, indigenous practices with more occidental, western medicine. This was a really great learning experience. It was very interesting to see how they incorporated both (very distinct) styles into a single clinic. In addition to a medical doctor and nurse, they are also staffed by a partera (traditional midwife), and various other indigenous shamans and practitioners. During the course of our tour, they demonstrated two traditional techniques for us. I volunteered for the first one, which was performed by the partera. She essentially took two eggs and rubbed them all over my body in order to remove the negative energy. A rather tame demonstration overall, but interesting nonetheless. The next demonstration, however, was where things really got wild. Chris, one of my peers, volunteered for the following technique, which is typically used as more of a diagnostic tool than a treatment. It is called "limpia de cuy*", and is certainly not for the faint of heart, or for the avid PETA supporter (faint of heart, avert thine eyes). In fact, it was just about the most gruesome thing I have ever witnessed. The basic idea is this: the healer takes a guinea pig and rubs it all over the patient´s body. The negative molecules associated with their illness are thus transferred into the guinea pig, and the pathology can be determined thusly. We were told beforehand that the guinea pig always dies following the test: it is a necessary part of the procedure. I was prepared for this, but was still astonished at the manner in which the death took place. The healer started by holding the guinea pig by both ends and rubbing it gently over his body. However, as he progressed, he switched his grip, grasping it firmly at the midline, and started shaking it violently whilst continuing to rub it over Chris from head to toe. In case I´m not portraying this clearly enough, let me put it this way: he essentially shook the guinea pig to death. It started making squealing noises, and you could hear its head slapping back and forth. At one point it even urinated on Chris´ back. The idea is that the faster the guinea pig dies, the more negative energy the person has. Once it finally expires, the healer takes the animal, holds it over a bucket, and skins and eviscerates it on the spot. As he does this, he looks for various abnormalities -- since the molecules are transferred from the ill person to the animal, he is able to discern the pathology of the illness based on the location of the abnormalities. From this, a diagnosis is made, and the proper treatment can be administered. Apparently Chris has lower back pain, a recent mild bronchitis, and parasites.
So, in summary, I watched a guinea pig shaken to death while rubbed over someone´s body, skinned, gutted and discarded. What did you do today?
Now, I will be the first to admit that I viewed this entire procedure from an entirely different cultural perspective than those native to this area. I also realize that this is a traditional, indigenous technique that has been around for a very long time. And, even though there is likely no empirical evidence for the efficacy of this technique, let´s just assume for the moment that it does serve some diagnostic purpose. Great. With all of this considered, I still struggle immensely with the ethics of this procedure. It just seems so cruel. Again, I say this coming from an entirely different place culturally, and I can respect that. But still.
All things considered, today was an great day. Whether I agree with the technique or not, everything I saw today represented an incredible learning experience. I look forward to seeing more examples of how traditional and modern medicine are intertwined in this culture.
*Cuy is the word for guinea pig. If they don´t already have one, I am going to go ahead and put forth the motion to make Cuy the national animal of Ecuador. Not only are they utilized in the strange manner described in hopefully-not-too-gory detail above, they are also a traditional delicacy (yes, I mean food). Though I´m told they are rather fatty. Hm. Personally, I think I´ll stick with chicken and beef for my meals, and with xrays and bloodwork for my diagnostics. And while the egg cleansing wasn´t so bad, I think I prefer medications myself. But, to each his own.
Next we hit up the crafts market, which was an even cooler experience, if slightly less hygienically remarkable. I won´t go into too much detail, but there were tons of incredible hand-made products. I bought a couple of great gifts, and managed to get them at some pretty ridiculously low prices following a bout of fierce (and impressive, if I do say so myself) haggling.
Finally, we spent the remainder of the afternoon checking out Jambi Huasi, a local clinic which combines traditional, indigenous practices with more occidental, western medicine. This was a really great learning experience. It was very interesting to see how they incorporated both (very distinct) styles into a single clinic. In addition to a medical doctor and nurse, they are also staffed by a partera (traditional midwife), and various other indigenous shamans and practitioners. During the course of our tour, they demonstrated two traditional techniques for us. I volunteered for the first one, which was performed by the partera. She essentially took two eggs and rubbed them all over my body in order to remove the negative energy. A rather tame demonstration overall, but interesting nonetheless. The next demonstration, however, was where things really got wild. Chris, one of my peers, volunteered for the following technique, which is typically used as more of a diagnostic tool than a treatment. It is called "limpia de cuy*", and is certainly not for the faint of heart, or for the avid PETA supporter (faint of heart, avert thine eyes). In fact, it was just about the most gruesome thing I have ever witnessed. The basic idea is this: the healer takes a guinea pig and rubs it all over the patient´s body. The negative molecules associated with their illness are thus transferred into the guinea pig, and the pathology can be determined thusly. We were told beforehand that the guinea pig always dies following the test: it is a necessary part of the procedure. I was prepared for this, but was still astonished at the manner in which the death took place. The healer started by holding the guinea pig by both ends and rubbing it gently over his body. However, as he progressed, he switched his grip, grasping it firmly at the midline, and started shaking it violently whilst continuing to rub it over Chris from head to toe. In case I´m not portraying this clearly enough, let me put it this way: he essentially shook the guinea pig to death. It started making squealing noises, and you could hear its head slapping back and forth. At one point it even urinated on Chris´ back. The idea is that the faster the guinea pig dies, the more negative energy the person has. Once it finally expires, the healer takes the animal, holds it over a bucket, and skins and eviscerates it on the spot. As he does this, he looks for various abnormalities -- since the molecules are transferred from the ill person to the animal, he is able to discern the pathology of the illness based on the location of the abnormalities. From this, a diagnosis is made, and the proper treatment can be administered. Apparently Chris has lower back pain, a recent mild bronchitis, and parasites.
So, in summary, I watched a guinea pig shaken to death while rubbed over someone´s body, skinned, gutted and discarded. What did you do today?
Now, I will be the first to admit that I viewed this entire procedure from an entirely different cultural perspective than those native to this area. I also realize that this is a traditional, indigenous technique that has been around for a very long time. And, even though there is likely no empirical evidence for the efficacy of this technique, let´s just assume for the moment that it does serve some diagnostic purpose. Great. With all of this considered, I still struggle immensely with the ethics of this procedure. It just seems so cruel. Again, I say this coming from an entirely different place culturally, and I can respect that. But still.
All things considered, today was an great day. Whether I agree with the technique or not, everything I saw today represented an incredible learning experience. I look forward to seeing more examples of how traditional and modern medicine are intertwined in this culture.
*Cuy is the word for guinea pig. If they don´t already have one, I am going to go ahead and put forth the motion to make Cuy the national animal of Ecuador. Not only are they utilized in the strange manner described in hopefully-not-too-gory detail above, they are also a traditional delicacy (yes, I mean food). Though I´m told they are rather fatty. Hm. Personally, I think I´ll stick with chicken and beef for my meals, and with xrays and bloodwork for my diagnostics. And while the egg cleansing wasn´t so bad, I think I prefer medications myself. But, to each his own.
Sunday, June 26, 2011
Day 1: A Thrilling Start
Here´s a rundown of day number uno. We started off the morning with breakfast and a logistics meeting, talking about the program, the clinics we will be working in, and our general itinerary. In the aftenroon, we did some exploring around Quito, walking around the quaint "old town". We had some lunch (tasty tamal de pollo), and then decided to head up to see the Virgin de Quito statue, which adorns a wonderful viewpoint overlooking the city. Pictures will come later but all I can say for now is this: Quito is huuuge. Astoundingly so. It seems to go on forever in every single direction. The city is like a giant bowl: completely flat in the middle with similarly sized buildings, surrounded by vast hills -- completely covered with houses -- which slope off into the distance. I think one of the reasons the city is so impressive is the sheer density with which it is packed full of buildings. It will be hard to do it justice with pictures, let alone with mere words (even despite my attempts at elegance).
Oh yeah. So we debated for a bit as to how we should get up to the viewpoint. Our guidebook said it was dangerous to walk, but a local told us we would be fine in a group at that time of day. So, we decided we would take the stairs to the top. Almost immediately upon reaching this decision, a fight broke out in the street among a group of locals, who promptly started picking up boulders and throwing them at eachother. The single policeman was utterly ineffective. Hmmm. On second thought...let´s grab a taxi.
Finally we visited the Basilica, a huge cathedral which absolutely dominates the view of the city, especially when seen from atop the viewpoint. It was beautiful from the outside. But it was the view from the top that we were really interested in. So, we payed our two dollar admission fee and started the long trek. We climbed stairs. Followed by ladders. Followed by more stairs. It just... oh wait, then came some more ladders. It just kept going and going. The view from each subsequent floor was more spectacular than the last. Upon reaching the top, we were astonished. It was breathtaking. An absolutely wonderful experience. The one downside was the sheer, unbelievable quantitiy of graffiti and writing debasing the walls. Sad.
It´s fun to just walk around the streets. TONS of people are walking about. There are people playing music, vendors with all sorts of delicacies (ice creams, pastries, and cool-whip-like dessert). There are loads of places selling incredible baked goods, which emit powerful aromas into the streets to entice hungry food-lovers over to the dark side of indulgence. Hmm, perhaps just one.
Oh yeah. So we debated for a bit as to how we should get up to the viewpoint. Our guidebook said it was dangerous to walk, but a local told us we would be fine in a group at that time of day. So, we decided we would take the stairs to the top. Almost immediately upon reaching this decision, a fight broke out in the street among a group of locals, who promptly started picking up boulders and throwing them at eachother. The single policeman was utterly ineffective. Hmmm. On second thought...let´s grab a taxi.
Finally we visited the Basilica, a huge cathedral which absolutely dominates the view of the city, especially when seen from atop the viewpoint. It was beautiful from the outside. But it was the view from the top that we were really interested in. So, we payed our two dollar admission fee and started the long trek. We climbed stairs. Followed by ladders. Followed by more stairs. It just... oh wait, then came some more ladders. It just kept going and going. The view from each subsequent floor was more spectacular than the last. Upon reaching the top, we were astonished. It was breathtaking. An absolutely wonderful experience. The one downside was the sheer, unbelievable quantitiy of graffiti and writing debasing the walls. Sad.
It´s fun to just walk around the streets. TONS of people are walking about. There are people playing music, vendors with all sorts of delicacies (ice creams, pastries, and cool-whip-like dessert). There are loads of places selling incredible baked goods, which emit powerful aromas into the streets to entice hungry food-lovers over to the dark side of indulgence. Hmm, perhaps just one.
The Beginning of An Epic Which Will Rival All Others, One With Which All Future Epics Will Ultimately Be Compared -- Part One: The Pilot With the Upside-Down Map (AKA Hasn´t This Guy Heard of GPS?)**
Greeting from Ecuador! I have arrived safely (though somewhat circuitously) in my destination of Quito. Though my ultimate arrival was as expected, the route I took to get here -- well, not so much. Let me explain. So I was on my final flight of the evening, purportedly heading from Panama City to Quito. The flight was supposed to take about 2 and half hours, and the expected arrival time was approximately 11pm local time. After flying for what seemed like some time, thoroughly engaged in some leisurely reading on my brand new Kindle (a must for all international travelers), I thought to myself: self, this flight seems to be taking a bit longer than expected, wouldn´t you say? When suddenly, almost as if in answer to my innocent ponderings, the an announcment was whispered over the speaker system. Seriously...whispered. for whatever reason, the captain of our plane literally, and quite frustratingly, whispered everything he said over the loudspeaker. I mean, comon man. I appreciate your attempts to make my travels a more intimate experience, but I´d really like to hear what you have to say -- especially when it is something to the effect of the following: DING -- this is your captain. The Quito airport is closed. We will be landing at the Guayaquil* airport instead. ...Um, what? Excuse me? Care to elaborate? No? Can you even do that!? I´m quite sure the destination on my ticket says Qutio!
Long story short, we flew all the way to the Guayaquil airport (I didn´t have a watch so I´m not sure exactly how long it took, but it seemed like at least an extra hour or so). Upon landing, we, the tired, confused masses, prepared to depart, when we were met by another delightful announcement. DING -- this is your captin. Please stay seated. We may be going to Quito afterall. ...Ahem. I...this...awesome.
In the end, we sat in the Guayaquil runway for what seemed like at least an hour and a half. Then we flew to Quito (another hour, perhaps?) We ended up arriving at 2:30 am, 3 and a half hours after our initial arrival time. After going through immigration and customs, I finally met up with Chris and Natalie (who seemed just as relieved as I was), at slightly after 3am. We hopped in a cab (here I am, for the first time! Looked to my right saw...oh hell, I dunno -- it was late.) and took a short ride to a local hostal where we stayed overnight. It it now 8:30 the next morning. I am waiting for the others (Chris, Natalie, and two with whom I haven´t yet been acquainted) to awaken for our breakfast, courtesy of the hostal. We will stay in Quito today, discuss the clinics, do some exploring, and stay here again overnight. I believe we head down to Tena tomorrow. The hostal has free WiFi and a computer (which I am currently using, in case you were wondering how I was posting this -- what is this black magic!?). So in any case, I should be able to respond to emails, blog comments or Facebook posts for at least the next day or so.
And so begins my amazing journey of absolutely epic proportions (Odysseus would be jealous). Though it started off a bit bumpy (it really wasn´t so bad -- more strange than anything), I made it, I am safe, and more than anything, I. am. STOKED. So please, keep in touch. I´ll update more when I can. This is going to be incredible -- I assure you: you won´t want to miss it.
*Ecuador has two major airports, one in Quito and one in Guayaquil
**I thought the length of the title should match the perceived length of my trip (as well as match, proportionally, the epicness of my adventure)
Long story short, we flew all the way to the Guayaquil airport (I didn´t have a watch so I´m not sure exactly how long it took, but it seemed like at least an extra hour or so). Upon landing, we, the tired, confused masses, prepared to depart, when we were met by another delightful announcement. DING -- this is your captin. Please stay seated. We may be going to Quito afterall. ...Ahem. I...this...awesome.
In the end, we sat in the Guayaquil runway for what seemed like at least an hour and a half. Then we flew to Quito (another hour, perhaps?) We ended up arriving at 2:30 am, 3 and a half hours after our initial arrival time. After going through immigration and customs, I finally met up with Chris and Natalie (who seemed just as relieved as I was), at slightly after 3am. We hopped in a cab (here I am, for the first time! Looked to my right saw...oh hell, I dunno -- it was late.) and took a short ride to a local hostal where we stayed overnight. It it now 8:30 the next morning. I am waiting for the others (Chris, Natalie, and two with whom I haven´t yet been acquainted) to awaken for our breakfast, courtesy of the hostal. We will stay in Quito today, discuss the clinics, do some exploring, and stay here again overnight. I believe we head down to Tena tomorrow. The hostal has free WiFi and a computer (which I am currently using, in case you were wondering how I was posting this -- what is this black magic!?). So in any case, I should be able to respond to emails, blog comments or Facebook posts for at least the next day or so.
And so begins my amazing journey of absolutely epic proportions (Odysseus would be jealous). Though it started off a bit bumpy (it really wasn´t so bad -- more strange than anything), I made it, I am safe, and more than anything, I. am. STOKED. So please, keep in touch. I´ll update more when I can. This is going to be incredible -- I assure you: you won´t want to miss it.
*Ecuador has two major airports, one in Quito and one in Guayaquil
**I thought the length of the title should match the perceived length of my trip (as well as match, proportionally, the epicness of my adventure)
Thursday, June 23, 2011
The End of A Journey, The Start of An Epic
Hello friends, family, and familiar followers. I apologize for the lapse in updates. I stand before you today a free man, recently released from my bonds of studying and homework, sauntering listlessly into what most refer to as the final summer of my adult life. In only a few short hours, we shall embark together, you and I (though really mostly just I), on the adventure of a lifetime. More details on that to come. But first, I will enlighten and entertain you with the juicy, highly sought-after details of the final few weeks of my first year of medical school. Oh, and while I know that I have said this countless times in the past, this time I really mean it: I'm going to keep this short.
1. My final course for the year, Biological Basis of Disease (BBoD), took me on a fantastical, whirlwind tour through the world of microbes, antibiotics, and parasites -- we spoke intimately of diarrhea (more frequently than one might have hoped), as well as various other types of intestinal assaults, including my personal favorite parasite, diphyllobothrium latum -- a human tapeworm which can grow up to thirty meters in length and can produce millions of eggs per day. Astounding. BBoD was a great course; where it lacked in organization it made up ten-fold in entertainment. I love this stuff. A career in infectious disease could very well be in my future.
2. My final preceptorship for the year was spent with a trauma surgeon. I worked weekly in the trauma clinic, where I worked with various doctors in addition to my actual preceptor. Trauma clinic was a nice change of pace from my previous preceptorships because I actually got to spend a bit of time seeing patients myself (though patience, it seems, is not a virtue highly touted by surgeons, so I was rarely able to spend more than a minute or two with any given patient). That was all fine and dandy, but here is the really cool part. Though I rarely worked directly with my preceptor in the trauma clinic, there were a few times she was around. There were two occasions where she got called in to do a surgery and, lo and behold, I got to tag along. But to my (and surely your) surprise, I wasn't only invited to observe the surgeries, but to assist in them. Hands on. Scrubbed in. Fitted with my very own pair of specially-sized surgical gloves. The first case: a splenectomy following a skating boarding accident. For this one, I didn't do too much myself -- mostly just held some organs out of the way. No big deal. But I was right there, in the action. As for the next case -- well, you'll hardly believe the details. I wouldn't have believed it myself had I not been there. Which I was. In the operating room. That's the whole point of this paragraph. Haven't you been listening? Guh. Anyway, the patient was an elderly woman who had "degloved" (it's a word, I promise. Google it if you don't beleive me. Actually, on second thought -- don't) her leg whilst moving a couch. The idea was to simply remove the excess skin (which was essentially completely torn off, knee to toe) and to clean things up. However, after consulting with a plastic surgeon (who had fortuitously been meandering about nearby), we decided to kick things up a notch. Why make this woman go through another surgery in the future to graft skin from her buttocks over the wound (a standard procedure, as I understand it)? Why not, instead, take the degloved skin, run it through a machine to turn it into a mesh, and then stick it happily back on her leg, right then and there? Why not? Because it's way too crazy cool sounding? Psh. That certainly didn't stop us. That's right folks -- I actually got to assist, hands on, with taking this freshly degloved, necrotic, dying skin, trimming it up, thinning it out, removing the excess subcutaneous tissue, running it through what I can only imagine is called a meshifying machine (things in medicine are always very aptly named), and reattaching that sucker right back on her leg (yep, I even helped suture it back on). And the best part? A few weeks later, the graft was almost a complete take. We ended up likely saving this woman another trip to surgery, and probably trimmed several days off the rear end of her hospital stay (and trimmed nothing off of her rear end). Pretty flippin' fantastic, if ya ask me -- which I'm just going to assume you did. Because I know you value what I have to say. Why else would you be here?
3. I mentioned a while back that I had been looking into various opportunities for this summer. Well, I finally decided on a trip, worked out all the details, and in just about 36 hours, will be hopping on a plane to have the summer of a lifetime. Here's a very brief rundown: I'm going to Ecuador to work in rural, government run clinics for four weeks. Afterwards, I'm going to travel around on my own for two weeks. First off, I'm going to hit up THE GALAPA-FREAKING-GOS ISLANDS, a destination that has been centered in my sights for many years. I'll be doing a 6ish day cruise around the islands, enjoying some sunshine, surf, and--assuming all goes according to plan--catching a ride on the back of a Galapagos tortoise. And for the final week -- I'll be doing a 4-5 day hike to the top of Machu Picchu. I. Cannot. Wait. And I think I'll leave it at that. I'm planning on updating my blog throughout the trip, so be sure to check back frequently so you can live this life-changing experience vicariously through me. I mean, let's be honest...what else have you got going on? Water balloons and lemonade stands? Psh-ah! We both know your time would be best spent reading about my wacky antics. I mean, turtle surfing? Come on! How cool is that? So don't disappoint me! Be here.
Well that's about it. Fast forward a few weeks, several tests and lots of studying, and here I am, the free man I described to you at the beginning of this long (dang it! I did it again!) post. Well, I'm calling it quits here for the day. Be sure to join us again next time as our dashing hero embarks on a journey of epic proportions. You won't want to miss this one. Stay tuned.
1. My final course for the year, Biological Basis of Disease (BBoD), took me on a fantastical, whirlwind tour through the world of microbes, antibiotics, and parasites -- we spoke intimately of diarrhea (more frequently than one might have hoped), as well as various other types of intestinal assaults, including my personal favorite parasite, diphyllobothrium latum -- a human tapeworm which can grow up to thirty meters in length and can produce millions of eggs per day. Astounding. BBoD was a great course; where it lacked in organization it made up ten-fold in entertainment. I love this stuff. A career in infectious disease could very well be in my future.
2. My final preceptorship for the year was spent with a trauma surgeon. I worked weekly in the trauma clinic, where I worked with various doctors in addition to my actual preceptor. Trauma clinic was a nice change of pace from my previous preceptorships because I actually got to spend a bit of time seeing patients myself (though patience, it seems, is not a virtue highly touted by surgeons, so I was rarely able to spend more than a minute or two with any given patient). That was all fine and dandy, but here is the really cool part. Though I rarely worked directly with my preceptor in the trauma clinic, there were a few times she was around. There were two occasions where she got called in to do a surgery and, lo and behold, I got to tag along. But to my (and surely your) surprise, I wasn't only invited to observe the surgeries, but to assist in them. Hands on. Scrubbed in. Fitted with my very own pair of specially-sized surgical gloves. The first case: a splenectomy following a skating boarding accident. For this one, I didn't do too much myself -- mostly just held some organs out of the way. No big deal. But I was right there, in the action. As for the next case -- well, you'll hardly believe the details. I wouldn't have believed it myself had I not been there. Which I was. In the operating room. That's the whole point of this paragraph. Haven't you been listening? Guh. Anyway, the patient was an elderly woman who had "degloved" (it's a word, I promise. Google it if you don't beleive me. Actually, on second thought -- don't) her leg whilst moving a couch. The idea was to simply remove the excess skin (which was essentially completely torn off, knee to toe) and to clean things up. However, after consulting with a plastic surgeon (who had fortuitously been meandering about nearby), we decided to kick things up a notch. Why make this woman go through another surgery in the future to graft skin from her buttocks over the wound (a standard procedure, as I understand it)? Why not, instead, take the degloved skin, run it through a machine to turn it into a mesh, and then stick it happily back on her leg, right then and there? Why not? Because it's way too crazy cool sounding? Psh. That certainly didn't stop us. That's right folks -- I actually got to assist, hands on, with taking this freshly degloved, necrotic, dying skin, trimming it up, thinning it out, removing the excess subcutaneous tissue, running it through what I can only imagine is called a meshifying machine (things in medicine are always very aptly named), and reattaching that sucker right back on her leg (yep, I even helped suture it back on). And the best part? A few weeks later, the graft was almost a complete take. We ended up likely saving this woman another trip to surgery, and probably trimmed several days off the rear end of her hospital stay (and trimmed nothing off of her rear end). Pretty flippin' fantastic, if ya ask me -- which I'm just going to assume you did. Because I know you value what I have to say. Why else would you be here?
3. I mentioned a while back that I had been looking into various opportunities for this summer. Well, I finally decided on a trip, worked out all the details, and in just about 36 hours, will be hopping on a plane to have the summer of a lifetime. Here's a very brief rundown: I'm going to Ecuador to work in rural, government run clinics for four weeks. Afterwards, I'm going to travel around on my own for two weeks. First off, I'm going to hit up THE GALAPA-FREAKING-GOS ISLANDS, a destination that has been centered in my sights for many years. I'll be doing a 6ish day cruise around the islands, enjoying some sunshine, surf, and--assuming all goes according to plan--catching a ride on the back of a Galapagos tortoise. And for the final week -- I'll be doing a 4-5 day hike to the top of Machu Picchu. I. Cannot. Wait. And I think I'll leave it at that. I'm planning on updating my blog throughout the trip, so be sure to check back frequently so you can live this life-changing experience vicariously through me. I mean, let's be honest...what else have you got going on? Water balloons and lemonade stands? Psh-ah! We both know your time would be best spent reading about my wacky antics. I mean, turtle surfing? Come on! How cool is that? So don't disappoint me! Be here.
Well that's about it. Fast forward a few weeks, several tests and lots of studying, and here I am, the free man I described to you at the beginning of this long (dang it! I did it again!) post. Well, I'm calling it quits here for the day. Be sure to join us again next time as our dashing hero embarks on a journey of epic proportions. You won't want to miss this one. Stay tuned.
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