The Days After Today, Tomorrow and Yesterday

Having cleaned my wounds and bandaged my ego, I have now nearly fully recovered from last week´s endeavors (see post: A Minor Setback). Consequently, I am also once again going full-speed-ahead with my clinical experience. I spent Tuesday in the private hospital in Archidona and Wednesday and Thursday in the larger, public hospital in Tena. Both days had their ups and downs, which has sort of been the experience with all of the clinical time up until to this point. The Archidona hospital serves a smaller population, and is private, so things were rather slow. Or should I say sloooooow. We did some rounds in the morning, and then went to an early lunch around 11:30am. We came back around 1:30pm, but the docs still weren´t back. So we took a 20 minute nap at Natalie´s apartment -- still no go. Ok. Fastforward 45 minutes, after a quick stroll to the river: "Great! They´re bound to be back by now!"  

You´ve got to be kidding me...

Anyway, I think you get my point. The doctors took a lunch until 3:00pm or so. We spent the afternoon with a gynecologist, which was ok, but he wasn´t the greatest teacher. I have found that there are three different types of doctors working on Ecuador, and I refer to them appropriately as 1) The Whisperer -- a quiet talker who is virtually impossible to understand in your native tongue, let alone a language you barely speak; 2) The Ecuadorian Fly Catcher -- a doctor who amiably welcomes you to spend time shadowing them, but then doesn´t say a single word to you the entire time you are there, as you if you were oh but a fly on the wall (...ahh, now I get it! -- I told you I named them aptly); and finally, everyone´s personal favorite, 3) The Educator -- a mentor/teacher who not only acknowledges your presence (and speaks in a tone within the realm of human audition), but also goes so far as to inspire young American doctors in the making, teaching them about the situation at hand and making darn sure they know what is going on (which is less often the case than you might expect). Man, what a guy/gal!

Wednesday in Tena there were much more patients, but the docs were still sorta hit or miss. I spent the morning with a gynecologist; we only saw a few patients, but she was a great teacher. At one point we were doing a checkup on a woman who was well into her pregnancy and presenting with new pains. It was just myself and two doctors in the room. Things were pretty slow. The one doing the exam said something to the effect of "ok, she is fully dilated". And that´s when s**t got real. All of the sudden, nurses started appearing out of nowhere. Before I knew it, there we like 20 of them in the room. They were popping out from behind doorways, poking their heads out from behind plants; I´m pretty sure one of them even emerged from a previously empty bathroom.

"Labor?"
"She´s ready?"
"Time to go?"
"Who wants icecream?" (ok, that one was me).

And that, my friends, was the day I officially witnessed my first birth. That´s right, friends. Danny and I were fortunate enough to get to tag along to the operating room and observe all of the shenanigans and tomfoolery that subsequently ensued. It was pretty cool. A bit gross, but cool. Nothing too spectacular of note, save for maybe my observation that the doctor delivering the baby was fully scrubbed in, but wearing crocs with socks on. Also, the baby came out pretty darn blue (I asked Danny how he would rate it on the normal to blue scale, and he appropriately relied "Avatar baby"), but everything turned out fine.

Today we did yet another stint at the Tena hospital. I went on internal medicine rounds with a cool doctor I had met the night before. Saw some neat stuff (one patient had necrotizing fasciitis, post surgery). I spent most of the morning helping the doctor with his charting, assisting him in filling out prescriptions and orders for tests. Though not particularly thrilling, it was pretty fun and certainly educational. I spent the afternoon in the ER and saw some interesting stuff there, too. Of note, a guy with a seriously broken arm who had been continuing to work for several months. I also identified a murmur in a patient with left ventricular heart failure (that is, befor  anyone pointed it out to me). That was pretty darn gratifying, especially since heart and lung sounds are dang difficult to get down.

And now comes the fun stuff. I´m going to be doing a bit of adventuring this weekend -- questing, if you will -- all on my own. I´m not sure exactly how it´s going to look yet (I just found out that the bus trip I was planning to make in a single afternoon actually takes 13 hours, so I´m going to have to rework my itinerary a bit), but I have the essential idea in mind. My ultimate destination is Cuenca, where I will probably spend a couple days. There is a national park nearby -- Cajas, I believe -- that I will definitely be hiking during that time. I´m also probably going to make a stop in Banos (either on the way there, back, or both) in order to split up the bus ride a bit. They are famous for their volcano-fueled hot springs. And that´s that! More details will definitely come soon; I just wanted to give all you a bit of information on my upcoming adventure, as I knew you were all waiting with baited breath.

Ok. My companions are beckoning me to leave the internet cafe. More updates to come, along with fantastical adventuring and nonsensical antics. Stay tuned!