Primera semana

I've capped off my first week here in Santa Cruz. It's been a week full of adjusting to to how the clinic works, speaking Spanish with patients and living with my family. I was a little surprised at how quick I got thrown into things on Monday. I got there in the morning and met Dr Craig for the first time and he gave me a quick introduction to the clinic, which sat on the the second floor of the ministry of health building in the town center. Within a few minutes of arriving I was seeing my first patient. He sent me in with a translator and I realized quickly Spanish was the only language that I was going to be speaking, especially since my translator was translating the locale language into Spanish for me. I honestly don't remember what complaints the patient had because of was pretty flustered the whole time. I finished seeing the patient a went to report what I found out to the attending.  Luckily, Dr Craig was cool about me not really knowing what the hell I was doing for my first patient, but it is always interesting the first time you present a patient to a brand new physician. There will always be a question you didn't ask and the diagnosis will always be wrong...

As the week went on I realized quit a few things about my new clinic. Firstly, it isn't a clinic in the US so I don't need to compare them. There are simply things we do in the US that aren't done here for either lack of resources, money, or personnel.  Secondly, it runs very similar to other clinics I've been a part of internationally, in under served areas. It's hard to explain exactly but it seems we are always searching for supplies, trying to find charts or trying to get all the vital signs written down by the nurses. Lastly, these are different patients and I need to understand their culture in all aspects in order to help treat and diagnose them.

We had a great clinic on Thursday where we traveled by boat to a town called Tzununa. This was a town that mostly spoke the local language so again  my patience was tested.  Luckily, I had a new arsenal of medical Spanish I had been working on and although I still got caught up from time to time I was able to get most of the history and exam down comfortably.  Here I saw the extent of parasite infections, presumably Ascaris, which is a big problem in underdeveloped countries. At least half of my patients walked away with a 400 mg prescription for Albendazole to treat their parasitismo intestinales.

Tomorrow I think Ill head to another town on the lake and enjoy my time hanging with travelers passing through.  It will be nice to hang with some other people because my gringo contact has been pretty limited as I think I'm the only one living in town with the local people ( at least that I've seen). Most foreigners live in the big houses or hostels  by the water about a 15 minute walk down the hill.  All things considered it was a fruitful work week and I think after 4 weeks Ill feel comfortable with my Spanish and happy my experiences.