Amazon Trip

Today we all ditched work and went to an indigenous village in the Amazon.  This was the place they were originally going to send me, and I'd be doing a homestay.  Thank the Lord that they changed their mind and sent me to Codo.  I think they've only had electricity for a year, and I'm not really sure they have running water yet. There was no real drama; the kids did a little customary dance in their native costumes, and they made us a meal and some fruit juice.  They were really just dirt poor more than anything, they didn't have a pot to pee in much less a window to throw it out of. I'm pretty sure the head guy didn't know we spoke Spanish, because he gave this hellfire speech that if they were ever going to pull themselves out of poverty they needed to focus on tourism ... And that we all had a pocketful of money, and it was there responsibility to not let us leave with it 😳 At some point, we went to a part of the Amazon River that everyone went swimming in ...

It was my first day at the clinic, and I didn't really know what to expect.  When I got there, there was one doctor and one ob/gyn in the front, and it was more or less the ED.  In the back was the "hospital", which had about a half dozen rooms where patients can stay that are admitted. They put me with the doctor. Keep in mind they treat about 8000 people in the entire district, and the nearest real hospital is 5 hours away over that dirt road from hell. I would guess we saw about 25 patients in my 5 hour shift.  It was a little crazy, but I think I held my own. Side note - there was a big annual festival that lasted all of last week, that pretty much went 24/7.  It appeared that there were a lot of people that were injured or had infections, that just didn't come to the clinic because they didn't want to miss the festival.  I probably saw five people that were septic, which is just nuts.  So Monday was kind of a s*** show.  One of the highlights was ...

Every day you finish and go wtf, it couldn't possibly get any crazier.  But then it does.  So today, Brendan, the other guy in the medical program who is a first year student, wanted to do triage so they put me back in the ED. When I got there, it was me and one other doctor, and two nurses.  They told me there was a woman in labor in the operating room/l&d room/lunch room, so I went down to watch (hoping I could tap in). Well shit howdy, I'm not even sure I can put the visual image into words... First, maybe one or two of the nurses had gloves on. I don't think anyone, including the doctor, had a mask on.  There was no monitor on the mom, or the baby, no actual equipment in the room, and for all intents and purposes she might as well been having this kid in a field.  When she had a contraction, a nurse would get on a step stool and literally push down from the top with all her weight, almost like CPR.  The doctor was trying to dilate her with his index...

Today I skipped work and we went to the jungle for the day.  Ali is actually doing a project for school credit, and she has trail cameras set up in a biological preserve.  It was a fairly uneventful hike, we went about five or six miles in to a cabin some poachers had built.  On her last trip they had found a dead calf, so they tied it to a tree and put the trail camera on it. Sure enough, there was a leopard on it one night, and a panther on it another night.  Totally cool.  I'll try and post some video if I can get her to send it to me.  Not much else today, so I thought I'd post some random facts ... Everyone here drives "tuk tuk's", where they quite literally cut off the back wheel of a motorcycle and weld the frame to a rickshaw.  I have no idea why it's a thing. I haven't come across a piece of concrete that doesn't have dog prints in it, including my bedroom.  I don't know if people don't care, or if the dogs just think it's funny.  ...

Today I was in triage, nothing really too exciting.   I asked the doctor to take some skin cancer off my face, and he was too nervous to do it.  So I walked Brendan through what to do, and he did it without a problem 😂 Then the doctor asked me if I wanted to put in some IV's, and between my hand tremors and my lack of being an actual doctor, I passed. I'm confident I could do one, but one of my <many> character flaws is that I pretty much think I can do anything if I've watched a YouTube video.   But I 100% give injections better than they do, though, cause they still sink a 3" needle in the patients' bumm like they used to do when I was a kid.  Most people are ready to pass out.  I do an IM injection in their arm or thigh and they look at me like wait, wtf, that was it?  The biggest problem is when I asked for a 3/4-in #26 needle, they were like "I don't even know if we have those". The other interesting thing ... Here when they put in an ...

Today was relatively uneventful, I was in triage, and it was a lot of pregnant women and kids getting checkups. There was one good one; a woman came in and one whole side of her face was swollen and droopy.  The area around her eye was particularly swollen, and she had some stitches on her cheek that looked like she had a stent at one point.  She had the same look my dog had after she was bit in the face by a rattlesnake.  I was thinking to myself, it's only a matter of time before that infection rots her brain and she's eating out of a straw.  Seriously, I didn't even know where to begin with her. When I went to take her blood pressure, she said I couldn't because she was there because of her hand. 😳. It was at that moment I realized she had a towel or something around her hand and a jacket over it ... Apparently as bad as her face looked, her hand was worse.  Easy decision - let me send you back to see my colleague, Dr Jon... Other interesting thing - the loc...

Today was fairly uneventful, I did triage again and worked with an old guy who was totally out of F's to give.  He would leave for like an hour with no explanation, and once I found him dead asleep at his desk.  So I got to do most of the work, which was fairly fun and wasn't an issue except for the paperwork.   It's like these people have a different word for everything...  No crazy injuries today, but 3 of the people I saw on Monday were back again today and were probably nearly septic.  All the hospital did on Monday was give them a shot of antibiotics and send them home.  I think it tells you where the bar is at when I'm about the best medical care they're going to get here 🙄 My big accomplishment today was I went shopping, and got some bananas and eggs.  And I finished the closet I built.  All the college kids here teaching essentially live out of a backpack, but I guess I'm way more boujie.  I know I am.