Tuesday, February 2, 2010

Day Two: Excursion



Another day come and gone. And what an eventful one it was! We woke up at 6:30 a.m. to the sound of roosters crowing, and it literally felt like we hit the ground running.

After a quick breakfast, we arrived at the hospital at 7:30a.m. for morning report. So much of this seemed incomprehensible, especially to me and my pronounced inability to understand Dominican Spanish. The room we were in seemed extremely crowded with residents and interns. And of course, there was the constant hubbub of cars, sirens, honking horns, and other sounds that comprise the cacophonous symphony of Santiago's streets.

We then went on rounds with the attending physician. As usual, the pathology and high acuity of the cases never failed to astound me. Our first patient was a man who had organophosphate poisoning from ingesting rat poison in a suicide attempt. As we stood there discussing his case, the medical intern was stationed in a corner, patiently pushing atropine every 15 minutes in order to counteract the poison. As we left his room, I remember thinking with amusement about how different things would be in the U.S. if interns were really made to do things like that...

The other patient who really caught people's attention was a 30 year old woman who had untreated HIV for the past 8 years. She presented with a 3-day period of pronounced neck swelling in the context of a month-long history of constitutional symptoms. There were so many things that were apparently going on with her, ranging from significant anemia (the lab reported a hemoglobin of 2.9...this has to be a mistake) to an extremely huge mass on her neck that has yet to be biopsied. She also had evidence of tuberculosis in her lungs symptomatically and on x-ray. In the United States, any one of these would qualify a patient as a train wreck. Here in the DR, every patient seems to be an overwhelming mess. I really admire the attendings here. I don't think I would have the stomach to do the extent of the "watch and wait" type medicine they do...

Our attending, who is probably the most energetic yet laid-back person I know, decided to give us the majority of the afternoon off so we could get to know the city better. This was a blessing to our group, as the majority of us are foodies who were anxious to see what the local markets were like. What a treat, to be in a city where we have a seemingly endless variety of produce, beans and grains.


It was my turn to make dinner. We had Chinese-style fried rice, porkchops with orange marinade, and a salad made from avocado, cucumber, and red peppers. The avocados here are amazing...so much so that we had another dish made with avocados flavored with fresh-squeezed orange juice and salt. Yum...it was heavenly!

These nights, we eat family style. There are 6 of us sitting around the table, eating happily and sharing stories. It's times like these when I feel particularly grateful I'm here with a big group. I will definitely miss experiences like this in a couple of months when I'm in Cambodia as the only medical student particpating in that rotation.

Well, I should get to bed. I need to get up early so I can start brewing the coffee in time to drink it. We only have a french press coffee brewer...which makes for wonderful strong coffee, but takes a long time to make.

Til next time...

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