Back To The Clinic

It was brought to my attention that an uncomfortably large number of my posts deal with babies that are the subjects of my obsessions.  I can reassure you all that the likelihood that I will be coming home from Guatemala with a child is zero negligible low.  This post will include no pictures of babies (mostly because my camera broke). 

As of yesterday, the whole group has officially arrived and we hit the ground running.  There are eleven of us in total, with 4 actual doctors – pretty big difference from the first month, when there was just Anne and two halves (me and Puja).  Funny thing is we’re not seeing that many more patients, although the clinic is entirely different.  First of all, I have done ZERO paps in these two days.  Second of all, I actually have used my stethoscope and physical exam skills targeting areas above the umbilicus, which is refreshing.  We are running a full service clinic, and the patients I saw today ranged from a 3 week old baby with feeding issues to a 27 year old pregnant woman to a 55 year old man with a frozen shoulder to a 75 year old woman with abdominal pain.  Luckily, it’s all reminding me why I’m excited to be a family doctor. 

Today and yesterday we had clinic in Las Viñas, a village about 15 minutes up the road from El Naranjo, where I spent the first week of the trip.  We were about 30 km from Belize, but despite my best attempts I couldn’t convince Ismael to take us there for lunch or dinner.  For a variety of reasons, we have faced some difficulties in holding our clinics in established Centros de Salud, so when we were thinking of coming to this village we looked for other options.  This community is wonderful (this is the one that I wrote about here where over 100 people came out to the introductory meeting about starting the Kids Against Hunger food in the village) and jumped at the opportunity to have a couple days of clinic there.  They quickly had a family volunteer their house as a clinic site!  The house was beautiful (gorgeous tiles throughout, three good sized rooms – hopefully I can post pictures at some point) and the family was unbelievably accommodating.  They offered to move out all of their furniture, insisted on cooking for us throughout the day, and even spent most of the day helping clinic run smoothly.  It was an unbelievably selfless act, as the only real benefit they got was that their family members were seen first during the day.  As I spoke to the woman, Sandra, it was clear that the motivation was to help serve a need in the community.  What a great example. 

Yesterday I spent most of the day with Carrie (family medicine resident) doing general adult medicine.  After so long I was completely caught off guard when the first male patient walked into the room – I actually thought he had wandered into the wrong place before I realized we were no longer doing female-only clinics!  Carrie is continuing on to a sports medicine fellowship and I was able to witness a lot of her osteopathic manipulation methods.  In the coming days I’ll hopefully learn joint injections and better musculoskeletal exam skills.  Today I spent the day with Gary, the pediatrician.  I thought I was mostly going to be his translator, but he essentially allowed me to work independently with him as preceptor.  It feels good to push my knowledge and abilities a bit, especially since I think there are more than a few spider webs after a long time out of clinic.  Can’t tell you too much more, since I promised not to make the post about the loads children I saw today…  Suffice to say, they were adorable. 

These two days were much busier than we expected – showing up this morning to a porch already brimming with patients brought me back to some of the clinics last month!  The desperation these patients have to be seen in our clinic (and the determination they show by waiting for hours even when we say we don’t think we’ll have time to see them) points to the myriad of problems they face in finding care here.  Luckily, we were able to work efficiently enough to keep from turning anyone away today.  The balance of efficiency and providing quality care remains a constant struggle. 

I’m looking forward to three more busy days at our Santa Ana clinic.  It’ll be nice to be a bit closer to Flores, as the days have been long (getting home around 8 or 9 the last two nights) with over an hour drive each way to clinic.  Plus, we can’t help but feel a bit at home in our little clinic.