The One About Pop Wuj

Two weeks down, two weeks to go in Xela, so I guess it’s about time that I talk about my school here!

I chose this school relatively arbitrarily off of a list of programs my medical school already supported, and I’m so, so glad I did. My school, Pop Wuj, has been fantastic and exactly what I needed to learn medicine and Spanish simultaneously.

My afternoons are jam-packed with Spanish. Each day from 2-6 PM, I receive one-on-one language tutoring, which is fantastic, because my learning is tailored to my specific needs. Typically, we spend an hour on grammar, an hour on medical vocabulary, and the remaining time either reading Spanish stories aloud or conversing. I’m probably a really difficult student, because I tend to be pretty shy at baseline, so when you add in the constant struggle of a foreign language, I’m not super talkative. Regardless, I’ve been learning a ton and I can barely imagine where my Spanish will be in two more weeks!

My mornings, however, are way more fun. On Mondays and Thursdays, we have medical lectures on tropical disease, nutrition, or other common problems in Guatemala, while the other mornings are dedicated to clinic.

On Tuesdays and Fridays, we run clinic at our school. It’s a free clinic, and patients line up even before 7 AM to secure an appointment with the doctors. The clinic is set up and runs similarly to those in the US, but operates on donated medicines from an American NGO, so when the medicines run out, it’s time for Plan B. Students are responsible for triage (taking vital signs and getting a basic history) and consults (the actual patient visit) with the help of two Guatemalan physicians who are actually around the same age as me! I have to apologize for not having pictures of the school clinic yet… it’s a busy place!

This Wednesday, I traveled to mobile clinic in “Alaska.” Okay, so obviously, I didn’t really hop on a microbus to Alaska (would I even be there yet?), but that is the nickname of a small community called Xeabaj that was forced to rebuild its entire community after a hurricane several years ago:

Again, the poverty was palpable; we traveled down bumpy, dusty, motion-sickness-inducing roads to the middle of nowhere and held our clinic in a one-room concrete building:

…I’m not really sure why we left ONE chair in the middle of the room.

Here, we’re limited in medications (we were forced to prescribe an antibiotic that doesn’t cover skin bacteria super well for an abscess!) and privacy (lacking the ability to perform a pelvic exam, we had to treat a woman for both urinary tract infection and vaginitis). Working at a safety net hospital in the US sometimes feels like working with few resources, but this experience has been an incredible reminder that much can be accomplished with even less!

All in all, I was really proud of myself this week: I was able to get through all of my visits (along with my pediatric resident partner) with our intermediate Spanish levels. I’m confident by the end of my time here, I will feel confident enough to carry out a full visit on my own in Spanish. Mission (hopefully) accomplished!

Until then,

K

The One About Xela

Having completed my first week here, including a full day of simply wandering around the streets of Xela, I figure it’s time to share a glimpse of my life here (minus school, which I’ll talk more about later this week after I’ve had my first clinic). So, without further ado, here’s Xela in pictures!

My Xela home!

My room in Xela.

Typical street in Xela

Parque Central!

Main Cathedral

Because why wouldn’t you hang advertisements on the old beautiful church?

Just a pretty building we found…

La Democracia – a bustling, colorful market that sells anything you can imagine, including avocados bigger than my hand!

“Almuerzo economico” – Saturday’s lunch special!

Chicken buses!

Walmart really is everywhere..

View from Panorama – a restaurant overlooking the whole city!

Tomorrow will be my first actual clinic here, now that we’ve had several days of teaching on Mayan medicine and tropical diseases. More on that soon!

Until then,

K

The One Where I Used a Machete

Yesterday, I had the opportunity to join my school on one of its social missions: to build safe stoves for the families of rural Guatemala. In many homes, families are cooking over open fires, which is problematic for a multitude of reasons. There’s the obvious fire hazard, along with the threat of respiratory disease due to smoke inhalation, and also the less obvious fact that an open fire doesn’t allow control of the heat, so much of it is lost, requiring more wood or other fuel to cook the same amount of food.

My school channels much of its tuition into buying the supplies for these stoves, and the students volunteer to provide the labor once per week.

The day began with my first chicken bus ride!

 

I have yet to take a good picture of a chicken bus myself, so here’s a stock photo!

Basically, a chicken bus is a school bus clad in colorful designs or cartoon characters jam-packed with native Guatemalans in local dress. I was kind of bummed because the one that we took was unfortunately just plain yellow, but I have to admit I never thought I’d be riding a school bus again!

As the bus headed farther and farther outside of the city, the change in socioeconomic status was visible. The scenery transformed from colorful storefronts and houses to dilapidated sheds without doors in fields of dust:

Our group of four arrived at a small little home barely larger than my bedroom in the US, which was home to a couple and their three sons, ranging in age from 1-6 years old. There were stacks of concrete bricks, sand, and concrete mix waiting for us, but we almost immediately ran into a problem: the family did not have a water source in their home.

Upon venturing across the neighborhood a few times to refill buckets of water at a neighbor’s house, we got to work: soaking the bricks so they would adhere to the cement. Mixing cement. Stacking the bricks in a precisely measured and leveled rectangle.

And my favorite job: chopping apart concrete bricks with a machete.

My handiwork!

In the end, we’d made this:

Our stage 1 stove! There are two more stages to be completed in weeks to come!

There’s no doubt that the extreme poverty of this family was striking, but what stood out even more is their generosity. While six year olds in America have no qualms asking for a laundry list of items for Christmas, the six year old in this house divided his single cookie into five parts: one for himself and each of four volunteers.

Why is it that people with nothing share so willingly, while people with everything hold on tight?

The One Lost in Translation

I can almost guarantee you this situation is happening in some hospital, somewhere, with some patient: the medical team walks in, asks a few simple questions in English, and gets the correct answers. The team then proceeds to explain the entire treatment plan in English, assuming that if the patient can respond to basic questions, they must have a grasp of the entire language.

My experiences this week have made me acutely aware of how dangerous this situation can actually be. When speaking to Guatemalans, I can demonstrate a reasonable grasp of Spanish, and often receive responses that are far more complex than I can fully understand. Sometimes, I just get the general gist of things. Other times, I make incorrect assumptions and miss the point altogether. Or worse, I may not have even the slightest idea what was said, but don’t feel comfortable enough (or can’t remember the words!) to ask them to slow down. But typically, I’m only trying to buy a bus ticket or understand my host brother’s new job, so a few words lost in translation are usually not a huge deal.

But when explaining a cancer diagnosis or the risks and benefits of a surgery, losing words in translation is not an option we can afford. I have no doubt there are patients for whom English is a struggle, but they may be too embarrassed or respectful to interrupt to remind us that they can only handle the basics. No wonder patients have difficulty complying with treatments, or even articulating what exactly their medical problems are.

Though I came to Guatemala to learn Spanish via cultural immersion, this trip is also a firsthand experience confirming the importance of using interpreters, avoiding assumptions, and checking to ensure patients are understanding their providers, regardless of language.

The One Where I Resurfaced in Guatemala

Oh, hey.

Yes, I’ve been incredibly neglectful of this sad little blog for months, and for that, I apologize. However, turns out it takes up a lot of time to travel across the country to interview with eighteen different residency programs. But the good news is, my rank list is completed and certified, and I will hopefully be matching in (drumroll, please!) Combined Internal Medicine and Pediatrics come March.

But we can talk about that later. The more exciting news is that I’m typing this from here:

…in beautiful Lanquin, Guatemala, a little town in the eastern portion of Guatemala well-visited by tourists because of its proximity to Semuc Champey, a gorgeous natural wonder which I’ll be visiting tomorrow.

Wait, rewind… I guess I should tell you how I got here. I enrolled to participate in a Medical Spanish course at a school at a little town up in the mountains called Xela. I’ll be there for four weeks starting this Sunday, staying with a host family, and embracing some cultural immersion to improve my Spanish, which I’m discovering needs LOTS of work. I’ve been grateful for my travel buddy who has spent two weeks here already and has a much better grasp on the language.

But for now, I’m fumbling through my Spanish and enjoying a week of tourism. I arrived in colorful Antigua on Sunday and spent the evening ambling around the beautiful town. Most of my photos, however, happen to be from early this morning… we had intended to book our bus for 2 PM today so we could enjoy a leisurely walking tour of the city, so when we discovered late last night that we’d miscommunicated and booked 8 AM, the only option was to wake up at 5:30 AM and enjoy a sunrise tour of Antigua. We weren’t disappointed:

One of Antigua’s charming, colorful streets.

Inside the Las Capuchinas convent… because they’d left the door open at 7 AM, so we let ourselves in…

Nuestra Senora de la Merced

I just can’t get over this archway with the mountain in the background. Gorgeous.

The other highlight of my (three-day) trip thus far? Hiking Volcan de Pacaya. The ascent was PAINFUL (and my legs are still sore), but the incredible views were totally worth it!!

An incredible view…

This view negated any doubt that the trip to the volcano was worth it.

Some areas are so hot from the lava below that you can roast marshmallows…

Volcan de Pacaya itself.

At the top of the world…

But for now, necesito practicar mi espanol! Hasta la vista!

K

The One Where I Joined the Walking Dead

It’s Medical Monday again, so obviously that means I come out of the woodwork to introduce myself. This is me:

Image from The Walking Dead

Okay, so that’s not always me. It’s me when I’m in the midst of my second week of night shift for my pediatric subinternship. If that’s not an excuse for an extended absence, I’m not sure what is. At this point, even coffee gets me to about here:

 And of course, I’m also working on my residency applications right now, which makes me look something like this, even on a good day:

But even among the hustle and bustle, I’ve been hoarding ideas for future blog posts. Like about the time that an elderly veteran in ophthalmology clinic decided to read my palm. Or about how I finally managed to write a personal statement after months of procrastination. Or about my patient who disappeared off the floor at 1 AM. Or about narrowing down which residency I want to pursue (!).

Really, I’m going to write about all of that. Someday.

But right now, all I can think about is sleep.

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 It’s the first anniversary of Medical Mondays, and I am so grateful for the efforts of Emma and Jane over the past year. It’s been so much fun to connect with other medical student/medical wives/medical professionals in the blogosphere. The posts shared each week remind me that I’m not alone in the hectic world of medicine, enlighten me on the various roles played by different staff in the medical system, and provide advice on everything from raising children as a physician to the latest in interview suit fashion. While I hop on into my bed, I highly recommend you hop on over to their blogs to meet the other fabulous participants of MM.

The One with the Belated Blogiversary

I am the worst blogger ever.

Yesterday, I spent the day overdramatically collapsed on my bed, exhausted after spending the prior two weekends travelling, and the days in between scrambling to finish oral presentations, studying for and completing Step 2 CS, and doing laundry. I was grateful for a day that demanded absolutely nothing of me, and I chose to indulge in absolute nothingness.

But the consequence of my indulgence? I’m now one day late on acknowledging my one year blogiversary! 

I can’t believe it’s been one year since I started this, intending to offer stories to family and friends during my third year, when I had few other opportunities to catch up with them. And despite my third year schedule leaving dozens of stories yet to be told, I’ve managed to keep in touch with family and discover a whole community of medical (and other) bloggers, mostly thanks to Medical Mondays.

Special thanks to all of my readers for all the support and encouragement. Looking forward to another awesome year with you!

<3, Kay

The One With the Accent

This morning, I attended an anesthesia resident lecture, led by one of the chief residents with input from a well-respected and extremely knowledgable attending.

And it’s a great educational opportunity and I’m grateful for the opportunity to work with this man… but I’ve spent the first few days of my surgical subspecialty trying to place why his voice sounds so familiar.

And then it hit me. He sounds exactly like:

 And now I have to spend the remaining 1.5 weeks trying not to giggle at the image of Puss in Boots as an attending.

…life as a fourth year is SO hard.

The One with the Last Minute Lesson

“It’s your last day, right?” Dr. Family asked as we entered her office to start our lunch break. “I think it’s time to teach you how to balance work with real life. Come on.”

I tossed my stethoscope aside and scurried to catch up with her as she wordlessly exited her office and led me to her car. As she placed the keys into the ignition, the chorus of Nelly’s “Ride Wit Me” blasted through the car, and I stifled a giggle at the thought of my attending jamming out on her way to work.

“Are you up for ice cream for lunch? We can eat it on the beach…”

Ice cream? Beach? Now this is my kind of lesson.

And for thirty lovely, relaxing minutes on the sunny, warm waterfront, we indulged in peanut butter fudge ice cream. 

Lesson learned.

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For my new visitors (and old friends!), thanks for stopping by! I’m K, a fourth year medical student in the US who realized I recently had my 22nd and final first day of school EVER! Please take a look around (and maybe even subscribe or follow me on FB/Twitter), or hop on over to visit our lovely hostesses Emma and Jane to peruse some other fantastic medical blogs.

The One With the Appropriate Gift

During my first year of medical school, a textbook author named Barbara Fadem played a huge role in my education. An expert on behavioral health, Barbara guided us in how to address defense mechanisms, recognize substance abuse, and approach complex ethical issues.

For whatever reason, one particular line from her textbook has always stood out in my mind:

From Fadem, Barbara. Behavioral Science in Medicine. 2007: 26: 493.

This concept has always made me chuckle at its seeming absurdity, because who in an urban environment even raises chickens, let alone thinks to package their eggs up for their doctor’s appointment?

But this week, my jaw dropped as I walked into a patient room.

Because there, on the counter, with “Mindy’s Farm” scribbled on top, was this:

“Mindy,” I began, giggling. “You have no idea how appropriate this gift is.”

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Also, I’m taking this opportunity to wish a very happy Father’s Day to the man who always read me countless stories and taught me to ride my bike and to drive, who still washes my car and changes my oil, answers my frantic 6 AM phone calls when my car door freezes shut, and supports me no matter what. Love you, Dad!