It’s been quite a while since my last post, and of course that was about my last travel adventure with my family. Since then, I have started my med school program at Bastyr. It’s been quite an adventure in itself, but I thought I would spare you all the details of my life in biochemistry, anatomy and physiology.
As most of you know, one of the main reasons that I chose to go into medicine is to be able to combine my love of travel and international volunteering with my newly honed doctor skills. In October, I heard about a group called Natural Doctors International (NDI), that was going to have a medical brigade going to Nicaragua in December. “Sounds fun, but I’m only a first year ND student. I probably can’t go yet.” “Sure you can!” “Seriously? Where do I sign up?” That was about the extent of my conversation with the girl promoting the program at a table in the hallway during “Club Day”. It was “sign-up now, ask questions later.” I honestly didn’t know what I was going to get to do there. I had only had one observation shift at our school clinic and basically I just sat in the corner and didn’t speak unless spoken to. I thought it would be the same in Nicaragua, maybe learning to take temps and blood pressures too. Whatever, I was going to get preceptor hours too so I was excited. I grabbed my friend, Anna and told her she was going with. Before we knew it, we were finishing finals on Friday the 12th and heading to the airport a few hours later.
The island of Ometepe is in the middle of Lake Nicaragua. It consists of two volcanos, the active Concepción, and the dormant Maderas. We stayed in the little town of Los Angeles at the base of the active one. Only a few blocks long and wide, dirt roads and lots of horses, cows, chickens, pigs, and dogs roaming about. There were about 14 of us that came down to work with Drs. Tabby Parker and Dawson Farr. They own a ranch near the clinic, where they have their homes as well as the NDI office. It has a beautiful view of the volcano with all kinds of fruit trees and animals roaming arounds. A bit of paradise, for sure.
From the get-go we got right into things. We learned how to do a full intake physical from head to toe… in Spanish to boot! Not only would I learn to take temps and blood pressures, but looking in eyes, ears, mouths, feel for nodes, listen to the lungs, heart, and stomach, palpate the liver and spleen, test reflexes and nerves on the feet, just to name a few things. Whoa! I was going to do all this on someone, for real? Yep. When Monday came, we arrived at the clinic to about 17 people waiting for us, some come as early as 4am to wait outside. This we were told was a “light” day. Our day was broken into two 4 hour shifts with job rotations every 2 hours. One team would start out doing physicals while another team would be with one of the doctors, or Lilliam, the clinic psychologist. When we were with the doctors, it was great to be a part of the conversation. We weren’t there just to observe, we got to ask questions, were asked questions ourselves, and we were able to assist in coming up with and preparing remedies in the forms of supplements, tinctures, and homeopathy… whatever we had on hand. Everything I know about herbs and homeopathy I learned right there on the spot. It was great! The doctors really cared about our learning and never once made us feel like we were in the way. We saw patients who had back pains (lots of field workers), radiating pains, stomach issues, infections, lots of diabetes, and dehydration. I was on hydration patrol. As soon as a patient would say they only drink about 2 cups of water a day, I would grab a glass of water and say, “here you go.” I wouldn’t ask, I would just give.
When we weren’t in the clinic, our evenings were spent in class at the ranch learning about the history and culture of Nicaragua and our little community as well as globalization and its impact on global health, especially where we were. Globalization isn’t really news to us, but it brings on a whole new perspective when you are meeting the people whom this effects. For me and many on this brigade, this isn’t just a trip to help out in a small, rural clinic in a developing country, there is so much more to it. It’s getting to know the community, the way of life, what things cost when you make $2 a day and how globalization continues to keep the poor, poor.
One of our assignments was to work in pairs and we were each given a fictional family and their living situation. Typically mom, dad (usually a field worker), and a couple of kids. Dad would bring home 50 cordobas a day which is about $2. So what do you buy for a family on that budget when they need to eat and perhaps a child is ill and needs medication? For $2, you might get some rice, a tomato, onion, a little soap and perhaps 2 days worth of medication to get you along until dad gets paid again. It really puts things in perspective. All the goods that we purchased were going to be give to families in the community who are in need.
At the end of our nights we would retire to our homestay families. My host mom, Carolina was so welcoming and kind. She was also a great cook… a little too good. Every meal, my roommate, Ruth and I were greeted with a mound of food on our plate. So much that I could rarely ever finish… and I am one who doesn’t want to waste food or insult by not finishing. When I would ask for less food, it was only just slightly less. Oh well. Typical meals consisted of rice and beans, plantains, and maybe chicken. Because we were paying guests, we also got fruit, and fishcakes (for breakfast) as well, a bit of a luxury.
Life in our house was modest. Ruth and I shared a bedroom and it had its own bathroom. A toilet but no running water so flushing, washing, and bathing were all done with buckets. There were two other bedrooms shared between about 6 other members of the family, a main gathering room and a kitchen, though some cooking was still done outside. At night the town was quiet except for the barking dogs, crowing roosters and the 4am church bells across the street that sounded more like a fire alarm… and they rang for service EVERY morning! Needless to say, sleep was not achieved by me. One night in particular I was just about to turn the light out when I saw a huge spider on the wall inches above my pillow. I freaked (what a surprise), and Ruth tried to keep calm about it but she knew she didn’t want to deal with it either. In my frozen, hyperventilating state, my host sister came to the rescue. She laughed and said it wasn’t dangerous but she would be right back. She came into the room with a machete! Yes a machete. One whack and a scream from me and it was over. Needless to say, I wrapped myself in my cocoon of a sheet and didn’t come out until morning.
Overall the trip was more than I would have ever expected. I met many great new people, had all kinds of new experiences, and learned more in one week than I have since starting med school six months ago. Besides learning physicals, I got to give my first shot, mix tinctures, research remedies, do a urine analysis, test blood glucose, give a massage (“I think this patient would be a great candidate for massage.” “Do you know how to?” “I can fake it!”), assist a pap, give some counseling advice, and comfort tears. These are skills that no text book can teach. The smiles, hugs, and new friends are the only grade I need to know that this is exactly what I want to do.