Monday, October 13, 2014

Week 2: Learning the Ropes (La Paz Style)

Day 9 - October 6th, 2014 -First day alone

As you can all imagine, my experience here in La Paz continues to amaze me the longer I remain in the city. No matter what I am doing, I am either learning something new or pushing my personal boundaries farther than I ever expected.

This day marked the first day of rotations that Katie, the other intern, would not be able to help me find my way around. Which actually was a problem.

When I arrived at the hospital this morning, I went directly for the head coordinator at the hospital, Dr. Velasco's office. But when I got there, I could not find him. I found out later that he was teaching a seminar for some of the residents in a room that I didn't know existed.

So I waited.
And waited.
And waited a little longer until I finally gave up and asked the lady in the office where I could find him. She told me that he actually hadn't arrived yet, and she took me to the Infectious disease ward; the same ward I was in the week before.

As well as coordinating the CFHI student and resident rotations, Dr. Velasco is a certified infectologist at the hospital. My guess is the lady thought he may show up to the ward and I could talk to him then.

So I sat in the ward for 10 minutes. And then it was 15 minutes. And then half an hour. And finally after an hour of waiting, I decided to contact the local coordinator, Gonzalo Claure. He said he would call Dr. Velasco (he did not end up having his phone on) and he left a message for Dra. Uribe (who never got back to me about the problem, but that's alright!).

What ended up happening was he told me to find another doctor who could help me, Dra. Bocángel. I went to the information desk to ask where she was, and luckily, she was about 10 feet from the desk. I talked to her about Dr. Velasco and she helped me find him.

When we finally found him, he ended up placing me with Dra. Bocángel anyways. I was totally fine with that because she was extremely nice and also very funny, and she spoke a little bit of English but I'm starting to be really comfortable with Spanish now so that wasn't a major problem.

Dra. Bocángel is a pediatric nephrologist, who also works in general pediatrics, the ward that I spent my time in this week.

The first patients I saw in the ward were two children with chronic kidney disease, connected to dialysis machinery.

If you don't know what a dialysis machine does, it basically takes blood full of toxins, and cleans it because the kidneys cannot filter it.

After the hospital, I had my Spanish lessons. And just as I had suspected, after about a week in the city, my language skills had improved drastically. I was finally able to communicate (somewhat) what I actually felt without beating around the bush. And it was great.

My day concluded with a small get together with some friends I met here in La Paz. Surprisingly, I have met people from all over the world, including Belgium, England, Germany, Ireland, and even other Americans. Almost everyone I have met has an incredible story on why they are here or where they came from, and I enjoy every minute I get to spend with my worldly friends.

Day 10 - October 7th, 2014 - Strange diseases and heart-wrenching experiences

Upon arrival in the general pediatric ward, the itinerary was basically the same as infectious diseases. The residents spoke to Dra. Bocángel about the patients medical records and treatment as well as whether or not the patient's recovery was favorable or not.

The first patient was a young child who looked to be in very poor shape. It was obvious he was in pain, but I didn't know what was wrong. Dra. Bocángel explained that this patient had iron poisoning, with almost a level 10 times the norm. All Dra. Bocángel could tell the parents was that it was very very bad and the parents began to cry.

Eventually the patient was rushed to emergency care. Sadly I don't know exactly what happened to him. All I know is that when I showed up the next day, he wasn't in the general pediatric ward.

The next patient I saw in the ward had a very uncommon disease that I had never heard of. The disease was called Henoch-Schönlein purpura. The symptoms are actually very strange as well. The patient exhibits purple spots on the skin, hives, vomiting or nausea, and in some cases, kidney problems, which is why Dra. Bocángel was involved.

The day ended with consults, exactly like infectious diseases. Dra. Bocángel has many patients with kidney problems, as well as gastrointestinal issues or gynecological issues. These consults gave me insight into a variety of different aspects within pediatric medicine. Not only did I experience multiple cases of constipation (hahaha), but I experienced false tumors, patients who only had one kidney, and parents who believed there children were sick, when in actuality, they had autism.

The other notes I made involved how the residents take notes, coincidentally. In order to track patient evolution while admitted in the hospital, the residents use typewriters. That's right, those things that were really popular years before I was born. Although it seems somewhat out-of-date to me, they are most effective. The residents can practically take the original clinical history and just amend it with ease.

Even though the residents' hands are very capable of using this odd machinery, I know for a fact that I would not be able to, and I admire there ingenious usage.

Day 11 - 13 - October 8th - 10th, 2014 - Not much happening

Although La Paz is always busy and exciting, with many things happening all the time, these three days were actually quite relaxing. The hospital was as normal, with clinical histories in the morning followed by consults. But most of the patients had the same issues during these days.

The most interesting patient was a young girl who had a disease called Lupus. This disease is characterized by inflammation throughout the body. The body's immune system begins to attack its own tissues and organs, caused by a combination of genetics and environmental stresses.

This young girl will need constant treatment to control the effects of the disease as well as a close watch by doctors to make sure the diseases does not lead to organ failure.

Besides this one case, hospital work was pretty standard. Even the city was very calm.

I finally found out why.

The next couple days (Friday and Saturday), alcohol was prohibited to sell because of the upcoming elections. People were preparing for the vote, and none of the normal clubs were open, keeping the city much quieter than usual.

Day 14 - 15 - October 11th - 12th, 2014 - The World's Most Dangerous Road and the Elections

Yes, I did visit the world's most dangerous road, otherwise known as "Death Road" or "La Ruta de la Muerte". And yes, I did mountain bike down a road where three people had already died this year. And yes I survived. And finally, yes, I had the greatest time of my life.

Death Road is notorious for being extremely dangerous for cars and buses, but in the last decade or so, mountain biking down the road has been a huge tourist hit.

The road is known as the most dangerous road because several years ago the land was surveyed. The amount of switchbacks combined with the proximity to 150 foot cliffs led to the claim that this was the most dangerous road in the world (I guess it could have been that there was almost a death a day at this point in time).

The trip began meeting at an English pub in the more touristic area of La Paz. The bus drove my group to a city slightly higher in altitude than La Paz. The fog slowly cleared as morning drew on.

The guides unloaded the bikes from the top of the bus.

And then our group tested the bikes.

After an extensive run down of the road we were off. The road started with 22 kilometers of paved highway. Although it was paved, the roads were extremely busy, as well as windy.

That small green rock about 100 feet below. It's not a rock. It's actually a bus. Or what used to be a bus...

After the initial "test ride", we took the bus to the mouth of the road. The rock/dirt/gravel road of death was approximately 32 kilometers long, winding back and forth on the edge of the cliff (my head is resting off the edge of the cliff!).

Waterfalls lined the rock walls as I biked underneath them as well as through puddles of water.

Following the experience of a lifetime conquering death road, I hopped on to a zip line to complete the adrenaline rush.

The trip ended at a small animal refuge called "La Senda Verde", where they took in illegally kept animals and raised them to be wild again. I saw macaws as well as monkeys, but apparently there are Andean bears and crocodiles on the reserve too.

This trip incredibly changed my life. I had no fear going into it and I don't really have anything else to fear. Probably the greatest experience I have ever had.

When I arrived back at my house, my friends had invited me over for "pre-election pizza and a movie", which I gladly attended. The night ended with a recovery sleep. I ended up sleeping 11 hours; more sleep than I have gotten in months (excluding when I arrived in Bolivia).

Election Day

The morning marked the opening of the polls in Bolivia. The presidential elections had begun! In Bolivia, voting is practically mandatory. If someone does not vote, their taxes, credit cards, bank accounts, etc. become extremely difficult to access. There is also the alcohol prohibition, a mandate of no propaganda for 24 hours prior to the elections (including group gatherings), and a midnight curfew for all vehicles and travel.

The basic process involves going to a place of voting (strictly in one's department), signing in which involves permanently marking one's finger, the registrar showing the ballet to the people surrounding them, ensuring that it has not been marked, and then privately voting in a room.

I found these elections to be a much larger deal than in the United States, specifically because one elects to vote and does not have to.

The experience was great as I went with my host family to the polls and learned a lot about the political system within Bolivia.

Surrounding each voting area are hundreds of food shops and stores, taking advantage of the surplus amount of people.

Overall, this entire week taught me so many new things about myself. I have not feared this city since the day I arrived and I continue to be blessed because of it. I am so thankful for this opportunity and plan on making the most of every week, every day, every minute, and every second.

This week, I leave you with this:

In this city of wonder and awe, still, my human senses remain.

My nose is always dry, my throat is always sore, and I am always thirsty. Always (you probably thought this was going to be some profound statement).

I love you all and ¡nos vemos!

1 comment:

  1. You are amazing! I am so glad you made it off the dangerous you never have to do it again:) We love you and can't wait for you to get back and visit about your amazing journey! Have fun, be safe, and enjoy every minute!


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