My first full week of work!

Warning: long post ahead!  I wanted to take time to explain what a typical week will look like for me while I'm interning here in Costa Rica.  So, we'll just start with my first full week of work!

Monday – Monday I went to the EBAIS in Santa Rosa.  In Costa Rica, there are three levels of care facilities: EBAIS (similar to general/family practices), clinics (which may have several doctors and a few specialists in house) and hospitals.  At the EBAIS, I shadowed Dra. Alvarez for the day.  We saw a lot of kids that day, mostly under the age of three and just there for a checkup to make sure they were growing properly and eating well.  There’s also a stomach virus going around giving lots of people diarrhea and nausea, so we saw a few patients experiencing those symptoms.  Several “control” patients came in as well.  These are mostly diabetics or people with high blood pressure (or both) coming in to check their vitals and renew their prescriptions.  Dra. Alvarez was really nice and was pretty good at explaining things along the way, but she didn’t have much time to do so, as she had to keep every appointment to 15 minutes long.  She even had to essentially kick one woman out who kept asking questions, making her appointment last about 30 minutes (God forbid).  There was another student shadowing her as well – Fabian.  He’s about to start his final year of medical school here in Costa Rica.  He obviously knew much more than I did, but was very nice and wasn’t condescending about the fact that I haven’t even a clue about where I’ll be attending med school at this point!

Tuesday I returned to the same EBAIS and worked with Dra. Alvarez again.  Fabian was there again as well.  The morning was much the same as Monday, but in the afternoon, Dra. Alvarez ran the breast clinic.  We saw a few women just coming in for routine checkups because of high risk for breast cancer, as well as a couple women who had recently had surgery to remove a lump.  Even though it was more repetitive in some ways than the morning was, I found it really interesting.  It was also quite a nice break from the cases of diarrhea!

Wednesday – Wednesday I went to a new location – La Clínica Central de Santo Domingo.  There, I was in the emergency department.  Kim, the other volunteer with my program, was also there.  Although the vast majority of people who came in didn’t have an emergency, or didn’t seem to have anything wrong with them at all for that matter, it was still an interesting day.  I shadowed the head of the department (I don’t know his name…everyone calls him “El Jefe” – the boss), who was great at walking me through everything, allowing me to listen and feel along the way.  The only emergency of the day was an approximately 7-year-old boy who had fallen while running, as many little kids do, and split his lip open.  He needed two stitched in his lip – easy, right?  Ha.  I don’t think he could have made it more difficult for the doctors.  He kicked and screamed the entire time and it took 3 doctors to hold him down so that El Jefe could give him stitches.  Personally, I don’t think I would be quite comfortable sticking a needle into the face of a kicking, screaming kid, but that’s why I’m not the boss (yet)!

Thursday – Every Thursday, our schedule changes a bit and we attend one or two medical lectures in the morning at a private hospital in San Jose and then spend the afternoon at a non-profit organization called Obras del Espíritu Sanctu where there is a free clinic for people without health care.  This past Thursday, our schedule was a bit more of a deviation.  After one lecture about obesity in the morning, I had most of the day off before attending two lectures at a medical conference in the evening.  Of course, our supervisor failed to tell us that these talks were part of a very formal medical conference, so Kim and I were a bit underdressed, but it was alright.  The two talks we attended were about pain management and were very obviously endorsed by Pfizer to promote specific medications.  That being said, the first of the two talks was very good.  The second, well…the man spoke a million miles a minute and still didn’t get through his entire presentation.  Of course, they waited until after both these talks finished (around 9 pm) to feed everyone, which I don’t think was their best strategy, unless they wanted to guarantee that everyone would be in a bad mood throughout the presentations.  Ah well.  The food finally came, and it was DELICIOUS.  I’ve only been in Costa Rica about two weeks, but I’ve already had a life time’s share of rice and beans, so this dinner was a welcome change, complete with red wine and chocolate mousse at the end!  YUM.

Friday was an early, but very short day.  We attended a clinical session that consisted of three different specialists analyzing a patient’s progression of symptoms in the time leading up to his/her death.  It was way too early for me (it started at 7), but it was really interesting and a very thorough exploration of the patient’s symptoms.

Whew!  Well, that’s about it for my first full week of work.  Stay tuned to hear about the weekend adventures I’ve had thus far, and the little cultural tidbits I’ve picked up on!

~Pura vida~