It is hard to believe how far I’ve come in the past two weeks in Nicaragua. My Spanish has improved immensely: I’m now chatting it up with my host family and the nurses at the hospital. My comfort at the hospital has increased exponentially: I’m saying hi to people in the hallways and correcting nursing students. And my medical knowledge is growing everyday, although there’s a lot of it that I can only say in Spanish. One of the advantages of interning in a developing medical setting is that more patient contact is allowed. That was an understatement. Often times in this crowded public hospital where the government offers free services, I’m literally running into patients in the hallways.
But the experience for a pre-med student is incomparable. Most days I help out in Pediatrics where the nurses welcome some additional hands to do basic patient care: chart food and liquid intake, changing bedsheets, taking vital signs, and preparing medicines. I am even allowed, after careful training, to administer some medicines to patients. When I’m at a stopping point helping the nurses, I’ll often jump over to watch a doctor clean a wound, recast a broken arm, or take a patient history. As of now, I’m still trying to find my place in the hospital. I don’t know enough to be with the medical students and doctors but I’m already growing bored with the tasks of the nurses and nursing students, which, although very necessary, are quite repetitive. Luckily, if I want to do anything new in this hospital, I usually just ask and it happens.
One day last week, after I simply asked permission, I was given the green light to put on my scrubs and spend the day in the operating room. It was a crazy day to say the least. I arrived early in the morning as directed, skipping breakfast to make it on time. That was a bad call on my part. Some combination of low blood sugar, the smell in the operating room, and the blood from the first surgery I watched made me feel so faint that I had to be nearly carried out. There to observe patients, I had just become one myself. Once I had eaten something and satisfied them that I was good to go again, they let me back into surgery. I was grateful for that second chance because the rest of the day was incredible. I was in the room for parts of at least 8 different surgeries including a hysterectomy, the skin graft of a motorcycle accident, and the repairing of a hernia, jumping between the four different operating rooms. I tread carefully because I knew that doctors would likely not take lightly to some random gringo getting in the way of their surgery. But on the contrary, the surgeons must be some of the most relaxed people in the hospital, making conversation and beckoning me to come closer to the operating table to see the surgery better. One pediatric surgeon even listened to 80s music in English in the operating room, singing along and throwing in some dance moves while he cut into patients. Whatever works, I guess. Either way, it was a great day of learning experiences for me, not the least of which was to remember to eat breakfast.
As I mentioned in my first blog, I’m also teaching English at the hospital. The classes are going well and I’m definitely growing more comfortable with the nurses that I’m teaching. They give me free food every single day, which certainly helps in that department. I know I need to strive to make the classes more exciting and with more speaking to accompany less writing. I delved into sentence construction way too early when all the nurses want to know how to do is point to something and say its name in English. I did have some success in my last day of classes however when I taught parts of the body using some horrible drawings of mine.
It still shocks me at times when I see things as outdated as the actual sheets of carbon paper used to make copies when writing prescriptions (yes, that’s where the term “carbon copy” comes from). I’m shocked when beds and instruments are rusty, when patients are all packed into a waiting area while the halls are fumigated, when pigeons wander around the patients’ beds, when we run out of a medicine or something basic like sheets or syringes. But, while I haven’t accepted all this as good practice, I’m also adjusting to this setting as one in which medical professionals are trying hard with the best that they have to treat patients. That’s certainly a quality I can learn from them. Nos vemos la próxima ves!