Another exciting week down at the hospital in Leon, Nicaragua. This week was my first one in the emergency room and my first week truly shadowing doctors (up to this point, I had simply been working with the nurses in Pediatrics). It was a completely different experience. I spent the week in the internal medicine area of the emergency department which saw patients with a variety of symptoms or diseases including stomach and chest pain, high blood pressure, diabetes, asthma attacks, alcoholism, heart disease, and fever. I met some great doctors over the course of the week and some not so great ones. I learned which ones to stick with quickly and they taught me all kinds of cool medical things this week from how to perform a physical exam on the chest and abdomen to how to check for dengue to how to take an ECG. Like the rest of the hospital, when the emergency room has an influx of patients, it becomes extremely crowded with doctors and nurses and patients and family members running into each other constantly. Supplies run out on a daily basis, especially common things like a certain size of syringe or IV bags of saline solution. But I’ve become adjusted to expect this over the past month and medical personnel that work under these conditions always come up with a solution, whether saline or not.
I think I’ll take the rest of this blog post as an opportunity to share some mental lists I’ve been developing about the culture of Nicaragua which should give some good insight into my experiences here from day one.
Nicaraguan cultural practices that fit me perfectly:
- Laid back: Coming to Nicaragua is relaxing just because the culture here is relaxing. Even in the busy hospital, I have never seen the demands truly cause the people to work at a different pace. Everything is one day and one step at a time which is a great relief from the busyness of classes and job and perpetual hurriedness of back home.
- Just in the Nica-time: Nothing ever happens on time in Nicaragua. If the event starts at 8, it’d be a miracle for it to get started before 8:30 and even if it didn’t start till 9, no one would blink an eye. My family only begins to mention the word “tarde” (“late”) when we were supposed to be there an hour ago and we haven’t left the house yet. This fits me perfectly since I’m always just a few minutes late for everything back home. In Nicaragua, I’m the first one there.
- Food: Nicaraguans love food and those that can afford it eat 3 large meals a day. I love the food: beans and rice with every meal, salty cheese, lots of chicken, pork, and beef, fried plantains, yucca at times, fresh tropical fruit and juices, pastries with fruit or cheese inside. It’s all delicious. I love the food prices: my family’s shown me that it’s possible to buy a full dinner for under a dollar (26 Córdobas) and my occasional breakfast on the way to the hospital of 3 freshly sliced mangos runs me about 40 cents. I love that giving food is a sign of appreciation: the nurses that I’m teaching English to always call me skinny and provide me with a mandatory snack at the beginning of class and lunch at the end.
Nicaraguan-isms that it’s hard to adjust to:
- Calling people by labels: Fatty, grandpa, whitey, Chinese (for anybody with Asian-looking eyes). These are all common nicknames for friends, strangers, or even patients at the hospital. And while it’s natural and accepted here, it’s hard for me to remove myself from the condescending nature and political-incorrectness that these names have in my mind.
- Throwing trash in the streets: The streets of León are pretty dirty. There is a trash service in the city although very few public trashcans downtown (they only exist around the touristy parks and shopping areas). Most gutters eventually get swept clean by the residents of the houses or the businesses in front of those gutters but there are many ditches or sections of streets that never get cleaned. Even when it caused some of my family making fun of me a little for bringing trash home from dinner one time, the environmental consciousness won’t let me join nearly every Nicaraguan and just throw my trash on the ground.
- Nicaraguans don’t read: I love to read books. Nicaraguans don’t, according to everyone who sees me reading one. It seems to me that Nicaraguans are very satisfied with entertainment in TV in their free time while for me, I try to be unplugged from electronics for at least part of the day.
A few things in Nicaragua I’ve gotten used to over time:
- Heat: It’s really hot here. I can probably count on two hands the number of fully air-conditioned buildings in León and they’re all ones I rarely go into. Everything is open-air to allow the occasional breeze to float through. But the heat is oppressive and I blame it for causing me to get tired much earlier and need more sleep than I normally do back in Tallahassee. I’m also nearly always thirsty but I drink plenty of water and have truly gotten used to the heat on a day-to-day basis.
- Pants: All men wear pants in Nicaragua if they’re leaving their house. Shorts are what tourists wear or what you’re supposed to wear to go swimming. Despite the heat, I’ve adjusted accordingly and have a regular rotation of my 3 pairs of jeans.
- Hair gel: If you are a male under 45 in Nicaragua and want to be taken seriously, you better have a short haircut with plenty of gel to spike it up or slick it back or at least make it look wet. This includes every professional setting: all the male doctors at the hospital are regular gel-users. I even get self-conscious now if I show up at the hospital having forgotten to put a healthy amount in my hair.
And that’s where I’ll leave it for this week. I’m on the downhill part of my experience at the hospital now but still with 4 weeks left, I’ll have plenty of adventures to share in the next month of blog posts.