lunch outside the paved city streets

One October day, Carlos came to the hospital, likely accompanying a family member or getting his blood pressure checked.  Little did he know that two American girls would gently harass him and ask to join their study.  He kindly obliged.  Two weeks later, he came back for results (Chagas test, diabetes A1c test, EKG).  He was thankful and invited us over for lunch, which we unfortunately forgot about until we saw him again last week.

So today, Jackie, Toria (another med student located in a nearby city) and I went to Carlos's house!  We were told to take a taxi to the end of one road, where he would wait by his "white volvo".  So here I am hanging out the window inspecting each old sedan.  What a surprise when we found him standing outside his only car...! (his daughter later confessed she was slightly mortified haha)

So we went 5mph on dirt road to his house where his wife and 2 daughters cooked as the 3 grandkids ran amuck.  I stuffed myself with pork and chicken (likely one that was running around the backyard), corn and cheese salad, and rice.  We all chatted, watched tv, and looked at photos.  Then 4 hours later we decided to go- they were so surprised we weren't staying for a cafecito (small coffee) too!  Anyways, it was a such a lovely lunch, and I hope one day I can offer whatever of a home, family, and cooking skills I may have amassed to others.

Jackie and the grandkids

like many houses in neighborhoods,
they sell something out of their door.
here they have ice, soda, and cold beer

their lack of smiles in this picture is not reflective of how much they love to
joke around and smile in real life! (smiling in pictures isn't a fad here)

oh the weather outside is frightful

So to everyone back in NYC right now, I hope you are well-bundled!  Apparently the city has been murder free for a week due to the below-freezing temperatures (the last streak sans murder was shortly after Sandy, and before that was 2010).  As a side-note, NYC is leading the nation in crime reduction of 75% in the last 2 decades, attributed them shifting tight money from the prison system to put more cops out on the streets, also saving about $1.5 billion/year from the resulting decrease in incarcerated criminals.  

Anyways, here is the heat of summer on the edge of the Amazon jungle- hitting 90s everyday with full humidity.  Thankfully, we sleep with ACs set to about 77, which keeps it dry and cooler.  Yet at the hospital, only a few rooms (some clinics, the director's office, the room holding a broken MRI machine, and possibly the ORs) have this luxury.  Needless to say, our office does not, nor does the main room of internal medicine- one holds 20 women in 2 rows, the other holds 20 men.  The other day Jackie reported back after lunch "the men all have their shirts off and are lying sideways on their beds". 

The other day I was taking blood of one patient.  I got 2 tubes with my first stick, but I must have perforated the vein changing tubes (we attach the vacutainer tubes directly to the double-edged needle) and I needed one more tube.  We use straight needles, without butterfly handles or a flash, so it's a little trickier, and drawing blood under pressure can always be nerve-racking.  So there I continued on, sweat dripping off my face, my scrubs changing color from my back to my shins as they absorbed more sweat, large gloves plastered oddly to my hands.  After two more sticks, I called it, and found someone else to do it.  By the time I settled down, I looked and saw white lines streaking my entire thighs as if my scrubs were cleverly whitewashed.  And white dots all around the collar.  My sweat had crystallized on my scrubs!

No one can have it all (though I tend to remember Pomona's dry Southern Cali weather as quite perfect), but would you take the hot or the cold?

Outpatient Care, Hospital San Juan de Dios

To secure an appointment:

à Grab a bus or taxi before sunrise.

à Arrive from 530 am – 6 am.

à Wait in line, hope there is no unexpected strike (more on this soon)

à At 8 am, workers arrive and begin assigning appointments.  About 8 appointments/ doctor for their 2 hour shift.  The early bird...

àPay 15 Bs ($2) for the appointment.

à Wait for appointment, often seen around 9-11 am.

Note this is for the largest public hospital in Santa Cruz where we work.  Nonetheless, this system applies throughout the city, including private hospitals.  I’ve heard horror stories of some of the specialties like cancer clinics, where patients have been heard to camp in line overnight!

Needless to say, when we try and capture patients after their clinic appointments, the last thing they want to do is stay longer.  And still they will often sit through our study.  Whether it be for us, the advancement of research, or the free electrocardiogram- in any case we are grateful for their patience!

*This may seem like a crazy system, but just think that everyone has an equal opportunity of same-day care.  Not something that can be said of most clinics in the US, where it may take months for a simple appointment

Las Cabañas

 cabaña       

English dictionary: cabin, hut, or shelter, especially one at a beach or a swimming pool

Spanish dictionary: hut, cabin; hovel, shack

Interesting what happened to that loanword when it crossed cultures, likely at tourist resorts.

Language lessons aside, we took a trip to Las Cabañas this weekend.  Part of an old village of cabañas (Spanish language kind) on the city’s river bank have transformed into a weekend hangout.  The river is the focus and huts with traditional food line the road up to it.

Julius (aka Junior), a Bolivian who grew up in Virginia, escorted us around.  In the procession of cars to the river, we quite randomly passed his uncle driving out (note this is a city of ~3 million).  Ten minutes later, we got a call that his uncle was out of gas, so fortunately we were around for a small rescue mission, which ended up cutting our trip short.  Nonetheless, enjoy the photos!

Typical Food- all variations of rice and meat, except for the peanut soup

"cabaña" selling different dough creations

a monster truck!  even Junior was slightly
 impressed when this guy forded river

this random child would not stop hanging
 off the spoiler of Junior's car, despite
Jackie's best ugly face.  so to end the
5 mph thrill, we had someone hosing the
front of their restaurant spray her 

cars filing to the river

welcome to the river, respite for a hot day

New Year

Happy New Year!  Hope everyone was able to have a relaxing and enjoyable holiday, and are back into everyday life.  After a much needed visit home for the holidays, Jackie and I returned to Santa Cruz, Bolivia until May 2013. 

Here’s a very basic report we gave to the director of our hospital.  So we fell short of our 200 patient goal, but we spend a few weeks distracted by other things (visits from the head researchers in the US, one week organizing echocardiograms for 35 patients, etc.).  Anyways, we have completed a thorough database in excel, and are looking to get a statistics program to start analyzing what we have.  It’s a bit overwhelming, as we still have to get readings and scores on EKGs and digitalize them, do follow-ups, work on getting more echocardiograms (budget constraints), and the list goes on, but we’ll keep afloat.  Maybe 500 patients total by May?  We shall see…

It’s been a fantastic 4 months.  I have really enjoyed getting the opportunity to come down here, and many thanks for everyone’s support.  Indeed, hard to leave home again, but Jackie and I have a lot more work to do here!