Friday, January 31, 2014

Wound Cleaning, Peruvian Tai Chi

The clinic was very tame today, but I did have a chance to talk to the med student for a while.  There was a patient who came in with little incisions in several places over her abdomen.  This was clearly the result of a surgery, and Nadin figured out the procedure and later told me about it.  The patient had an ulcer under her belly button, which was caused by excessive pressure in the abdomen.  Some of the incisions were to fix the other organs, and the one in the belly button was for the ulcer itself.  Later she explained a patient she was seeing for her medical training who had tumors in her gallbladder and bile duct.  It is much harder to understand in Spanish, but she was able to draw pictures so that helped.  I also think these little exercises are very useful for improving my medical Spanish.

Between this patient and the next, I rushed out into the hallway because of some screaming that was going on.  There was a man and woman almost ready to start a physical brawl.  Spittle was flying everywhere, and a doctor ended up separating them and shutting a door between them so that they had to leave.  Gotta love drama. 

I was able to perform a wound cleaning today!  The man had been in several times, so his injuries were fairly clean and shrinking.  He had one on his inner thigh and one on his finger.  Quechua was his primary language so I didn’t talk to him much.  He was from the jungle, and had malaria in his medical history.  The cleaning went fine with the guidance of the people who’d done it before.  It’s really quite simple, it’s just doing it for the first time that’s intimidating.  I can have more confidence now.  My only errors were not pressing hard enough at first to get dirt out of a wound, and I didn’t tape the bandage on the finger quite right.  I’ll take that for a first attempt. 

While I was in the ER, someone in the hallway was attempting to hang up a sign.  It is standard protocol to involve me in anything a tall person would be good at, so I was called in.  The big wooden frame (approx. 3ft by 8 ft) that held some kind of information was too big for that spot, so we moved down the hallway to a waiting room.  We began hanging it on the wall, but there wasn’t any nails in the wall that could hold it.  When we saw this they started talking about a stone.  I was hoping this was some kind of code word for someone with a drill, but I should have known better.  A few minutes later everyone returned with another nail and a stone.  We moved the huge board into place and the security guard began pounding the nail into the wall using the stone.  The first one broke, but the second one got the job done.  Just another day in a Peruvian clinic.  I’m not sure anyone will ever read this, since the text is 12 pt. font and the board is above eye-level.  Oh well. 

Just about every day since I’ve arrived to Peru, I have had some moment where I’m surprised or I realize the absurdity of a situation when I view it with a US perspective.  Today, this experience was very easy to identify.  At 11:45, a middle aged woman who I think works in the hospital came in to the ER to tell us about a Tai Chi class she was hosting at noon.  I was non-committal and just asked to see if anyone else from the ER was going.  She returned in about 10 minutes, and I followed about the same protocol.  I don’t know why she was so insistent that I come, but just before noon she came back again.  I was chatting with Katherine (the other American) and she decided to go.  At this point I didn’t think that lady would allow me to say no.  So, here we are.  We entered the room, which is apparently typically used for maternity, to some Chinese music playing in the background.  The walls are painted blue and have cute Peruvians painted all over the walls.  My assumption that I would be the only guy in the class was correct.  Aside from Katherine, the rest of the people there were middle-aged to older women.  In its very nature, I think Tai Chi is designed to be awkward, and to me this was accented well by the instruction in Spanish.  The entire time I was combating my inner desire to laugh uncontrollably.  I can’t describe all the movements to you, but I’ll give you highlights.  In one, we got in a shallow lunge and were alternating hands hitting our butts and thighs.  The lady who got me to attend came over to show me the correct form, and eventually took my wrists to help me do the motions correctly.  I was the only person of the 15 in the room to get this special treatment.  I doubt I will ever again receive such detailed instruction about how to spank myself.  My second favorite was when we had to relax and move our bodies however we wanted.  Julia from the ER decided to attend, and she just tends to be a fairly intense and hilarious person.  One glance at her and I lost my composure.  After a few minutes I was able to wipe the foolish smile from my face and stop my hushed laughter.  Wow, what an experience.  The problem is that it’s every week, so I’m going to have to hide if I don’t want to get roped into this again.  I also enjoyed telling my family why I was late from work when I returned home.

There wasn’t much else out of the norm to report.  My Spanish lesson was fun today.  Rodolfo asked me to look up a bibliography of some person and we’d go through it as practice.  Of course I picked a physicist; Max Planck.  And as you know, when I start talking about physics I don’t stop.  So almost the entire lesson was me attempting to describe quantum mechanics in Spanish.  I’ve been longing for a physics conversation, so I was in a state of pure bliss.  I do find that I miss physics right now, even though the classes they cause me so much pain.  I guess this is why I am willing to go through all that; I do love it.

I am also making leaps and bounds toward planning a trip to Puno for the “Fiesta de la Virgin de la Candelaria.”  This party is the third biggest party in South America.  First is Carvaval in Brazil, second is a similar festival in Bolivia, and this is third.  I wouldn’t want to miss it while I’m so close.  Hopefully I can go earlier and see some of the sights of Puno before the party really gets rolling.

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