Poco por Poco

Visiting Orthopedic Team and Local Physicians

Bit by bit my Spanish, medical vocabulary, and ability to assist at the clinic are improving.

Still, the learning curve was steep this past week. A surgical team from the U.S was at the clinic the whole week. The team—an anesthesiologist, bilingual RN, orthopedic resident, and two orthopedic surgeons—very kindly allowed me to work by their side and learn from them. The first day, the team saw somewhere around sixty patients in clinical consultation. I was surprised to find myself translating much of the time when the RN was unable to assist in translating two cases simultaneously. While many peds patients were from nearby, others were from a pueblo four hours away and still others had traveled on horseback to reach this pueblo before coming to Portoviejo. Clinical concerns ranged from club feet, to complications arising from poor casting of feet or ankles after former operations at other medical facilities, to removing an excess digits patient’s feet.

Translating, helping with the patient records, and photographing limb deformities for later physician referral—I felt useful. Many patients were told to simply wear una férula (a brace) on their wrist or ankle and observe changes in limbs throughout the next year. Yet about fifteen children were asked to return that week for an operation.

In the OR the rest of the week, I learned from the local nurse how to best be of assistance from pre-op to post-op—translating, cleaning, opening sterile equipment for the surgeons… After many operations, I helped the physicians explain to expectant parents how the surgery went and instructions for cast-removal and physical therapy. While the majority of parents nodded, some seemed more in shock than their children and gave a blank stare.

Me & New Med School Friend

The kids here are tough. Most went home the day following a major surgery involving reconstruction of bones and joints. While given what meds were available, they definitely weren’t sent home with the same deluxe gift-bag of pain relievers available in the U.S.

While most time was spent with children or adults (I am not a real adult yet…right?) I also translated two lectures for medical school students. Eek! While I am not one to have stage fright or be overly anxious about public speaking…I did have a few butterflies before walking into a classroom of fourth year med students with the visiting physicians. (As students here don’t go to University with an undeclared major, the university is a combination of college and professional school. Med School here is six years, maybe seven. Translating two lectures about hip dislocations & upper extremity anatomy and pathology proved tricky. It also involved a great deal of gestures and pointing to various parts of my arm. All in all, I think it went well though—I judge this by the fact that many students came up to ask the physician questions after the lecture—always a good sign. Moreover, two students returned to the clinic the following day with x-rays of wrist injuries, looking for medical advice.

Best part about the week: The days flew by and I again feel a confirmation that I want to study medicine.