Showing posts from May, 2018

Day 19 - Code Red

I started earlier today, because Dr. T was going straight to the OR to graft that burn patient who got here last week.
I met some other med students who I haven’t seen before, and they were watching alongside me. Dr. T took skin from the patient’s leg and grafted both of his arms and hands, which had 3rd degree burns. She had to cut the burnt skin off in order to get the graft on, which was something I haven’t seen before.
The surgery took about six hours, and afterwards we went to change the dressings of the woman who had a skin graft last week. She was so kind, even though she was very anxious. I actually helped Dr. T! I opened and prepared dressings, and helped put them on. I was so happy to help and be engaged in the process.
Right after Dr. T left her room, she got a code red page! A man had a box fall on his head, and he needed to be seen right away. We rushed down to the emergency elevator that opened straight to the emergency room. Everyone from the trauma team was there examinin…

WEEK 4: Overall Thoughts

WEEK 4 HOURS Day 14 - 8am-2:30pm Day 15 - 8am-2:30pm Day 16 - 8am-3:30pm Day 17 - 8am-3:30pm Day 18 - 8am-3:30pm
This week was amazing and I learned so much from Dr. Tandoh and her team. In Peru, much of what I learned was about the culture and the social aspect of being a nurse. From Dr. Tandoh, I’m learning so much about the medical world in the U.S. and about the human body.
From day one I was learning about burns and what burns do to the body. I met all of the trauma patients, so I learned about their specific conditions as well, and how Dr. T interacts with them. I learned through the team’s discussions, x-rays, CT scans, and notes. I feel like I'm sucking up information like a sponge. I'm eager to learn, and the other medical students and doctors are happy to answer my questions.
The daily routine of meetings, rounds and OR time became more manageable when I learned how to properly eat and hydrate myself before standing and walking around for hours on end. The schedule changes f…

Day 18 - School Nurses in VT

Today I met up with a nurse named Hilary, one of Dr. T’s friends, in Monkton where she works two days a week as a school nurse. She gave me a tour of the school and nurse’s office, and I got to compare how her office is run with how things are in Peru. The biggest difference, of course, is the plumbing and facilities… the standards in the US are much different. 
Hilary talked about the difficulties with communication between the faculty and the nurse, and with the parents as well. The nurse’s office at Monkton Elementary is in the middle of the main office, which sometimes can cause communication problems if the kids report to the front desk instead of all the way in the nurse’s office.
We took some equipment that needed to be calibrated over to Bristol Elementary, which is where Hilary’s best friend works as a school nurse. We got another tour of their school and I heard more about how the offices functions and the types of problems that can arise in their work. We met the principal th…

Day 17 - The Clinic

I managed to get breakfast in before the meeting today at 8. This time, it was in an auditorium with all of the residents. I watched presentations on several complications that happened after surgery. It was quite entertaining to watch the nervous presentations, followed by drilling questions from the other doctors in the room.
After that, we did rounds for a few hours. Several patients were finally discharged, and everyone looked like they were progressing at least a bit. I found myself more comfortable in my space now, talking to nurses and everyone without hesitation (it’s a lot easier when everything is in English!).
Dr. T then had her least favorite job: clinic. Patients who came in for followups would come to the clinic, and Dr. Tandoh would clean their wounds and give them more advice. She doesn't like the screams that came from the younger kids, which is why this job is her least favorite. We actually saw two separate pairs of 2-year-old twins, each with burns on one of them…

Day 16 - The Operating Room

I made sure to have a muffin, some iced tea, and a banana before our team meeting today to make sure I had energy to be standing all day. I’m glad I did, because Dr. T was finally called for her case about halfway through!
I’ve never been in an operating room before. It was so exciting to scrub in and be a part of a skin grafting procedure. I thought wearing Dr. T's coat was cool, but wearing a face mask and a hair net was even cooler! I followed her with confidence, knowing I was with the best. Dr. T is respected in the OR, as she should be, and it's great to watch her in action.
The anesthesiologist gave me a few stools so I could peer over the drapes and watch the skin graft. I learned the steps and potential complications of the procedure, mostly asking questions to the anesthesiologist as Dr. T was busy. The patient had deep leg sores, so the procedure was to take some healthy skin from her thigh to place over the sores so they could heal easier. Every little detail and ste…

Day 15 - I Belong Here

We met as a team briefly, before Dr. Tandoh beckoned me to leave. We went to the cafe and got breakfast, where she explained that she was waiting to be paged to the operating room today.
I was excited! And now that I was prepared to be in a burn room (they're hotter than normal rooms to help regulate the patient's body temperature... a fact I hadn't learned until yesterday, when I was dehydrated and unprepared to be in a 98 degree room), we went to change the dressings of one of the burn victims from yesterday.
While we were there changing the dressings, I met some other med students and even a nursing student! She had just finished her third year. I also met another doctor who appeared to be their teacher, and he let me touch the different burns to compare them to normal skin. I helped them change the bedsheets (rectal tube leaked) and asked more questions to the students and doctors.
After lunch, Dr. Tandoh was still waiting for her case. We went to meet the mother and gran…

Day 14 - Meeting The Trauma Team

Today was my first day with Dr. Tandoh and her trauma team at the UVM medical center. I know Dr. Tandoh through my dad’s church as an an amazingly warm-hearted woman, and she was so happy to have me shadow her. I wasn’t nervous at all to come in (maybe a bit about the drive - I haven’t driven in three weeks) because I knew I would be safe in her hands. She's a trauma surgeon with a specialty in burns.
First, I sat down with her team as we went over the patients. There are about 30 of them right now, so the team has their hands full! We went over each patient and what the next steps were for their care.
After that, I got to say hello to the team. There were case managers, nurses, nurse practitioners, doctors, and two medical students who were shadowing like me! They could actually help out, though, while I could only watch. They were friendly and told me I could ask them questions (they were more excited to answer because it let them test their knowledge).
We did our rounds and went t…

WEEK 3: Overall Thoughts

Day 9 Hours: 8am-3:30pm
Day 10 Hours: 8am-3:30pm
Day 11 Hours: 8am-3:30pm
Day 12 Hours: 8am-3:30pm
Day 13 Hours: 8am-2:45pm (early dismissal)

My last week in Peru was my best in terms of personal growth. I stepped outside of my comfort zone in terms of asking the questions that I needed to, and improving on speaking and understanding Spanish.

I spent more time alone in the nurse's office, and time running things while Karin was busy. I learned more ways to identify a problem that a child is having, through learning more Spanish words and by watching their body language and tone of voice. I didn't have a single child walk through the door who I couldn't help! I understood all of their complaints and took care of them, which made me feel so much better.

I got to know Karin more, and I got to know students from the high school. I also spoke in front of the entire high school, thanking them for helping me during my stay. I was nervous about speaking Spanish in fr…

Day 13 - Feliz y Final

Today was my last day at Colegio Santa Ana. During the secondary school’s formation, they gave me a colorful purse as a gift and applauded me. Naira stood up and briefly talked about how the experience of hosting someone was fun, and then it was my turn to talk. I, of course, had something prepared to say, but I still managed to mess it up.
“Muchas gracias a todos por darme la bienvenida a este colegio, y gracias a todos por ser paciente con mi español. Yo aprendí mucho y me divertí mucho con ustedes. Espero que pueda volver a verlos de nuevo” I stumbled over about half of that, but still got polite applause.
I’m disappointed that I didn’t get to spend more time with the older kids. I was only beginning to get to know them. I’m glad I got some time with them, though, because I made a few friends.
At lunch time, I went to the kiosk to buy some popcorn for Karin, and the sweet ladies there gave me a free treat as a gift. I tried a juice from a Peruvian fruit I’ve never tried before… it was…

Day 12 - Fiesta y Hospital

After Naira’s first class, her section had a party for everyone whose birthdays are during the summer. They had cupcakes, chips, candy, and Inca Cola of course! They also had two giant decorated cakes in the middle, but nobody was eating them. At the end of the party, they were still untouched, and they took the candles out. I asked Gabi why nobody ate the cakes.
“They’re fake! We just use them for photos and give everyone cupcakes.” I raised my eyebrow and she laughed. I was glad I didn’t end up asking for a slice.
During lunch, I made cards for Gabi, Karin, and my host family in the art room. Some kids from Naira’s class had art class (about half of them), and one boy named Joshua helped me find markers and invited me to sit next to him. I got to share American music with him, and found some people from my class at home to play Fortnite with him. It was really fun to get to know some more of the older kids.
I spent the rest of my day with Karin. We talked about what I should buy for so…

Day 11 - Secondaria y Nerviosa

My first class this morning was English with some high schoolers, a classroom that I haven’t visited. I played a word jumble game with them, and got to speak English the whole time. They were so advanced in their English that I didn’t even have to speak slowly.
It was so much fun, and at the end of the class I got to ask a group of girls about the social scene in their class. It’s always so interesting to hear about the friend groups. I felt like I was in on the gossip (although there’s a lot I don’t know, based on telling exchanged looks). It was great to get a chance to bond with some of the high schoolers.
I spent the rest of the day with Karin. We talked about the process of ordering supplies for the nurse’s office, and about baby names for her little one on the way.
I spent the latter half of the day in an unfocused daze. To be honest, my return home is starting to stress me out. More people commented on my allergies, because they probably got worse as I started to stress more. It w…

Day 10 - Confianza y Chocolate

This morning, the students from the primary school sang me a song during formation! They also gave me an adorable llama t-shirt as a gift. I’m sure most of them think I’m leaving tomorrow, so I’ll be a pleasant surprise.
Today I spent all day with Karin, because there were no English classes for me to help out with. I felt so much more confident today with asking the students what they needed, but I also wanted to step further out of my comfort zone with talking to Karin.
I did a bit of research on how to ask what I wanted, and when we had free time I surprised myself by asking everything and more. We talked about the process of becoming a nurse in Peru, what clinicals look like, the huge floods last year (we watched some videos on that) and which songs were her favorite. I got to know Karin better, and got to practice my Spanish too.
As I was leaving the school, I got to say hello to Flavia, a student who came to Vermont last year! She’s in university now, but we got to chat briefly and…

Day 9 - Niebla y Reglas

It’s autumn in Peru, and this morning was as cold as it’s been so far. I came to school hoping the fog would lift and sunshine would break through, but as I sit here now writing this in the afternoon, the grey sky hasn’t changed.
Today I helped Karin for most of the day, minus an hour I spent in a high school English class. I helped a few students with English work in an activity book, which was fun, and was even a bit challenging for me. Explaining why English grammar rules exist is like explaining a color that doesn’t exist. Most of the time I just said, “that’s just how English is, you can’t break that rule.”
Karin was out for the first part of the day because a teacher got sick. From what I gathered, her blood pressure was really low due to a condition and she hadn’t eaten that morning. She was also stressed out, so everything got to be too much and she had to be taken to a clinic. I watched Karin help her and noted that the way she took blood pressure was with the stethoscope UNDER…

WEEK 2: Overall Thoughts

Day 6 Hours: 8am-5:15pm (extra class)
Day 7 Hours: 8am-5:15pm (extra class)
Day 8 Hours: 8am-2:45pm (early dismissal)

Although this week was short, I learned a lot about my own limits. Peruvians work long hours and work very hard, and I got to experience what that was like on Monday when I had extra classes and gym afterwards. I became more familiar with my surroundings, and learned that even when I am comfortable with the norm, things can happen that throw you for a loop.

Language barriers are tough to get around. For a medical professional, if you don't know exactly what's going on, you can't help out. Me knowing half of the details only get me so far. With another native speaker by my side, treatment is easy. When Karin is gone, I realize my place. Even with being fully immersed in the language, a lot of phrases and specific words spoken quickly stump me. Giving a response is even harder, especially when I get hung up on grammar and how to exactly articulat…

Day 8: Cartas y Sola

Today was my last day in the primary school classrooms, and I was with a class I've never been with before. They were by far the most excited to have me, and they made letters and drawings for me, which picked up my mood from yesterday! One little boy even gave me a sticker of a soccer player, which is a popular trading game in Peru right now for the FIFA World Cup. The adorable kids and their bright energy improved my day so much.

After lunch, I went to work with Karin in her office just like every day - but she was still gone, probably eating her own lunch. About five students walked in just then, all wanting something different. I scrambled to find creams and cotton balls to help everyone, but this one girl had an issue with her foot and I couldn't understand what she wanted. I told her to sit down and that Karin would be back soon, but she didn't want to. She kept walking around (on her bad foot) and kept asking for Karin. She eventually just said she wanted to go back…

Day 7: Ejercicio y Frio

I woke up this morning more exhausted than ever, barely stumbling out of bed in time for breakfast (a chicken sandwich, highly underrated breakfast food).
Yesterday, I had a leadership class with Naira after school in which student committees helped plan events that happen throughout the school year. After the class, I had a short rest at home before going to a dance class.
Dancing was fun! It would have been more fun if I had any idea what I was doing, but maybe I’ll go again sometime when I’m here and try again. I was so ready to go home and collapse into bed, as it was 8pm, until Naira told me we were going to an aerobics class next.
“Que?? NAIRAA…” was my response. I begrudgingly tagged along, and actually had fun with that too. I actually knew what I was doing with the aerobics, and felt like I could keep up. One of Naira’s friends was there, and she does boxing, so we talked about that a bit in between classes. We finished at 9pm, and got home at around 9:45.

I slept well, but not e…

Day 6: Presentaciónes y Sol

Today was my first day back after my four-day weekend! I had so much fun over the weekend. I went to visit the capital with my host father (and I actually spoke to him a lot! He’s cool), and I made chocolates with my host sister Naira. We visited Mira Flores and the mall there where I had Starbucks, and another mall where I had French fries. I know… so American. I promise I had some Peruvian food as well.

My first day back, I had two presentations first thing in the morning. I gave two presentations to the youngest kids in Primary school about the importance of brushing your teeth. These presentations were SO MUCH better than my previous ones last week… If you know me, you know I get nervous for presentations. I usually quake in my boots at the thought of presenting in English to kids my age, so presenting to kids younger than me who don’t speak English should have been terrifying.
Maybe it was the bright, sunny day or maybe I’ve just had a change of character… I was barely nervous. I t…