Monday, December 31, 2012

Dec 30 More than the physical

Words cannot describe my day. It started this morning when I woke bright and early at 8:30. After a delicious breakfast, we were on our way. After a 15-minute drive up the steep mountainside, we arrived at our destination. The scenery was gorgeous. We could see all of the terrace farms, the lake in the distance, and plenty of natives climbing the steep mountain trail. When we got there I didn't even realize we were at the hospital. From the front, it looks just like a meeting center. Once we went around back you could tell that we were in for a special surprise. As you enter, on the left is triage, including height, weight, growth curves, blood pressure for adults, heart rate, respiratory rate, gluco stats, and an eye exam. As I continue down the hallway, to the right through a big set of doors are two bathrooms. In one of them is a big dentistry kit with a giant inflatable toothbrush and many small dental hygiene products. In the other is a bunch of cleaning supplies and a bucket to bring water from the well to flush toilets. Down the hallway is a soon-to-be X-ray room, a pharmacy, 3 clinic rooms, a laboratory being set up, an optometry/dentistry room, and a back room for us to eat in. To begin our day, we sorted 2,040 pairs of eyeglasses. Most of the team sorted glasses into light, medium or heavy, also known to our patients as suave, medio, or fuerte. We also have a random stack of sunglasses and bifocals but haven't really used the bifocals and have only given out a few sunglasses. After doing that for 45 minutes we prepared for setup. The pharmacy has been set up by Dr. Lauri, Dr. Richard and nurse Cathy. We put as many of the glasses onto the shelf as we could and were divided into our positions for the rest of the day. I was assigned to triage with Stephanie, Ian, and Grace. Kirsten was in charge of the pharmacy, Tess and Sarah were with Dr. Lauri, Maliah and C.J. were with Dr. Richard, Ashley was in optometry and Julia was in dentistry. Thankfully for us, David and Katie floated around to help with our (ahem) beautiful Spanish as well as our two lovely local translators, Michel and Diana.

After a quick crash course in triage, our first patients arrived. Soon, my first patients came to get their eyes examined and their glucose checked. I will be honest and say I was very scared. Not only was I doing something relatively new, I was fighting a barrier with a language I had not used in years. However, with some Spanish holophrases and much pointing, I was able to get my point across. Even though my role was important for everyone downstream, I did not feel that I was truly connecting with the patients and their families. I would have to go out on a limb and really attempt to use my Spanish. This only became more and more evident as the day progressed as I really felt like I was missing something. I’m not quite sure how, but as everyone became more proficient at communicating in their own way, communication became - dare I say it - acceptable. It was then that I really started to connect with the patients. I asked several of the kids what they liked to do for fun, what living was like in Guatemala, what the adults did for work and for fun and I realized how much I had to learn. The best part was that as I became more communicative I could be more receptive. The gratitude on the patients’ and the parents’ faces when I took the time to explain to their child how we might be able to help their vision or that their glucose levels were okay, was something to see. As the day has progressed, I have increasingly begun to realize something inside my head is changing about how I view medicine. I cannot put it into words at this point, but my grip on what I thought medicine should be is loosening. On reflection now, I believe that the communication barrier was serving particularly well. By the look on the Guatemalans' faces I could tell they trusted absolutely without a doubt what the doctor had told them. At first glance this should seem like a no-brainer as I thought science is a universal language. However, when I heard stories of the problems these patients were running into in local clinics, I realized there is far, far more to medicine than just the science of treating symptoms. I always "knew" a doctor treats another human being, but I never really thought about what that entails. A person is more than the sum of parts and medicine should respond to all of a patient. What may work in one culture with a patient of certain values could be disastrous in another. Medicine must take into account the spiritual aspect of healing as one is usually not just getting rid of a bacterial infection. A medical professional is bringing joy, healing, hope and a new chance in a family to be closer. Medical professionals are in the unique circumstance of altering far more than a patient's physical health. They give hope. The only way to learn this is by realizing what one can take from another in healing. As Dr. Richard succinctly put it, "One thing you will realize is that when you leave a place like Guatemala is that you will not even realize what sort of ‘good’ you did or help you gave. You will only leave thinking of what you have gained as a medical professional and most importantly, what part of you has been enriched by your time here." And I believe that will be the heart of this trip.

Tom Gerbus

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