Thursday, March 9, 2017

Privilege and Perspective

It has been a privilege to spend the past few days in Guatemala. I have already learned so much from the staff members accompanying us on the trip.  For example, Dr. Lauri demonstrated how to properly examine an eye and view the capillaries then allowed for me to practice the technique.  Nurse Stephanie reminded me that the clients are always the priority, no matter what is going on around you.  Stephanie’s actions reminded me of this when triage was a madhouse, but she managed to still provide a young boy, Wilmar, with attention and education while accomplishing other tasks.  Dr. Eric taught me the importance of a smile by always having a smile on his face and announcing how many hugs and kisses he receives in a day.  Rabbi Abie taught me about the brain’s great ability to compensate in incredible ways when sight is involved.  Stephanie Renny emphasized the importance of organization to maintain order, a necessity when several doctors and many many clients are involved.  Finally, Dr. Richard demonstrated caring for the whole person, not solely the physical aspect of a person.  It has been remarkable thus far to see how dedicated and engaged the staff members are, but also my fellow Xavier students.

Each day has been incredible, but today was by far the best.  I had the privilege of spending the morning with Dr. Eric in the pharmacy which allowed for me to further learn about medications, especially the different forms of insulin replacement therapies.  In addition to pharmacy, I was able to play with all the kids, help educate them about proper dental hygiene, and simply hold babies.  Something about holding a child puts all of life’s problems into perspective, especially in Guatemala; the mothers are so trusting and willing here.  Then, in the afternoon, I was afforded the opportunity to shadow Dr. Richard.  Shadowing Dr. Richard was certainly a treat due to his love for education and wealth of knowledge.  He is able to spout of information about cholesterol, thyroids, vascularization, etc. without even having to stop and think.  While I did greatly enjoy learning about Statin medications, the best and worst part of my day occurred during an interaction with a client.  On Monday, I had met a girl only a few months younger than me who loved Twenty-One Pilots, Fergie, and Coldplay, so naturally we rocked out to Fergie.  However, on Wednesday I learned that the same girl was faced with many life difficulties and was having physical symptoms because of it.  It was a hard pill to swallow that I hadn’t seen it on Monday, but it was a reminder that so many people have things going on that others know nothing about.

Madeline McGraw

Sweet Little Abraham

Wow. What an incredible three days. Between traveling to a brand new part of the world, with some amazing friends, to finding my sea legs in a small clinic in a new language, I’m exhausted. But a good, tired to my bones after three long hard days of work, tired.  I wouldn’t change this feeling for the world. In fact, I’d give anything to always feel this way.

Today went so smoothly for me in my little pharmacy corner and triage spot. Want to know why it went so smoothly for me? Because I have the best team in the world. I did not have to worry about trying to communicate medication instructions, because I have friends who actually studied Spanish (minorly regretting my choice to study French) and a pharmacist who might not know a lot of Spanish, but he knows the Spanish he needs. And yesterday, one of the best people on this planet stopped me and told me to essentially buck up, because I am a FREAKING NURSE. And you know what? I am. I’m this close “ “ to being a nurse. THIS CLOSE. I am a freaking nurse. And I might not know how to speak Spanish, but I know how to point, and they know what to do. And I have scripts, (which today I realized, I do not even need anymore.) I adapted. And I learned what I needed to learn to do what I needed to do. That moment yesterday of I have no idea how to say what I want to say and I want so badly to communicate with you almost paralyzed me. I could not have done it without the most blessed Stephanie Ibemere. What a super woman. Words cannot describe how much I appreciate the confidence boost that was. I will always remember that moment and that little baby who I was then able to triage. Sweet little Abraham. He might have spat up on me, but he never once stopped smiling at me, never knowing that he almost paralyzed me.

The love and the grace that I’ve experienced in the community astounds me. From my team, to my patients, I couldn’t do it without you. I am incredibly grateful to those patients who patiently waited for me point and scrape together words. To those patients who have given me hugs throughout the days, know that I will never forget those hugs. I love you Guatemala. God Bless you.

Michelle Indelicato

Pulled in a New Direction

Yesterday morning, I got to nervously eat my breakfast in anticipation for the dreaded shift in Triage. I kept running all the necessary tests, exams, and measurements I would need to take for every patient that made it through the clinic that day while trying to picture how if I would even be able to take a head circumference on a crying baby. My partner for Triage Katie held some similar pre-shift jitters and wanted to practice taking blood glucose and pressure to ease us into it. My blood pressure was on the high side, and all the healthcare professionals and my partner immediately started making me drink tons of water. The nerves continued to build up until our first patient.  We ran through all the steps, took all the measurements and asked any questions when we were uncertain. We successfully completed our first patient’s triage and then her family’s.  Triage had finally found some rhythm, no administration and paperwork problems were occurring, and we simply had less patients to see that morning. The pace was calm and organized and besides a few little mistakes, Triage was a great success for me. One baby even put my owl pen into her mouth so I would even go as far to say that I enjoyed Triage. The ambush I was expecting never happened, and my blood pressure stabilized. I was almost disappointed that I did not get to experience the crazy mess that Triage had been… almost…

I got to spend another afternoon with Dr. Richard Walter examining the adult patients to unravel any secret symptoms or events the patient to us that day. Working alongside Madeline, Dr. Richard Walter allowed us a more hands on approach with the patients. He let us look into ears and mouths while asking us to identify the tympanic membrane or the ear wax in the canal or comparing the sizes of tonsils in our patients. I even got to use the tongue depressor. After hearing a few of the interesting cases Dr. Richard had seen in relation to our patients’ symptoms, an eighteen year old came in with her sister.  Her sister explained many of the symptoms and a concern for her sister being depressed while showing an inspiring and heartbreaking concern for her sister.

The girl had complained of stomach pain, swelling, and a numbness of the face. Dr. Richard identified the likely cause of an infection, but he slowly took the time he needed to determine any possible explanation for face numbness.  He began asking her about any upsetting events that have occurred recently. After a little bit of time, she responded. Her life was hard. She had been suffering in many ways recently and more than a lot of people do. Dr. Richard described how these events in conjunction with the infection could further her symptoms and bring her to a worse state. Dr. Richard expertly advised the woman about counseling and seeking more resources and support for herself while she had the most gratitude for being a physician that actually delved deeper and explored her life to come to a wholistic, appropriate, and individual examination of this woman. This had not been the case for the previous doctors she had seen.

I couldn’t help but to keep thinking back to the fourteen year old girl that Dr. Lauri had seen the previous day with me shadowing. Caty had cerebral palsy and was completely blind. Her mother carried her all the way the massive hill that leads to the clinic. Caty’s hair, teeth, fingernails, and her clothing were all perfect which none of these especially the toothbrushing are easy tasks for a mother to perform on a child who has cerebral palsy. All I could see in this incredible mother was unconditional love for her daughter.  This superhero of a woman did everything she could for Caty alone. She was astounding. This profound love displayed by Caty’s mother and the love of our patient’s sister who picked up on a sudden change of emotion has been rolling in my head for the past few hours.

There are no coincidences is what the Mayan priestess kept saying. Our team and all of its members came here for a reason and that cannot be attributed to luck. I do not believe that I was in both of these patients’ rooms by chance. I feel like I’m being pulled in a new direction and am excited to explore it more fully whatever that may mean.

Evan Purvis

Gratitude and Joy

Two days in and I’m already overwhelmed with all that I’ve seen, heard, and done. After we arrived on Sunday, the nerves and anxiety associated with this trip began to sink in. I didn’t know how much help I would be, how well I would be able to communicate with patients, or if I would be able to make a difference at all. After yesterday and today I can confidently say that those worries have vanished. I can physically see the difference we are making in these people’s lives.

This difference comes in many shapes and sizes. Yesterday I saw it while working alongside Rabi Abie in glasses. Many of the elderly patients coming in had lived their whole lives without even knowing what good vision is. It was so rewarding to have a patient walk in nearly blind and leave with almost perfect eye sight. Even if we couldn’t improve their sight significantly, every single patient showed a tremendous amount of gratitude and joy. It really made me question how much we take for granted in the United States.

Another place I saw this difference was when I was shadowing Dr. Richard. While he taught me a lot about internal medicine, he taught me even more about doctor-patient relationships. The amount of time and energy he puts into each patient is truly amazing. Each patient was given so much attention and care. He never made a diagnosis or wrote a prescription without fully examining every aspect of the patient.   I would be lucky to be a physician as thorough and caring as him.

Joe Kavanagh

Wednesday, March 8, 2017

An Open Heart and Mind

"Enter this journey with an open heart and open mind," Megan wrote me in the journal she gave me before leaving. I didn't realize how meaningful this would be until I finally had the opportunity to work in the clinic these last two days. I started my morning working with Dr. Richard examining patients. Right from the start I knew it would be a busy day because although he had only scheduled 10 patients for today, he was told he would also be seeing some of the 21 diabetic patients who come to the clinic every month for a checkup. It wasn't long before we realized we would not get through half of these patients before lunch time. The four patients we saw that morning had complex situations that needed more than a simple examination, whether it was for extreme anemia, high blood pressure or from simply being completely confused about which medication should be taken and at what times.

Señora Clara Luz, a woman in her late 70s, was waiting outside of the glasses station when I called for her to see Dr. Richard. "Como se siente oí?" I asked her. "Muy feliz." She told me she was happy because we were here to help her with her vision and pain she had been having for a while now. We began by observing and asking questions about her medical history and her current health problems. It was inspiring to see how Dr. Richard was so patient and empathetic with his patients, even though he did not speak the language. After his evaluation, he decided to prescribe a medication she would be taking every day along with the one she already had. She explained that she would not be able to afford taking this medication every day and that she was just getting by with the one she was already taking. Often times we forget about the obstacles these individuals face every day. We forget that they may not have transportation to the city in case they are in need of more specialized attention or how difficult it is to arrange a trip there. We forget that they may work every day and can't afford to take a day off to see a doctor, and we forget how emotional this can be not only for us, but for the patients themselves.

Señora Clara luz was only one out of the many cases with challenges that we encountered these last days. Challenges that go beyond the science. We come as advocates for these people, as Dr. Richard said, giving them tools for better health. However, the people we have seen have also helped us. They have helped us see through a different lens and appreciate things we often take for granted. They truly have helped me open my heart and mind and I can only hope that we can continue to grow as we all embark this journey together.

Natalie Castillo

Tuesday, March 7, 2017

Why We Do What We Do

Today was our first day in the clinic and I'm at a lost or words. I was so excited that I was back in a country that I'm glad to call my second home. I spent two years of my life here and it's this country that has inspired me and pushed me to pursue a career in medicine, specifically global health.

Today allowed me to see a piece of what I could be doing in the future, and I couldn't have asked for anything better. I started off my day working in Spanish pediatrics with Doctora Patricia, who's experience and knowledge definitely transcended in the doctor's room. She was kind, loving and was extremely good with kids. She highly emphasized the importance of the growth curve and how mothers should always ask for them and know what they mean. While there was some difficulty in understanding her methods and trying to figure out how to incorporate our methods with hers when it came to the clinic, everything in the end turned out great.

The second part of my day included working with Dr. Lauri, another pediatrician. She was very informative and allowed us to be hands on, more than you could ever get in a shadow visit. She challenged us and got us thinking on important pediatric issues such as failure to thrive and what the child should be doing a specific age, such as being able to sit up by 6 months with support or babbling words near 7-8 months. As well, it was amazing to be able to spend time with the little babies who were absolutely adorable. However, among the many children we saw today, many were falling behind on their growth curves, either barely making on it or not even making it. It really brought to light the lack of nutritional foods that the kids have access to as well as fresh water.

Fresh water was something that Dr. Lauri highly emphasized and asked questions about for each family, because many of the root causes of the sicknesses and illnesses in children are caused due to drinking non purified water. She constantly brought up the clay water filters we have that were donated and that members of the community could buy for Q300 (~$43) which would guarantee them fresh water for several years.

Finally, my day ended working in glasses with Rabbi Abie. In particular, we had a specific patient who was 77 years old who was blind in one eye and could barely see in the other eye. She told us she has been considered blind since she was a child. After many trial and error runs, we were able to get to read 20/20 with the glasses and the expression on her face was priceless. She was amazed at the fact that she was finally able to see and it was so heartfelt that we all started to tear up and we shared a sweet moment with her.

This is why we do what we do. These people who come and sit for hours on end without complaining just to get basic healthcare offered to them are just incredible. That have offered more to me than I think I could ever offer to them. We are one with these people, no matter where we come from, no matter what religion or cultures we have, in the very core we are all human who deserve love and care.

Angela Ellis

Make it Work

Today was the first day in clinic and boy did it feel like a first day. There was so much to do and a lot of kinks to be worked out, but I am pleased to say that we did it. I believe that a big part of taking part in trips like this one is being adaptable, and with that, having the Tim Gunn “make it work” attitude. No matter the situation, first days always bring the unknown. No amount of planning and preparing can truly prepare you for a new experience. However, I am of the opinion that the right attitude can. Today was chaotic, but it was not pure chaos as it could have been, and I’m going to credit a decent portion of our success to the incredible attitudes that everyone in triage came to clinic with.

Please forgive my seemingly triage-centric blog entry, but since I spent both my morning and my afternoon in triage, I did not get to explore much of everything else that was going on and have to base my account of the day on what I saw and experienced. I’m confident that the passionate and persevering attitudes that I am describing were not specific to triage, but I can definitely say that they were crucial for our success. Deciding to make it work, whether “it” being blood glucose tests without lancet devices, or overcoming a language barrier, was something that we did. It was a Tim Gunn day and I can only see the week getting better and better from here.

Xye Inzauro

Language Isn't the Only Form of Communication

My day started waking up to a rooster at 5:59. An actual rooster call, like one you would see in a cartoon. As if that wasn't unreal enough already, I emerged from my room surrounded by beautiful volcanos. However, I'm not sure that the amazing landscape can compare to the amazing people I had the privilege of working with today.

At the clinic first day nerves set in right away. When we got there patients were already lined up waiting outside. I started my day setting up our pharmacy, but once we were waiting for the prescriptions to start rolling in Katie, another student on the trip, encouraged me to come with her to blow bubbles with some of the children waiting in line. They looked at us like we were a little crazy at first, but eventually they couldn't help but smile. Les burbujas were definitely a hit. I was nervous to interact with the kids (or anyone for that matter) because I don't speak Spanish, but this experience showed me that language isn't the only form of communication, smiles and laughter count just as much.

This was a wonderful start to my day because it gave me a small amount of confidence, and opened my eyes to a new perspective when working with patients as well. I spent the afternoon shadowing Dr. Richard, and I'm not sure that a pre-med student could even hope for a better shadowing experience. He exemplified what a doctor should be. He spent as much time on a patient as needed without worrying about time. This means he never let anything a patient said to him slip through the cracks. He listened to everything the patient was experiencing and was able to make the connections necessary to treat them. He did all of this while taking teachings moments for me, in order to make sure I understood why he was doing what he was doing. It was also inspiring to see him do this because he, like myself, does not speak Spanish. He had an amazing interpreter with him Mishell, but was still able to connect with his patients and give them the highest quality of care on a personal level. This was incredibly important for me because it reinforced the idea that I can still make an impact on someone's life, despite the barriers we may face. Clinic day one may have come to a close, but I can't wait to see what other surprises the week will bring.

Anna Klunk

Monday, March 6, 2017

Early bird gets the worm...

¡Hola amigos! Today began our journey to Guatemala. After packing our suitcases yesterday, we woke up at 3 am today, driven by caffeine and our desire to be for others, ready to head to the airport. We have spent countless hours planning and carrying out fundraisers, we've learned medical terms and techniques and we've worked on our Spanish skills and it's all lead to this moment. As I'm writing this, our plane just started moving and we are headed to Atlanta. Our excitement is obvious because we are the only section that can be heard at 5 am, probably annoying everyone else on the plane but our intentions are pure. We are sleep-deprived but extremely pumped to start our work in Choacorral!

We were welcomed by the community with open arms and wide smiles. After lugging dozens of suitcases full of medicine and equipment, we spent some time unpacking and arranging the clinic! It's exciting to see how much we've already made in just one day!

What stands out the most to me is how Guatemalans carry their hearts on their sleeves. I have already met a few people and we speak as if we have known each other for years. This kind of genuine sense of community gives me the permission to be freely vulnerable with those around me. It's only day one and I can already feel that I am growing into my better self.

Aichetou Waiga

A Poignant Perspective

Whenever people asked me how I felt for the months leading up to our trip, I could not really put it in words. Before we began our journey to Guatemala (that started with meeting promptly at 3:45 am on Sunday morning with our caravan drive with all of our luggage to the airport), I think my primary emotions were nervousness and excitement. But still, it never really felt real until we were actually in Guatemala. As soon as we landed in Guatemala City, however, it finally kicked in that this was real and going to be our reality for the next week. In that moment, the excitement took over the nervousness (mixed with a bit of tiredness and sore musclesness from the lack of sleep and the heavy lifting of pounds upon pounds of medical supplies from the packing party the day before).

After we loaded all of our bags onto the bus, the first thing we did was head to a cemetery tour in the city. Before I describe what I learned in this cemetery, however, I feel like I need to provide a disclaimer that I have a weird thing for cemeteries. Whenever I go on family vacations with my family and we happen to be in a city with a famous cemetery, like Père Lachaise in Paris, I make them all visit it with me. I think there is something so uniquely beautiful about all the brilliantly intricate marble tombstones and looking to see which grave sites still have fresh flowers. Though I certainly saw some fancy marble handiwork at this cemetery too, I leaned that they only stood to mark the deaths of the wealthy. As we stood before an overwhelming Egyptian-styled grave complete with a massive pharaoh head, Jose Rolando, an amazing and hilarious human being who has been organizing our trip for us in Guatemala, described how this cemetery stands as a direct depiction of the difference between the rich and the poor. Just a couple of meters (practicing using the measurement base unit that I will soon be using with Dr. Lauri to complete growth curves in the clinic :)) beside this elaborate grave were the graves of the people who were not as wealthy, buried with just enough room to fit their coffins and their graves decorated with fresh flowers. As Jose Rolando said, even in death, the difference between the rich and the poor can be seen. Seeing the cemetery from this point of view made me see this inequality from a new and very poignant perspective, and it all happened within hours of landing in Guatemala.

Now, I think that the excitement has most definitely overtaken he nervousness and I am looking forward to seeing what else I will learn in the coming week.

Zenab Saeed

A Kind of Calm

The first ever Guatemala Medical Mission Trip to San Lucas began like the previous medical trips with this massive caravan of undergrad students with too little sleep and the entire team dragging a ton’s worth of medical supplies. I’ll admit I was not the happiest person in the world at 3:45am, but by the time we got lined up at the airport, all the excited and nervous energy for the trip started to slowly build up and once we got through security we were all busy chatting away. We all thankfully made the first flight to Atlanta, and a bunch of us just passed out for the hour long flight.

Getting to Atlanta and meeting Dr. Richard Walter was when it all just sort of hit me. I am going to Guatemala. This trip that I have been working towards with the rest of the team for these past months is finally happening! Eric began interviewing us asking how we were fee1ing. I wanted to say nervous, but I couldn’t. I was just so content and excited for this trip. I hone1stly have a small idea of what to expect for the trip. I don’t know what actually running the clinic will be like besides busy and sometimes stressful or how long or exhausting these days are going to be… But I just felt assured. Confident. The long hours of meetings, fundraising, and preparation has just left me with feeling that being in this clinic at this time and date is exactly where I am supposed to be. A kind of calm.

Now, I know this is probably just the calm before the storm. Our team though gives me this confidence in the face of that storm anyway. Seeing everyone’s pure joy and even nervousness when reaching Guatemala, the moment for reflection, solidarity, and mindfulness at the cemetery, the conversations we had eating Pollo Campesino, dragging all the medical supplies up that absurd hill in Choacorral and seeing each other laughing and smiling the whole way up between some pretty big breathes, us taking charge to set up the clinic with the other community members of Choacorral expecting to improvise our first day of clinic too, and screaming Adele's "Hello" on the bus ride back to the hotel. Our translators, Roland Jose, and a pretty fantastic dinner with strawberry flavored marshmallows. All these moments, people, and working with our team... They have been fueling my experience this first day. I am ready to go through the rest of the trip with these people and see exactly what my twin brother Adam described as "the single best experience I had with Xavier" because this first day was exhausting but great.

Evan Purvis