Almost time for school...

Well, my 2nd year is coming swiftly upon me - apologizes for the lack of updates, these last few weeks have been crazy. After Bolivia I went to the Galapagos Islands for a week with my family, then I came home and my boyfriend and I sorted stuff out and plan to move in together this fall. It'll be nice having him there, after a year of long distance. We had to look for apartments and budget my financial aid money, since I took out a bit less than I probably should have and so we don't have much breathing room.

Our first unit will be Neurology - so we get to learn brain functions, nerve stuff, etc. It is supposed to be really hard, so I'm glad I've had a sequence of Cognitive Science courses at UCSD. I have at least two textbooks I can refer to if things get too complicated. I am also reviewing old material from Semester 1 - I want to review old material and make flashcards for it at least once a week, since it'll be good practice for the USMLE/COMLEX when that comes around in the Summer (shudder).

I may continue my research on bacteriophages, I would like to, but we shall see. Also, since I took Medical Spanish last year and went to Bolivia, I now have a spot for an elective for fun, so I am curious what will be offered. Anyhow, tonight I drive back up to Northern California after spending the rest of the summer in San Diego - Kit will be following me up in a few days, but I have some meetings at school on Monday and that was our assigned moving day, so I have to get up there. I got a new phone too, a Droid Incredible, which is, indeed, quite incredible - I love some of the medical apps - particularly the drug interactions app. Really cool. It'll even tell you the details and why.

Third Week in Bolivia

Rather late update, I know, but I figure I shall update for the third week when I went in the mobile medical units. The first day I went up to a school where we did general health exams on the classes of kids - most were under 10 years old. They all had horrible teeth, some were malnourished and had herpes skin outbreaks, a few had upper respiratory problems, and we were checking their fingernails since parasites in fingernails is a big way they enter food. We dispensed two de-worming pills per student, and returned the next day to extract broken teeth beyond hope of repair. I even have pictures this time! Since I had been watching the examinations closely the previous day, I volunteered to help conduct the exams the next day, so I got to do essentially half of the kids. I hope they understood my accent well enough.

Another point about their teeth - a lot of them had teeth so bad that they also had abscesses...poor kids. A few less typical cases include...tonsillitis and bronchitis. All in all, it was a very interesting experience and gave me a chance to get some hands on experience. I listened to the kids with stethoscopes and was able to discern bronchitis (and we were just listening through clothing too...you definitely let a lot of things slide when you're on the go in a third world country).

The next day in the ambulances was our last day doing hospital stuff and I went in the mobile unit that parks at various street locations and takes walk-ins for treatment. Most of them were all alcoholics or pregnant ladies, and the guys would stay and talk for 10-30 minutes at a time about their problems...got really boring, and I could understand what they were saying too. The stories just all sound the same after a while, and so we did very little actual medicine that day. The only good thing that came out of it was a female patient came by who had a mitral valve defect - mitral regurgitation - and we were able to hear the valve defect in the flesh so to speak. It was definitely more pronounced than the audio clips we had been given to listen to during our last examination.

That's about it for medical stuff in Bolivia - the next day we went to Lake Titicaca until Saturday, then I just hung around until Wednesday, when I got to leave for the Galapagos Islands with my family! I was so happy to return to the US when I finally got back - after being in Bolivia for 3 weeks, seeing familiar food, familiar settings, stores, etc. felt great. Anyhow, I shall soon begin posting on the various medical conditions I saw or heard about in Bolivia. Until then, off I go.

Second Week In Bolivia

Well I am into my third week now, but this post shall mostly be about last week. Last week was...interesting. I will briefly describe the weekend - we went first on this crazy hike up to the Muela del Diablo. It was quite neat. The next day we went on a bike ride, something like 55km down the Worlds Most Dangerous Road. Ended up going down from bout 14k feet to 3.5k feet into the rainforest where there was an animal sanctuary so there were lots of really friendly monkeys, birds, etc. Some insects too. No pics, alas, since these computers dont have memory card readers.

Anyway, Monday was fine, I followed Dr. Fernandez around for a while. Tuesday was more of the same. Wednesday I shadowed in Obstetrics and Gynecology, since we were all switching locations on Wednesday and I was absolutely miserable. Cannot stand OBGYN. First off, the sight of pregnant women, babies, breast feeding, etc. is definitely NOT my thing. Next, I know very little about pregnancy and complications. Finally, all the doctors spoke super quietly so it was near impossible to understand anyway. Then Thursday I tried to hang out mostly in ER but that got kinda boring, since it was mostly UTIs and women with abdominal pain. Friday we were going to leave early to go to Lake Titicaca for the weekend, but one of the guys in our group was feeling pretty ill from some bacteria, so had pretty bad GI upset... so we ended up not going. Me, the doctor, and the other girl in our group went shopping for souvenirs and went to the Coca museum, which had a lot of interesting information about the history of Coca in Bolivia and the world. Saturday...three was more souvenir shopping. As was Sunday, but we also watched a lot of partidos de futbol! Wednesday we had gone also, but it was just a local game and there was not as much skill as in the world cup. It is a pretty big deal here.

Anyway, this week we are spending mostly in the mobile units, checking out schools and kids in the streets. It is pretty neato, but I will do a full report later, since we have only done this for one day so far!

First Week in Bolivia

I would have written sooner but it's a little difficult to find time among all the things we are doing. We got in on Sunday morning at about 6am after flying to Miami and then La Paz. A lot of flying. Very long flights. We were met by Mr. Gonzalo who is our liason/coordinator for the volunteering we are doing. He helped us get a taxi which took us to our homestay. We are on the fifth floor of an apartment complex and staying with a woman named Olga. She speaks essentially no English but among our group of three (Nourah, Me, and John), Nourah and I usually are able to make sense of things. We were considering taking Spanish lessons, but we placed as intermediate/advanced so we weren't sure it'd be worth our money. Anyway, we napped that first day, then met Nathalie, one of our professors, at a coffee place in one of the plazas. We then explored the area a bit, did some shopping, that sort of thing.

The next two days were kind of a blur of meeting with Gonzalo to discuss the cultural and social climate here in Bolivia, discuss our role in the hospital, how we can contribute, that sort of thing. We also were joined by a physician from Touro, Dr. Mokari, who is hanging out at the hospital with us. We visited the hospital and were introduced to people but didn't stay long enough to do much else. Then we returned, have been eating out a lot and getting drinks, that sort of thing. We saw Prince of Persia the other day in Spanish, have gone on two bus tours, and the like. We're starting to get a pretty good feel of the city, including which taxis and minibuses are sketchy.

First day in the hospital I chose to follow an infectious disease epidemiology specialist - of course - and we saw four cases of Dengue fever (apparently really unusual for this time of year), a case of gallbladder stones, and then discussed the etiology, causes, diagnostics, treatments, etc. Today I saw a patient with tuberculosis, got to look at his X-Rays and auscultate his chest. It was really interesting. I was also shown around the SUMI office, which is insurance for low income individuals and they keep tabs on the most significant infectious diseases or conditions including yellow fever, leishmaniasis, rabies, influenza, tuberculosis, dengue, AIDS, hanta virus, polio, rubella, measles, etc. We're going to do a survey on Monday, and this weekend our group is going to do a biking trip to the rainforest, hopefully! Until then!

First of the Last Tests

Well, today we had our last anatomy test - yesterday I went to the Bay to Breakers event in San Francisco, so my head wasn't quite as into the test today as I'd have liked, and I wasn't nearly as prepared as I could have been. If I pass, I'll be satisfied.

In the meantime, we have three days of Jewish holidays this week AND on Friday's we're not allowed to be tested so we don't have any tests until Monday. They will be rather intense, and I'll need to do some practicing of various techniques for OMM and doctoring, among all the basic science and medicine studying, but at least I don't have too much exciting stuff planned, besides maybe watching a video or two and study breaks to hike. Gotta mix it up a bit or I'll go insane, after all.

Anyway, I need to rest my head - yesterday was insane, and I wish I were updating things more...there will probably be a decent number of updates once I go to Bolivia - leaving on May 29. I got my vaccinations, but I do need to fill my prescriptions...hmm...

Another Hurdle

Well, just finished a pseudo-midterm - feels like I've been doing nothing but study lately - and in my spare time, computer games. I really need to get out more and exercise... Feels like I'm trying to do a million things at once, but I guess that's nothing all that new. I can't believe I'm almost done with my first year of medical school. It's rather intimidating because sometimes I feel like I've learned a lot, and other times I feel like I haven't learned anything. Now with the midterm done, I plan to just relax as much as humanly possible between now and Saturday night - Saturday we have a semi-dance thing on campus, it's a fundraiser for the group that is going abroad to Ethiopia and Tanzania. Unfortunately they're more established, better organized, and have the Global Health program director in charge of their group, so they have been putting on a lot more events than my group (Bolivia) and the Taiwan and Israel group.

The latest stuff we have been studying is all the respiratory illnesses - mostly those that cause pneumonia, bronchitis, that sort of thing. There was a section on pediatric illnesses and upper respiratory problems, which was okay. I'm not a fan of babies in general, and learning about the millions of ways that babies can turn out wrong frustrates me, since there are no laws permitting parents to relinquish their responsibilities for an incredibly unfit offspring. Definitely a controversial view, which as far as I'm concerned will only apply to myself and my future offspring, not the patients for whom I care (so don't worry), but human societies have practiced infanticide since before they were even humans - all animals practice infanticide if they do not have the resources or the animal is too unfit to survive and care for itself. It seems a crime to force parents to spend say, 5 years of their lives caring for a child that is 99.99% doomed to die - that's 5 years in which the child will be suffering, becoming progressively more mentally retarded, and slowly wasting away until its inevitable demise. It's an emotional drain for sure, not to mention a financial drain on the parents.

Like I said, I know it is my duty as a physician do everything in my power to keep a patient alive, and I will do that wholeheartedly - I just don't want to end up a slave to any offspring I produce with conditions that are incompatible with life for which medicine can offer no acceptable end.

In other news, still doing bacteriophage research. My medical Spanish classes have picked up again, so we're practicing those and we have our practicals next week. The trip to Bolivia is essentially ready, though I still need to get all my vaccinations...mental note: call the travel center. OMM is going well, I suppose - we're learning the high velocity, low amplitude techniques (the cracking techniques). I've had mixed success with them, so I definitely need more practice. Thank goodness we don't need to make an audible crack for it to be 'treated' - otherwise I don't know how we could get anything to treat during a practical after we've been practicing on each other for days.

Still working on balancing personal life with school, but everything's a work in progress these days... Now for the joy of computer games!

Spring Break

Hooray for spring break and being done with blocks exams for the time being. I ended up going to Monterey for a week, and then down to San Diego for the remainder of the passover time we have off. I have done essentially no medicine-related stuff all break - a welcome change and break for my brain. Looks like we get to start out with venipuncture and the respiratory system next block. Makes sense, as we just covered the cardiovascular system. It should be interesting.

In other news, we're needing to raise some money for the Bolivia trip (as in, get money to buy supplies for the hospital, mobile unit, and for the impoverished down there). I'll be returning to my research soon enough, and want to exercise a bit more so I'll join in the weekly karate class and do pilates on the side. I also got a LASIK checkup and my eyes are still healing perfectly and there are no complications. I also need to start making my own food more often - as much as I like letting my parents cook everything, sometimes I really prefer my own cooking. Anyhow, back to enjoying the last couple days of leisure that I have...