Roatan - Day 5

Today I was assigned to triage and it was J’s turn to see patients.  Another nurse and I pumped those patients in and out in a good solid 3 hours and then I was left with nothing to do.  So I was roped into seeing patients again since there were at least 15 waiting.  It’s crazy here.  These people leave their mountain villages at 4 am to get here early to be one of the first people seen.  There are so many people they can end up waiting until after noon to even be seen by the doctor.  Then they might have blood work to do in the lab.  Then they have to wait for pharmacy to fill their prescriptions.  Just plan on spending the whole day at the clinic.  I guess that’s why there’s always a lady out front selling fresh fruit and pastelitos (fried goodness filled with chicken).  And then if you’re a gringo (I’m so surprised just how many there are on the island) you can pay a “rapid care” fee of $25 and skip to the front, don’t mind the little old lady with stomach pain and diarrhea that has been waiting for 3 hours.  It’s a crazy system.  At least their healthcare is very affordable - $3.50 for their whole office visit AND medications.

I double teamed with J during the afternoon to translate until a patient paid the rapid care fee just 15 minutes before our shift was supposed to end.  Chest pain x 3 days.  Previous history of a MI (heart attack).  We definitely want to see this.  Almost 2 hours later, we ruled out any cardiac etiology and sent her on her way.  At least we got an offer for free zip lining out of it.  No, but really, always happy to see patients, whether it’s in ghetto paradise or not.

Turns out it’s always a good idea to name drop Nurse Peggy.  She is the one that set up the clinic here so many years ago and everyone on the island seems to know her and appreciate the service she provides.  Our taxi cab driver to the beach wouldn’t take ANY money from us after he found out we were volunteers at the clinic.  The taxi cab driver on the way home seemed a little put out that he agreed to half the price he originally stated, then completely changed his disposition when he found out what we were doing on the island.

After I accidentally dumped J out of her wheelchair after running into a speed bump due to rubbernecking (thankful for the 5 local men who ran to the rescue), we found a prime spot to relax – beach chairs bolted down to a dock extending out into the bay.  Our new favorite tanning and snorkeling spot.

Dinner at Rotisserie Chicken proved delightful, filling my tummy with ¼ perfectly roasted chicken, coconut rice & beans, and fried plantains.  Reminds me of the Chicken Hut in Rocky Point.  We were heartily enjoying our meal until a dog came bounding by us to the kitchen and the cook rubbed her hands all over it.  Always a good time in Latin America.

Final mosquito & sand flea count = 71 bites (that spans 5 days… 5 more weeks sounds like el infierno…)

Roatan - Day 4

Today I had the most autonomy I’ve had in my whole clinical year thus far.  What a day!  Turns out it takes a lot longer to see a patient completely by myself than I anticipated.  And my sloppy rusty Spanish didn’t speed the process along either.  I averaged about an hour per patient, and they weren’t easy cases either.  Take for instance the 18 year old girl coming in complaining of stomach pain and diarrhea… turns out she’s been having chest pain and passing out pretty regularly for the last 2 years with a recent visit to the hospital for the same a few weeks ago.  Challenging, but glad for the challenge!  Anyway, I presented each of my patients to the doctor/PA after doing the whole history and physical myself and after solidifying a diagnosis and plan, I finished up with the patient alone.  What I’m used to on my previous rotations is my preceptor briefly seeing the patient him/herself just to verify my findings.  That isn’t the case here, but if I want him to double check something on my physical exam, the doctor is available and happy to do so.  It’s excellent practice for coming up on my graduation in just 4 short months.

The rest of the day wasn’t very exciting… J and I stuck around the clinic for a few extra hours to take advantage of the free WiFi and to complete some school assignments.  By the time we got home it was time for a tuna-topped salad accompanied by a cheese crisp and a whole plate of mangos for dessert.  We don’t dare cook in this apartment.  The million dollar question of the night for J was if she would use the lonely cheese grater sitting up on a high shelf.  She replied “no way” without hesitation.  Looking forward to more mangos tomorrow!

Roatan - Day 3

After getting oriented to the clinic yesterday, I was assigned to work with a PA today to see patients.  I was very excited to work with her since she has over 30 years of experience.  We teamed up – I did the history and physical while she typed the chart note.  Toward the end of the day, we realized it would be more efficient if we both saw our own patients and I presented my patient to her with my assessment and plan.  Excited to start out this way tomorrow.  J was in triage and during a break discovered a lady outside the clinic selling a whole bag of mangos for one dollar.  Yep, we will be buying mangos every day I think!

After putting in a full 5 hours of work (hey, I didn’t get a break or even lunch during this time) and an hour or so catching up on emails, we headed to the beach.  We took a taxi to West End which has all the shopping and restaurants, as well as a very nice white sand beach.  We walked up and down the road following the beach, then found a perfect spot to spend the rest of the afternoon.  Fortunately the water wasn’t very far from the road so it wasn’t a problem getting J down to the water.  I popped her up onto her back wheels and wheeled her down.  Getting her OUT of the water was the problem.  I tried to carry her – turns out she’s too heavy for me, not because she’s a big person, but because I don’t have the muscles I need (I haven’t worked out regularly since before Christmas, ay…).  So I wheelbarrowed her out of the water onto her towel, then pulled the towel up the beach, a pretty steep incline mind you.  Then I had to wheel her back to the road.  Turns out a wheelchair doesn’t move very well in the sand and turns out I’m not very strong.  I may throw my back out while I’m here, but at least it’s for a good cause!

Also, turns out the sand fleas everyone has talked about are indeed real.  I was hoping they wouldn’t dare ruin my ghetto paradise staycation, but it looks like they just might.  I am covered in bites, all over.  I thought they would just go for my legs, but turns out they seemed to have liked my back quite a bit.  Mosquitos and sand fleas are turning out to be my nemesis. 

We ate dinner at an outdoor joint called Monkey Island, right next to the beach with a perfect view of the setting sun.  J had heard good things about it from another nurse at the clinic.  I couldn’t decide between coconut fish and a burrito, but fortunately I went with the fish.  SUCH delicious fish!  Coconut crusted w/ a coconut dipping sauce accompanied by coconut rice & beans.  I will definitely be back!  By the way, just a warning… I may talk about food a lot on this blog.  Food is pretty big in our family.  My brother would remember our family vacations by where we ate lunch or by what he ate for dinner, anything that applies to the sense of taste :)

J was impressed with my taxi bartering skills.  I’ve been getting us good deals on our fares.  And after some chavo (what’s the Hondureño word for dude?) tried to charge us 6 bucks and I cut the fare in half, maybe I’ll shoot for a lower amount next time.  I LOVE bartering.  Why can we not do this in the States??

Oh, and by the way, I could really go for a bag of red vines right now…

Roatan - Day 2

As I sit down to write this post tonight, I am furiously scratching my face.  The mosquitos have already keenly discovered my juicy blood.  I have 3 bites on my jaw, one on my chin, one on my neck, one between my eyes (seriously?!), and one on my eyelid.  And that is my head alone.  I may survive Ed’s unkempt apartment (barely), but I don’t know if I’ll survive 6 weeks of mosquitos.  Don’t worry, I’m taking antimalarial medication.

                                                                 

Oh, and by the way I got an email from my pops today entitled “Urgent, Kristina--read this.”  He had me really worried for a bit.  Yes, there is a travel advisory to Honduras posted by the government and as the article in the email my dad sent pointed out, San Pedro Sula is apparently the most dangerous city in the world right now, followed by Acapulco, Mexico then Caracas, Venezuela.  Good thing I’ve already been to Acapulco.  No, but really, there is no need to be alarmed.  For the following reasons: I fortunately am not on the mainland, Roatan is a cruise ship stop, and our school wouldn’t send us here if they didn’t feel it was safe.  Hey, I’m a 6 foot Spanish speaker.  No one dares mess with me.  Don’t worry, I’ll be extra careful and not go anywhere alone.  I promise.

Well, after sleeping in off and on until 10 this morning, we finally got up and got ready for our first shift at the clinic, beginning at 12:30 pm (yes, I got cold during the night and yes, I used my beach towel as a blanket).  We didn’t really get assigned to do anything in particular until we’d been there for an hour or so, but finally got put into triage (there are a ton of other medical students here right now).  Wow, I can now appreciate all the work that goes into taking vital signs and flagging patients appropriately for who is next in line for care.  I absolutely loved using my Spanish today and had a smile on my face all afternoon, but man, I forgot how much work it takes to get a history from a Latino, excuse me, Hondureño.  I constantly had to redirect a few patients coming in with very vague complaints.  A lot of these people just need reassurance, no meds necessary. 

My Spanish is extremely rusty and I thought it was mostly my speaking skills that was having difficulty, but after thinking a patient was saying “adicción” instead of “inyección” and J (who speaks no Spanish) figuring it out, I soon realized that wasn’t the case.  At least we had a good laugh out of it. 

We put in a good full day’s work today – 6 hours.  Booyah.  After getting home and preparing a delicious salad for dinner, turns out Ed only has one fork in the entire place.  J ate dinner first followed by me.  Hey, if this is how it has to be done, then so be it.  We work the morning shifts for the rest of the week so hopefully we’ll get some beach time and exploring in, even some snorkeling perhaps.  

Roatan - Day 1

So I didn’t think I’d blog while I was here because we don’t have internet in our apartment, but I found an easy way around it.  I’ll type whatever it is I want to say while at the end of each day and then post it to my blog the next day when I get to the clinic.  My only caveat is that I might be behind on the weekends since I only work M – F.  Also, these postings will be strictly words only.  If you want to see pictures you’ll have to check Instagram or Facebook.

What a day… where to start?  I guess at the beginning; that would be the most logical choice :)  So I’m here on the island of Roatán in the Caribbean, which is part of Honduras, given over from the British in the 1800s (for you history buffs out there).  You may know it as a popular cruise ship stop.  I’m here for my Community Medicine rotation and will be working at Clínica Esperanza, a local medical clinic.  We’ll be seeing everything from the underserved to tourists. 

My classmate (we’ll call her J) and I am came down together.  She’s a paraplegic from a recent snowboarding accident in the last few years.  She is seriously one of the strongest and most optimistic people I have met.  There’s perks to traveling with someone in a wheelchair – we got bumped up on both flights to Economy Plus, where I enjoyed a wide expanse of leg room.  So we took the midnight flight last night from Portland and landed in Houston, TX at 5:40 am, about a 4 hr. flight.  I asked J if she’d rather leave at midnight or at 6 am?  She said 6 am.  I still don’t know…. All I know is that I dislike red eyes, very much.  And not being able to catch even a wink in Houston for our 4.5 hr layover just made things worse.  Fortunately the flight to Roatán from there was only 2 more hours.

We were greeted by a blast of heat in our faces stepping off the plane, but with a pleasant cool wind to follow it up.  Dang, I should have taken my sweatshirt off BEFORE getting off the plane.  Brilliant.  With J in a wheelchair, I juggled 6 bags between the two of us.  We only had to wait a moment before Nurse Peggy showed up to take us to our new apartment with a brief stop at the supermarket along the way.  A few tire-screeching turns later (Peggy blames the road, NOT her driving) we arrived at the supermarket, not having a clue what to purchase.  So J and I stocked up on the essentials – the makings for PB & J, cheese crisps, chips & salsa, and salad.  Yep, that’s pretty much what I’ve lived off of the whole last year, aaaaaand turns out I don’t have to change my diet living in a third world country for the next 6 weeks.  That’s what I’m talking about.

With J’s situation, our housing options were limited.  She needed something with doors wide enough for her chair to fit through.  That automatically threw out the beach house next door to Miss Peggy’s (not to mention the full flight of stairs up the front door) and the usual apartments across the street from the clinic.  We had previously arranged a different beach house that was going to work out FABULOUSLY (come on, right on the beach?!  You know me and the beach…), but of course that fell through last minute as the current tenants were long term instead of short term (egg their house for April Fool’s tomorrow?  Ha, I kid).  So instead, we ended up at Ed’s Apartment.  As my mom intuitively asked, Ed doesn’t live there does he?  No, Mom, he does not.  But he owns the laundromat next door, which is quite convenient.  It looked innocent enough on the outside, but a nice stench greeted us in the kitchen upon opening the front door.  Nooooot the nicest, but hey, we’re in ghetto paradise so what can I say?  I’m happy to have A/C, a bed, and a door that locks.

This evening J and I went to Nurse Peggy’s for a potluck gathering of volunteers at the clinic.  I was expecting only a handful of people, but as the handfuls kept walking in, I just kept hoping I’d still have patients to see tomorrow.  There was probably 15-20 from all over the world there and I’m sorry if I sound British, but I spent a good chunk of time conversing with a British 19 year old medical student.  Loved her accent of course.  It was great to be in such pleasant company sitting on the balcony overlooking the ocean and enjoy the sunset.  Not my typical way of spending Easter, but it was fabulous.

I just admitted to J that earlier today I was already missing the U.S.  Maybe that had to do with me being awake for 30 plus hours, or maybe it was Ed’s stinkin’ apartment, or maybe I just miss my family.  Whatever it is, I know how shocked you are.  I didn’t even get home sick when I spend 9 months in Spain teaching English.  Don’t worry, once I get some sleep in me and start working at the clinic and exploring in my free time, I’ll be right back on track.  Very excited for what the next 6 weeks has in store!

And if I type THIS much EVERY day that I am here, the only reader I’ll have left at the end is myself…