My last full week in Quito

I’m writing on a much more positive note this week — Yay. My week at the surgery unit in the military hospital was amazing. This was the second time in the last few years that I’ve been able to scrub in on surgeries (now in two different continents), and I loved everything (ok like 99%).

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This time, I got to see a little bit of everything (which was nice considering I had a 40 minute commute and had to be there by 7 am). I got to see pre-op patients, check up on post-op patients, participate in rounds with the other medical students, scrub in on surgeries (one gallbladder removal, one hernia repair), sit in on consultations, be a part of diagnostic meetings, and sat in on a gastro-intestinal lecture. Can my life get any cooler?

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Unfortunately, I also had to sit in on family members receiving bad news about their loved ones. Which was incredibly difficult, and it made me glad it wasn’t something I had to personally be doing. It was especially difficult because Ecuadorians tend to have a strange way of reacting (in my opinion) to someone showing weakness or discomfort. I’ve never seen someone here acknowledge when a person starts to cry, instead they just turn the other way. My assumption is that this is to allow the person to try and “save some face” or recompose themselves to not appear emotional, which likely stems from the incredibly machismo culture they’re brought up in. Even the children at the preschool were ignored when they cried. Like they didn’t want them to be embarrassed for letting some emotion slip out. After saying goodbye to the great people at the surgical unit, me and the girls headed 9 hours south to Cuenca. A town worth the distance for its architecture alone. The fact that it was a solid 75 degrees and sunny the majority of the time was also an added bonus.

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And some more:

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Here we explored churches, plazas. museums, flower markets, artisan markets, a zoo, and ate some of the best food I’ve had while in Ecuador. The zoo was fantastic. There were baby lion cubs just feet away from a fence (yes, that’s literally all that separated us from them–and their mom) AND monkeys swinging freely from the trees as you walked around. I’m talking no cages of any sort. They sat on branches inches away from your face, I could have touched one if I didn’t forgo on the $900 rabies vaccine. Here’s a picture, I named him Frank:

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Okay, I told you I’d get to the food. So, the first day we got there we had breakfast at a German bakery. For $3 you got scrambled eggs, tea or coffee, and unlimited helpings to a buffet of freshly baked German bread. Poppy seed, rye, cinnamon, fruit chunks, you name it. Plus like a million different types of spreads. Yes, we stayed there for like two hours.

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On top of that we had delicious coconut juice, pesto bagel sandwiches, and Indian food that easily put me in a food coma. (Just a reminder I ACTUALLY haven’t cooked for myself in almost 3 months. Just let that sink in) Something that I’ve noticed a lot here is the obsession with Westernized culture (not surprising, considering it seems to be pushed on everyone). One thing that people seem to love here is imported US clothes and other goods. However, a shirt that would be like $15 in the US is easily $40 here, so most people can’t afford it. Unless of course you get a knock-off version of a brand that is popular with 14-year-olds int the States:

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On Sunday we decided to travel 45 minutes to a nature reserve called Cajas. Little did we know that just 45 minutes outside of beautiful Cuenca there was a raining, freezing, mess. And of course we didn’t dress accordingly. So instead of getting to hike a couple of the 200 lakes and over 75 trails, we sat in a restaurant by a warm fire, enjoying hot potato soup, and viewing the scenery while being sheltered from the cold. Not complaining over here, I wouldn’t have wanted it any other way. Except maybe for it to be sunny.

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By the way, that fried cheesy goodness behind the soup is an epenada. I have at least 3 a week.

And here is a picture from on top of a hill, over looking part of Cuenca (Ecuador’s 3rd largest city):

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Other than having a great week, and weekend, my knee still kind of sucks. I bought a brace to keep it sturdy during my adventures, but I’m in constant need of ibuprofen and my mobility is a lot more limited then I would like. After being checked out by the doctor I’m shadowing this week, and by my medical director, both told me they would highly encourage an MRI as soon as possible. They talked about lateral ligament damage, and possibly a fracture from the patella hitting the other bones when it dislocated. I don’t really like the sound of that (obviously), but I’m very thankful I’ve been able to walk and my injury hasn’t ruined my trip, or cut it short.

Here is a picture of the swelling the morning after the dislocation/injury (thankfully no bruising and the swelling has gone down. It only hurts to straighten out or bend, and to the touch in some parts):

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Even though it’s not ideal that I have to use them, it’s pretty cool I’m surrounded by doctors that can give me consultations and checkups without appointments or being charged. I love being surrounded by medicine here: the girls I live with study it, we constantly talk about our clinical experiences, the Spanish I learn is mostly medical Spanish at the moment, and then I work in medical facilities at least 4-5 hours a day during the week. I’m in heaven (again, minus the knee)!

Today was my first day at a hospital for Familiar medicine. It was quite different than what I’ve been used to shadowing: which is private hospitals for people who can afford to pay a ton of money for excellent care. The hospital I went to today was for those getting help from social security, in a hospital that hadn’t had much attention itself in what looked to be decades. The consultation room I worked in had a small window, no working lights, a makeshift desk, and an examination bench/bed that looked like it belonged in MASH. But I’m so thankful I got to see this side, considering this is how the majority of people here receive health care (and those are the ones that even have access).

After shadowing the doctor who was checking in on patients with chronic illnesses such as diabetes and epilepsy, me and the other med students moved on to the Emergency Room. The ER was a large, square, cement room, with about 25 beds placed maybe two feet apart from each other, most with thin curtains between for “privacy.” No one had monitors for their vitals, most didn’t even get a pillow. And the weirdest thing? They had a hose-down station for pediatric patients. I kid you not, there was a room with a large basin, and if you brought your child into the ER, you were expected to put them in it, and hose them down. When I asked the doctor why this was, he said kids are often the most dirty of patients, carrying harmful germs, and they usually have some sort of bodily fluid on their clothing/hands. Especially when sick. Since the beds are so close to each other, they want to lower the risk of passing illnesses/bacteria on to weak, elderly, or pregnant patients…Interesting huh?

Speaking of those little germ-balls, everyone in the clinic who asks me what kind of specialty I want to go into, already assumes it’s pediatrics or maternity. In fact, many people have just answered their own question for themselves, before I got a chance to respond. In their defense, that’s what most young med/nursing students who are women want to do here. But I think it’s because it’s kind of already decided for them, in a societal-pressure type of way.

Sexism is incredibly obvious here, from little things that most people have learned to overlook, all the way to basic human rights issues. I have had very few public meals without a strange man commenting on how much I eat — obviously they have never witnessed what Thanksgiving looks like. My lunch portion has no comparison to the amount of food I wish I could be eating in two days.

Unfortunately, thanksgiving will be just another day for me. We’re not allowed to use the kitchen at my host-house, so we can’t make anything ourselves. And I looked into the big chain hotels around like the Marriott and the Hilton, but nothing is advertising some sort of celebratory meal. Looks like I’ll have to celebrate over chicken and rice, and count all the things I’m thankful for from my room here in Quito. There’s a lot, so it will probably take a while 🙂 I hope everyone has a fantastic holiday, please know that I’m thinking of you and am thankful you’re all in my life.

Buenos Noches.

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