Gooooooooooooooooal...well almost

It is pretty late so I will make this one brief.

I started in a new clinic on Tuesday. I stayed home on monday and slept because I was not feeling well and wanted to get better, plus my friend beth was home as well so we watched movies all day and slept a lot. By tuesday I was feeling great and ready to get back into the swing of things. The clinic this week is with Dra. Guaman. I have learned in the past two days that she pretty much does it all. On Tuesday i went to a clinic in Atatucho (sp?) which is the poorest neighborhood in Quito. When you picture a third world country, this is the area you would think of. Here a medical consult costs two dollars. I saw several patients who had bronchitis and pneumonia and several women who were having issues with menstruation. It was hard to understand everything because the doctor speaks zero english, so I am being given the opportunity to REALLY work on my spanish (check out the positive attitude!).

Today (Wednesday) Beth joined me in the clinic. We went to the other place where Dr. Guaman works which is a hospital, rather than a clinic. This facility is private so patients are charged $8 per visit. As a result, I noticed the doctor spends much more time with each individual and the operation seems a lot more organized. I was really pleased to find today that I can understand ALMOST everything that the doctor says. Yesterday was a bit overwhelming but I am definitely getting the hang of things. I am also learning a lot of the important medical terms that come up frequently in conversation, so that makes it easier to understand the patient interview. At today's clinic the doctor saw patients (she is a general family doctor), but she also supervised in the ER. This afforded me the opportunity to see a wide variety of cases. In the ER there was a man with a distended stomach. When the doctor palpated his abdomen he did not feel pain (when she applied pressure) but when she took her hand away he nearly vomited and cringed from the pain. I learned that this is how you diagnose appendicitis, so the man will need to be transferred to a facility where surgery can be performed. I saw a little girl (age 4) get stitches out from an appendectomy. There were several patients with headaches, so I used this opportunity to ask the doctor when a neurological exam is necessary. She explained she checks reflexes (Ex. pupil constriction when she shines a light on the eye, knee jerk etc.) and if these are normal, it is not a neurological problem. It seems, based on her recommendations to the patients, that most of the problems here are due to malnutrition (too many papas-potatoes and not enough frutas/carne/vegetables).

Tomorrow I will be back in the poorer area which I prefer to the hospital setting. Because the patients pay so little, they are more willing to allow students to examine them and I was able to do more. But, I am really enjoying working with this doctor. She is very thorough and she teaches at the Catholic medical school so she does a great job explaining what she is doing and why and she is always happy to answer preguntas (questions).

Other than clinic, not much has been going on. My friends and I went to the Quito vs Guayaquil league futbol game tonight. It was INSANE. The stadium was huge and it was packed with fans. We noticed before the game that security was pretty intense in the area There were guard dogs, a swat team and police on horseback. The spectacle made me both nervous about my safety and glad that there was such a large law enforcement presence to prevent riots. Quito's team scored first but the goal was called offsides. During the game, people launched fireworks in the stadium and threw streamers at the goalies-totally not allowed in the united states but it definitely made the game interesting. It ended 0-0 and my friends and I made it safely back to Pricilla's (host sister) car and back to the house.

After clinic tomorrow I am going to happy gringo travel agency to plan a biking trip at Cotopaxi on sunday. This is the second largest active volcano in the world. I had planned to climb to the top but due to excessive sun in the month of August, there is avalanche warnings. So mom, rest easy I will be stopping at the base camp (which is still a bit of a hike) and biking down. I also have my race on Saturday, so I have to pick up all the gear tomorrow. I am going to be alone at the house with Robinson for a bit because Noah, Beth and Caitlin are headed to the Amazon. I thought about skipping the race to go, but I choose running over spiders and snakes any day.

Thats about all for now, talk to you all soon.
Buenos Noches.