Twelve Dollars, Six Years, and You’re a Doctor

Thursday, June 9, 2011

Fundacion Hospital Ortopedico Infantil

Like the past two mornings, we arrived at the Fundacion Hospital Ortopedico Infantil (HOI) at 7am today to report to our pasantias, or internships. Today Ethan was in the surgery room, Seth in the recovery and transition room, and Terence was in the Sala de Yeso, where the casts are made. Our rotations among the positions have the advantage of exposing us to different elements of this setting, and we take turns with ups and downs in our places. The recovery room tends to be a bit slower, so today Seth spent the morning waking kids up from anesthesia and monitoring them after surgery. Ethan learned what it feels like to spend four hours standing still as he watched an operation he describes as “slow, until the doctor picked up the hammer and chisel.” Terence was in the casting room where the Ponseti Method is used to cast children’s adducted feet. What he enjoyed most of the morning was spending a half hour chatting to a military doctor doing his residency at the hospital. They talked about public versus private hospitals and educational institutions, typical debt of an American college student, and the cost of becoming a doctor in our two countries. After doing some envelope calculations, the doctor said his medical degree cost him $12. Twelve dollars. Total. (Of course, as an economics major, Terence did note this does not include the opportunity cost, but it’s still darn cheap.) The conversation also brought them to cover insurance requirements and the costs of medical treatment in the United States. At HOI, the doctors are well-paid and happy. As Dr. Caratolana says, it is a welcoming environment, one that is good for learning and discussions.

We are also going to do an observership in the polytrauma room the Domingo Luciani Hospital, which is a public hospital in a rough part of town. Over a nightshift, we expect to see many patients suffering from a number of serious wounds, and a staff that is much more stressed than at HOI. Our partners at Venemergencia are making sure we have a companion there with us at all times, because in Domingo Luciani, you can never be too cautious. But that is another day, and today was rather easy. Unfortunately, for the wrong reasons.

The director of Venemergencia, Dr. Andres Gonzales, was hit while riding his motorcycle yesterday. He is extremely lucky. He walked away with some bruises and a broken rib, but with his life intact. (A note on city life here: drivers fear that motocyclists are armed, so the person who hit him drove away after seeing that Andres was alive.) So rather than spending this afternoon working at Venemergencia after leaving the hospital, we went to the local YMCA, bought monthly memberships, and got in some exercise. Terence swam and biked, and Ethan and Seth played a game of pickup basketball with some local kids. The sun and exercise was a great respite from our routines the past few days, but we miss Andres’ company and hope for a fast recovery. He’s also one of the main instructors for our EMT course, and his absence immediately began to wear down on our team.

After the YMCA, we returned to one of the two Venemergencia offices and prepared for the evening’s class. Tonight we covered AMPLIA (the local equivalent of SAMPLE, an acronym for collecting information on a patient during an initial assessment), diabetic conditions, vital signs and several other items that are much more technical than the United States’ EMT standard curriculum. The three of us learned a lot in this lesson, as Dr. Luiz covered some complicated aspects of the renal system. Saturday, however, it’s our time to teach.

Okay, it’s 10pm and tomorrow begins early again. We have a meeting with Salud Chacao, a public health organization funded by the city that offers clinics and ambulance services. We hope to set up ride-alongs with their paramedics.

Hasta pronto.

Terence