Round 2 Week 2

Week 2 has been much more productive. After our trip to Salar de Uyuni, we returned to the Clinica Americano Boliviano with fresh enthusiasm. Increasing familiarity with the hospital, the city, and the language has encouraged us to explore more and interact with more people. I keep an open mind because I find myself learning several topics simultaneously. Medicine, Spanish, and geography are all important, but I have placed the most emphasis on learning the language. While medicine and geography help, I find the most pleasure in connecting with others through language. I am making a feeble attempt at learning Quechua, the native language of Cochabamba and surrounding regions. The language is very difficult for several reasons. It is clearly not a Romanic language, the words share no similarity with English, and the texts I am learning from are all in Spanish. An ambitious goal, but I love the expression of pleasure that overcomes the locals as they hear me murder their language.

Within the hospital, my colleague and I have remained mostly on the operating floor. Surgeries typically start at 8:30 AM. There is no set schedule as the agenda written on the whiteboard changes on an hourly basis. I may try to gather more on the history of the clinic. So far, from what I gather, the Clinica Americano Boliviano was started about 25 years ago by American Dr. Tim Wallace. The clinic started as a small back-building off San Martin Street, but it has been growing over the years. Now, the clinic has expanded to a 5 story building with a courtyard and various offices behind it. Today, the hospital is staffed by about 80 doctors who come and go around the clock. All the doctors also have offices elsewhere.

When Will and I are not shadowing on the operating floor, we follow other doctors in their temporary offices or around the clinic. The Spanish remains the largest barrier. It is very tough to learn anything about medicine in the office because everything is conversation. There are a few small tests and procedures performed that remind me of first year. In that way, I am able to follow the doctors more closely. The operating room is an easier learning atmosphere. With some Spanish under our belt and first year anatomy relatively fresh in our minds, Will and I are able to follow the surgeries, understand particular methods, and learn proper protocol in the OR.

We are expected to compare American medicine with the practices here. My experience in American operating rooms, however, is limited. Interestingly enough, I am getting my introduction to surgical procedures from a Bolivian perspective. I will not be able to properly compare the two practices until future years in medical school. This is what I know, and this will be the standard by which I compare surgeries.

This week I shadowed a pediatrician and two traumatologists in their offices. I was able to view a few X-rays although I had difficulty analyzing them until the doctors relayed the problems through very strained very slow Spanish. In the OR, Will and I observed many operations. We saw several rhinoplasties, a skin graft, laparoscopic cholecystectomy, liposuction, several cesarean sections, and an open cholecystectomy. The gallbladder could not be removed, however, in the open procedure due to complications that neither Will nor I were able to understand in Spanish. From this week, we inferred that the American Clinic seems to place much emphasis on aesthetic plastic surgeries (although the skin graft and one rhinoplasty seemed to be reconstructive). Why this is so, we still need to ask. This demonstrates a noticeable difference with the burn clinic in Viedma hospital where children are in dire need for reconstructive surgery. Nevertheless, the doctors in Clinica Americana Boliviano are excellent and I am impressed repeatedly with the ease and precision that they operate.

As for our main contact, Dr. Wallace, we have not had much time to connect with him, but it is our intention to shadow him and learn a little bit about ultrasound in the coming weeks. I also wish to learn how a man such as Dr. Wallace finds a calling that places him thousands of miles from home to build a fully staffed clinic from scratch.

As a cap to the week, Will (squared), Nicole (squared), Maggie, Carolyne, and I trekked to the Cristo statue that looms over Cochabamba. After having acclimated over a couple of weeks, one would expect to climb the 2,000 stairs with more ease than we experienced today. We realized how long the hike would be after stopping to catch our breathe after the first 50 stairs. Regardless, the view is amazing, Cristo is large, and the snacks sold beneath his outstretched hands are incredibly refreshing. We opted to take the cable-cars back down. I look forward to what Cochabamba has to offer over the next couple of weeks as I continue to learn more Spanish... and maybe some Quechua.