Skip to main content

Letters from Mexico: Excerpts from my journal

Saturday, March 24th, 2007
We leave for Cancun today, and since Thursday I have felt rushed from one place to the next. MUlation was Thursday, then I picked up some of the medical equipment that John told me was available. Friday morning I received a vision exam by a retinal specialist, and now have visual field testing scheduled for just after Step 1 to absolutely rule out the possibility of a nerve cell tumor or impingement of my optic nerve from drusen deposited around the cup.

Friday night I packed, and my tension continued. Packing and laundry interspersed with phoning family engrossed my evening until 11 p.m., at which point I felt I might truly rest. I was in bed by 1 a.m.

I awoke at 6:45 a.m., none too rested. With two hours to spare I still felt stressed and rushed...My general lack of control of the trip leaves me feeling inadequate...

Sunday, March 25th, 2007
The night passed harshly, as the sound of the air conditioner kept me up much of the night.

Our morning meeting was at 7:30 a.m., although our breakfast was at 9 a.m. Prior to 7:30 Bret and I went for a walk, and we came across the large cathedral at the square. Going closer we could listen to the hymns in Spanish, and the poetry of the responsive chant. The haunting sound was beautiful, and the sound of it all will be etched into my mind.

We went to see some Mayan ruins after a brief Sunday service by Doug Hornok, our leader. It was a relatively recently uncovered site, Ek Balam...

After that we went to a swimming hole in a cavern. It was a very refreshing reprieve from the hot weather. The lighting came from a large hole in the ceiling, which now has the roots of a tree descending to the rock island in the center....

"We're all important in God's eyes," was Doug's words this morning. But I want to feel valuable to people. I want people to be invested in me. I want people to think I am special, too...

Tuesday, March 27th, 2007
...Yesterday we worked in a clinic, and the system of seeing people was rather hodgepodge...The whole operation was somewhat organized except for the area where the doctors were gathered. It was something of a catch basket.

My first patient was a woman with eye problems, and I expected it to be a great opportunity to do a fundoscopic exam, until I ran into her bilateral cataracts. Several patients I saw on my own, only consulting a doctor when I had taken a history and physical. I find my increased depth of knowledge is profound compared to last year....

Popular posts from this blog

Learning Leadership

This past Thursday-Friday was the annual Internal Medicine Residency PGY-2 (means a second year resident) Leadership Retreat. At the retreat, we had several lectures, breakout discussion sessions, and role play practice in how to employ leadership skills that help foster a positive learning and working environment. The lecture and discussion series was led by facilitators who have been trained through the Stanford Faculty Development Center and utilizes their Clinical Teaching Program curriculum. The focus was for how we, as residents, can facilitate a positive learning environment for incoming interns and for medical students on the team. It also focused on how to set goals for an inpatient team, and how to best use your attending as a resource. Overall, it was a great retreat. Though many people think that some people are natural born leaders, I think many leadership qualities, if not most, can be learned and trained. Sometimes those who have had some kind of training or learning in...

The Sterile Field

In 1847, maternal mortality from childbirth in a Hungarian clinic was approximately 18%. A second clinic that offered maternity services had numbers much nearer to 2%. Women begged for admission to the second clinic in order to avoid puerperal fever, the name of the illness associated with such significant death rates. At the First Clinic, medical students and physicians routinely performed autopsies as well as patient services, including maternity services. At the Second Clinic, midwives did delivery and did not participate in any autopsies. Following the death of a colleague who became sick with puerperal fever after being stuck with an autopsy scalpel, a physician named Ignaz Semmelweis inferred that cadaveric particles must cause puerperal fever, and that students and physicians were transferring them to mothers after doing autopsies. After instituting the practice of handwashing in the First Clinic, the mortality dropped from 18.3% in April of 1847 to 1.9% in August that same year...

The $2000 monkey on my back, deferred

It’s been more than a week, and I think an update is due. Plus, I can give updates on my own status with my heart murmur, having seen the doctor this past Friday. The only thing that has kept me from updating until now is simply laziness (in other words, I was far too busy studying/eating/cleaning/sleeping to actually relax and write). This past Friday I went to the Student Health Center to see my doctor about the previously mentioned murmur recently discovered. My doctor presumed it was most likely an innocent flow murmur, which occurs if a heart valve doesn’t close all the way or in time when the heart beats, allowing blood to flow back the opposite way, and the blood causes turbulence heard as noise. If you’ve ever heard turbulent water flowing over and through rocks and back upstream in eddies in a river, you should get the idea of what a murmur is. It was recommended that I have an echocardiography done, or an ultrasound picture of my heart. This would allow us to see exactly how ...