Friday, December 14, 2007

Bueno, lo que pasa es...

let´s start with the description of an unimaginable life, that for you to read makes no sense and for me to live experiences sense only. The last time I wrote I said i´d be in Los Palacios jungle clinic from wed to sat.. it´s Friday now and i´ve returned to santa cruz twice. Once as an ambulance,minus lights and sirens. And the second time as an intended airport taxi, minus airport as sole destination (Early this morn we learned of political blockades beginning at 3pm in Portachuello a tiny town between Palacios and Scruz. So instead of transporting half my Docs.. I took them all for fear that I wouldn´t be able to get back to the clinic to pick them up late Sat. Tomorrow is a big day for SCruz autonomy. There is a referendum meeting close to our Scruz mansion. There will prob be lots of action in the streets.. but luckily we will be safe and sound inside the casa.

Second day at clinic: So we´re chilling at the clinic struggling to attend to 60 plus patients from two very rural very poor communities and I learn (thru lots of medical babble) one of our older patients is experiencing a heart attack and must be seen by a hospital immediately. There was a window of 3 hours ending in treatment or fatality. Our docs were slammed and left with only 1 spanish translator. Butttt, this is the job and as the Coordinator I quickly learned I am, well, everything. I either do it, make sure it gets done, or nothing happens. So mike and I jumped in the car with a med resident, the heart attackee, and 1 tag along ulcered patient with a possible absess and off we bumped. Palacios is 2 hrs (the first 20 pure bumpy dirt road) from santa cruz. As we made our way slowly to santa cruz we ate some meat soy patties with rice that our cook had packed us to go, listened to the beatles. Chatted in english… all the while the woman next to me was HAVING a heart attack. And The ulcer absess lady next to her was in a lot pain. Mike dropped me and doc and heart attack off at hospital… I scrambled to figure out the joke that is “emergency” on chill jungle time, checked the woman into the hospital, paid her admittance fee, connected with our doc connection, saw the woman off with lots of attached nodes, and from there our job was done. Our doc´s diagnosis and Mike and I´s in between responsibilities, saved a life… atleast I think that´s what happened. Oh yeah and then we spent the rest of the day dealing with the ulcered lady. At 8 pm on our way back to Palacios we dropped her off at the gate of her pueblo Santa Rosa. Her house was 70 km past that point. We left her there with a friendly villager whom I befriended and in the meantime conviced to find her transport and wait with her to receive it. The day started for me at 7am.

Already I can tell that this is how I will be sensing here. Things will happen. I will respond. I will do without knowing and know without doing. Already what i´ve seen (and not processed) is amazing. On Monday and tues my job is to reunite with patients referred from the jungle communities to the city to see them through, process and pay for every step of their care. This week I connected with a heart patient with complications of chagas, an Elfantitis patient with symptoms never previous seen by the ameri nor boli docs, a woman with infected ulcers needing hospitalization, several urgent uteran patients, a dude with something giant stuck in his ear… I have a notebook. I write down their names and problems and I get lucky when they have phone numbers. And then slowly, one by one, during my 2 days in Santa Cruz, I make sure they are taken care of

Last Monday mike and I made our rounds at my first bolivian hospital experience. The atmosphere was how I can only imagine prison would be. The faces, the diseases, the realities, the results (met and not) are breath taking. Half my time at the clinic I repeat the words of the docs to the patients. In the cases that need further care, I take the Docs words, repeat ´them again to Douglas (our City doc) and then somewhere down the road I transport and assemble those words again in the city setting…with the patient by my side. Oh yea and also these people look-feel-and are treated like complete foreigners when in the city. They have no idea what is going on and half the time don´t realize (and aren´t told) of their medical state and care. Already I see these city docs are talking through me and Mike… looking and touching the patient only to examen them. The patients can´t afford aspirin or a taxi… and then suddenly they experience a ride to the big city (listening to Beatles and English on the way) and treatment for things they didn´t know they had and, if they survive, might never know could have caused their death.

And when all that is over, I waltz back into the clinic residence to dodge bugs, share food, watch movies, smile and listen to boring medicine stories. Here in Santa Cruz I return to a mansion, to gmail, to filtered water (I don´t use the word Mansion lightly), eat the really great food of our housekeep Nico who prepares Cochabamba specialities just for me, chat with her about the princess americans (her words not mine), play with her daughter, go on runs with long-legged med-students, read the Boliv news. All in a days work I suppose.

Oh yes Politics… very bad right now, very iffy knowledge of what will happen in the future. You may have heard the US announced to halt unneccess. Travel to Bolivia.. good until Jan 11. They asked for extreme caution for foreigners already here. I´ll try to explain more tomorrow. Meanwhile, worry not… I´ll be holding out in the mansion, eating great food and chillin, while Santa Cruz will be reigning in their autonomy in a near-by park. Blockades and violence (celebratory and contrary) pending…

Mike leaves tomorrow 10 am. That means after this.. all my stories… well, will actually be… first hand. I have this second hand too. So i think i´m ready.

Love and appreciate you all.

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