I have found that as I progress through more and more of second year, I end up leaving more and more of myself behind. In a way, I have been feeling more spent than ever. I have said before that the exams are constant and the lectures are unceasing, and on any given day there is always something that requires the bulk of my attention. It has come to the point where I have not had enough time to pause and write. In looking for a pause, I found one in Spring Break. Ten days in March where I could do as I pleased and simply relax. Perhaps I would read some books or ride my bicycle around town, and on the whole, not have to think too much about medicine.
Instead, I went to Ecuador.
On March 2, at 4 a.m., my fellow University of Florida Health Science classmates and I boarded a plane in Miami, headed to Quito. This was part of a health outreach trip, of which UF was host to many. Our particular trip, called Project HEAL, was bound for many places in Ecuador, and our goal was to provide primary care to several rural villages and towns. I remember sitting on that plane in Miami thinking that this was going to be a good trip overall and a good chance to both learn something about myself as well as to make myself useful. In retrospect, that particular thought may have proved to be the understatement of my life.
I always wanted to participate in a health outreach trip, ever since I heard about them during first year. The idea of going to another country with no other motive than to help its people was exciting to me. There is something in me that wants to give and give, and receive nothing in return. Perhaps it is because I have already received many good things in my life. In truth, I was also influenced by the ideals of the Florida Medical Opportunity Scholarship. I have written before about the immense gratitude that I have for being able to study at the UF College of Medicine and being a recipient of a scholarship that prides itself on bestowing opportunities to underprivileged students. I have never let that sentiment stray far from my thoughts, and in keeping with the spirit of my scholarship, wanted to live up to it by helping others and making myself useful in any way that I could. And so, I applied to Project HEAL and they accepted me.
I remember being on the plane that morning; feeling the plane take off and leaving America behind. And the next thing I knew, we were landing, and I saw mountains.
March 3, 2013
Day 1: Breathing deeply at 15,000 feet
After we landed in the Quito airport, we quickly collected our bags and met up with the rest of the health care team. Our entire team consisted of two pediatricians, a cardiologist, two emergency medicine physicians, a gynecologist, three pharmacy students, two pharmacists, one nursing student, two fourth-year medical students, one third-year medical student, 12 second-year students, two first-year students, and a nutritionist. We were quite a well-rounded team, with people from both America and Ecuador working together.
We drove two buses from the airport, which took us from Quito to a city called Latacunga. We would stay there for a couple of days as we visited clinic sites close by. The first night in the hotel was both exhilarating and tiring. We were tired from travelling, but looking very much forward to our first clinic day. So I assume that my colleagues slept just as much as I did that night, which is to say not much at all.
For the first clinic day, we would find ourselves removed from the 10,000-feet-above-sea-level altitude that we had so little time to get used to, to the 15,000-foot elevation of Guangaje. This clinic site was in a small village in the mountains, which took us quite some time to get to by bus. But I did not mind in the slightest, as the view was incredible. I now believe that there are very few sights that can inform you as to how immense and beautiful this world is than the sight of the mountains in Ecuador. Though I have seen very little of the world, it is difficult for me to imagine anything more well-formed and breathtaking.
When we arrived at the clinic, our real work began. I worked alongside one of my classmates under one of the pediatricians. The patients who came to the clinic spoke both their native Kichwa as well as Spanish. However, I initially had difficulty communicating with the patients without the aid of a translator, as my Spanish was poor and the patients would often blend Kichwa and Spanish together. But as the day progressed, I found myself better able to communicate and adapt to my patients. I was surprised as to how much my Spanish improved, even though I really only knew how to conjugate verbs in the present tense.
I also learned many things about pediatric exam; especially regarding infants and toddlers. I learned about the importance of keeping growth and development charts for children, as well as important approaches to the physical exam itself. For instance, it is always preferable to listen to the heart and lungs of an infant first, as that is when they are the most complacent; if you start out trying to do more invasive things, like looking in their mouth and ears, they will start to squirm and scream and you will never be able to hear heart and lung sounds.
One thing that I did not expect was how the altitude would affect me. I did not notice anything back in Quito, but at the clinic I found myself suddenly dizzy and out of breath at certain moments in the day. One particularly terrifying moment came when I was looking in an infant’s ears and suddenly became very dizzy. I had to close my eyes because it became very difficult to see, and I did not know what to do, as the otoscope cone was already in the ear canal and I was unsure if I could safely remove it without possibly hurting the child. Fortunately, I was using my pinky finger to brace the otoscope against the child’s head, so I was able to hold it steady until the dizziness passed. I was able to finish the rest of the exam without any problems, and looking back, I was happy that I kept my composure and did not alarm the patient or his mother.
When it came time for the clinic to close, I realized that I had learned and done a lot. It was only the first day, and I could not wait for tomorrow. On the bus ride home, I thought about what it might be like to be a pediatrician.