My time in Chicaman is coming to a close. I’ll be leaving to head back to Lago de Atitlan tomorrow because the road to Cobán is impassable right now because of the heavy rains and some landslides that have covered the highways and other roads. I’m kind of excited to go back to Lago de Atitlan and enjoy the lake a bit more. I’m going to stay in a town called San Pedro this time around and hopefully the weather is nice for the next few days so that I can catch a few rays before coming back to the US.
Update on the past few days before I chat more about today…
Sunday, I went to mass in the morning with Miny and actually understood most of the sermon. Well, more like I understood the words the priest was saying but to say that I actually caught the meaning of his sermon might be a stretch. After mass, I had a bit of time so I decided to go for a run. I ran the same route as a few days before but 12 minutes into my run it started to downpour. So, I found a bit of shelter and waited out the rain for about 40 minutes and then continued on my run. I ran down the mountain for about two and a half miles and then had to turn around and run back up the mountain. It was pretty difficult at times and I walked up two of the steepest parts of the climb but for the most part ran the entire way. I think I went about 5 miles but that might be stretching it. If nothing else, I gave my lungs a good workout and I think that is what is most important when training for a marathon. My legs pretty much remember what to do, it’s my lungs and my heart that need the conditioning, haha. After my run, I showered and then went to have lunch with Myra and her daughter Catharinne. Their house is quite a different world than the Martinez house and doesn’t have all the amenities, but I’d have to say it is still comfortable and very homey. We ate lunch, listened to music, played with Catharinne’s dolls, looked at pictures and chatted about life. It was a nice lunch and I’m glad I got a chance to spend some time with Myra and Catharinne. After lunch and chatting, I went back to the church with Miny so that we could help Nick and Nicole, the Canadian couple, set up for their big dinner for the visiting doctors from Cuba that helped them out a few weeks ago as well as for a few nuns that have been very helpful to them while they’ve been in Chicaman working on their building project. We had quite a feast and I was glad to be invited and even happier to help out a bit since I would be eating some of their food. I didn’t do much to help in the way of cooking because Nicole had that under control. She is an amazing cook and we had so much great food the entire night. Miny and I mostly helped out by putting last minute touches on salads, cutting meats and washing the dishes. The four of us worked pretty well together in the hour or so before the guests arrived. Here’s what ended up being on the menu: vegetable and chicken skewers, tomato & avocado bruchetta, roast beef, meatballs, chicken stuffed with ricotta, spinach and mushrooms, twiced baked potatoes, macaroni salad, tomato and olive salad, pastel de tres leches, and tirimisu. Everything was delicious and above all, we all had great conversation the entire night. I even got to chat a bit with the doctors from Cuba. Not much more than a short explanation of what I am studying, how much longer I have to study and what I maybe want to be when I finish school. Needless to say, I was pooped at the end of the day and crashed right when I got home.
Monday, I went to the clinic in the morning and apparently the director only wanted me to observe in the Emergency area of the clinic. So, I went to the Emergency area and there was a nurse on duty and basically it was his job to triage those that presented to the Emergency room and decide if the doctor really needed to see them. It was different than last week because this week I guess there is only one doctor in the clinic each day and he/she sees normal patients during regular hours and then tends to the Emergency area at night. Anyway, not very many Emergency patients came in to the clinic but one very interesting case did pass my way. A woman came in with an infection underneath her thumbnail. It seemed very painful and you could even see the pocket of pus underneath her nail. Without calling the doctor to help or consult, the very experienced nurse, drained the puss and when he wasn’t quite satisfied with the results, he proceeded to numb her thumb and remove the entire nail. It was pretty grotesque but cool at the same time. I was just surprised at how much the nurse did without even consulting the doctor. It was definitely more time efficient but such a 180 from the system in the US where every move has to be ordered by a doctor. That was the most exciting part of the day. A few other patients came in for fevers and/or infections but the doctor was never called to consult on any of the patients that came in during the morning. I was debating whether I should stay for a longer period of time or come back after the lunch hour but after spending most of the morning twiddling my thumbs and not really understanding much of what the patients said to the nurse, I figured a better use of my time would be getting myself organized for my departure and having conversations with the Martinez family to improve my day to day Spanish. The rest of the day was pretty boring and I spent most of it relaxing and finishing my book, Devil in The White City. I also spent a bit of time going through flashcards and trying to learn a few new vocabulary words. Now that my time is almost up, I have realized that I should have set a goal to learn at least 20 new words each day so that I could have built a larger vocabulary. Hindsight is 20/20 right?
Centro de Salud in Chicaman
Emergency area in the Centro de Salud
Tuesday, I went back to the clinic in the morning and it was pretty much the same story. The nurse triaged any patient that arrived and then decided if the doctor was needed. However, the nurse on Tuesday was a younger man and he called the doctor a few more times than the nurse on Monday. Two interesting cases came in on Tuesday. One man had cut his thumb with his machete and the nurse had to stitch it up. I think he may have nicked an artery when stitching up the cut because it really wouldn’t stop bleeding after he finished putting in the fourth stitch. However, I can’t say that I’d do any better than he did. It definitely made me realize that I need some practice in suturing and other procedures before starting rotations next summer. I’m going to have to be a bit more forceful at my preceptor’s office and ask to get more involved in treatments and procedures. The next interesting case, was a mother and her 12 day old baby girl. The mother and baby came in for a post-partum check-up and it turns out that the baby had lost weight since being born and the mother was septic because she hadn’t changed her undergarments often enough since giving birth and she had not been walking around enough to get her body back to its normal shape. Both were referred to the more equipped hospital in Uspantán about 6 miles away. The mom was also started on IV antibiotics before being taken to the hospital in the Chicaman Ambulance. Having this short glimpse into the world of Guatemalan medicine, I am really interested in coming back to do a rotation here or in a similar area. Again, my afternoon was fairly boring. I did go running again in the late afternoon and went a bit farther than on Sunday. Down the mountain and back up, walking again up the steepest parts. Overall, I felt good but at the end of the run started to get a strange muscle spasm in my back and realized it was because I ran too soon after eating a very large meal.
One of the greatest things about being in Chicaman is the food and sitting down to eat lunch every day. It is their biggest meal of the day and I love it. Monday we had chicken stir-fry with noodles, Tuesday we had baked barbequed chicken with rice and vegetables and today, we had beef, soup, and a huge assortment of vegetables. I am still full from today’s lunch.
Back to my update from Tuesday…after my run, Sergio took me to see Jeni and Juan’s house on the family property outside of town. I’ll let the pictures speak for themselves but this was an absolutely beautiful location and the house was very cozy and I’m sure, a very good place to be while Jeni and Juan were living in Chicaman with their four children.
View of the cornfields and Martinez land from Jeni and Juan's house.
After getting back from our trip to Casa de Jeni y Juan, we ate a light supper and then sat and chatted for quite a long time around the dinner table. I actually got into a long medical conversation with Sergio and pulled out my Netter’s Clinical Anatomy book that I brought with me. For any of my fellow med students who are reading this, no, it is not the big Netter Atlas. It’s a different book that my PCB preceptor bought for me while I was in Cherokee, IA. I was starting to doubt why I decided to haul it along with me but it came in really hand for the conversation last night. I enjoyed talking medicine and trying to impart knowledge that I gained during the last year. We joked a little about how I know enough to know that something is not right but I don’t know yet how to diagnose or treat anything. Sergio told me I’m not allowed back to visit until I know how to treat and cure his ailments, haha.
As for today, it was a day of organization. I did my laundry, checked e-mail, sorted through my luggage and tried to eliminate any unnecessary items. I will probably dump more stuff when I depart Lago de Atitlan for Guatemala City but for now, I gifted some toiletry items to the Canadian couple and threw away a pair of my cheap flip flops because I have plenty of shoes to wear for the rest of the trip and they were pretty much worn out. Of course, I knew when I was packing that I probably wouldn’t need all of the clothes I packed. However, I convinced myself that it would be okay and I should just pack them anyway since I had the space. Now, I’m regretting that decision. I’m running out of room and will have to be very crafty in order to fit all of the wonderful gifts I have purchased (and will purchase in the coming days) for family and friends. I might leave behind a few clothing items that I don’t want anymore but we’ll see. I’m not so much worried about everything fitting since I’ve become quite an artist at packing my bag, I’m more worried about how much my luggage will weigh!
Today was also a day of baking with Miny. We made angel food cake and then also successfully made Grandma Mullen’s homemade mayonnaise. The first and only time I’ve attempted to make homemade mayo, it didn’t turnout quite right and I wasn’t sure why but when making it today, I realized why. The recipe calls for mixing the ingredients in a double boiler. Well, the first time I attempted to make the mayo, I started mixing the ingredients in the double boiler while it was hot. It turns out that when you put egg yolks into a hot container before you have mixed them with the necessary ingredients, they cook and turn into little chunks. Sometimes, it’s hard to believe that I have a chemistry degree. This time around, I mixed all the ingredients first and then put the pot in boiling water to cook slowly. It turned out really well, although I might have used a little too much mustard. I’ll experiment with it the next time, whenever that may be. Miny liked both the cake and the mayo so much that she wrote down the recipes and I told her that I would send her a proper angel food cake pan when I get back to the US. We used a bunt cake pan, which ended up being a little too small so we put the 2nd half of the batter into a normal loaf pan. The resulting cakes were wonderful but the one baked in the loaf pan ended up a little flat. The taste was the same though.
Table is set for a small dinner of sandwiches with cake and coffee for dessert.
Eni, Andrea, Me and Magdalena in the kitchen of Eni's house.
Mini and I after our successful day of baking.
Nick and Nicole came over for dinner and cake. We had sandwiches made with toasted bread, ham, tomatoes and the mayonnaise. Everyone really liked it and I’m quite relieved at that. However, some may have just been humoring me. One of Eni’s employees from the gas station comes to the house for lunch and dinner every day and he was at the table when we sat down to have our sandwiches. I asked him if he wanted to try the mayo and he said sure but I don’t think he really cared for the mayo. He said it was good but just a bit different for his tastes. At least he was honest, haha. I realized tonight that the mayo is more like a honey mustard sauce than a mayonnaise but delicious nonetheless.
As of now, I am packed and ready to head out tomorrow morning. Sergio is going to bring me to Uspantán and from there I will catch a mini-van to Quiché. From Quiché, I will take a chicken bus to Panajachel and depending on when I arrive, I will either take a boat across the lake to San Pedro to stay there for two nights or stay in Pana for one night and head to San Pedro early the next day. Boats stop running across the lake around 6:30pm. So, it all depends on when I arrive in Pana. After San Pedro, I will head back to Guatemala City to meet up with the grandparents of Andrea (Eni’s Daughter) who have graciously offered to let me stay with them and show me around the city a bit. Also, I will hopefully meet up with one of my former students who is now living in Guatemala City.
My trip is coming to an end and before I know it, I’ll be on a plane back to the US…sad but necessary as I am sure I have loads of errands to run as soon as I get back to Omaha. I’ll cross that bridge when I get to it :-)
Hasta luego gente!
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