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The Call of the Gecko

Fun Fact: Did you know that one of the most prominent mountain peaks in Central America is located in the coastal region of Honduras?  It's not one of the tallest, those are primarily volcanoes in Guatemala and Mexico, but it is striking in that it is within 5 miles of the Caribbean coast yet the summit is over 8,000 ft. above sea level. That's a pretty dramatic and sudden change in elevation as it rises straight out of the coastal plain, and it's quite an impressive sight. 

I'm currently sitting in the airport in San Pedro Sula awaiting my flight to Atlanta. It's so hard to believe that this month is drawing to a close. It was a busy week in the clinic. I treated a 2 year old with a fairly rare inflammatory kidney disease that makes him swell at random intervals. His little face is so puffy that he has a hard time opening his eyes all the way. He's very anemic and his lipids are seriously out of whack, but he keeps running and playing and babbling away. And thankfully the treatment is relatively simple - a good long course of steroids. I saw my patient with a non-healing wound on her leg that I've been treating every week. It's responded well to the antibiotics and wound care regimen we've started.  It's at a point that we can start spacing out her visits.  I was sad to tell her that I wouldn't be there next time she comes.  I treated a deaf and mute lady with stomach issues (took a lot of gesturing to get that across, but thankfully she wasn't alone) and a teenager who is mute due to a cleft lip and palate, though at least the lip is repaired.  I admitted a lady with presumptive meningitis - presumptive because we don't have the resources to get labs over the weekend and no ability to grow bacterial cultures. But she's improving with treatment, so hopefully clinical suspicion is sufficient. 

I had a Canadian patient this week, too. Evidently there is a beachfront community of Canadians, mostly from Alberta, in this very rural area. I mean, it's about an hour on a rough and rutted dirt road to the nearest gas station. Seems an odd locale for retirement/vacation homes, but whatever floats your boat!  Then again, I've never been to Alberta...;-)  They were very sweet, and pretty scared given he had a fever to 103 and felt miserable. I just knew he was gonna have malaria, but it turned out to be a kidney infection. We talked about hockey (I'm a Blackhawks fan, they pull for the Flames) and I got him feeling better in time for his 60th birthday midweek. There were fireworks I could hear from my apartment. 

We had a lady come in who delivered her baby at home, but then the placenta wouldn't come. This was her 11th baby. She started walking from her home in the mountains at 8:00 at night and reached the hospital at 3:00 AM. The placenta was extracted pretty easily and the baby looked pretty good, though it did have a bit of an elevated temp.  Once it was light she was ready to take her baby and start the trek back into the mountains. The next night a 16 YO girl who was 28 weeks pregnant took a bunch of pills to cause her to abort. She was in labor and her water had broken, but the fetus looked good on the monitor and even if it weren't a mission hospital, that's pretty late to perform an abortion. She got some steroids to aid fetal lung maturity and some magnesium to stop contractions and was shipped to the hospital in the city since it has a NICU. Who knows how that situation will turn out.  So sad. 

My evenings were pretty full with dinners at various folks' houses, movie nights with the med students and others, interspersed with call. One evening a group of us went to the nearby town of Rio Esteban for dinner. Rosie has a restaurant of sorts (if you call a couple days in advance she'll make a meal for ya) on the beach there. We ate traditional Garifuna food - conch soup with a coconut milk base, lobster and shrimp caught that day, rice and beans (kinda like red beans and rice), chimol (kind of like a cross between pico de gallo and seviche), plantains, and cassava. We sat in a shelter on the beach and watched the sunset while we ate the best seafood ever. It was pretty awesome.  

I made it back down to the beach again for a late afternoon and sunset. This time the surf was astounding!  It was more like the Pacific than the Caribbean. Finally saw the toucans - such improbable birds. Also lots of creepy-crawlies - tarantulas, snakes, rhinoceros beetles the size of my hand, and lizards in addition to all the flying insects around and myriad species of ants. I didn't realize until this week that the loud chirping in the house at night is the geckos.  The weather has been consistently sunny and increasingly hot, though there has been a nice breeze at night.  Once it gets dark and you get away from the lights (which doesn't take much) the stars are ridiculous!  I don't think I've ever seen so many. Orion, Sirius, the Big Dipper, Cassiopeia, and so many others I couldn't begin to name. The last few nights there's just been a sliver of waning moon and it's been breathtaking. 

I am loathe to leave my new friends at the hospital. During clinic days whenever there was a lull I would hang out with the girls in the lab. They showed me how they did the various tests, let me look at any cool microscopic findings, and generally chatted with me (patiently accommodating my Spanish skills). On my last day they gave me a card. The cards are made by another lady at the hospital who I spent time with, Digna. She works in the office and is paralyzed due to a gunshot wound she sustained 9 years ago. She lives in the nurses' dormitory and tries to stay busy making crafts. She is very sweet and very lonely. She is hopeful that she'll get the opportunity to do some physical therapy soon, but it's been a long time since her injury. The other staff and nurses and docs were all very kind and from very diverse backgrounds. I greatly enjoyed spending time with them.  I'll also miss the sweet people I met at the community church. 

I'm heading home now with my heart full.  I hope to return when I get a chance. I'm trying not to think too much about all the stuff I have to tackle when I get home so I won't delineate it here, but it feels like a lot.  It's so important to regain focus and get back to the simple reason I do what I do. I really hope that I can hang on to that sense of purpose as I get back into the routine and complete this stage of my training. 



( 9 comments — Leave a comment )
Feb. 27th, 2012 01:29 am (UTC)
Again, so terribly jealous. Sound like it was fantastic! (especially the stars - I'm going to have to go camping this summer, just to see that!). And I hope it goes well when you get back home.
Feb. 28th, 2012 03:21 am (UTC)
Thanks, dear! Every time I go somewhere I can actually see the stars I get inspired to actually learn them.
Feb. 27th, 2012 02:35 am (UTC)
Wow, amazing. I can't believe the month has gone by already. Hearing about your month has been fascinating, thanks so much for sharing it.
Feb. 28th, 2012 03:21 am (UTC)
Thank you for sharing the journey with me. :-)
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Feb. 28th, 2012 03:22 am (UTC)
Thanks so much, dear. :-)
Mar. 1st, 2012 12:28 am (UTC)
So sad that it's all come to an end...but it seems like you a had an personal adventure and also helped some v.needy people in the meantime! An excellent combination! Well done!
Mar. 1st, 2012 10:39 pm (UTC)
I know. :-( But it was indeed an adventure! Thanks for coming along with me! :-)
Mar. 1st, 2012 11:59 pm (UTC)
I enjoyed it v.much so thank you!
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Mar. 1st, 2012 10:40 pm (UTC)
I wanna go back, too! Thanks for sharing the journey with me! :-)
( 9 comments — Leave a comment )