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Quito, Ecuador 27 Agosto 2012

I'm sitting at the gate in the airport in Quito awaiting my 11:30 pm flight to Atlanta. It's bittersweet to leave - mostly because I have to reenter my everyday life, but also because I'm really going to miss the folks I've met here. I'm not going to miss weekends of call like the one that just ended, however. I was on call Saturday and Sunday and it was pretty much non-stop.  I got just enough down time to pack my bags between patients.  We had 4 transfers from the public hospital on Saturday - a preeclamtic expectant mom, a guy who got squashed by a tree, a lady with appendicitis, and a guy who got stabbed in the throat. On top of that I had clinic all morning, a delivery mid-afternoon, ER patients at all hours, and the intern was gone all day with a patient transfer to Quito. That left us down a man, and then down 2 when the resident had to go to the OR.  It was insanity!  Then Sunday we got another preeclamtic patient (thankfully after the first one delivered 20 hours after admission), a Shuar man who stroked out (his wife doesn't speak any Spanish), and a steady stream of ER patients - including a 7 year old girl with machete wounds to her hand and scalp. Thankfully neither wound was particularly deep.

The two girls with preeclampsia delivered Sunday, one 20 hours after her arrival and the other about 2 hours after her arrival. Both did well initially, but surprisingly the baby with the easier labor and delivery developed respiratory issues about 3 hours later. We put her in one of the antique incubators with some ambient oxygen and started working her up. She's not working particularly hard to breathe, but drops her sats as soon as you take her out of the box.  I had to leave her in the hands of the team this AM, along with the man with the stroke who will likely be extubated and pass today (he has no reflexes at all...his large family were there and though upset seem to have accepted the situation, and translated for his wife). I said my sad goodbyes, had a couple of rounds of hugs, and got the last of my stuff packed up to hit the road. 

Of course, it's the last week of being somewhere that I finally felt like I had the hang of things - call and consulta and ER, as well the local environs and idiom.  I even got some continuity with my patients - the lady with the brain tumor came back, feeling much better on the steroids; I had some repeat prenatal checks; gave out some good lab results to folks I've been following. All in all it was a very busy but rewarding week at the hospital, even if I do feel as if I left in a whirlwind this morning. 

The week was all sunshine and heat up until the last couple of days which were very, very rainy. The drive from Shell to Quito got progressively dryer. We skirted Tungurahua, the volcano that's been active in the last week with ash and lava flows that blocked some roadways (not the ones we were on), and headed deeper (or rather higher) into the sierra. We passed steep fields with brightly-clothed women crouched to plant seedlings. We passed Quichua women spinning yarn from llama's wool that they carry on sticks and spin by hand as they walk. We passed Cotopaxi, it's snow-covered cone shrouded in clouds, Pinchincha with its jagged peaks resembling a man lying on his back facing the sky.  When we arrived to Quito, quite the bustling metropolis, the driver dropped me off at the Quito mission's guest house for the afternoon. I finally got a chance to shower and take a nap which were both a huge relief. 

Now I'm crammed into a window seat on the runway and just found out that we'll be taking a detour to Miami for fuel before continuing on to Atlanta... *sigh* Anyways, I'll face the future tomorrow. For now I'll just reflect on the adventure coming to a close.  

Strange but True:  We stopped to pick up some lunch in Latacunga.  It was a chicken place called Gus and they distribute plastic gloves with the meal to use to eat.  Eating gloves in a fast-food restaurant.  Makes me think of the Earl of Sandwich...


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Comments

( 3 comments — Leave a comment )
pityparties
Aug. 28th, 2012 05:50 am (UTC)
i'm so happy you had a positive and super productive time, luz. it sounds like it flew by, but
i'm sure it'll stay a memorable experience. i hope your flight is a safe and easy one. <3
f_m_r_l
Aug. 29th, 2012 05:07 am (UTC)
Welcome back.
severina2001
Aug. 29th, 2012 04:34 pm (UTC)
Can't believe that month has gone by already. Hope you had a safe trip home.
( 3 comments — Leave a comment )