Every day is a school day

Last night I went to a lecture on the State of Healthcare after the election. Wow. Big topic. Back to that in a moment.

From the moment I started medical school people have asked me questions about EVERYTHING. I was warned that this would happen but didn't realize how quickly it would happen or how many different subjects I would be expected to be well versed in.

What do you think about health insurance?

Do you want to open your own practice? (aka do you want to start your own business)

How do you feel about charter schools? Public education? Health education?

Do you think that malpractice lawsuits should have caps?

This is where I remind you that I went to medical school. Not law school, business school, an education program or a public policy program. I do not know anything about these topics but I am somehow asked questions about these things all the time. This became a huge issue during the Accountable Care Act debacle and the more recent election where I was suddenly asked for my "professional opinion" about these issues. I can give you my professional opinion about flu shots (get one) and how much juice your kid should drink (4 oz) but when it comes to all this other stuff I'm just as lost as the next person.

One of my dearest friends has just embarked on her journey of "civicization" where she intends to learn more about how to be an involved and active citizen. Join her journey here: http://civicization.com.  This has inspired me to try to learn more about what it means to have a "professional opinion" in my profession. Hence my attendance at this lecture.

The first thing I noticed was that there was only one doctor on the panel. One doctor to represent the profession in a lecture on the future of our profession. This is a trend that I've noted in a lot of debates on the subject of healthcare - there are no doctors there! The future of our profession is being dictated by people who are not part of it - which, in my opinion, violates the definition of a profession. This is a larger issue and unfortunately I have no real answers at this point but I hope to keep working to find a balance between taking care of my patients and learning how to advocate for them and my profession throughout my career.

Every day is a school day.

Privileged

Privilege means a lot of things to a lot of different people. Today I reminded what a privilege I have to be involved in people's lives at a time when they are changing.

Today I was covering the hematology/oncology inpatient team while the interns are on their retreat. One of our patients was diagnosed officially with leukemia today and I was privileged to be present at the family meeting where this was discussed with his parents. I cannot even imagine the mind numbing quality of this news - your perfect child has cancer and we are going to start chemotherapy tomorrow. This time last week he was at home playing and being a normal kid. He is, of course, still a normal kid for all intents and purposes, but his path and his story are now completely altered. And there I was. Just sitting there, watching, allowed to be present.

Being present at this kind of meeting is one of the "hallmarks" of being a doctor - the famous "how to give bad news" event. Remember to pause frequently. Follow the parents' lead. Don't give too much information. Don't shy away from the scary words but always leave hope.

Today's conversation went about as well as one could expect it too and I went home today wanting to call everyone I know to tell them how much I love them. Today is the first day in a new journey for this family and I wish them nothing but blessings from here on out.

It continues...

So I was talking to my amazingly wonderful friend, Justine, the other night about her new blog. To start with, it's amazing and everyone who might read this blog should read it - http://lostonholiday.wordpress.com/

As we were talking about her starting out, I realized how much I miss writing on this blog and realized that my meducacion is far from over and I still have plenty to write about here in the good old USA.

Pop quiz, hot shot

Wish List

For my final days in Nicaragua I am running around trying to fulfill the wishes of the amazing people Ive worked with at the hospital. The head of nursing for pediatrics gave me a wishlist, which I was able to fulfill using money graciously donated by an anonymous donor and a member of one of the church brigades. So far I was asked for

1. An electric double burner to boil water (This purchase has answer my mother´s constant question "How do you have a hospital if there is no hot water?!")
2. Pots to boil said water
3. Standing fans to keep the patients cool
4. Pitchers of water to store boiled water

The residents will give me a list this afternoon. I am amazed at the simplicity of these requests and so happy to be able to provide these small conveniences. 

Heroes y Martires

Today at 9am (which really meant 10am) the entire hospital took a two hour break from work to celebrate the life of Dr. Oscar Danilo Rosales Arguello, for whom the hospital is named. El doctor was assasinated fighting for the Sandinista revolution again Somoza and today is the 45th anniversary of his death. There were lots of speeches about Dr. Rosales and some history about the war followed by about 30 minutes of songs supporting the current political party, the FSLN. While some of us go back to the wards, there is a large group of people going to visit his grave with snacks in hand. I didnt realize how many songs there could be supporting a political party. Are the Republicans singing songs today? I think they do it better in Nicaragua...

3 days until I´m home... hard to believe it.

Contact Precautions

 

I cannot believe that this is my last week in Leon. I spent the weekend relaxing at the beach and catching up on some reading and then it was back to work today.

Pictured above are two patients who have been on the Infectious Disease service for two weeks. They both have significant underlying diseases that leave them without good immune systems and are hospitalized for more acute issues.  Right next to each other. Yes. Because of a lack of space in the hospital all of the wards are open leaving airborne pathogens to fly freely around the room. Our kids with hepatitis are kept in another room together but there are no private rooms at all. While I dont think I will ever LIKE putting on yellow paper gowns before entering a patient's room, I am now truly humbled and grateful for their existence.