Wednesday- I started the day with a quick breakfast before heading off to the bus stop to meet Lauren around 7:20. We hopped on the bus headed for Colonia Estrella, and 20 minutes later were deposited by the cancha de baloncesto near El Centro de Salud Lomas de San Jacinto. When we got to the centro, we learned that Dr. Cipriano was not there. So we split up and spent the rest of the day with a couple different doctors. I was paired up with Dr. Felipe. He was a young doctor, likely in his very early 30's, who had been practicing for 5 years at the clinic. The majority of the patients we saw were either pregnant women (embarazadas) or children suffering from desnutrición (malnourishment). I asked Dr. Felipe about the prevalence of desnutrición, and he responded saying it is quite common in the Oaxaca area, especially in the outer pueblos. The outer areas generally have a larger concentration of poor people who are unable to buy the food necessary for an adequate diet. Desnutrición is very much related to one's social class in México. It is a very easy problem to fix, but sometimes the money is just not there to help correct the dietary intake.
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| El Centro de Salud Lomas de San Jacinto. It is open 24 hours and serves many, many people each day. |
- Dr. Felipe was a little bit easier to understand because he talked slower and enunciated a little better than Dr. Cipriano (and I had a day's experience in the clinic under my belt). Dr. Felipe was very good about explaining the diagnoses, and also let me perform some basic clinical procedures, such as taking pulses or examining wounds. But probably the highlight of my day was the opportunity to help determine the orientation of a woman's baby in her abdomen. I palpated her abdomen and identified the baby's head, back, and feet (with Dr. Felipe's guidance) before Dr. Felipe measured the foco fetal (fetal heartrate). It was really cool for the nerd in me to help determine those features!
- Language class went well, and was followed by dinner at Café Gourmand with Genevieve, Lauren, Sarah, and Shan-Shan. The toasted turkey sandwich met my expectations and then some. I then headed home, but first swung by a puesto in a makeshift market to pick up a delicious dessert: two postres, one with apple filling and the other with a milk-custard filling. They helped to make the walk home pass a little quicker!
Thursday- It was back to working with Dr. Cipriano on Thursday. We did much of the same work from Tuesday, filling out recetas and again performing some basic exam procedures. I again helped to determine a baby's orientation to help find the foco fetal, and I also got to measure the size of the women's belly, starting from the pubis symphysis and measuring to where the "bulge" ended, a few inches inferior to the xyphoid process. Nothing earth shattering, but still pretty cool (and very difficult to mess up!).
- Today was a much better day for understanding Dr. Cipriano. I am now more aware of the way he speaks and have gotten much better at anticipating what should come next. He still speaks pretty fast, as do most of the patients, but I continue to understand more and more. Another thing I have noted from the clinic is the way that Dr. Cipriano connects with his patients. He is very much invested in the lives of his patients when they are in the room. He gives them his full attention and always conducts himself in a way that puts his patients at ease. He has an extremely friendly and likeable personality, and is somewhat quirky with all his sound effects. Nevertheless, I really enjoy working with him! Before we left, he had us answer some questions about our lives, why we choose to pursue a medical career, our motives for coming to Oaxaca, some random odds and ends questions in a little notebook, as well as our contact information to possibly stay in touch. He is such a kind and caring man, and is a great example of what being a doctor is all about.
- Language classes are still just fine and dandy. You might suspect that a language class dealing specifically with grammar to be monotonous, but Manuel manages to keep them fun and interesting at the same time. We are now starting to venture into topics that are no longer review from my high school courses, so the work is becoming a little more challenging, but it is still bearable.
- After class, I hung around the school for a bit before heading off to a going-away party for Sarah and Shannon, two teachers from Chicago that had been staying with my family. After stopping at a little grocery store to buy some snacks to bring to the party, it was off to the bright pink residence home to a few of the students from their school. Their school (Solexico) has a residence with a bunch of rooms, a kitchen, and some common areas for students to rent for their time there. It was a pretty nice residence, and was a great spot to host a last get-together. A couple of their classmates bought some meat from a puesto in the streets, and others brought supplies to make tacos. We set up a little buffet table, and started to chow down. The group was a very fun and eclectic group, with 1 Mexican, 5 Americans, 1 German, 3 Swiss, and 1 Austrian to round things out. The food was phenomenal (lots and lots of pork, beef, and fresh grilled veggies), as were the conversations that took place. It was a fun group, so the game of "Never have I ever" got interesting quickly. It was a fun night and I'm glad I could participate in the festivities.
Friday- Sadly, Friday was the last day of my clinical rotation at El Centro de Salud Lomas de San Jacinto. I had really come to like Dr. Cipriano, and had learned a lot from him in just a few short days. Lauren did not make the journey with me to the Centro today because she was feeling a little under the weather, so I was on my own with Dr. C today. Surprisingly, I was able to understand nearly everything in the clinic, and ask some pretty good questions (or so I thought). One of the clinical highlights was that I prepared an entire patient file, from the patient history to the exam notes to the prescription. It was a small victory, but a victory at that! We saw a few more embarazadas, as well as the first case of cancer. A woman came in with pain in her left arm, and had been to an oncologist, who determined there was a cancerous mass in her upper arm. She was in good spirits, as were her two daughters. It seemed as though they had caught the mass early enough that it wouldn't be too big of a deal, but cancer is still cancer, and can be wildly unpredictable. Best wishes for her throughout her battle.
- Dr. Cipriano again handed his little notebook over to write a final goodbye letter to him. I thanked him for his time and wished him nothing but the best. He was an awesome doctor to observe and learn from. A parting gift he gave to me was a poem from Mario Benedetti, a famous Uruguayan author and poet, entitled "La Gente que Me Gusta" (The People That I Like). It was a beautiful and eloquently written poem written about a certain type of person that is easily likable, the type of person that a person likes. Here is an excerpt that quite honestly, I could not say better myself:
"Me gusta la gente que es justa con su gente y consigo misma. La gente que agradece el Nuevo día, las cosas buenas que existen en su vida, que vive cada hora con buen ánimo dando lo major de sí, agradecido de estar vivo, de poder regular sonrisas, de ofrecer sus manos y ayudar generosamente sin esperar nada a cambio." - Mario Benedetti
To those of you who don't speak or translate or understand Spanish, it goes something like this. He likes people that "are fair to others and themselves. The people that are thankful for the new day, for the good things that exist in their life, those that live every hour in good spirits giving the best they can, thankful to be alive, that smile regularly, that offer their hands and generously help others without hoping for anything in return." This is such a beautiful way to phrase this sentiment, and I couldn't agree more with the message. Dr. Cipriano is definitely a member of the "la gente que me gusta" club. I'm very thankful to have worked with him for the short time that I did, and hope to someday return to work with him again. One of the really great things about the Carver College of Medicine is the global health distinction track they offer. A definite possibility (if I end up at the U of I, who knows) would be to return and work in Oaxaca as part of the requirements to complete the track. Hopefully Oaxaca is one of the approved sites to do so, but I will worry about that at the appropriate time. Anyways, it is safe to say that I had a great and unforgettable experience with Dr. Cipriano.
- After class, Lauren, Sarah, Shan-Shan, and I ventured to a restaurant we had all been wanting to try since we first arrived, La Biznaga. It is a little more pricey (for Mexico, about $100-150 pesos a plate), but it was SO worth it. The food was absolutely amazing. I had a delicious combination of beef, cactus, onions, peppers, beans, and guacamole to chow on. It had a chile con límon seasoning and was to die for! We of course had to get some dessert, so I choose nothing other than the "cinco hermanos," which was a chocolate mousse dessert made with local oaxaqueñan chocolate. Unbelievable tasty! After dinner, I returned home to rest for the big trip day of Saturday.
Saturday
- Today, I went on a huge trip with Dani, Lauren, Sarah, and Shan-Shan covering locales such as Monte Alban, Arrazola, Cuilápam de Guerrero, and San Bartolo de Coyotepec. Monte Alban consisted of ancient Zapotec and Mixtec ruins, Arrazola was an alebrije market, Cuilápam de Guerrero contained an old monastery and church, and San Bartolo de Coyotepec was home to a black clay ceramic making facility.- Monte Alban was first up, and it was quite the site to see. The civilization was abandoned in the 15th century after Spanish conquistadors came and mostly slaughtered the people. Those that weren't slaughtered likely converted to Roman Catholicism (it was either convert or be killed for them). We learned of a game they played to honor their god (a sort of baseball meets handball meets volleyball, it was played with a huge ball that was thought to weigh nearly 4 kg) and saw the ruins of the playing field. There were a lot of pyramid shaped buildings, each with a different purpose. All the ruins were centered on and around a huge plaza on the top of a mountain. We saw an ancient medical school and hospital, various temples of worship, and some breathtaking views! It was a really cool place to visit, and it was very interesting to learn about a way of life and culture that has long been forgotten.
- Arrazola was next on the trip, and was pretty cool in that it included a stop in an alebrije factory. We learned how the alebrijes were made and got to look around their shop to see if any were fit for a purchase. Alebrijes are so cool, and so unique to Oaxaca. They are very intricately designed, and some are really, really interesting. Plants with many hummingbirds sucking up nectar, or a lion chowing down on a deer can be found, all hand-carved out of wood and painted by an artist. Real neat!
- A stop at a buffet was next before we went to an old monastery. It was delicious, and had a table with 7 different oaxaqueñan moles...mmm mmm good! The monastery in Cuilápam de Guerrero was another cool historical site. It was the site where the Spanish conquistadors built over the indigenous population's city to provide a center of conversion for the indigenous peoples. The monastery was beautiful, and had two distinct parts. Building of the complex was started, halted, then finished, over the span of approximately 200 years. As such, the architectural styles vary greatly from the older and newer portions. There was a wedding about to take place when we went through, so it was a pretty busy site, but a great place for a wedding!
- Our last stop was in the city of San Bartolo de Coyotepec to stop by a place where all sorts of ceramics were made from a special clay that turns black upon curing in the kiln. Apparently, only two locales produce this color of clay. Oaxaca is one, and the other is in the United States somewhere. The time of curing also affects the color. 8 hours produces a shiny black, while 15-20 hours produces a slivery black that, while not as aesthetically pleasing as the shiny black, is much stronger. There was a quick demonstration of how the clay was molded into the shapes and how the designs were carved into the pots. Pretty cool to see how their techniques did not rely on modern technology, but tried and true traditions from their ancestry.
- Upon returning to Oaxaca, we observed some talented musicians playing the marimbas, and hung around the Santo Domingo plaza to watch a little bit of a parade going on down the Alcalá. After heading to a café and then to another, it was time to call it a day.
It's hard to believe that I only have one week left down here. I have thoroughly enjoyed my time, and will be sad to leave. I've met some pretty cool people and sparked some neat friendships that I hope continue once I leave. And I've been blessed to find so many people willing to help out and help me learn. La gente que me gusta. There are a lot of them here! But also a lot of them back home. I do look forward to seeing everyone again when I get back. So long for now!
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