T-day 2008!

I've finished my last full week at the Hospitalito! The time has flown by (mostly) :) Last week was a blur: clinic on Monday and Spanish class, on call on Tuesday, slept on Wednesday and got sick enough to actually not even go to work on Thursday, T-day dinner that night which I unfortunately couldn't resist, and clinic again yesterday with Spanish class and a B-day celebration afterward (complete with pinata!). Some disconnected musings:

1) Thanksgiving dinner was very impressive. Traci and her husband Jared, who are volunteering here in Santiago for a year and are the 'Mom and Dad' at Las Milpas where most of the Hospitalito volunteers live, cooked up a storm! (Here is their blog.) They even got a turkey! Someone who recently came down also brought canned pumpkin and cranberry sauce :) Different people made their favorite T-day foods which were fun to try, and I made an apple crisp (thanks Anne and Stephen for the recipe!) which was a hit. All things considered, it was an excellent T-day (besides the being sick part), but it certainly did make me miss everyone at home! Here is a picture of the feast:


2) Last night we watched the movie 50 First Dates, a romantic comedy with Adam Sandler. It features Drew Barrymore who, a la Groundhog Day, can't remember anything day to day. Now, she certainly 'lives in the moment', but that phrase must mean something different from the inability to make new memories. Any thoughts?

3) Today I finally felt well enough to have a piece of pineapple. If you are not already familiar with my attachment to fruit, suffice it to say that I adore and crave it probably as much as chocolate. Well, I guess I chomped down too hard on my fork. Here is before and after:

I had a little filling between my two front teeth that is no longer there! It is kind of funny because a similar thing happened to me in Morocco when I was very excited about eating salad. I bit down too enthusiastically on the fork and chipped my tooth. Coupled with the GI distress I seem to be prone to acquiring, the tooth problems make me think that perhaps fruits and veggies are a true menace!

4) Today a veterinarian came to town to fix dogs and cats. Some of the other volunteers were saying that it is a lot more efficient in terms of 'family planning' to fix a male dog or cat. I'm not sure if I lost a bit of brain when the filling between my two front teeth came out, but I can't seem to understand. Of course I understand that gestation takes time and so that in one year a male could father many litters. However, as far as I learned in the 80s in school, each baby needs a mother and a father -- so how can it be more efficient to neuter one versus the other? If there are, for example, 2 males and 2 females in the entire population, how does better control the population to neuter one male versus one female? Please please explain this in a way that makes sense. It is driving me crazy.

5) I've been busily making plans for the next month or so. On Tuesday I'm heading up to Tikal, and on Friday to meet Chris, Chad and Laura in Belize. We'll be there for a week with part of the time on the beach :) After that I'll meet my mom in Mexico City for 9 days!! I'll work my way back South stopping at San Cristobal de las Casas and stay back here in Santiago Atitlan over New Year's. Jess is coming to visit from the 5th to the 12th and we will have a few glorious days in Guatemala before I come home. I'm not sure how much I'll get to blog in the next few weeks, but I will take some pictures and post them later ... I hope that everyone is doing well and I would love to hear from you :)

Comfort

Yesterday a very surprising thing occurred. Someone dropped off my package! Thank you very much Gary and Sue :) I am currently enjoying butterscotch krimpets (Tastykake), cinnamon tea and sitting in bed writing by the light of candles as well as the glow of my computer screen. What a treat to be able to do this, and at 7PM none-the-less ...

Travelling Across Lake Atitlan

Yesterday we went to Pana in the morning and did touristy things until about 2PM. The day after that point was quite terrible but before I tell you about it I want to show you a painting I got from a gallery/meditation garden/workshop of a Mayan painter from Panajachel. We had a wonderful tour by the artist's wife and one of the many bizarre things we saw is this cow/monster painted onto the natural face of the rock. I see an elephant in the picture that I got, but what I like most is that it reminds me of this wonderful museum/studio.


Well, then we went to lunch which was lovely until we received a phone call from the Hospitalito. I was with a family medicine doc, a pediatrician, the volunteer coordinator and her husband. The information we got from the hospital is that a boat had sunk in the lake, and there were about 12 people on board some of whom had died before being rescued. The survivors were being brought to the Hospitalito but there were only 2 people working at that time: one doctor and one nurse. We were called and asked to come back immediately.

The ride over to Pana had been a little rough, but to be honest I didn't think it was that bad (compared to going to San Pedro on Tuesday). But sometimes the wind does pick up in the afternoon and with it the waves as well. So we had a bit of a dilemma because we could either take a big, slow and perhaps safer boat back or take a small, fast and perhaps less safe boat back to Santiago. In the end we hired a small boat just for the 5 of us and made sure there were enough life jackets (which we all wore). It was, to say the least, a nerve wracking 30 or so minutes. We saw from the boat that there were about 100 people or so all crowded at the boat dock where we later learned two bodies had been taken to shore.

When we arrived at the Hospitalito there was one French woman who was hypothermic and had aspirated quite a bit of water. I think that her husband had died shortly after arriving at the Hospitalito. I don't want to say too much more to respect their confidentiality, but here is a link to a news clip about the accident. The Malaysian archbishop also died in the accident. Apparently this was the first accident/drowning in 7 years on the lake. We ended up stabilizing the woman and transferring her to a private hospital in Guatemala City. Riding in the back of the ambulance on Guatemalan roads through mountains was, well, not easy on the stomach. It took a little bit over 3 hours to get to the hospital, but it seemed like a very good hospital where she would be in good hands. Here is a picture of Jen (family medicine doc) on the way home in the ambulance. I slept (quite soundly) on the floor of the ambulance on the way back and didn't wake up until we arrived back at the Hospitalito around 2:30AM.

I've thought a lot today about the accident, the people who died and their families. It is still a shock that something like this could have happened. Hundreds of people travel in these boats across the lake every day. I travel in these boats several times a week without ever having seriously considered that something so awful could happen. I did go out on the lake today in a kayak, but stayed very close to shore and wore my life preserver. Apparently the passengers on the boat were urging the captain to go more slowly or turn around but he didn't listen. I believe he is currently in police custody. Supposedly it might be safer for him with the police as I've been told that the community sometimes takes justice into their own hands.

Well, I think that is enough to report for one entry. Today Lago Atitlan, supposedly one of the most beautiful lakes in the world, feels to me like a monster.

The Home Stretch at Hospitalito!

Well it is 8 PM Friday night and I am finally relaxing in bed. It has been kind of a long week; I worked 7AM Monday to 7AM Tuesday, 7AM Wednesday to 7AM Thursday, Thursday afternoon and all day today. But, both call nights I got quite a bit of rest and I had Tuesday off. Let me share with you some of the week:

Monday: I got to catch a baby! Mom had a post-partum hemorrhage which was kind of scary but bimanual pressure on the uterus (one in one out) actually seemed to help stop the bleeding. Later in the night there was a woman who had a spontaneous, incomplete abortion at 9 weeks. She has 5 kids already but this was her 2nd in a row and needless to say it was tough.

Tuesday: This was the last week of one of the volunteers (Camilo) and so I tried to go with him to the lake-side town of San Marcos. However, the lake was so rough that not very many boats were running and as it turned out the first boat ride to San Pedro was more than enough for us. I felt pretty sick but was kind of relieved to see that the Guatemalans on the boat also looked scared and sick. I'd rather be vindicated but unsafe rather than wrong and safe! So Camilo and I spent the day hanging out in San Pedro. We at a lot:Luckily the boat on the way back was less terrifying and as an added plus the sunset was gorgeous. Here I am at the front of the boat and also a view of Santiago from the lake:


Wednesday: On call again. A 13 year old came in unconscious and having vomited blood. She had a blood glucose of 11 (very, very low). The family said that this happened all of a sudden. They were convinced she was going to die and wanted to go home rather than be transferred to another hospital. After quite a bit of convincing (during which time we couldn't get any other blood work because, among other things, the person who processes labs was sick), the family agreed that she could be transferred to Solola, about 2 or so hours away. Well, she made it to Solola, and they were working on transferring her to Guatemala City when she died. The thing is that she started kind of making sounds after we gave her some dextrose (sugar) ... I guess as is often the case we will never know what happened.

Thursday: I spent the morning getting my travel plans together for the remainder of the trip. I feel very good about having gotten my tickets (first Tikal, then Belize with Laura and Chad and Chris, then Mexico with my mom, then St. Cristobal de las Casas, then back to Guatemala for travels with Jess). In the afternoon I went back to the hospital to do prenatal clinic, and had dinner with the other volunteers because it was Camilo's last night here. We had a delicious zucchini quiche and carrot cake for dessert.

Friday: Clinic was super busy this morning but quieted down in the afternoon. Class with my Spanish teacher was good today. I've been having a 2 hour lesson about 3 times per week and I think it is helping (finally). I also got a phone call from my host mom that they picked up the package in Guatemala city. I think that is what the message said anyway :)

Tomorrow we are planning to go to Panajachel which is the most built up town on the lake. I hope that the lake isn't too rough (there were actually white-capped waves the other day when we went to San Pedro). I think that we're going to make a T-day dinner and need to pick up many of the ingredients. Is everyone looking forward to Thanksgiving??

Guatemalan Post System

This will be a quick post, but I just want to find out what you think about the following:

I have received one very nice package with cookies in it without a problem (Thank you Gary!!).

However, last week I got a letter from the post office saying that I had to call them because there was a package for me in Guatemala City. My host mom called for several days and finally talked to someone who said I had to go to the post office here in Santiago and pay about $15. So, I made repeated attempts to go to the post office which has no posted hours and is rarely open. On my 5th attempt I was able to talk to the postman who was quite surly and said that I had to come back not only with my passport and the money but also with the letter advising me of the arrival of my package.

I asked him why there was this extra charge whereas in the past I had received a package without having to pay extra. He had no answer.

The thing is that I don't mind paying but I feel like it is just a bribe of sorts and I really didn't like this guy at the post office. My host family is going to Guatemala City this weekend and they said they might be able to pick it up from there.

So, should I just suck it up and pay and try not to role my eyes and sigh with exasperation too much? I will be interested to hear your opinions!

Sick :(

I just would like to take a moment to complain that I am sick of getting sick. You can't really go anywhere or eat anything. All I can say is hostile microbes of my GI tract beware. Your days are numbered. (I hope.)

In other news, clinic Friday was quite busy. The exciting thing for me is that there was a chart with a post-it note on it that said "Rebecca," which indicates that this patient actually wanted to come back and see me in particular again :)

Random Pictures and The Summit

The hospital: the laboratory and wash area for patients and families (no food is provided).




















Pictures from Volcan Pacaya (the hike we went on from Antigua) where there was real, live flowing lava. This is actually a view of another volcano that frequently sends off plumes of smoke.
































Before I describe the ascent of Volcan San Pedro, I'd like to report what I considered to be a frightening experience. It happened while I was on call last night. The Guatemalan doctor I was on call with was busy taking care of a patient with 2cd degree burns on his arm (the burns had occurred about 5 hours earlier but he had to keep working at the bakery until he arrived around 10PM to the hospitalito). Anyway, two women rush in and say there is an emergency but that the patient can't walk so can't make it in the hospital. An unconscious patient is embarrassingly enough already enough to freak me out. So somehow they carry in the patient -- woman, mid 20s -- while I'm trying to remember how to assess her. For some reason Dominga, the doctor on call, was not at all frantic about this and didn't even really move much from the burn patient. Anyway, the unconscious patient was found this way in her house and apparently something similar has happened in the past. She wasn't responsive to questions, but her vital signs were just fine. Finally, vigorous sternal rub produced some response. I couldn't ascertain any medical history and as it turns out she and her family agreed that it was an 'attack of nerves' brought on by her husband coming home drunk and fighting with her. So basically, all this to say she just fainted. Dominga and the nurse said that this happens quite frequently to women here in Santiago and that is why they weren't really concerned. Well, now I know.

Luckily the rest of the night was uneventful and I got plenty of rest because this morning we headed across the lake on a 7:00 AM boat to San Pedro to begin the hike up the volcano.We rode in the back of a truck to the entrance to the park which houses the volcano and arrived around 8. It was overall a rewarding hike but quite strenuous. We went with a guide (and there were armed police kind of trailing us). The guide wanted us to hurry up and get to the top because the cloud cover obscures the view in the afternoon. I was more of a slow and steady hiker which was good because otherwise I don't think I would have made it the 2-3 hours up the mountain. I don't that switch backs have really made it big here in Guatemala. The peak is at around 3000 meters, but the start of the hike is not at sea level. Never-the-less, it was more than enough for me! The view at the top was indeed mostly of clouds and not of the entire lake region, but by that time I was just happy to have made it :) The hike down was blissful by comparison to the way up.

After the hike we ate lunch outside overlooking the lake and then I got chocolate cake. Yum. I am currently working on the idea that I should shower before crawling into bed (it being 6PM and all I don't want to delay it any further)! Just one more day of work and then the weekend :) I am almost at the half-way point of my journey and am looking forward to coming home and seeing everyone again!

Ridiculously Relaxing Trip

So, for numerous reasons, last week was quite stressful. Not to worry! Just two boat rides away from Santiago is Paradise. Let me show it to you:This is Casa Del Mundo, a hotel in Jaibalito which is pretty much as close to Paradise as I've been recently :)

Thursday night I had call (which was relatively uneventful) and on my way home Friday morning all I could think about was going away somewhere. There are two great places to stay here in Santiago, but I wanted a complete change of pace. So, I went off to Jaibalito, by way of San Pedro which is another village on the lake. Actually on the boat to San Pedro I ran into someone who used to live here at the house with me. I had a snack with her and her friends in San Pedro in a bougainvillea covered veranda overlooking the lake.

Here is a map (North is Down for some reason) of the lake. The place I stayed (Jaibalito) is so small that it isn't on this map. It is between Santa Cruz and San Marcos I think. Anyway, when I got there I was a little bit desperate for R&R and found my way quickly to Volcano Lodge.

The first wonderful thing about Volcano Lodge is that there is a beautiful garden all around the cabins. The second wonderful thing, which I didn't find out until later, is that there is HOT HOT water in the showers which is something not to be found where I am living in Santiago. I took two 20 minute showers in 2 days which is a record for me as I generally find bathing about as much fun as going to the dentist. I went down to the lake to swim and read for the afternoon and finished my book (Veronica by Nicholas Christopher, entertaining and fanciful but not superb) which I was able to trade in for a new one at the hotel (Golden Country by Jennifer Gilmore, Jewish family saga from 1920s-1930s centering on what it means to be successful). Dinner came in 4 courses and I sat with an interesting couple who live in Guatemala City. He: American, used to be in the military, now working at the embassy and for NGOs. She: born in Guatemala City, quite Evangelical, was the head of a family planning organization in Guatemala.

Unfortunately that night I didn't sleep very well -- fevers, chills etc -- which I took as a sign not go climb Volcan San Pedro the next day. Instead of going home to get my hiking boots and meet up with the other people going for the hike, I went to the other hotel (Casa del Mundo) and spent the night there. I didn't take full advantage of the views and location as I slept for a good bit of the day, but I was super happy to be there every time I woke up and realized where I was. I skipped dinner secondary to GI distress (seems to be a dependable part of life here) but breakfast this morning was delicious!! I hung out with an American woman who now works in Antigua (Guatemala) for a while and we went to a nearby restaurant for coffee. You sit and drink coffee and look out over the lake with the volcanoes in the distance. All I can say is WOW!

On my way back to Santiago I walked around San Pedro again, this time through the marshy/forresty/hippy part. I got 2 new books which is very exciting: The Kite Runner (which I have glanced through before but never slowly and completely read) and Mirrors of the Unseen (Jason Elliot, about Iran). I know Isabel Allende or Marquez might be more relevant :) The guy who ran the bookstore was fun to talk to -- he is currently interested in ethnobotany/space cookies.

Anyway, I'm back now in Santiago and am ready for another week! I feel quite refreshed :)