I feel well-acclimated to our clinic adventures. It feels very natural to wake up early (my body wakes up by itself now), eat breakfast, and hop a micro to another micro to the clinic. This week I am spending most of my time having direct patient contact. Monday and Tuesday I was assigned signos vitals to take blood pressure, pulse, temperature, and weight of all the patients before they are seen by the doctor. I encountered patients who only spoke Quiche, who could not see well, and one who only spoke Quiche and could not see (her daughter was essentially dragging her around and translating for her). The patients ranged in age from 7 to 70. A few had high blood pressure, all had regular heart rates, and they all weighed less than me except one woman (over 200 pounds). Some people appeared more sick than others. During a lull in the influx of patients, I spent my time with Sarah, the 4th medical student from UVA. She gets to see patients on her own and then consult with the nurse practioner Chery or Dr. Fredy. I worked with her to help translate and hand her supplies as necessary for laboratory tests or exams. Her Spanish is pretty good but she is not always confident or knows the right word. I often repeat what she says in slightly different words to help the patients understand. She lets me listen to the heart and lung sounds and look at patients’ concerns. She is a great resource for answering questions.
Wednesday in Xela, I worked with Sarah the entire day. We saw a wide variety of cases. One of the most frustrating was an elderly man with a cataract. There is a surgical team coming to the Camanchaj clinic over the weekend to do eye surgeries. However, the list is full. He will need to come back to the clinic in a few months to get on the list for the team coming next year. He kept asking us for a medicine to fix the cataracts and unfortunately, the only solution is surgery, which is an option out of reach at the moment. Dr. Fredy gave us the name of another opthomological clinic in Xela but not how much it cost (another limiting factor for this patient). Hopefully, with a low sugar diet this patient will not develop a cataract in the other eye before the next year.
On Thursday, we trekked out to San Antonio again. Luckily, there was a clinic car going out there to bring our temporary doctor. Since Cheryl is back in the States for the next few weeks and Dr. Fredy works in Xela on Thursdays, there was no one to see patients in San Antonio. Dr. Manual lives in Xela so the clinic arranged transportation for him and we got to tag along (awesome!). We left two hours later than we did last week and arrived at the same time. I worked in the patient reception room to take vital signs. I measured blood pressure manually with the sphygmomanometer and took pulse and blood oxygen content with an electronic finger thingy (I do not know what it is called). I also recorded their temperature and current weight. I also taught Candelaria how to weigh patients. She usually works as the receptionist in Camanchaj and Xela but in San Antonio she does patient history. I really like helping her out because she wants to learn and I can practice my Spanish and share what I know. In between patients, I helped translate for Betty, a retired nurse from the States now living in Guatemala to volunteer indefinitely at the clinics. Unfortunately her approach to communicating with the staff is to yell loudly in English. Then they all look at me for help. It was nice to work on my translation skills but a bit awkward to be in the middle of it all. Betty has lots of concerns about the efficiency of the clinic but cannot communicate any of her questions to the staff so they all went through me - questions about lunch, questions about toys, questions about staff family members, questions about cooking. Through this process, I found myself preparing lunch. Maribel, the cook, does not travel with us to San Antonio but she prepared food for us that we need to reheat. Betty asked me where the water was, where the pots were, where the plates were, and was concerned about everyone not eating at the same time. In Guatemala, especially in the clinic, it is customary to eat when the food is hot and you have a break in your work. If you are still working, you keep working and join the table when you can. Betty did not want to offend anyone and serve all the plates pre-served at the same time. I tried to explain my experiences so far and how things work at the clinic but she was interested in learning for herself. Needless to say, we heated up chicken fried steak, veggies, and spaghetti. Tomin bought some tortillas and Victor bought Coke at the tienda across the street. The meal came out just fine and still warm.
Today my experience with Betty made me question why some people come to Guatemala. Don’t get me wrong: it is incredibly wonderful that people are willing to give up the comforts of home and volunteer their time and expertise for people who need it. But … If you cannot communicate with the people, you cannot learn from them. Very few people in Guatemala speak English. The fact that so many do in our clinic is a rarity and some of the doctors and nurses would be lost if those people were not there. If you do not spend time experiencing the culture, you cannot embrace it. Living with a family has been the best thing about this whole thing. I understand how families work and social norms because I live them myself everyday. Overall, my experience this week in the clinic has been great. I have learned a lot about communication and seen how scared some people are my modern healthcare. I realized that narrating while I am taking vital signs is comforting to the patients so they can learn from their visit too. I found this incredibly helpful with patients, especially children, who had never been to the clinic before. I also really want to learn Quiche. It is quite difficult to communicate with both you and the other person are speaking in a common second language. Unfortunately, Quiche is only recently a written language and is very difficult to learn. Luckily, I am making great connections with the staff :)
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