Taking off the training wheels

Last year I went to Honduras as a medical student. It was a comfortable happy life of 'sheeping' around behind other doctors and sucking up knowledge like a sponge. (Sheeping is a favourite term of mine...its like following but implies you are a clerk or resident in a white coat...and hence you look like sheep). This year I have grown up into a doctor. A real doctor. They took me as a full fledged physician, seeing my own patients, having my own interpreter and a corner of the clinic. Of course they were all around to help when I needed it, but I was flying solo for the most part. I initially joked that I wasn't a real doctor, I was just pretending, but my friends quickly shut that down and I accepted my name tag which sported a fancy "Dr." at the front.

Our first clinic was when we were still near Tegus. The day is a bit of a blur. I was really nervous, and really excited, but I had a hard morning. The first couple patients had things that I couldn't fix. And that happens all the time, and its ok, but I really felt useless by lunchtime. I actually went for a walk around the village at lunch to clear my head, calm down, and possibly cry a little. I just felt overwhelmed with the impossibilities, and it was clouding my ability to see all the good things. I guess we all have days like that.....where the doubts and the fears and the negatives get in the way of all the great things, and you lose perspective. But my team was fantastic - the head doc reassured me that I was doing fine, I was pulling my weight, that it was ok to ask questions, and that if they didn't trust me and respect my clinical judgment - then they wouldn't have brought me.

That afternoon I had one of the most memorable patients I've ever had. She didn't appear to be sick. She was clean and well nourished. And she smiled the most beautiful smile. But when I looked at her patient sheet the complaint was - depressed. I remember giggling and saying to Churri (my beloved interpreter) - this must be wrong, she can't be sad, she's smiling! So he spoke with her for a minute and then said - yes, she's very sad, she says she feels like life is overwhelming and little things are hard to handle.... and I realized her smile was a nervous smile. And I could relate to the look in a 14 year old's eyes that say - growing up is hard, I don't know how to do this. I guess it is the personal understanding that really makes her stick in my mind. So Churri and I talked to her about what things make her sad, and then more importantly what things make her happy. I suggested that on days when she feels down she go back to one of those happy things for a while to help. "Doctor's orders - listen to music when you're feeling sad!" hahaha... It's hard to do solution focused therapy through an interpreter, but boy did I try. And in the end I think her smile was a little more genuine.

The rest of the clinics are a bit of a blur. Long hot days. Some incredibly long, bumpy, winding drives where I thought at some points we wouldn't make it through the roads. But at the end there was always an excited crowd beginning to form as they waited for us. I learned a TON. I did joint injections, I did minor surgery (the pic is me removing a lipoma from a man's shoulder), I listened to lots of lungs and felt lots of bellies. I saw lots of babies, and a few people that I know will have moved on to a better place by the time I get back next year. And I even got consulted by the other docs when their female patients felt more comfortable being examined by a woman. I still had to ask lots of questions....but I think I did ok. I spent one afternoon lying on a cold cement floor while I was intractably dizzy, but besides that my body stood up to the test. And so did my soul.

I asked a few women if I could take their babies home, cause they were so darn cute, but they all opted to keep them :) I guess I'll just have to visit often. You know, I'm always taken by how happy the kids are. I think that life is more authentic there. You need a roof, but you don't really need windows. You need your family and your community to get by, its not just a relationship of pleasantries. You live off the land and you care for each other. It is beautiful in its simplicity, and in a way I envy them. It makes you realize the difference between the 'needs' and the 'wants' in your life.

And at the end of it all I was invited back for next year :) I think I might become a lifer - going on this trip every year. I love the medicine, I love the climate and I definitely love the people I work with. The one change for next year is that I've signed up for a spanish course - I think solution focused therapy will work a lot better if I can converse with the person one on one!

Lots of love
Pamela

p.s. Stay tuned for one final Honduras post on all the fun times - you have to work hard and play hard!