03/29/14-03/30/14: returning home

I took a picture of every meal I had here. :D (I figured everyone else would have the people + scenery parts covered.) It is my hope that I will one day be able to recreate healthier version of all of em’. :] This is an assortment of some of em’! I love colorful foods. :D

It took a good number of hours to get back, mostly because there were so many hours of waiting in between. Here’s our timeline:

• 9-10:30 p.m.: traveled from Hato Mayor to Santo Domingo
• 10:30-3:30 a.m.: hang out at airport in Santo Domingo
• 3:30-7:30 a.m.: fly back to Boston
• 7:30-10:30 a.m.: hang out at airport in Boston
• 10:30-12 p.m.: fly back to Richmond
• 12-2:30 p.m.: redistribute luggage + drive to Charlottesville
• 2:30-3:30 p.m: lunch at Zin Burger! :D
• 3:30-4:30 p.m.: driving back to WV
• 4:30-5-ish p.m.: obtain coffee/gas/some sleep at Sheetz
• 5-7:30 p.m.: finally back at school!

The green bottle on the top left is the DR’s version of our moonshine, which they called “gasolina.” Brad was a source of constant worry for our group because he was always losing things/himself and kept unintentionally scaring locals/patients by trying to speak to them in Spanish that would translate into really awkward things, so he made himself a sign.

We got to the airport at 10:30 p.m. and our flight wasn’t going to leave til 3:30 a.m., so there was a lot of lying around and/or sleeping in that time frame.

My seat got taken so I made a compromise.

I’ve missed being able to flush toilet paper and drink tap water and I haven’t combed my hair or taken a hot shower in over a week. I’ve been struck down by “el gripe” and may or may not have typhoid fever/malaria/a couple parasites that I’m hoping the albendazole will take care of, but…it’s a small price to pay for all the experiences and memories I’ve made? (I’m most worried about the typhoid fever because risk of malaria is fairly low and other than my slightly late start due to the Philly trip, I’ve been participating in our Chloroquine Fridays. However, the county clinic completely failed at life at giving me my oral typhoid vaccine properly because they told everyone else that it was a live vaccine and had to be refrigerated/gave it to them in a plastic bag on ice…and for me, they mentioned nothing of the sort and handed it to me in a paper bag, so it was pretty much long dead by the time I realized this. THANKS, GUYS.)

In all honesty, I was originally somewhat regretting my decision to go on this trip because I felt like I should be studying for boards at home instead, but I’m really glad that I went. I learned a great deal on this trip and would love to come back next year, if I can make my vacation dates align with the trip/convince my parents not to disown me for not coming home. (They’ve already been gracious enough to not be angry about my telling them about going on said trip 1 hour before boarding the plane. :x In my defense, I figured it’d be better for them to worry for 1 week as opposed to half a year. They told me not to get dark/tan and not to get sick and I managed to do both.) If I do get to come back at any point, there’s a lot I want to bring with me just to leave there for people.

03/28/14: beach day

I feel like the title is pretty self-explanatory. :O Pictures of pretty beaches below!

Shannon got two rather awesome panoramic shots–one of the beach and one of [almost] all of us (at the bottom of this post).

I will very much miss this weather. *-* The beach was absolutely gorgeous.

‘Playa Juan Dolio

I’ve never done a beach jumpy picture, so here we (my room) are! :]

03/27/14: day #4 in rural Seibo

Last clinic day! We went to a super, super rural part of Seibo today and managed to see everyone there as well (tis a plus, because I hate having to turn anyone away). We saw 150 patients and I got to witness several pretty unique cases.

We saw a case of what we think was Beckwith-Wiedemann syndrome, as well as several hypertensive emergencies (I took a 224/106 and a 232/118). where one of our doctors did her very first IV Labetolol push while an translator interpreted for her and the patient through the window.

We stopped at a craft market put together by several women in the area after clinic and also set up a makeshift clinic back at the hotel for all the staff when we got back. OMT is a big hit with them because almost all of them had aches and pains of some sort. (We’ve coined a new phrase of”machete back” for the workers in the fields that end up with extremely tight back muscles.)

I’m unfortunately coming down with something that I sincerely hope is just what they refer to as “el gripe.” ( Typhoid fever would suck, but the incubation period is 6-32 days, if I recall correctly, and I think these are the wrong symptoms, so hopefully, I’m in the clear.

We’ve been really spoiled here. I’m sincerely going to miss having our meals prepared for us. ._. I’ve never had people legitimately stressed out that we were still working and hadn’t yet taken a break to eat. This is probably the most salt and sugar my body has seen since junior high. (My salt/sugar intake this week is probably more than I’d have in at least half a year.) My feet are so swollen that I no longer have malleoli. :( Small price to pay though, because the food has been delicious! I’m very much going to miss the passionfruit juice, fresh pineapples and coconuts, and plantains.

This encompasses our entire group, minus two of our Dominican doctors.

03/26/14: field day #3 in rural Seibo

We went to a different clinic today and decided to just keep seeing patients until there was no one left. I shadowed our pediatrician and got a ton more experience in taking histories and performing physical exams in children and babies (as well as some more adults). (I’d never done a physical exam on a child/baby until this trip.) There were a good amount of moments where I just felt completely incompetent, but I think it was good for me, since it forced me to learn and grow.

We had a lot more Haitian patients at the clinic, which was difficult in the sense that most of them spoke mostly Creole, so there was definitely a game of telephone going on with two translators interpreting what was being said.

I think what’s most frustrating about the language barrier is that you have no idea whether your entire message gets across. The differences in enunciations, the nuances in the 2-3 languages, and the terms they have that have no actual English translation make the chances of something getting lost in translation that much higher. I feel like we’re not giving them the best help that we could be, even though we really are doing the best we can with the resources we brought with us. On the other hand, body language is paramount. 80% of communication is nonverbal, so I probably shouldn’t have been so surprised that the patients understood so much off what I was saying to them (I’ve gotten pretty good art pantomining).

We managed to see 196 patients, with at least 20 more that we didn’t have papers for (we gave them multivitamins, toothbrushes and/or condoms, depending on their age).

The mosquitoes (I’m assuming they’re mosquito bites) here have decided that my blood is absolutely delicious, so I’ve been taking it for the team in terms of bug bites. My skin apparently really does not agree with them though, so my legs look horrible. Each bug bite looks like a massive bruise, so I kinda look like I’m being abused again (so what else is new? :[ ). At least we have a whole lot of hydrocortisone & calmodulin cream that I can swipe!

03/25/14: field day #2 in rural Seibo

We returned to the same clinic in rural Seibo to finish the work we’d started. I got to follow/help one of the Dominican doctors that I’d requested the day before because she was fluent in both Spanish and English and I’d seen her taking the time to explain the situations and cases to my friend the day before. Our [entire] team managed to see and treat 157 patients this time, and didn’t have to turn anyone away.

I worked with a friend and got a ton more experience with listening to hearts and lungs, examining ears, mouths, and noses, as well as with reading urine tests (I know that’s not hard, but weirdly enough, I really never actually did one til I came here) and taking more blood pressures. It was a lot hotter and more humid, possibly because it didn’t start raining on the second day. Our coordinator would stop us periodically to remind us to take mandatory water breaks so we wouldn’t get dehydrated. We’re actually working at a clinic in the middle of the sugarcane fields, so some of the patients brought in some for us. :D! I haven’t had any since I last went to HK, so that (among other things) pretty much made my day. :]

Again, the likenesses to clinic were kinda awesome. (I’ve really missed being able to go there and still feel that there is no better reminder of why I decided that I wanted to go into medicine than being able to help my patients.) I think a lot of people end up assuming that I don’t like babies/kids because I have absolutely no desire to give birth to any. This is a fairly incorrect assumption. I think the ones that are raised well (aka have manners and all that good stuff, which is tragically uncommon these days) are awesome.

The ones I got a chance to work with were pretty darn adorable. One little girl (her name’s Carolina) was talking to me and gesturing to my earrings. Since my Spanish knowledge is fairly nonexistent, I kinda figured she was just telling me that she liked them, so I smiled and nodded. She looked so incredulous and happy when I nodded that I realized I’d agreed to give them to her. I cleaned em’ off with an alcohol wipe and her little brother ran with her to the bathroom to put them on. When she came back out, she ran over and hugged me. You cannot put a price tag on happiness. The smile on her face warmed my heart. <3

Random discoveries today include the fact that there are apparently ostrich eggs incubating in the living room (top right in the picture below). I may have failed to mention that there are actually two ostriches living on the property where we’re staying. I’m not really a fan of them because one tried to bite my fingers when I was at a zoo as a child, so I’ve been slightly traumatized by the incident.

Top Left: WV vs. CSA in pool
Bottom: We had lots of company all over the hotel. <3

I did a core/yoga workout outside after we got back from clinic, jumped in the pool for about half an hour and went off to dinner. I’ve been having a lot of trouble carrying bags/boxes from one place to another because some guy will always come along and take it from me. When I voiced this concern to Mike (it’s not that I mind, but they’re kinda ruining my workouts of the day, because there’s nothing else to lift other than my own body weight):
M: I know, Farrah, it’s because you’re tiny and they want to help you. Little do they know, you’re actually stronger than most, if not all of them. (takes box from me and carries it to the van)

Top Left: Chucha! <3 My loyal breakfast-lunch-and-dinner-company! He’d just sit in my lap for pats. <3
Top Right: 3/4 the gang. Sean decided to stay at home to study (and as we found out later, basement-dwelling [playing Halo with Tanner], cleaning fish tanks, and witnessing some really awkward gay fish porn in said fish tank; I shit you not).
Bottom Left: Also from aforementioned bonfire! Mike decided to recruit me to be his partner in crime in carrying two beach chairs to the bonfire. It was a good idea. People were pretty jealous, so we shared.
Bottom Right: Lunch break! (We’re probably vulturing for food again.)

When I was giving Isaac some crap about not helping out with carrying things (one of my roommates ended up having to drag the suitcase that he wouldn’t carry up to our room), Mike teamed up with him to carry me up the hill whilst sitting on a “chair” made out of their arms. It was slightly frightening since the road was super bumpy and Isaac was slightly shorter/not really trying, so I eventually convinced them to let me down.