Beaches and Clinical Rotations

The week has gone by so fast I can’t stand it. I’m hoping the others slow down, I can’t bare to believe that by this weekend I will only have one month left here. It’s physically painful.

Last Thursday I said a bitter-sweet good bye to my babies. One little boy even started crying, saying I could get a job as the school doctor, and that I didn’t need to go shadow in the hospitals. How can I not tear up at that?

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That night me and the girls boarded a 10 hour bus ride to Montanita, a beach town known for its shops and surfing, but quite possibly more famous for its non-stop partying. Although we had somewhat of an idea of what we were getting ourselves into, I think it’s safe to say we were a little clueless on this town’s idea of parties. I’ve never been to Vegas, but I’m going to go a head and make that comparison.

Our days were mostly overcast, but don’t let that fool you: we lounged in 80 degree weather the majority of the time, and none of us escaped without some sunburns.

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Our hostel was probably the nicest place we’ve stayed in so far, besides maybe the tree house in Mindo. It also had a bunch of Hawaii signs and sayings, which was fun to see. According to our neighbor from Peru, many Hawaiians come to Ecuador and Peru’s coast to see what “real surfing” is.

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And although the night clubs (discotecs), banana coladas, and general night life were fun to experience for a short while, we found it much more enjoyable to be doing other things, like riding bikes through the sandy streets, looking around shops, and reading on the beach.

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Shocking enough, the coast is famous for it’s seafood (who would guess?). And while here, I promised Chris’s dad that I would try one of Ecuador’s most famous seafood dishes: Ceviche. It’s like a cold soup, with (usually raw) squid, fish, shrimp, and shellfish, along with a sauce similar to pico de gallo: tomato, onion, peppers, cilantro, and lime.

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Although tasty, I think it was a bit much at 11 am (locals swear you have to have it before noon), and I couldn’t help but feet like I should be eating it like a salsa with chips, instead of straight with a spoon. Either way, it’s probably safe to say I had one of the best and most authentic versions of the dish.

We also managed to find bowls of at least 8 types of fruit, omelettes for $2 that were twice the size of our face, and coconut juice that would make you buy a plane ticket to Ecuador just to come back and have again (have I mentioned how much I’m going to miss the juice here when I have to leave?).

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After 3 nights in Montanita, including being mildly impressed by the Halloween activities and making friends with multiple street dogs, we took a bus an hour and a half north to the beach of Puerto Lopez.

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Here we took a 1.5 hour boat ride to La Isla De la Plata , an island off the coast of Puerto Lopez that is said to be similar to the Galapagos Islands. I was NOT one of the two people who got sea sick on that trip (Thank goodness for Dramamine).

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On our way to the island we saw a whale, which is a really big deal because the majority of them make their trek to warmer waters (is that possible?) in mid August-September.

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Once there, we snorkeled the coral reef where we saw a sting ray, sea turtles, and other exotic fishies. (That picture is of a sea turtle) And little sand crabs!

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After snorkeling we hiked to the highest point on the island and along the way saw some lizards, but more impressively: some birds literally called blue-footed boobies. Their feet, legs, and beak become a darker shade of blue with age. Their nests are lined all over the island, and we were lucky enough to see them not only sitting on eggs, but to also see them hatched with day old baby boobies.

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On the way back we lounged in the sun and ate water melon (life is hard, isn’t it?).

We spent the evening enjoying Puerto Lopez and the festivities that commenced for El Dia De los Muertos, the second of three holidays this weekend. However, the fiestas were not so intriguing when the music was still blasting at 3 am and we had to be up at 4 am for a 12 hour trek back home to Quito. (By trek I mean annoyingly long bus rides) We did, however, get to share a hostel and dinner with two girls from the Netherlands, which was fun!

Today, Wednesday, was my first day in clinical rotations. FINALLY.

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My first rotation is at a dermatology clinic instead of general medicine (which seems to be just a lot of prescriptions and medication checks). I was in HEAVEN today (some of you may know I’m considering dermatology as a specialty). I worked along the side of 7 Ecuadorian medical students and a fabulous doctor who cared a lot about teaching us. (Also, a little perk, most students and staff at the clinic could speak a decent amount of English, so when I had trouble understanding something, they could clarify!)

First, the doctor showed us pamphlets they give patients, and forms doctors fill out during the consultation. Then he showed us their most commonly used tools. They have a scope you use to look closely at problem areas, like moles or acne, and that scope can attach to an ipad, where you take a picture. With that picture you can discuss the diagnoses with multiple doctors or students, get second opinions without the patient present, save it as a reference to see the progression of the skin issue, and email it to your patient for their own references. When we had downtime between patients, the other students and I would zoom in on each other’s freckles, moles, and other skin abnormalities. Which was extra fun because the doctor showed us how to label moles based on their color, size, symmetry, and density, then rank it with a point system, and determine if it the mole was possibly problematic or needed further evaluation.

Once we were more comfortable and sat in on a couple consultations, the doctor would have us do an entire appointment in pairs. We’d interview the patient, collect medical and family history, even do a physical consult (in simple situations), then come up with our best diagnoses (the patients knew we were students of course). After that, the doctor would come in, go over our notes, give us advice on how to improve them, then do his own consultation and diagnoses, and compare it with ours. After his diagnoses he would explain his recommendation/prescription to both us and the patient, then after the patient leaves we would have a discussion about the appointment. I got to be a part of four of these and saw everything from fungal infections, to warts, to contact dermatitis, to skin ulcers. On patients ages 4 to 84. IT. WAS. AWESOME.

Due to the week being so short, I will get to spend another week at this clinic and I’m incredibly excited. After that I will spend a week in surgery, a week in maternity, and a week in pediatrics (then a week in Peru, then home! What?)

I was incredibly nervous for my first day today and am so happy I left with a huge smile. I made friends my age (all on my own, with a language barrier) that are interested in the same fields and live in Quito as well. The doctors were beyond friendly and welcoming, and the patients were even more encouraging than I expected. I couldn’t be more thrilled. Tomorrow, the doctor asked us if we could come in early, but he’s buying us breakfast to make up for the inconvenience. I mean what the heck, is this real life?

Alright, I have to get to bed if I’m going to do anything productive with my day tomorrow (rumor has it we are eating cuy, also known as guinea pig in the United States).

Yo Escribire mas adelante! 🙂 Chao!

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