Last week I finally put the clinic schedule back together. I had been re-arranging it a bit to accommodate for a little R ‘n R while I had visitors, and likely confusing all those who are used to the regular schedule. Although lately I don’t know how much it matters, as people still seem to question when my hours are, how many doctors work with me and in which towns I work. Usually this conversation happens right beside a sign with said information in black and white (and Spanish). The past couple weeks have been busy at both the clinic and in the hospital. We have been working on a new system in the clinic in Los Angeles to help me organize the patients better, which also means I will take time for lunch and leave before the sun begins to set to bike home. It has been a huge help and makes it a lot easier to explain to people that I can’t see everyone who comes that day but I will be back another. One of the harder things I have come to notice in working here is to not be swayed by the patients. Given the chance everyone has an emergency and needs to be seen as of yesterday. Also most people have come from far away and so it is difficult to explain to people that I see them in order they arrived and not in order of how far away they live. To some it is easier to explain than to others. I must say my favorite response I have heard after telling people that I am unable to see more patients that day and if I can please put their name down for the next day was that yes I could but chances are they would be dead by then. Unfortunately for them, they told me prior to that comment they just had a cold so on the list they went.
I am still constantly challenged and surprised by the different presentations and conditions that people come to see me for. The real challenge is the lack of available testing on the island as well as the poverty, which often means that people are unable to get certain tests until a medical brigade comes to town. And then there are those times when all the tests come back fine, as they do in Canada, and as the doctor you are stumped as to try to figure out and give a name to the condition that is causing the patient so much discomfort. There is a surprising number of people with liver disease who do not drink, there are people who work in the fields all day who are unable to lose weight, there are people with constant bone pain and then there is a surprising amount of facial paralysis or Bell’s Palsy. I don’t fully know the causes of certain conditions, but I am curious to know whether it may be the exposure to certain pesticides used in the fields or the burning of plastic. No matter how challenged I am here, I am constantly reminded at how effective natural medicine is here. I have seen many cases really turn around using treatments like massage, vitamins, homeopathy and acupuncture. I have been having great results with acupuncture and have had a lot of people being referred to me for acupuncture from the staff at the hospital. I bring up acupuncture mainly to share a recent story I have. I always try to explain treatment options to my patients so they have some choice. As many people have a fear of needles I try to give a little more explanation with acupuncture. The other day I had one patient that decided on acupuncture. When I was ready to start I look over to see that they are literally saying a little prayer, cross and all. That was a first for me to see. I let them finish and double-checked if they were ready, which they were and carried on.
Last week I was able to try my hand at tour guide again as my friend Alison and her boyfriend Jesse came for a visit. Somehow the first night they were here I was convinced to hike the volcano Concepcion. That would be the taller, active volcano. After the beating my body took from Maderas I don’t know what I was thinking! So the next morning at the crack of dawn (my neighbours were just waking up!) we got ready to make the trek up Concepcion. We had a really great guide who explained about the different wildlife (don’t spend too long taking pictures of the Capuchin monkeys…) and the various plants (especially those that had traditionally been used as medicine as she knew I am a naturopathic physician). Alison and I decided to take a rest just shy of 1000 m, while Jesse and the rest of the team continued up to the lookout. We had time to catch up and even caught a clear view of the lake and across when the clouds cleared for a moment. As the rains have started the hike up was muggy at best. I honestly don’t think I have ever sweat so much in my life, and after having been here for 5 months that is saying a lot! Even our guide, who happens to do this particular hike 3 days a week, was sweating. It made us feel a little better. By the end of the hike I did another very foolish thing, which was to agree to start running with our very fit guide. We’ll see how that goes… We got down to brunch at the Cornerhouse, also known as where you can find me any given Saturday. I may not know all the local sights but trust me I know where you can find really excellent food. That night we went to Jonny’s bar to see if the Gallo’s were fighting, which they were and Jesse luckily enough won some money on the last fight of the night. It was a quick stay on the island, and I am sure I could have convinced them to stay longer had it not been for a very loud mother’s day greeting at 4 in the morning.
I am what some might call a city girl. I grew up in the city and have lived my entire life in the city snug and happy. Even here I live in the big city on the island. This past week I have been playing country mouse by house sitting in Los Angeles. It is surprising to see really how much of a difference there is between the two towns. By 7 at night Los Angeles is completely shut down, except for possibly the churches and maybe some goings on in the park. However come morning it is all early risers and hustle and bustle, much to my sleepy headed chagrin on the weekends. Another interesting fact about house sitting in the country is that not only is there a house to watch for but a garden… and therefore possible animals that might nibble on said garden. You might be able to take the girl out of the city but you can’t take the city out of the girl. I have absolutely no skills it seems in how to rope or wrangle. In a contest between 3 calves vs. one me it seems that the calves win and think their opponent brought them a snack. In the end I called for re-enforcements, which turned out to be a fourteen-year-old boy. Also here in my attempts to be a country mouse, I have been preoccupied with thoughts of mice scurrying about. I am sure they are in my house too otherwise I don’t know why that cats would get so worked up, but here closer to the fields I tend to be a bit more jumpy at any sound, scuffle or oversized bug. So no matter how rural my city gets, I am still just a city girl. On the weekend I was invited to a fiesta on the other side of the island. It was the first time I had been to Alta Gracia and the event was held right at the beach at a hotel. Angela and her cousin Marietha took me, and there was lots of eating, some dancing and chatting. It was a birthday party (which if I had known I would have dressed in something other than shorts) and the guest of honour even played the saxophone, clarinet and sang. It seems the entire family on that side is musical and plays together in a band. On the way back we were shown another hotel near the beach on the other side of Moyogalpa. It seems word is spreading that my tour guide skills need a little boost and so now I am show about. As long as I don’t have to worry about cows I should be fine.