Last 2 days!

I can not believe how fast this month has gone. I remember finding the internet cafe the first week! So much has happened to me in Quito and I have learned so much. I feel incredibly fortunate to have had the opportunity to travel here this summer and learn medicine, Spanish, and the way of life of Ecuadorians. I have laughed until I´ve cried and I´ve cried until some very special people have made me laugh again. I´ve learned that I HATE the Trole. And my state of mind is more important so I will pay $4 for a cab if it means I can actually breathe. I have learned that although the healthcare is not the best, they are doing the best they can and really trying to reach out to everyone. I have also realized we have it extremely EASY in the U.S. and even though our country isn´t perfect, any person who spends a month in Ecuador would agree with me. I have learned to give everyone a chance and slow down, listen, actually listen, to people talk and you will be amazed at what they have to say. I am happy and proud to say I have made friends for life down here not only within my program but with Ecuadorians as well. Ok so that was my ramble session but I really wanted to post what is coming up in the next two days before I leave because I´m sure I won´t get a chance to write a lot.

Tonight is my roommate and I´s last dinner with our host mom, even though she never eats with us. It is her last night cooking for us. Then we are planning on heading to the Mariscal (downtown area) for ¨Ladies Night¨where us girls get in for free. Sorry guys :) Tomorrow (Thursday) is our last day of clinic :( And then Rosita, the coordinator at the school, is taking all 30 of us out for dinner and then we reserved a CHIVEA for the night. Like I defined in my Baños post, it´s similar to an American party bus but BETTER. So we all plan on doing that and then probably going out again. Friday we do not have clinic, due to the CHIVEA the night before (Thanks Dr. Alvear) and I am planning on, when I wake up, returning to La Maternidad to say one final (and difficult) goodbye to Fernando and hopefully anyone else who is working that day. Fernando wanted me to work an overnight shift but unfortunately we can´t do that because A) it´s not in the program and B) it´s dangerous...or MUY PELIGROSO. I will explain the humor behind this all to common phrase when I return. Anyway, after that I will most likely run around Quito and try to squeeze in a few more sights, tastes and smells before a group of us head to Tapas y Vinos for round two! All you can eat appetizers (tapas) and wine (vino). Then Saturday morning I wake up bright and early and head to the airport around 6:30 and my flight leaves at 8:35. I´m not thrilled about my 4 hour layover in Miami but Hilary, another student, is flying to Miami an hour after me so I should have someone to hang out with for awhile. I get in to Chicago around 8PM that night where Cody, and my long anticipated Dr. Pepper, is picking me up. I´m not sure how to feel right now. Part of me wants to come home but the other part could see myself staying for awhile. I do miss my family and friends and I can´t wait to see all of you!! I´m pretty sure I am going to have reverse culture shock when I return, walk into a store and they charge me $8 for lunch instead of $2. Not cool America. Not cool.

I did want to mention what I did today (Wednesday): I was in clinic with Dr. V until 11 AM where I witnessed a hernia repair. It was pretty intense and the resident even showed Matt and I how to do the stitch. We did not get to scrub in because I guess they didn´t need that many people. After, I walked to the TROLE (ugh) and took it to Santo Domingo church which was finally open. I have been there three times and its been closed every time. I walked around inside for awhile although they were just finishing up Mass when I entered. I then walked across the plaza so I could take a picture of the church and a lady came up to me and said, ¨Cuidado.¨ which means, ¨Be careful.¨I asked her why, all I was doing was taking a picture and she said because I might get robbed. Once again, MUY PELIGROSO. I thanked her and put my camera away. Don´t worry mom, I did NOT get robbed. Everyone just thinks Quito is like the most dangerous city and you are going to get robbed every time you whip out your camera. FALSE. After I went and had lunch in El Historico on Espejo street which is really a cobblestone walkway blocked off to trafffic. I found a cute cafe with soup, main course, desert and bebida for $2! I sat outside and ate and then planned on heading back to my house. However on my way back I happened to walk by Santa Catalina Monastery, where the nuns live. Being my curious self, I walked in and they immediately asked if I wanted to a tour. It was only a dollar and I was fortunate to get a tour guide who spoke English! It was amazing to see the convent and hear the stories about how the indigenous people taught Catholic religion through paintings. I learned about Saints, although sorry mom, St. Anthony was not included. I did see the nuns outside in the garden where they are allowed to speak with each other for only an hour during the day. The convent was built in the 1560´s and is proof when you walk across the squeaky floor. The church inside was absolutely beautiful and she even took us up to the bell tower. She showed us the handicrafts the nuns made and at the end I tried the wine they made! It was delicious. I´m really glad I accidently stumbled in. Well once again, it´s dinner time! And my last dinner at my host mother´s house. Love and miss all of you and I will see you soon!! :)

Love,
Hilary

Hospital Militar

I wanted to write about my day/this week before I forgot. This week I am in Hospital Militar which is the Military Hospital. According to Evon (a professor at the school I took Spanish classes and who gave us a tour the first day) this hospital sees and treats not only the men and women in the military but also their families. Matt, Julie and I are with Dr. Vargas in cirguia (surgery). Monday morning bright and early, we saw a cardio-thoracic surgery. A 27 year old male was beaten in the chest with a wine bottle and the shards of glass had puncture his lung and diaphragm. We did not scrub in but we pulled up stools so we could lean over and see the two surgeons working. Matt and I were on one stool and Julie was on the other side. Dr. Vargas told her to put her hands on the surgeons back so she could lean forward and see better and the surgeon told her the only stipulation was that she had to give him a kiss ever ten minutes. HA. Then Dr. Vargas asked Julie if she wanted to scrub in on an appendectomy (sp?). Of course she said yes so Matt and I stayed to watch the rest of the current surgery. I saw the heart beating, the lungs inflating and the diaphragm contracting and relaxing. Amazing! The surgeons were brillant and fixed this kid up. After about an hour, and the surgery was complete, Matt and I wandered over to the other OR (Quirofano) to check on Julie. We walked in to see the small intestines sitting on top of the patient. Apparently, they couldn´t find the appendix and it took them another hour and half to do so! The sigmoid colon was apparently overlapping on the appendix which made it tough to find. Sorry, that´s the science portion of the post :) Matt and I just watched but it was crazy to see the intestines completely outside of the body. It was easy to see, too, because the light above the patient had a camera which projected the surgery onto an HD TV located at the foot of the patient. It was the nicest, and cleanest, OR I have seen yet. Since it the surgery got complicated (and they had to make another incision around the bellybutton) Julie was allowed to leave around 12 when Matt and I did.

Today (Tuesday) we met Dr. V in the report room with a bunch of other doctors and med students. He told us we would only be doing consults today. And every single person we saw, post and pre-op, had a hernia. Most of them were not grave (pronounced grAv-ay or serious) and we watched the resident remove stiches for the most part. Dr. V is absolutely hilarious. He told us today the he studied in Paris for 5 years and knows French. He also did his residency in CHICAGO! He speaks very good English but told us the first day that we can speak to him in Spanish so we can improve and he will, occasionally, explain complicated procedures in English so HE can practice. That was our agreement. I should mention he is a general surgeon but mostly concentrates in the abdominal region. One of our patients was a FAMOUS SOCCER PLAYER who plays for the National League. I feel like I am completely breaking HIPPA rules but I´m pretty sure they do not exist down here. His name was ¨Michael Jackson¨and he told us that his mother was a huge fan of his so that´s why she named him that. He had a hernia as well but did not was to be operated on because he was being drafted by a Mexico team for more money. Dr. Vargas said that was fine because it wasn´t serious enough but he needed to be careful while working out. Then, randomly, Dr. V told us that he had a houes in Miami and one in Crucita (Little Cross) a beach town close to Chone, in Ecuador. Since Matt is going to Chone next week he told him he should come chill at the beach house!! Which includes a pool and sauna. This guy rocks! He asked us to write down our email addresses and he will send us pictures of his FOUR houses. I want his life. He´s pretty much a baller. He operated on the top soccer player for the national team here via laproscopic surger and he played in the championship game a month later and won. Yep, he´s pretty much the coolest doctor EVER. After consults, which ended at 11:00, we went back up to the 8th floor (we were on 1) via STAIRS. we had to stop at the 4th floor so Julie and I could catch our breath. He told us he never takes the elevator because he likes the exercise. He also runs. I honestly felt like I learned more about his life than abdominal surgery today. After arriving on the 8th floor, we took a picture with him and then left for the day. We´re back tomorrow in the OR and hopefully I will get to scrub in! Even though intestines gross me out. I would rather be delivering babies!! It´s time for dinner now so I better run so my host mom does not freak out on me. That will need to be an entirely new post. She´s a sweet, old lady but sometimes, ok most of the time this week, she drives me crazy! I can not believe I only have 3 days left here!! I am actually looking forward to coming home and seeing everyone. I love and miss you all!!

Love,
Hilary

Piña Colada´s and Hammocks Galore

We left for the beach yesterday (Thursday) morning. Our flight was supposed to leave at 9:30 but we did not end up taking off until close to 10. It was a 35 minute flight! The fastest flight ever. We arrived in Guayaquil, grabbed some lunch and then tried to find a taxi to take us to the beach for $30. Unfortunately the taxi company we found outside the airport wanted to charge us $170 for each car!! We would need to take two because we had six people and apparently people dont travel in groups that large down here because they did not have a taxi van for us. So we asked them if they could take us to the bus terminal because we were not paying that much. Will, Elise and I get in the first cab and our driver is going on and on about how much time we will save and blah blah blah by taking a taxi so I tried to satisfy him by saying that we needed to talk to our friends before we made any decisions. So he decides to pull over in the middle of the road and tells me to get out and go talk to the three others in the taxi behind us. I was like, ¨NO! Take us to the bus terminal!¨ Apperantly the other taxi driver was also trying to barter and told us that he could get us a taxi van and it would only be $20 per person. We said screw it, would would rather pay $4.25 for a 4-hour bus than $20 to get there an hour earlier. We finally got our bus ticket and left Guayaquil around 12:30. Arriving in Puerto Lopez, we found our hostal which appeared sketchy at first but turned out to be relatively nice. The lady who runs it, Maxima as she told us to call her, absolutely loved us. She gave us a deal on the rooms and told us about 10 times that she has over 700 movies if we want to watch them. Our rooms have mosquito nets in them so that was my first experience with that last night and it wasn´t bad. Last night after the Chone people got here, we ate at a little cantaña right on the beach that served HAMBURGERS. They were amazing! and cheaper than the piña coladas. They had hammocks that overlooked the beach as well...absolutely perfect. All ten of us then went to the beach to play ¨ten fingers.¨ It was absolutely hilarious and I was crying I was laughing so hard by the end of the night. Inside jokes that no one in the states will understand: ¨Wait, what constitutes Europe?...But Granny was there, so it doesn´t count...being assaulted by a toy...creepy dogs...taking a nature walk on the beach...what do I wear to a passion party?...MUY PELIGROSO...DING! Then Katie, Eleanor, Hilary and I went to get another piña colada and ended up making some Ecuadorian friends. I don´t remember all their names but they were super cool and invited back for happy hour at their cantaña tonight. Also, there is ONE discoteca called ¨Taurus¨so we are going to check that out tonight as well. One of the guys was trying to tell me they all had the same name so I asked if they were his sons. Also, another inside joke that no one reading this will understand. Sorry, I just wanted to make sure I did not forget anything. Today it was a little cloudy so we went whale watching!! It was aboslutely amazing! They jumped out of the water about a dozen times and swam right up next to our ship. I saw four humpback whales and blue footed boobies on the island of Salango and the entire excursion cost $15. I love Ecuador.

Beautiful Sunday :)

I was really happy we stayed in Quito Saturday night A) because I was sick and B) because I wanted to have a whole day to explore the city! I have been here for two weeks but haven´t had the chance to see much beyond the new town. Which if I didn´t mention before, Quito runs north to south in the Northern part of Ecuador. The Northern end of the city is called, ¨New Town¨and is just that, new and modern with shopping centers, plenty of McDOnalds and other fast food resturaunts, businesses, hotels, schools, etc. The southern end is the ¨Old Town¨or as the locals call it, El Historico. It is full of churches and cobblestone walkways and plazas. It also has plenty of hole-in-the-wall resturaunts (which I love) and little boutiques. Before we explored its grandur, ¨our group¨(Julia, Jay, Katie, Me, Alisa) met at the bus station to go to ¨Mitad del Mundo¨(the middle of the Earth=ECUATOR). It was finally nice out for an entire day and we definitely took advantage of it!!

We then spent all afternoon Sunday strolling the beautiful, colonial streets of Quito where we sat outside for lunch, had samples of ice cream shoved in our mouths at the country´s oldest parlor, climbed the sketchy ladders to the top of the Basilica, witnessed breathtaking views and had a gaucho ride by and yell either ¨I love you or I want pizza¨and then anticlimatically ride away as his hat flew off. I have to go eat dinner that is why this is so short! I can not believe I only have a little less than 2 weeks left. CRAZY!! I´ll try to write more this week. love and miss everyone!!

Love Hilary

Otavalo

On Friday after clinic, I had to come home and pack so we could leave for Otavalo that night. It is a small town about 2 hours north of Quito. It is known for the artisan market and is one of the largest in the world. That means one of my favorite things: SHOPPING. The streets are lined with vendors every day of the week but the biggest day is Saturday. Note: the reason it takes two hours to get there is because the bus stops every 50 feet for more people to get on. In the US, it would only be about an hour away. Anyway, after about a half hour on the bus a man gets on WITH A LIVE CHICKEN!!! All I could think of was Spring Break and Mexicana...gobble, gobble, gobble (only Cody, Maggie, and Nick will understand this :) Katie and I began to doze off and suddenly it started clucking like 2 seats behind us! I looked at Katie and said, "I swear if that chicken clucks one more time it´s going to be pollo (cooked chicken...aka DEAD).¨Luckily, for the chicken, it simmered down. Arriving in Otavalo we went to find our hostal but unfortunately the guy did not have our reservation. Although upset, we walked about a half a block down and found a better hostal that had rooms for all six of us, Katie, Jay, Julia, Andy, Alisa and I. The hostal looked like a log cabin and had hammocks in the courtyard. We found a good, at the time, place to eat and then went back to our other friends hostal to sit around the fire and enjoy a few cold ones. We met two ladies from Germany who were both school teachers and were spending 17 days in Ecuador for vacation. They were like me and only brought one pair of jeans because they assumed it would be warmer here. So one of them was trying to dry her jeans in front of the fire. Daniel serenaded us with the guitar and we just enjoyed each other company. That was the end of the ¨good¨in Otavalo. I woke up around 6 AM Saturday not feeling well at all and well, I won´t scare any of you but I was pretty sick all day Saturday. But I wanted to shop!! So I made myself get out of bed around noon and walk around the market for a few hours, just long enough to spend over $60 or so on hand made items. Definitely worth it. We came back to Quito Saturday night and went out for sushi which I probably should not have done since I was not feeling the greatest. Yep my body was not ready for it because I woke up sick again Sunday morning. I contemplated taking my anitbiotic I brought with me for traveler´s sickness but thankfully by late Sunday morning, my sickness had subsided and I felt 100 percent better!! I hate getting sick away from home and hopefully that was a one time deal and I am good to go for the next two weeks!! Otavalo was amazing and I´m bummed I did not get to see as much of it as I would have liked too. I´ll make Sunday it´s own entry :)

Perfect Ending to an Outstanding Week

So the rest of last week was pretty hard to top after delivering my first baby but it honestly got better! I am now friends with pretty much everyone on the unit, doctors, residents, nurses, EVERYONE! Fernando and Maria Fernanda greeted me this morning (Thursday) with a kiss on the cheek and we saw a birth right away. Actually, Fernando was the pediatrician and almost forgot!! I looked behind me and saw him sprinting to the scrub station as this lady was pushing. The woman was my age (22) and she had a girl. During the birth, Jen and I held her hands and caressed her shoulder but I noticed she was not breathing right and her lips were turning blue. After the birth, I thought she might perk up when they brought in her new baby girl for a kiss on the cheek. Instead, she just layed there and showed completely no interest. Fernando, although being up since 8 AM the previous morning, whisked the baby away to the nursery. She was really blue and I got nervous so I left and went back to check on the mom. Unfortunately she was not much better and they began giving her oxygen as they called other doctors (anesthesiologists, internal medicine, I think?) to help intibate her. Apparently she went into shock because she suffered from pre-eclampsia. As I returned the nursery, Fernando was giving the little baby oxygen and suddenly she began to cry. I can not describe the joy and heartwarming that comes with hearing a baby cry for the first time. It chokes me up and gives me goosebumps each time. She was only 30 weeks only and tiny. From what I could understand between Fernando and Maria, the mom became hypoxic and was loosing a lot of blood after delivery. Apparently, she came into the ER that morning around 6 AM and they diagnosed her as pre-eclamptic and gave her magnesium sulfate to help lower her blood pressure. Unfortunately, the ER docs did not make a note of the dosage on her chart so the doctors in Sala de Partos gave her even MORE mag. The membrane around the baby had also ruptured and no one had reported that as well. Therefore, because of the overdose she went into shock and they had to sedate and intubate her. It was a scary sight to watch but after a few hours they had her stablized and I was assured she would recover fully. That would be a lawsuit waiting to happen in the US. Fernando and Maria are so great!! I absolutely loved working with them. Fernando was teasing me because I told him Ecuador was NOT a third world country in my opinion and for an example, I said, "You have cell phones." He laughed and then I asked later if they gave Rhogam to women who were Rh- and he said, "Of course! Yes Hilary, we have cell phones and rhogam here." I about died. I love talking with him and he´s absolutely brillant! I learned that when they are "on call" they spend 28 hours straight at the hospital with 1 or 2 hour nap the entire time. Dr. Marquez has beeing amazing as well. He taught me how to feel the baby´s body while it was still inside mom and I also got to watch him perform a c-section today. Fernando told me hates gynocology but he loves babies! He wasnt to be a urologist in 2 months when he graduates. I am so sad that tomorrow is my last day! I have met and became friends with so many people even though it has only been 1 week! I learned Maria studied in Montana for 11 months and speaks English very well. She also told me that a lot of girls here, name Maria, prefer to be called by their first and last name because ¨Maria¨sounds like a housewife´s name. Her and Fernando are absolutely incredible and are going to be outstanding doctors. So right as I was getting ready to head out another lady goes into birth and Fernando runs and asks me if I want to do his job, which includes taking the baby after it is born to the nursery, basically being the pediatrician. Uh, YES!! So not only did I get to deliver a baby, I also got to play pediatrician and take care of it afterwards. After the OB doc sets the baby on the mom´s stomach, I suctioned the mouth and nose and began stimulating the feet and back. It was a little girl and she started crying immediately! I even got to give AP GAR scores, MOM! She was an 8 after 1 minute and 10 after 5. A perfectly healthy baby :) I couldn´t have asked for a better way to end a perfect week at La Maternidad. Fernando invited me to come back whenever and I may have to take him up on the offer later this week or weekend!

I DELIVERED a BABY GIRL today!!

I don´t have time to elaborate right now but definitely the coolest and most amazing thing I have ever done. Even though I tried to explain to Dr. Harin that I had never done this before he smiled and said, "You will be fine." Fernando knows English really well so he coached me through the entire thing...and took pictures. The baby´s name is Carla. Enjoy :)