Hasta pronto, Córdoba

I am officially 24 hours away from the first flight of my journey home and just thinking about it makes me tear up a little bit. If I could go back in time, I would definitely have planned to stay here longer. Yesterday, la guardia was more quiet than usual so I spent more time hanging out with the doctors and residents in the break room. The way that the hospital staff interact with each other here is much more relaxed than what I've seen back home. They are constantly joking around with each other and always take their meal breaks together - everyday around lunch time, if there are only a few patients, la guardia empties out and you can find almost everyone downstairs in the cafeteria hanging out together. A couple of doctors asked me if the atmosphere was similar in the States and I said that it wasn't, that people were still friendly with each other but it was very toned down compared to here. They told me that they need to be able to make jokes and laugh so that they get through the day. Especially in the emergency hospital, the work load can be very demanding both physically and emotionally so they take every chance they get to kick back and relax for a bit. Also, here in Argentina, the medical profession isn't as prestigious as it is back home (bus drivers can make the same salary as doctors) so they are only in this line of work because they really like what they do. 

Last night, all of us CFHI students got together with Carlos and Charly for a wine tasting class. We tried 7 different kinds of wine all produced in Argentina along with a classic assortment of bread, cheese, and salame. We got to taste Malbec, Cabernet Sauvignon, Torrontes, Syrah, and a couple others. What was supposed to only last about an hour and a half ended up lasting almost five hours because we started listening to Argentinian music and that quickly evolved into a karaoke-like party. It was a lot of fun and a great way to wrap up the trip for me and the other two girls who were also only here for 2 weeks. 

This morning, I tried not to cry as I put on my scrubs and headed for the hospital one last time. La guardia was quiet again but we finally got to go to el quirófano - the operating room. We watched a gall bladder removal which was done laparoscopically and only lasted about 30 minutes. I was very tempted to hold the gall bladder in my hand when they took it out of the patient but I wasn't wearing sterile gloves so I thought it'd be best to just admire it sitting on the table. Before we got to enter the surgical ward we had to put on these ridiculous looking surgical scrubs and put on booties, a mask, and head cover. I've never gotten to dress up for an OR so this was a fun experience and it was the perfect ending to my time in the hospital. 

Everyday in the hospital was a new and fun experience for me and I am so happy that I decided to come to Córdoba and participate in the Hospital Medicine program through CFHI. I have had the opportunity to see and learn things now that back home I might not have seen until the end of medical school or even until residency. All the people I got to meet and talk to have been so great and helpful. Overall, my time in the hospital surpassed all my expectations and I hope that I can come back soon. 

I want to say thank you to everyone at CFHI in California and everyone at ICC and the Hospital de Urgencies here in Córdoba. This experience was so amazing and I will cherish the time that I have had here for the rest of my life. Leaving Argentina is really bittersweet but this is definitely not the last time that I will travel to this amazing place. Again, thank you to everyone involved in this program - words cannot fully express how much I have enjoyed my time here and how truly sad I am to go. 

Muchas gracias,

Sophia

Maddy and I with Dr. Feuillet

Inside the operating room

The surgical attire

My attempt at taking a nice picture in front of the hospital while its 100 degrees outside.

Almost to the End (unfortunately)

The closer it gets to Saturday, the more I want to change my flights and stay here longer. I've enjoyed my time here so much and I am really so sad that it's almost over. Both Monday and Tuesday mornings I was in the hospital and I saw the usual kinds of patients: motorcycle/car accidents, alcohol/drug intoxications, abdominal or chest pains, and wounds that needed stitches. I think I have seen at least one patient from each of these categories every day that I have been in the hospital which is concerning because supposedly the month of January is relatively calm since so many people are out of town on vacation. Since Argentina just recently had a change of President and governing political party, I've been told that a lot of people are choosing to stay home and save money because they're not sure how the economy is going to be for the next couple of months. Even still, if this is how the hospital is during a quiet month than I can't imagine how it is when everyone is back in town for school and work.

Tuesday night, I decided to do a night shift in la guardia and I had also been invited to an asado at the hospital that occurs every Tuesday night. An asado is a typical Argentine gathering similar to a barbecue back home where the menu consists of a large portion of beef or pork. They roasted a whole (but small) pig and cut it up for everyone to eat - it was delicious. This began around 10:30pm and once everyone had finished eating people sat around and chatted until almost 3am. Some of the doctors and residents were still working their shift so people would come and go but it was a relatively slow night in la guardia so there weren't many patients to see. Everyone asked me a lot about my life in California and the medical school process back home. People here really enjoy comparing life in Argentina to life in the US and I ended up talking so much for so long that I lost my voice today. I really enjoyed getting to know everyone on such a friendly level because things like this don't happen in hospitals back home - at least not the ones I've been to.

After the asado, I ended up going back home around 4:30am (technically this morning) and sleeping a bit so I could be back at the hospital at 8:30am to do my regular four hours of observation. By the time I went home around noon, I was so worn out that I took a 5 hour nap. Now I'm about to go to sleep again so that I can get up and do my second to last morning in the hospital. I really wish I had more time here in Cordoba to spend time in the hospital because I have been able to see and learn so much in the short time that I've been here but I am grateful for the experiences I've had and for the people I have gotten to spend time with here.

Weekend Wrap Up

I'm starting to realize that keeping up with this blog is a lot harder than I thought it would be, which is both a good and bad thing. I'm pretty busy everyday because I'm at the hospital and then I have class but that means that when I do get to go home, I'm super tired and ready to pass out. Luckily, I've been making sure to write down some notes about how the day went every night before I go to sleep. This way I can get a good night's sleep and not forget any of the awesome stuff that I get to see everyday!

This past Friday was by far the best day in the hospital. There were fewer doctors working that shift than there had been on previous days but they were still very nice and inviting. One of the doctors let Maddy and I use his stethoscope to try to listen to each other's breathing because we had never really done that before (we didn't hear much because we didn't actually know what we were doing). Another doctor let us watch closely as he stitched up a massive cut on a patient's hand; this was very bloody but also very cool. And then there was a surgeon who basically made my day when he taught me how to do stitches from start to finish - I didn't do anything, don't worry, I just watched. He started by showing me how to thread a needle that does not already come with the string on it, then showed me how to best inject the Lidocaine, and then did every stitch very slowly so that he could explain everything that he was doing. The wound was a cut about 2 inches long on the top of a patient's head but it was a pretty clean cut so the doctor was able to close the wound with only 4 stitches. I felt like a little kid on Christmas while I stood by his side and he explained every step. After this, I didn't think the day could get any better - I was very, very wrong.

A large man came in with his left hand wrapped in a bloody sheet but he was very calm as he waited for the nurses to tell him what room to sit in. I went to see a different patient and, when I came back, one of the doctors was setting up the suture kit while the man was laying on his back with his arm stretched out and his hand resting on a wooden plank sticking out from the side of the bed. I stood outside the door of the room because I hadn't met this doctor yet and I didn't know if she would let me watch her or not. Just like the other doctors, she invited me into the room so I could get a closer look. The man has sliced open his finger so deep that the tendon was exposed and blood filled the wound in fractions of a second. With the help of another doctor, I watched as she stitched the tendon first because it had too been cut a little bit. Just as she was getting ready to move on to suturing the layers of skin back together, the surgeon from the head wound came over and told me to follow him. We went to the small ICU of the hospital where an unconscious man was hooked up to a respirator. I was going to watch the surgeon perform a tracheotomy - he was going to make an incision in the neck down to the trachea (windpipe) and then insert a tube into the incision which would be attached to the respirator so that the patient could breathe. I watched the doctor put on the gown, mask, and gloves while a nurse prepared all the tools necessary for the procedure. Once everything was ready, he began with a small incision in the lower part of the front of the neck and cut all the way down to the trachea. He then made another hole in the trachea itself; when this happened, there were little specks of blood that shot out every time air escaped (I personally thought this was really cool). The tube went into the small hole and the respirator was attached to the other end of the tube. The entire procedure lasted maybe 15 minutes. After this, I felt like I had adrenaline rushing through my body because I couldn't believe I had been allowed to watch the procedure from the surgeon's side. The fact that I looked inside a man's neck is absolutely crazy, but in the best way. At that point, it was time for me to go so that I could make it to class on time but before I left some of the doctors suggested I come in for a night shift because that is when la guardia really gets busy. Tomorrow morning I'm going to ask my hospital supervisor if I can actually do that - I'm really hoping I can!

Yesterday, while still reliving the awesomeness of Friday, two girls from the program and I went to a cute little pueblo about 3 hours away called "La Cumbrecita". It was originally inhabited by German immigrants so all the buildings looked very germanic. The town itself was tiny but was filled with restaurants serving traditional foods like sausage and beer as well as several small hotels and gift shops. The highlight of this little town was the little waterfall that you could get to by hiking. Really it was more of a 20 minute walk along a narrow, rocky path and then a 5 minute climb because the path ended and there were just a bunch of large rocks in the way. Luckily the sky was overcast so it was cooler than usual and there was a slight wind, otherwise this hike would've been miserable. The waterfall itself was really pretty and I managed to get some good pictures (as you can see below). Afterwards we walked back through the town, did a little shopping, and got on a bus to head back home.

The adorable mugs of hot chocolate.

A bridge over the river. 

The "wasserfall"

One of the many little restaurants - this one had live music. 

I am so sad that this first week has gone by so quickly but I am so excited to get back in the hospital tomorrow morning!

As they say here in Argentina, Chau Chau!

Week 1 of the Program

It's 9:30pm on a Thursday night here in Cordoba and I've just finished having dinner with Beatriz, my host. It's probably important to note that it is very unusual that we have already had dinner because Argentinians typically have dinner at around 11pm during the summer, but I (and my stomach) am very glad that we do things a little differently in this household. I realize that I probably should not have gone all these days without posting anything but I've been so busy that I unfortunately haven't had the time until now. So much has happened so I'll try to sum it up as best as I can!

Monday morning, one of the other program participants and I were taken to the Hospital de Urgencias by the local CFHI coordinators, Carlos and Charly, so that we could meet our hospital coordinator, a very kind woman named Mary. Charly picked me up outside of my apartment (here they are called departamentos) and we walked to the bus station just around the corner. I don't use the bus system at home, or anywhere, so naturally I was terrified of the idea of having to ride the bus to and from the hospital on my own. Thankfully, the bus ride is very short and there's a large sign that points towards the hospital right at the stop where I have to get off so it's hard to mess up (although I did miss my stop on the first morning but I blame the rain for that one).

Monday evening, the other 9 program participants and I had an orientation meeting with Carlos and Charly at the Intercambio Cultural office. We got a short but thorough introduction to Argentina and its history and people, which was helpful considering I actually knew a lot less about this country than I had originally thought. They gave us lots of tips about how to conduct ourselves in the hospital so as to not offend anyone (don't say no to the yerba mate, that's a big one) and reminded us to take full advantage of our hospital time because students here in Argentina never got these kinds of opportunities. I was placed in the emergency hospital but other students were placed in the pediatric hospital, the infectious diseases hospital, and a larger public hospital.

Tuesday morning, as I said before, I missed the bus stop for the hospital but, luckily, I had left my apartment way too early anyway so I was still 15 minutes early to the hospital. Maddy, the other CFHI program participant that was placed in the same hospital, and I met with Mary again and she walked us down to la guardia, which is basically just the emergency room that sees the patients who are urgent but not critical. The patients in really bad shape go to the "shock room", which is in the same area as la guardia but is behind closed doors. Unlike emergency hospitals in the US, the Hospital de Urgencias is the only hospital that handles emergency patients. Anyone involved in car accidents or who has wounds from firearms, for example, is taken to this hospital automatically, no matter where they are in Cordoba. This makes it hard to define a "typical" kind of patient that you would see in this hospital because really you could see just about anything.
All of the doctors, residents, and students (who I cannot actually tell apart because everyone wears scrubs and no one has any sort of identification badge) were very kind and most of them were curious to know why 2 random American girls were in their hospital. I also was asked multiple times why my Spanish was so good and overtime I explained that my family was from Costa Rica so I learned and spoke Spanish at home. Also, since it was only the first day, Maddy and I ended up spending most of our time in the break room which was located right in the middle of the guardia and didn't really get to see much. Looking back, I definitely should have been more vocal and asked more questions, but it was only the first day.

Good news though, both yesterday and today went super well and we got to observe lots of cool things like EKG's, ultrasounds, cast removals, stitches, blood draws, and basic patient history intake and physical exams. We are only in the hospital from 8 AM to about 12:30 PM but the emergency rooms tends to be quite busy so we see a lot in that short time. I still don't understand the scheduling because it seems like doctors, residents, and students, work at this hospital only one or two days a week but this means we get to meet new people everyday. Most of the younger doctors and residents encourage us to stand closer to them during patient encounters and explain what is going on, which is really amazing. Also, when we're all in the break room, everyone shares food, coffee, and mate with us, which is both good and bad because I need to stop eating so many bizcochos. They love asking me questions and learning more about California and Costa Rica so I've become very comfortable around everyone.

It's about 10:15 PM now and I've got to be at the hospital bright and early in the morning so I'll end this here but in general this week has been really great and I am so happy with everything that I am learning! I can't wait to spend more time in the hospital tomorrow and next week!

Cordoba!

Early yesterday morning I got on a short flight from Buenos Aires to Cordoba so now my CFHI adventure has officially begun! My host, Beatriz, is incredibly kind and her apartment is so lovely. When I was dropped off, she made me lunch right away and that afternoon we went to a house in the hills of Cordoba about an hour from the city to escape the heat. Her daughter and granddaughters were there waiting for us by the pool and everyone was so kind I immediately felt comfortable. We have just returned to the city and I'm getting ready for the hospital orientation tomorrow morning, for which I am both nervous and excited. I am still trying to take in everything and wrap my head around the fact that I am here in Argentina but so far everything has been so wonderful, I could not be happier!