During the second week of observation, I went to the Centro Médico de Especialidades de la Universidad Católica. There, I got to watch several endoscopies. One endoscopy that was performed was on a nun in her 50's or 60's who had swallowed some kind of caustic liquid. Since she told the story in Spanish, I only really caught the gist of what happened. Apparently, she wanted to taste some kind of liquid she found in her cabinet, because she thought it was anise. Turns out it was something caustic instead, and it burned her entire mouth and esophagus. Seeing the extent of the damage through the endoscopy made me realize how painful it must have been.
That day, I was only able to watch a few procedures because Chile was playing in the World Cup at 10 AM. All procedures conveniently concluded at 10:00 sharp, and there were none taking place after that, since the doctors wouldn't dare schedule one during the game. It was a really new experience for me to see how literally everything was put on hold for the sake of watching soccer. The only thing to which I could attempt to compare the situation in Chile would be the Super Bowl, but that's only one evening! Imagine the Super Bowl, but lasting for several weeks, and having the whole country united and cheering for the same team. Well, Chile won that day, and it was complete madness in the streets. I thought there were a lot of people when Chapel Hill rushed Franklin Street after winning the national championship, but compared to what I saw here in Santiago, that was nothing!
The next day of observation, I saw my first surgery ever! Although it was a relatively minor surgery, I was very excited about it. I watched a doctor remove a tumor from a woman's thyroid to be biopsied. The whole time, the doctor chatted and joked with the other nurses and anesthesiologist in the room, which somewhat caught me off-guard. I expected the climate in an OR to be a little more serious, but that definitely wasn't the case. I'm curious whether this happens in every OR in both Chile and the US. I guess I'll find out in time!
At the same hospital, Hospital Clínico de la Universidad Católica, I spent additional time in palliative care with a palliative care physician. I followed the doctor as he made his morning rounds and listened to him speak with patients who had terminal cancer or had very late-stage cancer. I am glad that unlike other days, I wasn't just thrown into a patients' room and told to speak with them about their experience, because quite honestly, I don't know what I would have said to someone dying with cancer (especially in Spanish). I feel like the ability to speak with a terminally ill patient is a skill that's only acquired through time and only successfully acquired by certain types of people. It was very interesting to watch this doctor speak to and care for his patients; he did a very wonderful job at it and I was really impressed by his dedication to such a difficult field of medicine.
During the last day of week two I went to a Reiki and Hipnosis center. The entire morning basically consisted of me discreetly rolling my eyes and attempting to keep my mouth shut about my own rather strong opinions. A lady performed Reiki on me, and basically all she did was try to gather "energy" from her surroundings and transfer that energy to me by waving her hands around. Feel free to call me a skeptic; I just can't get myself to believe that these therapies are legitimate. I do believe they can have a positive effect when used in addition to modern medicine, but only because of the "placebo effect" they have on patients. For example, the Reiki woman told me someone was cured of cancer after receiving Reiki. The only way I believe that could be possible is because she was also receiving chemotherapy, and that Reiki helped her maintain a positive attitude towards her disease. There are studies that have found tangible effects of patients' positivity on their recovery from diseases, including cancer.
Another example of alternative or traditional medicine I learned about was Mapuche medicine. We went to a Ruca Mapuche, which was basically a hut that was considered the Mapuche health "clinic." There, we spoke with a Machi, which is basically a Mapuche witch doctor. He practices traditional Mapuche medicine on his patients while his wife cooks the special medicinal herbs in the hut. It was an interesting experience visiting the Ruca, and it definitely gave me a small glimpse into a world completely different from my own.
Later, we went to the Centro Médico Madre Teresa de Calcuta. This clinic is located in Puente Alto, which is part of the southern region of the Greater Santiago area. The clinic serves mostly low-income patients. I shadowed a dentist, and although that wasn't my first choice, I enjoyed observing and talking to him. The dentist had a lot to say about health education issues in Chile, specifically oral health. Oral health education is lacking not only among low-income patients, but among the entire Chilean population. My conversation with the dentist made me realize how thankful I was for being raised in an environment in which oral health and dentist visits were very important, but it also made me realize how unfair it is that people have not benefited from the same situation.
During my very last day of clinical observation, I went to the Centro de Salud Comunitario Lo Franco. This clinic was poorer and had even less resources than Madre Teresa de Calcuta. At this clinic, I observed an OB/GYN. Each checkup lasted only 15 minutes on average, which was rather surprising to me. Because of this, I got to see him perform checkups on many patients. Some were pregnant, some had already had a child, some had infections, and some wanted birth control. Of all the patients who were pregnant or who already had children, the pregnancy had been unplanned and the patient was extremely young. As in the United States, this is a significant issue in Chile, but the influence of Catholisism on culture and certain taboos in the country make things a bit more complicated here.
I concluded my internship with a research paper and presentation related to my clinical observations. My research topic came from the day I spent at the orphanage for HIV-positive children. The title of my project, which I worked on with another student, was: El progreso de la lucha por la conciencia de VIH/SIDA en Chile y los Estados Unidos: Una Comparación de las Campañas, las Pruebas, y los Estigmas Relacionados al Virus. Or, in English: The progress of the fight for HIV/AIDS Awareness in Chile and the US: A comparison of campaigns, testing, and stigmas related to the virus. We worked really hard on this paper and I was really proud of the end result (and the fact that we did it all in Spanish!).
My clinical observation experiences here have revealed many things to me. Firstly, the fact that I've been simply reflecting on my future career has made me realize something that should have been obvious a long time ago. How did I not realize before this what kind of doctor I'm being called to become? It's so obvious now that God has placed in my heart a really strong love and compassion for children, and that's who I'm called to serve when I'm a doctor. I've known for a long time that there's a special place in my heart for kids, but I never but two and two together until now. I also realized that I have a fascination with surgery and the idea that we can just go in and fix the human body just like my mom can fix my ripped jeans or like glue can fix a broken toy. While I've got tons of time to decide my specialty, it's becoming clearer that I definitely want to do something involving both children and surgery.
Observing and learning about the health inequities both in Chile and the United States has both increased my frustration and increased my desire to do something about it. We'll see exactly what that means in terms of where I end up in my career, but I feel really strongly called to work in an underserved hospital in a US city and am also constantly reminded of the Lord's desire for justice and mercy for his people in the city.
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