First Day in the Hospital

We had our first day in the hospital and spent an unfortunate amount of time shadowing. Hopefully, we'll rectify that tomorrow.

In any case, we spent the morning rounding with the high-risk OB team, where we saw cases of pre-eclampsia, preterm labor, pyelonephritis, and a sad case of a woman measuring small for dates carrying an anencephalic baby to term who likely would not survive the delivery. Afterward, I spent the rest of the day in labor and delivery, while Amy was triaging (or more like watching the OB residents triage) in the ER.

A couple of interesting things I learned today. First, an abortion of any kind is illegal in Nicaragua - even an unruptured ectopic pregnancy (for non-medical readers, an ectopic is when a pregnancy is somewhere else outside the uterus). Theoretically, according to the law, one has to wait for the woman with an ectopic pregnancy to show signs of instability (pain does not count) before proceeding. The third-year resident did tell me, though, that often many of her attendings will still go ahead with it prior to its rupture because of its obvious danger to everyone but the ignorant lawmakers. I also learned that one can deliver a baby without any of the many tools we use in the States. I'm exaggerating, of course, as I know it's possible. More, I felt sort of lame on just how much I rely on machines, intrauterine devices, etc. to perform what is a natural process. I felt embarrassed telling the third-year resident that my fancy $120 Littmann III stethoscope had never touched the belly of a pregnant woman before. "What? You can hear the baby's heartbeat without a doppler??" And, get this!, the residents use their very own hands to estimate the frequency and strength (calculating pseudo-montevideo units) of contractions and to rupture membranes. Pitocin drips are "calculated" based on the number of droplets per minute. Crazy. Tomorrow I take my first "turno" (call) and will get to experience all this firsthand. I'm actually looking forward to it, as I'll sure be learning new skills...

Today Amy told me, "Boy, you sure get ogled at." as many calls of "Ooh, chinita, chinita!" finally surfaced as expected while walking on the streets (and even during a funeral march, if you can imagine that!) In one particularly funny incident, I was inside a store asking for directions and Amy was striking up a conversation with the guard outside that went something like this:

Guard: Is she (meaning me) Japanese?

Amy: No, she's Chinese.

Guard: Oh, are you Chinese, too? (To his credit -- sort of -- Amy had on dark sunglasses and a large hat.)

Amy: No, I'm American.

Guard: Oh, why are you friends then?

And he was being completely serious. Bizarre. The other day, our driver Julio also asked me out of the blue: "So does your father own a Chinese restaurant?" Random. Oh well, maybe I'm just a target for seemingly ridiculous questions, as I've had some patients in Santa Rosa ask me if I'm Mexican. Hmmm... Anyway, I'm off to relax a bit before learning to use my stethoscope on parts of the body other than the heart and lungs tomorrow. Wish me luck!

Cindy