TGIF!

It's only been five days really but I'm wiped out -- the result of the hot-sun, speaking in a second language, and navigating around a new city, hospital, and culture. I think Amy would agree with me. (She's currently scrubbed into some surgical cases.)

I delivered another baby today to a primip without an episiotomy, or laceration. Phew. There were different nurses and residents around this time and, again, they were equally skeptical and providing much commentary throughout. The poor laboring woman. One nurse told me she'd rather have an episiotomy than a vaginal laceration. I guess to each her own. I also brought in the two vacuums that Labor & Delivery donated. The residents played around with it on each other, making lots of ring marks. There are hardly any instrument-assisted deliveries done here, but maybe they'll get to see one or two before Amy and I leave.

Amy did a very cool thing today. She made two "home-visits" to home-bound patients. Santiago, our main contact person here, runs the Polus Center, a non-profit organization for social and economic development. One of his main projects has been trying disabled men find jobs. Some of these men are amputees (I'm not sure from what, possibly the war and landmines?) and some are paraplegics. Today, Amy went to see two of them on behalf of Santiago and their respective families. I'll try to egg Amy on into writing a brief entry about what that experience was like. One comment she did make to me was after seeing pictures in Santiago's photo albums of these unfortunate men on crutches trying their hardest to work on farms and in the fields. Their desire to work despite their obvious handicap contrasted the number of patients we see in the States applying for disability for pretty vague reasons.

Tonight we're headed to see a local Nicaraguan salsa band to which my R3 OB resident invited us, and then tomorrow we're off to hike and camp at a nearby volcano. Sorry no witty remarks or funny stories today -- I'm feeling pretty pooped. Hopefully the weekend will rejuvenate us and we'll upload fun pictures from our weekend. Stay tuned!

Actually, I just remembered something I wanted to mention. On my overnight call, I ended up "sleeping" on a table because there are no call rooms for residents so residents sleep wherever they can, including patient beds (when there is no patient in it, of course, although the thought did cross my mind...) There was a strike about 1.5 years ago for higher resident and physician salaries. Before the strike the residents were paid nothing, zero, nada. Since the strike they now receive about $450 US dollars a month, which is still not much. They work q4 shifts from 7am to 3pm the next day, but on the intervening days they work just from 7am to 3pm. At night the residents run the hospital and attendings are called in possibly once a month. The one thing that remains the same in the US and Nicaragua is . . . paperwork! There is a "monton" of paperwork and residents are always busy filling them out, and, of course, the interns have to do the brunt of it. Because I wrote an H&P that got a lot of laughs because of its elementary direct translation from English, I'm exempt from the paperwork. Here's an example that made the R3 resident laugh aloud.

General: La paciente esta alerta y comoda. Hace algo ruido durante los dolores pero no esta gritando... (The patient is alert and comfortable. She makes some noise during contractions but is not screaming...)

Alright, Amy's back and we're going to get ready to head out.

Cindy