Just an Idea of the traffic here...

This is only mildly exaggerated...

First day!

So today was my first day and I think it was an overall success! I'm pretty sure I stick out like a sore thumb american, but I think I held my own. The morning started off with me not being able to find. Apparently I'm not the only one who pays for taxi's to go to work in the morning. Instead I had to flag down one of the taxis driving probably 70 mph (not kidding) on the street in front of the house. I had no idea how to get to where I needed to go so I really was praying that my taxi driver knew the address and could get me remotely close. The ride was rather interesting as the whole way there, which wasn't very long thank goodness, the driver wouldn't stop talking to me about how his wife just left him for a younger man and that he kissed her feet and she still laughed at him! Seriously, you can't make this stuff up. So as he's telling me about his wife and her new bf I quickly see that I'm close enough and ask to get out please! It was an interesting ride.

I got to the education building and after the mandatory purse check (this is required to enter any building here) I sat down with about 15 other med students and new residents starting rotations at the hospital. Talk about being intimidated! So after waiting in the group for about 30 mins I realized I needed to be in a different place since I'm an international student with totally different paperwork lol. Nevertheless, I figured it out and they sent me to the hospital to make the usual rounds: ID badge and White Coat. Here they don't allow me to wear my ATSU short white coat, they require us to wear the hospital emblem and a long white coat :) I feel special. Maybe its a preview of what it will be like a in few months! ANyway, I miraculously found my way to the ID badges. I did however, get so lost looking for the place where I collect the white coat (which btw is in a small grey seemingly abandoned trailer in the back of the hospital parking lot!). I'm pretty sure I ended up OFF of the hospital grounds, don't ask me how.  BUT I got everything and finally made it down to the ED before noon.

THe doc I'm with is amazingly nice and awesome. She teaches a lot and has asked me to teach her as well. She wants to learn english so she'll ask me how we say common diseases. My first patient of the day was great, it actually gave me some confidence since I was pretty nervous about the whole spanish thing.  I saw a little guy who's mom said she was feeding him, he rolled on his arm weird and since then he hasn't moved it.  She let me examine him and I was pretty sure it was a Nursemaid's elbow, it was pretty obvious.  The doc consulted orthopedics (which is a common thing here for anything even remotely related to orthopedics) and he found nothing and did nothing. SO, mom came back down and the doc let me fix it! It's no big procedure or anything, but it was nice of her to let me do that on my first day. Baby felt better within 10 minutes and everybody was happy, yay first patient!

The only other really exciting/frustrating part of the day was the trauma that came in. The kid was about 9 yrs old and he ran into a volleyball net and flung himself backwards and hit his head on the concrete at school. According to his mom he was fine for an hour and then started to drool and slurr his words, pretty scary.  Side note: in the midst of the say, one of the other attendings (also very awesome) assumed that I was a 3rd year Peds resident, something clearly got lost in translation lol. SO, we're at this trauma and she says "go ahead start, I'll be right there"......ummm....WHAT?! Luckily my initial attending had already gotten there and everything was fine. BUt i seriously, in less than 2 seconds, panicked and started sweating through my clothes lol. Anyway, everything was going on and I knew what I had to be doing to help, but I was so oooo frustrated! I could barely understand what the doc was calling out because she was talking so fast! Also, traumas seem to be run differently here, so I was a little lost. But the most frustrating thing was that I just couldn't get my words out fast enough. I think in english, so it takes me a second to think about it all in english and get it out in spanish. Everything was fine, he got taken to CT (which btw i had no idea is called TAC) and he ended up being fine. But i was really so frustrated that I felt like a total idiot standing there in the trauma bay. I felt helpless and like everything I know is useless if I can't get it out the way I need to. I know it was only my first day, but I hated that feeling so much. I am getting the hang of it and training my ear to the Bogota accent. That feeling is another huge reason why I came here. I need to practice! The spanish I speak in Phx with the mexican people is VERY different than here. Anyway, that was my excitement for the day.

A list of some things that are different here that I think are worth mentioning:

- Med students wear long white coats
- nobody does undergrad, they go straight from high school to medical school (6 yrs)
- you actually have to pay for residency, you don't get paid
- nurses are called "jefe"  (translation: boss) by everyone
- EVERYONE takes a full hour for lunch, even the ED attendings! (this I'm NOT used to)
- White coats are NOT allowed to be worn outside f the hospital
- Parents (for the most part) are very educated about what to do when their baby has a cold (waaaay more than in the US!)
- The docs aren't terrified of getting sued by everybody that walks in the door


More stories tomorrow and more will be added to the above list! :)

[BOGOTA]

I'm in Bogota! After spending most of my 3rd year of medical school setting up this international rotation in Peds EM in Bogota, Colombia, I'm finally here! I don't even want to count how many awkward conversations I had with the department of education of the hospital where I'm rotating (Fundacion Santa Fe de Bogota). Trying to ask them if they would take me as a student, explaining exactly the documents I needed, translating said documents to english and vice versa, and apologizing for the infinite number of requirements from my university was extremely frustrating. Also, it's somewhat annoying when your own university doesn't even believe you'll ever be able to set something up in such a "dangerous" place. Nevertheless, I'M HERE! My rotation starts tomorrow, yikes! I've been in Bogota for just a day now and I'm getting more and more excited to start. I have some hesitations that make me nervous, mainly because of my spanish. I do speak fluent spanish, but my medical spanish isn't perfect. Living in AZ i've had so much practice and I've come a long way, but for me, it's still not good enough. I know (i hope) everyone will be very helpful no matter what, but i can't help but be a little nervous!

A couple people have asked me why I decided to come to Colombia, a place I've already visited several times in my life. Why not try for India or Africa (which I WILL do in my life guaranteed) or just someplace new????? The truth is that yes, I've visited Colombia before, but this is different than just visiting. It has always been a dream of mine to do medicine in different countries and really immerse myself in the country/culture. I chose Colombia because it seemed like the most natural place to start. Although I've been here several times, I have to say that I still feel like a stranger here. There are so many subtle cultural differences that, when put together, really make it a different world. I love that. I've always said that you never really know people until you've seen them when they're sick. Granted, I'm doing peds EM, but working here for a month in a hospital is going to give me a completely different experience that I've ever had here, I know that for a fact. The intention is not to go see the "pretty" things (although I can't skip some tourist things), but I just want feel the culture from a different perspective. I also want to see how medicine is practiced in general here. Based on the cultural differences alone, it should be interesting to see the differences in the ER alone.

I went to visit the hospital today just to look around and I loved it. I'll post pictures once I get more comfortable and know when and where it's ok to use my big camera like a tourist. It's in a cool, very business oriented part of the city. I have to take a taxi to and from everyday. It's cheaper since it's not far and just easier than taking a bus or walking.

I'm still not entirely sure what to expect or how tomorrow will go. My main goals for the first day are to just make a good first impression and not look like a total idiot. I'll let you know how it goes! :)

Residency post!

When I talk about my match results (residency), i’ve had lots of people look at me with the “why is she so happy? I thought she wanted ER”- type of look. Anybody that knows me even remotely well knows how committed to emergency medicine I am. So, I understand the confusion going through my friends’ heads. The truth is that I was upset, quite upset when I first found out that once again, (flashback to not getting into med school first time around) it didn’t work out the way I planned and really really wanted it to...big surprise. I think I put so much weight on matching to EM this year because of how tough it was for me to fight my way out of a path that wasn’t in my plan (maintenance officer at Holloman AFB) in the first place and get back on track with my original plan for medical school! The LAST thing I wanted was to have to give myself the same daily pep-talk that I did when I found out I was doing the opposite of my dream in, what seemed like at the time, the worst place on earth lol. Everyday I would tell myself, “it’s not what you wanted, but it’s just an alternative route to get to where you want to be and no matter what, you’ll be better for it. Never give up”...blah. So I took not matching to EM pretty tough at first. 

Oh and also, in my own defense, just to put things in perspective for non-medical students. Being in med school, surrounded by hundreds of other type A personalities that make not matching seem worse than dying a fiery death, tends to make the mere thought of doing something other than what you want totally UNTHINKABLE! For some reason, it’s equivalent to failing. So, we can graduate medical school and be in the top 1% of people but in our minds we’ve failed lol. Dramatic? Yes. Ridiculous? Absolutely. But that’s how we crazy medical students often think. And actually, that sort of thinking is what has actually brought us this far. But anyway, not trying to defend my craziness with this post.

 So all that being said, my sadness over the match lasted only a day or so. I quickly realized, possibly because I’ve done this before, that all is not lost, not even close. Just because I didn’t match this year (to EM), doesn’t mean I’m never going to match into EM. Internal medicine is not something I would have chosen (obviously), but it is still a great year of experience that I can get under my belt. I’m in no way changing my mind about EM. Some friends in my same position have had a change of heart and decided to continue with the specialty they were given, and I’m happy for them if they’re happy. I’ve even had someone in a position of leadership in my school “politely” tell me that i should switch to a less competitive specialty so I have a better chance of matching again. (really?!?!?!) And honestly, that would make my life a lot more simple and maybe slightly more predictable. Fortunately (or unfortunately), it seems that it’s my plight in life to take the more difficult path. No regrets though, I wouldn’t want it any other way. I’m actually very excited to start intern year in internal medicine. I know it will only help me be a better ER doc in the long run. I’m trying really hard to look at from the perspective that I am still doing what I love! I'm still going to be an ER doctor that's for sure, but I know I'm going to love just being an intern. Sometimes I get so caught up in working towards what that “final goal” that I forget that life is happening right now. Sure I want to be an ER doctor that's very clear. But I'm not going to dwell what I did or didn't match into this year and not make the best of the opportunities the next year brings. I'm still going to be a doctor in an awesome internal medicine slot learning at a very sought after location. It's very cliche but very true, "Life is what happens when you're busy making other plans..." I highly doubt I'll ever be able to stop planning, but rather than looking at this match as a failure or short fall, I'm looking at it more as a previously overlooked opportunity and stepping stone to the next thing (ER next year!)  :) 

I'm extremely excited, very scared, and totally ready to start! I love the city, love the people there already, and can't wait to make it my home. And you already know that I'm going to find my way into that ED every chance I get!! 

So that's my story and the long version of what I tell people when they give me the awkward stare when asking me about the match. 

Updates :)

It's funny that I've started my last few entries with something like: "it's crazy how long it has been since my last entry..." Well, to continue my theme, it's been 3 months! Actually, it feels like longer than that to me. Big things have happened since the last post! Just to name a few: I matched to a PGY-1 spot in Internal Medicine (see below) at San Antonio Military Medical Center :) , I got approved for my international rotation in Bogota at Fundacion Santa Fe de Bogota University Hospital (for which I leave tomorrow!!!), and I started a great relationship with an awesomely understanding and extremely sweet man that makes me very happy! So needles to say, things have been going very well for me.

Rather than try to post one looooong update post, I'm going to post a couple of long overdue posts after this one :)