3 days left in Colombia :(

My month in Bogota is coming to an end and I´m torn. Part of me really wants to stay and experience more, but the other part of me can´t wait to get home! I turned in my white coat today, the hospital gave me one to use, and I´m basically done working´now. The past couple of days I was getting REALLY tired of kids with gastroenteritis, so I think its safe to say I was ready to be done lol. All in all, im happy that I got to coem here and learn in a different system. Fundacion Santa Fe is actualy only a very very small picture of what the medicine in Colombia is really like though. It very much resembles the US in terms of EMR, medical resources available, etc. If i could do it again, after already experiencing FSFB, I would want to do EM in a not so nice hopsital in town that gets trauma or at a rual health center in one of the surrounding small towns. But that´s def later, once I have a few years of being a doctor under my belt lol. Maybe one day... :)

Anyway, now that Im almost gone, I´m starting to think about where I want to visit next. I know craziness (intern year) is going to start soon in June and I wont really have anytime, but I´ve decided that I want to always have travel plans in the works. If not now, then when will I ever do it? Its all too easy to say theres no time. ANyway, I would love to come back to Bogota with Tim and show him how amazing it is. I also have really been wanting to go to Brazil lately. My cousin was there for 6 months and, although I already have been wanting ot go for a looooong time, the way he talks about it is just making me want to go even more. Also, #78 on my list of 200 things I have to do before I turn 50 is: learn Portuges!!

In other news, now that i only have a few days left, ALL of my aunts want me to see them. Theres too many aunts and family and not enough time :( I have gotten to see a good fair share of family though since ive been here and Im happy about that. Everytime I come to Colombia I meet more cousins and I love that. I dont think you can ever have too much family, even if they are somewhat crazy or weird lol.

what else...Ive met some pretty awesome people here at the hospital too. I think I work pretty hard, but Im constantly amazed by how hard the med students work here. They are brilliant and juggle school, research, traffic, and life in Bogota (which can be tough at times). I can honestly say, they work MUCH harder to be doctors than most american students do.

ok, now Im off to make the bes tof my last 3 days here!

Week #2 in Bogota!

Time is really flying! I cant believe its already the end of my second week in Bogota! I feel like I just got here. This week was good. I am mastering the flow of the ED and learning the different quirks of the different docs/nurses (i.e. some like notes in a certain format, some don´t let me write notes, some want me to do everything, and some nurses get offended if I put a pulse ox on a kid without asking them to do it, very ridiculous, I know). Im also mastering the art of gaining weight! I´m not dieting while Im here but I have been trying, and failing miserably, to eat small portions and work out. Its not that I eat all the time (almost), but the food here is very heavy. Lunch always is some sort of meat with rice, potatoes, some other carbs, etc. I know its not the best, but I cant resist it!! ALso, if you dont clean your huge plate of food here, ive noticed tha tpeople look at you weird, like you are wasting good food. Im trying not to think about it and enjoy everything here, but I feel like a lard. I havent worked out in 2 weeks and that makes me feel more tired! Its sort of like the lady from the movie eat, pray, love, who has to buy herself some "big lady pants" after 4 months in italy. Im almost to the big lady pants point in only 2 weeks!! yikes!

In other news, walking home has been awesome this week! I figured out a faster, although initially more dangerous, route home. By more dangerous I mean I have to cross 2 really busy streets and a railroad track, and then its all sidewalks. Everyday to cross the initial 2 busy streets people (including me, but I let them go first so if anybody gets hit its them) have to sort of step right out in front of cars hoping they will stop. Nobody has gotten hit since ive been here, so Im assuming that tactic is pretty much the norm and cars are used to it by now. Nonetheless, i still get a little scared. After that though, the rest of the walk is side streets that take me through the mall and straight home. There are lots of cute stores on the walk home that Ive stopped in. Theres one, Inkata Design Store, that I really love. There are stores all over Bogota and theyre awesome! THey also have a really awesome outdoors store on the way home that I have yet to stop in because Im waiting until I have time to shop and buy things :) Ive also tried almost every coffee place (which is probably about 15) on the way home. The biggest coffee store here by far is Juan Valdez. Its the equivalent to our Starbucks, only better and they sell clothes! Its funny because at home, pretty much nobody would be caught dead wearing starbucks sweatshirts or jackets. But here, everyone wears clothes from juan valdez and its def in style!

THis weekend was super fun. I hung out with my cousins, went out one night, and explored the downtown area of Bogota. Some people say the "Centro" (downtown) is really dirty and ugly but I thought it was awesome! There are lots of homeless people around thats foro sure, but what downtown doesnt have those? The only difference between these homeless people is that they have no problems walking right up to you while youre sittin goutside having coffee, telling you a crazy story and asking you for money. THey will literally sit down with you until you give them money. After the 5th one, it gets really annoying. But the downtown is really artsy and down to earth, I loved it. Full of museums and really cultural places. I prefer that waaay more than ritzy parts of Bogota. I went with my cousin Mauricio, we were both sort of hung over from the night before lol. We called it the hangover trip!

I got a little sad today because I realized that there is soooo much more I want to do and see in Bogota and I only have 2 weeks left! I want to take a bike tour, go to more places with my cousins, go into the mountains. I know I wont be able to do it all while im here this time. :(  I wish I didnt have to work M-F and I could have more time to be on vacation! But I guess Im technically here for school. I have a feeling though that Im going to keep coming to Colombia for a looong time. Everytime I come here I want to come back more and more. Just have to make time for it somehow once I start working.

ANway, it was a great weekend. More posts to come...

First week realizations

My mid morning snack today :)


So Ive been here for 1 week now and everyday I´m getting a little more comfortable! I´m finally seeing my own patients and its awesome! I spent the first 2 days more or less shadowing the docs and "interns". I was really frustrated at first because I wanted to have the same productivity and initiative that I usually have but I didnt really feel comfortable´presenting a patient with the proper medical terms, nor did i even have the slightest idea of how to use the computer system. I didn´t really get an orientation or at least a "this is how things work" talk lol. I showed up, everyone said hello and welcome, and i was just ready to go :) Im getting the hang of everything though, even the crazy confusing program they use for notes lol. I made myself a little template of the proper ways to present a patient and write a progress note, without sounding like a gringa (aka white girl) Also, its tough to understand people because they speak SOOOOOO FAST!!! I can understand 99% of spanish but when they speak so fast I just stand there like, "ummmm.....huh???" But its going really well overall.

After 3 days of taking an hour to catch a taxi, fighting wiht people over taxis, getting ripped off by taxi drivers (they like to drive in circles to charge me more because they know im not from here and have no idea where im going), and getting lost in said taxis (here you have to tell most of them exactly where to go, the address isnt really enough for the ones ive been in), I decided to walk home everyday! :)  My family told me it was pretty far but when I walked it a couple fo days ago its pretty close! Its only about a 25 minute walk at a godo pace...but it takes 40 mins for me because I take pictures of everything. Its even nicer for me because I dont mind walking through the city and I can stop and get coffe, shop, etc on the way home.

I was talking with a couple of the interns today about the differences in their school vs. ours. I´ll try to explain. They go to high school, and go straight into medical school. The medical school is 6 years, the first couple being classroom oriented, and the last years are rotating in hospitals. Then they do 1 year of internship, which also consists of rotating through all of the specialties. After internship, everyone who wants to practice medicine in Colombia MUST do 1 year of rural medicine in a small town. This is required to get liscensed in Colombia. After that year is when they can apply for residency here. SO, eventhough they dont do college, it ends up being pretty much the same amount of time spent to become a doctor, excluding residency. One huge difference here is that they have to pay for internship and residency themselves! So basically, they dont get paid until they become attendings...i found this crazy at first.  How on earth do they pay for school and residency without ever getting any type of salary or anything?? There are some ways to get loans but basically, you have to have money to become a doctor plain and simple. When I first heard this I thought: In the U.S, NOBODY (well not me anyway) would be a doctor if we had to pay our own way through med school PLUS residency!!  The difference is this: the cost of their entire training, including residency, comes out to be approximately between $80-90K. That is less than HALF of what med school costs for us!! SO, in actuality, its not that bad. I just cant imagine working for a hospital, with intern hours and the 36 hr shifts they pull here (and in the US, despite new rules limiting hours) and not gettign paid. It seems like the hospital is totally taking advantage of the interns and residents, its crazy. But that's the system. Some people love it and stay, and some get leave to the U.S or other countries.

Here are some more random things I found to be really interesting:

- Metronidazole and other heavy anti-parasitic meds are given out like water here! A parent can actually call a pediatricians office and say, "my kid has belly ache and diarrhea"...and they will give you Metronidazole without even seeing the kid. Reason: Amoebiasis is rampant here! In fact, tons of people walking around here have E. dispar (the asymptomatic amoeba). Its so common that people just go to a parmacy and by metronidazole and abendazole and use them at the first sign of a stomach ache. I just thought that was pretty interesting.

- They RARELY use CT scans in the ED. We've had at least 5 kids this week who 100% wouldve had CT scans in the U.S. to confirm appendicitis. They use ultrasound in 95% of cases in the ED. The only times they do CTs are when the surgeons demand it. Which surprisingly, itsnt very often. BUT, its possibly a good thing in peds since CTs are waaaay over used in the US and ultrasound saves the kid the radiation.

- There is one day every 3 months whare cars are prohibited and only taxis, busses, and handicap cars are allwed on the road. There a really big emphasis placed on improving the air quality, the environment, and healthy lifestyle. So, that one day every 3 months is very cool because everyone either walks, rides a bike, or takes taxi/bus. My cousin said that just 4 days per year of eliminating cars has improved the air quality by something like 20%. As cool as it sounds, I doubt the states could ever do that because its so big and spread out. Bogota is big, but everything is fairly close.

- New mom´s are give 3 MONTHS of maternity leave. I think thats pretty awesome.

Ok well, more stories to come soon!

Heres a picture