Monday July 11, 2011
After traveling for two days, I arrive in Cusco at 8am. I was immediately rushed to the hospital to accompany the gynecologist on his rounds. He discussed the patient’s history and had me touch the patient in order for me to understand his diagnosis. I had only been in Cusco for a few hours and here I was fully emerged in medicine.
Around 1pm, I began my next rounds in neonatal. I saw an infant with a cleft palate, who just began to nurse and a baby with anencephaly. The doctor asked me to observe a 14 day old infant. He asked me, “What’s wrong with this patient?” I responded, “He’s having trouble breathing.” He tells me, “what else?” Now at this point, I’m just a premedical student with only enough knowledge of the fundamentals. He tells me, “what’s different and what else do you see?” I began to realize that one side of the infant’s chest rose higher than the other side. Come to find out, the infant suffered from an underdeveloped lung on one side and an abnormal curvature of the spine. This is where I learned that in medicine, observation and attention to detail is the best method of diagnosis.
Right as I was about to leave the hospital at 8pm, Dr. Rolling come down the hall. He quickly scoops me up and has me accompany him on his rounds. A young boy had his eye and arm blown off from a fire cracker and two children sat playing on their hospital beds, both with broken legs and who had lost their mother and brother in the crash. The doctor was back at the hospital to check on his patient that had sepsis. I got a chance to speak with the patient as he told me his battle for life. He began to tell me that Dr. Rolling was the only one who thought he had sepsis and was so thankful that he was there. The patient had such an admiration and appreciation for Dr. Rolling, which brought tears to my eyes.
Tuesday July 12, 2011
Today began at 8am in the Pediatric clinic. A boy came in with a huge swollen bump on his neck behind the ear. The doctor allowed me to feel the bump and showed me later the difference between a hot and cold bump. He also taught me to pay attention to the palms of the hands, because they were a good indicator if the patient had anemia. Many children suffered from bacterial infections, malnutrition, and anemia. I really enjoyed getting to be so hands on with the children.
Later at around 4pm, I returned to OR and got to scrub in to surgery. The first patient had a twisted intestine, in which the doctors removed 6lb, 1 meter long section of the colon from the patient. The second patient had an abdominal hernia and even after 6 hours on my feet in surgery, I still had a huge rush of adrenaline.
Wednesday July 13th, 2011
Starting at 8am, I began doing rounds with the Gynecologist in the clinic. The doctor allowed me to find the fundus of a pregnant woman and explained to me the most commonly venereal diseases in Cusco. He allowed me to feel a swollen ovary caused by an infection and the next patient had an abnormal lump inside her breast tissue, in which he also allowed me to participate.
Later at 1pm, I returned to Pediatrics and got to sit in on a discussion of a unique patient. A 3 year old boy was believed to have mastoiditis and had a tumor growing in his ear canal caused by a bacterium. The bacteria became resistant to the antibiotics they administered. The tumor surrounded a nerve and the boy needed surgery, in which they didn’t have the necessary resources. He went on to explain to me that swollen lymph nodes on both sides of the neck are most likely are viral. And that swollen lymph nodes on one side of the neck are most likely bacterial. Surprisingly, the pediatric doctor was called into two cesareans in which I was allowed to scrub in. During the second cesarean, the doctor showed me how to administer oxygen to a new born. Moments later, he allowed me to help administer oxygen to the newborn.
Thursday July 14th, 2011
Today, we started in the emergency room. The doctor took me around and showed me the facility. He discussed the sequence of diagnosis for appendicitis and that intestinal blockage was one of the most common reasons for visits in the emergency room. The emergency room has three observation rooms, males, females and mixed. He took me through all of the patient charts and read me their history. Next, we visited Plastics, where he showed me burned victims and results from a skin graft surgery. Finally, we ended in Neurology, where we discussed with the medical students the most interesting cases. A 17 year old boy was having seizers, who had previously had brain surgery to remove a tumor. They showed me the incredible results the young man had and how incredibly lucky he was to be alive.
Monday July 18th, 2011
I met Dr. Rolling in the OR on Monday morning. When I arrived, he was assisting in a surgery where a man hand broken his radius and ulna. After the plates were placed and they began to suture up, Dr. Rolling and I moved over to the next room where he was preparing to do a bone biopsy. This by far, was the most exciting experience. The patient suffered from Osteomyelitis and had an infected abscess. Dr. Rolling allowed me to assist during the entire procedure. Where I got to apply pressure and assist in separating the tissue. My heart was racing and I was so excited to be a part of it all.
I am so thankful for Dr. Rolling and his fellow colleagues at the Regional Hospital of Cusco. I am very fortunate to have had such a life altering experience. By experiencing the TPaIDA program, it only further verified my love for medicine. I look forward to a lifetime of serving such a rewarding field and it will be a privilege to work alongside such excellent doctors such as Dr. Rolling and the fellow doctors at the Regional hospital of Cusco.