Monday, June 29, 2009

Remain Overnight in El Salvador

After some EXTREMELY long boat trips back and forth from the ship to shore in El Salvador, the decision was made to allow us to remain overnight in La Union so that we could maximize our time for patient care at the medical site.  I think it was an excellent call made by our fearless leaders CAPT Cole and CAPT Anderson.  I would now be going ashore for four days and staying overnight at a hotel called (you’re not going to believe this)- THE COMFORT INN.   

How to pack?  Trying to fit enough clothes, a computer, and workout clothes into a small backpack for four days was just not happening.  Something had to give, and that thing was the excessively large book I have been reading by Tom Wolfe called A MAN IN FULL.   I crammed in some extra socks and T-shirts and we were off.   That morning we traveled by helicopter which made it super convenient, and we were seeing patients by 8am!   

El Salvadorians have some interesting cultural ways about them.   One thing in particular is their preference for gold teeth.  I have seen more golden smiles over the past few days than I have in my entire life.  After asking many patients about their golden “crowns” I came to find their common response was an even bigger smile, and a gracias (thank you).   When asked why they didn’t prefer a traditional tooth colored crown they answered that in their culture it is a sign of wealth and vitality to have golden teeth.  Some I saw had their two front teeth etched with their initials.  I snapped a few good photos with some and for a second thought about changing my veneers to gold.  Nah…. 

Something else I observed was a functional fashion piece that woman wore called a “De Lantal”. It was an El Salvadorian version of the fanny pack or purse. They look like a frontal dress/apron with pockets and lace adorning them and they come in many colors.   They carry anything and everything around in this thing- money, medical records, food, and even little dogs.  I kept getting the pronunciation of DeLantal wrong, calling it a “frontal” a “vestida de fronte” and other things, so one woman finally set me straight and had me stand up and took hers off and made me try hers on.   It was yellow and I suppose my own El Salvadorian version of a “man purse”.   Hey, I’m embracing the culture, what can I say?  

I saw patients today with a Pre-Dental student from UCSD named Rowan.  He is a real life version of Casper.  That’s what everyone calls him so I did the same.  Casper is a sharp guy.  He speaks Spanish and has quite a command of medical knowledge for his level of training.  He also has a high degree of care and compassion.  We made a solid team for the day. At one point in the day, a Cowboy looking guy asked if Casper was my son!  I had to take a step back and say, “Wow, am I really that old!” From that point forward I made sure to introduce Rowan as my brother.  I got some even stranger looks from that pronouncement, but all the well.   

One lady we saw came all the way to San Salvador for a medical visit.  She launched into a flurry of questions and demands from the get go, and we had to tell her to go a little slower and to tranquilo (relax).  We ended up talking with her for a half hour about her lifestyle, and ways to improve her health, and must have said something right because this lady proceeded to change her tune remarkably.  She told us that her trip was well worth the wait and she was happy with the medical care she received and then gave both Casper and I a small poster with a poem on it and she proceeded to sign the back and say Muchas Gracias.  After she left we read the words more carefully and what it basically said was that she would be with us forever, and if we ever destroyed or threw away the poster we would owe her dearly and God would come after us.   Rowan and I looked at each other, nodded, and simultaneously put the posters away in our bags.   

As the afternoon came to a close, we were sweaty, exhausted, and definitely ready to experience a real 

hotel in La Union, El Salvador.  We piled onto the big bus and it took us to the top of the hill overlooking the town, and there it was, the COMFORT INN.  I found out my roommate for the next three nights would be Major David Hsieh, the same guy I had roomed with in our Colombia stint.  This hotel was quite a bit nicer than that one though (no bed bugs), and the TV got several channels other than CNN International.  We were halfway through watching an episode of The Simpsons (even funnier in Spanish!)  when the news flash came on about the death of Michael Jackson.  I couldn’t believe it.  The first cassette tape I ever had was Thriller and I have memories of my brother Matt and I performing Beat It and Billie Jean with our pretend microphones downstairs in the basement at our old house in Amish Country.  Full on with our parachute pants from the ‘80s.  We listened to that cassette tape so much it wore out and snapped one day. RIP MJ.   We’ll miss you.  Buenas noches from La Union.   

In El Salvador and onto the ship the news spread quickly and on the front page of the paper the next day the headline read “El Rey de Pop Murio”  (The King of Pop Died).   Some patients even had T-shirts with MJ’s picture on it that they wore to the patient exam site.  I wish that I had had my camera with me.  I’m sure one of the newbies got a shot of it.  

That morning I realized that in a technical oversight, and maybe due to lack of room in my backpack, I had failed to pack my toothbrush and toothpaste.  Luckily we had a dental contingent next door, and I signed myself up to be seen, and got a quick exam and a toothbrush J  Problem solved. Back to work. Rowan and I were cranking on seeing patients, with a pace set by Navy Cardiologist CDR Eric Schwartzman who was new to this site this day and uber fast..  We had to see as many as possible by lunchtime, because that is when we were told we would break down in order to get to another site about a half an hour away where we would travel to and set up to begin afresh tomorrow.   Helping us triage the patients today we had two fantastic nurses from the NGO Project Hope named Marley and Karri.  Marley is a nurse at SF General, where I spent many a day and night during medical training.  It has been fun relating stories from the “Mish.”  Marley has been there for many years and is probably the most positive and happy-go-lucky person I have met on this trip.  Her daughter is also with us serving a different type of population- animals- as a vet.  Karri recently graduated from Johns Hopkins School of Public Health and is also a Neonatal Intensive Care Nurse.  

The other woman from Project Hope we have with us is a Certified Midwife named Ann from Seattle. Ann brings a wealth of experience and knowledge to the team and has a positive attitude and smile that is contagious.  I made sure to get a photo of them during the morning.   Project HOPE has been in existence for 50 years and has impacted hundreds of thousands of lives for the better.  We are overjoyed that they are part of Continuing Promise 2009.  

Lunchtime came and it was as hot as its been yet- close to 100 degrees.  Some genius had misplaced the MREs so we were stuck with boxed lunches prepared by the ship consisting of canned ham, cheetos and softbake cookies (exactly what we had just been telling our patients not to eat).  I put the ham down the hatch, but said no thanks to the other processed bolado.  We loaded up the trucks with all of the dental, medical, and optometry supplies and drugs in under an hour with an extremely efficient assembly line.  

By the end of the lifting workout we were drenched with sweat and even the lukewarm bottled water hit the spot.   I handed one to CDR Schwartzman, the cardiologist, and as I did I saw a divine omen on his chest!  In perfect symmetry on the front of his brown T-shirt in emblazoned sweat was the form of a heart.  He truly was meant to be a heart doctor! 

The past two days our small medical team had seen over 1000 patients at the La Union site, and we set our goals for the next town called Pasaquina about 30 miles away to the East toward the Honduras and Nicaragua border.  The drive there was gorgeous as we hugged the coastline, with the ocean on our right side and the volcanoes to the other.  We began to head more inland, and suddenly screeched to a halt.   Many of us had been dozing off and we jerked awake.  The reason for the sudden stop was a herd of cattle crossing the street (some walking and standing in the middle of the street).  The driver honked and we waited patiently for the cow to make up its mind whether to step aside and let the bus go by, or stand it’s ground..  Cow vs. Bus full of American Military/NGO Humanitarians.  

It was a peaceful exchange, the cow relented, and we were on our way.   Meanwhile, not too many miles away in the country of Honduras, we were hearing reports from the security element that the Honduran President was not ruling within lawful constraints and that a possible Coup may be in the works.  Given our nearby location to the border, there was much talk of contingency plans.  I raised my head, peeked above the bus seat in front of me and made sure our heavily armed El Salvadorian military escorts had our front and our tail.  We were a caravan of humanity, hope, and continuing promise moving through the Land of Volcanoes to the next town we would help and heal with compassion. 

1 comment:

  1. Is this mission making you think of finishing your residency? I am sure you have excellent bedside manner and will make a big difference in the big picture.
    That photo of the good MD is just right, a ♥ for schvitzing doing good you all do.