Sunday, July 12, 2009

Nicaraguan Coffee and Six Fingers

The weekend is here in Nicaragua and for the Navy Medical Strike Team that means two more days of humanitarian assistance in Somotillo, Nicaragua. We are starting to get into a routine, and today we were up in plenty of time for breakfast and without the disaster from Friday morning. Snoozing in and out along the way on the bus sitting next to Dr. Lynn Sterni, I apologized each time I fell asleep on her shoulder. I think I am becoming narcoleptic. Either that or caffeine has no effect on me any more. Probably the latter. When we arrived at the site I visited my friends Erika and Cristina and baby Angel at the food stand, and Erika made me two strong cups of coffee as I held little Angelito. The premature baby had had diarrhea for the past few days so I questioned whether he was able to get any sleep the past night, and they answered yes, that the medicine had worked and the baby had slept. “When are you going to give him a bath?”, I asked. Sure enough that’s what they were preparing to do as the father cut a plastic bag of water and poured it into a metallic bowl, and in went little Angel for a good scubbing. The chickens scrambling nearby took a moment to observe. They would be lunch in a little bit. If they only knew… Cristina shooed them away and she showed me the green T-shirt she had on today which said “Jamiaican Me Crazy”. She had no idea what it said or where Jamaica was, so I told her what it meant. She smiled.

My translator today was a gorgeous 19 year old woman named Ariadna from Managua. I couldn’t for the life of me figure out why she was here volunteering her time to translate. She was not part of the Mormon church crew and just didn’t seem the type to do community service on the weekend like this. She was shy and her English needed some work. I was patient and by the time we had seen a dozen or so patients she had the hang of it. It was only upon further questioning that I was able to ascertain that she was starting a job next week in Managua at a call center where she would have to be speaking English. So this weekend was her forced practice. Not a bad idea. Smart girl I surmised. And she told me she had a fascination with Looney Tunes Band Aids (Tweetie Bird to be exact). I obliged and she put one on her arm and then in a show of team spirit put one on my arm as well.

An elderly woman came in mid-morning (I think her name was Matilda) who had six fingers on each hand and six toes on each of her feet. Most cases of polydactyly (extra digits) people have a non-functional appendage, but this woman had an extra “pinky” on the lateral portion of the hand that had full functionality and worked very much like an opposable thumb. It made for a handshake like none I had felt before. She was a very sweet woman and proceeded to give unsolicited hugs to both Ariadna and I in a show of thanks. Genetic mutations such as this are fascinating to me, so I asked Matilda whether any of her family shared this morphology. Her sister had extra digits as well, and sadly she was not able to have children (she had lost three due to miscarriage). You could just sense and feel the long life and wisdom this woman had had.

For lunch I showed Ariadna how to eat an MRE (she was mesmerized), and I decided to risk eating the quesadillas that Cristina and Erika were preparing. Over by the stand I saw the two main Chiefs for the site – Chief Francis and Chief Weber. They are the ones who make the site function logistically (busting their tails in the searing heat all day) and I tip my hat to them. Chief Weber is permanently based with the USNS COMFORT in Baltimore and is going to ride in the Baldwin PA Health Ride we are doing in October – Please check it out and make an impact in combating childhood overweight and obesity.

Every patient I see I make sure to ask what type of work they do. People in the Somotillo region are mostly farmers that grow corn and beans. This morning I met a guy named Jose who grew and processed coffee. I told him about my love for coffee and he told me all about Nicaraguan coffee and how it is the best in the world. I mentioned (in passing) that I would love to try some, not thinking anything of it. Well, guess who showed up this afternoon on his bicycle with a big green pot of coffee and a matching green coffee cup- Jose! He had gone home and brewed some up fresh for me and the docs. With a bit of trepidation I accepted Jose’s cup of Nicaraguan Joe. It was awesome! Hit the spot. In return I scrambled to find a “regalo” (gift) to give in return and luckily in the MRE container there was a leftover Lemon Pound Cake safety sealed in the brown plastic. I gave it to Jose with pride and told him that this is what we eat with coffee in the U.S. He opened the package and smiled after taking a bite of the pastry. Whew…..

The day ended with us seeing a bit less than the day before – about 1500. Since the town had only a few thousand people, we began to realize that those people we thought looked the same as yesterday, probably were the same people from yesterday…….
Oh well, it’s all good. We’re providing a stockpile of medication for them. The longer it lasts the better. Just so long as they know the proper usage. And it’s not like we are doling out Diprivan or Propofol or something like that (MJ).

I am trained as a medical doctor of the Allopathic discipline. Many other docs are trained additionally in the Osteopathic discipline, learning to do “adjustments” and chiropractic treatments. I have never been much of a fan of these but tonight I changed my tune. After several days of seeing hundreds of patients I felt like dog doo, and my back was stiff as a board and my neck jacked up. Barretti is a D.O. (Osteopath) and so I gave in and asked him to crack my back and my neck. I am now a believer. Thanks Mike. See, I knew under that insolent hard shell with your jaded view of the world, there really is a nice guy who can crack peoples joints and allow them to feel better.


  1. I was wondering when you are going to use that "milky" concoction in your story....;)
    "The appropriate use of Propofol, Vecuronium and sedatives is a universal goal in the clinical care of critically ill, septic patients".... By experience, we do see the good results....That's why it shouldn't be abused!
    As I was wondering they have a clinic for after care when the Comfort leaves? I hope that they do..... to continue your good work. Thanks again for the blogs....and for sharing what is the best side of America with our neighbors!

  2. Hey brother, what an adventure. You're a hero man, that's a ton of patients. Wow.

  3. I think that the work you do is amazing! It is so nice to be able to follow your stories and be a part where to get to visit, and see how much you do help! I think that Matilda, has a very speical gift having a extra finger, because she can use those beautiful hands to make people smile. I wish there were more people like that, she has the kindest eyes i have ever seen. Keep up the good work, and thankyou for sharing your story!

  4. I made my son read your blog for the past few days. He always said he wanted his job to be about helping people so I thought your blog would give him ideas as well as perspective about the world. You have inpired him to become a doctor as well as a triathlete ( we have been swimming, riding and running together since the beginning of the summer). Thank you for your blog and thank you for what you do, you inspire many!

  5. Oups! Forgot to say...I use alternative medicine for my sore muscles all the time!!!!