Week 2's Clinic

Ok so I haven't been keeping up with this as much as I wanted, but I first wanted to post about my week 2 experience at La Hospital Civil.

I already talked about week 1, where I was at the public clinic-Xochimilco working with the nurses doing vaccines and then with Dr. Anna.

Like I said, Week 2 I was at La Hospital Civil. Here I was in the pediatric ward working with Dr. Jacob, who specializes in Pediatric Gastroenterology. He was absolutely awesome to work with. The days would usually start around 730am with some type of lecture presented by a medical student (it's a teaching hospital, right next to the local medical school) followed by the Attending Doctors commenting and questioning their reasoning/understanding/etc. One morning the Residents gave a run-down on a few of the patients and their treatment plans, while another morning was a talk on sepsis and the best methods of treating it. After the morning meetings, Dr. Jacob would take Dr. Maya, Cliff (A 3rd year med student at Touro Univ), and I for morning rounds. Dr. Jacob would give us the history, treatment plan, and prognosis--accompanied by lots of questions ranging from anatomy/physiology, medications, prognoses, etc.

We saw a variety of situations. I'll run through the ones I can remember off the top of my head:

• One 8-9 year old kid had nephrotic syndrome. He was experiencing some serious edema throughout his body and especially in his stomach and genital area. He was on some corticosteroids if I remember correctly--suppressing the immune system, as this syndrome is often a result of autoimmune diseases. I'll never forget this kid though... his name was Javier. Dr. Jacob tried to get him to learn some English from us, but whenever he asked him to say "Good Bye", the boy would just say it in his native dialect. He was so cute and he would always smile when answering questions. His smile couldn't get any bigger and it kind of just made you appreciate the innocence and positive attitude many of the kids maintain even in unfortunate situations.
•  Another kid had chicken pox or 'varicela'. Chicken pox is still a problem here, more-so than in the US where the vaccine is more readily available. This boy had a terrible case that had reached the point of encephalitis--inflammation of the brain. This ultimately lead to brain damage and it was sad being there as Dr. Jacob explained to the boy's mother that he may never be the same. She was very upset to say the least :(
• We saw at least 5 or 6 appendicitis cases. Appendectomy's are the most common procedures done on children.
• One 10-11 year old boy was hit by a car while he was riding his bike. He had a fracture in the temporal bone of his skull. We were able to look at his X-rays and Dr. Jacob went through the entire workup with us, as he did with every patient.
• A few young children with pneumonia. He showed us the X-rays and basically explained to us the antibiotics they use to treat it.
• One patient that was really a sad situation was in the pediatric oncology room. She had some treatment for her leukemia that pretty much killed her immune system to the point where she became terribly ill. She had bacterial and fungal infections on her skin and throughout her entire body. The next day we were informed that she had significantly improved, so that was good news.

The day of rounding would usually slow down around 11am. At this point we would just talk to the Residents or learn more about the patients. One of the days we went to lunch with Dr. Jacob and the Pediatric Oncology Dr. who's name escapes me. The food was amazing as always and it was fun to talk to them about things other than medicine.

The people at La Hospital Civil were great, and they made us feel more than welcome to come back the next week if we didn't like our new clinics, haha. I have a huge amount of respect for Dr. Jacob and all of his residents--they have a tough job and work non-stop--but they are excellent at what they do. Based on this experience I can definitely see myself working in pediatrics someday.

p.s. I'll post some pics of the Hospital along with a bunch of other pictures this weekend.