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Posts Tagged ‘Mexicali General Hospital’

This post is a little overdue since I was out of town for a few days.. I missed the 115 degree temps and I missed Mexicali too..

Dr. Juzaino (left) and Dr. Rivera

Usually, I go to surgery after I’ve spoken to the surgeon, and talked to them for a while but in this case – I had heard of Dr. Juzaino (after all – he practices at Hospital General de Mexicali) but couldn’t find a way to contact him – he’s not in the yellow pages, and no one seemed to have his number..

So I just hung out and waited for him when I saw his name on the surgery schedule. He was supernice, and invited me to stay and watch his femoral – popliteal bypass surgery.  Case went beautifully – leg fully revascularized at the end of the case.   Patient was awake during the case but appeared very comfortable.

intern during surgery

There was a beautiful intern in the surgery – her face was just luminous so I couldn’t resist taking a picture.  Unfortunately, I didn’t get her name, and no one recognizes her because of the mask – so I am hoping some one from the OR recognizes her here.. I’d like to send her a copy of the picture.. (and get permission to post it..)

Saw Lupita Dominguez – who in the role of nursing instructor that day.  She is always so delightful – I need to get a picture of her with out the mask so all of you can see her -besides being an outstanding nurse, and nursing instructor,  she is just the friendliest, sweetest person with cute freckles to boot.. (I am very envious of people with freckles..)

On another note entirely, here’s some more information about the ethical implications of transplant tourism for my interested readers as follow up to my Examiner.com article.  It’s a video of lectures by one of the leading ethicists and transplant surgeons, Dr. Delmonico.. (yes, like the steak.)

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Resident rounds were particularly interesting today. I was a little surprised how well I was following cases. I still miss many of the small details, sometimes because of the language/ terminology but sometimes just because some of the residents have quiet voices.  (Speak up, doctoras, the gringa in the back can’t quite hear you.)

But today I was following pretty well, and feeling a bit less lost than I often do – as I listened to a discussion about anion gaps, and noticed that wow, I understood that question.. (Usually I get the lectures, but the question portion is more difficult.)  Then we moved to the next patient and as I reviewed a chest film and thought ‘ hmm. Looks like congestive heart failure. I wonder if they got an echo,” only to hear the professor turn around and start questioning the students about the significance of the chest x-ray in a patient with an ejection fraction of 20%.   I knew not just the question – but had plenty of answers.. but still keeping quiet because not always sure if I know how to say the answers..

So that was nice, to know that my Spanish is actually getting better. (Sometimes I feel like I have just plateaued to a point and feel frustrated. Everyday, I try to learn new words but find out that I just as easily forget them.

More patients – missed a couple due to ‘soft voice’ phenomenon.. Then two in a row – understood everything, even the questions.. In fact – when the doc (not the good doc, but another attending) asked, “and what should you think about in a woman with ascites?”  I even thought the answer – in Spanish..

It wasn’t until we got to the cardiology patient with the obvious EKG (and believe me, a lot of them aren’t this obvious) along with the rest of her clinical presentation that I actually spoke up and said the answer.. (Too bad it was in English)..  and I didn’t even mean too – but all the residents were just kind of looking around and shuffling their feet – and the answer just kind of fell out..

The attending looked a little startled, and I am not sure if it was in a good way – so I will go back to being the quiet gringa in the back..

But I’ve rounded with this attending several times  and he’s excellent.  He’s a gastroenterologist and I’ve watched him do an endoscopy, so one of these days I will chase him down to interview him..

But for now – a momentous day in the life of a student – as I knew the answer, and I knew it in Spanish..  Maybe I’m not entirely hopeless after all..

Life in the ER

After rounds I spent some more time down in the ER with Dr. Ivan.. (well – that’s what I called him, since I completely blanked on his last name.)  He’s young, and very nice, and didn’t mind me looking over his shoulder at films, rounding with his residents and talking to patients.  One cardiac patient in the ER so I talked to her a bit – she’s being transferred to another facility for surgery.   I asked the resident but didn’t quite understand his response, but then again – it was obvious he didn’t really understand my question, poor guy..

A couple of traumas so I will give you a break down, so readers have a better idea what sort of things they are seeing..

a motorcycle accident from out in San Luis (about an hour away), a car accident with chest / abdominal trauma,  another accident (patient fell) and a guy who got into a fist fight (and was presumably the loser.)

A seizure patient, a stroke, a patient with a wound dehiscence after previous surgery, and a neutropenic cancer patient with a fever (in a neutropenic room).  A teenager in the corner room – didn’t get his diagnosis but didn’t look trauma related.

The Life of a nurse

Best part of the ER was talking to some of the nurses.  (Did you know that it’s nursing week back at home?)   The two nurses I talked to in the ER liked the idea that doctors bring nurses gifts during this week.

Nurses train for four years in Mexico and then complete a mandatory period of service in public facilities (similar to Colombia.)  Kind of wish we had that at home to a larger extent – particularly if it would negate my student loans.

We talked about their job, (they work 32 hours a week at Mexicali General) and the fact that nursing pay is poor in Mexico.  One of the nurses was explaining to me that nurses usually have a second job just to get by – sometimes in occupational health positions with some of the very large companies that make their home in Mexicali, sometimes in jobs unrelated to nursing.

We talked about the maestria (master’s degree in nursing) and they explained that there is a similar position (of a sorts) in Mexico where nurses can prescribe from a very limited formulary.  But when we compared the rest of my job description – it didn’t sound like there were many people doing that sort of thing.  Then again – the nurse practitioner arose from a physician shortage – and here in Mexico, there is no shortage.  (We talked about that for a bit too.)

All and all it was a delightful discussion, before too soon, my busy friends had to race back to their patients.. Unfortunately, I didn’t get any pictures, but maybe next time.

A ‘dia libre de Cristina’ tomorrow for the good doctor as I head off to interview Dr. Ham (who is the Dr. Oz of Mexicali..)  Hoping to get some more interviews in soon.  I have a couple ideas I want to discuss with the doc, so maybe we’ll talk about it later this week.

Good thing the Professor never reads the blog – he’s be completely mortified at how often he gets mentioned.  (He’s a pretty humble guy..) But then again – hard to write a blog about studying with a thoracic surgeon and not mention him..

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Mexicali General Hospital

I thought it was about time that I post some pictures of all the great people I see at Mexicali General.. I still need to get some more pictures, of course – so everyone can hear more about all the people I meet and talk to every day.

First, there’s Lalo,  who is probably one of the world’s nicest residents.. (After all, he rounds with me everyday – and hasn’t run away screaming..)  No, seriously, he’s just really kind – and patient with me, particularly when I have questions about cases (usually translation).  I haven’t convinced him that thoracic surgery is his passion yet – but he does have a thing for cardiac surgery, so he’s not entirely hopeless..

Lalo

Then – there’s Jose Luis – who is just about the nicest, friendliest guy an extranjera like myself could ever hope to meet..  Actually, everyone in the respiratory therapy department has been pretty awesome (and their use of slang has certainly advanced my education!)  I talk to Jose Luis about all my ideas about pre-surgical clinics and such – he never laughs.. Maybe he doesn’t completely understand me, (especially when I get excited and talk really fast in my horrible gringa spanish) but he never laughs at me, or does that shoulder shrug thing that people do when they aren’t real enthusiastic about your plans..

Dr. Ochoa is second from the left, Jose Luis is in the center (in blue)

Of course, there’s Dr. Ochoa – who certainly got more than he bargained for when I first contacted him for an interview (back in November 2011).   I don’t suspect he ever thought he’d end up with a gringa student (but then neither did I, at the time).

But he’s always gracious and good-natured – and I always feel like I am learning a tremendous amount, even when it’s not all surgical.  He certainly handles a lot more pulmonary medicine than I ever expected.

There are so many other cool people who I cross paths with – like Ariel (Raul Ariel del Prado Rivas.)   I don’t have his photo (yet!) but Ariel is the nurse in charge of emergency & disaster response for the hospital – for everything from natural disasters like earthquakes (which are pretty frequent here), mass casuality events, to biohazard / environmental spills, and bioterrorism.. If that wasn’t enough for any one person – he also teaches.. In fact, I’m planning to take his ACLS class next month..

Hopefully, knowing about all these nice folks who are always looking out for me will ease the fears of any of my friends and family at home..

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