It has kind of been a long week. I guess for many reasons. There was a dance class last night that I had originally planned on attending but I was really tired last night and not in the best emotional state. I also didn´t have to be at a medical Spanish class at 7 am. So, I got more sleep last night and had a restful morning. I feel a lot better this morning.
I´m still with the same host family. I kind of feel like part of the family after all of the turmoil this week, even though I have such limited communication with them. I´m starting to understand more but am intimidated and nervous when I have to speak.
My host mother´s father was buried on Tuesday night, the day he died. Quite quick turn-around. I don´t think that happens much in the states.
The life expectancy in Costa Rica is 76 but people seem to live long here. Many people living well to 90. They have a national health care system, they eat well, few people are overweight ... all different from the US where life expectancy is 77.
Friday, February 22, 2008
Tuesday, February 19, 2008
Es muerte
I´ve been in La Fortuna near the Arenal Volcano (4th most dangerous volcano in the world, Mt St Helens is 1st ...) since Sunday. I´m staying with a host family. The host mother speaks a little English, actually seems better than my Spanish. And I feel so dumb trying to speak to them or rather to try and understand what they are saying to me. We had our first Spanish class yesterday afternoon after a medical Spanish class in the morning. Many people have been here for a few weeks and feel that their Spanish has improved considerably. I´m hoping.
Our group just went on a hike this morning to the forest around the volcano. It was initially very foggy but burned off some while we were up there. But we still couldn´t see the volcano. From town on a clear day you can see the volcano but there are often clouds obscuring the top, which is how it has been since Sunday. It was a fairly easy hike but since the altitude about 4,000 ft you get a little short of breath easily. It was very much a naturalist sort of walk with a great guide. We saw a sloth hanging asleep in the tree. Apparently they eat the leaves and fruit of this poisonous tree, well at least the leaves are poisonous. Max, our guide, was suggesting that the reason they move so slowly is that they are influenced by all of the poisons they ingest. No say. Well the sloth that we saw from a distance just looked like a gray thing in the tree. Apparently as they spend their whole lives in the trees they become more green because of moss getting into their fur. As I looked through some binoculars, the gray blob moved an arm to scratch or something. We also saw toucans, vultures, turkey vultures. The wandering Jew houseplant grows wild here. I got a picture of a large patch of it.
When I got to my host family on Sunday, the host mother asked if I minded staying in the house since her father was sick. She asked if I wanted to meet him. It wasn´t much of a meeting since he was not at all interactive and didn´t appear long for this world. It seems that much of the extended family has been here to see him. One of my host mother´s sisters came out this morning saying that he didn´t seem to be breathing. After going in to see him, my host mother came back out, grabbing me by the wrist to go in and check to see if he had a pulse (I didn´t bring my stethescope with me). No pulse, no breath, felt kind of cold, and I couldn´t hear anything with my ear on his chest. He also certainly looked dead. I´ve never told anyone that their family member is dead, let alone in Spanish and when I´m not in a medical role. I was leaving 5 minutes later for the volcano hike. I felt bad going but didn´t know what I could possibly do to help by staying. My mind has been wondering whether anyone else would have found any signs of life in him because in order pronounce someone dead you have to listen for a heart beat for an entire minute. I don´t know whether staying in that house now is good or not. We´ll see.
Our group just went on a hike this morning to the forest around the volcano. It was initially very foggy but burned off some while we were up there. But we still couldn´t see the volcano. From town on a clear day you can see the volcano but there are often clouds obscuring the top, which is how it has been since Sunday. It was a fairly easy hike but since the altitude about 4,000 ft you get a little short of breath easily. It was very much a naturalist sort of walk with a great guide. We saw a sloth hanging asleep in the tree. Apparently they eat the leaves and fruit of this poisonous tree, well at least the leaves are poisonous. Max, our guide, was suggesting that the reason they move so slowly is that they are influenced by all of the poisons they ingest. No say. Well the sloth that we saw from a distance just looked like a gray thing in the tree. Apparently as they spend their whole lives in the trees they become more green because of moss getting into their fur. As I looked through some binoculars, the gray blob moved an arm to scratch or something. We also saw toucans, vultures, turkey vultures. The wandering Jew houseplant grows wild here. I got a picture of a large patch of it.
When I got to my host family on Sunday, the host mother asked if I minded staying in the house since her father was sick. She asked if I wanted to meet him. It wasn´t much of a meeting since he was not at all interactive and didn´t appear long for this world. It seems that much of the extended family has been here to see him. One of my host mother´s sisters came out this morning saying that he didn´t seem to be breathing. After going in to see him, my host mother came back out, grabbing me by the wrist to go in and check to see if he had a pulse (I didn´t bring my stethescope with me). No pulse, no breath, felt kind of cold, and I couldn´t hear anything with my ear on his chest. He also certainly looked dead. I´ve never told anyone that their family member is dead, let alone in Spanish and when I´m not in a medical role. I was leaving 5 minutes later for the volcano hike. I felt bad going but didn´t know what I could possibly do to help by staying. My mind has been wondering whether anyone else would have found any signs of life in him because in order pronounce someone dead you have to listen for a heart beat for an entire minute. I don´t know whether staying in that house now is good or not. We´ll see.
Saturday, February 16, 2008
Butterfly mobiles hanging in the sunlight
A 5 hour plane ride doesn´t sound that long on paper, but when you are in the air that duration in the middle of the night in seats that don´t recline, it certainly feels like it´s never-ending. For those who don´t know I´m in Costa Rica for 3 weeks studying medical Spanish and taking a break from residency and the NW winter. I got here to the guest house of the Spanish school and promptly slept for over 2 hours. I had ear plugs in but didn´t hear someone knocking on the door at all.
2 others and I walked in downtown San Jose to this kind of tourist-y market. But they were selling some neat crafty things. I found myself drawn to these butterfly and fish mobiles that were hanging in the sunlight and to the man who was selling them. Unlike other vendors, he was proud to point out he made all the crafts he was selling. I walked past and "talked" to him 3 times before finally saying that I was interested in one of his butterfly mobiles. I initially thought they were quite similar but he said, no they are all different. Different colored butterfly wings, different colored seeds and painted wood. He didn´t speak any English and was patient in getting me to understand him and to understand my limited Spanish. It felt like a genuine encounter with a real human being. Granted he was selling and I was buying, but it felt bigger than that somehow. Like something deeper in me drew me to his booth over and over again.
I´m headed to a home stay tomorrow morning in Arenal, several house NW of San Jose. It is all an adventure and feels like me extending myself in many ways. I´m going to try to keep posting during my trip but we´ll see how internet access holds up and how time allows. But, hopefully more to come.
2 others and I walked in downtown San Jose to this kind of tourist-y market. But they were selling some neat crafty things. I found myself drawn to these butterfly and fish mobiles that were hanging in the sunlight and to the man who was selling them. Unlike other vendors, he was proud to point out he made all the crafts he was selling. I walked past and "talked" to him 3 times before finally saying that I was interested in one of his butterfly mobiles. I initially thought they were quite similar but he said, no they are all different. Different colored butterfly wings, different colored seeds and painted wood. He didn´t speak any English and was patient in getting me to understand him and to understand my limited Spanish. It felt like a genuine encounter with a real human being. Granted he was selling and I was buying, but it felt bigger than that somehow. Like something deeper in me drew me to his booth over and over again.
I´m headed to a home stay tomorrow morning in Arenal, several house NW of San Jose. It is all an adventure and feels like me extending myself in many ways. I´m going to try to keep posting during my trip but we´ll see how internet access holds up and how time allows. But, hopefully more to come.
Monday, February 11, 2008
The Business of Being Born
This was a busy weekend of visiting my parents and spending a little time with Miguel. Mom and I went to a showing of the documentary The Business of Being Born (http://www.thebusinessofbeingborn.com/) at the Hollywood theater. Despite the fact that it took 1/2 hour to get into the theater because of ineficiencies of will-call tickets (imagine one person, looking up names in a little alphebetized card holder for hundreds of people), the the film was great. The film was sold out, mainly to women, and many of them pregnant. It discused the awful state of affairs in this country with having obstetricians delivering healthy, low-risk women in the hospital. Even though we are one of the most "developed" countries of the world, we have the highest infant mortality rate of all of the industrialized nations. OBs are surgeons by training and are not good nor interested (by-in-large) in "normal" deliveries. They want to intervene, feel that they are important. Women in the hospital delivery babies on their backs, which does not allow the pelvis to enlarge as much as it could if a woman was squatting to deliver her baby as women have for milennia. And, who is in charge in the hsoptial? Certainly not the woman.
Any why do I get fired up about this topic?? Well, on my inpatient OB rotation in med school, I was so unhappy. I did not enjoy the "male" attitude around delivering babies, with women flat on their backs, seemingly quite powerless; it just didn't seem like a joyful experience bringing life into this world. The OBs themselves seemed so unhappy. And then there were the C-sections. There is certainly a time and place and a need for these surgeries to occur, but is failure-to-progress (meaning the cervix isn't dilating anymore) after 2 hours really an indication for section? How could this possibly be the right way to do things. Oh, and then I see a different view during my NICU rotations in residency. Women who have "failed" home birth for any number of reasons or the baby was sick after being born and needed to come into the hospital for care are not met with the most respect. I don't know if the mother's notice these sentiments but I certainly hear them, the derogatory statments, snide remarks about home births, water births, birthing centers. Of course the sterility of the hospital would never have let this happen to these babies ... as if babies don't become septic being born in the hospital.
The film made a comment to the effect of "it is time to get the women out of the hospital," which was met with much applause. The film definitely has an agenda but it is quite balanced in its presentation and even highlights the appropriate use of C-sections. I just hope this film will increase awareness and increase the number of women who are informed of their options for birth and utilize midwives for all they are worth. I, for one, intend to.
Any why do I get fired up about this topic?? Well, on my inpatient OB rotation in med school, I was so unhappy. I did not enjoy the "male" attitude around delivering babies, with women flat on their backs, seemingly quite powerless; it just didn't seem like a joyful experience bringing life into this world. The OBs themselves seemed so unhappy. And then there were the C-sections. There is certainly a time and place and a need for these surgeries to occur, but is failure-to-progress (meaning the cervix isn't dilating anymore) after 2 hours really an indication for section? How could this possibly be the right way to do things. Oh, and then I see a different view during my NICU rotations in residency. Women who have "failed" home birth for any number of reasons or the baby was sick after being born and needed to come into the hospital for care are not met with the most respect. I don't know if the mother's notice these sentiments but I certainly hear them, the derogatory statments, snide remarks about home births, water births, birthing centers. Of course the sterility of the hospital would never have let this happen to these babies ... as if babies don't become septic being born in the hospital.
The film made a comment to the effect of "it is time to get the women out of the hospital," which was met with much applause. The film definitely has an agenda but it is quite balanced in its presentation and even highlights the appropriate use of C-sections. I just hope this film will increase awareness and increase the number of women who are informed of their options for birth and utilize midwives for all they are worth. I, for one, intend to.
Wednesday, February 6, 2008
Germs to share anyone?
You know that feeling of your throat just starting to hurt but not quite realizing the sensation? Well that was yesterday morning prior to a multivitamin plus about 2 g of vitamin C. Anyone else's mothers always insist on mega-vitamin C doses at the start of a cold? Well, it seemed to help yesterday but today is bringing sneezing, nasal congestion, and a huge desire to crawl into bed and sleep. Gotta love the sick kids coughing on me and sharing their lovely germies.
I'm on an easier rotation this month but 3 late nights in a row working urgent care doesn't suite my body rhythms very well. As anyone who has ever spent much time around me knows, I am a die-hard morning person and have a hard time sleeping in ... although Miguel is certainly having an impact on my ability to stay in bed longer.
I'm on an easier rotation this month but 3 late nights in a row working urgent care doesn't suite my body rhythms very well. As anyone who has ever spent much time around me knows, I am a die-hard morning person and have a hard time sleeping in ... although Miguel is certainly having an impact on my ability to stay in bed longer.
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