Another day

Bright, cheerful puffs of sound are the polytonal point and counterpoint of the morning traffic conversation on the way to the hospital.   The tempo is at first a pleasant andante as we pull out of the resort with an occasional “hello” or “coming along side” through the country.  Today, columns of spicy, sweet, hazy smoke rise through the clear morning air at irregular intervals along the road and sometimes back into the hills, a sign that the rubbish collection system is currently down.  As we drive closer to town, the conversation accelerates to a brisk allegretto as the roads become filled with cars, and with bicycles and pedestrians on their way to school or work who ride or step into the street without thought or hesitation, and with goats, which carefully look both ways before venturing into the busy morning traffic.  Owners of the many tiki shops and restaurants are starting to arrange their wares for the day into neat stacks of colorful fruits, or strings of smoked fish, or cloth bags, or t-shirts.  A police car tends to a small altercation between a guilty-looking gray sports car with a large rear spoiler and an unassuming bicycle just before the turn-off to the hospital, which I’m just starting to recognize and expect. Sitting in the office waiting for the morning’s dockets, the other emergency medicine doctors and the chief medical officer pop their heads in to make sure I’m comfortable. (I am).  One brings me up to the pediatric ward to say hello to the few patients up there, one of whom is a toddler who was hospitalized for treatment of a severe skin infection.  She looks quite well, with small dark eyes peering curiously at me underneath the sky blue gauze of the surgical hair net she wears, and I am told that she is well, but being kept for evaluation of neglect.  Her brother, it turns out, was recently hospitalized for a similar infection and his mother received copious education at that time.  Fortunately, his sister is better off as, unlike her brother, she did not have “little people” (maggots) in her infection when she was brought for treatment.  Nonetheless, there is understandable concern regarding the household hygiene.  Her case led to an informative discussion of the local social work system, which is not substantially different from home, though they may be working with even less funding and support. The day was a rush of orthopedic evaluations and skin infections.  By the time I rode back to the resort, the smog from the morning’s rubbish fires had been replaced by majestic afternoon storm clouds billowing above the mountains.  Not a bad way to end the work day.