First Draft

 
Before I get started, a heartfelt apology to my writer friends.  You would be able to convey this experience with much more elegance, and quite probably with more grammatical expertise than I am capable of producing. Work Day 2:  The day really began en route to the hospital.  Imagine driving along a winding road through the Caribbean forest with the shade of the banana and almond trees cooling the humid air to a pleasant morning breeze.  A feeling of familiarity pulls at the fuzzy edges of your still awakening consciousness and you realize that the hokey pokey has insidiously emerged under the cover of a steady reggae beat coming through the car stereo with an overlay of laser sound effects.  Go figure.  The standard small-country driving experience, where the primary and possibly the only rule is, “Do your best not to hit anything, but if you do, oh well,” is not sufficient to wake me up, but reggae laser “Hokey Pokey,” gets my attention.  Now being slightly more awake, I see a few hints of the community I’ll be working with over the next month:  the children walk together dressed in neatly pressed school uniforms, every car full of people, and those that aren’t pulling over to pick up one of the people dotting the shoulder of the road, neighbors calling out and waving to each other on the way to work.  Here at the hospital, everyone helps keep an eye on one of the clinical officer’s children, Shaun, who has come in for the day.  He’s about 3 years old and is happily thumping away on a succession of musical instruments.  First, with rulers repurposed as drumsticks, then with a truck and a table, and now with a reptilian themed Fisher-Price ™ alligator xylophone and an allosaurus figurine. Flashback: After arriving this weekend, I spent the first day sleeping and relaxing at the resort, which was a welcome recovery period after a week of night shifts back home.  I thoroughly enjoyed Monday night performances by a magician, limbo king, and fire breather.  On two occasions, I was a volunteer on stage:  once to assist in the magical appearance of a dove (I still have no idea where it came from!), and once to hold a lighter for the fire breather.  Interestingly, the other two assistants for the fire-breathing performance had 2-foot long torches, which they held extended at arm’s length while the fire breather sputtered kerosene over the flaming end to create a small fireball over the audience.  He performed the same trick with the lighter in my hand.  This was not one of the nice, long, extended lighters, but a standard 3 inch cigarette lighter.  As a result, both the kerosene and the resulting flame were much closer to my person than to the other two volunteers.  Later, I wondered if their hands and arms smelled as much of kerosene as mine did, or if they avoided most of the spray by virtue of lengthier props.  I will likely never know.  The resort is lovely, though I suspect it will be difficult to keep my girlish figure intact given the highly accessible supply of quality food and drink.  Spinning instructor, Mike, may be able to help me stave off the sloth. Thus far, there’s not a lot to report on the medical front.  The clinics provide a dose of reality in contrast to the grounded cruise ship feeling of the resort.  Yesterday afternoon, I saw a few patients at Port Maria, where they’ve recently acquired a wall unit ophthalmoscope and otoscope.  In general, the clinics are well-appointed and the other doctors and staff have been welcoming and supportive.  It’s always a bit of a gear shift to go from “pull out all the stops” medicine in the US to “practical medicine” elsewhere with a sense that my brain is finally coming out of hibernation and that I am indeed capable of setting up my own clinic space, and doing phlebotomy, and reading plain films and all number of useful things which have been lost in the hierarchy back home. Present Day: We rounded this morning with Drs. Ramos and Fisher, who are as thoughtful and enthusiastic as others have described and I look forward to learning from them over the next several weeks.  This afternoon will be my first round in the A&E unit seeing acute patients, which is roughly equivalent to our emergency room (or ‘department’ if a ‘room’ just wasn’t enough).  Wish me luck!

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