diving in head first

Just a few days in and I've already seen so much.  I guess it helps that I'm on call q3 (every third night for those non-medical)... It's a steep learning curve.  I came in semi-confident in my Spanish only to be blown away by rounds-- imagine speed-talking medical terminology-- sometimes difficult to understand in English let alone Spanish.  But things I took for granted in Memphis take a lot of time and effort here (doing my own EKGs, ordering labs one at a time instead of just CBC, CMP, etc...).

We see such a variety of patients, some of which I thought were just examples in antequated textbooks.  Leptospirosis, for example, would not be on the top of my list for diagnoses my patient with a fever and body aches.  I wouldn't have even thought to order the test for it.  I was humbled.  I was wrong.  And leptospirosis was positive.  

Simple things like equipment that works and specialists in every possible disorder imaginable, are unfortunately not widely available.  A woman came rushing in this afternoon carrying her precious 5 year old, yelling "she needs oxygen, please!"  The valve had broken on her home O2 tank and she had no way to fix it.  The little girl has end stage osteosarcoma (a type of bone cancer) that was not cured by amputating her leg or chemotherapy.  She held my hand and her mom gushed with gratitude.  

Thankfully I've had no run- ins with snakes or tarantulas yet.  I shouldn't say that too loud.  But the humidity is killer.  Everything is damp-- book pages feel soggy, the salt clumps in the salt shaker.  There is even a "dry closet" in my apartment that has a light bulb that stays on constantly to generate heat to dry the air inside.  People think of Ecuador as a tropical place, which it is, but tropical doesn't necessarily mean warm.  It's constantly cloudy, rains about 10 hours a day, and is in the low 60's.  A nice break from 90-100!