Hospital IESS Continued

So, to be honest, I didn’t know if I could finish out the day at Hospital IESS. It was incredibly stuffy in the hospital and paint was peeling and curling off the walls on top of the patient beds. Their names weren’t important, only their conditions and surgeries. Open electrical sockets and light fixtures laid their claim on every wall. A janitor was sweeping dust off of the floor, collecting an extraordinarily large pile in front of the stack of patient meals. The one thing I remember thinking was this: do NOT get sick in Ecuador, this is where they will bring you. It was a selfish, bratty, privileged thought, but to be honest, with what I’ve previously been exposed to, Ecuador seems like a “third world” country (I know some of you take issue with that term, but for lack of…) I think back to the US, with our nice, sanitary, shiny hospitals. They may not be terribly welcoming, but you at least feel hopeful that you will get better. Here, I look at Senor Lava (pronounced lay-va) and I can’t help but notice the look of absolute misery in his eyes. I don’t blame him. He’s been in various hospitals for over 2 months, had undergone two surgeries, and met me on his sixth day in Hospital IESS with a list of various complications on his chart. Dr. Jimenez explains to us the difficulty that he’s experienced with Senor Lava—leakage of pus into his abdominal cavity, ruptured intestines, carcinoids (which, from what I gathered, he had to look up on the internet to figure out). At this point, I thank God for Eve and James, who seem to understand every word. Medical Spanish, like I said, is more like Medical English than actual Spanish.

They explain to me that back in the US, in the clinic, they’ve seen at least 10-15 carcinoid tumor cases. This was a first for Dr. Jimenez, not because of his ability or inability (he seems like a very capable doctor), but because carcinoids mainly go untreated. When Dr. Jimenez lifts up Senor Lava’s shirt, I’m sure I’m about to faint. He has a large bandage wrapped around his belly with  a bag intended for draining his cavity of pus-blood. I handle myself.

Today, Dr. Jimenez only has 2 patients—the other is a simple ruptured appendix. Dr. Jimenez assures us that this is routine, no problem. His main concern is Senor Lava. Afterward, he talks to us a bit about competition in the hospitals and how it can be good, when it is used for patients and not for the self-importance of the doctors. He talks to us about ethics. He wishes us luck. And I leave Hospital IESS with a lot of food for thought.

 

What kind of commitment do you make as a doctor? Through medical school, how is it possible to know enough to make the right kinds of decisions? How can knowing what the patient is feeling or going through make you a better (or worse) doctor? I don’t know these answers yet, but at least, now, I’ve asked the questions.