Surgery and Spanish and Strikes…oh my!

Yesterday we started our week of pediatric surgery. It took us a while to find our surgery preceptor, Dr. Galindo, but once we found him we got to observe an orchiopexy. For all my non-medical friends, this is a surgery to correct a condition called cryptorchidism. In male embryonic development, the testicles develop in the abdomen and then descend into the scrotum by the 35th week of gestation. In cryptorchidism, there is usually one (sometimes both) testicle that doesn’t descend and can be “stuck” in the abdomen. This surgery removes the undescended testicle from the abdomen to put it in the scrotum. I was pretty surprised to see that the OR was very much the same here as at home. There were only minor differences that I noticed: the surgeon and scrub techs used cloth gowns rather than the disposable ones at home and there was a Coke in the room sitting next to some medicines on a cart. Other than that, most everything else was similar (even the high tech equipment used by the anesthesiogists, from what I could see). I enjoyed watching the surgery and seeing the OR, and Dr. Galindo is very nice to work with. He spent about 10 minutes after the surgery yesterday chatting with us (in Spanish- he doesn’t speak English) about a variety of topics including his training background in surgery, the Superbowl and March Madness (haha). Thank goodness my sweet husband has been keeping me up to date on all the basketball craziness going on at home! In Bolivia, pediatric surgeons complete 3 years of general surgery and then 3 years of pediatric surgery (as opposed to in the U.S. where it is 5 years of general surgery and then another 2-3 years for pediatric surgery….not quite sure how long that fellowship is). Dr. Galindo trained for one month at Stanford University learning how to do laparoscopic surgery, and he is the sole surgeon here that does laparoscopic surgery from my understanding.

A little dark but this is the surgery unit at Hospital del Niño. There are 10 beds all in one big room and then 2 beds that (as far as I can tell) are like an isolation unit (i.e. for patients who have a specific infection or are more prone to an infection).

A little dark but this is the surgery unit at Hospital del Niño. There are 10 beds all in one big room and then 2 beds that (as far as I can tell) are like an isolation unit (i.e. for patients who have a specific infection or are more prone to an infection).

Today we showed up at the hospital and found the huge front doors closed and locked. A little confused, we entered the hospital from the ER. I noticed a sign on my way in that said “what would the hospital be like without surgeons, anesthesiologists, and other specialists?” but I didn’t think much of it. The nurse who is in charge of distributing scrubs for the OR told us there weren’t any surgeries today except for emergencies. She mentioned something about the front door being closed but we didn’t fully understand what she was trying to tell us. Still confused because yesterday Dr. Galindo had told us to show up at 9 for surgeries today, we wandered up to the infectious disease unit where we worked last week to see if we could participate in rounds since there were no surgeries on the schedule. However, there didn’t seem to be much going on in that unit either (other than the residents busily typing notes on their typewriters) so we went back down to the surgery unit and ran into Dr. Galindo, who informed us that there was a strike today- they are protesting the fact that there are not enough doctors at Hospital del Niño (suddenly I put 2 and 2 together…the locked front doors, the interesting sign outside the ER, the nurse trying to explain to us the lack of surgeries today…of course we didn’t understand because we didn’t know the Spanish word for strike). Apparently strikes like this are pretty typical here in La Paz, not just in the medical field but in general. Dr. Galindo assured us it is only a one day strike and that he has 2 very interesting cases on the schedule for tomorrow. So back home we went! On the way out of the hospital, I noticed another sign that said “we want a better hospital.” I was sad that I didn’t bring my phone to take pictures of the signs as I found the whole situation very interesting! We did check on the young boy I mentioned last week who had the swollen face and they now think he has Melkersson-Rosenthal syndrome (interesting to read about for my medical friends who want to look it up…pretty rare). His face did look a little less swollen today so hopefully those steroids are helping.

We have been going to Spanish classes with our teacher every day. I am learning lots and having fun! I am nowhere near fluent still but am feeling much more comfortable getting around, asking questions, and understanding things at the hospital. Jenny speaks in Spanish for our entire 2 hour class and I am pretty excited that I understand around 95% of what she says (just some random words here and there that I don’t know). Tonight we have our second meeting with Dra. Uribe and she is going to lecture on pediatric surgical emergencies- perfect for this week of surgery! Judithe and I have to go downtown early this afternoon to wash our clothes at a laundromat (apparently there are not many of them here as most people still wash clothes by hand on washboards) so that should be an interesting experience…wish us luck!

 

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