Instituto de Maternidad = Maternity institute

So, with about 1.5 weeks left, I switched hospitals to the Maternity Institute, a public hospital in downtown hospital, obviously specializing in maternity. I'm with Dr. Mercado, who is a radiologist, working in the ultrasound room. I think he also used to be the director of a few hospitals and that he still teaches medical students. My first day, I was able to stay with the fifth year medical students and see a natural birth, the end of a c-section through the "gallery" = the window of the door outside the surgery wing, and another procedure after a miscarriage. The natural birth was pretty long, and they had to repair some damage done to the woman by the baby after. It was also really funny because there were 4 medical students, me, a 2 residents, a doctor, and a nurse, all crowded into this small birthing room. We were moving around and trying to see from any angle -- pobre mama, as my host mom said (poor mom). It was a little bit 'grosser' than I thought, but so interesting. I've seen a bunch of ultrasounds as well:
-pregnancy (a lot)
-baby's hips
-transvaginal
-thyroid
-kidneys
-ovarian cysts

We also saw a museum of preserved specimens of fetuses and miscarriages, which was interesting but really creepy, and kind of weird to think that they were once someone's baby or baby-to-be, and were inside a woman.

I also got the chance to see a C-section! In the actual room with the doctors! We ran to the pharmacy to buy a disposable gown, mask, cap, and booties, and then we rushed to get changed and go in the room! They were all really nice, and asked us about ourselves and where we were from, etc. All the doctors operating were residents, not yet specialized in OB. And there were 2 anesthesiologists in the room, who were really funny - typical, playing music, dancing, laughing with the doctors. They played us this song, really funny:
Anesthesiologist Song

It only took about 5-10 minutes to get the baby out, but then it took another hour to sew everything up! I was surprised at how long it took. I saw all the different layers of the abdomen and uterus, and the different types of needles they used and the sutures they were doing. It was so cool.

Anyway, I hope to see more this week! And I'll try to post again soon. I also want to post about medicine in general in Argentina, about my family, and about other general observations.

Peace,
Kelsey

Medicina - Sierras Chicas

So, I've been at this one small private clinic in the town where I live for about 2 months, called Sierras Chicas. I worked mostly with Dr. Murqui, who seems to me like a general or family practitioner. He was in charge of all the hospitalized patients (we had ~20 beds), except for the ICU (7 beds), and the walk-in/on call clinic area called 'la Guardia'. We didn't have an emergency room of any sort. He and another doctor shared these duties. Mostly, I just followed him on rounds and observed him in the Guardia. Whenever he was charting, or didn't have any more patients to see, or just didn't have anything for me to see in general, I followed the nurses around. With them, I helped change patients, change the beds, and just watched them do stuff. And when they didn't have anything to do, I folded gauze, because they cut, fold, wrap, and sterilize their own gauze.

It was definitely interesting to see the range of patients that Dr. Murqui saw. A good portion of the hospitalized patients were older, and some were bedridden, either because of old age, or hip fractures, etc. So, I'm just going to make a list of some of the things I saw:
-pnemonia
-diabetes
-urinary infections
-bug bites
-gastroenteritis
-flu/cold/allergies
-laryngitis
-appendicitis
-hip fractures
-cystic fibrosis
-toenail removal
-putting in/taking out male/female catheters
-hernia
-colon cancer
-kidney stones
-putting in/taking out IV
-stroke
-car accident
-fell off horse
-work injuries
-sports injuries
-enema
-naso-gastric tube
-remove blood from catheter
-take blood pressure/pulse
-pinched nerve
-epilepsy
-pregnant woman with contractions
-bleeding during pregnancy
-various other small wounds
-dressing changes of wounds
-heart murmur
-bedsores, including removal of sore.

In general, it was a really good experience. I got to see all kinds of different patients, and the relationship between the doctors and the nurses. I got to actually interact with patients, whether it was helping the nurses change them, feeding them, taking their blood pressure/pulse, assisting the doctors with handing them gauze/saline/tape/syringes, and other random tasks. I got to listen to a heart murmur, and to hear the lung sounds of patients with pneumonia.

The doctors were really nice. Dr. Murqui spoke very clearly and slowly, so I could understand him, and was very willing to answer any of my questions. At first, I thought some of the nurses didn't like me, but it was sometimes hard to understand them and I often felt like a burden to them. However, in the end, I had a good relationship with them and really enjoyed my time there. I will definitely miss it!