Match Day

Today I learned that I am going to McKayDee Hospital in Ogden, UT for residency in Family Practice. This is a great day. While in Peru, I realized that I need my support of family and friends. I also that I needed my recreation of mountains and southern Utah. I realized that it isn't that great when you are the only one that doesn't drink at a party. I have been praying that I would stay in Utah for these factors and I am happy that I am. This is great news and excited for the future. I am also with 2 other good friends from the University of Utah. Good times for the future

Peru Saga: Sunday:a day for guns and alcohol

I was on call last night and am a little hung over...from sleep deprevation. 3 gunshot wounds, a 23 yo with gun shot to the head on life support, a 18 yo with a broken femur and another shot in his foot that we dug out with local anesthesia, and another guy who passed away. I was watching the news today and his family was on there telling the story. One of the guys that went to surgery was shooting at police and as he went in the police said to the doc Just let the SOB die. And the doc said jokingly I will do my very best. The guy is doing just fine. One of the crazy things about this hospital is there is not a lot of linens so yesterday I had to mummy wrap two kids to suture their heads and got sheets bloody...nevertheless the ladies in charge of the linens were pretty angry because they didnt know if there were going to be enough sheets for the patients. Most of the gurneys don{t have any sheets at all on them. They are pretty gross to because they don{t get cleaned after every patient and will have dried blood clots on them. Another guy came in with infected wounds from a car accident the day before. he broke his femur into 5 peices and his tibia in two. His wounds smelled horrible. Another guy got into a motorcycle accident and I had to suture up his face. Before he was leaving I commented to the intern taking care of him that he had lost consciousness after the accident and was thinking that we should get a CT scan because of his trauma. He didnt show any huge signs of bleeding in the brain, so right after we talked about the warning signs of mass effect on the brain such as vomiting, seizures, somnelance...As we were talking he started to seize. And we got a CT scan. The problem is that if you dont have the $100 for the CT scan they wont attend you and the center said that the there was no doc until 8am the next day (which was not true) Anyways it has been pretty frustrating and even though our system costs a lot of money I am happy for materials, sheets, and being able to get diagnostic testing for patientsLast night I went in on a appendectomy and was also surprised to see that they don{t put the patient under general anesthetic and intubate. The patient woke up during the procedure and was thrashing his arms. Crazy.As for other things, I went to the institute dance and had a blast. I am pretty shy when it comes to asking girls to dance, but I felt like the world was my oyster here and I had a great time. Also other news, I just got an email telling me that I have matched and that I will find out where my residency is on Thurs.Thanks again Melis for picking me up and we will see you guys on WedScott

Peru Saga: tonight I celebrate with goat

Another crazy day at the ER. Two kids who were run over. Another guy who cut off his finger. A kid who split open his head. A guy who cut his finger with a knife. A guy who was working and part of the machine split open his leg and his hand that I had suture. Two gun shot wounds. One of the guys whose family didn´t want to show up and help him so sat there with an open wound for 5 hours before I got to work. I cleaned him up and put some extra gause on his wounds and bandaged him up. He was still pretty drunk. I cleaned up the burn victims from the day before and the guys who were beat up. I don´t remember the other patients but I do remember that I haven´t sat down all day and my feet are throbbing. This is pretty typical of 12 hours with no sitting and no lunch. But tonight on my way home from work I sat down and a fancy restaurant ($7) and ate cabrito a famous dish here made from goat meat. It was pretty good. Last night, I had awesome ribs for $3 at a fancier restaurant. The restaurant is right by my house and calls my name every night. It was so good. They serve big peices of corn called choclo and salad. I also had fresh squeezed O J. I am going to the beach tomorrow after my institute dance tonight.Partying up my last couple of days in Peru. Thanks Melis for picking me up. My flight gets in at 1245pm from Atlanta. I am flying Delta and they say that it is flight 150. However it only has my flight from Lima on the itinerary so the number might be off.

Peru Saga: Family does serve a purpose

I was sick this morning but I went to work at noon and ended at 8pm. 2 guys with bullet wounds. One was 16 and was shot once through the back and died. The other guy was 32 and shot 3 times and lived. It isn´t known if it was the police that shot them or if it was another gang. The 16 yearold mother came about 2 hours later looking for her son. When the intern told her that her son had passed away she was frantic. Screaming, crying and wouldn´t let go of the doctor telling him to tell her that it wasn´t true. Another 13 year old girl was hit by a taxi. She came in very confused and in and out of consciousness. She was frantic and kept trying to get off her gurney while we held her down. When I said her name for some reason she came back to reality for a second and was calm and then would go crazy again. It was eerie. She didn´t break any bones but definitely had a concusion. Another guy cut off the tip of his finger and I had to sew his finger together. I had to put the needle through the finger nail which was a pain because there was no skin to put it back together. Another guy had an electrical burn from work, and was in so much pain. We had to check his heart and his bladder for injury because electric burns cause damage throughout. Pain is one thing that they undertreat here and that we overtreat in the US. I think I would want my pain to over treated though.Another 6 year old boy cut his head open on the swingset. It was down to the bone. I had to sew two layers. he was pretty frantic. I first had him count to two hundred for me as I sewed him up. Then we played the animal guessing game like mason likes to play. I don´t know too many animals in Spanish as he would try to have me guess animals like walrus. It was quite a challenge. Then I asked him about his birthday and he told me about his friends and the food. Then he wanted to play the guessing game with food. It took about 30 minutes to sew him up given his wound size and my inexperience. I put in about 12 stitches (6 in each layer) so it was great to at least have something to distract him. Another day in ER paradise. Tomorrow church dance Wahoo!Scott

Peru Saga: I was lost but now I am found

These last couple of days have been more of the same. Sad story today. A lady 25 years old came in with serious brain injury after her minibus was hit (this is pretty common as these volkswagon buses don´t have seat belts) It turns out she is 3 months pregnant. They are going to try to keep her alive as long as possible but most likely she and the baby will pass away. Another 50 year old guy was playing soccer and broke his leg. Two other motor vehicle accidents today with broken femurs. An 90 year old lady with a broken hip. Three kids with sliced open lip, head, and fingers that I sutured as they screamed at me from their burrito blanket restraint. Another sad story, a baby with multiple injuries most likely from child abuse. However, there is no child protective services so they don´t do anything about it. Lots more cases that I don´t rememberLast night I got off work around 7 and thought about going to institute and looked it up on the internet. I couldn´t figure it out so I thought that I would go to the movie theater instead. I saw one close to my house as I was walking home from the hospital. Nevertheless I went on the wrong street and was lost and ran into the institute building 2 blocks from my house. I met some of the members and classes had already started so I just peaked in. They have 5 different classrooms with schedule from early morning to 730 at night. I ended up going tonight and the teacher loved to pick on me. All of the classes were full and they had to bring chairs in. It was really great to see. I went with a couple of the members to eat afterwards. I ended up going to the movie theater last night to watch Wolf Man and was surprised that my ticket was less than $2 so I got popcorn and a drink for $3. It was great..the first time I have had refreshments at a movie theater. Living it up in PeruScott

Peru Saga: it was good the old man was drunk

Today was actually slow and ironically a group of students from florida came to see what an ER in peru was like and there were no patients. I laughed as hours before the place was full of gun shot wounds. I sutured up a man in his 50´s that was drunk and was hit by a car and again was flung on to a metal fence. (They are human shishkabobs here). He broke 5 ribs and had a deep wound the size of my toe nail clippers and about 1.5 inches deep. We were worried he had punctered his lung but he was alright. I had to sew three layers of sutures from his facia to his skin. It took me a long time so his anesthesia wore off but luckily he was still feeling his self medicated anesthesia. I decided that if I ever get in an accident I want to be drunk or drugged up. Other cases today included an old woman who broke her arm. A guy whose motor cycle taxi fell on his foot and had a compound fracture aka his bone was sticking out of his foot. Another guy who broke his nose a woman who fell on a fence and had air in her abdomen but no signs of damage to her intestines or diapragm and some other people that I don´t remember.today I actually had lunch and had a good time talking to the interns. it was also so good to speak english again with the students from florida. they actually thought I knew what I was doing . Scary thought.I am going to try to go to find instute

Peru Saga: alcohol and church

So don´t worry I had two dinners yesterday and I am not losing weight but I bought some apples to start getting at least some vitamins. Last night I got ready to go clubbing...however, I went to my friends house who invited me and she was shocked by what I was wearing (tshirt and jeans) She said that I needed a collared shirt and slacks so I dug my pants out of my pack and they were pretty wrinkled and then put on my polo type shirt that I used for work. It turns out that we weren´t going clubbing and that we were going to a party for her cousin that was graduating from nursing school. I thought that this was going to be alright with my dress. It turns out that the party was all of the graduating class and their parents and they were wearing suits and ties and that nobody else was meeting with us. So already sticking out as a white guy, I walked into the party being very underdressed. There were 400 eyes staring at me as we walked in.They also brought us dinner at 1100pm ( I had eaten right after I wrote the email last night) But I ate the pork and mash potatoes. Also then there was a toast, which I thought was going to be lemonade that wasn´t. It burned as I sipped it and made me feel a little funny. I instantly recognized my mistake and then asked the girl who invited me to drink it. It was a drink called Pisco Sour that had 40% alcohol. We ended up having a great time. It was like LDSBC prom but latin style and we danced until 3 am. At 2am there was something called La hora loca when a bunch of clowns came with balloon animals and masks to the dance. It was a little different. The greatest part was that all of the parents were also dancing with the 20 year olds at 3 am when we left. I told them how I didn´t even think my brothers and sisters would have made it that long never the less my parentsI also made a mistake and opened my mouth about the funny differences between our cultures. As latins are more passionate and show their emotions a lot more than we do (even more than mom). And how adults have stuffed animals on their beds and in their taxis with them is almost pathologic for borderline personalities in our culture. It is funny that I have culture shock after visiting all the places and cultures that I have seen. I don´t know if that sip of alcohol helped disinhibit me or if i just have diarrhea of the mouth but I realized after that they probably didn´t need to hear that.Luckily we had such a good time that was not the most memorable part of the night. I woke up this morning at 9 when my doc called me to see if I wanted to come to breakfast with his family. Afterwards he mentioned that their was an LDS church close by and I went to see if there was a meeting at 11 or at 1 so I could go home and change. It turns out that their meetings start at 8 and 10 and so I went to church in my t shirt and jeans from the suggestion of the elders. I met a bunch of young single adults and found out that the institute building is by my house and am going to go to class in the next week ( they have classes all day long and full time staff) and to their party on Friday. It turns out that there are 7 stakes here and a million people. Funny how that is a lot of mormons and I still haven´t met one in the hospital.After church I went home to find out there was no power and my room was baking so I took my book and went to the beach and fell asleep from feeling the effects from the night before. So I am a little baked right now. I am about to call home but I thought that I would write this stuff down before. I am disappointed that I only have a week and a half left as I am just overcoming my culture shock, feeling comfortable at the hospital, and getting to know the members.Such is lifeScott