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Medicina de la Selva

Please forgive me. I had to type the title in Spanish. I'm not trying to be a poser or anything, you know that person who goes all "native" and speaks rubbish Spanish all the time. It's just that right now, I only have three months left and I'm trying to say EVERYTHING in Spanish. And, yes, I know those two sentences contradict each other. Irony.

Anyways. The type of medicine we did in the jungle was not too different from the medicine we do in other places in Peru. We still saw (what felt like) millions of patients with low back pain, lots of gastritis, and moms who were convinced that their children had parasites.

Quick, an excerpt from a real live conversation:

Me - "Entonces, su hijo tiene la grippe. Algo mas?"
Anxious Momma - "Seguramente tiene bichos tambien."
Me (with eyebrows raised)- "Hmmm, bichos. Porque piensas que el tiene bichos?"
Anxios Momma- "No come bien, y solo quiere comer carmelos."
Me- "Ahhhh..." *writing down "Mom thinks he may have a parasite because he only wants to eat sweets, nutrition consult?"*

However, during our forays into jungle medicine we did see a few things that are rare in other parts of the world.

We saw an 8 year old boy who was the size of a 4 year old because of growth hormone deficiency.

Alfredo, our optometrist, saw a few cases of copper toxicity in people who had worked in the copper mines (you can see a copper ring around the iris which demonstrates that the body is not metabolizing the copper fast enough)

We saw a woman with a fixed tumor on the right side of her face that had wrapped around cranial nerves III, IV, and VI (which means she had no eye movement or pupil constriction and had a pronounced eye droop).

We saw people with weird fungi and edema patterns.

But most of all, we saw a lot of need. There were people at our clinic who had not seen an MD (or an dentist or optometrist) for years. They call the district we were visiting the forgotten district, in terms of health care. The physicians who practice there, at the free health centers, are doing their mandatory year of service to the country. They are fresh out of school, and have few resources. The patients we saw in Iberia, for example, would have to make a three hour drive to Puerto Maldonado if they wanted an X-ray or blood work.

Then there was this lady.

We met her when we were passing through a community called Infierno (literally translated "Hell"). She has rheumatoid arthritis and has been in constant pain for years. As you can see, her wheelchair is not far up on the technology list either. And this girl, who has streaks in her hair from protein deficiency.

Although the people who live in Infierno only live about 45 minutes out of Puerto, the bridges wash out a couple of times a year, and the corrupt government officials have stolen all of the money that was delegated to build new bridges. Imagine being stuck somewhere and having a sick child.

Finally, on the weekend 10 members of our team happened upon a recent car accident while they were driving to Puerto Maldonado. A motorcycle carrying two men had collided with a car coming from the opposite direction. The accident was 25 minutes old, the driver from the car was fine, but both motorcyclists were thrown from the bike and one was dead on the scene. The other was lying in a state of shock with an open fracture. The team stopped and got out of the car. One of our doctors was able to splint and tourniquet his leg. They took time to clean the wound. And the pastor spent some time praying and talking with him. They waiting an hour for the local nurse to arrive, helped her start the IV and get him into the transport, and then got back into the car.

He passed away a few days later. We wonder if there was internal bleeding that they did not detect because they lacked the imaging equipment.

Jungle medicine is terrifying and hopeful all at the same time. It's terrifying because, what if you are wrong? You don't have all the support and comfort that you usually have at home. What if the people don't follow up with a surgeon or a specialist, like you told them too? They could die or develop a secondary infection. But, on the other hand, what if you hadn't ever been there in the first place. What if you never touched them, what if you kept driving, or ignored the need right in front of you?

I don't have answers. Just more questions. Jungle medicine breaks my heart and makes me frustrated. How about you?


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