Hospital Times

Looking in the front doors of the clinic I've been working at.

I have MADE gauze and cotton balls--yes, just like they might have in the 1920's. I betcha they also did that in the Civil War.

Things are different here in Peru. Just a little different. Some of it isn't so bad, because we're pretty wasteful in our healthcare system. But some of it really sketches me out: things like MAKING gauze and cotton balls. I'm not a machine. We have machines for this! There is also a hand towel, singular. There are not hand towels, plural, in the form of paper towels. What you will find is a towel labeled "manos." With this, dry your hands, as so many have before you.

Patient privacy is a thing of the future. As you're cleaning a huge gash or talking about an illness with a patient, another patient might just walk into the room. Or maybe they've been sitting there the whole time because they were there first. Maybe they're passing out after giving a blood sample. Who knows. You couldn't look long enough to find HIPPA.

Gloves. For the birds. There's not really much to say about them and there aren't really that many of them. You use them when you're about to be bled on and that's it. I suppose you also use them when you're preparing a feces sample to be checked out under the microscope.

The lab here is a real lab. You don't place a piece of blood in a spacemachine that tells you all about it. You actually have to spin the blood, take it to dinner, and then manually measure the hematocrit using a plastic instrument. This is actually really beneficial for learning because you are able to physically see what a low or a high hematocrit looks like, for example. You don't get that with a magic-lab-spacemachine in the US.

Also dogs just run in and out of this little clinic as they please. Sometimes kids play with them. Other times people say ch-ch-ch and chase them out. Still other times they just take a nap by the pharmacy window. I don't believe I've stressed that these are wild, street dogs. They don't have collars or houses or Purina. So they just do what they want all the time. All dogs go to heaven.

Some things are the same though. People need shots, people need wounds cleaned, people need nebulizer treatments, and some people need their feces tested for giardia. Those things don't change and the basic treatments and procedures are roughly what you'd expect. But it's what you'd expect if you weren't living in a culture of abundance and surplus. So there are fewer needles, vials, sutures, and you MAKE gauze. You begin to appreciate how much we really have to work with in our hospitals. You've really got to McGyver things here sometimes.

A lot is different but I can agree with some of the differences. Not on an evidence-based level for sure, but on a come-on level perhaps. Like the gloves. In the US, I go through 30 pairs of gloves while asking a patient their name and date of birth. Here I've used about 3 pairs a day. We could really tone down the gloves and for the most part it wouldn't kill us all. It's also refreshing not to have to worry if each patient wants to sue everyone. I'm all for patient privacy, and do my best to maintain it down here, but it's for the patient… not to protect myself from getting sued. That's the way it should be. Also, dogs in the hospital: sign me up.