Week 1: Adolescent Clinic

Monday and Tuesday were spent in 8 hours of language class. I am in the intermediate class with 3 other students in the program. We are only allowed to speak Spanish during school hours so class consists of a lot of hand gesturing and blank stares at the professor-especially from me! She is very patient with us, but strict. There is a special kind of head ache you get from only speaking Spanish all day and by 4 o'clock when class gets out we are all too tired to do anything but go back home and lounge on the couches until dinner.

The classroom

On Wednesday I began my first hospital rotation. This week George and I are with Dra. Carrera, a pediatric doctor at a hospital in north Quito. I was nervous, because up until this point, I had not spoken Spanish with anyone except for our professors, host mom (who all know English and can bail us out if we need help) and a few taxi drivers. I didn't know what to expect.

At this adolescent clinic, prenatal and postpartum care is provided free to all mothers between the ages of 12-18. Dra. Carrera explained that many of her patients are abandoned by the fathers and at such young ages as 14, 15 or 16 these mothers are uneducated and unprepared to take care of a child, so most of her work involves educating the mothers and making sure they have some sort of support. 

We spent the next 3 days with Dra. Carrera. Each day started in her office where she would see 3 or 4 patients for a routine check up. She would lecture the mothers on the importance of breast feeding, prescribe vitamins and preform a quick physical exam of the baby. Next, we would go to the post delivery ward. This was three large connected rooms with 10 beds in each. Every time I walked in I was hit by how young the faces staring back at me were (the oldest mother we saw this week was 17). You could feel their nervous energy in the room as they sat on the bed with their day old babies. The mothers were suspicious of me to say the least. I'm sure it made them uncomfortable having an American girl wearing a white lab coat, only a few years older than them, staring down at their child. 

Dra. Carrera gave each baby a physical exam where she would draw blood, check for jaundice, and test their reflexes. She had us listen to their heart and lungs and showed us how to feel the soft spots on the skull. My previous anatomy knowledge really helped me here as I was able to engage with the doctor in naming the cranial bones and explain the formation of the skull. Even with my broken Spanish she began to realize my level of understanding and would turn to me more and more and ask me the cause of this or that. It was intimidating, but it helped me learn a lot.

We saw some unique cases over the three days spent in pediatrics. One baby boy had an undescended right testicle, another baby had a misshaped skull because of her position in the womb and the pressure of the mother's organs on her head as she developed, one  mother was 17 and already had a 5 year old son at home (yes she had a baby at 12!), and one baby's nose was broken during birth.

I couldn't have asked for a better first rotation. Dra. Carrera was very helpful and George and I actually got invited to a party by some of the nurses we worked with.