Smooth

A quick note before the morning begins. We are working hard here. Really hard. With a 30minute commute up and down the valley in an old bus, a 8-5 work schedule and really no breaks, strangely I feel like Im on a rotation. :)

Id say so far this week has been a smashing success. Yesterday we were infinitely more organized, seeing 80 patients in the same amount of time we saw half that yesterday. The level of teaching for the fourth years has been great -- we see patients on our own, present them with an assessment and plan, and have the doc look over the physical/history and do some one on one teaching. Everyone agrees they are learning a lot. The first years were paired with four years for a while yesterday. I taught Matt how to do basic things like take blood, give an injection, as well as STD differentials and such indicators. Today they will be paired to a doc directly, since now we have more doctors here (2 more arrived last night).

Yesterday we officially diagnosed the Leishmaniasis from the day before (unusual at this elevation but she had just come from the Jungle), as well as domestic violence, renal failure, UTIs, standard gastritis and diarrhea, hypertension, palpitations, quite a few hernias (inguinal, umbilical, ventral), and a very sad neurological birth defect. It was a full full day. Hilariously, the goiter shown below wasnt even a complaint, I stumbled across it on physical exam (how could you not), but she said she had it for 20 years with no problems, so there you go.



Today we round out our excellent week with a final day of 8-5 and then the weekend off to explore Cusco, the market in Pisac, and for some, Machu Picchu.