Friday, July 4, 2008

¡¡¡¡FELIZ 4 de JULIO!!!!

My life since my last update:

* I've become worryingly addicted to Chilean telenovelas.

* On Wednesday I watched a C-section. It was pretty intense. The baby was over 12 lbs. That's like...3 of Noa when she was born. That'd be like if Carole had triplets. Except it was ONE HUGE BABY. It was pretty cool seeing a little person come in to the world, even if he was covered in nastyness and looked kinda like the mandrake from Harry Potter:
* Yesterday I met two very nice boys who play for one of Chile's rugby teams. They both used to be on the NATIONAL Chilean Under-20 team, and one of them was the captain. It was a ton of fun talking about the game and comparing our rugby cultures. One of them used to be a wing, so we compared strategies. I'm really excited to watch one of their games! Apparently they have a women's national team here too so if I get a chance I want to watch them play.

* Speaking of sports, I'm going to go skiing tomorrow!

* I am currently sitting in a Starbucks ... with a smoking section. I kid you not.

* And last but not least, a very happy 4th of July to everyone.

HUGS!
- Lauren

Wednesday, July 2, 2008

These entries always end up longer than I planned

Some pictures to capture the way I see Santiago...


For those still convinced that I live in a shack, here's a picture of my neighborhood:


The signs below translate: "Alcoholics Anonymous. If your problem is alcohol, call us."
I've actually seen fewer homeless here than in Boston, but I just thought this was ironic product placement.


Inside Hospital Clinica de U. Catolica (Pabellon)


And of course, there's the graffiti. I have an undeniable affection for graffiti, as long as it's for a cause I support, or it amuses me. I suppose a picture of the student protests would be more relevant to current events, but I thought this might amuse/shock a few people. The animal activists are pretty busy here -- they protest outside the research building I'm shadowing at on a near-daily basis.



Anyway, I wimped out and didn't try to bring a camara into the operating room on monday. I did, however, get to observe a nifty colon surgery. They removed a huuge part of the colon and the appendix, all covered in nasty tumor-y stuff. It was pretty sweet. My favorite part was the late 90's "soft rock" music they were listening to, and the fact that one of the doctors was constantly bobbing his head in time while the nurse was fully dancing as she passed along the . Once we were in full scrub gear they pretty much let us wander wherever we wanted in the unit, since we looked identical to the medical students they have floating around everywhere, except a bit more foreign. When someone looks like they aren't in the process of saving someone's life, I really like talking to the doctors and nurses and students and patients (ok, maybe I just like talking), and they are almost always receptive to my questions. Unfortunately people tend to talk to me as if I'm at least a 3rd-year medical student so I probably wouldn't understand them even if they were speaking English.

Today we ran into some students from Texas who just got here two days ago. I can't believe I've already been here a month, it feels like I just got here yesterday...but seeing how bewildered they are by things that now seem completely common place to me made me realize how much I've adapted to the city. I wish I could spend more time here...

Anyway, it's getting super late (no, seriously, why we in the same time zone??). More tomorrow about the public hospital, etc.




Chilenismo of the day: ALTIRO. It means "right now" or "really soon". It's a relatively flexible term for most of the Chileans I've met, though. I fit in well here.

Saturday, June 28, 2008

Almost July!?!?!

The rest of my clinical observations have been trying, but interesting. Today I observed internal medicine and on Wednesday I was in the neonatal unit. It was pretty hard seeing the tiny babies all hooked up to machines and struggling to survive. There was one who had suffered severe asphyxia during birth and was now essentially brain-dead. I couldn't imagine being in her parent's shoes.

I only have one day left in my observation at the private hospital. The grand finale is going to be scrubbing in on surgery on Monday. Due to the lack of privacy laws in this country, there have been rumors that we may be allowed to bring camaras into the OR, so get excited! Apparently at the public hospital next week we might get to see a baby get born. I'm not going to lie, it sounds less than appetizing to me. Maybe it'll be life-affirming and beautiful, but I'm pretty sure it'll just be bloody and gross.

Speaking of bloody and gross, I started shadowing in a research lab this week. There were animal rights protesters outside the building. It was very cute. The lab I'm in works on microglial cell cultures, which is really exciting because that's what I worked with all last summer so I'm already familiar with the protocols and chemicals, etc. It's cool to watch how they do things here because they have so fewer resources but there still manage to do really important science. The research institute I'm shadowing at is the largest in Chile, and they only have ~28 labs.


I got a new camara, so here's some pictures from today:

We went to Bellavista, where we got cotton candy at a little park/zoo thing, and then headed over to Pablo Neruda's Santiago dwelling where we took a really fascinating tour and learned all about his secret love affair and how he built the house to accommodate it. There's also a lot of evidence of destruction/re-building because the house was badly burnt during the 1973 coup. Now I've toured two out of his three houses (see the entry from Vina), so I feel like I have to go back to Valpo and catch the third too.



Tonight we decided to explore a new neighborhood, Ñuñoa, where we visited a microbrewery. (Disclaimer: I am legal drinking age in Chile)
That's my "which one should we choose?" face. The other lovely ladies are Katie and Kirsten. These are the beers we tasted -- rubio (blonde), ambar (amber), and negro (black). I preferred the amber. The "negro" was faaar too intense for me. Kinda tasted like tar. But I guess some people are into that. The rubio tasted like vaguely beer-flavored water.


We decided that even with the poet's house and the microbrewery, we hadn't been quite artsy enough today, so then we went to a Jazz Club.

And that was my day in pictures! Thank you and come again soon.







Chilenismo of the day: Manjar. I'm kinda cheating cus this is actually a food, not a modismo, but it deserves a mention. Manjar is in any chilean candy worth eating, and most desserts...and some savory dishes. It's pretty much the same thing as Dulce de Leche...which is like Caramel made from condensed milk rather than sugar. It's incredible. They make these candies called Afajor, which are like baby cakes with Manjar in the middle, coated in chocolate. I'm making it my duty to try every brand and figure out which is the best and then take a huge box home.

Tuesday, June 24, 2008

¿Cachai? Sipo.

Riding the metro in Santiago is a blast, and it’s super efficient and speedy and goes to all the places I need to go, but it’s also crowded as hell. At rush hour, it's literally wall-to-wall people, clown-car style. It makes a pretty good environment for pick-pocketing since you’re being bumped and touched all over anyway. So it’s important to keep your backpack OFF your back and within sight, and to keep all valuables somewhere that’s really hard to get to without you noticing. I did none of this things because I’m a dumbass. So anyway, my camara got stolen out of my backpack. I'll get a new one but until then, no more pictures :-(. Luckily I didn't loose any because I had already uploaded it. Here's the last picture my faithful camara took before being stolen from me by the mean metro pickpockets:

That's my host family. Don't I fit right in? Now that I actually understand what everyone's saying (sometimes), I'm starting to get to know them and really loving it. They're a very smart bunch of people, and it's really fun to talk politics with then...or just watch trashy telenovelas (much more common past time).



I just realized I haven’t yet talked about my trip to Maria Pinto on Friday, so I’m going to do so now. Maria Pinto is a rural area (“Comuna” – like a collection of little towns.) The area is very dispersed, lightly populated, but far enough away from the city that they require their own health care system. Our trip was pretty short, just a few hours, but we got to meet the mayor and observe the various forms of health-care providers that exist in the community. There’s one slightly larger one that serves about 6,000 citizens and is open 24hrs, but there isn’t always necessarily a doctor. Then there’s the “Posta Rurales” that serve about 1.000 people each, and are open during very specific hours, which makes sense consider the lack of resources but less so consider the fact that the purpose is to provide emergency care. We didn’t get to speak with any patients but we talked with a few nurses and “tecnicos”…they are like medical technicians/paramedics, who only get 1 or 2 years of training. Most of the time, in the Posta Rurales, that’s all there is…the doctors and nurses are there only 1 or 2 days a week. It’s a little depressing. But what else can they do?

Today was also an adventure, starting out bright and early at 8:30am at the Hospital Clinca de la Pontificia Universidad Catolica. My group was assigned to the “cirugía” unit, which turned out to be less exciting than expected since it was just post-operation care. But we did get to learn a lot by talking with the nurses and patients, and most important by snooping around the files because there’s no such thing as HIPAA in Chile. It’s a teaching hospital, so since we I was wearing a white lab coat and taking notes, no one questioned me when I started searching through files to figure out what surgery a certain patient had just had. Talking to the patients was my favorite part, though. I spent a lot of time talking with a younger-looking man who was undergoing kidney dialysis and has been awaiting a kidney transplant for a year (if I understood his Spanish, which I might not have…). Even though he was hooked up to the machine and stuck in a hospital bed he (along with most of the other patients I talked to) was in pretty good spirits, and very interested in what I had to say about the Chilean healthcare system, how it compared to the one we have in the US, and most importantly, who I had supported in the democratic primary. Such is life, I guess.

I also had a fascinating conversation with a professor who gave our lecture today in the “theory” portion of the observation. He’s a physician who also does epidemiological research (SIDE NOTE: did you know that in 1960, Chilean children under 5 had a malnutrition rate of 60%....guess what it is now? Due to a free milk and nutrition program provided to 100% of children who need it, ZERO percent of Chilean children under 5 are malnourished. Unfortunately, one of the downsides of a country and the children developing so rapidly? …Obesity has become a huge problem. Thank you, globalization. McDonalds for everyone! I find this stuff fascinating, sorry if you don’t care.) ANYWAY, this professor and I had a fascinating conversation after class, comparing our opinions about the health system in the US and it was so interesting to hear his “outside observers” opinion of the US. We eventually segued from healthcare to politics in general. I mentioned how I was surprised by how much the people here care about the outcome of American elections. He said something along the lines of, “When the US sneezes, Chile gets a cold.” It reminded me of the Great Depression section of the Museo Historico Nacional from yesterday. I’m going to blame my ethnocentric schooling for the fact that I had NO IDEA that the NYSE collapse had effected other countries so gravely. I’m kinda embarrassed to admit that now…it makes a lot of sense in retrospect.

Chilenismo of the day: "po" I think it originally started as "pues" which means "well" but now it just gets added to random words, usually "si" and "no" as in, "Sipo" and "nopo" or the anglification, and my personal favorite: "yapo."

Sunday, June 22, 2008

Getting into the swing of things...

Sorry it's been so long since my last entry. There's not that much to update you all on...no more volcanos yet. I've been getting into a routine here in Santiago, just going to class and exploring the city. Tomorrow morning I start clinical observations, when I'll have more to talk about.

For those concerned about the state of my social life, do not fret! Friday night I went out to a Discotec with some friends. But I really can't keep up with these Chileans...as I was leaving at 3:30 am, probably the latest I've ever been out in my life, a bunch of people were JUST getting there.

Today I went to the museum of Chilean history. It was really incredible, and cleverly organized. It was chronological as you went through the different rooms, so you literally walked along the decades and centuries from pre-Colombian native history to colonialism to independence, etc. One of the most moving exhibits was also the simplest. The coverage of the Pinochet coup involved a display of half of Allende's glasses, burnt and cracked from when he shot himself as Pincochet bombed his presidential palace. This display is followed by various front-covers of papers from Chile to Spain to England, detailing what occurred on Sept. 11, 1973. It was so simple, but I must have spent at least 20 minutes staring at and trying to comprehend the gravity of it.

Anyway, that's all for today. How're ya'll doing back in Michigan?


Chilenismo of the day: ¿Cachai? = "You understand me?" Usually my answer is "no."

Monday, June 16, 2008

Long update...Santiago, Pucon, and Volcano Pictures!

Before talking about Pucon, I just want to update you all quickly about Santiago. After two weeks I'm starting to get the feel of the city...I'm using the micros (buses) and the metro like a pro...at least around the streets I frequent...and during the daylight hours I've started talking walks (don't worry parents, only in the safe areas) to loose myself in the crowds and listen to the noises of the city. It's hard getting used to the pace of life here, though. Even when I'm just walking around for leisure, I always want to walk significantly faster than the Chilenos, and I get annoyed when I'm stuck behind them. My NYU friends (hi Sarah!) would probably drop dead here from the slow pace of the sidewalk traffic. After so much time in Boston and visiting NYC, I'm used to rapid-fire walking pace of American businesspeople and students. Now I get stuck behind men in fancy suits taking it really slooow as they walk back to the office from lunch, laughing and enjoying their cigarettes (everyone smokes here, sad news for the smog). I think we could definitely learn some from them, though. Why are we always in such a rush? Why not walk a little slower, let our heart rates settle and our anxiety subside for a few short minutes as we move from place to place? . . . this is why I'm a science major and not a philosopher, but you get what I'm saying, ya?


Anyway, on to PUCON:
I think the quote that embodies this trip came from Lauren M: "Where did you think we were going??" She said it several times...first when I wasn't sure I brought my bathing suit for the hot springs, then when I was shocked by the notion that we would need warm hats to wear during our hike, and again when I didn't have long underwear, and again when I didn't have gloves, etc. It's a lot of objects that don't seem to go together, of course I was confused!

To be fair, the last time I climbed a volcano, in Guatemala, it as really hot and there was no snow involved at all. I think I wore a tank top and shorts. I just didn't realize until the day before when they were fitting us for snow pants and ice picks and shoe clamp things that we were climbing a volcano that was completely covered in ice/snow. As in, a glacier. There's skiing in the later winter months. That kind of covered in snow. I was thinking like, a sprinkling of snow at the top. I don't know why...I could see from the town that the thing was huge and completely white, but I must have blocked it out somehow because the night before we hiked it I had to rush around finding a hat, scarf, sunglasses (there's no trees and the sun on the snow is inteeense). But I was prepared by the time the hiking began. We made it pretty far -- all the way to the cinder cone (about 5 hrs of hiking) but we didn't summit because Reva, who has bronchitis and was pretty stupid but brave for deciding to climb the volcano anyway, starting getting really sick. Going down was the best part (see pictures below).



And now, the volcano in pictures. I don't have pictures from the hot springs yet, but they were reeeally nice.

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Anyone want to ski an active volcano? No thanks, we'd rather hike...(and the lifts don't open till July, which sucked because usually you don't have to hike this part, you just take the lift and start from there). It's about two extra hours of hiking.


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Here's me, Reva, the other Lauren, Katie, Elizabeth, and our new friends from France and Brazil further up the volcano. Here is the remains of what used to be another chairlift...skiers don't go this high now unless they climb. It was destroyed in 1984 during the last eruption. Pretty cool, ya?


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Here's Katie, me, and Lauren at the highest part we got to...you can see the cinder cone and the smoking hole. It was really cool. And cold. And exhausting! But the chocolate snacks we brought tasted ooooh so good. And then we got to climb back DOWN...


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Did I say climb? I meant slide. It was AWESOME.


So that was Pucon! Now I'm back in Santiago, chilling at my house in Las Condes with the host fam. I had a quiz in my seminar today and tomorrow we have a quiz in our medical spanish class. Plus an essay due on Thursday. I think I'm going to try to compare FONASA (chilean public health insurance system) and Medicaid. I'm LOVING learning about the Chilean health system. It just fascinates me. Our professors keep saying that oh, Chile is just a developing country so of course we shouldn't expect such-and-such to be as good as it is in the US....or, the students are protesting because in developing countries, the education system isn't as good as in the US...etc, etc. It's hard to have our health and education systems with all of their many MANY problems put on such a pedestal. Everyone wants to know how it works in the US, and it's kind of sad when I have to burst their bubble by telling them that our health system fucks over a very, VERY large portion of the population on a regular basis. For example, a friend of mine from this program has a "pre-existing" heart condition, and because of it she can only get one kind of insurance in one state in the whole country, and so she can't move out of that state, and she has to pay an absurd amount of money for the coverage she does get. We're all created equal, but not equally healthy...so the insurance companies get to piss on the people who need them most. Because giving health care to the sick people would just make too much sense.

Ok, that turned into more of a rant than I intended but I'm too lazy to edit it, so enjoy! I'm going to go learn me some spanish. Adios!

- Lauren

Saturday, June 14, 2008

FYI

Just a quick heads up to let everyone know that I´m in Pucon right now, in the south of Chile (it´s beeeautiful and coooold here) with limited access to internet, etc. We took a surprisingly fancy overnight bus...they gave us cookies and coffee in the morning, it was super legit.

I got skype the other day so now I can call people using my computer for 2 cents a minute. Yay! Anyway, I have to go and I promise an update about all my Puconian adventures (I´m climbing a volcano tomorrow...in the snow!)