Photo Dump 6: Moray and the Salt Mines

I posted a lot of pictures recently...but there were even more. Last Saturday we visited the Salt Mines and Moray. The salt mines are just what they sound like. Moray on the other hand is a little more interesting. It stands as the ruins of an agricultural research site. Each tier has a different temperature over the course of the year. Thus the Incas could grow different crops on each one.

The plague

Hello readers,

Apologies for the delay in posting but we've had a little setback this week. We've been hit by the plague. By "plague" I mean flu season in Peru. As you can probably infer from this blog, it's winter in Cusco right now. It's cold, very very cold! It's also the peak of flu season, and as health care providers we've been exposed to patients with the flu at the clinic quite often.

The first to be hit was Marilyn. After I came back from Machu Picchu, I found out she had run a fever of 103F during the weekend. The fever and malaise continued until we decided to take her to get checked out at the clinic. Eventually she had to be hospitalized. Thankfully, as I type this she is back home and is on the mend. The nuns and everyone at the clinic were amazing!

The next target was Veronica. The poor dear also developed a fever after Marilyn and had to spend a couple of days at home recovering. Eventually we also took her to the clinic and she got a Z pack for an infection. She's also on the mend now.

In the meantime, Erick, Monsy, and I have been trying to hold down the fort. Now, however, Monsy is coughing up a storm and I am as well. It seems Erick is the last man standing (perhaps something to do with this Peruvian blood...). Throughout this entire process, the nuns have been incredible. They have taken excellent care of Marilyn in the hospital, and have sent home food for Veronica. I don't know if I've said it before, but just in case I'll say it now, those women restore my faith in humanity. They are the most selfless souls I've ever met.

I'm hoping to get better soon from whatever I have because 1) I have a scholarship interview via skype tomorrow at 4:30pm our time, and 2) Julia and I are supposed to head to Lake Titicaca this weekend. I've wanted to visit Lake Titicaca since my days studying fish in college, so I will be extremely disappointed if I can't make it. Cross your fingers that I can :).

Saludos,
Annelys

Dealing with loss in Cusco

Hello readers,

I'm back to Cusco after a weekend in Machu Picchu with one of my best friends, Julia. I added some pictures to the blog prior to this post. This post isn't about my weekend though, spectacular as it was. Julia and I had a blast at one of the wonders of the world. This post is about a patient that we all met during our first day at the clinic. He was in a coma and had a tracheotomy tube. He had been in an accident and had been transferred to the clinic from one of the regional hospitals when his family couldn't pay anymore. Erick and I grew attached to this particular patient because we rotated with the Chilean doctor first, and this particular patient was being cared for by the Chilean doctor. Every day, Erick and I would look in on him and see how he was doing. We would try to get him to open his eyes and respond to our voices. He seemed to be improving daily and had even been started on physical therapy. Sadly, he passed away this weekend.

I was compelled to write this post because when we found out about his passing, Erick and I were filled with a profound sadness. This was a man we had never actually spoken to. Our interactions were brief and one-sided. Yet, his death has left a mark in our lives. We had hoped he would improve. The clinic had patients in the past that had made miraculous comebacks from similar conditions. Yet, his body finally gave out and his spirit went to a better place. I've been trying to analyze why it is that I feel so sad. I think perhaps it is because this patient was by all accounts our first patient. We knew his history, his story, and his ailments. He didn't need to talk to us because he communicated plenty without uttering a single word. Wherever he is now, I hope he is finally at peace.

R.I.P. Senor V.

From my favorite poet...

Ah, when to the heart of man

Was it ever less than a treason

To go with the drift of things,

To yield with a grace to reason,

And bow and accept the end

Of a love or a season?

Robert Frost

Weekend in Machu Picchu with Julia!

On the Perurail train to Aguas Calientes (aka the Machu Picchu town).

We're here!

Eating lunch at  so-so cafe with an amazing view.

It looks like the background is fake, but it's not. Promise.

We hiked to a waterfall about an hour away from Aguas Calientes. Julia wanted to take a little dip.

Machu Picchu at around 6:30am. Notice that the mist hasn't lifted yet. We took a bus at 5:30am and got there around 6am.

The mist is slowly lifting...slowly...slowly...and...

Mist is gone!

Yes, this picture is being blown up and placed in my room for next year.

Julia looking out at the beauty of nature.

Probably my favorite picture of the entire trip.

ALPACAS! We had an alpaca traffic issue while walking around Machu Picchu.

On our way to the top of Huanypicchu, the giant mountain next to Machu Picchu.

Looking at the beautiful surroundings.

We're on top of the world!

Julia said my feet looked giant next to hers. She was right.

On the way back from our epic day at one of the wonders of the world. Two tired friends.

An epic Jenga game to end the day! Julia won twice.

 

 

 

 

Photo Dump 5: Odds and ends

So my camera's over due for a dumping! And since it's been quite some time, the time stamps are a little fuzzy on these guys. Also many of these photos might have been replicated in previous posts. With that being said, here's a few more sights from Cuzco.

Also, in the month of June, people in this city love to party. Every day there is a parade for something, it almost is one continuous thing. So remember that you're probably seeing three or four different events in there. Today is the culmination of all that because we're hitting the winter solstice, but you know what? We're taking it pretty easy today. Emails, updating posts, cooking in, and taking care of our health.

But enough of that, onto pictures!

Many pictures. Maybe too many.

Cherish your independence.

Today Marilyn and I made the long trek out to Acopia. We were lucky to go, because once the doctor they have for that location passes his board exams, there won’t be a reason to make the gas guzzling journey. Doctors in Peru do a year of service after their medical school. Acopia is definitely a prime candidate for the program.

Anyway, I was surprised to see patients from Oropesa there, but it’s not uncommon to switch patients to different sites. Like oropesa, acopia is nestled in the mountains, serene, and bathed in light. The difference being that Acopia has less terminal patients and more otherwise healthy patients with disabilities.

Reflections on Oropesa

Hugging the bottle of hot water. We've been boiling drinking water and dumping it in the giant plastic bottle. At night it doubles as a nice heater since it's so cold.

Tomato soup at a surprisingly delicious Mexican restaurant called "El Cuate."

Main course at "El Cuate." This chicken chimichanga was absolutely scrumptious.

Hello readers,

First I want to apologize for the delay in posts. Our internet has been spotty the past couple of days. I posted some fun pictures above because this post isn't going to be very cheery. Erick and I went to Oropesa yesterday with Dr. Velasco (the Chilean doctor that's the chief medical officer of the clinic). I mentioned Oropesa before, but in case you've forgotten it's essentially a hospice for terminally ill cancer patients. I went once before with Dr. Patricia (the Spanish doctor that left) but this last trip affected me far more than the first.

Oropesa is an interesting place. It's an oasis of tranquility that lingers in the shadow of death. The hospital is found at the top of a mountain and it's the only structure for as far as the eye can see. All of the patients inside the hospital are terminal and near death. Some are closer to the other side than others. During this last visit, the patients were not doing well. One poor man was writhing in pain, delirious from the colon cancer consuming him. Another with gastric cancer told Dr. Velasco he would rather die than live with the pain he was experiencing. It was too much for me. My heart hurt for them and I felt helpless. I know that I will encounter death frequently in my chosen profession, but on this particular day death felt like a thief stealing the lives of these poor people.

At the same time, Oropesa is the place where I would like to die. I don't mean to be morbid, but the place is already one step closer to heaven. The nurses dispense loving care, birds chirp by the windows, natural light fills the air, and nuns sing in the background. So I guess I came out of my second visit conflicted. Ultimately, I'm comforted by the fact that without the care these people receive in Oropesa, they would most likely die alone and in pain. The alternative, spending their final days surrounded by the peace offered by nature, is infinitely better.

Saludos,
Annelys

Week 1: Patient Reflections II

I don't have any extra images for this post. But I had to write a second one, because this week I saw my first surgeries!

The surgeries themselves were interesting, and I was given great spots to watch. The doctor spoke English, showed me how to scrub in and explained everything has he did it. I saw one gallbladder removal, along with 3 stones. The first one that came out was roughly the size and shape of a mini marshmallow. But a little bigger. Huge. The second surgery was a wound cleaning. If you think hydrogen peroxide fizzes a little when you put it own your own cut, this was a volcano of foam. 

And trying to follow directions in Spanish can be kinda difficult when you don't know the language. Oh, I felt bad for Hna Alejandra. She tried to give me the simplest of tasks but there was always at least one integral word that was missing. We spent five minutes just on where to get dressed, and WAY too much time on whether I needed a break between surgeries. 

I had figured out that she was giving me the opportunity to take a break, but I wasn't sure how to communicate that rather not take one because I was pretty sure I wouldn't find my way back to the surgery ward, or I would spend so long trying to that the surgery would already be started. So I settled on trying to tell her that I would eat after the surgeries. Best to stay safe. 

But then I realized I didn't know 1. how to speak in future tense, 2. how to pronounce surgery in Spanish. 

I figured I would take my luck and say operation in a Spanish accent. Finding out what to do with the word "I will" was a different story.

Luckily, Annelys had just taught me the word "puedo", which means "I can" or "Can I?". I had asked her earlier because sounding rude in front of nuns was the last thing I wanted to do. "Just put puedo in front of everything and you'll be fine."

YES! PUEDO!

So in the most choppy, jolted sentence ever I said " I can... eat... after the operation." 

And Hna Alejandra threw her arms in rejoice, looked towards the ceiling, and let out an exasperated sigh. Praise the Lord.

Week one. Patient reflections.

It's been a good first week so far. I had the fortune of traveling out to Oropesa, which serves as an inpatient facility for San Andres. Truthfully, it is hospice. Nearly each patient is dying of metastatic cancer. I was surprised how ok I was in the moment.

PART 2

The main cathedral in Plaza de Armas.

Shadow Julia with Plaza de Armas in the background.

Visiting White Jesus.

These are the ruins of Sacsayhuaman, another very important Inka temple.

Me with an alpaca Julia aptly named Leo. He looked like a Leo too.

Shadow Annelys with Plaza de Armas in the background.

Julia trying her first cup of European hot chocolate at the Choco Museo in Cusco.

We stumbled upon a military parade on Sunday morning after going to mass.

There's always something going on in Cusco!

First real weekend in Cusco (+Julia)! PART 1Anot

Another festival celebration. Cusco residents really like to celebrate.

Julia on her first day in Cusco, with the main cathedral in the background.

Having some chicha morada (tastes like lemonade) at a lovely restaurant called Granja Heidi.

ALPACA WALKING ON THE STREET!

On our way up to see White Jesus.

WHITE JESUS! I'm not trying to be funny, it's actually called White Jesus.

With one of my best friends. We had such a nice weekend.

Hi readers,

It's currently Sunday night, and our first real weekend in Cusco is coming to an end. One of my best friends, Julia, was here for the weekend and left today at 3pm. She's going to be working in the medical field about 30 minutes from Cusco. I was so excited to see her! We tried to show her the main sights in Cusco (Plaza de Armas, the two churches in the plaza, White Jesus, Sacsayhuaman). Julia and I are like two peas in a pod so spending the weekend with her was lovely. I miss her already! But don't be too sad for me readers, because she's coming back Friday and we're going to Machu Picchu together next weekend! The adventure continues!

Saludos,
Annelys

First friday night in Cusco...and Julia is almost here!

Hola readers,

Currently I'm writing this Saturday morning because I was too tired to write last night. I feel like I've learned so much in one week! It's both extremely exciting and overwhelming. I feel like I've cycled from excitement to extreme sadness at seeing the suffering of the people we treat at the clinic. Time has also gone extremely fast. The four weeks will be over before I know it.

I have one anecdote from Friday at the clinic. It was another slow-ish day but we learned a lot about pulmonary function from Dr. Velasco (a Chilean doctor that moved to Cusco with his family to work at the clinic) and Dr. Patricia (it was actually her last day so we were really sad to see her go). Before we left, we noticed that the nuns were not around. As we were walking out we heard this beautiful song coming from the top floor. The nuns were singing hymns! I could have stayed there all day to listen to them sing. It was so incredibly moving and beautiful. I know what you're thinking, "The Sound of Music" right :). I have to be honest, I have a small urge to ask one of them to sing me a verse from "Climb Every Mountain." Of course I won't...maybe.

Since it was our first Friday in Cusco, Marilyn, Erick, and I headed out to experience some of the nightlife. We ate some "chicharron" at a traditional chicharroneria and we tried the national drink for the first time, the pisco sour! We went to "the highest Irish pub in the world" aka Paddy's Pub. The environment was very relaxing and we talked for a while. It was a fun night after an intense week.

Before I sign off I wanted to let everyone know one of my best friends, Julia, is due to arrive any second at our apartment! She's also a medical student (at another school) and will be spending two weeks in another part of Cusco working at a hospital. Julia and I met at the NIH, and we've been pretty inseparable ever since. I love her like a sister and I'm so happy we get to have part of this experience together. We're headed to Machu Picchu next week! I'm so excited!!!

Saludos,
Annelys

Peruvian "chicharron" or how Cubans call it "masas de puerco."

Marilyn being brave and trying the chicharron.

A gator inside Paddy's Pub. The Gator Nation is everywhere!

My first pisco sour!

A toast to our first week in Peru!

Photo Dump 4. The Corpus.

Today after clinic, we just happened to run into a parade. This is Corpus, a huge promenade of the saints. Each district of the city comes together with their own personal saint that represents them. The saints sit upon floats, followed by dancing and a marching band. Flowers and music everywhere. 

More photos under the cut.

Cultural and religious immersion...and chocolate.

The Corpus in Cusco aka procession of saints through the town.

Each village has a saint and the members of the village carry the saint through the town.

Inside Koricancha/Dominican Church.

Koricancha was a sacred Inka temple that was partly destroyed and later a Dominican church was built on top of it.

Notice the symmetry between the walls of the temple.

The "Catholic" part.

This wall is an original wall from the time of the Conquista.

View of Cusco from Koricancha.

Peruvian McDonalds aka Bembos! Except this was 100x better. My burger had sausage, eggs, and small fries (mi hamburguesa tenia chorizo, un huevo, y papitas fritas).

Chocolate cake with chocolate filling and frosting. What else would you expect from me :).

Real coca tea from coca leaves. I actually thought it was quite good. 

Hola readers,

Today I was shadowing Hermana/Sister Elaine in the clinic. She specializes in treating patients with leishmaniasis so I saw several of the classic cutaneous ulcers today! I realize that having extensive knowledge of a rare parasitic infection is probably going to be useless in the U.S., but when I get to see that one patient during my entire career as an infectious disease doctor that does have leishmaniasis, I'll be ready!

As part of our daily excursion around town, we (everyone except for Monsy) went to the Inka temple of Koricancha. The temple is actually the foundation for a Dominican church because the Spanish conquistadors destroyed most of the original temple and built a church on top of it to try to evangelize the locals. And boy did they do a good job converting the locals! Peru is an extremely religious country, as you can see from the procession of saints we witnessed today. We had a guide through the temple that explained everything to us and all I kept thinking is that I felt a little ashamed of my Spanish ancestry. They destroyed an entire civilization, stole their gold, and killed their people. It's hard to swallow all of that, although we'll never know what would have happened without the Conquista.

After our daily excursion, Erick (the native Peruvian) suggested we have some Bembos aka Peruvian McDonalds. Now I've had McDonalds all over the world, and this was 100x better than anything I've ever had. My burger was fresh and perfectly cooked, had local sausage on it, an egg, and small potatoes. I got a medium side of fries that was tiny, which says a lot about portion size in the United States. After dinner, we all went out to one of the local bakeries to celebrate that we've all officially passed the first year of medical school! Here's hoping to a fantastic second year!

Saludos,
Annelys