Road trip in Puerto Rico: drove all the way from the narrow streets of Historic Old San Juan to El Yunque Tropical Rainforest then to the beautiful beaches in La Cabeza Bay; then drove a mini motorboat across the Atlantic Ocean to Island Icacos; snorkelled the Caribbean Sea, then kayaked into Laguna Grande, the bio-illuminiscent bay.. ahhhhhhhhh vacation has finally started after 2 months of hard work!
Archive for May, 2010
Feed the kitty… if you dare!!
watched Shrek 4 in a local Puerto Rican cinema! “Feed the kitty… if you dare!!” (in the cutest spanish accent)
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yankees fans
Attended a lecture on Baseball Orthopaedics surgery by a professor at Harvard Medical School!!!! The first thing he said was “If there’s any Yankees fan around I’m going to skip the 10 most important slides!!”
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sanjuan
landed San Juan, Puerto Rico and thought ‘Whoa, what a paradisal metropolis!!!’ FIMS sports medicine world congress here I come!
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Kung fu
my mission: educate people in every single country that just because someone has brown eyes, black hair and yellow skin without having jaundice DOES NOT automatically make them a fucking Kung Fu fighter
20+ years of my life, 40 countries, been asked that bloody question over a trillion times.
next time i’ll answer ‘if i were u i would back off, i’m a kung fu master don’t mess with me’
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Hispaniola
Hispaniola is an interesting island. it lies in the caribbean sea and is divided into 2 countries, on the east coast there’s Dominican Republic, a country that nurtures baseball geniuses that eventually get signed by major league baseball clubs in the USA: examples are Pedro Martinez, Manny Ramirez, to name a few;
on the west coast there’s Haiti, where people can’t even hold a baseball bat properly.
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Malaria scare in Haiti
My first ever overnight stay at a hospital as a patient was in a temporary tent hospital in Leogane, Haiti!
Okay so this is what actually happened:
2 nights ago I had the following symptoms:
fever and chills
severe headache
myalgia
nausea
dizziness
diarrhea (after 7 days of no bowel output)
general malaise
loss of appetite
postural hypotension
which were 100% suggestive of malaria
- Differential diagnoses
gastroenteritis: salmonella
amaebiasis
dengue fever
Couldn’t really fall asleep, and on my way to the toilet I met a staff and told her that I was feeling shit. she said another volunteer had been feeling funny too so we headed off to the a&e of the tent hospital where I helped out for the past week which is 3 minutes walk away…. only to find out that it’s closed for the night.
So we headed back to the basecamp, took some ibuprofen to symptomatically treat my headache and chills and TRIED to sleep.
The next morning I felt much better but by afternoon the same cluster of symptoms started to emerge again and I took my temperature. 38.8′C, 102F.
Last week a girl with 103F had to be evacuated by a helicopter to dominican republic (the neighbouring country with better health care), just 1 degree away n I get to ride a helicopter!
Anyway, I immediately talked to some other volunteers and they kindly walked me to the a&e, which was finally open.
The Haitian nurses there recognized me as a volunteer for the past week and greeted me with a wide smile. some American volunteer nurses were there and took a history from me. Noticing that I’m a pretty proficient historian (i.e. using medical jargons) they asked me what I do.
“4th year medical student”, I said
“oh very good! what are you planning to specialize in?”
“umm, orthopaedics” I have no idea how that came out of me so quickly
I told them that I was worried about malaria since I’ve been having all those symptoms. I have been taking Chloroquine as malaria prophylaxis, but it’s not always 100% effective especially with the rise of drug-resistant strains of Plasmodium falciparum – the most malignant strain of malaria parasites. It could have just been my chronic medical student syndrome though, but I’d still like a rapid malaria test just in case. Better safe than sorry.
They don’t have the luxury of those fingerprick pens like the ones we use for blood glucose. instead the nurse used a sterile needle and poked my finger directly.
“Wow you don’t really like to bleed, do u?” then she poked me again
They took my vitals, I was very tachycardic (120), tachypneic (20) and hypotensive. I didn’t even know that I was flushing until they told me so. I reminded them to rule out dehydration since I’ve been very well hydrated and electrolyte balanced since I have been making sure that I take in sufficient sodium as well as potassium. Good old oral rehydration solutions…
“Wow, you actually look much better than your signs and vitals!”
Yes. I am invincible.
15 minutes later the malaria test turned out to be negative. *phew*
their plan was to give me ciprofloxacin, broad spectrum antibiotics which basically covers most bugs causing gastroenteritis, metronidazole to cover amaebiasis or any protozoa/parasites (my god, metronidazole tastes even worse than aspirin!!!), and paracetamol for my fever and pain. and they want me to stay around until my temperature goes back to normal, ie. stay over night.
I forgot to bring my books over to read so I lied down and took a nap
“Hello, so are you that medical student from hong kong who wants to do orthopaedics?”
She was a korean-american orthopaedic surgeon.
“The nurses told me about you just now”
She then had a long chat with me about orthopaedics, problems women encounter in this field, and career advice in general.
‘You don’t have to be a beefy Olympic weight lifter to be an ortho surgeon, but u definitely can’t be weak and scrawny’
‘General surgeons hate us, because we work half as hard but earn twice as much’
‘Usually the smartest medical students go to orthopaedics since 1. it’s so competitive, 2. there is so much physics and mechanics behind;
then after a few years they turn out to be the stupidest of all doctors – forgetting all the drugs, not knowing the meaning of blood pressures, and everything’
Then we chatted about joining Medicins Sans Frontieres, balancing time between life as a doctor and family, everything. she even told me to join her at the ortho clinic the next morning!
so staying at the hospital for the night wasn’t so bad afterall!
a little update:
So this is Port-au-prince, capital of Haiti
Life still goes on…
Worked at a rubbling site one day, where we helped clear up collapsed buildings so that new houses can be built at that site again. Neighbourhood kids were so eager to help out!
Cheeky boys posing with my sunglasses
Haitian kids have the habit of greeting random passerby’s and foreigners by yelling
“HEY YOU!!!”
A British gentlemen from my group then corrected them
“In Britain, we say Excuse me”
An American dude then added
“In the States we say YO MOTHERFUCKER!!!!!!”
The orphanage
Art classes
A Haitian girl dancing
Spent a day training teachers on post traumatic stress disorders in children, disaster awareness, and art therapy which may assist in recovery of PTSD.
endless suturing
An orphaned premature (born at 7 months) haitian infant for adoption, safely bound by a mosquito net!
a 3 month old baby went to the xray department and stopped breathing (why did she end up in the xray department nobody knows) she was then brought to the a&e and was resuscitated for 31 minutes with no avail. no one knows the history of this baby and she doesn’t have a mother. she was brought in by a distant relative of her father’s cousin and had very severe abdominal distension. it was probably to late to save her. a doctor from msf came and picked up the body and the a&e became all quiet once again.
There was a little orphaned boy with an unknown rash at the paediatrics ward the other day. after ward rounds I stayed behind and played with him. he took my stethoscope and listened to the chest of his little playmate! when his guardian came and picked him up he held my hand and wanted me to go back to the orphanage with him!
then a little Haitian girl had fun playing with my stetho too!
Look at haiti’s future doctors!
ps I hate the way facebook distorts the hue and saturation and lowers the resolution of the photos I upload! Better quality photos and text will be available in my travel blog (yes I do have one) once I return to Hong Kong!
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A&E
spent the whole day at the A&E suturing and dressing traumatic wounds, and treated a few testicles the size of a basketball (lymphatic filariasis – transmissable by mosquitoes)
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Haiti
at Haiti: Totally panic-struck by how mother nature can completely devastate a whole country just by a little shudder. seeing the ruins, all I could think of was ‘now what?’
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I will survive
one of my instructors at electives told me one day:
I saw all the bites on your completely damaged legs, then I saw the gleaming smile on ur face, getting into the mud and jungle with the rest of the team, I knew that moment that this girl will just survive! she is fearless. this is the doctor we will want to take on expeditions.
another instructor said another day:
you’re not just an extremely gifted artist, you’ll soon become an amazing physician-artist, just like dr frank netter, the best physician-artist that ever exisited.
Just sharing a few of the best compliments I’ve ever received in my life, and the most horrific septic-looking bites you will have ever seen.
And I consulted, examined, made diagnoses for and treated a few big families of 6 or 7. I’m glad I had paediatrics as my previous rotation. Still, I hope they are still doing well now.
Spent 2 days doing some vet medicine too. we helped give vaccinations to the horses at our ranch, and we get to drain the sinus of a chronically infected horse.
yes. I am still alive.
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