a: for better or worse, everything i cleverly composed over the last half hour was deleted, so readers can now relish in the much abbreviated, much less humorous, much more pissed off version of our quotidian life.
as aforementioned, we live in a "suburb" of san jose called san pedro, those these suburbs are of course a far cry from those of detroit. our compound is composed of three parts, the main house (where our hosts live and argue loudly each morning), a guest house (where our roommates live and where david resided prior to my arrival), and our apartment, complete with a private kitchen, bathroom, living room, and occasional cockroaches that, based on their sheer size, i would approximate have been living there since the cretaceous period.
our courtyard is typically abuzz with the sounds of arguing adults, yelling children, and three dogs, one of whom i´ve taken a particular liking to: a four month old chow named "chowchi." i can´t decide if this is because he reminds me of our very fat and fluffy cat, ben, or because he reminds me of david.
we are managing to keep very busy, at least that´s what we tell ourselves when we drag ourselves to bed at 8pm, thoroughly exhausted. some more insight into how we´re spending our days:
we are managing to keep very busy, at least that´s what we tell ourselves when we drag ourselves to bed at 8pm, thoroughly exhausted. some more insight into how we´re spending our days:
d: my scheduled rotation here blatantly just did not end up materializing, as my contact dropped off the face of the planet. long story short, emails used to take weeks to be returned; now they just disappeared i suppose. it might have been a blessing in disguise, however, as i have jumped on board with ashley's program to ride around in a private san jose ambulance for a couple of weeks. we do assist as needed but more than anything we just observe the paramedic practices here and get a chance to lay eyes on many of the local emergency rooms.
the scope of practice for the medics here is quite similar to the scope of practice in the states. their drug boxes look almost identical, although they do stock many medicines (ibuprofen, antiemetics, topical lidocaine) for use in non-emergent situations that aren't used in the field back home. the whole gig is really working out quite nicely, especially since those with whom we're working, as everyone else we've met, are really great hosts and are curious about us and about life in the states.
a: as much of a bummer as it is that david couldn´t get in touch with his people at the children´s hospital, it has worked out great for me to have him on board with my assignments. while the paramedics we work with are truly awesome people (not hard to see why david fit in so well with that group when he was a paramedic in the states...seems that not only the practice but also the personalities are much the same in cr and the us...all of them are super friendly, outgoing, sociable, and smart), it seems that one of the job requirements is to speak about 100x faster than the average citizen. considering i have no medical training beyond prime time hospital dramas, i can´t tell you how comforting it is to have a calm and gentle voice whispering slowly in my ear, in english, where to stick electrodes on cute little old ladies with cardiac ischemia, for example. and, i don´t have to pay attention to what bus i´m getting on or when to cross the street--also very difficult tasks for me to complete solo.
d: thus far, major highlight has been watching paul (a large, burly tican medic) show himself off by very seriously singing along with Eternal Flame by the bangles (in the proper octave), as well as Gangsta's Paradise by coolio (back to back, no less). i can guarantee that hearing those songs sung in ESL will really put a smile on your face.
a: i dunno, i kinda liked it when he showed us the picture of the guy missing half his face from an explosion, or better yet, the one who got hit by a bus and who´s skull was literally crushed with his brains spread all over the street. honestly, i read in cars all the time. bringing motion sickness meds was really an afterthought, but never has my nausea in a vehicle been more pronounced than when cruising around in the trunk of a non air conditioned ambulance looking at pictures of brain evisceration.
d: for better or worse, the recent change in traffic laws (increased penalties for illegal turns, drunk driving, etc) has really decreased the number of car wrecks and subsequent trauma calls-- while we can't say that we've been on any life-changing calls thus far, we've gotten a taste of the local barrios in a way that we would never have otherwise been able. it's a very real dose of the culture to be able to enter daycare centers, homes, etc as healthcare workers to be able to see how everyday people live. and again: one cool thing about emergency medicine is that you never know what lies in store tomorrow. we're excited for our remaining shifts.
a: and, to their credit, the medics are really considerate about maximizing our experience. the night shifts are surprisingly pretty quiet, so in between picking up quiznos carryout for their girlfriends and participating in a team photo shoot in front of their largest truck, they took us to see different hospitals and to hang out in the red cross call room. and to get ice cream sandwiches. mmmmm.
d: our very first day on the job was also supposed to entail shadowing a local general practioner in her clinic for several hours. unfortunately, however, she did not have any appointments that morning. no worries, she removed a few moles from my back as ashley watched, then asked ash if she wanted to remove the final one. ashley agreed and did a marvelous job with her first ever lidocaine injection and bovie treatment. i was very proud. the doc hooked me up to the ECG machine to show how it worked-- good lord that thing was old. i'm talkin maybe 1960s-style suction cups all over my chest. see picture if you young folk are wondering what ECGs must've used to look like...
a: alright, here´s what *actually* happened. the dr had no patients, somehow this quickly evolved into prodding some of david´s moles and offering to remove them to enrich my morning. i don´t know if it was the bus ride or the heat or my hunger or what, but something about watching her trade off between burning david´s flesh via electric shock and then sloppily burrowing and scraping at it with blunt tweezers made me a little queasy. i discreetly looked away for the removal of the following three moles, so when david joked around that "now ashley should be ready to do one...see one, do one, teach one!" i merely giggled nervously and tried not to vurp.
imagine my horror when dr. brenes grinned, handed me a syringe full of lidocaine(which i´ve of course never handled, i´m a nutritionist for christ´s sake) and told me to get crackin. again, i appreciated the gentle whispering of an english speaking almost-doctor as i proceeded to poke, prod, burn, and maim his arm. i had to remain seated the whole time so i wouldn´t faint, which made for some awkward angles during the procedure, and will leave a scar about 1.5x larger than it probably needed to be. i should have at least made it in the shape of a heart or something...
i´m telling myself all the discomfort was because i performed minor surgery with no training on my almost husband as he watched (for chris´s sake) rather than on, i dunno, a dummy or something. and no, all of this general nausea i´m experiencing "in the field" isn´t causing me to reconsider my nursing career...until i´m well fed, well rested, in an air conditioned room, well trained and still wobbling as i stick someone with a needle, i refuse to believe i´m just a big baby. in the meantime, i´ll continue watching "trauma: life in the er" to increase my exposure. or just hang out in the san jose er...grossest.
d: we took advantage of our first morning off today to go to a local farmers' market and load up on some excellent fresh fruits/veggies. while the food here is generally very expensive (at least as pricey as in the states, as we've previously mentioned), the market had some great deals on some very high quality food. much of it is totally foreign to us by both name and appearance. we closed out the morning with a straw in a coconut and a 'pinto,' which is the local traditional breakfast of rice and beans with meat. excellent.
...just got an email back from barry, the wealthy divorced retiree who has decided that life in costa rica is far more relaxing than life in the states and has permanently set up shop down around here. he worked in banking for many years and was divorced very young without any kids. his most serious relationship since then ended about 5 years ago: he was dating a UPenn medical student but broke up with her when she graduated and started talking about marriage.
barry and i started talking randomly on my first night in costa rica-- he owns several properties around the country. he's invited ash and me to head out to his beach place at the end of the month to spend some time in Jaco. if it works out, we'll be staying at what he calls his 'penthouse' with him and his very young tican girlfriend who lived for a time in california but came back to relax, apparently with barry. everyone wins as far as i'm concerned. should be a good time.
this coming week involves a trip to a nearby (supposedly very beautiful and relaxing) town, five shifts on the ambulance, an eighth grade appropriate dinner and a movie date, a hike up a volcano, and a local professional futbol game... all before we start our 'real' vacation without commitment closer to the end of the month. very exciting.
we´ll be in touch...keep those comments rollin in...
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