A Man's Routine & A Child's Lesson

He is to this day the noblest man I have ever met. He was the strongest rock, yet he had the gentlest smile. He spoke softly for the most part and was well known for clearing his throat with a little cough before answering the phone, but his voice held a sense of importance. It was captivating. It was truth. His words were spoken fluidly and surprisingly softly, often intertwined with Spanish phrases, and he was likely to finish most sentences with a little smirk and a flash of his envied straight teeth. He was my Grandpa Gurule.

He was also known for being a man of habit. For instance, I could count on him to cheerfully greet me, “Mi Pancha, mi consentida,” when I entered his house and then quickly offer me some cookies or a soda. Growing up in the house about two dozen steps away, I had learned his routines. It wasn’t challenging, because he did the same thing every day, in the same order, never skipping a beat. He would wake early like most men of his generation, walk through the curved hallway between his room and the kitchen passing the washer and dryer and a pantry that was always full on the way and he would slowly shuffle across the kitchen to the large set of windows that covered the front of the house and he would open the blinds. It was the first task to be completed every day. That’s how you knew if he was awake yet. Then straight to the bathroom to prepare for the day ensuring to pay extra special attention to those beautiful teeth I mentioned earlier. He would undoubtedly emerge cleanly shaven, with the wisps of hair that circled the crown of his head neatly in place, with khaki pants, which later in his life were supported with striped suspenders, and a collared short-sleeved shirt. The rest of the day included watching the news and maybe some crazy wrestling on the Spanish channel, drinking a glass of cold water from the jug he faithfully filled every day in the refrigerator, spending hours in his beautifully kept garden (only after putting on his fedora that sat on the long hutch in the dining room), eating meals with too much salt, making a fresh batch of tortillas that were perfectly round and pudgy, and sitting on the porch quietly watching traffic pass (I always wondered where his mind took him). A man of habit, a man you could say I’ve grown to be like. My parents and other family members often tease me, because I am so different from everyone in my family. When I remind them that I am just like my grandpa, they nod their heads in agreement and we become silent and a smile spreads over our faces. He was a good man.

The few weeks leading up to the start of school, I began to dread the work that was in store for me- the hours I would spend in the library before tests to retain the biochemical pathways found in the body, the weeks I would spend studying for my first set of board exams, and the months that would unquestionably be jam-packed with sequential lectures, tutorials, and so much more. I dread it, I’m dreading it right now, but on the contrary, I am craving the routine. I crave the life of having a full schedule, meetings to attend, things to do and people to meet. I enjoy being busy and waking up each morning with an already formulated to do list. I like knowing that at 5 pm I will be on my way to the gym and following that I will be preparing dinner. I know that sometime in the day, I will spend a few minutes talking to my mom on the phone, a few more minutes checking and replying to emails, and even more minutes tending to my very own garden (with only a couple of squash plants remaining).

Routine, planners, appointments and reminders- It’s a life I’ve chosen for myself and a life I’ve grown to love.

Bring it on med school!

Crumbs

8 weeks have come to an end, a bittersweet and abrupt end. Just like baking a pie, much time and preparation is involved, then a beautiful dessert is created and enjoyed, and before you know it all that’s left is a plate with crumbs and dribbles of fruit filling. My piece of PIE was no different. I spent some time arranging and anticipating the experience, then I was beginning to feel like I was getting into the groove of a beautiful experience, and now I’m back in Albuquerque enjoying a much needed two week break before school begins. My plate is left with crumbs of medical knowledge and new relationships filling my heart.

The last week was incredible. I saw much of the same stuff with a bit more fluff- including two fish hook removals (the forest opening up was the beginning of fish hook injury season) and a really deep splinter removal. Upon anesthetizing a woman’s arm, I felt a sense of comfort that would have felt foreign only a month ago. And while keeping a young boy preoccupied with small talk of sports and school, I felt like I could also offer comfort to a patient in need. I was rewarded with a huge hug from the big brown and teary eyed kiddo.

My experience was more than an opportunity to learn medicine and biological processes, but rather it was a time to gain hands on experience with fancy technical stuff, talking to patients, and working through problems like a detective. It was a wonderful time and of equal importance, it was great to be home with family and friends. To share a room full of princess décor with my 6 year old sister and sleep on a twin sized trundle was an experience that I didn’t see coming, but truly cherished nonetheless. I loved being home in a community where my family lives, where I could attend Zumba classes at the local community center (an old renovated bar) and take a jog at the local high school track. It was very fulfilling to complete a community project on nutrition education that will hopefully continue to be used in the clinic. Everything was memorable and definitely worthwhile.

Ordinary Solutions for Extraordinary Problems

In one room, I was seeing a Rastafarian man. He complained of not feeling well and needing us to “flush his body of the bad feeling.” He had already visited a health food store and a chiropractor in search of a cure, but decided after significant weight loss that it was about time for some western medicine. He was a pleasant man, a strong presence, and an artistic soul. With his lanky and thin arms, he gracefully added movement to each statement. It was very exuberant, but natural and smooth at the same time. I often asked questions and got strange replies. For example, when I asked when he returned from his home country, he began to tell me about the food he ate back home and how delicious it was. And when I proceeded to ask the same question again, he replied, “I go home often, I’m a performer and enjoy making my music back home.” My attempt failed not once, but twice and I explained what had happened to my preceptor when I left the room. He asked the question a third time and still did not get a reply. It happened often… I imagine, because for every question there is more than an answer. There was a story. Various cultural interaction, which I have witnessed, often take time to provide details and offer background to every story and every statement. It was different for me, but I enjoyed it. I once again felt like a Sherlock Holmes in the making. After the interview, I began the physical examination. Since he complained of abdominal pain and diarrhea, I thought it would be fitting to listen to bowel sounds and palpate the abdomen. I asked my new and jolly friend to lie on top of the examination table. He lifted his shirt and I was surprised by an umbilical hernia the size of half a fist. I could see very active peristalsis beneath the thin layer of skin. It looked like hundreds of creepy crawly worms running amuck. I had never witnessed anything like this and was startled… I later found out that it could be quite normal with a hernia in that spot. As I gently placed the stethoscope on his belly, I heard very loud grumbling similar to water quickly coming out of a jug. He was later diagnosed with an H. pylori infection, described by the lab tech as the most impressive positive test she ever did. We gave him our western medicine, said our long good-byes, and encouraged him to drink his tea concoction that he was convinced settled his stomach. His problems were complex, but could be easily treated. But out ordinary treatment wasn’t the answer to his reluctant use of western medicine, his unwillingness to visit a doctor in a timely manner, or his fear that the bacteria had also spread to his brain. They were just pills in a bottle that would invisibly extinguish bacteria, but do no more. Our drugs are far from overachievers, but rather do the minimum to aid our patients.

In another room, I met with a woman in her late 20s along with a nurse I’ve grown very fond of. The women brought along her new baby boy who had only laid eyes on our world a week ago. We were seeing this baby, because of his label as a “high risk newborn.” He had this title, because his mother, who had tattoos covering her arms and neck, had used cocaine while pregnant and the newborn was brought into this world addicted to a drug that ends lives. While in the room, the new mother answered a phone call and explained that her boyfriend was in jail and she didn’t get calls often, so she had to answer. My heart wrenched and in that short time that she spoke on the phone a million ideas ran through my mind. How this baby was already so disadvantaged, a step behind the starting line, and how he would have to work hard to make up for a poor beginning. How he didn’t have any control over his situation and how his parents’ struggles would affect every day of his life. I was saddened by the entire situation and I said a silent prayer for the new family, for new beginnings and for happy endings. For this woman, we prescribed suboxone, a medication that can be successful in treating opiate addictions. Once again it was an ordinary pill that would ease the physical symptoms of withdrawals and help ease cravings, but it would do no more. It wouldn’t take her boyfriend out of jail and wipe his slate clean. It wouldn’t teach a mother responsibility and patience. And it wouldn’t give this baby a pure welcome into a world that he deserved.

Our ordinary medications do no more than they are designed to do. They work wonders and ease pain of the muscles and joints, but do not heal pain within the soul or heart. They calm overactive intestines and prevent infection in wounds, but they can’t calm someone out of anger or prevent heartache and sorrow. They have limits and only our passion and words can begin to penetrate all the other problems that need solutions.