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June 20th, 2011
rainclouds bear a different meaning here. a thick dark cloud draped over San Miguel can hardly be called ominous, not when the desert has waited over six months for its arrival. thunderclaps bear good tidings, not danger. the flashes of lightning through the window are more like the celebratory fireworks that so frequently illuminate the sky than like some frightening warning sign to stock up on duct tape and milk. rain is always peaceful and serene, but somehow when it falls here, there is almost a sigh of relief from the earth and a city which has been so desperately thirsty for it. driving home under moonlight, drizzle and the city lights was relaxing and restorative, holding hope for is yet to come.
this morning, at 7:15 sharp, we set off for our first health fair. after passing Dr. Ashkin’s taxi on the highway and waving him to follow us, we arrived at the school to find the gates locked and no one in sight. fortunately, a few madres soon showed up to let us in, and we pulled some desks from the classroom out onto the playground and set up shop. we went from 2 moms to 20 in just a few minutes, and as forgiving and welcoming as people are, we started to feel a bit of pressure to get folks through and on their way. we all dialed it up, and tried to push through the mayhem to help folks as best we could. “glucose checks here, are you fasting? no? thats ok, we can still do plenty at today’s fair.” “yes, i’d say 20 tortillas in a day is too many, even if they are the small ones.” “and you’ve never been told you have diabetes? i think you’d better talk with the doctor…”
i can’t write too much about what we found due to the fact that it is research related, but let’s just say that we first wondered if we were having equipment malfunction due to some of the fasting blood sugars we were finding. but with Dr. Ashkin’s help, i hope we helped some folks, and we certainly got the chance to speak with a good number of them. it is a much more personal experience, doing health fairs, than giving health education talks to a group of a dozen moms. it is an opportunity to directly connect with, advise, and learn about the lives of average campesinos (rural folks). i also did some depression screening as part of another project we are working on, and found myself at times feeling almost over my head in what these women revealed to me. it was heartbreaking to realize that with some, in our 15 minute conversation, i had become one of their closest confidants about some of their most personal problems. i consulted with our faculty advisers and have amassed a few resources that i think may be able to help these women more than just the ear of a concerned but inexperienced american medical student.
unfortunately, when we finished, we found out that neither teacher in the community had their car that day, so we were stuck hiking the 8 or 9 kilometer trek back to the highway to catch a bus back to San Miguel. each passing truck raised our hopes for a moment, then dashed them as they sped on past in the blazing heat. by the end, we had become defiant (although i hope not belligerent, an early warning sign of heat stroke) that we wanted to finish the hike for our pride and sense of accomplishment. whether fortunately or not, no car tempted our declaration, and we finished the trek, found a bus, and sank exhausted into the plush seats.
this evening, we had a lovely dinner at a fantastic italian restaurant in downtown San Miguel with Alex, Kelly, Dr. Quiroz (the local nephrologist who has been involved and very supportive of our project from the beginning), Drs Clark and Ashkin, and our four-some of students. fried calamari, bottles of red wine, fresh foccacia bread, large plates of richly prepared pasta, and lively conversation highlighted our dinner. a few plans were made, a few jokes shared, and all around, good will and partnership were spread from Carolina del Norte to Guanajuato. that’s the point of this whole thing: Proyecto Puentes de Salud (Bridges to Health) – we want to form some lasting bridges between a region with both need and support for better health, and the resources, enthusiasm and youth of our medical school in NC. and while working in communities and hospitals is one essential part of that, so is conversation, planning, friendship and positivity to ensure that these connections are not fleeting.
on our ride back from the restaurant, Alex took a short cut (or long way, I’m not quite sure) through a beautiful section of the city where they used to live. we enjoyed the light rainfall, the cool evening, and the company in which we have so fortunately found ourselves. hopefully the rain will not be too short lived, and while we want to pull of our health fair tomorrow, we want to see prosperity, life and health return and thrive in a region that is ready for it. onwards and upwards, but for tonight, i’ll doze off to the drizzle outside and hope to continue what we’ve set out to do.
Jake Stein (Proyecto Puentes de Salud)
First thing first, Congratulations on making it through your first year of medical school! Really, congratulate yourself, as this is a pretty big accomplishment. For many people, the transition can be difficult and life as a medical student can only truly be understood by other medical students, regardless of what your law school friends tell you. 🙂 Just kidding! I’m glad you all have made it this far, and what you have upcoming this summer is something you will truly cherish in the future when you reflect on your medical school experience as a whole.
My name is Mehul Patel and I am a soon to be third year (scary times!) I believe many of you are on your way out of the country right now, and I must say I am very envious. I’m in the middle of studying for boards, so I am quite happy to take a break and attempt to give you all some tips about the upcoming summer. These are just my own thoughts that I was asked to share, so use your own judgment to decide what is best for you as you travel the globe.
Just FYI, I spent my “last summer” (it’s really not your last summer, by the way) in Hong Kong and China working on a glaucoma project. I’ve been really fortunate to spend a decent amount of time abroad in different places the last 4-5 years. Whether this will be your first trip abroad working in a medical setting or your fifth, you will have an enriching experience undoubtedly. I’ll try to be brief (my question-bank awaits me) on the points I want to get across to you guys – having been in your shoes last year, and then let you think about what you want to take away from your experience abroad.
1. We’ll talk BRIEFLY about boards. I know you guys have finished first year, and even with the summer ahead of you, some of you might be thinking about Step1. My advice is to NOT think about Step1 at all over the summer. You can start thinking about it in August once you have started second year. (Email me or your advocate with questions come August.)
Just take a moment to think about what you will remember most about this “last summer” ten years from now? Probably the awesome time you had in Machu Picchu, serving the rural communities living in the Himalayas or the safari you went on in Tanzania, yeah? You won’t remember Lesch-Nyhan Syndrome or Orotic aciduria. Don’t study for boards the next couple months – there is a time and place for that. (That time is NOT this summer.) You’ll burn out quickly into third year and making it through June 2012 for you guys is important.
2. Be adventurous. Meet the locals. Try the local cuisine (at your own discretion on this last one – you all just finished up micro so you know what you’re susceptible to.) If it’s a place you have never been to where they speak a language you don’t know, learn it a little and see how receptive the native speakers of the country will be. Random fact–63% of US citizens don’t have a passport–while you’re abroad take in the culture and the sights and have a great time in a different country. You define what you want from your experience, so think about what it is you want to take away from this summer. What are your goals?
3. Go abroad with an open mind, another obvious piece of advice. Research projects and clinical experiences rarely are executed the way you thought they would be when you were sitting in Chapel Hill. Once you go to a new place, there will always be adjustments to make, so know that everyone has to adjust and take each situation as it comes. Work hard on your project (within reason, of course), enjoy the people you are with, and don’t think about anything school related that you don’t have to. Looking back, I am so glad that I spent the summer abroad resetting myself for second year and doing something worthwhile, too. You won’t regret it!
4. Come back rested, and focused. You’ll have lots of stories from your summer, and hopefully many more positives than negatives from the adventures you went on. You do pick up the pace during second year, and then that test is waiting for you at the end of the summer, too. The last thing you want is to have such an exhausting and non-relaxing summer that you feel like you’re about to crash and burn by December. Second year is a marathon and getting rest before it starts is really important to conquer second year and boards.
5. If you think it might be worth it, make a list of what you want to do this summer from a project standpoint and from a personal standpoint. (I made a list last year.) Hopefully it is filled with more relaxing activities than not, but be realistic and make sure you spend time doing things that make you happy, whether it’s here in Chapel Hill or anywhere else your passport takes you. 🙂
I hope my thoughts were worth your time. Hopefully they give you a little perspective from someone that was in your shoes not too long ago. You will love being away from Chapel Hill and everything med school related for a quick breather, I’m sure. You’ve worked hard this year, and this is your time to have a pretty awesome experience before you reset for the start of second year. Safe travels to all, and come back in August with the feeling that you made your summer the best break you could have. Take lots of pictures, too!