Our first refection comes from Dr. Frank Baudino, a family practice physician at Mercy Medical Center in Merced, CA:
What surprised me about the mission was the ease with which we all fused into a team.
I suppose this should not have been unexpected.
People who self select to participate in a mission of this sort tend to be team-players and “givers.” Team members with all sorts of different skills would often act as a “rapid response” team to urgent situations in the clinic.
No one had the attitude of “that’s not my job.” Getting the job done was everybody’s job.
The three patient experiences that will stay with me:
First, there was the septic baby (the picture above is not the baby with sepsis, we will link to a picture of that baby in another post). It’s very difficult to evaluate babies. I was in a clinic room at Centro de Salud and heard this very odd cry from a baby in the waiting area just outside our exam room. Nancy Samudio and I converged on the baby at the same time.
The baby was less than a month old and looked as if it was having a seizure. Or was he just frantically hungry? I brought the baby right into the room and he looked sick. The mother looked quite young and had delivered at home. By this time Mary Carol Todd and others had arrived. We managed to get a first dose of antibiotics into the infant and transport him to the hospital. As it turned out, the baby did well and was discharged a few days later. We were able to visit with the baby when the mother brought him back to the clinic. It bothers me somewhat that I will never know what the true diagnosis was. Nevertheless, I’m confident that we did the right thing for the baby.
Another child that sticks in my memory was actually 21 years old but looked about size of a 10 year old. He had severe cerebral palsy with very dysmorphic features and had never walked--his very loving mother carried him. I regarded him as a hopeless case. Mia Paredez, our occupational therapist, worked with him and actually got him to walk in one session! I know his mother will work with him to improve this skill. Moreover, I’m sure his ability to walk will open up new worlds for his intellectual development as well.
A final patient was one I never saw. She was a patient seen by Nancy Samudio and who was a victim of spousal abuse. The team discussed this patient after the end of our clinic day. In Guatemala, women have no rights--they are the property of their husbands. And without a husband, they and their children have no means of support. There is no safety net or women’s shelter. What I remember about this case is that some problems have no solutions. We are left with a feeling of sadness, helplessness, and frustration.
The mission to Guatemala was a tipping point in my career. (Or perhaps I should say, one of many tipping points.) I have long been frustrated by our medical-industrial complex here in the US. Returning from Guatemala to the “standard of care” was very hard for me. Our medical system runs, for the most part, on money, not on caring. As a primary care physician I feel especially disheartened to see health care dollars spent predominantly on “rescue medicine” rather than on prevention and chronic disease management.
In response to these feelings I have decided to take a three month sabbatical beginning January 7. I’m going to stay in Merida, Mexico, where I have a small house. I doubt that I’ll be doing any medicine there but I will be exploring the possibility of doing volunteer work of some sort. More importantly for me, I will be in a culture that seems more friendly, more tolerant, more giving, and less polarized than what the US has become in recent years. If these are only illusions, I’ll find out soon enough.
My thoughts and feelings to my colleagues can be summed up in one word--thank you. I can’t remember when I have been with such a group of stimulating, dedicated, and passionate people. I hope to have the opportunity to meet with you all again in Guatemala or anywhere else.
The mission was challenging just because of the sheer volume of patients we saw. After seeing over 100 pediatric patients on our last clinic day I knew I could not go back to another full day right away. What sustained me was our great team and the sense of making a contribution to the wonderful children I saw.
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