Reflections on the week

This is Margarita, a third year student, in the medicine room. She is wearing the uniform that all students must wear.

This week I did my monthly 4 nights of night shift in the intensive care unit. In Hospital Evangelico, the ICU also serves as recuperation post-operation. I really enjoy that unit because it challenges my clinical skills and my assessment skills. Although some nights are terribly boring and a huge struggle to stay awake (if I only have 1 patient who sleeps the whole night) but this week I actually had some "happening" nights, which several large post-op surgery patients, a few who were there for closer observation. One of my patients only passed there 2 hours, because it was just a quick operation. Let me tell you about her.

I had heard that a woman had come into the ER with complications post partum, or after having a baby, so they had to take her to surgery to stop the bleeding. In Honduras, the folks without much money go to a health center (centro de salud) because having a baby will cost them a whole $8.00. Or, 150 Lempiras. If it is a normal partum, that's just great. But in the moment of complication, it's not the place you want to find yourself because there are not doctors, nor oxygen, they just have nurses attend the birth. So when we get these folks from the centro de salud, we know they have little financial resources. Which matters in the Honduran health care system. Many times that means sending them onto the public hospital in Comayagua, because Hospital Evangelico is a private hospital.
As they were passing the patient from the transport bed to her unit bed, I thought to myself, "woah, this patient has got to be like, 15 years old." No no, this patient was barely 13 years old. This tiny little girl had just had a baby, no wonder there were complications. She was so emotionally flat. I couldn't figure out what was going on inside this little girl. She was neither scared, nor admitted to any pain, nothing.
So in that moment, I had this emotional outrage. What in the world was the 13 year old doing having a baby? Of course I immediately thought "wow, curiosity with ignorance really can be a problem." But then upon talking to my coworkers, they explained to me that sometimes in the rural villages, this girls get sort of "handed over" to get married to older men. What?? this is 2011, do people really do that? I don't completely understand it still, nor do I know what the situation really was with this little girl. But her mother was there with her, of course the man who got her pregnant was not. The baby also had had some trauma to the face during birth, and therefore was not tolerating the bottle very well. Her mother acted like this was completely normal, for her 13 year old to be a mother. I felt like it was a young raising a young girl, raising a baby. We had to transfuse 2 units of blood, and I realized that this mother had no idea was what going on. It was a difficult situation for me.
At that point I realized it was just better to see the situation relatively, and not try to figure it out, nor let my feelings get the best of me. There were some serious factors at play here: poverty, lack of education, lack of opportunity, and culture. Perhaps they were just happy in that situation, and it wasn't quite the crisis that I thought/think it was/is. I know that happens in the U.S. too. But there is at least good health care to deal with the situation. Anyways, just some reflections.

Other than that, I've been just fine. Pretty much working, and trying to spend quality time with the girls at the hospital, and my friends from outside. This Christmas will be the annual Christmas party for all of the señoritas/students and nurses, that I'm sure I'll get to help with, which is exciting.
I am looking forward to Thursday, which of course is turkey day, or better known as Thanksgiving. My cousins are planning to come up from Choluteca to visit me, and we will hopefully spend some time going to a national park nearby and enjoy some nice nature hikes and maybe even camp.
Anyways, HAPPY THANKSGIVING!!! May it be a time of realizing our blessings, and thanking the Lord for everyone of them. I personally am thankful that I will never have to have a baby in a centro de salud. :) Blessings.