Mexico's Labor Day is May 1st so there's no hospital for me next Tuesday. And Children's Day (dia del nino) is April 31st so they just gave us Monday too and made it into a nice big weekend for us. I'm passing the time in Ixtlan enjoying as much time with my family here as possible while I still can. In a little bit I'll be headed back to church for the Sunday afternoon singing and I'm expecting a rather small turnout. We might be just a quintet singin' for Jesus, but somehow I don't think He'll mind. Two weeks older than Tucker is Bryan Josue so we had two brand new babies in church this morning. Make that three. Josue's older sister, Betel, had her baby doll with her and as she went around greeting everyone she'd hold out her baby doll's hand so you could greet it too.
Hasta!
Sunday, April 29, 2012
Tuesday, April 24, 2012
Yo estoy reseca.
It's nearing the end of dry season. And boy is it dry! Rains don't start until mid-June, but it'd be nice if God kind of bumped up the schedule a bit. Colomos park once beautiful with overabounding green is now brown and dead. Trails where once you couldn't see the path due to the green grasses and bushes occluding your view are now covered with nothing more than a layer of dead pine needles. In my head I had storyboarded a short video to shoot in Colomos but never got around to it, and now it's too late. I'll be gone before the rains restore it to life again. (Kind of rings similar of my last blog post - I never took advantage of the time I had and now that video will never be more than an idea I once had.)
Anyways, along the same line of our current state of dryness, the point of this blog is the wildfire that's been eating up Primavera Forrest and wildlife refuge just West of Guadalajara. It's been burning for a few days now. Many are able to see the fires at night from their rooftops but our house isn't tall enough so the pictures below aren't mine, but from Google images. At times throughout the day, depending on the direction of the wind, I can smell the smoke. Right now is one of those times.
Anyways, along the same line of our current state of dryness, the point of this blog is the wildfire that's been eating up Primavera Forrest and wildlife refuge just West of Guadalajara. It's been burning for a few days now. Many are able to see the fires at night from their rooftops but our house isn't tall enough so the pictures below aren't mine, but from Google images. At times throughout the day, depending on the direction of the wind, I can smell the smoke. Right now is one of those times.
View of Bosque La Primavera burning at night.
Another view of Bosque La Primavera burning at night
Aerial view of Bosque La Primavera wildfire.
Bosque La Primavera burning.
Looking West of Guadalajara at sunrise you can see the smoke rising from Bosque La Primavera as it continues to burn.
Hasta!
Monday, April 23, 2012
Yo estoy sorprendida.
To my disblief, the lake has been filled in!! The palm tree is still there. The house is still there. But all the boats gone. All dancing dazzling reflections of light gone. I never got my "picture perfect" capture of the view, but the two pictures I do have are now all of a sudden much more valuable to me. I am sorry to have to relate my personal explanation of the picture, but I wanted to blog because I wanted to make a point about taking advantage of opportunities. About not letting time slip by thinking you'll still have time latter. About redeeming the time you're given. You never know...tomorrow the lake may be filled in.
Here's a closer view.
Hasta!
Ecclesiastes 9:10-12
10Whatsoever thy hand findeth to do, do it with thy might; for there is no work, nor device, nor knowledge, nor wisdom, in the grave, whither thou goest.
11I returned, and saw under the sun, that the race is not to the swift, nor the battle to the strong, neither yet bread to the wise, nor yet riches to men of understanding, nor yet favour to men of skill; but time and chance happeneth to them all.
12For man also knoweth not his time: as the fishes that are taken in an evil net, and as the birds that are caught in the snare; so are the sons of men snared in an evil time, when it falleth
suddenly upon them.
Sunday, April 22, 2012
Welcome to the World Tucker Dane!!
The weekend in Ixtlan took a sudden turn for the happy. A little person decided to join us in this world, a miracle.
Excited to welcome Tucker Dane Beer!!
Beautiful family. Regg, Bev and Tucker Beer!
He is soooo precious! And a whole bunch more of wonderful adjectives!!
Excited to welcome Tucker Dane Beer!!
Beautiful family. Regg, Bev and Tucker Beer!
He is soooo precious! And a whole bunch more of wonderful adjectives!!
Hasta!
Wednesday, April 18, 2012
Yo estoy estudiando.
I have put off blogging for the last few days because to blog I knew I'd have come clean about why I'm home and not at the hospital right now. I could talk about some nonrelated topic and avoid the subject entirely, but really being at home passing the hours on my computer leave for some very uneventful days and therefore really the only topic worth blogging is this one.
Due to my rotations in the States my hospital schedule here kind of got messed up. To accomodate my odd schedule I was scheduled to be at the hospital during the weeks everyone else would be on break. So last week when the rest of the students were to get signed off having completed their rotation I kind of took advantage of them, slipped my paper in with theirs and got signed off myself. If the boss man and the sub-director of teaching had actually read my form they'd have seen I was scheduled for one more week and if called out on it I was prepared to work my last week, but based on experience I knew they wouldn't read it. And they didn't. That last rotation the ER was so full family members really couldn't fit between the beds lined along each wall so had to stand at the foot of the bed; so even when the rest of the students took off I decided to stay and work the shift. Maybe I was trying to justify my leaving a week early by working that last shift. Either way the interns were so thankful I stayed to help that when possible they would try to help me with my patient list. For example, for one particular patient I had already made two trips to the lab to pick up his results, both times they weren't ready. I didn't get a chance to go a third time because one intern who knew I was waiting for them had grabbed them for me on one of his trips. I felt awkward, here I had stayed to help them, and yet they were doing everything they could to make my job eaiser.
I left at the end of that shift with a whole week of vacation time ahead of me only kind of feeling bad about it. But I eventually had to tell my roommates, and upon telling one she responded, "That's how you do it Christy!!" And then I felt really bad about it. By her approval of my playing the system I realized I had stupped to that level. Sooooo many of my classmates play the system to the result that they spend very very little time actually in the hospital each semester.
I had justified my actions: 1) I'm not actually going to persue Emergency Medicine 2) Everyone else gets 2 weeks vacation, this will still be just 1 week
And now I feel weak that a "break" was dangled in front of me and I easily justified grabbing it.. And in so doing I became just like the students I didn't want to be anything like. I dropped the ball on that one. Dang it!
So I'm spending my time studying this week. Although I must admit it's kind of half-hearted. 20 pages in this book. 8 pages in that book. 5 lessons in that subject. Just kind of here and there. Not really sure how effective such studying is, but it's better than nothing. And it definitely makes the day pass by quickly. Reminds me of Jane Eyre's cousin telling her sister to divide each day into sections and fill each section with one useful task, and before you know it, you've passed the whole day...and then she goes on to make her sister cry and run out of the room, so I'll just stop here.
Hasta!
Due to my rotations in the States my hospital schedule here kind of got messed up. To accomodate my odd schedule I was scheduled to be at the hospital during the weeks everyone else would be on break. So last week when the rest of the students were to get signed off having completed their rotation I kind of took advantage of them, slipped my paper in with theirs and got signed off myself. If the boss man and the sub-director of teaching had actually read my form they'd have seen I was scheduled for one more week and if called out on it I was prepared to work my last week, but based on experience I knew they wouldn't read it. And they didn't. That last rotation the ER was so full family members really couldn't fit between the beds lined along each wall so had to stand at the foot of the bed; so even when the rest of the students took off I decided to stay and work the shift. Maybe I was trying to justify my leaving a week early by working that last shift. Either way the interns were so thankful I stayed to help that when possible they would try to help me with my patient list. For example, for one particular patient I had already made two trips to the lab to pick up his results, both times they weren't ready. I didn't get a chance to go a third time because one intern who knew I was waiting for them had grabbed them for me on one of his trips. I felt awkward, here I had stayed to help them, and yet they were doing everything they could to make my job eaiser.
I left at the end of that shift with a whole week of vacation time ahead of me only kind of feeling bad about it. But I eventually had to tell my roommates, and upon telling one she responded, "That's how you do it Christy!!" And then I felt really bad about it. By her approval of my playing the system I realized I had stupped to that level. Sooooo many of my classmates play the system to the result that they spend very very little time actually in the hospital each semester.
I had justified my actions: 1) I'm not actually going to persue Emergency Medicine 2) Everyone else gets 2 weeks vacation, this will still be just 1 week
And now I feel weak that a "break" was dangled in front of me and I easily justified grabbing it.. And in so doing I became just like the students I didn't want to be anything like. I dropped the ball on that one. Dang it!
So I'm spending my time studying this week. Although I must admit it's kind of half-hearted. 20 pages in this book. 8 pages in that book. 5 lessons in that subject. Just kind of here and there. Not really sure how effective such studying is, but it's better than nothing. And it definitely makes the day pass by quickly. Reminds me of Jane Eyre's cousin telling her sister to divide each day into sections and fill each section with one useful task, and before you know it, you've passed the whole day...and then she goes on to make her sister cry and run out of the room, so I'll just stop here.
Hasta!
Thursday, April 12, 2012
Yo estoy una hoja.
For a hospital that is administered on 100% paper the IMSS never seems to have any paper.
Charts are handwritten. If any official evolution form is not available then you write your evolution note on any random piece of paper you can find and stick it in the chart, or even just put your note in an open spot on a sheet that is already in the chart. One day one of the interns actually went to the office to ask if we could have some sheets of paper. He returned rather upset and holding a grand total of 2 sheets of paper that they had given him. 2!!! About a 1/2 hour later he burst into the intern room giggling and clutching about 1/2 a ream of paper. We didn't ask where he'd gotten it from; we just hid it in one of the cupboards. The sheets ended up being the wrong size of paper, but that's easily fixed; you just tear off the end of the sheet and voila!
There is one ancient computer in the intern room with an even older printer. It is used to type and print discharge reports. Couple problems with that...say 5 discharges are ordered at the same time, if you're in charge of the last report ordered you've got to wait to have access to the computer, and your patient has to wait even longer. Plus you still have the problem of paper...can't really print a report on air. It wasn't long and I joined the rest of the interns and students and started bringing my own sheets of paper from home.
Not done talking about paper yet! The bathrooms. Yup, even the bathrooms. If I need to go I run around to the sinks in the ER scrounging for some paper towels before I even head there. Patients lined up bed after bed in the ER will have a bag of their personal belongings beside them and more often than not you'll find a role of tp in that bag
It's amazing how a place run on paper can be more paperless than a US hospital run on computers.
We have one EKG machine in the ER. It's of an ancient design with little suction cups you adhere to the patient. It must somehow know or understand that it absolutely can not give up or stop working because it's all they've got. So many times over these weeks I've thought it was at it's end, but somehow it would surprise me each time. Once it wasn't working, so we tried everything even changed outlets, it still refused to turn on, that is until we started smelling something burning and switched it back to the original outlet. Then for some reason it worked!!! We had a line of patients waiting for their EKGs so we didn't turn it off after that, but still by the time the next patient was ready to go the machine had died again. The intern I was working with suggested we try burning it again as that had worked last time. We eventually figured out that even though on the screen we couldn't see anything the machine was still actually working and we just had to from memory push the right buttons in the right order and at the right time and then pray until you got those three things all right and a little slip of paper started printing off. That was the status of the EKG machine for a while until of course we ran out of EKG paper. Sigh! However, the last time I used the EKG machine not only was there paper but the screen was also working. Like I said, it's a machine full of surprises.
Hasta!
Charts are handwritten. If any official evolution form is not available then you write your evolution note on any random piece of paper you can find and stick it in the chart, or even just put your note in an open spot on a sheet that is already in the chart. One day one of the interns actually went to the office to ask if we could have some sheets of paper. He returned rather upset and holding a grand total of 2 sheets of paper that they had given him. 2!!! About a 1/2 hour later he burst into the intern room giggling and clutching about 1/2 a ream of paper. We didn't ask where he'd gotten it from; we just hid it in one of the cupboards. The sheets ended up being the wrong size of paper, but that's easily fixed; you just tear off the end of the sheet and voila!
There is one ancient computer in the intern room with an even older printer. It is used to type and print discharge reports. Couple problems with that...say 5 discharges are ordered at the same time, if you're in charge of the last report ordered you've got to wait to have access to the computer, and your patient has to wait even longer. Plus you still have the problem of paper...can't really print a report on air. It wasn't long and I joined the rest of the interns and students and started bringing my own sheets of paper from home.
Not done talking about paper yet! The bathrooms. Yup, even the bathrooms. If I need to go I run around to the sinks in the ER scrounging for some paper towels before I even head there. Patients lined up bed after bed in the ER will have a bag of their personal belongings beside them and more often than not you'll find a role of tp in that bag
It's amazing how a place run on paper can be more paperless than a US hospital run on computers.
We have one EKG machine in the ER. It's of an ancient design with little suction cups you adhere to the patient. It must somehow know or understand that it absolutely can not give up or stop working because it's all they've got. So many times over these weeks I've thought it was at it's end, but somehow it would surprise me each time. Once it wasn't working, so we tried everything even changed outlets, it still refused to turn on, that is until we started smelling something burning and switched it back to the original outlet. Then for some reason it worked!!! We had a line of patients waiting for their EKGs so we didn't turn it off after that, but still by the time the next patient was ready to go the machine had died again. The intern I was working with suggested we try burning it again as that had worked last time. We eventually figured out that even though on the screen we couldn't see anything the machine was still actually working and we just had to from memory push the right buttons in the right order and at the right time and then pray until you got those three things all right and a little slip of paper started printing off. That was the status of the EKG machine for a while until of course we ran out of EKG paper. Sigh! However, the last time I used the EKG machine not only was there paper but the screen was also working. Like I said, it's a machine full of surprises.
Hasta!
Saturday, April 7, 2012
Yo estoy enojada...
The other day I got an earful from the boss man about some paper work I had written up. It made me mad. Let me tell you the story.
During rounds we decided to discharge one of my patients whose abdominal pain had subsided and surgical emergency had been ruled out. In writing up her discharge paper work I noted that she still had some residual abdominal pain with palpation. To me it wasn't worrisome pain but rather realistic to still have some light pain. However the boss wouldn't have any of it and progressed into a lecture about how a person cannot be released unless they are 100%. In other words I have to write up the report again saying that the patient has absolutely no pain...is 100% better than when she came in. His reason...so that it can't come back to bite you (to put it nicely). It made me mad. He wasn't concerned about the pain, still wanted the patient released, but I had to just redo my report, lie basically, saying the patient had no pain, so his butt could be covered on paper (to put it not as nicely). But what ticked me off even more was that even though I was taking care of the particular patient in question he didn't even direct one word of this lecture to me, but rather to the resident next to me who was standing there like an ignorant bobblehead with attention wrapped around this guy's every word as if it were sacred. In retrospect no wonder he preferred talking to him instead of me.
To be honest I kind of detest the hypocritical boss now. For his own unethical standards that he dresses up and sells as ethical, but also for making me act unethically myself. I wonder what would have happened if I'd refused to rewrite the report. I also wonder if I'll ever have the guts to actually even do that.
Later that day, the boss was set up in one of the few chairs in our tiny little break room once again lecturing to an audience of interns and students hanging on his every word. I was standing next to him and even though I was listening I busied myself staring at the papers I had in my hand. He finished his lecture with what he ment as a joke and the whole room burst out in a polite over-abundance of laughter. Perhaps it was because I was still put out about the whole situation that morning, but I really did not think the joke was funny and was not about to humor him with any undeserved laughter. When he tried to turn my silence into another joke about how I hadn't understood, I'd had enough with the guy, and rather coldly affirmed that I had indeed understood, but then left it at that; for him to assume the rest.
I really should have just laughed. Why do I feel it necessary to pick a fight with the boss man? I'm going to meet many that I don't agree with ethically in the coming years...probably the rest of my life. But at this stage when I'm barely above pond scum....I really should have just laughed.
Hasta!
My 24 hours this weekend falls on Easter Sunday. Sad about that. But still praying that the holiday at least keeps people out of the Emergency room.
During rounds we decided to discharge one of my patients whose abdominal pain had subsided and surgical emergency had been ruled out. In writing up her discharge paper work I noted that she still had some residual abdominal pain with palpation. To me it wasn't worrisome pain but rather realistic to still have some light pain. However the boss wouldn't have any of it and progressed into a lecture about how a person cannot be released unless they are 100%. In other words I have to write up the report again saying that the patient has absolutely no pain...is 100% better than when she came in. His reason...so that it can't come back to bite you (to put it nicely). It made me mad. He wasn't concerned about the pain, still wanted the patient released, but I had to just redo my report, lie basically, saying the patient had no pain, so his butt could be covered on paper (to put it not as nicely). But what ticked me off even more was that even though I was taking care of the particular patient in question he didn't even direct one word of this lecture to me, but rather to the resident next to me who was standing there like an ignorant bobblehead with attention wrapped around this guy's every word as if it were sacred. In retrospect no wonder he preferred talking to him instead of me.
To be honest I kind of detest the hypocritical boss now. For his own unethical standards that he dresses up and sells as ethical, but also for making me act unethically myself. I wonder what would have happened if I'd refused to rewrite the report. I also wonder if I'll ever have the guts to actually even do that.
Later that day, the boss was set up in one of the few chairs in our tiny little break room once again lecturing to an audience of interns and students hanging on his every word. I was standing next to him and even though I was listening I busied myself staring at the papers I had in my hand. He finished his lecture with what he ment as a joke and the whole room burst out in a polite over-abundance of laughter. Perhaps it was because I was still put out about the whole situation that morning, but I really did not think the joke was funny and was not about to humor him with any undeserved laughter. When he tried to turn my silence into another joke about how I hadn't understood, I'd had enough with the guy, and rather coldly affirmed that I had indeed understood, but then left it at that; for him to assume the rest.
I really should have just laughed. Why do I feel it necessary to pick a fight with the boss man? I'm going to meet many that I don't agree with ethically in the coming years...probably the rest of my life. But at this stage when I'm barely above pond scum....I really should have just laughed.
Hasta!
My 24 hours this weekend falls on Easter Sunday. Sad about that. But still praying that the holiday at least keeps people out of the Emergency room.
Monday, April 2, 2012
Yo estoy maloliente.
Time change happened in Mexico this past weekend. Just happened to fall on my shift this weekend making my 24 hrs into 23 hrs. Hey, if I have to lose an hour twice in one year at least one was to my advantage.
A patient came to Urgencias Saturday night in respiratory distress. The time lapse is kind of relative, but sometime later and she was coding, ACLS protocol was initiated....or was attempted. At NMH last month when a code was called respiratory was there for an airway, surgery was there for venous access, pharmacy was there with needed drugs ready, and by the time anyone arrived the primary team was already underway with CPR. The first time it happened at NMH I realized I was standing there detached from the whole scene enfolding before me. This was a soul they were fighting for. I took a step back and looked at the scene again and wondered what was happening that I couldn't...that none of us could see. We were fighting for his physical life, but was there another battle going on in that room, a battle for his soul? I didn't know the patient, he'd been intubated/sedated his whole time at the hospital. I wondered was Jesus in that battle? And wondering about that second battle, made our whole effort seem just so pointless. At the end another student leaned over and said, "The hospital just spent a million dollars in the last 30 minutes." We spend sooooo much money for life, and for what? When the patient's mother arrived shortly thereafter her howl was heard throughout the unit, "NOOOOOOO! HE WAS JUST FINE YESTERDAY!!" Even with the miraculous abilties of medicine today it's events like these that remind us all that our physical life will end one day. It's a fact. An inevitability. And so this past weekend while standing on a wobbly stool so I could be up and over the patient to come down at a 90 degree angle with methodical compressions I wondered at my own efforts to keep her heart pumping. Was this battle already over? Really, what was the point to what we were doing?
To be honest, I am a little disturbed that as a doctor I would find a fight to the end futile. I know that I will do it. I'll fight to the physical end and then past it for anyone. But it's not this physical fight that matters. And in fighting it I feel....no, I know, I'm fighting a battle that in eternity doesn't matter. And in fighting it, it makes me feel pointless too.
Hasta!
A patient came to Urgencias Saturday night in respiratory distress. The time lapse is kind of relative, but sometime later and she was coding, ACLS protocol was initiated....or was attempted. At NMH last month when a code was called respiratory was there for an airway, surgery was there for venous access, pharmacy was there with needed drugs ready, and by the time anyone arrived the primary team was already underway with CPR. The first time it happened at NMH I realized I was standing there detached from the whole scene enfolding before me. This was a soul they were fighting for. I took a step back and looked at the scene again and wondered what was happening that I couldn't...that none of us could see. We were fighting for his physical life, but was there another battle going on in that room, a battle for his soul? I didn't know the patient, he'd been intubated/sedated his whole time at the hospital. I wondered was Jesus in that battle? And wondering about that second battle, made our whole effort seem just so pointless. At the end another student leaned over and said, "The hospital just spent a million dollars in the last 30 minutes." We spend sooooo much money for life, and for what? When the patient's mother arrived shortly thereafter her howl was heard throughout the unit, "NOOOOOOO! HE WAS JUST FINE YESTERDAY!!" Even with the miraculous abilties of medicine today it's events like these that remind us all that our physical life will end one day. It's a fact. An inevitability. And so this past weekend while standing on a wobbly stool so I could be up and over the patient to come down at a 90 degree angle with methodical compressions I wondered at my own efforts to keep her heart pumping. Was this battle already over? Really, what was the point to what we were doing?
To be honest, I am a little disturbed that as a doctor I would find a fight to the end futile. I know that I will do it. I'll fight to the physical end and then past it for anyone. But it's not this physical fight that matters. And in fighting it I feel....no, I know, I'm fighting a battle that in eternity doesn't matter. And in fighting it, it makes me feel pointless too.
Hasta!
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