From Columbia 1: el Hospital General de Medellin

Danielle is spending five weeks in Medellin, Colombia working on a research project involving tobacco exposure in pregnancy. The project involves two surveys: one targeted to prenatal care providers and one for pregnant patients in four different medical institutions throughout the city. She will blog about her experience here at OHSU StudentSpeak.  Learn more.

Just as I was starting to forget why I have begun to incur thousands of dollars of debt and why come August my life of wander and reading novels will end once again, I began work at el Hospital General de Medellin. The morning I rounded with Dra. Mesa and her resident minions in the fifth floor’s high risk OB/GYN wing, I felt like I had come home after being on a brief but probably needed vacation away from medicine. I did not ever think that talk about toxoplasmosis and C-reactive protein would ever be music to my ears, but it has been great to feel knowledgeable about things I did not know even existed a year ago. Spanish has also  started to feel like a language I know again, as its medical terminology overlaps so nicely with English. Street Spanish in Colombia is far more complicated than medical Spanish, and much harder to follow.

The patients we see at el Hospital General, as I mentioned above, have obstetric or gynecological complications that place them in the high risk category. Many of them are also of lower socioeconomic status and insured or subsidized by the government. It’s not uncommon that a patient will come for consultation in the afternoon after a 3-5 hour bus ride from a more remote community.

The population seen at el Hospital General necessitates some good history taking from each patient. I’ve already learned a bit about the more traditional methods of perinatal care in these remote communities. For instance, it’s been standard for women to spend 40 days in bed postpartum, as it is believed that in this vulnerable condition they should not expose themselves to the outside world for fear of cold (not that it ever actually gets cold here). Consequently, a lot of women develop blood clots in their legs (thromboses) after giving birth. Also, women have classically consumed large quantities of fatty chicken after delivery to prevent hemorrhage (in order to promote blood coagulation). Interesting stuff.

Today’s shift at the hospital began with a terrifying experience.  I gave a short PowerPoint presentation to the residents during their early morning OB/GYN conference to promote the research project I am involved with here. My public speaking anxiety was multiplied by a factor of a second language, which equaled a large amount of stress the night before. The experienced turned out to be much less nerve-racking than I anticipated, however, and now I can breathe a sigh of relief to have one of these presentations over with.

The conference (people watching too attentively for my comfort level)

No babies yet at el Hospital General de Medellin, just many lady-parts and large bellies. Maybe soon one of them will pop at just the right time and I can see my second delivery (and first delivery outside of the US).

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StudentSpeak

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