TIRED. It’s the word that is in my head right now. A day listening to Spanish alone is tiring, not to mention the uphill blocks, the patients, the Spanish exam, and the lecture over the Bolivian health insurance system.

I arrived at the hospital this morning and an energetic Bolivian doctor greeted me enthusiastically. Dr. Velazco, an infectious disease doc and a highly respected man at Hospital del Niño would be who I would be following. I now think of him as one of the most amazing people on the face of the earth. We were in his office calling in patients one at a time. The mothers would hurry through the door holding their baby in their arms or pulling their toddler by the hand. The babies would be wrapped in layers of blankets and to perform an exam you would have to pull the layers back like the rose petals of an unbloomed flower. Under the wrapping comfortable blankets would be a dark brown baby wearing a jumper and a little handmade cap.

I had no idea what I was doing. I have never used a stethoscope on a human before, much less a tiny little baby. The hearing piece seemed to cover half the back of the child so it seemed to make little difference as I slid the round silver across the back of the baby. Dr. Valazco showed me where to correctly place stethoscope to hear the heart and the lungs. he assured me that all of the babies I would be looking at would have normal sounding lungs so I would just get comfortable hearing the healthy sounds.

As the day continued the kids would come in and Dr. Velazco would ask me to do the exam. I felt awkward in my white coat with the parents watching me, sometimes asking questions. All I would tell them was I can’t say and to ask Dr. V. They had no idea that I had no idea what I was doing. And I liked it that way. I started to get more comfortable placing the stethoscope and listening for the sounds. I would do the exam and turn to Velazco and nod as if I knew everything was fine. The fact is he knew what each baby had the minute they walked in the door, so me performing the exam had no effect on the outcome of the child’s treatment.

One of the last children of the morning, a small native Bovlivian boy hopped up on the table. As before Dr. V asked me do the exam as he struck up a conversation with the mother. I started to glide the stethoscope across the back of the child. I heard a faint crackling whistle. My eyes got big and my head popped up. The mother noticed and asked me what I heard. I had no idea what I heard. I felt bad because I probably caused the mother to worry for no reason. I turned to Dr. V, who was busy doing paper work, and asked him to take a listen. He pressed the scope on the back and turned to me and said, “this is not normal, good job”. “Sounds like asthma”.

I felt pretty good about myself about then. On my 7th or 8th pair of lungs in my life I noticed brachial dialation. I could have never of diagnosed the boy or knew what was even going on. I just knew something didn’t sound right, something wasn’t healthy. I guess this is how everyone starts their careers in Medicine. Notice a faint sound here and there. See a x-ray with a slight anomaly. And before you now it your calling the shots, providing treatment, and saving lives.

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