Huaytapallana Wipe-out

Pura Vida (I can almost hear your response to this Auntie P)!

Like I mentioned in my previous blog, life in Carrión is getting difficult. La gripe porciana (swine flu) is showing more profound effects than I could´ve ever expected. The Fiestas Patrias (the Peruvian Independence Day Celebrations) have been completely cancelled due to the possibility of a mass outbreak with so many people in such close contact, and Doctors and Interns at the hospital have been striking on and off because of unruly work hours and conditions in a potentially contaminated hospital where one Intern was recently diagnosed after working a 36 hour shift without access to a bed to rest or a clean bathroom. Even in the market it is not rare to have vendors ask the Americans if they are infected.

It could be a lot worse, though--I actually could be infected, right?

Let´s begin with early week.

Monday I found the doctor that was to be doing rounds in surgery for my first day in the rotation. The two members of my team and I stood behind the interns as I began interpreting the first case--a man that was recovering from a burst apendix that was taken out the previous day. Suddenly, the director of surgery stormed to the bedside and looked the three of us over. He proceeded to shout over the entire room that anyone that was not a Doctor, Intern, Nurse, or patient must leave the room immediately in order to protect his patients from the swine flu. Only three people left, us. I was so confused and dissappointed with the authority at the hospital. I knew that I couldn´t take the situation personally, but I couldn´t help but feel taken advantage of when I had worked so hard over the past 3 weeks to help out in any way that I could, not to mention the money and donations that I raised in order to earn the opportunity to stand in his room.

We moped around outside for a while, waiting for our coordinator to return and talk to the hospital directors in order to figure out exactly where we can and cannot be when our friend and local medical student, Juan Carlos came and chatted with us. He has got major pull at the hospital because he is an all-around great guy. He took us to the surgery rooms and introduced me to the doctor that was heading surgeries for the day. We talked for a little while about my goals in the medical field and how my studies are going, and then he invited me to join him in a surgery--YES!

I got all scrubbed up and headed in to Sala 3 while the anaesthesiologist was finishing up. It took the doctors and interns quite some time to figure out the technology for the camera that they would be using during the laproscopic gall-bladder removal, but once they did, everything was off and running. They made 4 small incisions in the torso of this particular patient and used each of them to access the gall-bladder and attached canals throughout the procedure. The doctor used clamps to close off the connecting canals leading from the gall-bladder to the stomach, blocking any potential for more signals that would activate the gall-bladder. The most time-consuming aspect of the procedure was detaching the organ from the surrounding connective tissue and from the liver by cauterizing the tissue (approx 1.5 hrs.).

Later that day we were able to visit another orphanage where we played games with the kids to help them remember specific words in English by targeting many different types of learning. It was quite difficult as they were absolutely horribly behaved--we could not keep their attention for more than a few seconds before one was biting/kicking/hitting/yelling at someone else. Their tías did nothing to control them. It is really tough to see how these children are so destructive and violent when they have never been exposed to the things that I took for granted, like constant positive reinforcement, rules, structure, and love.

On Tuesday we conducted our rounds with our favorite doctor, Dr. Soazo--the same surgeon that took us to the mansion in Concepción to attend the party of a lifetime. He was funny and a very good teacher. The most interesting cases were a pair of paratenitis patients, some intestinal fistulas that were leaking waste from the intestines into the abdomen of the victims, and finally, we felt the stomach of a man that had stuck a pen up his anus and which found its new residence in his colon. We left the hospital early due to another transportation paro so that we could make it to lunch on time. Next, we had some medical students come to our house to help us refine our suchering technique from the comfort of our roof, followed by an awesome yoga session as we watched the sun melt into the mountains.

Wednesday we had our first free weekday of the trip. The hospital and the transportation union announced a double paro--there was absolutely no way that we could drive anywhere or see anything in the hospital. We napped and went to ´la casa del artesano,´ a collection of artisans that sell authentic Peruvian goods. At this point the majority of the members of FIMRC here were growing quite weary of the many strikes and the draining afternoon activities. Six of the girls decided to hop a bus to Lima and then fly to Trujillo for the rest of the week/weekend. The remaining 4 thought it better to stay to perform our tasks at the hospital and orphanages.

The dicision by the other girls turned out to work out terrifically for me, on Thursday I introduced myself (I was now doing rounds alone) to a doctora outside of the surgery room who shuttled me from surgery to surgery all morning! I was able to see 4 different surgeries in a matter of 4 hours--Whoa! The first procedure was an osteosintesis, where the patient was a 2 y/o girl that had a broken arm. The doctor used a power drill to place 2 large rods connecting her humerus to her ulna (?), followed by a casting. Then I saw a hernia treatment, where the doctor opened up the groin of the patient and suchured in a metal screen in order to prevent the hernia from protruding. He proceeded to suchure the woman´s abdomen, followed by her skin wound. The third surgery was a ´legrado´. This was performed on a young woman who had had a miscairrage at 30 weeks. She had already passed the fetus, but needed to have her uterus thoroughly cleaned in order to prevent a horrid infection or possible death. It was incredibly violent and looked extremely painful as the doctor literally scraped her uterus, but it is still far better than the alternative. Finally, I was able to watch one of the procedures that I had wanted to see most--a caesarean section. The procedure went very smoothly, and the epideral that the patient had had enough soles to pay for really helped her out. The woman required a c-section because she was having her second child in less than a two-year span--potentially putting the health of her and the baby at risk. The doctors thought it best to perform this immediate procedure to avoid such risks. It seemed pretty sad and anticlimatic when the baby actually emerged from the womb, though. The mother was not even conscious to great the new infant into the world--it was painfully impersonal, but I cannot be objective about child birth in any way due to my obvious lack of the ability to squeeze one out myself.

I came out of la sala de cirugia absolutely exhausted, and my teammates had already gone back home. I walked back to the house and grabbed a delicious juice sack (jugo surtido--piña, papaya, fresa, naranja, lúcuma, and chirimolla) and took a power nap. That afternoon we had a break--we walked into town and bought some bargain CDs/DVDs. I bought a Picasso documentary done by the history channel, Planeta Tierra (Planet Earth!!!), and a collection of Michael Jackson videos for 6 soles! They are so in love with MJ here, I haven´t gone a single day without hearing ´Beat it,´or ´Billie Jean,´ blaring from a passing taxi. So cool--the King lives on.

Friday was our friend Anna´s last day at the hospital. We were all very sad to see her go as she was a HUGE asset to our team in providing motivation and moral support when we were weary. Fittingly, there was a pig roast at the hospital for the employees that same day, and Dr. Soazo took me to feast on this plato típico (traditional plate) after our rounds had commenced.

That afternoon we traveled to the teenage girls orphanage in town to teach lessons and perform skits pertaining to respect and techniques to proactively manage emotions. We then went to the teenaged boy orphan home to continue with our English lessons--body parts were the theme.

Finally the weekend, and the trip that I had been looking forward to for weeks--our hike up the snowy mountain peak of Huaytapallana! We woke up early on Saturday morning, piled on the layers of clothing for our trip up the only snow-covered peak in the Mantaro Valley, packed a pile of sandwhiches and fruit, and headed off to pick up a few of the boys from the teenaged boys orphan house. The base was about 2.5 hrs away, but the trip was full of incredible scenery: llamas, alpacas, mountains, rivers, bridges, etc. We stopped at a small tienda before arriving at our main stop to grab supplies for the traditional ritual: chocolates, a pack of cigarettes, a bag of dried coca leaves, a water bottle of sugarcane whiskey, and some lemon candies. The last stretch was only a few kilometers long, but it took about an hour to drive as the path was littered with treacherous potholes and questionable (to say the least) bridges. Luckily our driver had pinpoint accuracy, because some of the bridges were literally 2 boards, each about 6 inches wide--whoa.

We reached our starting point and set out on the trail with our guide, Henry, who has accompanied us on every journey thus far. The trail was not a trail, rather a steep and slippery mountain covered with ice and snow that we side-stepped our way up until we reached a path of stepping-stones that took us to more of a trail. Each step was exhausting as we were starting from a height of 15,000 ft. and traveling higher--not much oxygen up there. I was sucking air pretty well for the entire trip while the boys from the orphanage were sprinting through the path and hopping from rock to rock with ease. Stupid sea-level hemoglobin count.

After about 45 min. of climbing, we reached the point where we would perform our ritual to pay homage to ´La Virgen de la Nieve,´(the virgin of the snow). We began by each grabbing a handful of coca leaves and sorting through them to find the absolutely perfect leaves with no rips or imperfections. Each perfect leaf represents a future child--smaller leaves represent chiquitos (little boys), while the larger leaves represent girls. I am apparently going to be cursed with poor luck and little prosperity as I accumulated 2 very questionable leaves--a boy and a girl. We found a hole in the Earth where we started our ceremony by piling all of our leaves together after wishing happiness, health, and prosperity on our children. We then each added a small lemon-flavored candy , followed by the lighting of our cigarettes. We each took a single puff from our cancer-sticks and made a wish for our future before lining them in the hole above our children. We added a single piece of fruit (granadilla) and a chocolate bar (sublime) to the pile before breaking out the sugar-cane whiskey. Henry poured each of us a single shot, and poured another over our ritualistic pile. He then filled up and entire Dixie cup for me and asked that I make a wish on behalf of the group before downing the searing juice with a gulp. It was really quite a spiritual experience. The boys covered our hole with a large boulder and then built the traditional tiered rock building on top of the boulder before I sizzurped on the whiskey. Immediately after I downed the stuff, an enormously stiff and steady wind blew down from Huaytapallana and over our group as we marvelled at the site. I felt like I was on another world--completely calm in mind, body, and spirit, and surrounded on all sides by pure wilderness. Whoa.

We continued on our journey for the snow cap with fresh minds and rested (and significantly looser) bodies. After about an hour we reached our summit--an enormous boulder feet away from the snowy cap where we sat and nibbled on sandwhiches and chocolate bars. Doña Elena was nice enough to prepare enough for each of the boys to share in our feast. After eating, we scaled up the slippery ice face of the mountain to play in the snow for a bit=snowball fight. We met some really chill folks up there from Melbourne, Halifax, and Barcelona that were trying to volunteer in the local orphanages in Huancayo but were being rejected religiously (they need a coordinator like Elena).

We headed back down the mountain and toward the turquoise lagunas that we passed on the way. There is a chain of about 6 different natural spring lakes (not hot springs, might I add) that are each a different color on the Blue-Green chromatic spectrum. We approached the most vibrant of the 6 lakes--the most incredible site that I have yet witnessed. As we came upon it the sun was shining brilliantly on the snowy peak and on the emerald water, but as we passed along the edge a thick cloud of fog billowed across the surface. We came to the edge of the water to rest and feel it to make sure we weren´t delirious. I must´ve been feeling the effects of the fire-water at this point--déjame explicar. I perched myself on a rock sitting in the lake and began to inch closer and closer to get a few handfulls to refresh my hot face. All of the sudden, my hiking shoes caught a slimey spot on the rock and I slid feet first into the water! I stood up to my thighs thoroughly confused and surprised for a moment before hopping back onto the rock and dropping my head in shame. Really? Yeah, really. It wasn´t so bad though, kind of refreshing for my steamy feet, and I definitely wasn´t about to let it ruin my trip. Naturally, I decided that since I was already half-wet, I might as well enjoy the water all of the way! As if a sign from the Virgin of the Snow, the sun popped its face from behind a cloud that couldn´t have been 50 meters above us and burned up every ounce of fog that covered the water. I stripped down to my skivies and hopped back into the water, took a dive, and proceeded to backstroke through la laguna (who knew that pools water got colder than Allegan High School´s pool?). It actually turned out to be one of my better ideas, contrary to what my conscience was telling me--my buddy Chris even joined in the fun. Everybody that passed must´ve thought we were two of the craziest gringos they´d ever encountered, but two Limeans thought we were pretty cool, and wanted photographic evidence to prove it. I then dried off with the extra sweatshirt from my backpack and we headed back on our way with some new found energy (thank you adrenaline).

The end of the hike (1.5 hrs remaining) was to be taken at double pace as the sun had set and the cold was setting in quickly. The shadow cast by the mountain was absolutely frigid and the race to the car began. We were literally counting down the kilometers until we could rest our aching legs in the van. We knew we´d arrived when we spotted the baby vicuña resting outside the restaurant where we´d began our journey. We all slumped into the car and endured the rocky ride back to Huancayo.

I hope that you all enjoyed this weeks edition of my blog--stay tuned for updates from my last week in Perú!

Paz y salud,

Nate