Just finishing up my first real day here in Lima. I arrived yesterday afternoon and pretty much just spent the afternoon settling in, after a rather terrifying ride from the airport. Seriously, I think the lanes painted on the roads are more suggestions than actual rules. And who needs stop signs when you've got a horn on your car?? As evidenced from what little I've seen of it so far, Lima is a sprawling metropolis, and an interesting mix of modern city and slum. Some of the older buildings harken back to the Spanish style, while others are high-rises, but the majority are about 4 stories maximum, often painted in many colors, most covered in dirt and graffiti. The district where I'm staying, Miraflores, is the nicest I've seen so far, but I haven't had the time or the guts to go for a run yet (and im feeling it haha). Ill probably do it next time I'm free in the middle of the day.
Today was the first day I've been to the hospital, Dos de Mayo. It doesn't look like much from the street where the main entrance is, just a blue facade about 2 stories high, but inside it was all hustle and bustle and apparently it's a 500-bed hospital. There are courtyards connecting the different areas, and the wards are open-air. Like Civil War-style. We did 3 ear surgeries today, and the first two only used LOCAL ANESTHESIA. For actual surgery. Mind = blown. It worked surprisingly well, except for when the patient would move a little, and then they'd get yelled at ("no moviendo!" or something like that). The time between cases was precisely equal to the amount of time it takes to wheel the first patient out and the next one in. Operating rooms run a heck of a lot faster without an hour of room turnover time. Mind = blown again. I'm not sure how that jives with the whole sterility issue, but hey, things got wiped down with alcohol puro (mmm... Smells like undergrad). At least I know I wiped down the microscope (they don't have those complicated plastic drape-y thing specifically for the scope here. You may know it as the one the med student gets warned on penalty of death not to touch). I also mixed said local anesthetic (9 parts lidocaine to one part epi. Hope I did it right). Scrub gowns are made of heavy cloth instead of disposable paper and are sweltering, but I did get to close on the last case of the day, so hooray. We also decided the last patient was likely Turners Syndrome, as she was approximately 3'11" and had what looked like a shield chest to me. The pathology in the cases here is so much more advanced than anything I've seen so far in the states because there isn't access to regular ENT surgery for so many people. Sad stuff.
After the day of operating (which ends earlier without room turnover time) we stopped at a bank because Dr. Wagner wanted to close out his Peruvian account. Bill (a really nice 4th year resident from Mayo) and I are sitting in the lobby when these two dudes in line start verbally abusing one another in Spanish and start pushing each other. The security guards (who pack a lot more heat than their counterparts in the states and even wear bullet-proof vests) came to the rescue, but one guy did end up with a bloody nose. Bill decides to document the event via video on his camera and the rent-a-cops with guns come over and start yelling at him to delete the video. Apparently that's not allowed here.
Let's try not to get arrested in a foreign country, Bill.
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