Dia de los Muertos

I will never forget the sights and smells of Dia de los Muertos. Locals dressed in costumes, vendors, and tourists flooded Alcala at the beginning of the week. Banda music rang throughout the cobbled streets and people joyfully danced throughout the night. It was honestly a wonderful sight to see and experience.

Our group had the amazing opportunity to enter into the local alter making competition at the local cemetery, El Panteon General. We decided to honor the railroad workers who gave their lives to build the railroads.

We traveled to two different markets to buy the necessary materials for the altar—a local market in Teotitlan and El Mercado de Abastos in Oaxaca. The local market in Teotitlan was so beautiful. Golden, magenta, and purple flowers decorated the area. The fragrances of fresh bread, smoky incense, and sweet chocolate danced around in the air, mixing with the beautiful languages of Spanish and Zapotec. El Mercado de Abastos was also full of people, colors, smells, and sounds. However, there were a lot more Western influences—there was a specific section in the market filled with scary masks, props, and costumes.

Mercado in Teotitlan:

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pan de muerto
pan de muerto

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Mercado de Abastos:

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sugar skulls (calaveras)
sugar skulls (calaveras)

We spent that night stringing manzanitas and peanuts together, de-stemming flowers, and creating/decorating a sugarcane arc. The next day, we stuffed all of the materials into taxis and rode to El Panteon General. The cemetery was huge but also very peaceful. The vibrant blue sky contrasted beautifully with the stones and trees. Many different families scuffled around carrying bundles of marigolds (among other flowers) and buckets of water.

We worked on our altar and tapete for a total of 8 hours or so. Everything came together very beautifully. Everyone helped each other out and worked together. It was a great bonding experience and I enjoyed every minute of it!

jason and maria practicing their presentation for our altar
jason and maria practicing their presentation for our altar

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our tapete
our tapete

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Later that night, we visited El Panteon General to see our altar as well as the others. It looked a lot different in the dark. However, the beauty remained the same. Rows of lit candles lined the walls and emitted an orange/yellow tint. The earthy scent of marigolds and incense drifted among the visitors who were packed into the hall.

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We also visited a cemetery in a pueblo 20 minutes from the city (Panteon Atzompa). This was a lot more different. It was a lot more emotional to me. A live banda played on a stage at the corner of the cemetery. Light from the candles dotted the darkness and lit the faces of those remembering their loved ones. Although the upbeat banda music rang throughout the cemetery, it could not disguise the solemn atmosphere.

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We all experience the pain of losing someone. However, we cope with it in many different ways. Participating in the traditions of Dia de los Muertos was a HUGE blessing and honor, and it was a beautiful experience.

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We ended up winning 2nd place in the competition!

Here are some pictures of the other altars:

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HOME SWEET HOME

It’s been about 4 days since I returned back to the states. Oaxaca will forever hold a piece of my heart. 

On another note! I will be posting more updates about Dia de Los Muertos and Puerto Escondido soon!

6 months: An early passing

Karina and I had the blessed opportunity to visit the gynecology/labor and delivery unit at Hospital Civil on Thursday (211113). The unit was pretty different than the one that I visited at ISSSTE. The biggest difference was the number of patients at Hospital Civil—there were A LOT.

Everything was going smoothly. Karina and I witnessed the birth of a beautiful baby girl. We got to help the nurse dress her. She absolutely captivated us with every move she made. She spent her time squirming around in her pastel yellow pants and top or crying. It was mind-blowing to imagine that the little girl lying in front of me had only been on the earth for less than an hour!

The second labor that we witnessed ended very differently. The labor started off normally. The lift team transported the 18 year old mother to the delivery room and the nurses cleaned and prepared her. A few minutes later, I saw the frail dark body of a neonate with a 6 month gestational age. I let out a sharp gasp as the OBGYN handed the thin and delicate body into the arms of the pediatrician. Soft, weak cries echoed through the delivery room—then quite. A heavy blanket of seriousness descended upon the room; a small foreshadowing of the coming event. The doctor softly told the pediatrician to hand the baby over to her mother. That was when we knew—the baby wasn’t going to make it…

The mother tightly cradled her child against her breast and started sobbing— the pain in her heart overriding the pain from just giving birth. A weighty silence filled every crevice of the room, only to be broken by the distant cries of the other neonates and the sobbing of the woman. The head OBYN moved close to the woman and comforted her with a warm and gentle voice. He never left her side.

We later learned the circumstances of the woman’s birth. Her baby had massive amounts of fluid buildup within the brain and had a very low chance of survival. Furthermore, the mother had preeclampsia and, as a result, had hypertension. According to the head OBGYN, the two #1 causes of maternal deaths in Mexico are hypertension and hemorrhage.

It turns out that the women had discussed her situation with her doctor beforehand. The woman faced the hardest decision of her life—save her baby’s life or save her own. I can’t imagine half the pain that she went through making the decision that she did. Even though the baby was not full term, the baby was still hers and a part of her own flesh.

After this occurrence, I couldn’t help but wonder how I would handle a situation similar to what this woman experienced, as a mother. I acknowledge that my personality, situation, reasoning, motivations, and outlook vary from those of the woman. So, at this moment, I don’t have a definite answer.

Also, I couldn’t help but contemplate how I would address a situation like this as a doctor. A career in medicine includes situations where one must face death. If a time like this ever arises, I hope I could handle the situation with the similar respect and warmth that the OBGYN handled it with. I greatly admired the sensitivity and comfort that he offered to the woman while she grieved. The whole staff worked together to help the mother go through the grieving process.

Life is a beautiful but also fragile gift. My heart and prayers are with this incredibly strong woman and her family.

Hospital Civil (102413,102513)

A few students from my program and I started our third rotations at Hospital Civil starting October 24th. As soon as we arrived, we met with Dra. Mayda and she divided us up into pairs and assigned us to the various departments in the hospital. I was placed in the urgent care department—or urgencia.

Hospital Civil is the biggest public hospital here in Oaxaca and the hallways and corridors accurately depicted that.  As Dra. Mayda escorted us through the hospital to urgencia, I observed lines and lines of patients waiting to receive care. Doctors, nurses, security guards, and medical students flooded the labyrinthine hallways and corridors. When we finally reached the department, we joined a giant team of medical students, residents, and preceptors on their rotations/debriefing. It was reminiscent of the gynecology rotations that I observed at ISSSTE, but the speed, amount of activity, and movement was on a different level. The team formed multiple concentric circles around each patient’s bed and the medical student in charge of the patient presented everyone with a concise overview of patient while the rest flipped through their notes, wrote on their clipboards, or conversed with each other.

Fortunately, we met a resident, Karey, who was very caring and genuine! After the rotations, he let us look at a chest x-ray. He took the time to explain each element that a doctor looks for. His explanations of the anatomy of the pulmonary and coronary system reminded me a lot about an anatomy course that I took during my winter quarter at Davis. Karey also showed us how to use an EKG monitor and check blood glucose levels. He was very bright and made sure each of us understood the anatomy. It was a bit mind-blowing to think that he was the same age as me!

Being a non-native Spanish speaker, it was very difficult to keep up with the conversations between the doctors and students. Most of them were too focused and concentrated on their work (understandably) to give me a thorough answer to some of my questions.  To be honest, it was also intimidating to be around that many doctors and students. Many times, I found myself slipping back into a state of passivity. However, meeting Karey encouraged me to keep pushing through and keep asking questions.

Karey’s generosity and kindness inspired me to strive to do the same in the future. Since my conversation with Dr. Francisco during my rotations at Colonia America, I’ve been reflecting a lot on why I want to become a doctor. Of course, part of my reasoning involves caring for others, interacting with a wide variety of people, and putting some of my favorite subjects into practice. However, I’ve recently been thinking about clinical teaching/precepting in the future as well. After learning about public health, cultural competency, emotional intelligence, and a bunch of other topics (power of conversations, perceptions, etc.), I’ve realized how important it is to share this information with others. I think that this is especially true in a setting where diagnosis and treatment are at the forefront.

Alas, I must take things one step at a time. I still have to apply… yet, a girl can dream no?

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A normal x-ray

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An abnormal x-ray

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My first EKG!

Hospital Psiquiatrico Cruz Del Sur

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Our class had the opportunity to visit Hospital Psiquiatrico Cruz Del Sur on Friday. We began the day with a presentation of the mission statement/goals of the hospital and the specific ways in which the hospital tried to cater their services to the patients. Their main goal was reintegrating their patients. Throughout the presentation, the administrator mentioned the lack of resources that the hospital had.  One of the students asked how the patients paid for their treatment at the facility.

Afterwards, we toured the hospital. We first looked through the cafeteria: a medium sized building with rows and rows of tables. There were plates of enfrijoladas (a fried fajita with beans in it), rice, and fruit. The nutritionist explained that the meals were individualized to meet the needs of the patients who had allergies or were diabetic. The 75 patients there received 3 meals—breakfast at 9am and dinner at 6pm. Their dinner is fairly light (like gelatin or yogurt). This 15 hour gap between dinner and breakfast posed a big problem for the patients. According to the hospital administrator, the hunger kept the patients up at night, so they had to receive medication to help them sleep. She described that there used to be extra land where they had guava and orange trees. However, the government took the land for other projects (none of which were finished).

We moved into the main courtyard. A placid but strange atmosphere blanketed the area. The attendant’s voice echoed across the gray cement and the lifeless grass. There was a building on the northeast side of the area that was supposed to be a rehabilitation center. However, the building was poorly built and therefore, not in use.

Many of us wanted to interact a lot more with the patients. Unfortunately though, the regulations changed a few days before our visit and thus limited us from doing so. Most of our interactions with the patients took place from afar or behind a metal fence. Nevertheless, they were one of the most meaningful encounters that I had. A veil of sadness covered the patient’s faces, but as we continued to talk to them, the sadness seemed to melt away—even if it was for only a moment. We talked to a man who aspired to start a support group for alcoholics. He explained how his own problems with alcoholism had hurt his family and how he wanted to help those who were facing the same problems as him.

There may have been a good reasons and intentions behind keeping us from fully interacting with the patients. After all, the hospital faced some safety issues between the patients and visitors in the past. However, it is also beneficial to have the patients interact with others as well. The main goal for the Hospital Psiquiatrico Cruz Del Sur was to reintegrate their patients back into society. I believe that effective reintegration also involves slowly exposing the patients to other members of the society.

The stigma against those with mental illnesses can be the hardest to fight. However, I realized that simple actions could also have such profound effects. Showing genuine interest in the patients as people and giving them the attention they deserved seemed to pull them out of that lifeless courtyard and into a world colored with love, hope, and life. Far too often, the stigma of mental illnesses (in both Mexico and the U.S.) veils our eyes from looking past the mental illness and into the hearts of those afflicted by them. The patients at the hospital were more than just the illness that they have. They each had their own struggles and histories. They were just like us.

ISSSTE

My second rotation took place at the Instituto de Servicio y Seguro Social para los Trabajadores del Estado, or simply put, ISSSTE. Compared to CS Col America, ISSSTE was very different.  Unlike Col America, ISSSTE is a hospital. Thus, it was a lot bigger and there were a lot more people—patients, doctors, medical students, residents, etc. The environment was also a lot more fast-paced.

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We began the day with an hour long discussion about a case study about a boy who displayed symptoms of appendicitis as a result of amoebas. Then I joined the residents and medical students in the gynecology department while they made their rounds. Taylor and Wyatt went to surgery and Maya went to observe a C-section. Somehow, towards the end of the day, we all ended up meeting and observing a pediatrician clean and swaddle a newborn.

The fast-paced nature of the hospital is definitely evident during the rounds. All of the students, residents, and doctors would encircle the patient’s bed and then, a 10 minute session of rapid-fire questions and answers, conversations, and movement would commence.  A multitude of things would take place during that timeframe. One medical student would check the patient’s vitals while a resident would brief the head preceptor with the patient’s information. The others would intently scribble down information, converse with each other, or fetch certain medical instruments for the doctors.

Overall, I noticed that we had a lot more freedom at ISSSTE. Consequently, it also made it very easy for us to take a passive role. Many times, I found myself waiting for someone to direct me to a certain area or invite me to observe an interesting procedure. However, I realized that I can’t wait around for someone to guide me—especially in a hospital setting. I realized how important it was to be proactive, ask questions, and show interest in the work that the doctors and residents do.  Given my generally passive personality, I felt pretty uncomfortable reaching out to others. Nevertheless, doing so opened up a plethora of knowledge and opportunity. I was able to learn how to perform a checkup on a baby, and observe 4 births (1 natural, 3 Cesarean).  

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Taylor, me, Wyatt, and Maya as we prepare to observe a natural birth.

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A courtyard in ISSSTE

 

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On another note:  The miracle of life is beautiful. No amount of words can come close to describing the moment a mother sees her baby for the first time. Nor can it describe the expression on the father’s face as he holds his child in his arms.