Copa America and Curaciones

Yesterday, as I mentioned before, was both the Independence Day of La Paz and the finals for the Copa America - the soccer tournament that is basically the Latin American World Cup. Soccer is a huge deal in Latin America, kind of like Football is in the US, so you can only imagine how excited people get about this tournament. The whole point of soccer (for me at least) is that you go watch it with a bunch of fans and be there for the collective experience, so I headed out to the nearby coffee shop. The finals were Brasil vs. Argentina, and while Argentina was favored to win, I decided to cheer for Brasil because I feel that they’ve represented the spirit of Latin American soccer for a very long time. The whole place was filled with Argentinians, chain smoking their cigarettes and looking arrogant, but I found myself in a corner with a tiny group of very loud, very energetic Brasilians. Brasil finished with a pretty definitive 3-0 win, so while our crowd was making merry and being obnoxious in the corner, the rest of the coffee shop was giving us dirty looks and taking long, annoyed drags from their cigarettes.

Today, despite it being a very important holiday, I decided that I would go into work at the Hospital to see if I could be of any help. On my way over this morning this city was markedly deserted. None of the usual shops are open, and the traffic has been reduced to about half. When I got to the hospital it too was deserted – only a handful of doctors were there, and there were no patients or students wandering around the corridors. Due to the low volume of hospital traffic, the two Claudias actually had time to do their “curaciones” (treatments) early in the day, so for the first time I was able to watch the actual process involved in treating and dressing wounds.

I almost ended up going home because we couldn’t find an extra face mask and hair net (I was not about to deal with sick patients without them), but I ended up borrowing one from Claudia #2, complete with makeup stains (they re-use them here). The majority of the cases currently in the ward are infected bedsores, which while interesting from a medical and immunological point of view, are quite disturbing. The first patient we treated, a 60 year old woman with both a mental and physical disability, was quite the introduction. The patients in the nearby beds had to leave the room because of the apparent smell (I was breathing through my mouth) of this woman’s two bedsores on her back and hips, the smaller of the two (about 3” in diameter and exposing her hip bone) which was infected and oozing a nice grayish liquid. Although I don’t like the sight of blood, I would say that I have a pretty strong stomach for these things after several years of working with animals in my lab…but I was this close to running to the bathroom to vomit after the sight of her wounds. The only way I could stand being there was by forgetting that this woman was a living, breathing human being, which presents quite a quandary for me after my critique of how the doctors here treat these people more or less like animals. But now that I actually have experience with treating patients, I can say that this is the only way I can handle medicine, by putting up some sort of mental block.

The actually procedure of treating these patients involves wiping down the wounds with an antibiotic, the hydrogen peroxide, and then iodine (no anesthetics are used to ameliorate the pain). While the tools in the US come individually wrapped in plastic and are discarded after a single use, these tools come in burlap sacks in a sort of “kit”, along with the cotton, the gauze, and the tray for pouring the treatment liquids (I just hope it’s all been sterilized). I’m not so familiar with the procedure for treating bed sores in the US, but I can tell you that when the interns used a minimal amount of clear packing tape to secure the gauze, my head started to explode. I couldn’t stop thinking, How does anyone leave this place alive?

All in all I got to help out with 6 patients, most of them with bedsores. One man is actually a prisoner from the city jail (a car thief, so I’ve heard), and he’s there because he was (apparently) playing soccer, received a small injury on his leg, and then winded up with an infection that ate away at all of the skin from his ankle to his upper thigh and left the muscle exposed. So while one leg is wrapped entirely in gauze, the other is tied to the bed with a chain…as if he’s going anywhere, anyway. I also had the delightful experience of treating the 15 year old boy with cerebral palsy, which isn’t so bad because of his wounds, but because of the piercing screams he lets out every time we try to move him. This poor child is so pathetically thin and incontinent, and he moves like a lizard, waving his cross-eyed head back and forth as he reaches his arms out to grip his legs or my hand.

Now that I’ve been there for a few days, and now that I’ve proven that I’m there to get my hands dirty, a few of the nurses and patients have started to warm up to me. They’ve stopped going “oh my, there’s a gringa” and started to ask me questions like “Why exactly are you here?” I had a bit of a shock when the attending nurse asked me “So, what do you think of that guy who’s in the government in the US?” As I started talking about how I despise President Bush (she couldn’t remember his name) and how I think the War in Iraq is a disaster, just to make sure she was following along I asked her if she knew about the War, and he reply was “A little bit, I’ve heard of it.” That was when I realized that an awareness of International News is basically non-existent here. It’s a different world, in every respect.