But I hate white shoes

I returned to the Hospital de Clinicas for the first time in over a week today, and was greeted with a lot of “Whoah, were did you disappear to?” It was good to be back – it gives me a sense of purpose in life down here – although my stomach does flutter every time I walk into the ward and smell the sickness.

Today I got my first glimpse of a surgery, although a minor one, on a 75 year old woman with cervical cancer (apparently there is a high incidence of cervical cancer caused by HPV in Bolivia). She has a large tumor pushing on her urinary tract such that she can’t urinate (it had been 15 days), so I watched as they put some sort of catheter into her kidneys to help her “urinate”. We brought the woman over to the imaging unit, where they had her lay down on her stomach as they used an ultrasound to view her kidneys. There was no protective paper on the bed, and the woman was lying there with her pants around her ankles, her feet resting on a folded cardboard box. I watched, rather stunned, as the room filled with all sorts of medical students, as the poor woman sat there without any friends or family to comfort her. The doctors were wearing gloves, but no scrubs or facemasks, and of course the rest of us were without proper medical attire as well. My naive, childhood vision that all doctors are perfect and will automatically make me well has certainly been replaced by a more skeptical appreciation of medical staff.

They cleaned her back with iodine, and then proceeded to put a catheter through her back. The process seemed so crude to me – they used the ultrasound to see if they were “in” her kidney, while a bit of urine mixed with blood from the tube dripped onto (and possibly into) the area around the wound. It scares me a bit that when I asked the intern why they used the chemicals they do for curaciones, her reply was “It’s what we have around here,” with no hint that she knew that the methods they use are quite bad for tissue healing and health.

At the end of the procedure the attending doctor finally noticed that there were students standing around, and he asked the doctor I was standing with who I was and what I was doing there. After a brief introduction as a biology student from Chicago, the doctor looked me up and down and, in front of all of the people in the room, started to talk about how all attendees in the hospital should wear white shoes and white pants – focusing on my black converse and khaki pants. Not referring directly to me, he talked about how patients needed to see people in the hospital looking professional, and how even though “this is a third world hospital, we still have our idiosyncrasies.” And before I could really grasp what was happening, he told me “Avoir” (why in French?), and then I found myself waiting outside.

In the month and a half that I’ve been at this hospital, I have NEVER been castigated for my clothing, much less in public. I’m not really sure what he was trying to accomplish, but I have a feeling this is another case of prejudice against foreigners, which could have happened for any number of reasons. In my experience, most people are happy to see a foreigner working as a volunteer in a poor hospital, and the white lab coat ensures that I blend in more than well enough. I know that some people look at me and automatically assume that I’m a western doctor who thinks she can just barge in, prance around, and insert all-knowing remarks once in a while. While part of that statement is certainly true, minus the comments and the prancing, it’s that same assumption that bothered me so much at the Cabildo in El Alto. I understand is a complicated mix of history and race relations, but I still get worked up that people are so quick to judge.