Thursday, March 30, 2017

Medellin: Adapting to Life at the Intersection of the Hospital and the Language Classroom

Alister Martin
Resident MGH/Brigham - Harvard Affiliated Emergency Medicine Residency

Medellin: Adapting to Life at the Intersection of the Hospital and the Language Classroom 

It’s been three weeks now and I think I’ve found my rhythm here in Medellin. Since my last post was focused on the study details, and the data collection process is coming along well (we’ve successfully arranged data capture at both of the target sites) I figured I’d zoom out a bit and show you what life is like for me here during rest of my time. When I landed a few weeks back I signed up for a month-long full immersion Spanish language course in the mornings through a wonderful school called Colombia Immersion which was set in the picturesque Colombian town of Envigado. My daily schedule has been to go to these immersion classes from about 9A until 3P. I then make the long hike out to Hospital Pablo Tobon Uribe in another barrio on the opposite side of the city called Robledo. I usually take an uber and this provides a fantastic time to practice my Spanish with the locals. We talk about all sorts of things, the weather, the Colombian peace process, the food(Bandeja Paisa has been a weekly treat), and US politics. Mostly though, we talk about how proud they are to have Pablo Tobon Uribe hospital in the city. They tell me stories of mothers who were saved there, of accidents on ‘motos’(motorcycles – which are very popular in the city) that Hospital Pablo Tobon Uribe helped them through, of diseases that were misdiagnosed at other hospitals but were correctly treated there. One driver told me that he thought it was the best in the country. It was very clear to me that the people of Medellin love this hospital for the care it provides. After spending most weekday nights in the halls of that hospital and experiencing the gratitude the patients have for the care we provided I am also, in some small but tangible way, left with that same pride. This hospital, much like the city of Medellin, has left its mark on me.

The emergency room at Pablo Tobon Uribe has been like a home away from home for me here. Perhaps that's because when you're in a foreign city for an extended period of time with a different culture, you grasp at that which resembles the familiar, that which feels like home. Maybe in these foreign places home beckons even at the same time as it pushes you away and towards this new place you've found yourself in. For me that was the emergency department. Whether it was scurrying for the ultrasound to evaluate for pericardial effusion or doing a late night snack run with co-residents on an overnight to the pastelleria(cafeteria) downstairs there were so many things that felt like my job back home stateside. In those first few days, when the culture shock was most palpable, and I was just learning how to balance in this beautiful, big, scary city, these tiny creature comforts reminded me that not all was different, that some things were the same. 

Even here in this home away from home there were still stark differences, particularly in the patient mix. The volume of trauma here was higher than at my home institution and the nature of the trauma varied. One patient I had, a mid thirties male had been arguing with a "friend" and was struck with a machete directly in the middle of the face. I later saw him as he was being wheeled up to the OR, calmly watching a music video of J. Balvin(an international reggaeton artist and Medellin native), tapping his fingers to the beat, as if he were waiting for the metro. I can't count the number of motorcycle vs MVCs we've had. The number of motorcycles on the road here is astounding.

The Spanish immersion school was a pleasant surprise on this trip. I had not been expecting to grow so close with the people there. The coaches, the other students, and the professors were all fantastic and the school accommodated my having to leave early to make it to the hospital. The classrooms were small and modest and free of distractions. You sat on these soft padded wooden grates and the professor used a large whiteboard. In the afternoons I’d have private coaching sessions where my coaches and I would practice “escenas” which were essentially mock patient-doctor interviews. Overall, I think I have built a solid foundation upon which to continue building my medical Spanish fluency.

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