8.1.13

I could not have asked for a more amazing summer. Here in Guadalajara I have "bagged" a patient, stitched up people, pumped a woman's stomach, and so much more. I love wearing scrubs and being called "Doctora". I have an insane amount of responsibility here. I have my own patients and consult with doctors only to get their signatures on the bottom of the charts. I write up prescriptions, order x-rays, and even get to wear a stethoscope around my neck! Today was our third at the North Green Cross Clinic. As the doctors begin to recognize us, we are given more and more responsibility. Today they tossed almost all of the stitches to Decs and me. Decs and I make a great team. We switch off doing the stitching, with the other person assisting getting non-sterile supplies and blotting off the blood.

As Decs and I have discovered all of the cases start to run together. Even when we sit down and try to remember the day we can’t pull apart the patients. The record we came up with for today was:

Finger 9 stitches

Back/butt 7 stitches (decs)

In between tow 5 stitches

Stomach pump 2l of fluid activated carbon

Drunk guy and boob grab

Forearm 6 stitches

Back of hand (decs)

The stomach pump, however, I do remember in great detail. One of the attending doctors called me over by saying Doctora Nina. I really want to correct him and say I'm not a doctor, I’m just a kid, but then he wouldn’t give me any cases. “Doctora Nina” he said, “there is a stomach pump case coming. Let one of the nurses finish putting the bandage on your stitches and get ready.” So, I put down the gauze and gave it to a nurse who was passing by. I went and stood by the doctor while the EMTs wheeled the girl in. The doctor pointed to her and said, “Go pump her stomach. She swallowed pills.” I mean I know my mom got her stomach pumped after she ate mushrooms in her backyard but that’s about all the context I had. Unfortunately, there were no Greys Anatomy episodes about stomach pumping. So I went over to the women and asked what she had swallowed. I got her to admit to taking about 30 pills of unknown origin. Then the doctor came back over and asked what I was doing, that we had to get going, that we didn’t have much time. Go to the cendis (the little supply room where a man sits and gives you everything you could ask for) and get the asdfghjklkjhgfdsa. Right away sir. I went over to the cendis and asked for the equipment to do a stomach pump. Thankfully the guy behind the counter was experienced and knew what I wanted. Then the doc asked me to open the bad with the tube in it but of course it was super strong plastic so I had to run and get scissors (I know, no running with scissors, but the doctor had gotten off his ass for the first time that day, so I figured it was important). Then he got surgilube and introduced this 3/4cm tube up into this woman’s nose and down her throat. She was not pleased. There was a lot of blood. It was actually quite violent. Then he left and I was in charge. I assumed pumping a stomach required a machine. I was incorrect. The nurse handed me a syringe and walked away. I walked after her and whispered to her, “what am I supposed to do with this?” She smiled and said, “I think you stick it in the end of the tube and pull out the contents of her stomach.” So that’s what I did. I pulled out the contents of her stomach with a 50ml syringe. The procedure was simple but insanely tedious. Introduce about a minute and half of water-ish stuff into her stomach, let it run out, suction out the rest, repeat. I went through 2L of solution over two hours. It took me a long time to get all of the pills out. You could see the bright green pill remnants going through the clear tubing so I did it until there were no more green pill spots. I squatted below her bed coaxing the stomach contents into a bucket for about an hour and a half. Then I put in about half a liter of activated charcoal solution to absorb any more bad stuffs still in her tummy. Then I took out the tube and had her sit up. She talked to the social worker about how upset she was in her life. Her husband didn’t sound like the best guy, but he never beat her or raped her or hurt the kids so that’s a plus. She was just sad and thought her husband was having an affair and just sad about life. I told her to wait there until the doctor saw her again and walked her to the bathroom and made her talk to me the whole time. Last thing I needed was to have spend 2 hours saving her for her to jump out the window or slit her wrists. That sounded insensitive. I didn’t want her to die. Dying’s bad. That’s rule numero uno in doctor-ing. I kept an eye on her as I did the rest of my stitching and she left with her father a little while later.