Hello again!
Today marks the completion of the three day Costa Rica needs finding bootcamp. For the past two days, we were split into three different groups to observe clinical practice in a variety of different specialties across four different hospitals. My group observed plastic surgery, pediatric emergency observation rooms, and pediatric general surgery.
Rei and I Outside Calderon Guardia Reconstructive Surgery on the First Day
Yesterday in the morning, we saw five different patients requiring reconstructive surgery, diagnosis biopsies, and wound dressing replacement. Dr Bogantes walked us through all the clinical background and procedure steps. In the afternoon, we were immersed in the emergency observation room in a pediatric hospital. We got to experience firsthand the long lines of patients waiting outside of the hospitals, as well as the categorization system of patients based on severity that affects wait times. Through these observations, we were able to identify many differences in clinical practices as well as potential sources of improvements.
Today, I observed a surgery where a baby with a congenital ventricular septal defect had to have repairs done. This was a three hour procedure that required the use of a heart-lung bypass machine. This machine was incredibly complex, albeit very new and modern, with multiple ports of connections, buttons, and indications. I was able to see both the expertise demonstrated and challenges experienced by the doctor to complete its setup. The open chest surgery was surprisingly less bloody than I imagined. Due to the defect, the baby’s pulmonary artery was significantly larger than the baby’s aorta. The physician mentioned that this was not normal and was a result of insufficient blood separation between the ventricles on the two sides of the heart, resulting in the pulmonary artery bearing more blood pressure than normally needed. I did not end up watching the entire surgery due to time constraints, but would love to come back to complete the observation of the entirety of this surgery in the upcoming months.
In addition to the clinical observations, we were also able to get to know our Costa Rican classmates a lot better by traveling and conducting observations together. I learned that there is no summer break in Costa Rica and classes are oftentimes in the evening to accommodate for work and other activities in the day. Our new friends also recommended coffee brands, grocery stores, and even a road trip to Arenal volcano and other sites in San Carlos that will hopefully be an update in a future post, so stay tuned! Fingers crossed that the weather stays as dry as it has been so far!
Post Pediatric ER Observation Group 2 Selfie