Today was the last day of our Needs Finding Workshop. This workshop was the first time I’ve ever done any clinical observations, so I was both excited and nervous. My biggest fear was that I wouldn’t know what to do or I’d do something incorrectly, but on the first day of the workshop, Prof. Howard explained what to expect and how we should conduct ourselves.
My first day of observation (Tuesday, May 27) was at Calderon Guardia Plastic Surgery with Dr. Bogantes. (Fun fact, apparently Dr. Bogantes refers to many different people because the Bogantes family had many siblings that became doctors. At this point, it’s a big family business.) The first procedure was intense; a lady came into the office with a botched cosmetic surgery done by an unlicensed doctor, so the skin under her right eye was drooping heavily and she couldn’t close her eye completely. The procedure Dr. Bogantes performed was a graft to add more skin underneath the drooping lower lid, however he had to take the graft from the other eyelid. Here are some of my notes that (hopefully) help illustrate what happened.
A few sketches from the first operation on a woman’s eye.
It was crazy to see the number of people and the variety of cases he saw. My understanding of plastic surgery was pretty minimal, so I was shocked to see that Dr. Bogantes had patients that came in about an Achilles heel injury (apparently the man had severed it with a “metabo,” or an angle grinder type blade), a carpal tunnel flareup (he had surgically relieve the pressure inside her hand), and a skin cancer biopsy (he took a large sample from her forehead, and I had to turn away a few times while he was suturing the wound back together).
My second observation was later that day at Hospital Nacional de Niños (National Children’s Hospital), where we were stationed at the ER. I really wasn’t sure what to expect since my experiences in the emergency room have thankfully been minimal. I tried to make myself as small as possible while I was making observations because there was so much going on and I didn’t want to add to the chaos. What stood out to me was how crammed the space was—there were gurney beds in the hallways and parents sitting on chairs with them, making the ER more congested, but I was most concerned that they only had one isolation room. I made a quick sketch of the ER layout:
Rough sketch of the ER layout.
My third observation was today (Wednesday, May 28th). I wasn’t able to join the rest of my group to observe general surgery due to Housing Selection tomfoolery, so instead I followed Dr. Sixto Bogantes throughout the morning. (This is not the same Dr. Bogantes as the previous day but they are, in fact, brothers.) He was constantly moving from floor to floor to examine patients, so it was really interesting to see the variety of cases he saw on a daily basis. I really admired how well he got along with his patients and their parents; he could get children to open up or laugh and smile. Dr. Bogantes also gave me quick summaries of the patients’ conditions in English, which was really thoughtful.
Overall, I really enjoyed my time at this bootcamp. I never would have imagined myself watching surgeries or diagnoses in the ER, but in the past three days, I did that all in Costa Rica. This was truly a “once in a lifetime” experience, and as cheesy as it sounds, I made some amazing friends along the way. Shoutout to Chris, Rafael, Pili, and William for helping translate for me and Apple!
A delicious Subway meal after our first observation at Calderon Guardia Plastic Surgery
Post ER observations—or for Rafael, post following Dr. Bogantes around Hospital de Niños for an afternoon.