WOW...

...I am the worst blog-updater ever. In my next life I'll be better at it, I swear.

A picture, just to make this post a little longer:

Wow, that's an oldie. I promise to update more often. Well, I guess all I can promise is that I'll try to anyway...

Song of the Week

I've been listening to (and watching on DVD, and learning to play songs by) the Beatles a lot recently, so...here's a Beatles song. It's a nice one (not that all aren't).

My First Earthquake

Put that way, it sounds like a children's book. But a scary one! No, just kidding, it wasn't scary. It was just weird, having never before experienced the sensation of the earth shaking. What was weirder, though, is that no one around me (I was sitting with 3-4 people) acknowledged what was going on, they all just kept on chatting like everything was normal (I wanted to shout, "PEOPLE, EVERYTHING'S SHAKING!" but I kept my cool, a.u.). Then after a minute (or maybe after one of them saw my face), one person said, "it's an earthquake," and I said, "huh." (Interestingly, in Spanish a small earthquake is called a temblor, and a large one a terremoto. I tried to explain that English has just one word, and it didn't depend on the magnitude of the shaking. They were perplexed by this.) It lasted for what felt like a while, but was maybe only a minute or so. According to reuters (so it must be true) it was a magnitude 6.1 quake off the Pacific coast. The fun never stops down here...

Happy Columbus Day!

Or, as my dad put it, have a "very happy Columbus Day, with all the joys, responsibilities, fun and solemnities thereto appertaining." I'm celebrating by watching 'La ley y el orden: UVE' (not dubbed, thank goodness) and wasting time online. Not that I had the day off (they don't exactly celebrate Columbus down here). I hope everyone had a good day off! (If you were lucky enough to).

Pics from the weekend

Lake AtitlanSantiago de Atitlan

Lake Atitlan

updates, pics, and whatnot

Hi friends & family,
Hope everyone is doing well up in the chilly(?) northeast. Just wanted to post to check in. No particularly new or exciting things have been happening here. I have a surprise day off, since we were supposed to go away for three days, but something happened with the car (information relayed over the phone in Spanish...never a recipe for thorough understanding) so we're not leaving till tomorrow. So I find myself lounging around the house, playing the guitar, reading the nytimes.com....essentially exactly what I would be doing if I were home. With the exception of going out somewhere, cause I live in a locked, gated community and there's nowhere to go except around the small neighborhood. Which I did (pics included).
Other than that, not too much happening. I've been enjoying the hospital (it's called the Hospital Nacional de Amatitlan), and have been amusing myself by comparing it to American hospitals I've been in. 1, at home you don't have to bring your own toilet paper. 2, our sterile scrubs aren't see-though (literally and seriously). 3, men and women have separate OR changing areas. 4, patients in the ER have some semblance of privacy, and don't have, you know, foleys placed in front of a dozen other people. One similarity: there are drug reps (complete with expensive suits and trinkets to give out).
I've also been keeping up on politics (the debates are shown here in English, and it's in the paper every day) and fighting people about why Obama is better than McCain (somewhat difficult in Spanish). I live in a house of Democrats, but the extended family is Republican (two people actually high-fived about McCain the other night at dinner...and a piece of my soul died), partly because they seem to all be evangelical Christians. Which is a somewhat, uh, interesting situation to find myself in. I was actually in the backseat of the car the other night, and we stopped short, and a Bible came flying off the back shelf and hit me. Maybe God is trying to talk to me.
Take care everyone, and step on some crunchy leaves for me. :)

My street
The world outside the walls

Pictures

Pictures of the beautiful Antigua, Guatemala, a city about 30 min from here.

Day 1 in la emergencia

Ok this has been quite an interesting day. I was supposed to spend part of the day in surgery, but I never ran into a surgeon (nothing is too pre-planned here), so I just spent the day in the emergency room. By 10 am I had seen an arma blanca wound to the buttocks (side note: it was not explained to me what an arma blanca is. It was just stated to me as the mechanism of injury, as if I was supposed to know what it was. I was foiled in googling it because it´s also the name of a Spanish rap group. I finally had to inquire around the house, and it turns out it´s a long piercing knife-like thing. I guess everyone in the ER knows what this is, and people come in with these wounds all the time, like everyone in the UMass ED knows what a switchblade is.), a cockroach-from-the-ear extraction, and two amputated fingers (on the same person). And I seriously got to put my rusty suturing skills to good use today. And every time I sutured I was surrounded by 3-8 students, who I gather were the Guatemalan equivalent of pre-med (they said they were in high school but were wearing matching uniforms...they were probably 17 years old). At one point the (only) doctor said, "I´m going to a meeting. You can finish suturing this cut then sew up that head wound over there?", and before I could process the fact that she had just annouced she was leaving, I was on my own. (HELLO?!? Imagine leaving a fourth-year in charge of the UMass ED. Disaster couldn´t be far behind.) At the time I felt ok, I could definitely suture these people up in a vaguely competent fashion. But of course in short order there were trauma victims coming in, and paramedics (we´ll call them that...I mean the people that bring patients in on stretchers) were telling me about car and motorcycle accidents, and nurses were coming up to me saying, "Doctora, (something in Spanish I barely understood and even if I understood the question I didn´t know the answer)." One of the nurses located the doctor´s stamp, which she had left behind (with her name; it´s what you need to write orders), so I could write xray orders (hey, it takes hardly any Spanish to elicit C-spine tenderness). And of course, everywhere I went there was a gaggle of white-uniformed students following me, who may or may not have been under the impression that I had any idea what was going on. FUN TIMES. Everyone lived though, and everyone eventually stopped bleeding. (i.e. no harm came to anyone, in case there´s some liability lawyer or med school administrator that´s eventually going to read this.) More later. I took some pretty (I hope, I haven´t seen them yet) pictures yesterday that I want to upload. Besos a todos. :)

Life is good

Alright! I have figured out a way to update this blog. I have to type the entry into word on my computer, then transfer it via USB drive to the house computer and upload it when the internet works. Thus far, the internet has stayed working long enough to let me check one email account. (addendum: this post took more than 24 hours between writing and uploading due to the vagaries of the internet connection. So...I guess they´ll be a little like snail-mail in the sense that 'today' isn´t actually today (or the posted date).)
But life is good. I wish I had very exciting things to report, but I don’t. I don’t actually start working in the hospital until tomorrow. But for now, some observations for you:
1. It’s wet. Very wet. Only after 2 pm though. How is it sunny all morning, then every day at 2 pm for 6 months it pours? Mother nature is a mysterious lady. I belive “winter” (what the rainy season is called) ends at the end of October.
2. Mayan (or whatever you want to call them) women stash cell phones in small pockets sewn into the inside of the neck of their (traditional) shirts.
3. Mayan/indigenous women wear traditional dress consisting of a high-waisted extremely colorful skirt that goes to mid-calf, and a tucked-in blouse. And, often, heels. The men for some reason wear regular old western clothing. Why is this.
4. Guatemala is nowhere near as poor as Nicaragua is. I kind of expected it to be similar (being the only other central American country I’ve been to). Wrong. We went to a shopping mall the other night that was bigger and fancier than most malls I’ve been to in the US. The cars here are all pretty nice and new (whereas the cars in Nicaragua looked like if they went over a big enough pothole they would collapse into a heap of parts). Homes have computers! And cable TV! (Confession: I watched ‘Gossip Girl’ last night. I know, I know, that’s hardly advancing my Spanish or medical knowledge. But lord was it enjoyable.) And washing machines! Obviously there is still exteme poverty here. But there was extreme poverty in Nicaragua, without the obvious displays of wealth right alongside.
I have been lucky enough to land in the middle of an extended family of musicians. The father in my house is trying to teach me how to play American songs on the guitar, which are apparently “classics” but because I was raised on a diet of Mozart and Gilbert & Sullivan (thanks, dad!), I have never heard any of them before (or my strongest recognition is “hmm this part sounds sort of familiar”). I’m amused that he’s teaching me songs from my own culture. And the doctor who’s organizing my entire trip (I’m living with his sister’s family) is a good guitar player and singer, but mostly plays the marimba. Heaven.
Um, so if someone could please locate some information on the Mayans and what exactly happened to them, that would be great. It hurts my eyes to read this computer screen too long, and the bookstores only carry books in Spanish or something. But I’m curious, so if someone could find out a little history there and get back to me, that would be great. Thanks, Nat. :)

Hope everyone’s good! Thanks for reading. :) If you’ve just skipped to the end, well, thanks for visiting anyways.

p.s. Dear Dad,
I have not been trapped beneath a mudslide, fallen into a volcano, had my car hijacked, been kidnapped by rebels, or contracted Dengue fever. I am in fact alive and well, and for the most part feel pretty much like I’m in the US, except for the cold showers and the volcanos.
Love,
Your daughter

Pictures!
This is my new best friend, Chispa. I tried to take her picture sitting upright looking at the camera, but every time I tried to get her attention by calling her name or touching her, she flopped over pathetically on her back.

This is a tree. Um, I forget what it’s called, but it’s the national tree of Guatemala. And…they look cool. (I´m pretty sure I´m going to be able to parlay this eloquent blog into a lucrative book deal.)
This is one building of the main public university in Guatemala; it’s in Guatemala City, and it’s called the Universidad de Juan Carlos. I enjoyed the placement of a centuries-old Mayan sculpture in front of a university named after the leader of the people that invaded and decimated the indigenous culture.

I´m alive

in case you were worrying. :)

I arrived in Guatemala city this afternoon, after almost missing my connection in Miami (but making it!). I am staying with a v. nice family with two girls living here (and a son living elsewhere). I have my own room, and, most importantly, the house comes equipped with a very small white fluffy dog that likes to have its stomach rubbed and 3 (three!) beautiful guitars in the corner of the living room. I have met my soulmate, Guatemalan-houses-wise. Since I am lucky enough to have internet in this house, I really have no excuses for not updating this regularly. So...feel free to harass me for a post if I seem to be slacking. :)

I just...love this picture

I love how Republicans are talking about how they're going to be a "change" in Washington. Give me a break. I guess they think voters are actually dumb enough to forget that they have been the ones tanking this country for the last eight years. Well, a picture is worth a thousand words. It beautifully and clearly displays how the current Republican candidate feels about W and his s*****y policies.

Thank god, only 115 days left

(or, however many...see widget below) (I tried to find one that fit in a more streamlined way into the layout of this blog, but I couldn't. So...it's big and bulky but it's ok, it does its job.)

So I was having dinner with an old friend the other night, who's very level-headed (well, like most of my friends...but her in particular) (Caroline I'm talking to you), and we were discussing the inane stupidity of the current administration. And how mad they make us. Thinking about George Bush is actually one of the only things on earth that makes me mad. Like, heart-rate-up mad. So rather than sit here with steam coming out of my ears, I'm gonna channel the anger into enjoying some lovely music, courtesy of everyone's favorite folk singer, Antje Duvekot. It's a new song called Christian Boys. And it's the new Song of the Week! (See the little mp3 player to the right.) Lyrics below:
How does a poor man on a bench become a criminal
While the rich man on the hill hails to the thieves?
How does revenge equate to pride until the flag becomes a gun
How will the sun go down after the war is won?
How come the wise man is so quiet
While the killer speaks so loud?
He is hollering from out of my TV
And he is claiming that he knows me
He is taking little bows
But he is drinking from the silver palms of greed

And Mama, aren't you proud
Oh, he plays with such big toys
And he thinks it's all a game
Your little virtuous Christian boys

So you're playing by the rules
But every time it is your turn
He moves the net a little higher up
And you think it must be fair
'Cause that is what you've learned
But he scores every time
And you score none

And Mama, aren't you proud
Oh, he plays with such big toys
And he thinks it's all a game
Your little virtuous Christian boys

Oh but this is an impressionist painting
And we are standing way too close
We are sitting in the circus tent
Just waiting for the show
While the cannibal elite
Eats from their sacrificial plate
And they are lying through their teeth
Making a mockery of faith
And your dollar lets you buy
Yet another empty cup
And that is how they fund their lies
And they hope we don't wake up
And they are feeding us this fear
They are feeding us the news
And they know we're biting off
Less than we could chew

And Mama, aren't you proud
Oh, he plays with such big toys
And he thinks it's all a game
Your little virtuous Christian boys

It's here! It's finally here!

What we've all been waiting for for the past 364 days...International Talk Like a Pirate Day! Before you think I'm totally crazy, this day is bona fide: it was in the New York Times crossword puzzle today (8 down: "Well I'll be" as might be said on Sept 19. Answer: Shiver me timbers). And no holiday can be solely in the counterculture if it makes it into the crossword puzzle. So why have TLAP day? Why not! According to the website, the whole point of TLAP day is that there is no point. So have a great day! And remember, today's the one day of the year you can't make too many harrrrrible pirate jokes. :)

p.s. whoops, somehow I neglected to actually post this one. okay, it's now a week after TLAP day. well...close enough. :)

New feature! New feature! Read all about it!

I decided to embed an mp3 player into this site, at the advice of a friend. It's taken me several attempts, and several hours at each attempt, sadly, to figure out, but it's finally up and working. I think I'm going to change the song every week or so (or maybe longer, if I forget about it). So the inaugural song is Beethoven's Heilige Dankgesang. At times other than 2am I could extoll its virtues and tell you why I love it so much. But not now. I'm too tired. Sorry it's so long, but have a listen, it's really nice. If you're interested, you can read a bit about the piece here (it's a little verbose though).

Some pictures from last weekend

View from the 38th floor of East 42nd Street.

Sunflowers on the farm, Tarrytown, NY

Brooklyn Bridge, the waterfall, Manhattan Bridge

Lerner Hall, Columbia University

Sheep's Meadow, Central Park

Waiting for the train at Bleecker Street

Freakin' social conservatives

What is wrong with you people?? Sorry to have a random post about politics and bat-shit-insane Republicans, but I need to get this out of my system. How is it possible that gay couples, some of whom have been partners for 40 years, are ruining the "sanctity of marriage" by getting married, and yet when 17-year-olds get pregnant, the right moral thing to do is to get married? How are shotgun weddings preserving the institution of marriage, yet marriages of long-term couples eroding it?? Argh! Crazy Evangelicals and their moral high ground. Thanks for letting me vent, I feel a little better.
p.s. Dear Conservative America,
Please teach your children about birth control. When they decide abstinence-only isn't cool anymore, they will need it. Thank you.
Fondly,
Liz

You can't make this stuff up...

Patient (looking at me intently): You look like Amy.
Me: Who's Amy?
Patient: My cat.

A night out in Worcester

So as part of my Emergency Medicine rotation, I have to do two ride-alongs with Worcester EMS. I had kind of a crazy and interesting night, which I feel like sharing parts of semi-publicly. We had quite a few calls tonight, which usually came in right as we were nearing a coffee shop (did the dispatcher know what we were doing and where we were going? perhaps). There were a couple non-interesting calls, so I'll leave those out. But even amid the mundane, the two paramedics I was with were quite a duo. They were hilarious and inappropriate, and just as I was on the brink of rolling my eyes at their adolescent humor, they quickly and smoothly sedated and intubated an old woman in respiratory distress. I mean, I had barely opened the bag with the equipment and I looked up and the tube was in her mouth (paramedic: "When you look in and see their teeth come out, you know you're golden"). Preceding her florid respiratory failure, she had just been having some difficulty breathing. Her rapid decline (this was the most serious gasping for breath I have ever witnessed) while we were on our way to the hospital forced me to poke my head up toward the driver and ask, in a polite and high-pitched voice, "um, excuse me? could you please pull over?" and as soon as we stopped she was intubated and we were on our way again. And the medics were nothing but patient with me as I fumbled with IV tubing and squirted saline on them (and on me) (Medical Students: Always Cool Under Pressure). Actually the scene wasn't as frantic as I would have imagined an emergency intubation on the side of the road to be. (End result: we brought her to the hospital, and I have no idea what eventually happened to her.) (Unsatisfying, I know.) What's also interesting about this lady is that she kept saying over and over she didn't want a breathing tube (known in medicalspeak as being DNI: Do Not Intubate), but then when she actually started gasping for breath and frothing at the mouth, she said she wanted the tube. This is not the first time I have seen this happen, where people swear up and down they want no "heroic" measures, then when it comes down to it, they want everything. I guess your feelings are different when you're thinking about what may potentially happen in the future and experiencing what is actually happening. I can't imagine the terror of knowing you're about to die, even if you're very old and very sick and have thought about it a lot. But this is a discussion for a whole other post.
Anyways, we had this other call which was to a "man down" in downtown Worcester. He ended up being a drunk guy with new and old cuts, scrapes, and bruises all over him, and large switchblade hanging out of his back pocket (which, upon noticing it, the paramedic and police officer quickly took). At first I was thinking, this guy's totally drunk, he was stumbling around and fell and hit his head, he's refusing to go to the hospital, why are we here? Then I got more of an idea of what was going on, and it turned out he was well-known to all parties on the scene, he's a sometimes-resident of the PIP shelter, he's pretty skinny and pathetic and gets jumped all the time, and had been beaten up today because he had $20 that someone else wanted. He carries the blade for protection. The officer told him he understood it was for protection, because there were some dangerous characters out there (I'm cleaning up his language in paraphrasing here), and then told him, after seeing a bottle of gatorade in his bag, to "pound that shit." I was kind of surprised (and then felt guilty that I was surprised) at how patient and respectful and just plain nice everyone was being to him. The man eventually decided to come to the hospital, and as we were getting out, the medic reminded him to please be polite and treat people with respect, and that's how he would get treated by the doctors and nurses. I'd like to think that's true, but I'm not sure the bleeding drunks sleeping in hall stretchers get treated the same as other patients. I know if there were a choice of two patients to go see, I probably wouldn't choose the drunk man in the hall. (I wish that wasn't true and I didn't think like that, but I'm being totally honest). But it was nice to see this man from a different angle; fine, he's an alcoholic (who am I to judge), but he's also just trying to survive (and has probably had a pretty bad life so far), and ends up bleeding on the sidewalk every couple of weeks because Worcester's Finest want to mug him for his $3.50 bottle of vodka. Life's a bitch for some people...so who am I to judge them and not treat them with respect??
[Side note: talking about this man brought up one of UMass' family physicians who works at the PIP shelter, Worcester's only (I think) wet shelter, and an all-around rough place. We quickly concluded that this particular doctor is a bald, male version of Mother Theresa, in that he is compassionate and respectful and patiently treats everyone, even if they walk out the door and start shooting heroin into their eyeballs; then they come back the next day and he treats them again. We are certain that he has an express, speed-of-light ticket to heaven. He's the kind of doctor that before medical school we all wanted to be like, treating everyone, being kind, being non-judgmental. Now most of us are just in awe that someone like that exists, and we mull over his saintliness as we elbow each other out of the way for the few open derm slots.]
And just when I thought I'd seen enough for one night, we got a "FDGB" (fall down go boom) call. We walked into the house, and it was (I'm not making this up) a family of deaf people. Most people that know me know that I love sign language and that learning it has been a hobby since college. It's not really a handy life skill (even though ASL is the third most common language in the country, after English and Spanish), and I don't think I've ever been called upon to actually use it. Needless to say, the paramedics were kind of stunned that I could communicate with this family and figure out what happened, and then talk to the patient on the way to the hospital. I ended up waiting there until the interpreter got there, leaving my ambulance to go out and take more calls, cause I felt bad leaving this poor person in a cervical collar strapped to a backboard staring at the ceiling and unable to communicate with anyone. I'd imagine that would be a pretty scary situation for a deaf person, only able to look up, not really able to move at all. At the end of the night I was pretty pleased that I hadn't totally forgotten all my ASL, though certainly it could use some work.
I feel like I packed a bunch of crazy experiences into one short shift. Thanks for reading this very long post (if you even did...and didn't skip right to the last sentence...I have a short attention span too, I know how it works). I don't think my next ride-along will be quite as adventure-packed, but we'll see... :)

Pittsfield happenings

This is getting blogged about, per request...
There was one hell of a fire the other day at an apartment building across the street from the hospital. Of course being voyeuristic like we are we rushed out to watch (and take pictures). And mingle with Pittsfield's Finest. I'm not sure what time the fire actually got put out, but it was after 11pm (and it started around 8). From what I read in the newspaper, no one got hurt, and the fire started on someone's stove. It was pretty impressive. And HOT (I know, I know, you think that'd be obvious, but it still surprised me). Plus I was watching the firefighter on top of the giant ladder hanging over the burning building, thinking, we must be made of different stuff, or have different neural connections (see?? I'm tying this into my neuro exam tomorrow, so it's totally like I'm studying) than me, cause WHAT would possess someone to do something like that?? I mean, this was a giant ladder and a big fire (see above image). Now, alas, the building is very sad and burnt-out looking. But it's still there, and at least the fire didn't jump onto the house next door (it was close - you can kind of see the roof next to the bottom of the ladder in that pic).