Friday

The hospital was pretty slow again today. I’m not sure why things are so slow, but it might be the weather. It’s been raining a lot lately and most people have to walk to get anywhere. I received some bad news today. That little 4-month-old that coded in the ER and was transferred to Belize City died. All the staff was talking about it. He was stable when he left here so I was surprised he didn’t make it. There must have been some other underlying problem besides the dehydration, or maybe he had some brain damage for lack of oxygen. At first there were no answers; nobody knew what happened, just that he didn’t make it. I found Dr. Sierra to see if he had any other information. He had just talked to the grandma-in-law of the baby. Coming from her, he said the patient was doing okay until the evening of the day he left our hospital. Apparently, they had to put him on a ventilator at one point. Then Dr. Sierra tells me that during the night the ventilator malfunctioned and stopped working so the patient died. I was like, “What!?” I was surprised by the way he said it too, like, it was just one of those things and nobody could do anything about it. So, again, I said, “What?!” in disbelief, “Didn’t they have a back up ventilator?” I guess they didn’t. Mind you, this is the only pediatric intensive care unit in Belize and at a government hospital. How could somebody possibly die because the ventilator malfunctioned? Wasn’t there somebody watching him? Didn’t they have monitors going? Didn’t they have more than one ventilator? This is another great example showing the poor access to healthcare here in Belize. Maybe the grandma-in-law wasn’t giving us the correct version of the story. Whatever was the cause wasn’t important at this point. I was so disappointed to hear that after all we did to save this little life he still died. It’s one of those things that I know I’ll have to face regularly as a physician, but I have never experienced it this close yet. I haven’t even seen any situations where the patient died before my eyes. There was a patient in the NICU in which life support was withdrawn, which was pretty sad. Other than that I haven’t seen death first hand and having been involved in this patient’s care directly I was really disappointed to hear the final outcome. I don’t think it will ever get easy for me to see patients I care for die. While I may get more used to it with time, I’m sure every case is hard on you emotionally. That’s part of the job though and a difficulty I knew about going into this. Along with the high of saving lives you have to deal with the lows of losing lives sometimes.
I’m looking forward to next week when I’m going to start working with Dr. Sierra. He is much better at having students with him and while I would like the OB/Gyn experience I’m not getting much out of working with Dr. Lazo. He still hasn’t gotten back to me regarding seeing my own patients. I wonder why he is so against having me help him, especially since I was doing all this while he was gone. This has been a big frustration with this rotation. I also didn’t realize how slow things would be at this hospital and that is frustrating. Normally, they see a fairly good amount of patients and have about 20 deliveries per month. While I’ve been here they’ve had 4 deliveries, one I did, and the other ones happened over the weekend while I was gone. Little did I know that September is their slowest month of the year. I guess I’m still grateful that I came for some of the good experiences I have had, but this experience has not been exactly what I had hoped. I imagined being involved in many surgeries, deliveries, and procedures in the ER and having stuff to do all day long. I guess I should have researched things a little more, but in the site description they sure made it sound a lot better than it really is. Oh well.

Macal River - right by San Ignacio