Chris called me last night on his way back from Guatemala. I had no idea that he was down there; I though that he was slaving away and too busy to talk, like I was. Words do not exist to express my jealousy. It was really awesome to hear him talk about the places that I had been. He stayed in Antigua, climbed the volcano ( which was erupting!), visited Lake Atílan and went to the markets (where he had a much more enjoyable time than I did, because he’s used to the in-your-face bartering-and-begging system than I was).

It was, btw, 4 years exactly when I was Guatemala myself, struggling to learn Spanish, enjoying the 70 degree weather heat, hiking the ruins of Tikal, riding a donkey in the mountains near Antigua, wandering through the cathedrals during Lent and seeing the processionals. I dug up and posted a few of my Guatemala pictures here. Unfortunately, I have lost a bunch of the emails that I had written at the time to document my travels and didn’t realize it until now. I had written them on my old school account and I thought I had forwarded most of the messages to my other accounts, but apparently not (and that account is now way beyond defunct). I’m hoping (*hint, hint*) that my family decided to be sentimental and preserved some of those emails, but as we communicated mostly by instant messenger that trip, I’m not sure that they exist any more. I know I emailed Chris on a regular basis, but for the last 2 weeks of my trip, he was in British Columbia and didn’t write me. And his school email account is gone now too…

This was the only place that I had been that Chris hadn’t, so once again, I’ve fallen way behind in the world travels race. Drat.

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In other news of my life, (aka work), the new hospital has certainly proven to be interesting. It ‘s a private hospital a couple of miles down the road for me, and I feel like I’ve entered a different world, because things are so different from the academic world that I came from. Here, decisions are made purely by the whim of the attending physician (which never seems to be the same person for more than 2 days in a row) and trying to get the attendings to practice evidence based medicine, well, it’s a battle that I don’t think I’m going to conquer in the 4 weeks that I’m here. For example, yesterday the admitting physician seemed to have this bias against giving IV fluids. Our team admitted 6 patients over the age of 80 and ALL of them were dehydrated and showing signs of going into renal failure, but I had to fight with this particular attending to give them any fluids at all. I also had to fight for 2 patients coming in with fevers and elevated white counts to get the appropriate antibiotics–I’ve discovered a little bit of a stubborn streak that I never knew that I possessed.

The positive side of this has been that I finally can see that I have learned something in residency; that I am comfortable in making independent decisions. There’s still a ton that I need to learn – it’s not like I feel any where comfortable enough to go out on my own yet, and I’m more than grateful that I’ll have another 3 years of training before I get to that point, but I have developed the critical skills in that I can look at a patient, their labs and their x-rays and determine if I need to give them fluids. Or (roughly) which antibiotics I need to start them on and so forth. There are certainly areas where I need more guidance and direction, but I don’t think that the philosophy here at this hospital (where the interns meet with the attending and he tells them the plan and they scribe it down) is the best way to learn that.

But I certainly am enjoying finishing work and leaving the hospital by 1 or 2 pm on my non-call days. Friends, did you know that there is such thing as a round yellow ball that sits in the sky and gives light and warmth to the world??? Who knew??