My last trip to Roseau and the Dominican hospital.

I had my second trip to the hospital last Tuesday and boy it was a heck of a day. As usual, the day started with a dose of dramamine for the long winding road to Roseau. Midway though the drive, I realized that this stretch of highway looks a bit like California Highway 1. The Dominican Road (which, I cannot find a name for other than, "the road to Roseau"), is so windy, barley two lanes and plunges into the mountains and then plunges out toward the ocean before taking a hair pen turn back into the safety of land. There is one strip of the two way lane is straight (about 1/4 of a mile) that looks shockingly similar to the picture below from Highway 1 in California--and I heard Tom Cochran's "Life Is A Highway" for the rest of the day. The main difference between California and Dominica is that Dominica has huge mountains just inland of sea and it is much greener. In fact, Dominica is so green that it is almost intoxicating.

But alas, we are no where near the United States, let alone California (or Washington!). There is a sign outside of the library that states we are 3,818.42 miles from California and that California is 34°26'N and 119°50'W. The funny thing is that the sign is facing Southwest rather than Northwest. I'm not exactly where you would be if you went 3,818.42 miles southwest of Dominica, but I think it is somewhere in the Atlantic ocean or on the Atlantic coast of Africa.

Now onto the hospital, I was assigned to the OB/GYN unit for the morning of shadowing a physician. The first three patients we saw where all hospitalized for intense morning sickness. They were all between 11-16 weeks and overall doing well. Honestly, it wasn't too exciting because there isn't anything to see and basically they just give these women antacids, anti-emetics and IV fluids. I don't want to say that any patient isn't exciting, but I guess since three of them had the same thing wrong it wasn't as interesting by the third time through.

Sometimes you don't always get what you wish for because my next patient was exciting, but I'd never wish anyone to be in so much pain: a young woman who had a primary outbreak of herpes. I won't describe the lesions in too much detail because I know that most people don't want to hear the details of infections. I feel so horrible for this young woman as you never can get rid of herpes simplex virus. For those that don't know, herpes is an extremely painful infection and my patent's infection was so extensive that she couldn't comfortably sit down as she was in so much pain. On the other hand, medical students don't usually get to see such extensive infections so early in their career so I'm grateful that I was able to see this infection--it looked like something from a pathology or microbiology book. I was also able to see the vagina and cervix, which I have not done yet in medical school (they only let us practice pelvic exams on mannequins at this point in our education).

After finishing up with that poor patient, we headed upstairs to the delivery floor. Our next patient was 44 weeks pregnant! 44 week!!! For those of you who don't know, 40 weeks is the general length of pregnancy and a baby is considered full term at 38 weeks. In the U.S. (and Dominica), babies are not allowed to hang out in utero for 44 weeks (babies get big and can get stuck during delivery amongst other problems). However, that involves the mother coming in for prenatal care! This Mom had come in once before and then came in because she thought it was time that she had the baby. Upon ultrasound and a good history (I'm not sure how they got a good history out of this lady), they determined that the baby was 44 weeks along. The most exciting thing about seeing his patient was that the doctor showed us how to feel for the position of the baby and we got to listen to the heartbeat. I even found the heartbeat all by myself! It was SO exciting!! Babies have quick heart beats (if I remember correctly a normal fetal heart beat is 120-140 bpm) and they sound a bit like a choo-choo train.

After that patient, we went out to lunch. Again, I have no idea why we needed a two hour lunch. We went to a different restaurant this time and it wasn't that good; but I didn't get food poisoning, which in a third world country means that that it was a GREAT restaurant.

After lunch, I was assigned to the pre-surgical unit. My patient had two gunshot wounds and his hallicus (big toe) on his left foot lost all movement. The working theory is that his sciatic nerve was injured either from the bullet (less likely based upon his history) or the due to the healing process (more likely based upon history). He was going to have an exploratory surgery at the end of last week, but I don't know what they found out. At least the interview was interesting.

The ride home was, as usual, rather tipsy turny--thank goodness that I had time to take my dramamine before we left Roseau for the 20 mile, 60 minute drive back to school. That was my probably last trip to Roseau ever. Speaking of things coming to an end, I've got to enjoy these Caribbean sunsets while I can because I have less than 30 days left in Dominica. But that also means I have less than 30 days of cold showers left too!!

They give me fever....

Being away in the Caribbean means that I don't get to enjoy Gonzaga Basketball as much as I would like to. I'm teased by the alumni emails stating that "alumni seats are still available" when I obviously can't attend any games. Also, being so far away I only get to see games that are on ESPN and they often come on t.v. very late here. Finally, being out of the U.S.A. you generally cannot watch t.v. over the Internet, so I can't even watch games over the Internet.

But it's March and my Zags are still dancing, which is something to celebrate. The feed of the NCAA tournament in the Caribbean is via the east coast; therefore, we didn't see much of the Zags in the first two rounds. They would just pop on over during half-time of some east coast game to the Zags game and obviously we got to see the end of the Gonzaga/Western Kentucky game. My heart was pounding, I was screaming, and jumping with excitement, my sympathetics went into overdrive---it was like reliving the best moments of undergrad!!

I'm not sure if they will be showing the UNC/Gonzaga game in Dominica on Friday night, but I'm scheduled to be studying clinical medicine skills in lab at 10pm on Friday night--the same time as tip-off is scheduled. I'm not 100% sure my Zags will beat UNC, but I'm hoping and praying because then I can brag to all of the UNC graduates at school. Besides, we haven't been to the elite eight since 1999. Go Zags!

The call of the wild....

I don't know what is is about the animals in Dominica, but I think they are working against me. On Wednesday night, I had another five or six inch lizard get into my apartment. The first little guy, came in via my broken screen (remember I don't have glass windows). I'm not sure how this gecko got into my house, but when I returned from the Introduction to Clinical Medicine Lab, he was waiting for me on my air conditioner.


I've been trying to write this story since last Wednesday, but I every time I think about it I get the heby-jebies. When I called my parents and told them about this gecko story, they thought it was one of thethe funniest thing they've ever heard so I knew I had to get over my heby-jebies and write this story. Be forewarned, this is a gecko story and I think geckos are gross, not cute like the Geico commercials.


As I previously told you, I returned home after a study session in the Introduction to Clinical Medicine Lab Wednesday evening. I popped down on my bed while I was talking to my parents and I got the eerie feeling that someone was watching me. I looked up above my head (on top of my air conditioner) and I saw a white gecko staring at me. I slowly stood up and directly exited my apartment. I pounded on Farley's door and he kindly came to get the "little guy out." When we returned to my apartment, Farley chuckled at me as I left the lights and television on when I exited stage left. Our little gecko decided to take a stroll around the room and was sitting above the door frame to the balcony. Farley propped open the door with a chair and grabbed the broom. He knocked down the gecko, who safely landed on the chair. Rather than leaving the room quietly, the gecko decided that when he left, he would ceremoniously be escorted out of the building. After landing on the chair, he flew into the air, hopped on the fan, then scurried into the middle of the room before finding refuge in my closet. As he was moving, I was screaming and running into the bathroom and standing on the edge of the shower (as to not be standing on the floor, which clearly wasn't much help as the gecko can obviously FLY). Farley looked at me like I was from another planet and reminded me that running and screaming in fear, does not help the situation. I wanted to know what was going on, so I kept the bathroom door open--obviously another mistake. Farley, slowly and carefully with the precision of a vascular surgeon, examined every shoe in my closet until the feisty gecko reemerged. Now, this Gecko did not move toward either of the open doors that lead to the outside; nope, he picked door number 3 and headed into the bathroom with me. Obviously, I ran out of the apartment screaming, jumped across the apartment (remember my studio is only 288 sq feet, so I'm not as athletic as I sound). I ended up on the bed, with my feet moving in a running motion (fast feet!) and I was continuing to scream! Again, Farley reminded me to calm down because I was obviously not helping the situation. I continued my fearful stance (on the corner of the bed) and I saw him usher out the offending gecko. I was so relieved and thankful as I closed the balcony door, but before I closed the door a huge gush of wind came though the apartment. Honestly, I had so much sympathetic activation that the cool breeze felt good--sympathetics are the 'fight or flight' mechanism. I turned to walk back into the room to thank Farley when he said, 'watch out!' At this point, I noticed one of my shower caps (see picture below if you don't know what a shower cap is). I didn't think much of it because I figured that the shower cap had just be caught in the breeze before we shut the doors: I was wrong.

Since I was hiding on my bed away from the action, I didn't realize that Farley had tried to gently move this feisty gecko by lifting him out of the apartment with my shower cap. In the shower cap, the gecko became very afraid and did what geckos do: dropped his tail. I'm not sure of the scientific term for this, but the gecko leaves his tail, which flops like a fish out of water while the gecko runs the other way. Well, the gecko dropped his tail then sprung out of the shower cap as if he was spring loaded. At this point, the shower cap became loose in Farley's hand and the breeze carried it across the room to me. When he warned me, I looked down and there on my floor was a gecko's tail, rapidly flopping. Obviously, I jumped over floor and the tail onto my post at the bed from where I continued my rapid foot movement, and make squealing noises every time I saw the tail flopping in the corner of my eye.

Poor Farley. Not only did he have to outsmart this feisty gecko, he had to calm me down. I've known for years that geckos can do this, but I never expected to have a tail fly across my room in a shower cap! Interestingly, there was no blood or gecko fluids on the tail and it continued to flop around for probably 120 seconds--it felt like 20 minutes, but I'm sure it was closer to 2 minutes. It was a crazy night. I was so worked up, even though intellectually I knew the gecko couldn't hurt me. I was so frightened of this little, feisty gecko.

The moral of the story is that geckos are NOT as cute as Geico makes you believe.

Hot Showers

When I was hopping in the shower this evening, I was reminded that in the U.S., generally, you can get a hot shower on demand. It is the little things that make a difference. It will be nice to have hot showers in just six weeks. There will also be grocery stores and glass on the windows, rather than just misquote netting. That will be so nice and I'm getting more and more excited aobut it. I think I'm closer to finding an apartment---it's too bad Miami is so expensive, but I guess when you are paying for medical school you are going into hundreds of thousands of dollars of debt anyway. Oh well!!

Miami it is...

I was hoping to be able to stay in Dominica for the transition semester, but I will be heading to Miami. Rumor has it that 100 people applied to stay in Dominica and they only let 50 stay with first priority to those who promise to stay for one or two of their clerkships, those who has a spouse attending Ross and is in the 1-4th and a magnitude of other things. However, the most important factor is if you willing to stay and do the clerkships here: neither Farley nor I were willing to commit to staying for two clerkships until we had more information about them. I think that is why we are going to Miami. Oh, well. It is kinda a bummer because we had a plan about the next few months, but it's okay. There will be hot showers in Miami, real grocery stores, and we won't have to fight with the cows when trying to walk to school.

We had a huge test covering endocrine, female and male reproduction, gastrointestinal (including esophagus, stomach, small and large intestine, appendix, gallbladder, liver and pancreas), and breasts in all of our subjects (Pathology, pharmacology, microbiology and introduction to clinical medicine). I'm happy to say that both Farley and I had our best exams of our medical school careers. It is a bit funny that this was both of our best exam, since it covered more information than any other exam--excluding a final or standardized exam. Exciting! I even beat my arch Nemesis pharmacology by earning an A!

Last night was the 4th semester banquet. It was nice to have our whole class (plus another 200-300 people who somehow came as "dates") at one dinner. However, it seems a bit premature to me as we have a million more test before we are finished with the semester on April 22nd. It was held at a gentleman's mansion on top of the Dominican hilltops. I wish I could have gotten more pictures of the view, but with the tents set up for the students, it wasn't really possible. Here are a couple pictures:

There has been a lot going on in the last couple weeks and we will be very busy for the next two months. I have to master the kidneys, which is easier said than done! I better get back to my studies.

A picture is worth a thousand words.

I'm sorry I didn't have my camera on my yesterday---I often carry it down here just in case something interesting or strange happens (which is often down here in the Caribbean). I guess I should start at the beginning.

We had a HUGE exam on Monday. Excluding our finals and standardized exams, this exam covered more information than any other exam I've ever taken. It was a battle, but happily, I think it went okay. I'm never 100% happy with my scores (one can always do better), but all and all I'm proud of my performance, especially in my arch nemesis: Pharmacology.

This semester, we have clinical medicine laboratory days on Tuesday and Thursday and luckily neither Farley or I were scheduled to be in the clinical medicine laboratory or working in the hospital on Tuesday. We had a great day off. There is a new coffee shop that opened a few blocks from campus so we strolled over there to have some ice coffee and read novels. That's right, we got to read for fun rather than school. Next we ran some errands and relaxed at home for a while. It was a hot day for March, even by Caribbean standards, so we decided to head to the pool for a while. Everything was fairly normal on this beautiful day--children were playing, adults were reading novels, listening to I-pods, and talking amongst themselves--then everything changed. Out of the corner of my eye, I noticed a cow walking around the fence surround the pool. I said to Farley, I sure hope "Betsy" doesn't decide to come in here. I didn't think she would actually be able to get into the pool area because I didn't think she could get through the gate (it is at an odd angle for a cow); however, I was wrong. She easily moo-ved right into the pool area and casually walked right up to the pool for a drink. I don't think she should be drinking the chlorinated water, but heck, I'm not going to argue with a very large cow with horns. Some dumb guy in the pool decided to swim over towards here, which did NOT make Betsy very happy. Now, I don't know about you, but if a large cow with horns (probably weighing over 1200 Lbs) was taking a drink of water, I wouldn't go get in her space. She wasn't too happy and he managed to move our of her way before she showed him who is boss. Next, she decided to go check out the area within the fence (there is a little bit of grass within the fenced area, and she decided to get a snack). This was the time that I said to Farley, we are leaving NOW. By the time we walked the 100 feet back to the apartment and climbed the three flights of stares, she was heading out of the fenced in pool area. I wish I could have taken a picture of her drinking out of the pool. She looked so peaceful and up close, bovine have the most beautiful eyes. However, I wouldn't take her picture that close up--what if the camera flashed and made her mad. I know that cows are rather docile creatures, but I'm sure as heck not going to make a huge animal with horns mad--I'm not that stupid!

Okay...

My blog is behaving badly. It appears that my posts are not showing and I'm not sure why. I first noticed it last night, but I thought it was because the Internet was flickering on and off (as was the power). I'll get to the bottom of this, sometime next week AFTER the exam.

The application for the transition semester came out this morning and we are filled out the applications as quickly as possible. Much to my original dismay, Farley and I have decided to apply to stay in Dominica. I hope that we will both be assigned in Dominica! I never thought I would want to stay here, in a third world country, any longer than necessary; but I think that this is the best thing possible for my career. If I get to stay here, I will be working directly under attending physicians and if those attending physicians like me, I might be allowed to practice some hands on skills that students in the States are not allowed to do until they are further into their medical education. One of the most important reasons to stay here is that we have to take a HUGE exam on Monday, May 18th: the National Board of Medical Examiners Comprehensive Exam over the basic science years of medical school. It is an extremely difficult exam and I'd prefer to spend my three weeks studying for the exam (which covers the first two years of medical school) rather than moving. I hope that we both get to stay!

Two short stories and a sunset

I'm no longer shocked by things I hear in Dominica. Today, within about five minutes, Farley and I heard two very strange things. First, a student who is starting classes in May came down to find an apartment and see the island. The strange part is that he wasn' t sure how to read his itinerary and thought he was leaving at 6:00am on the 5th when he was actually leaving 6th. I felt bad for him as he must have been overwhelmed with the culture shock of landing in the hot, hot Caribbean and then being in a poor third world country. Farley didn't have as much sympathy. Next, we tried to pay our rent; this the second time in three days I've been asked to come at another time. On Saturday, the worker said the credit card machine was down. Today the lady was more honest: she just didn't want to do it! She asked if we would come back tomorrow between 7:00am and 3:00pm because someone else could help us and then she added, but don't come after 3:00pm because I'll be working tomorrow at that time. I'm so glad Farley was with me and he talked her into taking our money so that the owner didn't kick us out of our apartments. Geeze, it shouldn't be that difficult to PAY someone, but I guess since she didn't own the place she didn't care if or when they got paid.

Here are some pictures from the beautiful sunset yesterday. I've got to get back to my studies as we have an exam on Monday. I think I'll be ready, but we have covered an amazing amount of information--if you want to say a little prayer for me, I'd appreciate it!

Above: Picture taken from my third floor balcony

Below: Picture taken from the end of my apartment's hall way on the third floor
The following pictures are taken from the end of my building facing the sea, at sea level:

The last one was taken about 10 minutes after the others and was again from the end of the hallway on the third story: