culture shock

I don't know if I've mentioned culture shock before, but I've definitely been experiencing it over the past few months.  I've come to realize that most of my culture shock actually stems from work, and learning to understand and accept the way things are done over here.  Well, "accept" is a loose term in this context.

Medicine, I think, by nature, can be a culture of its own.  And so why can't you have medical culture shock?  Let's see, I've been through the honeymoon phase (wow, so this is what a hospital looks like!) and the negotiation or withdrawal phase (I can't believe this is how so-and-so is being treated for such-and-such disease) so far.  Now, I'm beginning to understand a little about the logic behind doing certain things (such as giving antibiotics without checking a urine or blood culture)...so maybe this means I'm moving into the adjustment phase.

Or not.  During my weekly home visit to a local foster home today, one of the kiddos looked like he was in respiratory distress (breathing fast, retractions, grunting, flaring - all bad signs).  I watched him for an hour and a half, and decided he needed to go to the hospital to be admitted.  Remember my last post about hospital costs?  Well, the ER doctor who saw my patient decided that it was necessary to admit the child to the ICU because the respiratory distress was so severe.  However, his foster mom said that she could not afford the ICU rate and could only afford a general admission bed...so that is where he's staying for the night.  I'm keeping him in my thoughts tonight.  The family had to sign something before being admitted to the general floor - I think it was an acknowledgement that the hospital had recommended ICU care but the family had refused.  Kind of like an AMA (against medical advice) agreement, but the patient still remains to be treated.  I'm shocked.  I'm shocked that such decisions (in fact, nearly all medical decisions) are determined by money.  Never in my training have I seen a child refused medical care because of lack of money.  Especially when they show up at the doors of your emergency room.  In obvious need of medical intervention.  But this is the way things are over here...and it frustrates, angers, and disappoints me.  So I guess I'm still in the negotiation phase.

...and more postings

A game of ball

We had a one-day work retreat last month and we spent it at an outdoors restaurant about an hour outside of the city.  The morning was spent playing baseball and the afternoon was spent doing team-building activities.  For many of our staff, this was their first time to play baseball.  For some of them, it was their first time to even hear about baseball...but they all played and we all had fun!  We even discovered some with a natural talent for the game!

Friday meetings

We have a lunch meeting every Friday where we can share, read, and learn together.  The meetings have been held at my place for the past couple of months.  All medical and non-medical staff are encouraged to attend and lunch is provided.  For me, it's a great time to get to know others better, especially the non-medical staff.  My favorite time of the meeting is actually in the beginning because not everyone has shown up yet, and it's a great opportunity to have some good conversations.

The front door to my apartment...and I think this is only with 1/2 of our staff!

Getting in shape

Almost every night, multitudes of people will gather outside and do some type of group exercise activity.  This night, I think they were doing some kind of line dancing.  I've also seen ballroom dancing and tai chi.  People will meet throughout the city and in the neighborhoods - this was taken just down the street from my apartment.

a beautiful day

Today was an absolutely gorgeous day.  The sun was out, the sky was blue and clear, the high was 80F, and there was a perfect breeze, not too windy but frequent enough to keep you comfortable while out in the sun.  The weather reminded me of my college days in Austin, TX when the spring moved into summer, sitting outside of Mozart's studying and chatting, then hopping over to Hula Hut for a tubular taco, and ending with some scrumptious fried ice cream.  Aah, the memories.

Well, I think this has been the most beautiful day I've experienced since living here.  I couldn't help but smile while being out and about today.  It was truly one of those days that lifted my spirit.  May you experience one of these days this summer!