A house call in Panama: medicine without the bells and whistles

[Rochelle Chijioke, MD, is a 3rd year emergency medicine resident at the University of North Carolina.  Earlier this year she did a 3-week international elective rotation in Boquete, Panama with a Spanish immersion program called Habla Ya, which teaches both basic Spanish and medical Spanish.]

While working at UNC Hospitals, I have found that I encounter at least one or two Spanish-speaking patients per shift.  To gain a better understanding of Latin American culture and their health care system, to elected to do a three-week rotation in Panama. I also hoped that better language skills and cultural knowledge would help me develop a better rapport with my Spanish-speaking patients in the future.

Rochelle "Chi Chi" Chijoke, MD, is a third-year resident in emergency medicine at UNC. She did a 3-week rotation in Panama

I learned very quickly in Panama that it’s better to sleep with the lights on (giant cockroaches). One day, more than a week into my rotation, I woke up early and got to school early for my clinical experience. I had been trying for days to get navigate the bureaucracy and get started on a clinical assignment, and this day was looking like more of the same, with no real progress made.

But as my teacher and I waited in a clinic to see if we could get permission for me to volunteer there, a lady walked in and asked me to go with her to see a sick elderly woman to determine if she needed to go to the hospital. The lady asking for my help owns a clinic with her physician husband, but he was out of town.

So my teacher and I followed her—a complete stranger—to the sick woman’s house. When I entered the room, I saw a poor, emaciated woman who definitely did not look healthy.  According to the family, she had stopping eating, had a fever, and complained of difficulty breathing.  After examining her, I determined that she likely had pneumonia.  Her vitals signs were stable but I recommended transfer to a hospital because she was unlikely to get better on her own.

Chi Chi volunteered at the Clinica Especializada Boquete in Panama

Finally I felt that my skills were being put to use! And it felt good. Something about being able to diagnose and care for a patient without all relying on all the blood work, nursing staff, and medical imaging that are readily available in the UNC ED was really refreshing. It made me realize how much I truly enjoy medicine.

My little house call paid off in more ways than one. As a result of helping the woman, I arranged to work with her husband, Dr. Chen, in his internal medicine clinic, Clinica Especializada Boquete.

Having finally secured a clinical assignment, attended classes, and having dinner with my “guardian angels,” two women who helped me when I first arrived in Panama, I got home that night and was totally exhausted.  I know I slept well, because I was too tired even to care about cockroaches!

- Rochelle (“Chi Chi”)

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One Response to A house call in Panama: medicine without the bells and whistles

  1. Pingback: At a clinic in Panama, a resident’s eyes are opened | GH Notes | Institute for Global Health & Infectious Diseases

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