[Rochelle Chijioke, MD is a 3^rd year emergency medicine resident at the University of North Carolina.  Earlier this year she did a 3-week international elective rotation in Boquete, Panama to study basic Spanish and medical Spanish and volunteer in a clinic.  Her previous post is here.]

Chi Chi with Dr. and Mrs. Chen, who run the Clinica Especializada Bouquete in Panama

Volunteering at the Clinica Especializada Bouquete in Panama was really interesting. I saw a wide variety of patients, everything from a routine Pap smear and a man whose ear was full of wax to a child with chest and back pain, a pretty severe paronychia of the big toe with accompanying cellulitis, and a woman with what was likely a partially torn biceps brachii muscle.

On some level, practicing medicine in Panama is just like practicing medicine in the United States. One thing that’s definitely different, however, is the sanitation. Some of the things I saw made me cringe a little (I used A LOT of hand sanitizer).

I enjoyed talking with the patients and other clinicians and hearing their stories (my Spanish is definitely improving). The doctor I shadowed told me that he has 35 years of experience as a general medicine doctor and makes about $3,500 to $4,000 a month, which is pretty much a resident’s salary in the United States.  He also told me that doctors who finished residency and are just starting out make about $850 to $1300 a month. To me this is unbelievable! A dollar does go a long way here, but still, this was an eye-opening experience for me.

I did have the chance to go back to the home of the elderly woman with pneumonia that I saw a few days earlier. She appeared to be doing better than when I first saw her. Even though I recommended that she go to the hospital, the family refused, so she was receiving IV fluids and IV antibiotics at home.

On my last day in the clinic with Dr. Chen, we had a gentleman come in with a history of severe depression who was having thoughts of suicide.  Dr. Chen was busy seeing other patients, so he had me talk to the patient.  It was clear that this man needed psychiatric help, but he couldn’t afford to go the psychiatric hospital in David. Dr. Chen gave the patient some sample antidepressant medication, made him promise not to commit suicide, and asked him to return the next day for a follow-up and more meds. This was a tough case and also a reminder that depression is not just a first-world problem.

At the end of my 3-week rotation I was amazed at how good my Spanish had gotten.  I was able to travel, ask questions, and feel comfortable interacting with patients. It was a wonderful learning experience, and I’m really grateful for the opportunity.

- Chi Chi