The ants come falling one by one...

The ants came falling one-by-one one this particular super-hot, sweat-mustache, chest condensation provoking afternoon in June, as one of my cohorts and I attempted to sit outside on a bench to begin preparing for the U.S. clinical skills board exam that we will be taking at the end of this summer/fall.  What would seem completely abnormal to many of you all was just a shrug off the shoulder to us.  My cohort and I were sitting outside on this bench, under the shade of the trees, yearning for any breeze that would cool us off from the afternoon heat and humidity of Cuba, practicing doing a history and physical exam on each other when we kept noticing ants crawling all over each of us.  The ants came falling one by one from the same tree that was providing us the shade.  Well, then these ants began biting us in the most personal areas that someone could be bitten in.  And these are not those nice, just minding my own business looking for my next source of sugar ants.  These were flesh biting ants that once you are bitten you become victim to an intermittent burning/stinging/itching pain that can linger for hours.  Yes, they are the tiniest little assholes.  But, the afternoon just kept getting better and better as we continued on practicing our physical exam under the watchful eyes of two Cuban men sanding the body of their door-less 1952 Dodge.  There was plenty of opportunity for us to be stared at since only one of them could work at a time, while the other one took turns watching what his buddy was doing and of course checking us out.  But, you know…they only had one piece of sand paper to share between the two of them, so it would make sense that one would do the work while the other one watched, and of course the one that would watch would become so fatigued that he would have to regain his strength by laying down and taking sips from the rum bottle.  So yeah…this is not your typical study environment, but this is our typical study environment.  So many stories to share that have become so mundane in my Cuban life.  Eventually, Evelyn and I just fell over from laughter in tears analyzing how “not normal” this is.  We should just automatically pass this board exam due to persevering in our studies during the most adverse daily living situations. 

Changing channels, time-warping from 1959 to August 2013: my journey continues after finishing a 4-week rotation in the hospital wards of Highland Hospital in Oakland, and now scrambling and pushing myself by studying for that clinical skills board exam that I will be taking before I head back to Cuba in the beginning of September.  Overall, I found my time on the Highland wards to be very challenging yet rewarding.   Although I felt some of the systematic challenges of using electronic medical records and more advanced technology, and of course just getting used to Highland during my first week on the wards, overall I found it refreshing to be able to do my job with more resources than I am used to in Cuba.  I felt that my Cuban education's strengths in emphasizing history and physical exam served me well on the wards at Highland.  And of course, being a fluent Spanish speaker (another reason to be grateful to my Cuban medical education) not only served my patients, but the team's patients as well.  I cared for patients with social determinants that I never have had to face while caring for patients in Cuba, like homelessness, drug addiction, HIV/AIDS, etc, patients coming to the ED, for example with shortness of breath, then being admitted and having to manage all of their preventable, chronic diseases in an in-patient setting.  It became so apparent to me how essential access to compassionate, comprehensive healthcare is.  It just does not make any sense to me that we cannot accomplish this here in the U.S. where we have such an abundance of resources.  My compassion for my patients and medicine motivated me to get through every challenge I faced during my time at Highland.  I came out of that experience of working 12 to 13 hour days more confident of my ability to function in a U.S clinical setting as a soon-to-be physician, fortunate to be able to start giving back to my under-served communities back here in the U.S. 

So, my summer “break” is coming to an end and I realize that it is that time again in which I am asking for suitcase love to send me back with on my journey to medical school in Cuba. Just think...it's my SECOND TO LAST TIME I will be sending out such request.  I cannot express enough gratitude for all of your love and support over these past 4 ½ years.  Here is the link to my amazon.com wish list if you are able to assist me in filling my suitcase: http://amzn.com/w/1FRMSH7O5SV3I. Much love!