She said yes!

Dr. Linnea said yes!! Well, kind of. There are a few stipulations. She said that they do not need volunteers, and also that I must have my medical degree before I can come down. So, this means that first, I have to graduate from medical school. Second, I have to learn Spanish because none of her patients or staff speak any English at all so I would really be very unhelpful without that knowledge. I can either come before or during my residency. Still though, that is five years from now andLinnea is already only in Peru 6 months out of the year now. The other 6 months she works in the ER in Wisconsin, which is also where Jerry (her lover) is. So, I am not sure if she will even be around by the time I could come. She also mentioned that she does not have anyone to take over the clinic when she leaves and although she is said, she said that over 50,000 patients have received care and that makes her life worthwhile. She does not know what the future holds, she has no idea of the “end.” Dr. Linnea is a true example of what it means to live in the moment. While we were at Explorama, we hiked over to the rum factory again and saw how they press the sugarcane and ferment it before flavoring it. They also make molasses. They have four different flavors of rum: plain, ginger, 7 raices (seven roots), and one that is sweetened with the molasses. On our walk back to the lodge, we watched as the water buffalo waded into the lily pad pond. It was really cute. We took a few hikes, one on the Bushmaster trail and the other on the lake trail. The Bushmaster is the deadliest snake here in the Amazon, and the trail was named so because they came across so many while creating the trail. Don’t worry, we didn’t actually see any! Last time, the lake trail was flooded and we had to take our shoes off to walk across; at one point we had to swim because the water was so deep. This time, there were a few muddy spots but definitely much drier and than last time! We saw poison dart frogs, red and blue, and monkeys running through the tree tops. We took two night boat rides, one was through a narrow tributary, where we saw sleeping butterflies, frogs and hummingbirds. The other was out into the open water of the Amazon. It was beautiful under the moonlight. This morning, it was raining so hard that we couldn’t even hear the alarm go off. We eventually woke up, got packed and headed to the last lodge, Ceiba Tops, which is like an Amazonia resort. It has a swimming pool, air conditioning and indoor plumbing. Because of the rain, we have the morning free and then this afternoon we will be going to Monkey Island, to play with all of the animal refugees!

More days in Amazonia

I should also add that when we were at ACTS, we ventured out into the jungle at night, to see the bioluminescent leaves. We hiked along with flashlights and glowsticks until we reached the tree. This particular tree has very small leaves, about the size of your thumb. We turned off all our lights and could see the leaves glowing on the forest floor. Even more interesting is the fact that the leaves do not glow while they are still connect to the tree, and further, other trees of the same species in different locations do not display this bioluminescence. We talked about different types of experiments we could do to determine what was the cause of this, and then had a lecture by professora on metagenomics. After ACTS, we went back to Explornapo, which was the first lodge we stayed at. Yesterday, we visited a local village, which was different than the village we went to in 2012. We all took turns squeezing sugarcane into juice, and then we chewed on pure sugarcane itself. Delish! We walked through the village and Bascilio explained a lot about daily life here. He said that everybody is farmers, and they plant their crops, mostly rice and yucca, when the water is low around June. The water level changes by about 25 feet minimum each year, and when the water is low, the soil is very rich. Noone owns the land, but everybody knows everybody so they al share id divide it up equally. Otherwise, the go fishing to catch food for the day, and if they get some extra, they will salt it and lay it out to dry in the sun so that it will keep for another day or two. The government recently has been providing families with solar panels, so that they can have some light in the evening. Kerosene lamps were outlawed because druglords were using the kerosene to make drugs. Now, oil lamps are used but they do not provide nearly as much life. Bascilio told us that at the center of every village is either the school, the soccer field, or both. Sometimes, villages will have soccer games against eachother, and this is a big social event. He said as far as going on dates, you might take a canoe on the river, or take a walk, or just sit along the river bank. We met a lot of the kids in the village, and they all gathered together to sing us Peru’s national anthem, It was so cute. Hannah and Carla brought candy for us to give to them, and someone else (Shawn maybe) brought stickers to hand out. They were all sucking on lollipops with stickers covering their beautiful brown skin. I played in the soccer game, which had two giant puddle in the middle of the field and, of course, we lost. It was so hot and I got quite burned by the tropical sun. That afternoon, we had some free time. I went for a canoe ride with Susan (a student on the trip) and Segundo, who works for Explorama. We paddled against the current and up a small, peaceful tributary, until the skies turned dark and the wind began to blow. We quickly turned around and got back to the lodge just in time for it to start raining. Then, I went on a hike to the canopy with a few other people to pick up Shawn’s time lapse camera, which was on the highest platform, and looked like something had chewed away at the strings holding it. A few more hours, or another night, and that camera definitely would have fallen. The footage was awesome, we got to see the sunset, a rainstorm and then the angle shifted, I guess because of whatever tried to eat it, so then we could see the bridge in the frame too. After we watched that, I gave my lecture on pygmy marmosets, which are the smallest monkeys in the world, and native to western Amazonia. I chose them because when I interviewed at Maryland for medical school, one of my interviewers had actually been to Peru to study social behavior of pygmy marmosets. They are cool, not only because they are so small (they weight about a quarter pound – think about that next time you eat a cheeseburger!) but also because they are matriarchal and polyandrous. They also give birth to fraternal twins about 70% of the time! This morning, we packed our bags and decorated ourselves with huito (pronounced like “we-toe”) before heading to Explorama lodge, which is somewhat bigger and “nicer.” Akash, one of the students, let me paint all over his face, ears and neck with huito, which is a natural blue plant dye that stains your skin. If you have ever heard of the huitoto (sp?) tribe in Brazil that covers their body in this blue dye, it is made from the same plant. I dyed my hand, and got a big extravagant sun on my right thigh/hamstring, that left a print on my left thigh when I crossed my legs (whoops). Carla rubbed it all over both of her legs, since doing her hands might freak out her patients when she gets back. Huito is funny because it starts clear and does not turn to dark blue until a few hours later. Sometimes, the locals play a joke on the tourists and tell them that it is good for mosquito repellent. So the tourists rub it all over their bodies and faces.. hahahah Before getting to Explorama, we stopped at the Yanamono Clinic, where Dr. Linnea works. I recently found out that she wrote a book, “La Doctora,” which Deena, another student on the trip, just so happened to have brought after years of it sitting in her house. I read part of it but don’t think I will have time for it all, so I will check to see if it is in the library when I get home. Dr. Linnea will be joining us for lunch today, so I hope that I will be able to talk to her about me possibly doing a rotation down here while I am in medical school!

The first few days in the Amazon

So much to catch up on… We have spent the past few days hiking and learning so much about the plants. Rodolpho is a dictionary of plants; he can identify every plant, even if you show him just the leaf, or the fruit, or a branch, He also knows all the uses of them, which ones are not medicinal and which ones are toxic. He is also very funny and has the most contagious laugh. At the end of one of our hikes, we came to a starfruit tree. Starfruit is my most favorite fruit in the world (unless you count tomatoes…) and so one of our guides took a very long stick to poke the fresh fruit and Rodolpho was supposed to catch it, but then he got scared and just covered his face so the fruit fell on the ground. Then he was trying to pick some limes from a lime tree but they were just out of reach and he had to jump. On both occasions, we were all laughing hysterically. Then we were all walking into the dining area, with Rodolopho in front, and our guide waiting at the end, stating “ladies first.” Rodolpho, having heard this, quickly jumped off to the side of the step to let us pass. I laughed at him again. We did the canopy walkway a total of three times, and each time, I noticed more plants that I didn’t see the day before. We also have Ruth and Shawna, who know a lot about botany and have been explaining so much to all of us along the way. It is really cool to have them here with us too. Last night, we stayed at the most rustic of the four lodges, ACTS (Amazon Conservatory for Tropical Studies). It is the smallest lodge, but still comfortable, no wifi and deepest into the jungle. It rained just as we were going to bed, and continued on as a steady, comforting continuity of beats as we slid into the sweet serenity of sleep. Professora brought some recording equipment on this trip, and I have realized even more than the last time, how beautiful the sounds are here. At the least, you can ere the buzz of the mosquitos, similar to the summer months at home. Then, if you listen more closely, you can hear so much more than that – frogs and birds, the water lapping against the banks. I love it. I should back up, and talk a little more about the canopy. The canopy is the top layer of the jungle, where most of the leaves are on the trees. There is a set of 14 platforms, each approximately 100 ft (the hishest is 117 ft) attached by make-shift bridges that are like horizontal ladders hanging by ropes from the trees with boards on top. It is an absolutely gorgeous site to look out over the jungle with a birds eye view. Shawna set up a time-lapse camera today that takes a photo every minute and we are so excited to see hoe that turns out! We did a mock ayahuasca ceremony today, where Julio blew tobacco smoke over us and snag in his native Shapibo languge. It was entrancing, and I wish that I could record his voice. Ayahuasca is known as the “vine of the soul;” it is the mother of all medicinal plants, and especially respected. Shamans will go into the jungle for months at a time when they are young, drink the ayahuasca and that is how they learn the traditional medicine. It is not allowed to do ayahuasca here at the camp, but many of the shaman still drink the ayahuasca in their homes. Then, we used natural plants to dye t-shirts! I put some random patterns on mine, and on the back, I wrote a saying that I saw in the graffiti of Iquitos: “vive sin miedo.” That means “live without fear.” Tonight, we just had dinner (delicious and fresh, as always) and Bascilio and the gang are playing music and singing for us. The group just got up to dance, so ciao for now!

Iquitos and the first night in the Amazon

I tried to post this last night but have been unable to connect to the internet. Tonight, it took me 40 minutes of patience for the page to upload, so hopefully this works! Yesterday, we flew into Iquitos. It was a lovely, warm summer rain when we landed. We made our way to thte hostal to drop off our bags and then walked around the town a little bit. Came back for a quick meeting. Iquitos is celebrating its 150th anniversary, so there was a lot going on in town last night! We saw a lot of performers, including a drummer/ snake dancer combo, comedic dancers, one of which was a man dressed like a woman and dancing around in high heels, and a set of young boys who were breakdancers. The most impressive thing about them was that they did everything barefoot on the stone. Ouch! While we were watching, I ended up talking (or trying to with my very awful Spanish) to a young girl named Jennifer. She was 15 and with a friend and two younger children, who I later found out were her brother and sister. She explained to us this game that they had set up, you take .10 sole pieces (analogous to a dime) and throw them onto the board, which is composed of many rectangles, weach of which has a number on it. If you get the piece in the box without touching any of the border, then you win that much money back. I did not win at all. Then we walked down the street where they had stages set up with a live band. Everyone else just stood and watched the band, but we started dancing and we danced for hours! Throughout the time, other people would come dance with us for a little bit. I danced with a lot of young kids, who I’d guess at aboutu 4 years old. They all gave me hugs afterwards and I was so happy. I later found out that Jennifer’s mother had passed away, leaving her as a maternal figure for her younger siblings. I could tell she took care of them with such grace and I wanted to be able to tell her that, and to be somewhat of a big sister to her, if she ever needed it. Again, my Spanish was inadequate and all I could say was that she is beautiful. I hope she understood what I meant by that. Being able to speak so little with these kids but feeling so much by their short presence in my life reminds me of the humanity in us all, that regardless of who or where we are, we have the capacity to love and to be loved. This morning, we went to the market where I bought eight starfruit for one sole, which is approximately 30 cents! Starfruit is my favorite fruit down here, so I wanted to stock up ☺ then, we went to IMET, which is part of Peru’s public health system. They are currently performing studies on various medicinal plants, in order to scientifically prove there beneficial physiological activities. Two major plants that show promise are Sangre de grato (dragon’s blood) and uña de gato (cat’s claw). He told us that in general, it is very difficult to keep the plants that they are testing the same, because the properties may change with the age of the plant, the parts used, and the altitude at which it grows. There is also difficulty in distinguishing one species from another, or if they are even different species at all. I really hope that they can draw some nice conclusions from their experiments and earn some respect for complementary medicine from the scientific community. After that, we ate lunch (rice wrapped in a banana leaf and some other snacks) and then finally, took the 2 ½ hour boat ride into the heart of the Amazon. We settled into our rooms and walked around the ReNu PeRu Ethnobotanical garden that professor helped establish. On our trip is a man named Rodolfo Vaquez, who is one of the greatest botanists in all of peru. Professora said that she has been trying to get him to come for years, and this time her finally said yes. She is learning a lot more about the plants from him and she is really excited about him being here. The Amazon is still as beautiful as I remember it, although the water is about 20 feet more shallow than last time. The soccer field at the base of the lodge is actually visible now. Last time, it was completely under water. The sounds are still magnificent, a beautiful chorus of birds, frogs and bugs. I am so content, swaying gently in a hammock and enjoying the warmth of my favorite place.

Back to Peru - the first day, in Lima

It has already been a pretty wild adventure and I am so glad to be here with two wild women – Carla, one of the ER docs and Deepa, who also works as a scribe in the ER. We woke up around 4:30 am Friday morning. After a long “de-icing the plane” session in Baltimore, a “too heavy” plane in Texas, and a lost taxi driver who left us parked in the middle of a dark Lima intersection to ask some shady street kids for directions, we finally made it in to our hostel around 3:30 am on Saturday morning.   Needless to say, we were exhausted and went straight to sleep.

We woke up this morning and after stumbling through directions from our hostel owner who speaks only Spanish and the native Quecha, we boarded a somewhat sweaty bus in search for pachacamac, a set of pyramids that the Incas used for religious purposes. I should mention that of the three of us, I somehow got appointed as the translator, although I really only know about seven Spanish words, Deepa knows about six and Carla knows that ‘jambo” means ham. The buses are crazy though, painted on the outside, with a man who hangs out the door until the vehicle screeches to a stop by the curb. People then jump in and out of the bus very quickly, because right as the bus stops to open its doors, it takes off again down the road, weaving in and out of traffic. After about 30 minutes or more, we transferred to a second bus but that was the wrong one (apparently) so we quick jumped off and a security guard (I think that’s what he was) told us which bus to take. So we got on there and eventually were dropped in what looked like a desert, until we turned around and saw the ruins. We walked through the museum and then walked around the pyramids, eventually all the way up to the Temple of the Sun.

Carla really liked the street potatoes that she bought.

Next, we wanted to go to Miraflores, a pretty major touristy area near Lima. So then we followed a stranger on a different type of bus that was going in our same general direction and he, like everyone else, did not speak any English. Given our lack of Spanish we played charades until eventually could communicate, and he had someone else on the bus help us transfer to the next bus, which we took to Miraflores and met the first English-speaking person of the entire day, who gave us directions to the mall and then to the cliffwalk. We walked along and you could tell that this was a much higher end of the neighborhood; there were more, clean parks and much fewer street vendors. We walked along, and then eventually ended up at the market next to the Inca Market and did all of our souvenir shopping. It was kind of weird to souvenir shop on the first day but I figured we wouldn’t have much other opportunity later on. I bought some presents for my sisters, and one for Chris (surprise! There’s your shout out) and a beautiful alpaca blanket for myself:) I can’t wait to cuddle up in it tonight!

Tomorrow, we fly to Iquitos! There are no roads into or out of Iquitos; you can only get there by air or by river.  It is on the edge of the jungle and from there we will be headed into the rainforest.

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The Maternity Clinic and The End

Me and Dr. Marquez in the Maternity
Hospital

This week I worked in the maternity hospital and totally loved it!  Colleen and I were both there together and we got to see 4 C-sections, 4 Dand C’s and I’m not sure how many natural deliveries!!!  I’m so glad I didn’t pass out because I have been wanting to be an OB/GYN for a while now, and was secretly worried that when I saw one I would change my mind.  My favorite was the natural deliveries; childbirth is really just such a fascinating thing.  I was surprised by the way the baby looks when it comes out.  I had heard that it was a purplish blue color but I was expecting it to have rubberyish skin.  And I didn’t even think about the umbilical cord, ehich is blue and then the placenta has to deliver after the baby comes out.  I can’t believe there are people who actually eat those things.  I’d never want it anywhere near my mouth.  The C-sections were also really cool because each one was different.  Like, one of them cut vertically, from the bellybutton down but the other three went horizontally the way I was expecting.  The C-sections in a way remind me of Mary Poppins, the way she reaches deep into her bag and pulls out something wild like a coat rack.  The doctors do the same thing, reaching down into the women’s abdomen and pulling out her baby that’s all slick and there is blood and liquid squirting out in random directions.  It was really an amazing week to be able to see all of that, totally uncensored.

I can’t believe that my month here is over already…  I have had such a great time and really do hope that I will get a chance to come back and visit.  I am said to be leaving but I am really looking forward to eating cheese – the one thing that I miss from the States!  This is going to be a big semester for me; I am starting a new job at Upper Chesapeake and working on my own project in the lab (not sure it will work but hey, you never know until you try!).  I will also be taking the MCAT within the next few months and applying to medical schools in June.

On the hike to our last waterfall in Banos:
"The greatest gift you can give to others is the example of
your own life."

Living in Quito for a month was truly an enriching experience.  It was a step outside of my comfort zone, because I was afraid of both cities and public transportation, which I had to take everyday to get to my clinical sites.  I also didn’t know the language when I came here, which just made everything scarier.  But I did it, and I am proud to say that my comfort zone has expanded.  Even though I had my money stolen and my bag slashed and I still often don’t understand people, I feel so much more competent in my abilities to travel and to not only survive in a new environment but to thrive in it.  I wish that I had more time to spend here, so that I could continue to learn and to grow in this way, but it is time to get back to my obligations and responsibilities in the States.  I am so happy to have had this experience and I am only more determined to pursue a career in international medicine.  Every time I do something new, I am pleasantly surprised at my capabilities to succeed and to develop as an individual.  I really hope that every person chooses everyday to learn something new or to take a chance, whether in big ways like travelling to a new country, or in small ways, by taking a new route or talking to a stranger.  You just never know what life has in store for you!

The Last Weekend

Me and Mamajuanita

This weekend was super busy!  On Friday, instead of going to the clinic, I went to Otavalo to the Huamba Juasi clinic, which performs traditional medicine.  We watched two shamans, who were both female and very different from the shamans I met in Peru.  Their rituals were very interesting.  The first thing we watched was a woman who couldn’t straighten her ring finger, we thought maybe because of a snapped tendon or something.  So the shaman massaged it back into place, pretty normal.  Then we sat in on the other shaman, who was being visted by a toddler, probably about 8 – 12 months old.  The girls who brought him were young, I’d say the one who was his mom was maybe 16.  They also brought two eggs,  one of which the shaman threw out.  Then she took the second egg and began to rub it all over the little boy, who was laying on the table.  She rubbed his belly, his legs, his head and his back for maybe 10 minutes.  Then she took olive oil and sprinkled it all over him.  She also had a handful of stones, which she doused in olive oil as well and then rubbed those on the boy too.  I think the purpose of this procedure is to rid the boy of his sickness or evil spirits, by transferring them to the egg.  It was difficult for us to understand because they were speaking quinche, which is the language of the indigenous people.

Rubbing the guinea  pig on the patient.

But the most interesting procedure of all was the use of a guinea pig as a diagnostic technique.  We saw two patients who had this performed, each complaining of pain in a different p lace.  The first lady was 56 years old and was having pain in her lower abdomen/uterus.  She came with who I assume to be her daughters and granddaughter.  Both ladies were older and had their granddaughters with them to sign the papers, I assume because they are illiterate. 

Anyways, the patient brings their own live guinea pig, which can e  purchased from a shop just down the street.  They give it to the shaman, who hold it by the neck and then rubs it all over the patient’s skin (they have taken most of their clothes off).  And I am telling you, this was a very vigorous rub that mainly concentrated on the certain area of pain.  So the first lady had the live guinea pig rubbed all over her lower abdomen, her legs, her butt but also on her chest and neck and back.  Sometimes, the shaman also grabs the guinea pig by the legs and moves it in circles, like when you twist a towel, still while rubbing it on the woman’s bare skin.  During this process, which takes 15 – 20 minutes, the guinea pig dies.  At this point, the shaman grabs a knife and cuts into its chest, pulling off its coat in the same way you would take off a jacket.  Then she cut the next layer of skin, so that all of the intestines fall out.  She examines the rest of the guinea pig corpse because they believe that whatever ailments are present in the guinea pig represent the condition that the patient has.  Then she treats the patient, seemingly by massage and then tying a white sheet very tightly around their abdomen.  Very interesting.

In case you were wondering what the inside of a guinea pig
looks like...

Cutting the guinea pig open.

On Saturday, I travelled by myself to the Bella Vista Cloud Forest, which was very beautiful.  I was worried about getting there by myself, because I had to take two buses (one of which was the same that I got robbed on) and then a taxi-truck up the mountain.  But I got lucky and ended up running into other tourists who were going the same route.  The cloud forest really is like being in a cloud, it is cool and misty and all of the plants are wet.  The sky is white, and when looking into the distance, all you can see is white, too.  The people there gave me rubber boots, a poncho and a map, and gave me directions on which trails to hike during my time there.  After I finished hiking, I ate lunch in their café, and grabbed a ride back to Quito with a few older couples.

Today, we went  on an awesome 45 km (27 mi) bikeride through the mountains.  When we started at the top of the mountain, it was super super cold and almost rainy.  I definitely did not bring enough layers!  Also, we rode on quite bumpy roads, some of which were dirt and others were paved.  Our first big stop was at the hot springs.  We went in the pools and in the river (which was NOT warm), but the pools were really nice and there were a lot of people there.  After, we had lunch in the mountains by a lake, which was really beautiful.  Then we continued our trek down the mountain, and later drove to an old train track, which now serves as a bike/ jogging trail.  The views of the mountains and the canyons and the rivers were very beautiful but also hard to look at for too long because of how bumpy the road was!

This week I am working in the maternity hospital, so this should be a really great week to see if my life plans will still be my life plans!