The ECHO Meeting.They pulled up the images of a patient with a mahooooosive post-MI right ventricular anuerysm with a laminar thrombus. She needs to get corrective surgery before her heart literally bursts. Or collapses from a stroke when that thrombus shoots up into her brain.
The Cardiology Patients. The consultant had a private patient admitted for shortness of breath. On examination, he had splinter haemorrhages on his nails, a ventricular heave, and tricuspid regurgitation (pan-systolic murmur loudest in the tricuspid region - and I identified it!). Later on, we were notified that the patient had deteriorated and had become dyspnoeic and anuric with an ABG lactate of 6. I watched as the consultant immediately ran off to make sure his rich little private patient didn't crash and die on him.
The Catheter Lab. Angiograms, where contrast is injected into the chambers of the heart and its own blood supply. Isn't it weird to think that the heart needs to pump blood to itself too? I watched as the coronary arteries filled to outline the shape of the heart, while the ventricle pumped out blood in real time. Then the insertion of a dual-chamber pacemaker. When checking for stabilisation, the doctors asked the patient on the operating table to cough. Turns out the patient was fully conscious despite having electric wires were being twisted into his heart muscle.
The science of the heart is remarkably straightforward - a muscular pump that pushes blood throughout your body. We take it for granted that it functions perfectly, but we forget that with each heartbeat, things could go terribly wrong.
Before I left for elective, I told my friends I was going to have a defining moment, a tremendous epiphany that would change my life forever. I also told them that whatever it was (a jungle creature, the wise words of a shaman), I was going to immortalise it with a tattoo.
Except nothing happened. I don't have anything symbolic to get inked as a reminder of my 4th year elective. There was no moment where I witnessed the chains of poverty, or the gravity of life. And maybe that's a good thing because now I don't have some cliche tattoo of a jaguar prowling across my back.
But that's not to say I haven't changed. I feel and act the same, but something's different. It's just been such a slight and gradual adjustment that I've hardly noticed it. The only way I can identify it is by doing a before and after, comparing the beginning of the trip to the present, waiting for the last leg of my flights home.
Before, my favorite words were cool, dude, and awesome.
After, my favorite words are que linda, claro, y buena onda.
Before, I flushed with a clear conscious.
After, I think before I flush, just in case the sewage system can't handle it.
Before, I was listening to the Twelves, Munchi, and Afrojack.
After, I'm listening to reggaeton, electronic tango and a crazy jungle song which loosely translates into I Won't Be Your Handkerchief Anymore.
Before, my Spanish sucked.
After, my cab ride to the airport was about the upcoming elections, lack of democracy, and failings of the Argentinean health system.
Before, I refused to eat an empanada because it looks like a curry puff.
After, it's no Old Chang Kee, but a freshly baked empanada de lomo picante is pretty damn delicious (Daddy, I'm talking to you).
Before, I hated dancing with a guy.
After, doesn't matter if he's got a pot belly, grey hair, and smells of stale cigarettes - if he marks with clarity and is a creative dancer, I'm going to tango with him all night.
Before, I was excited for a South American romance.
After, the women are a million times better than the men <3
Before, I could tell the difference between a Peruvian and an Argentinean.
After, I can't tell the difference between a Peruvian, Argentinean, Spaniard, Portuguese, German, Mexican, Haitian, or Indonesian.
Before, I wasn't sure if I'd like South America.
After, in some parts of Peru I felt like I was back in South East Asia, and I felt more at home with Argentineans than I have with any other culture.
Before, I thought if you gave a villager anti-parasites, they would be grateful.
After, I know some will lie about their symptoms to get more pills and free soap.
Before, I supported NGOs and Western aid.
After, I realise that without an intimate understanding of the local socioeconomic climate, it's a waste of time, effort and resources.
Before, I thought medicine could save the world.
After, I think clinical medicine on its own hardly changes anything.
So even if I haven't had that defining moment or come back a changed person, these past 10 weeks have been unreal. I know for a fact that never again in my life will I ever have a chance to explore the Amazon like I did in Peru (thank you Amazon Promise). And that I'm going straight back to Argentina the moment I have a chance to because I simply haven't had enough.
Thanks to everyone for following me on my elective. For those of you who care to continue, my next trip is MBBS 5, the last year of medical school. It promises to be complete with the fascinating drama of job application stress, placements in the the middle of nowhere England, and finding ways to make this final year of university (read: freedom) absolutely unforgettable.
But for now - suerte mis amigos, chau sudamerica, and for your listening pleasure... "Ya No Sere Mas Tu Pañuelito"!
