Sunday, January 29, 2012

Poptun Clinic

Every morning, Dr. Fred, Trisha, Dan, Lucinda, Dee, Kevin, myself (and possibly a translator from the Finca Ixobel where we stayed) would travel in two really old cars, that were functioning as taxis to go to the clinic on the outskirts of Poptun.
I'm not sure what I expected the dental work would be like in Guatemala. I know that what it was wasn't what I expected though. I guess because the trip had been a long standing trip (having happened every year for the last six years), I thought it would be better organized. Turns out I'm a little OCD and like things to be planned out. Mostly I don't like feeling like I don't know what I'm doing. I hate feeling out of sorts. So getting to Poptun and discovering that no one knew we were coming (Hospital and patients alike) was kind of disheartening. 
But we went Monday morning - talked with the director of the Hospital and asked if we could use one of their rooms and thanked him for his hospitality and we set up. Monday was a slow day, since no one knew we were coming. They have a dentist in Poptun that comes and works every morning in the Hospital in a room. We used that room. It had two chairs. We had a portable hand piece unit so we could do fillings that we hooked up to one of the chairs. We organized as best we could.
We used bottled water for the hand pieces and to give patients to take any ibuprofen we prescribed.

Lucinda's husband, Dan, had zero dental background, but you would have never known it.
He honestly was amazing. He disinfected instruments, assisted, organized, took pictures. You name it, and Dan had it under control. He was awesome.

The End of Day One at the Clinic

Working in Guatemala was very different from working in America. For starters, we didn't have access to some pretty crucial instruments (like a dental explorer - yup, we used a probe which is not the same at all in case you don't know) and did a lot of back street dentistry where we just had to get by with what we had. Our burs were dull, we didn't have a ton of oral surgery equipment. We didn't have suction. And a lot of the materials we were working with were old. But I think we got it working pretty smoothly. Lucinda, Dee and I rotated off taking patients at first. And we'd all help assist if we didn't have a patient. Lucinda's husband Dan was Dycal Dan and pretty much a rockstar. He helped us clean instruments, took our pictures as we worked on cases, assisted while we worked. He did everything pretty much. 
It was really different not speaking the language hardly at all. Everyone laughed at the very little amount of spanish I knew. Because turns out, even simple small phrases took me awhile to get my mouth to work the right way. But we were very lucky. We had several people from the community and from Finca Ixobel (where we stayed), that came and gave us entire days to help translate for us. They organized the mass of patients and would help us find out what was wrong with people. We were very lucky (and grateful!) to have their help and support. And the little bit of Spanish I knew allowed me to get by in a pinch. I often wished I knew more words so that I could explain something or just ease the fears of an uneasy patient. Learning Spanish is definitely on my list of post-dental school activities.
We started with two chairs - one for fillings and one for extractions. But we ended up jerry rigging the second chair so it could also do fillings and adding a plastic chair that we did extractions out of so we could try to get more patients through. 

The people were amazing though. Most of them (once they figured out we were there and it became busy), would wait in the waiting room. Some people waited for hours only to have us tell them to come back. And they did it cheerfully. They came in and often thought they needed a filling, when really they needed an extraction. And they didn't question, they just got right on board. It was heart breaking some of it. They were grateful for every little thing we could give them. Some of the dental need was crazy. So many people just had all this decay in their mouth. And I couldn't help but wonder how it could get so bad. But a lot of people didn't even have the basic knowledge of how to take care of their teeth. I felt the worst when young people would come in with horribly decayed front teeth, and I'd have to tell them that in all likelihood they would lose those teeth. Or the beautiful children (and some of those kids were probably the most beautiful kids I've ever seen), that would come in and we'd need to extract so many of their teeth because they've been drinking coffee everyday with tons of sugar and all their teeth were bad.

The appointments themselves were a little ghetto. I will never undervalue suctions or assistants again. Because we would work on people, give them a little paper cup and anytime their mouths filled up with spit or water, I would have to stop to let them spit. The spit cups were probably the grossest thing I've ever seen.
Most of the patient were amazing though.
One lady came in and I extracted all her upper teeth one day and the next day I extracted all her lower teeth, and then I extracted a couple teeth on her son. And she gave me multiple hugs and even though I didn't understand her words, I could feel her gratitude. She was so sweet. It was patients like that that made me feel really great about this trip.
Its hard coming on a trip like this, because I felt how entitled I can be sometimes and how selfish. And how I can complain when things aren't ideal for me. I kept having to take a good hard look at myself, and found that I didn't love the person I saw. And I realized that the self-absorbed, arrogant, pompous, twenty-something with the bright future isn't really who I want to be. I want to not try to buy my happiness. And be happy with my circumstances because I have so much to be grateful for. I still think, that while I may not struggle with poverty, I still have valid challenges - because Third World problems aren't the only important problems in the world - But I think I could use a little Third World gratitude and patience. Thats what impressed me the most. We worked till 7pm on a couple days, and some people waited all day for us to see them, and then we had to send them away and they didn't bat an eye. They just said they'd be back tomorrow. 

Working-wise, what I struggled the most with was treating children. Children are irrational. Some of them cry. Lots of them scream. They jerk their heads around. They don't understand what you're trying to do. Anyone who knows me knows that I'm not exactly comfortable with children. I love my nieces and nephew, but the second children cry, they are going back to their parents. I do much better with older kids who understand reason and who I don't need to force to do things. Forcing people to do things makes me physically uncomfortable. 
So when people in SoAB suggest I become a pediatric dentist I want to laugh in their faces. 
That is the last thing I would ever want to do.
One of the days in the clinic it felt like all I saw were kids. They had huge infections around teeth that needed to come out. Infection means my anesthetic isn't going to work as well. That means that I'm going to have to give more than one shot and that it might not be the most comfortable experience ever. And truthfully, the pressure from extracting a tooth is often uncomfortable and often mistaken for pain.
Pretty much every child who came my way screamed.
This little girl is probably the prettiest little girl I've ever seen and the niece of one of our translators - and I made her cry two days in a row because she had teeth that were infected and needed to be extracted :(
I felt awful. Some of them cried so much. And sometimes I just had to keep going because the tooth was almost out. But I felt terrible. Its terribly disheartening to have children crying at your touch. Even if you're trying to help them. Dee, Lucinda and Kevin kept telling me to not take it so personally. And that they don't know how I'm gonna make it in the dental field if I take things so personally. Sometimes kids cry. And while I can understand that, I also felt a small nagging that maybe it was me. Maybe I'm a bad dentist.

Not every kid was that way. There were a few that were so wonderful I sighed in relief. 

This little stud walked right in, smiling the most darling smile and told one of our translators this:
"Those three girls should come to my house after and teach my brother and I English"
Even as a five year old he was terribly charismatic. And I wished we could go teach him and his brother English. The entire time I worked on him he had his arm lounged behind his head. 

He was adorable and one of my very favorite patients. 
Plus, who can resist that head tilt and his arm around my shoulders?

I got to do and see so much on this trip. 
Kevin (Dr. Acone, who graduated five years ago from BU and was our legit saving grace so many times on this trip) walked me through doing my very first sutures on a patient.
I extracted so many teeth.
I did pulp caps and fillings.
And in so many ways, I got a glimpse of post-dental school life and felt how nice it is to feel like a competent dentist.
(A feeling that is often lacking from the school).
We worked with poor lighting (often using flashlights or our headlamps) and poor instruments.
But I feel like we did some good. 
It wasn't a lot.
And I wish we could have done more because so much more could have been done.
But it was exhausting.
We left everyday completely drained.
And it was not unusual for us to be in bed, under our mosquito nets by 9:30pm.

On our last day it was crazy to see the waiting room go from insanely packed to completely empty.



I was so happy to have had the opportunity to go with Lucinda and Dee.
I honestly couldn't have picked two better people to go with.

And I told Kevin several times over the week how grateful I was that he came.
He let us have free reign, but as soon as we needed help he was there.
I felt like he, as an educator, was perfect. He would instruct us, but wasn't overbearing and would teach us things so that we could do learn how to do it by ourselves. 
Plus, Dr. Acone was hilarious.

A few of my favorite sayings of his from the trip:
I was told that there would BE no math.
Boremonism (aka a boring mormon)
You know what they say here in Guatemala - Safety Fifth!
Got Guat?
Its called Melanin Melissa, Get some.
Casa de estrogen.
Guat blow out.
Rookasaurus Rex.
The only rule in the Guat: There are no rules.
[Kevin: Do any of you know how to suture bullet holes?
Dee, Lucinda and I: Um, I guess we probably could do it. Why?
Kevin: Because if I have to listen to Adele much longer I'm going to shoot myself in the face]

I laughed so much with Kevin around. 
I taught everyone how to play Rook while we were in Poptun at the clinic. Which lead to much hilarity.
Kevin was hating on me for an entire clinic day though because of Rook from the night before and me saying that Lucinda was the best partner ever, even though he and I had been partners for like three rounds.
It was fun though. Kevin added such a great dynamic to our trip and I was so glad he was around.

1 comment:

Tamsen said...

Wow, what an awesome experience! It was great to see you today.