Baca Ortiz

On Monday, Jennifer and I went to meet with our preceptor, Dr. Mauricio Espinel, for the second time. The mission: set up this week's hospital experience at Hospital Baca Ortiz, the hospital for children here in Quito. We left the meeting with only an assurance: that he would leave us a message with a name of a doctor and a place/time to meet him. We did, however, manage to get approval for a week off at the end, which we will use to go to the Galápagos Islands! To the left is a picture of us with Dr. Espinel - this may be the last time we will have seen him, as he is constantly jet-setting around the world to give lectures and attend conferences. He left for Bogotá, Colombia that afternoon.

Our free Monday came and went... and it wasn't until we got home that evening after scouring travel agencies for Galápagos options in the city that we heard the news from Mauricio (or rather from his mother, Señora Anita) that we had to go to Baca Ortiz and talk with the secretary in the Teaching Department about hooking us up with the Chief of Emergency Medicine, who may be willing to allow us to be there for four days this week. So, on Tuesday morning, at 8:00, we arrived at the Teaching office in Baca Ortiz, where the secretary took our names, asked who it was that referred us, and then made us wait while she prepared documents to give to the Chief of Medicine recommending us for the "job." After a while, we met another doctor, who was really nice, and he took us down to the emergency room to meet the chief. Unfortunately, the chief wasn't going to arrive for another hour and a half, so we went back upstairs and waited... for an hour and a half.

Finally, the nice doctor reappeared just as Jennifer and I had almost forgotten why we were there, and took us down to the emergency room once more. He showed us into the office of the chief of the ER - a portly, jowly man who appeared to have no sense of humor, or personality for that matter. The nice doctor presented the documents on our behalf to the man, almost as an offering. The chief looked them over, gave a consenting mumble, and then gestured for us to follow him. We did as we were told, following the lumbering man with his hands clasped behind his back, his slow pace out of sync with the chaos of movement around us. He showed us to a team of residents that was in the midst of presenting a patient to an attending. He picked out the senior resident, asked him his name, and then decreed that we are to follow him for the four days. (shouldn't he have known the name of his senior resident?!)

So our days this week are to pass as follows: we are to show up at 8:00 in the ER and basically observe what goes on until 12:00. If we're lucky, someone actually remembers we exist and lets us listen to heart or lungs. Fortunately, one of the residents speaks English and fills in gaps for us quite a bit on rounds when things get muddy. Oh yeah - they do rounds in the ER. There's actually an ER team with its own patients.

But all that being said, there's no shortage of interesting pathology. We've seen mumps (rare in the US!), salmonellosis, multiple types of trauma, terrible skin infections, neonatal pneumonias, older-kid pneumonias, and today we got to help work up a kid with a very loud, complex heart murmur and severe anemia - likely a congenital problem complicated by infection. So lots to see, for sure!