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!

Random thoughts 2

While we were doing all of our bargaining in Otovalo and working up a major appetite, here is one reason I managed to resist eating from the delicious smelling street vendors' food:

When we walked past this lovingly prepared sow, I was suddenly willing to wait until we had entered a real restaurant. Granted, this is probably where they obtained their meat, but at least in a restaurant I can pretend otherwise.


During our hike around the cascadas in Peguche, Justin and I encountered a creature straight out of Alien vs. Predator. (Actually, I've never seen the movie, but this is what I would imagine it to be like). From the side it appears just like a normal (if rather gigantic) caterpillar. (It was about the length of my palm or maybe about 5 inches long.)It was when you looked at its head that you got a shock. Look closely. It looks like some sort of alien head is fixing to pop out of this fake exoskeleton. Kind of like the aliens on Independence Day or Men in Black. Creepy. Very, very creepy. And last but not least - a random wooden horse in the little town just outside of the falls. Not really sure what its purpose was, but hey, there you go. Neigh...

...but they can never take... OUR FREEDOM!

There is a quiet battle going on within the confines of the room in which I inhabit. There are monsters under my bed. And in my sink. And in my shower. And in the crevices, nooks, and cracks in the wall. They come out of their squalid hiding places to perch in the safe place that I have created in my little corner of Quito. But little do they know; there is no tolerance for trespassers. The first one died a horrible death as it struggled against the torrents of water that washed it towards the sink drain, helplessly clinging to whatever it could grab before crumpling in a pathetic mass of legs and disappearing into the abyss. The second one briefly managed to survive the impact of a giant duffel bag before succumbing to the heavy weight of a tennis shoe. The third stood no chance against the shampoo bottle that plummeted from the sky, crushing it in a flash of justice.
Should other 8-legged intruders dare to enter, let the tangled corpses of those who foolishly came before them serve as a somber warning. For the shampoo bottle tolls for thee... oh yes... it tolls for thee.

In search of tradition

Before we left for Otavalo, lots of people (including our Lonely Planet guide) told us that Otavalo would be a great place to catch local tradition in the act. One of the things that Otavalo is supposedly known for is the peñas, or folk music concerts, that light up the town on weekend nights. Being a fan of music, I was pretty enthusiastic about the idea of finding some great venues for such concerts. Yet the town had a different side of tradition to show us...
We started our cultural journey at dinner. The restaurant that we went to was called Mi Otavalito, which served up traditional Ecuadorian food. Unfortunately, the restaurant has much more to offer at lunchtime when they serve massive four-course meals (which we went back for on Sunday). My dinner consisted of a slab of chicken and french fries, and Jennifer had some ketchup-tasting ceviche (not supposed to taste like ketchup). But, about halfway through our meal, a band of musicians slowly began to assemble, tinkering around on their instruments. Then, suddenly, they erupted into the most rhythmic, energetic, awesome folklórica! What a treat - we had a peña right in our restaurant! We stayed for a few songs, and then left for a pie shop, where they served us the most amazing Apple Pie (again in well-deserved capital letters) and Raspberry Pie. I'm convinced that these pies were what the conquistadors had in mind with God, Gold, and Glory, because the Godly Golden crust and the Glorious fruit inside sent both Jennifer and I to new heights in dessert experience.
After feasting, we went in search of a peña. Unfortunately, our Lonely Planet book lied to us. Again. They don't exist. We searched high and low for the places listed in our book that promised an awesome place for folk music, but all we found were dark alleys and broken dreams. Dejected, we sulked back to our hotel, but not before running into this:
It's hard to tell in this picture, but this is a street celebration for a wedding! The women circling outside are hoisting all sorts of food wares for a nighttime feast, and the folks more in the middle are dancing and playing folklórica music. This was so cool! Jennifer and I had half a mind to follow them down the street, joining in the mirth, until we saw this:

This is a rack of none other than guinea pigs - cuyes in Spanish. These guinea pigs are being hoisted down the street alongside a similar rack of hens strung upside down. Now we know what the feast is going to feature! What made this even weirder was that all the guinea pigs and hens were ALIVE. That's right, they were wriggling and flapping and clawing at the air as they dangled. Jennifer and I both shuddered as we realized that we were in essence watching these animals' march to the guillotine. But in any case, it certainly was an interesting slice of indigenous culture that we hadn't planned on seeing!

Otavalo Part 2

After spending a night in our very chill and touristy hostel, we awoke bright and early in our yellow beds, got ourselves together, and headed down for a breakfast of pancake and fruit. While there, we saw a girl at another table that we had seen the night before at the restaurant we ate for dinner. So we invited her to our table, and turns out, she's a 4th year med student from Georgetown named Sarah who'll be starting an OBGYN residency at UVA. Awesome! And, it also turns out, she is good friends with Sarah Baxley from our class! (in the off chance you're reading this blog Sarah, the other Sarah says hi!).
Thus energized by our pancake and fruit, we set out on our mission for today: seek out the beauty of the Laguna Cuicocha, a pristine blue lake formed in a volcanic crater with conical islands inside. Our route took us a short distance from Otavalo northwest to the tiny town of Quiroga, which has a very quaint and dusty plaza, pictured at left. From Quiroga, we hired a taxi to take us a few kilometers west to the site of the lake. Soon we pulled up to the gate of the entrance of the lake site, where they charged us $1 each to enter (they jack up the price for foreigners - is that extortion?) But soon we forgot all about it as we beheld what awaited us a little ways inside the gate:
Everything they had said about the lake was true. Serene azure set in a bowl of the greenest green, with majestic mountaintops peering into the blue basin. And the islands sloping out from the center of the lake added to the exotic atmosphere of the place. Jennifer and I were floored by the beauty all around us! So we wasted no time (after assuring that our taxi would come back for us at noon) in setting out for the trail that winds its way around the rim of the lake.
The trail, as it turns out, was quite a beast.

It's hard to tell from the picture, but you can kind of see the trail to the right along the crest of the hillside. That's the trail we were walking on. And when it comes to a hill, it goes straight up. But the views of the lake remained phenomenal, and our tired legs gave us plenty of reason to stop and enjoy the local flora:

Our hike took us about halfway around the lake (to the highest point of the lake rim), so that we had awesome views of the islands of the lake, as well as the surrounding hillsides outside the lake:

Unfortunately, it was pretty cloudy, so we couldn't see many of the volcano peaks that surrounded the lake. After our journey mostly uphill, we flew back down to the starting point to rendezvous with the taxi, which was there as promised! The taxi took us back to Quiroga, where we caught a bus back to Otavalo. Once there, we had a very exciting four-course lunch of chicken crepes, beef soup, beef with bacon weaved (yes, weaved) into it, and peaches with cream! We stopped by the marked one more time, which was a little smaller on Sunday, and I managed to score some cool gifts for my brothers, and Jennifer scored another piece of the awesome Apple Pie (it deserves capital letters - more on this later), and then we caught a bus back home to Quito, feeling the effects of the hard day's work:

Yeah, bus rides are that awesome. But as the goofiness turned into extreme exhaustion, we both had to drag ourselves an excruciating distance with all our loot as the bus dropped us off about 15 blocks from our casa. After doing a hike like we did, it took all we had left to walk home. And neither of us had enough money for a taxi! So once back at the casa, Jennifer went to shower and relax. I on the other hand, determined to cook for my home family, immediately set out for the local supermarket (another 10 blocks of walking), fought my way through the maddening food shoppers to buy all my ingredients, and took a taxi back home. With Jennifer's much appreciated help, I managed to put together a fine dish of Pasta y Fagioli (recipe courtesy of Leslie Roberts - you have no idea how much I love that stuff!). It hit the spot in so many ways: it gave me a little taste of home, it satisfied our need for veggies, and it was a nice way to say thanks to the folks who have been feeding me for the past month!
So, fed and relaxed, with the day finally over and some quality time with the home family under our belts, we headed to bed. Stay tuned tomorrow for some more posts about Otavalo, as well as an update on our hospital working situation, which is sure to be interesting as we have no idea what we're doing - if anything - until we get there.

Otovalo part 1

It was time for yet another vacation. I know you're surprised - we...take a vacation? Believe it or not, yes. Otovalo is a city about two hours north of Quito known for it's huge market on Saturdays. The market sells predominantly locally made/indigenous items such as wool clothing, wooden figures, jade and silver jewelry, local paintings, etc. It's pretty much a must-see for anyone spending time in Ecuador. Justin and I arrived there early Saturday morning ready to see and to purchase :) Our first stop was an inexpensive but cool looking hostel to drop off our backpacks. The hammocks were what drew us in and the $8/night including breakfast sealed the deal.The bedroom furnishings were rather sparse, and the bathrooms were communal, but when you're 25-26 yrs old, those are just trivial problems. After all, it's really not necessary to shower every day, and we're not there to spend time in the hotel room anyway. Off to the market we went! There were countless stalls crammed close together with the vendors calling out to you, their friend, to purchase their goods. If you showed any interest in an object, say a shrunken head or a llama fetus (alas, there were no llama fetuses to be found), instantly a very friendly lady would come over and help you decide what you wanted to buy. "Would you like this sweater in another color? We have gray, blue? What would you like?" (All in Spanish, of course). After that the bargaining began...You ask her how much said sweater costs. She tells you a sum you know is elevated - let's say $36. A special price, just for you, her friend. You give her a pained look and continue to contemplate the sweater as if you just can't quite bear to part with it but the price is too much to bear. She sees this and quickly moves to try and secure her customer. Since you are such a special friends, she is willing to make a deal. What price is her friend willing to pay? You ponder this and tentatively offer a much lower price. $20? Now it's her turn to look pained. Oh, this is too low. She made this sweater with her very own hands. She can't afford to give it away for so little. How about $32? You wince noticeably and back away just a bit from the sweater. I really can only pay $20, $25 at the most. I just don't have much money left. $30? She asks. This is the lowest I can go. You shake your head sadly. Thank you anyways, you say as you turn to leave. It only takes two steps before she caves. Okay, for you my friend, $25, yes? Deal.Every sale goes like this. If you give in right away you could end up paying more than double what they really want for the item. On the other hand, you can only barter so long. Buying multiple items increases your chance of getting a good deal, and sometimes you really do just have to walk away. Regardless, all that haggling works up a major appetite. By the time lunch came around I was just about to start gnawing on my arm. Or something like that. At any rate, with my stomach still remembering it's last encounter with foreign food, I demanded that we go to a pizzeria for lunch. Justin wasn't too difficult to convince as Otovalo isn't a treasure trove of restaurants. Here's the food (re: very happy Jennifer):Here's what it looked like about five minutes later (re: even happier Jennifer): After a very satisfying lunch, we ready for our next adventure - some cascadas in a nearby city called Peguche. These falls are considered sacred by locals, and on certain days of the year our guide book recommended that we not even go. Saturday was not one of those days, however, so off we went. I loved the path to the falls and took about 15 photos, here's just one.There were actually multiple smaller falls below the main one. We loved them all...Finally the main fall. There were many people there obviously for religious reasons. Some were standing solemnly in the spray from the falls. Others were playing instruments or singing or waving what looked like palms or some other plants around. Justin and I thought it special when we crossed the bridge and looked back and saw the rainbow. Rainbows hold a special significance for me as a Christian because they represent a promise from God. In a way, it became a bit of a religious experience for me too.We took a small path up around the falls. It involved a bit of climbing, scrambling, a few death-defying leaps - my perfect type of hike. When we had worked our way back around, Justin found a little tunnel through the rocks to a place inbetween waterfalls. I, of course, decided to check this out more closely.

Still alive, if slightly wetter than before, we headed happily back down the path toward home...er, Otovalo. Another good day :)

They're everywhere...

I found two more of these over the weekend... I think they're multiplying. These seem a little less disgruntled than the last one, so hopefully your children are safe... for now.