Rhett’s Blog

A Great Week

This week has been pretty good. There have been some interesting cases and I’ve been able to have some independence. Thursday was a bit interesting because there was no doctor here! Dr. Sierra was here in the morning and was leaving at noon. Then Dr. Gamero was supposed to show up at noon to finish the day off. The morning had a number of clinic patients and since Dr. Sierra was the only physician he was really busy. He’s great because he lets me see the patients start to finish and make the decisions, while giving me advice. He gave me a stack of charts and I went and saw them in the other office. The afternoon was full of even more responsibility when Dr. Gamero didn’t show up! He had gotten held up in Belize City and patients were lining up. I did the only thing I could and just started seeing everybody myself. It was actually fairly slow so I didn’t have to see many. Dr. Gamero finally showed up in the evening when I was giving fluids to an ER patient. That night Dr. Lazo and his wife returned so I’m wondering if my days of fun with all the responsibility are over. He’s a great guy, but seems really hesitant to let me do anything. We’ll see what happens.

                One interesting case that came in this week was a young Mennonite girl. She had a history of aplastic anemia and had been to Guatemala for diagnosis and treatment. She wasn’t my patient so I’m not really sure what type of treatment she was getting. She was as white as a ghost and had been feeling weak. I’m thinking she hadn’t had any treatment or anything since Guatemala and they were finally seeing a physician because she was feeling pretty weak. Dr. Sierra ran a CBC and her cell counts were pretty bad! Her WBC was 1.0, her Hgb was around 5 I think, and her platelets were 5! All obviously very concerning, but the platelet really jumped out at me. Dr. Sierra ordered a transfusion with pRBCs, but didn’t order any platelets. I mentioned that she really needed some platelets, but apparently they don’t have any! I asked about transferring her and he said they don’t have any platelets anywhere in Belize! As I think about it, I wonder if I misunderstood because how could they not have platelets anywhere? The nurse confirmed though that platelets just weren’t available so I was pretty shocked. The only option for platelets would be to send her out of the country. Dr. Sierra wanted to try steroids first though to see if he could raise the plt count that way. I’m not sure what has happened to her because I left town, but that was just another interesting example of the poverty present here within Belize really affects healthcare.

                I took some vacation time since I have been working straight since arrival and I want to see the tourist side of Belize too. I went to the Mayan ruins of Caracol one day and took a trip out to the tropical islands called the cayes today. Caracol was absolutely breathtaking and I would highly recommend it to anyone coming here. I suppose Tikal in Guatemala is the more popular touristy spot, but that was part of what was great. There was not one tourist there so we had the whole site to ourselves. I took a boat out to Caye Caulker this morning and I’m staying in a hotel here for a couple nights, since there is a holiday on Monday (Independence Day). This place is amazing. It is an absolute tropical paradise and I’m having a really good time here. I took a snorkeling tour this afternoon and saw so many kinds of fish and I swam among sting rays. I can’t wait for some more activities and I think I’m going to take a sea kayak out tomorrow and explore around a bit. Belize also has some great tourist sites, so in addition to all the good work I’ve been able to do here I’m happy to be able to see some of the things that make Belize so great. I’m half-way done and this experience has been great so far.