july 7

I am in Abancay. It is warmer here then cusco, althought there isnt anything to do here. I had my first patient yesterday, we will call her Senora H. It was really exciting. I was at the bus terminal, and I noticed a women sitting on the curd with her family around her. I hesitated, and got on my bus, but from my bus widow I could see the situation wasnt getting better. I got off the bus, and asked if the women need help. The pulse was weak at 84 beats per min. and the breathing was rapid and shallow. Senora H looked about 80, but was only 38 years old. Her mental status was slow, but she could understand my basic broken spanish questions. I could only ask a limited amount of questions about her condition. I understood that she had arrived to Cusco after 7 months in Lima. She had complaints about her stomach, couldnt walk, and difficultly breathing. The best we could do was a taxi to the hospital. The bus terminal people were very helpful in getting my luggage off the bus. She had some sort of medical history written on a piece of paper. Her family tried to put rubbing alchol in front of her mouth, not a good idea when she is having trouble breathing. I think with her weakend medical condition, the higher altitude of Cusco was too much for her. I just monitered the Senora and comforted her to the hospital. At the hospital, I was even more worried about communicating. The docotrs and nurses understood some of what I told them. They were much calmer then I. The entire episode ended within an hour, but it felt like forever. So, I took the later bus. It was a good experience, but, also difficult because of the language barrier. As any memoriable experince does, it keeps playing in my head over and over again. I could have some things differently, but I did my best at the time.