My Last Post

I can't believe it's all over. It really went so fast. I feel like I could have stayed another month and just traveled Europe. There's so many places I have yet to go to and see. I want to see Rome, Venice, Florance, Naples, Sicily (and that's just Italy), then there's Paris, London, Morocco, Egypt, Germany, Prague, Greece, Turkey, Ireland. The list goes on. I also want to see India, Japan, Australia, Indonesia, Thailand, Africa, Japan...I could go on all day. I love to go places and experience new things. I think I'll be back to Europe some day.

I really enjoyed my stay here for these past two weeks. To be honest I was a little disappointed with Alicante when I first arrived. It seemed too ordinary. Too boring. But I've come to realize it is quite the opposite.

Last night we went out for my very food friend Tom's 21st birthday. We knew we had an early flight so we packed before we went out. We got home around 530, showered, grabbed our bags and headed to the airport. No sleeping. We were kind of drunk in the airport. It was funny. Not so funny when we started sobering up. I slept the whole way from Alicante to Madrid. Then we almost missed our flight to Miami because our flight to Madrid was late and we had to go through customs and make it to another terminal. They were holding the plane for us. Thank god we made it.

I'm glad to be back in the US. I can't tell you how nice it is to speak English and not feel like a stupid American. I really wish I was bilingual. It was really frustrating not being able to speak their language. I really felt stupid. I felt like "why didn't my parents teach my spanish?" then I remembered, "oh that's right, because they're not of latin decent and I didn't grow up in Miami."

Even coming to Miami wasn't much of a change. My cab driver barely spoke English. So hopefully when I come to NY I'll get to speak newyorker to everyone and feel right at home. It's also nice not to have to use a converter and to use the internet whenever I want. WIFI is a godsend.

Tomorrow I head to NY. Being in Miami right now makes me want to stay here, but I know I'll be happy in NY when I'm there. Miami will always be here waiting for me. I'm sure I'll see it again soon.

At the closing of this trip I can truly say I learned some very valuable things:
-I love sangria
-and tapas
-and ham and cheese
-and wine of course
-I love surgery
-and medicine
-I love to travel
-and experience new things
-I love making new friends
-and realizing I don't need to be friends with everyone
-It's good to do new things with new people, you find out who you really are. I like what I saw.
-I will come back to Europe some day, maybe even live here for a while...

As for now, Hasta luego!

My final days...

I can't believe I leave the day after tomorrow. These three weeks really flew. At first the time was passing so slowly, but these last two weeks felt like 5 minutes. I'm really excited to go home and have a LI summer with my best friends and family, but on the other hand I could really stay here for a few more months. There's more I want to do and see. There's a million places I want to visit. I would love to stay places for weeks or even month at a time. You really get a feel for the place.

Today was a perfect day. We went to this market in downtown. It was a huge building that looked like a beautiful church from the outside. Inside there was rows and rows of kiosks selling meat, chicken, pork, you name it. They all looked fresh and organic. I personally didn't care for the carved up carcasses considering sometimes the heads were left on them, but I feel like this was something my mother would really appreciate. Oh and this was just the first floor. The bottom floor had all seafood, fruits, and vegetables. I loved it! There were so many delicious looking exotic fruits. I wanted them all. If I had an apartment and a kitchen I would have bought the place out. I did buy a cheese pastry from one of the bakery stands. So good! My friend bought cherries. They were probably the most delicious cherries I've ever had.

After we walked to the beach. It was packed because it was so beautiful out. The sand here is really fine and really dark. I went swimming in the Mediterranean Sea today! It was warm, kinda dirty, and a lot of sea week. But it was super shallow so we could walk way out and still be waist deep. I loved it.

After we got ice cream at this place our spanish teacher told us about. It was so good! My friend got this drink thing that's popular here. It was white and tasted coconuty, it was good though.

Tonight we are all going out to dinner for a final farewell. Tomorrow we are seeing a bull fight and celebrating one of the guys here, Tom's birthday. It's going to be a lot of fun. We all chipped in money and two people here coordinated a whole night. I really don't want to be hung over for the plane ride on Sunday. We'll see...!

More on Madrid...

The next day we woke up early, checked out, and lugged our baggage to this market we heard about. after getting very lost for 15 mins, we finally found it. It was huge! We were there for 2 hours and probably didn't even see half of it. It was a bunch of vendors selling clothes, jewelry, souvenirs, etc. They were lined up and down roads that seemed to go on forever. I bought so many things for friends and family. I would have liked to stay there all day. Unfortunately we had a train to catch. So we went back to the train station, which is huge, ate some lunch and we were off to Alicante.

This whole week we have been in los Centros de Salud (Health Centers). This is the primary care for the citizens of each assigned area. Instead of going to your primary doctor for health check ups, post surgery check ups, etc. you go to these centers. They are beautiful. Luckily me and Jessica got positioned at the Health Center closest to where we're staying. It's a 5min walk. The center was built in 2005 so it is fairly new and up to date. I really like the system they have there. You walk in, sign in at the front desk, and they point you to where you need to go. They have a few sections of the center. There's the "Curas" section, where they take blood, administer injections, take out stitches, and changes bandages. This is where we were the first day. I really liked it here. We got to see a lot of post surgery patients. There was this one lady who is probably the skinniest person I have ever seen. She literally looked like a skeleton. At first I thought "Anorexic" but we later found out she has a disorder where her body cannot produce fat. She was not in the health center for this disorder, but for a terrible flesh eating infection on her ankle. This wound was harder to see than any of the surgeries I have seen thus far. Her leg is probably smaller than my arm. This is no exaggeration. From the bottom of her heel to mid calf was exposed inflamed muscle that was all infected. It looked terrible. I couldn't believe she wasn't hospitalized. All they did though was changer her bandages and clean the wound. She came back later this week (today) and the would did not look better. They said she would probably have surgery later in the month. I hope sooner than later.

The next day (Tuesday) we followed a nurse around. First she did house calls. She literally took supplies in her purse and we walked around Alicante going from house to house. In Spain, people who cannot walk or move are still able to receive health care, they just have doctors and nurses come to you. It seemed like no inconvenience to them. We went to this guys house who just had abdominal surgery. He was obese and was cut right down his belly. He had staples but I noticed a few were missing. The nurse told us they had to remove them because they got infected. Because he was so obese, the part where the staples were missing was not able to close, so it just left large gaping holes. It did not look good. He had two of them. One was a few inches above his belly button, but the other was about 3 inches below and under his roll of fat. This hole could be a good 5 inches deep because of how much fat he had. We asked the nurse if this was a concern and she was just like "I guess he'll just heel eventually. It will just take a while." And I'm thinking "Yeah if it doesn't get infected and worse by then." I just feel like in the US that would have never happened. I noticed a lot this week people coming into the Health Center for problems after surgery. Mostly problems with stitches. I know in the US they've been starting to use this glue that unites the skin from within the wound. This gives less chance of infection and a more appealing scar. It seems like that haven't met this technology yet.

After a few more house calls we followed the nurse to her office in the Health Center. She did consultations mostly with older adults that had diabetes, high blood pressure, and weight issues. She would give them a diet plan to stick to and suggestions to help lower blood pressure etc. She kept lecturing everyone on their weight and health, and the whole time I kept thinking "That's pretty hypercritical considering I've seen you smoke like 2 packs of cigarettes this whole day."People here smoke so much. It's disgusting. It's like they have no idea the kind of damage they're doing to their bodies.

Today we got to shadow a doctor. He did mostly consultations with patients who had all kinds of problems. Respiratory problems, medication refills, etc. The system here is very interesting. There're certain medications that aren't covered by the health care system that people need to pay out of pocket for. These are the kinds that pharmaceutical companies in the US go crazy for. The ones with all the commercials: Viagra, Zoloft, Celebrex, etc. People were coming in today asking for medication they heard of from their friend or on TV. The doctor was trying to explain that there are generic brands of these that are cheaper. But the patients didn't seem to understand. It's all a gimmick.

We asked the doctor what he thought of the heath care system here and he brought up a good point. People who are retired and receive pension in Spain get a lot of money through the social security system. They receive free health care and free medications, while the active workers don't use the health care as much and are still getting a large percentage taken out of their pay check. The doctor suggested that the government look into how much families are spending and factor that into how much is taken out of their paycheck every month. Here they take a certain percentage out depending on the bracket you belong to. The doctor was suggesting that the percentage should not be the same for everyone in the bracket. Makes sense.

Later today we asked a nurse what she thought of the health care system and she said that people take advantage of it too much. She said the elderly come in for every ache and pain because they can. One elderly man today I noticed was taking about 11 different medications. I thought that was a bit excessive. The nurse said that the elderly come in and complain about every little pain. She said they take up space, medication, and time for those who could actually use it. I asked what the demographics were for Spain in general and she said there are a lot of elderly and a lot of young children: two groups that need health care the most. This is why the waiting rooms were packed, people were complaining for waiting so long, and our nurse could only take a 5 min break for lunch. I guess it's not so different from the US after all.

Spain's Health Care system has a lot of positives but a lot of negatives as well. For example, if you need to see a specialist that is not under the health care system (Orthodontist, your own Gyno, chiropractic, etc) it takes forever to get an appointment. You also don't get as much as a personal relationship with your doctor. I know my pediatrician has known my family before I was even born. My mom has a relationship with him and trusts what he says. I don't know if I would like my kids seeing a different doctor every time I took them to the doctor's office.

Interesting...

More on Madrid...

The next day we decided to get up early and make the most of our day in Madrid. We decided on a few places we wanted to go/see and found a good route. We started at the Royal Palace, which was beautiful and huge! It was also right next to our hotel. There was a huge line to go in, take pictures etc. but we decided we didn't want to stand on it.

After we started to make our way to Plaza Mayor. While we were walking there we heard a lot of people yelling and chanting something. It sounded fun so we followed the noises. We discovered it was a rally going on with probably 20+ police officers. We were curious so we watched from the outskirts. Since they were chanting in Spanish, I couldn't really understand what they were saying. Someone told us they were yelling about pollution? They were yelling at everyone in every direction so we decided to leave because we didn't feel like getting arrested.

Plaza Mayor was my personal favorite. It was this huge enclosed area surrounded by beautiful buildings and restaurants. There were so many weird people there. There was a Mickey Mouse dressing in red, white and blue...then there was a Minnie who had her head off...then there were a bunch of people with hats and swords? Don't ask me why. Weird people but a beautiful place:

After we headed to Puerta del Sol. I was really excited about this one because when I asked my lovely best friend Hayley (she'll love this shout out), about coming to Madrid, she said "Two words. El Sol." So when I arrived I was less than impressed. It was because there were all these protestors and rallies that set up huge ugly tents and blue tarps. They littered the place with words spray painted onto sheets. I didn't even know what they were rallying for. I don't think they even knew. We saw a bunch of different things. Political corruption. Going vegan. Voting. It seemed like everyone just decided to come together and complain about everything wrong in their lives. I was kinda annoyed because I wanted to see El Sol, not a bunch of hippies living in tents. It was dumb, but this was the best picture I could get...

Then we walked towards the Prado Museum. We had no intention to go in initially because we anticipated a long line and a boring art museum (I personally love art, but can sympathize with people who find it confusing). Anyway, when we got there we saw no line and found out that with a student ID there was a 4 euro entrance fee. So cheap! So we did it. And I LOVED it! Probably one of my favorite art museums I've ever been to. I sometimes forget how much I love art. I really have a true appreciation for it. I loved every single painting and sculpture. Some of the sculptures dated back to 200 B.C.! It's incredible to be in the presence of something that was around before Christ. Crazy! They also had these massive paintings that took up the whole room. And they were so lively. If these artists came back to life and saw the art today, they would probably faint in disgust. I'm really not a big fan of modern art. I went to the MOMA once and I'm sorry, but I do not think tying a piece of string to another piece of string and throwing paint at it is art. Call me old fashioned.

After that we went to El Parque del Retiro. LOVED it! It like central park but in SPAIN. It had a beautiful lake with dozens of row boats. It was beautiful. We got ice pops and laid in the grass under a huge tree. In that moment I was so happy with life. I was in Spain (Madrid nonetheless) in a beautiful park, enjoying a delicious lemon pop, with great friends. Nothing could have been better. Here is my favorite picture from the park:

After we decided to head back towards the Hotel. We stopped to get tickets to a flamenco show for the night, then went back to get ready. The flamenco show was amazing. I was so glad we went. It was in a theater that reminded me of broadway plays. We sat third row! I didn't really know what to expect, but I really enjoyed it. It was a bunch of dances that had a story line. The dancers were so talented. It was such a good cultural experience. I'll never forget that show. This was the only picture I got:

The curtain call...

After we were hungry so we walked around and found this nice tapas place outside. We ordered sangria and some tapas. (I love Tortilla Espanola) It's like a thick omelet with potatoes and scallions. It's just delicious. Then we got churros with chocolate. My favorite! They're like fried dough that you dip into this chocolate sauce that's thin and sweet. Ugh I wanted to drink the chocolate out of the cup.

Afterwards we walked around for a little, looking for a bar or club. To our surprise we couldn't find anything worth going to. I had known of some clubs, but they were no where near us and we didn't want to spend money on a cab or metro. So we walked around some more and eventually found a Fridays. Yes, as in TGIFridays. We were desperate for a drink and all feeling a little homesick so we went in and ordered an array of fruity drinks. After one drink we all felt tired and decided to call it a night. We got back to our hotel and opened our windows. Then we heard everyone going out for the night. Our mistake. I forgot everyone in Spain doesn't go out until 2:30 am. Oops. We were tired. I'll just go clubbing in Miami...

There's more..but I'll save it for my next post.

¡Me Encanta Madrid!

This weekend I went to Madrid and I have a LOT to write about.

Side note: OB was pretty boring. It was all woment who have already had their babies so we didn´t get to see and live births unfortunately. Just a lot of screaming babies.

So after clinical on Friday, me, Jessica, and two of my friends, Amanda and Tom took the train to Madrid. The trains here are beautiful. They are roomy and have tvs on them and a cafeteria and the bathroom doesn´t make you want to puke. It was so nice and the scenery was beautiful. I saw vineyards, farm, and even a castle. I didn´t realize how much of Spain is farmland. It´s actually mostly farmland with a few cities. I had to sit by myself because I´m and idiot and when I was booking my ticket I forgot to put what seat I wanted. I made friends though with the lady sitting next to me. Turns out she´s a doctor at the Alicante Hospital. I told her I was a med student (that´s the only way I can describe it becuase people here don´t understand pre-med). We were comparing and contrasting health care in our countries. To my surprise she told me she likes the way our health care system is. She said she feels our doctors are more educated and more knowledgable. I couldn´t disagree with her there. I did my best to speak and understand spanish. I think I´m getting better...

When we got to Madrid, we were overwhelmed with how big the train station is. It´s bigger than Grand Central, i´ll tell you that. We gota taxi and got to our hotel, which was actually kinda nice. The only problem was that we had 4 people staying in a room meant for 2 people. We had to sneak around the whole time to avoid getting charged for havign exra people.

After we unpacked we decided to walk around and find a place to eat. We walked down Gran Via (which is synonomous to Broadway in NY). After scouting out some menus we decided on this Italian Resturant called Bocca di Pepo. It was a nice restaurant, and reasonably priced. I got this ravioli type thing where the pasta was green and triangle shaped. It was in this creamy mushroom sauce. Delicious!

After we walked around some more. I was fascinated by the architecture of the buildings. Incredible. I have more to write, but I will do so in a seperate post because there´s so much!

More surgeries!!

Today I spent the whole day in the OR. It was awesome! I didn't want to leave. I saw two ENT surgeries and one plastic surgery. The first ENT one was a guy who had a tumor in his throat and one next to his ear.  To remove the one in his throat they went in with a camera through his mouth. It was so cool. I saw on a monitor the throat and then spotted the tumor. One of the surgeons was so nice. He showed me the charts and ex-ray and explained the whole thing to me. I just wish I understood what he was saying. I was trying my best to make out the spanish words I knew. I got the gist of it though.

When they found the tumor they used these long tools to burn the skin connecting the tumor to the throat. Then he pulled the tumor out through the mouth and put it on the table. I was staring at it, fascinated.

Then they worked on the tumor by the ear. I watched him make the incision, pull back the skin and everything. The way surgeons treat human flesh is incredible. They act like it's just a slab of meat they're cutting up for dinner. I guess they're so used to it. They kept pulling back the skin, poking around, then finally I saw the tumor. It was the size of a quarter. They pulled it out, then a training surgeon (I think) sewed him back up.

The second surgery was a guy getting his nasal passages widened (I think). I couldn't really understand what they were doing, but I think that's what he was trying to do. They went in through the nose with a camera again. They had this cool tool that was calibrated to a computer that showed him exactly where the probe was in the skull. It was like a live ex-ray. He used this tool that looked like a little skin eater. It would just eat away the flesh wherever he pressed it. He did that for a little bit, then he put this white tube-like thing up there and was playing around where he wanted to put it. He kept moving it and situating it. I was waiting for him to take it out, but he never did. Maybe this was to open the nasal cavity? I'm not really sure.

The third surgery I saw was AWESOMEE!! It was a guy that had somehow severely burned his forearm. The burn ate through his muscle all the way to the bone (they don't know how he did it because he speaks polish and I guess no one in the hospital could translate). Anyway, this was his second surgery and there would be one more. In this one they were cutting out all the bad muscle (which was white and dried up) and making sure only healthy flesh remained. There really wasn't that much flesh left. I could see everything. The muscle. The tendons. The nerves. The bone! It was crazy, but awesome. Once they finished removing all the bad muscle there was a gaping hole left in his forearm. To my surprise they rolled up some foam? and wrapped it in this black bandage thing then stuffed the whole thing into the gaping hole. Then they put synthetic skin over it (which just looked like clear tape) and bandaged the whole thing up. I think their plan for the next surgery is to take skin from his leg and try to make a skin graft? I don't know what they're going to do about all the missing muscle. It was a really cool surgery to see though. Glad I didn't pass out. Actually the whole time I kept thinking "I'm really hungry." hahaha

Tomorrow we go to OB. Hope I get to see some babies being born!

MY FIRST SURGERY!

So this week I started working in the hospital. Let me tell you, the way they do things in Spain is much different than in the US. In the US we are super precautionary about everything being sterile and hygenic. In Spain, it seems like they are much more lax about it. They don´t use gloves as often and aren´t neat about taking blood. For all you back in the states, be happy with our health care. It is much better quality than we think. Maybe our system isn´t perfect, but nothing beats the quality.

My first day was in the ER. It was actually pretty boring. In Spain, you usually go to you Health Center first and then you get referred to the hospital. So you would think the ER would only have exreme patients. No. People don´t feel like waiting to go to their Health Center so they just come straight to the ER for anything...

We saw a lot of people just not feeling well, feeling dizzy, nauseous, etc. We saw a lot of blood work being done, shots administered, etc. We did see one guy have a seizure which was pretty cool, but they weren´t too good about telling us exactly what happened. So needless to say I was a little disappointed with my first day...

The second day however...I was not disappointed at all! I got to see my first surgery. This was one of those pivital moments that I think changed my life.

Let´s start from the beginning. Yesterday I was in the Neonatal department. This is where babies who are born prematurely go. They are put in these glass boxes with all these wires hooked up to them helping them breathe, eat, etc. They are so tiny! Their little hands are the size of the pad of my pinky finger. To see them breathe and move is like watching a miracle in real life - you can´t believe it´s actually happening. I wanted to hold one, but I was afraid to ask (also afraid to hold one a little).

There was this one infant who was very premature. He was born at 24 weeks. This is 12 weeks early. He was born almost a month ago and was still only 2 lbs. Insane! We got to read his file and found out his mother was on coccaine and weed when she was pregnant. This infant had a twin, but it died two days after birth. It was a miracle this one was still alive. They did an ex-ray of the baby and found a mass in its abdomen. The doctors decided the baby needed surgery. We asked if we could watch the surgery and they luckily agreed. We were so excited.

We had to stay an extra 2 hours to watch this surgery but I personally didn´t care. I wasn´t going to miss this opportunity. When it was time to opperate they had a large transportation machine to take the baby to the OR. We followed them, unsure of what our place was. We didn´t even realized that we walking straight in the operating room. I´ve never seen a surgery in the US, but I can imagine the protocol is much different than this. We had to ask what we were supposed to wear. A lady took us to a room to change our scrubs, put on booties, a mask, and a cap. I looked like a surgeon. It was awesome. While we were standing in the OR waiting for the surgery to start, I was starting to get nervous. Everyone kept telling me horror stories of the first time they saw a surgery and passed out. I really didn´t want that to be me. I was starting to psych myself out. I just kept telling myself to relax and not think of it as a little baby, but more of a science project. This really helped. Finally they started the surgery. We weren´t sure where out place was so we kind of stood in the back. I couldn´t see anything. I wasn´t sure if I was grateful for that or not. One of the nurses motioned for us to get closer so we went around but stood behind a table. I could see the baby, but I couldn´t really see what they were doing. Then she told us to still get closer. This was when I stood right next to the surgeon. This was the moment of truth. I saw the intestines all out and expose, and unlike a normal person I was facinated! My first thought was ¨That is awesome!¨ I wanted to see more. I watched wide eyed, absorbing everything and wanting to ask a million questions. It was frustrating that I didn´t know what was going on because 1. I don´t know the medical lingo/medical backround. 2. I don´t speak Spanish! Jessica was trying to translate for me, but I still lost bits and pieces.

What they did was they felt through the whole intestines to look for a mass. They didn´t find anything so they made a hole in the skin and pulled a small portion of the inestines through that hole. They then closed up the first incision they made, then sewed the part with the small intestines hanging out to the skin. Apparently this is a common procedure, but not common on a premature baby. They did this because the baby was having trouble desiccating. With this procedure he could desiccate into a bag.

The surgery lasted about 45 mins. which is pretty short. After I came out of the OR I felt like a million bucks. I wanted to call my mom and tell her I didn´t care how much it cost, but I didn´t have my phone on me. This made me feel 100% about becoming a doctor. I was always a little unsure because I´d never seen a surgery and didn´t know how I would react to gross things, but this sealed the deal. I love surgery. I love medicine. And I no doubt want to do this for the rest of my life.

Today we went back to see the patient and he was doing much better. He looked so much healthier. He no londer had a swollen abdomen and the nurse told us he had been desiccating much better. As of now they won´t do any more procedures. I hope he makes it.

Tomorrow I go back to the OR. I can´t wait!