A couple days ago, we began our Amazon medical tour. This was the part of the trip I was most looking forward to. I couldn’t wait to bring medical care to these rural villages, whose access to medical care is inconsistent and largely dependent on medical missions like ours.
The first day our the campaign, we went to a town and opened clinic in their school, a concrete building composed of 3 or 4 different rooms. On this day, I worked in our “Emergency” rotation. Here, emergency was more of a relative term, as we didn’t really have the technology to provide true emergency care. We operated as a general medicine clinic, and saw patients whose complaints consisted mostly of pain or cough/flu-like symptoms.
Our first patient, however, did not fit this description. He initially came in with the complaint of feeling dizzy, but it was very apparent that there was something else going on with him: he was constantly making uncontrollable jerky movements with his arms, legs, and head. We also had to overcome a pretty significant barrier–communication. It wasn’t just issues in translation. Throughout this trip I’ve been able to rely on my background in Spanish to communicate and interact with patients, but with this man, it was different. At first we thought he was confused or demented because he wasn’t really answering our questions and would instead go off on unintelligible tangents. At one point, I crouched down next to him and gently grabbed his shoulders. “Senor,” I said to him. “Look at my eyes. I need to ask you some questions, and I need you to answer.” Finally, using this strategy (and a lot of patience), I got some more information on him.
After taking his history, we did a neurology work up on him, testing his muscle strength, reflexes, and cerebellar function. Everything came back normal, and the only conclusion we could draw was from the movements themselves. He didn’t seem to have muscular dystrophy, nor did he appear to have symptoms consistent with Parkinson’s. At the end, we could only conclude that he has parkinsonian-like symptoms and we referred him to a hospital in Iquitos, which is their nearest source of healthcare.
The man brought me to his wife to explain the situation to her. I told her what was going on, and explained to her that her husband needs to see a doctor for more intensive treatment. This beautiful woman, indigenous heritage abundantly apparent, looked into my eyes, and ask me how. “We don’t have the resources,” she said simply and directly, without any shame.
Wow. I felt like the breath had been knocked out of me. There I was, a privileged medical student from one of the wealthiest countries in the world, and I had to look this woman in the eye and tell her that I couldn’t help her. That her husband was to be denied medical care that could significantly improve his life, medical care that I have access to on a regular basis. Medical school didn’t cover this situation. There was nothing more I could say or do. I could only told her that I was sorry, so sorry, and there was nothing more that I could do.
This has been an amazing trip so far. We have seen some amazing cases, and have been able to help the lives of many people. But all of us have experienced cases like this man, cases that can’t be helped by our efforts. It’s these experiences that really open your eyes to how truly blessed we are.
Categories: Updates from Peru