Today was a little more laid back in the clinic today. We still saw so many patients that there was no break except for lunch but it felt much more organized and efficient like everyone had a system and got in their grooves. First I was with neurology but we also saw general medicine cases as well. I was so happy with my Spanish! I really improved over the course of two days that by the end of today I was conversing by myself with patients and felt like I wasn’t missing anything substantial or at least was retaining the important things they were saying. Neuro with Dr. Patel was cool; I got to practice my neuro exam again which I felt pretty solid on during my rotation. I really enjoyed my neuro rotation and learned so much and this one was an extra level of difficulty with the communication barrier since neuro relies so heavily on the physical exam portion of the H+P. Then we had lunch which was a nice fish dish and then I was with general medicine again with Dr. Tobar. He is very good at teaching and we got to have some didactic moments which was really nice, a great refresher from boards which I took a few weeks ago. We had a steady stream of patients and ended up referring a lot to OMM and radiology. We got to refer a man with choreiform movements to neuro today and I think that was one of the most interesting cases I got to see. Most of the complaints today were musculoskeletal. I was conversing totally on my own in the afternoon and I felt really proud of that. I also interviewed a woman who had migraines status post traumatic car accident 5 years ago and I was able to completely take her history and nail down a differential and treatment which I felt great about too. We weren’t able to prescribe her medications we’d use in the US for maintenance and abortion of migraines but we were able to tell her she should try to find a neurologist and gave her some acetaminophen. After we got back my roommate Taran and I went to drop off some laundry and then I showered and we went to dinner on a restaurant in the Amazon river! It was pretty cool but lots of mosquitos. The humidity went down a lot today because it rained on and off. After dinner I was pretty tired so I went straight to bed because we have another busy day tomorrow!