Detective

Guatemala, I am speechless. I was welcomed into Guatemala with open arms. When we first arrived at Ciudad de la Esperanza, the very first thing I saw was a little girl that smiled at me with the most beautiful brown eyes and smile. At that moment, I knew that this was going to be an amazing experience. She was my introduction to the people of Guatemala and she showed me how compassionate, nice, and positive everyone in this community is even with their current situation.

On May 4th, 2023, the force was upon us as we went through another amazing, emotional, inspirational, and loving day filled with questions, learning opportunities, and a motivation for the need to do more. I had the honor to shadow Dr. Richard, an internal medicine physician, today was mind-changing. Like every good FBI movie, there is always the main “detective” and there is the backup detective that just sits back and observes and makes false assumptions about the case. I was that backup detective. As I was sitting on the “observer” chair, I watched as Dr. Richard slowly solved the mystery of each patient’s case. 

Today, we saw a 19-year-old female who presents in the office with heart pain and blurry vision. One of the first things that I thought to myself is that Dr. Richard, like other physicians in the US, might disregard her heart pain because she is “ too young to have heart problems”. However, it was different this time. Dr. Richard took the time to understand the pain that she was experiencing in her chest as he checked off his mental list of possible diagnoses. Each question that Dr. Richard asked is tailored towards a specific diagnosis and I was amazed to see how asking questions about their home life and habits can tell you so much about the possible contributor of their pain. I was also fascinated by the power of a physical exam and all the different things it can tell you about a person’s overall health. Since this patient's complaint was heart pain, it was essential that we assess her rhythms, any fluid build-up, and any cardiac-related exam. Dr. Richard also assessed the tenderness of the muscles at and around the site of her heart pain. The physical exam was normal. 

So now, we're at a spot where the physical exam was normal,                                                                                                                                                                                                                                                                   nothing from her questioning was abnormal, therefore, the next step would be telling the patient that yay she does not have a heart problem but also giving her the right amount of reassurance so that she knows everything is okay. At times, physicians often forget that reassurance itself is a treatment especially when the patient feel that something is wrong with them. The hard part was giving reassurance in a way that does not dismiss the patient’s pain but instead gives them direction on the possible alternatives. Dr. Richard starts the conversation by acknowledging that he knows that she is in pain and that there could be many reasons why, however, the good thing is that it is not connected to her heart. He followed the conversation by listing all the possible things that could explain the pain, however, given the consistency and severity of it, there’s not much that could be done besides monitoring for any worsening symptoms. It might not be the news that she is expecting but it was the only news that we could give her. Even though she did not get the answer she wanted, she still had a big smile on her face as she left the room. I think it was a success because the smile on her face let us know that she was satisfied with the care that she received from Dr. Richard and at the end of the day, that's the most important thing 

Now this was just one example of the amazing work that I have witnessed in Guatemala. One thing that stood out most to me are the returning patients, especially the patients who have been coming to the clinic for years now. They continue to come back each year because of the love and connection that we were able to build with them. It truly amazes me as all the members on the medical team combined their forces to best help each kid and adults in Coban. Even though I do not know much about the story of Fernando , I was shocked when the medical team brought out the braille books in Spanish so that he could start to learn to read. At that moment , I was truly able to see the impact that Guatemala had on the medical team and the impact that the medical team can have on every single patient . 

The kids and adults have impacted and inspired me as well . Being able to help provide care to these patients truly gave me a new perspective about medicine here vs in the US. Each patient has their own unique story and our job is to help them through any situation as much as possible. This trip has inspired me and so I say, may the force be upon us on the following days of clinic. - Binh Nguyen