Just a day

Its hot. Good news is that the winds from yesterday have held on which helps alleviate the 110 degree humid day a bit.

Things have slowed down a lot for us. July is "vakans" for the schools here. The heat tends to drive people out of the cities into the countryside or by the water if they are able. Since the last group left, and with the Villiers gone for vacation, Patrick and I are enjoying a schedule that is relaxed and more open for a little while. The seminary is closed for the summer, so Patrick is having to find a little structure to his days in order to work on his Creole and some lesson plans he wants to make for the upcoming new semester starting in August. We've had a hard time filling mobile clinic sites, which seems strange to me, but as Miss Fano says, "its to hot, no one wants to work." Yesterday we were supposed to have a mobile clinic in a neighborhood church; we drove an hour through the twisty turny city to get there and meet the pastor. He had been excited to have a mobile clinic, says Miss Fano. But apparently he was so excited he forgot to tell anyone. Neat. So we changed plans and had a little spur-of-the-moment planning/brainstorming meeting back at my apartment with coffee and ice water. Its all about being flexible.

We found out today that the director of the seminary had a hypertensive stroke... the reason why he was "sick and in the hospital," per reports from pastors over the weekend. According to the girls at CONASPEH today, he has lost movement in a side of his body and can't speak. I worry about him because he is a big man, lives with his waif of an elderly mother, and there is no 'nursing home' for him to go and recover, no intensive physical therapy. What happens to him? I have no idea. The girls at CONASPEH say he's lucky because he goes to a big church and likely they'll raise money to help him out. But I imagine that can only last so long.

It also makes Patrick's job instantly more challenging.

I went to CONASPEH clinic this morning. No patients were waiting, the building was eerily quiet without students. I enjoyed visiting with Valena and Gouka in the office and updating some notes and paperwork for the clinic. Valena started to tell me about her mother who has a ton of untreated medical problems including having suffered a hypertensive stroke in the past that has left her weak in her right side and with a foot that swells, etc. She wanted me to recommend what medicine she could give her since she can't walk into clinic. eiii. So I told her I'd rather make a house call.

Valena directed me through this little neighborhood where her mom lives, up a little foot path between concrete houses, through a sheet covered opening in one of the cinderblock shelters to visit her mother. The "house" was one room with a double bed taking up about 50% of the space, a shelf with books and clothes and a television on it, a little desk, a chair in which she was sitting and a lamp. There was about enough walk space for two people to comfortably stand. I imagine the "kitchen" was outside as was the "toilet" But the room was neat and tidy, decorated with this's and that's, pictures of children and silk flowers.

The mother seemed happy to see me. I introduced myself, told her what a great daughter she had, and commenced doing an exam. She's not in great shape considering she is only 50. We discussed what her disease meant, what she NEEDED for good treatment, what was realistic for her to be able to do, and how at least we could start scratching the surface. So I gave her some blood pressure meds and aspirin. I'll go back next week to see if I need to adjust the dose. I likely will have to do so since her blood pressure was 220/110. That gets someone a hospital stay in the US. But she apparently felt fine. Sheesh.

On our return to CONASPEH, I finally had patients waiting for consultations. Three of the patients were follow-ups which makes me SO VERY HAPPY. One of the things I love about family medicine is the chance for continuity, to follow patients through their lives, helping with health matters that arise. Up until now, such continuity has been only a dream. But now that I'm showing up to the clinic with regularity on Tuesdays, people are catching on.

I puttered along in the clinic by myself, taking vitals, figuring out symptoms and trying to read stoic faces to see if any of the teaching I was attempting was registering. The CONASPEH clinic tends to be slow and sporadic, but I've noticed over the weeks a more reliable stream of faces.

Now I'm catching up with paper work with a napping Solomon at my side. He is really close to crawling, I think. Also close to pulling himself up to a standing position. He just can't get his leg positioning right. I'm patient. I'm savoring these days where he is minimally mobile because our lives will CHANGE after that ends. Patrick left for a scheduled meeting with one of our highschool translators--Freno--who is trying to learn to drive. Patrick is going to take him out in a field and give him some private lessons. I can't imagine learning to drive in Port-au-Prince. He registered for official classes, but was thrilled beyond measure to get a chance to get some practice in before the real deal. So that should be a story.

Just a day in the life.