Blog 27

Blog 27: 10/27/08

My third day at Hospital ISSSTE was amazing because I was finally transferred to surgery. Also, I was lucky enough to see a spinal surgery. To get the transfer, I went to talk to the administration, which was an interesting experience in itself.

At 8 a.m., I went to the administrative teaching office, which assigns students to various rotations around the hospital. At ISSSTE, the system is very regulated and permission is needed for students to change departments, and must be assigned specific doctors to rotate with; unlike Civil, where students can pretty much show up anywhere, as long as they have a proper identification. At the office, I wasn't able to speak a word of Spanish, I think it was just one of those morning where my brain wouldn't function. The only thing I could communicate was that I wanted to rotate in cirugia (surgery). After a lot of talking (none of which I understood), the secretary assigned a lady for me to follow. I followed the lady to a department that said Cirugia and Medica Interno (you can guess what those mean). She told me to ask for Dr. Eric Martinez, when I reached the department. So I asked for Dr. Eric Martinez, and he wasn't there today, so I was told to ask Dr. Victor Cruz about what I should do. Dr. Victor Cruz was a really nice guy, unfortunately I couldn't understand a word he was saying, and vice-versa. He took me to this room with two other doctors. This is where it gets funny. Dr. Cruz said something to do the doctors, and left. So, I was in an office with these two doctors, and I had no idea where I was, who I was supposed to follow, or where I was supposed to go. The lady doctor started talking to me, and I through she told me to enter one of the rooms in the hallway. So, I went outside and entered a room with a patient in it. The patient was confused and had no idea what I was doing in the room. What made things worse was that I couldn't understand a word the patient was saying. So I was waiting in his room for 10 minutes, and the patient's son told me to go outside to get a face mask. When, I went outside the male doctor who was in the office told me to follow him, and we ended up going to his consult room, which was two floors down. So as it turned out, I wasn't supposed to go into any of the rooms in Medica Interno, instead they just wanted me to wait for one of them to finish their paper work. So...not knowing good Spanish can make for interesting experiences and funny stories! I feel kind of bad because the patient, probably had no idea what was going on.

I'm starting to like ISSSTE more than Civil because my rotation is more personalized. It's just me and one doctor, and I follow him through his surgeries. The doctor is an orthopedic surgeon (title in mexico: Traumatologo); his name is Dr. Rene Velazquez. I'm really lucky to be shadowing him because he's a really nice guy, who's able to get along with everyone. His people skills are amazing. He also, really goes out of his way to make sure that I'm having fun and get to see really interesting stuff.

Today's case was really cool. Dr. Velazquez operated on a 33 year old woman, who had a "black disc" (deteriorating disc?) which was causing her problems (my guess a lot of pain). The surgery was especially interesting. Dr. Velazquez was learning how to do a new procedure from another orthopedic surgeon named Dr. Pepe. Dr. Pepe owned or worked for a company (www.lixus-spine.com) that developed special plastic spacers (and other orthopedic equipment), which would tie together and rigidify the vertebra that had the black disc in between. Dr. Velazquez entered the woman's back with a cauderizer. He kept going deeper, until we saw the vertebral arches. Dr. Velazquez used a special X-shaped tool to separate the vertebral arches of the two different vertebrae. Thereafter, there was an x-shaped space between the vertebral arches, where the x-shaped plastic spacer was placed. The plastic spacer was secured between the vertebra using this special rope that tied around the vertebral arches. The lady was then resealed. The deteriorating black disc could no longer act as a proper spacer, causing the spinal vertebra to start touching. It was a pretty simple procedure, meant to separate the vertebra that were touching and causing pain.

I really thank God for my experiences today. I was assigned to a really friendly surgeon, who was happy to have me with him. It did wonders for my learning and observational experiences. Dr. Pepe spoke English, and he was super happy to explain the procedure he taught to Dr. Velazquez; he ended up giving me his e-mail and card, and told me that next time I was in Mexico City, I should call him to check out his orthopedic company. Both surgeons were really impressed with my videos and pictures, and wanted it on C.D.. During the surgery Dr. Pepe wanted me to take a bunch of pictures of his equipment and how it looked inside the body, so I have some really cool viewing angles on photo. I'm going to continue my rotation with Dr. Velazquez next week, so I should see some pretty cool stuff. What's really interesting is that he's going to let me view him interacting in the consult room, as well as in the operating room in order for me to get a full understanding of the surgical profession. He also told me, I could come into the O.R. anytime I wanted, even if he wasn't there, and introduced me to Dr. Venacio Rodriguez, the head Anesthesiologist. Now I have full surgery observation access at ISSSTE! Kudos to the Oaxaca Program!

One more thing: ISSSTE's operating facilities are better funded than Civil. There is more surgical equipment available, and more resources are used during surgery (such as more sheets and coverings on the patient). There are less people in the O.R. which makes the viewing experience more personalized. It's better maintained, and the rooms are much cleaner. It was easy to see how good insurance, can get the patient better resources for care. The difference between ISSSTE and Seguro Popular is pretty big in terms of quality of care.