Halfway

I'm feeling more accustomed to the school schedule now - class, studying, quizzes for the first time in years. Just in time for the mid-term exam yesterday! Hard to believe we're already halfway through our time in Peru. I continue to be amazed at the sheer volume of material presented, but I understand tropical medicine much better now than I did a month ago - though I still have a long ways to go! We saw our second leprosy patient this week and our group immediately made the diagnosis - whereas we had no clue with the first case a few weeks ago. It's amazing how the brain can absorb so much information in such a short period of time! Isn't God's creation interesting?! Below follow pictures from the last week:

 Reviewing the CT scan from a young teenage girl (with a four month old baby at home) with symptoms suggestive of TB &/or AIDS. The CT scan suggested a hydatid cyst (echinococcus) in her lungs. Pathology (below picture) showed choriocarcinoma (very rare cancer associated with pregnancy). Certainly wasn't the expected diagnosis. Thankfully she's receiving excellent care including chemotherapy at this specialized hospital in Lima. She joyfully shared with us how she was in a coma shortly after she was admitted to the hospital for 2 weeks but miraculously recovered. I couldn't help but think we wouldn't even be able to diagnose her condition, let alone treat it in Burundi.

 Obviously she's still very sick. Please pray for her healing and for the team caring for her. Also pray for her mother who's quite worried and for her baby boy being cared for by relatives at home. 

 The highlight of the week was visiting the children's hospital in Lima. Though adults can be interesting :), I was reminded again of how much I love pediatrics! The kids smiled brightly and loved the stickers we handed out - toddler language is pretty much universal - no translation needed. :) We spent our time in the infectious disease ward - which was quite nice as you see in the pics - and saw patients with typhoid fever, chicken pox, pertussis, parasitic liver disease, TB, pneumocystis pneumonia, and AIDS.

 This case was quite heartbreaking. She's one year old and weighs the same as a newborn (3.5kg). She's been severely neglected and was just diagnosed with advanced AIDS (her mother refused to take medication during pregnancy to prevent transmission to the baby). She's evidently improved significantly during the month she's been hospitalized, but her long term prognosis is bleak. She is a precious child of God who waved at us and said "ma-ma". The injustice of the world is hard to fathom sometimes - how this little girl could end up in this state without anyone seeming to care. 

Isaiah 49:15-16: “Can a mother forget the baby at her breast and have no compassion on the child she has borne? Though she may forget, I will not forget you! See, I have engraved you on the palms of my hands."

 

Our group at the children's hospital pictured with our attending there and a couple new friends :)

 Random sight on the side of the road - not quite sure what the chickens are stuffed with. I guess I don't need to wonder where my daily chicken and rice for lunch comes from anymore!

 

 Mmm, intestinal worms...

 Learning about cholera from one of our favorite professors

 Hospital Cayetano 

 Studying for the midterm during a class break

 Classmates, Peruvian med students, & another favorite professor

 Celebrating after the mid-term exam with a Saturday brunch overlooking the ocean - awesome!

 The studying break continued through the weekend and I actually tried surfing for the first time Saturday afternoon. I'd like to say I'm the surfer actually riding the wave in the above picture, but, no, I spent most of my time paddling in the water and only stood up once - very briefly! But I had fun - and today I have lots of sore muscles to prove it!

 I bought maracuya (passion fruit) on my way home. I'm loving Peruvian fresh produce - especially maracuya, mangos, and avocados! 

 One of the best ways to end a day - frozen yogurt with two of my roommates!