We are sitting in the Lima airport waiting for our overnight flight to Houston. This dinner photo was from the Arequipian Dermatologic Society meeting. The two dermatologists I am posing with are named Lilia and Ferdinand. I played post on the hospital team. see you all soon.

Gringo medicos

The hospital time has been the most interesting part of our trip. We started in Lima, where we each worked for the first week. Everyone kept mentioning that we would be going to Arequipa for the second week, which we assumed was another hospital in Lima. Turns out, Arequipa is another city in the south of Peru. We caught a flight to Arequipa on Monday, and both agree this has been the best part of the trip. It is nicknamed the White City because of the abundance of volcanic white rock in the architecture. Anyway, we had no idea we were going to a second city while we were here. A lot is lost in translation. Heidi's Spanish is very good, so she gets by pretty well. I usually stare blankly, every once in a while catching a "Estados Unidos" or my name, and then I smile and nod vigorously. They brought a medical student off his vacation to interpret for me in clinic, and that has made all the difference. Yesterday Heidi operated late, so I wandered the city without an interpreter, and my sole crowning achievement was a successful purchase of a grape flavored gatorade. Today we shopped around the city. I will include some photos once we get them downloaded from the camera.

The nurses and doctors are unbelievably nice, and the patients are very gracious and thankful. There is lots of skin cancer here, as the city is at 7500 feet of elevation and it is sunny year round. I have seen several melanomas, and had a fascinating case we diagnosed today (glucagonoma, necrolytic migratory erythema). Heidi did a complex operation yesterday on a little girl with congenitally fused digits (syndactly). I think we are learning more from the physicians here than we are teaching...

The hospital facilities are decent but definitely still third world. For my delicate facial skin surgery, I was given a skin hook that looked like it was used to herd alpacas. The wards are decorated with lots of pictures of Jesus (usually dressed like an 80's glam rock star and levitating on some clouds) although the medical student told me all of these were put up illegally as the formal stance of the government is separation of church and state. Approximately 80-90% of Peruvians identify themselves as Catholic, although few go to church regularly. All of our cabbies have had rosaries dangling from their rear view mirrors, and little Madonna nativity sets decorate hotel lobbies. We have been hearing Christmas music during our entire visit as the Peruvian Christmas extends for several weeks.

Tonight I am giving a lecture to the Arequipa Dermatologic Society, and they are taking us to dinner afterwards. We will fly out tomorrow and will see you all soon! I should be able to post the photos tomorrow...

I have a polymorphism in interleukin-8

…or as I found out, while recovering from an awful case of food poisoning. We were assured by a tour guide that a tamale from a street vendor would be delicious and safe, but the latter proved gravely untrue. I was puzzled by our variant reactions to the tamale (Heidi had some “tummy bubbles,” I had bloody diarrhea and spiking fevers that were incapacitating), so while recovering I had my enfermera read to me from the Journal of Infectious Disease and to my surprise learned that genetic predisposition may play a role. Indeed, dear Emmy has several times gone prone with awful food poisoning. And of course, our brave cousin Luke, in a wildly reckless foray into the Nepalese water supply, was sadly infirmed in a far eastern hospital for nearly 2 weeks. Which brings to mind Ben, he of quixotian ambition in South America. This pedigree suggests it may be a mere coin flip whether his future travels include chasing windmills or bathrooms.

Unfortunately the illness gripped me just as I entered the sacred grounds of Macchu Piccu (the S. American version of Montezuma's revenge?). I dropped off the tour so most of the photos are of Heidi alone. The other photos are in Cuzco, the city we stayed which is about 3 hours from Macchu Piccu. The elevation in Cuzco is about 11,500 feet. It is a beautiful place.

Lima

Our first week was spent in Lima. This is a city of 8 million or so people. We worked at a government hospital called EsSalud. The people are quite friendly, but few speak English very well. The picture to the left shows a soccer field on the beach. There are a few photos in this post. I am about 2 feet taller than the average Peruvian. I could have been a slow version of Chris Dudley for the Peruvian national team.

Again, where are the tacos?

This is our first time in Peru. The title of this blog refers to our cultural naivete. Alas, there are no tacos here. But is brings to mind food, an appropriate leaping point to our discussion that follows. My father, for one, needs a literary hook to spend more than 5 seconds on the internet--so Dad, here it is: Peru is the birthplace of the potato, with over 2,400 varieties. And they have fields and fields of corn, each producing sweet kernels the size of marbles. But I digress...

The purpose of the blog is to resurrect my 15 seconds of fame that all but extinguished after my African blog. Also, we want to share some photos and stories from this beautiful country. Enjoy.

Andy and Heidi