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...