A delicious breakfast of french toast and gallo pinto was served promptly at 7:00. Instead of eating with just our medical group, we were accompanied this morning by two new ISL teams that arrived late last night. One group is comprised of seven just graduated nurses who will work in various health centers and clinics throughout the area. The other team is a group of female students here on a pediatric and women’s health service trip for two weeks. It was nice meeting some new faces. They reminded me of our group just a few weeks ago when we were the ones asking several questions about the days ahead. Our role has now been switched.
After breakfast, we caught a taxi to the hospital. The number of patients and doctors in the hospital was much smaller than normal because Nicaragua is celebrating Father’s Day today. We had the opportunity to watch a few surgeries before lunch, including a C-section and a repair of an inguinal hernia of a 60-year old female. The head of internal medicine had us take vital signs for a bit before guiding us around the hospital. She introduced us to several of the patients and talked about their symptoms and treatment. The degree of illness was varied, but we spoke with several incredibly sick patients. We met a 76-year old man complaining of severe swelling and pain in his legs. He took his sock off to show us necrosis of his foot. Two of his toes were completely black and the others were characterized by redish/yellow pockets of pus and purple lesions.
Before leaving the hospital, we were introduced to the orthopedic surgeon in Masaya and scrubbed in on a femoral fracture fixation surgery. The 13-year old boy was kept awake (though hardly lucid) during the procedure that consisted of putting three metal nails at the neck of his hipbone in order to fix the injury. It was a very interesting procedure to watch. I now have a much greater understanding and appreciation for why orthopedic surgery tends to be a male dominated field- the sheer strength it takes to drill and screw nails into human bone is quite great. The surgeon was sweating profusely by the time the task was accomplished.
Given the oddly few patients at Masaya, we called it an early day around 1:30. On the way home from the hospital, our team leader suggested we could tour El Coyotepe, a fortress built on top of one of the largest hills in Masaya by Nicaraguan president Zelaya in 1893. During the dictatorial regime of the Somoza family (1937-1979) a dungeon was constructed below the fortress that served as a prison, torture chamber, and execution center for political enemies.