Ay. Dios. Mio.

This is not a vacation. I feel like I've been treading water all day fighting to stay above the surface. Dr. Lopez's passion to teach me is so inspiring. He has shifted his entire daily lifestyle to take me on as an apprentice and he doesn't waste a single moment as an opportunity to show me something new. At the end of the day, I am grateful and fucking exhausted.
This morning first thing he got a call from the woman he treated yesterday with the heart problem. In Guatemala your health insurance only covers your med. costs if the consultation is done by your primary doctor or one specific doctor to be used as a back up. Last night neither doctor was available so Dr. Lopez rushed to the hospital to treat her, because he's not her primary doc she must pay out of pocket. She decided that it was too expensive and let him know this morning that he would not be paid. There is nothing that covers him for this behavior, at all. He pays the hospital a fee for all of the treatments he performs there. In this case he explained to me that he is now paying out of pocket for performing the nearly 2 hour treatment... what? the idea that a doctor would be taken advantage of is a joke, in the U.S. we are so used to the medical industry screwing patients regardless of if they are penny less or not. I was shocked that this was even a possibility-the patient having power over the doctor. I could tell he wasn't affected, he said "Well Christine, I don't understand why all of these people are waiting for the return of Jesus, do you know why? because here he is right here in Guatemala, I shower services on all the people with nothing in return" and laughed hard at himself.
The woman came to our house at his request to discuss the matter. I followed them to his office. I forced myself to concentrate on this conversation in espanol, to try, like I successfully did last night at the rehab house, to understand at least the gist of what's going on. I could catch a vocab word every 20 words-then zone out-pregunta-zone out-los manos-zone out-esposa-zone out...On and on this went until she left. I saw her pay him quetzales (Guatemalan money) so if you asked me I would have thought he got his way, I was not only clueless to the situation but discouraged by how little I could catch of her quick high pitched Spanish that ran together like a tongue twister. After the meeting he told me she paid him a quarter of the bill, slightly more than his fees to the hospital. Unreal.
As soon as she left the doc's lawyer and his wife came to the house for a minor surgery. His big toe was swollen with infection because a part of his toe nail was ingrown. The couple was lovely, constantly making jokes to me about the Dr. even though they knew very well I couldn't understand. Again I was forcing myself to try and understand catching 1 every 15 words, but it wasn't as laborious with them. I assisted him, handing him whatever he needed. As he was translating the stories and jokes back and forth he casually injected anesthetic in the lawyer's big toe and ripped it open with scissors and dug under the nail bed for the stray piece of nail, as thick, glossy blood rushed out my stomach did cartwheels. I am still amazed by the fact that doctors can dis attach from these situations, turn off the human in them and then turn it back on. They hugged and kissed me goodbye like I was their child going off to the war and then left. Another complementary medical treatment.
During the "surgery" his Aunt came home for the first time since I'd arrived. A very sweet, busy and lively woman in her late 50s. To my surprise she could speak English well, but I could tell she was holding back out of shyness about her pronunciation. Later the doc told me that when she heard I was coming a month ago begged him to rent a nicer apartment and new Volkswagen to make me more comfortable because I was from the U.S. I laughed in disbelief but he insisted it was true, she told him he'll regret it once the rich American girl shows up and can't deal this squalor. That explained a lot because throughout the day she was constantly dropping everything to fix me a sandwich, tea, make my bed, wash my clothes, she even requested that I make a list of all my favorite meals for her to make. I insisted I'd eat whatever they had not to worry about it.
He printed out a questionnaire 12 sentences long in spanish, about PAW (Post Acute Withdrawal syndrome..which basically means prolonged withdrawal symptoms after your body is done detoxing). He translated each sentence quickly and then told me that I needed to learn them in order to make "Dr. Fitzsimmons's patient interviews" smoother. Riiiight. As my tongue clumsily stumbled through the pronunciation of each sentence and I kept stopping to be reminded what different sentences even meant, I could hear his aunt giggling in the kitchen and reassuring me that she feels the same with english. We did a mock interview, he would answer the questions in spanish and say something like "well, I'm not sure if I feel difficulty with coordination, please explain what you mean." And I would just go on to the next question, I not only had very little idea of what I was saying but could understand even less of what the answers were. AY DIOS MIO. We took a break out of my frustration and he said "Well take a few more minutes to familiarize yourself, we're leaving for the hospital soon." I'm sorry? I'm doing this today? I don't get a day or 2 of rehearsal? He laughed at me and gave me a very long answer in the form of a story "If I want to know what your sandwich tastes like tell me how can you explain it to me......."yadayadayada the lesson is you must experience it yourself to know. I got that familiar weight on my chest that feels like bricks being stacked on my sternum, the same feeling I used to get in theatre when I was forced to perform with nothing prepared.
I practiced my questions all the way to the rehab hospital, it was just that less of a rehab "house" more of a hospital. Ghost hunting in an abandoned psych ward, that's what came to mind when we stepped in. Wall to wall cement, dark, restraintment straps everywhere. This was the second most expensive and celebrated rehab clinic in the country...my god.
The group room looked like a school cafeteria with a pool table, metal chairs and a TV. There we found our 1st targets for the interview. Three men stared at me, shaking with tremors, tired and terrified. Doc gave us a long intro in spanish, something about Dr. Fitzsimmons conducting interview all over the world, apparently I'm off to Chile next. As the questions tumbled out of my mouth clumsily doc had to repeat every question to them, they had no clue what I was saying, some how I understood their answers and scribbled them down on my very official clip board with my Lexapro labeled pen.
We attended one of the nightly AA meetings held in the garden, which are open to the public. It was packed, I guess that shouldn't be a shock-the doc informed me that 80% of Guatemalans have alcohol problems..80%! 8 out of 10 people. I sat in and tried my damnedest to understand what was being said, to no avail. They celebrated one member's 8 years of sobriety and we all feasted on tamales- which were nothing like Mexican tamales, they were corn husks filled with this mix of corn paste, seasoning and tomato mixed together.
We evaluated everything we saw and related it back to PAW (Post Acute Withdrawals). I tried to focus as we discussed further plans for our ibogaine clinic, but my head was dead tired from a the day. He told me the responsibilities he expected from me once our clinic was running, beginning with screening our patients;taking their blood pressure, testing their blood sugar level, taking a blood sample- that's where I stopped him to tell him I hadn't the first clue as to how I would begin any of this...in the U.S. we have machines for these things. His jaw dropped, "So you have never given an injection?" I shook my head, he paused and stared at me "WHY?" I answered "Uh the opportunity never arose" he shook his head in disbelief, "So you mean to tell me that if I went into cardiac arrest alone with you I would die?" I nodded my head. He gasped and said "No no no no Christine...you will learn all of these things tomorrow and it will be your job to perform them at our clinic."
Ay Dios Mio, Oy Vey, I'm Fucked...however you want to say it.