It is a joy to be back in Guatemala amongst staff and friends at the hospital and in the town of Santiago. I have fallen straight back into old habits of greeting strangers in the street without receiving the strange looks you get on the streets of Newcastle.  I find that in the UK, we rarely even greet those we work with everyday or pass in the corridors, and here the world and his wife wish you a good day as you walk by. Buenas Dias! more…

What with being caught up in the whirlwind of Hurricane Agatha, sinkholes, volcanic eruptions, and the daily grind of life as a doctor, it has been a while since I’ve had the chance to sit down and collect my thoughts, in fact its arguable that I still don’t have the time! more…

Strangely enough, I think I may have found it a more difficult transition returning back to work in the UK, than the initial challenge of starting work in Guatemala.    Working in Guatemala was shocking for a number of reasons, but as I grew to understand the system and the culture, I found myself working harder, and achieving more.  There is little more frustrating than not being able to help a sick and treatable child because the family has made the decision to leave it to God’s will.   Until I began to understand and accept this as part of the necessary treatment regime, I found myself working against the system.  After 5 months, and tears of frustration, I have learnt to negotiate, and to work with the family so they could accept medical as well as spiritual treatment. more…

A few years ago I lived in a flat with a dear friend Hannah, who like me is a collector of junk and disastrous at keeping things such like wires, lids, buttons, remote controls where they should be kept.  

For example, I would ask: “What does this cable do?”

Hannah: “No idea, but maybe we need it?”

And so was born “the drawer of misunderstanding.” more…

Guatemalan coffee is revered as a most tasty brew throughout the world.  I’ve even read reports from connoisseur “cuppers,” or coffee tasters, about it being a “kaleidoscope” coffee.  Apparently that’s a good thing, and certainly something the Guatemalans are proud of.  more…

The night before last, one of the other doctors admitted a 22 year old male who had ingested concentrated paraquat whilst intoxicated.  At the time of admission he was 24 hours post ingestion and his presenting complaint was pain in his mouth and throat due to chemical burns.  The night shift doctor handed over the case, along with a wealth of information regarding paraquat accumulated from internet searching and ringing the poisons helpline in the United States.  The outlook from all this data was bleak, especially given our lack of facilities to deal with multi-organ failure.  I have no experience with paraquat poisoning, but from published case reviews it appears that paraquat ingestion anywhere in the world is a one-way road.  more…

After the blow to my confidence last week with obstetrics patients, I have developed a healthy fear of the uterus and have understandably been reluctant to see ante-natal, labouring, or post-natal patients.  Any organ that bleeds 500ml a minute is a thing to be feared in my book.  Of course the problem with my reluctance is that over 50% of what happens here has something to do with pregnancy, and again today we found ourselves without an obstetrician for both a delivery and also an ante-natal clinic.  Me, again? Oh no. more…

Before I arrived here, I was concerned about quite how bad my first on-call could be given the new environment, the language, and the vastly different presentations that I could see.  I’d done my homework, I knew that Guatemala ranked highly in both maternal and infant mortality rates, but I’m not sure I’d taken the time to consider how I might personally react to an horrific on-call.  The transfer of a numerical statistic to human contact is a difficult step to take. more…

One of the most exciting aspects of working here is the opportunity to have a good rummage among the rarities of diagnoses that I learnt about for the MRCP.  There have been a few cases now, which have rung a big bell in my head, related to conditions which I never thought to save space for in my brain, as they seemed so obscure and unlikely.  more…

I thought I might be broken in gently to the new job, but I arrived last Friday in Santiago, and was thrown into a 24hr on-call in the ER on Saturday, which was thankfully remarkably quiet.  Sadly I have had to convert to transatlantic terms, as when I use the term A+E, my American colleagues seem to think I’m talking about the cable channel ‘Arts and Entertainment’.  more…