El Centro: First Day

As I sat next to my supervisor, Dr. Cueto, in his office, I was able to look across the room into a crowded waiting area. I expected each visit to be brief and to the point: a quick how are you doing, let's take a look, here's what you need. This seemed to me to be the best way to manage such a large volume of patients. After all, it was already 4 PM (Dr. Cueto has a private dermatology practice during the day), and these patients ARE getting free health care. That's why I was taken aback when the first patient sat down and started talking, and talking, and talking some more. Now let me remind you that my Spanish is far from perfect and I couldn't understand everything that was being said. But I thought I heard her mention something about her grandchildren. Then she reached into her bag, pulled out a large photo of her grandaughter, and showed it to Dr. Cueto as he smiled proudly. She then reached into her bag again and pulled out a baby outfit with the Gimnasia logo (one of the two local Futbol teams in La Plata). This provoked a different response from Dr. Cueto because he is a die-hard fan of Estudiantes (the other, rival team from La Plata).

This was not an isolated incident. Dr. Cueto talks to each and every patient on a personal level. This particular woman had been coming in for HIV treatment for years, but he expresses the same amount of interest in patients he meets for the first time. I eventually came to the conclusion that providing this type of personal attention makes his job more manageable, not more difficult; even though we didn't leave the office until 9 PM.

Within the span of a few hours the following patients came into the clinic: a teenage girl who was sexually attacked and awaited an HIV test, a twenty-year-old man afraid to tell his family he has HIV, and a woman with AIDS who is homeless but does not want to stay at a group shelter. Clearly, the patients who come to this clinic have problems that go beyond health. Most have been living on the margins of society their entire lives, and HIV is just one more thing they have to worry about. By simply treating each "case" that comes in, without getting involved in the human element, it could be very easy to burn out. Treating illnesses all day does nothing to change the underlying imbalances in the world that create them. No matter how fast you dispense medicine, there will always be more people out there getting sick. One might feel like Sisyphus rolling his rock up the hill each day only to see if break apart into little pieces. But if you treat the person and try understand his or her individual struggles, the work you put in has more of a purpose. You will be able to take part in, and therefore appreciate, the life you help sustain. Of course this all comes at a price. Opening up yourself emotionally to patients that will likely pass away in a matter of years can be very difficult, and I understand why many avoid it.

This has been a lot to take in and has given me much to think about the past few days. There is no doubt that I will continue to learn a lot from all of the doctors at this clinic. I hope that I can prove my worth my starting a good project. I already have some ideas, but stay tuned till next time for more.