Sunday, March 3, 2013

Travel Forms Youth: Someone Else's Turn

From Peru April 1992 Travel Diary
Pallav Pareek, one of our Chief Residents, has just returned from an international away elective in Peru, where he arranged to spend two weeks observing the practice of Child and Adolescent Psychiatry at the Universidad Peruana Cayetano Heredia in Lima.

I go on an archeological dig and find the aging diary, where I documented my own away elective to Peru, for a tropical disease rotation at the same institution, during medical school in April 1992.

Some extracts, almost without commentaries, because the writing speaks for itself..of my youth a the time:

From the Scholarship Travel Award letter:
"Dear Ms. Glowinski, It is with pleasure that I am formally notifying you that you were selected to be a recipient of..."
I remember that the scholarship required fluency in Spanish, to be verified by an interview to which I showed up entirely not fluent in Spanish... but making a case that the distance from French to Spanish was not that enormous...

April 2nd...

"The hospital is incredible. There is a cholera room, in full swing for the past three months, where patients are lined up, sitting in chairs and receiving IV and oral hydration. They drink patiently....every morning the roosters sing loudly. The first one I heard woke me up abruptly and disoriented me: I thought an angry person was protesting..."

April 3rd, 92

"This morning the whole city of Lima, at least at my window is like the movie Brazil......At this point, though it is more and more diagnosed, HIV (they call it VHI) is rare enough that the doctors here kind of don't mind it...."

April 4th, 92

"Today I went to the curzo Actualizacion en Colera, all day....I almost cried though when a man of the Ministeria de la Salud exclaimed "Gracias Colera!" because he had hopes that this disease, which is a minor cause of mortality compared to the vast array of diseases....will lead to some major public health changes.."

April 5th, 11:30 pm

"My first meeting with Cesar Cabezas was briefly followed by a military coup..."

April 7th, 92 6:13 am

"Each morning a new species of noise-makers awakes me. Today it was somebody spitting loudly..." 

10 Avril 92

"There is a Bunuel festival, called Bunel El Angel Exterminator..."..."Today I dealt with I----monster once and for all. He was telling me that when he saw me for the first time, he was devastated that I had a boyfriend. This was the last straw in a long getting on my nerves series. So I probed...and gave him advices. He is terrified of me now."

4-12-92

"Cesar talked about the novel he is writing....After he finished his medical studies...he was sent to a hospital in the selva to do his obligatory medical service year. It was 1986 and the amarilla fievre (Yellow Fever) was raging..."

13 Avril 1992

"Cesar explained to me that a Jaimito is an...irreverant charming boy who typically annoys teachers.....Peruvians are incapable of hurrying....The residents, overworked, stressed and post call, do not try to expediate their work to go home. That would be a major faux-pas here. They talk for hours in the halls...going over..New England medical journal articles."

April 16th, 92

"Cuzco is a royal city, suspended atop high mountains and invisible to the rest of the world. I successfully delivered the Amfotericin to la Doctora Gladyz Ramirez."

Vendredi 17 Avril 1992

"Yesterday was Jueves Santo. Tradition wanted that religious people visit at least twelve Cuzco churches before the end of the night....Yesterday, I also ended up talking for hours with Andy and Gustavo. Andy is from LA, a terrorized vegetarian...traveling all over Peru...for a movie about the Sendero Luminoso....Gustavo is a Peruvian physician who worked in Switzerland for twenty years as an emergency/trauma surgeon."

Dimanche 19 Avril 1992

"There was Rafael, who is...an espanol, who is spending the year in La Paz, Bolivia. He works for the Ministry of the Interior.....Flavio is a civil engineer from Lima whose parents are Italian....It was eerie to listen to Dylan's Tangled Up in Blue at such an altitude and with [this company]..."

Lundi 20 Avril 1992

"Today was a Friday the 13th with multiple disasters. I left Cuzco safely and spent the flight babysitting an agitated three year old little girl.....a young man jumped on me...to tear my watch off my wrist...On top of all this a man with a black and white shirt was following me for hours.... As my new friend Rafael said there is a chinese proverb: If a problem has a solution, don't worry and if it doesn't, why worry?..."

Mardi 21 Avril 1992

"One more week in Peru....the last three weeks have been no vacation but rather a not so easy adaptation to a complex country..."

Mercredi 22 Avril 1992

"A restaurant in a convent of French nuns who sing Ave Maria after dinner. I was expecting black and white old nuns serving food in a slightly austere religious atmosphere. The nuns were wonderfully exotic creatures...in beautiful...clothing. They spoke French with a charming French Guyane accent and had young smiles..."

Jeudi 23 Avril 1992

"Today I went to see my young patient, who I am afraid is dying of Aplastic Anemia. A beautiful young man, yellowed by his illness....His mouth is swollen with horrible hematomas. He immediately asked me if my camera had been stolen and proceeded to lecture me on the precautions that a reasonable human being would have taken. He spoke of the archeological treasures of his country: Extraordinary mummies, hidden ruins...even more magnificent than Machu Picchu.  He told me about the History books he was reading..."

Viernes, 24 de Abril

"Lima is like a gigantic Flea Market without beginning or end, especially in El Centro where I reside.....combs, make up, mais, gum, puppies, religious icons, dresses...sometimes objects of undefinable form and use......I saw ten AIDS patients today for routine ambulatory care. This for your crypto, this for your PCP, this for your anxiety, this for your CMV retinitis. We had to do an LP...on a young patient....emaciated, with headaches, a cough and dimming vision. His mom, the mother of 12 and grandmother of many more, was there. When Luccio was explaining the necessity of an LP, D-----violently shaked his head "NO, it's gonna hurt". Luccio launched into a typical medical speech. Escuches D----tu tienes una infeccion que te predispose a muchas otras infecciones opportunidades. Ahora nosotros no podemos hacer un diagnostico seguro etc...etc...I wanted to ask D-----what he wanted. Pain relief I bet....not putting his pants down and me, Doctorita, as he calls me, holding his head down, stroking him gently, telling him to relax and breathe like a woman in labor..."

1:30 am

"I had a wonderful evening with la Dra Terashima and su esposo who is a warm and wonderful Peruvian psychiatrist...We went to Barranco, which reminds me a little bit of France, to a pena restaurant..."

Domingo 26 de Abril,

"After yesterday's maledictions, where we were assaulted and wounded, later fell two times in the sea from rocks, which had seemed perfectly out of reach of the avid tide and finally broke Cesar's glasses...as we were going back towards Lima pondering how horrific (una pellicula de horror) our day had been. Hoy no es mi dia...Cesar kept saying."

Lunes 27 de Abril

"Today, what sorrow in the Pension. There is a sadness in the air and Maria and Rosita look sincerely triste that I am leaving. I settled my account and Maria did me the huge favor of not charging me for laundry. They always laugh at/with me when I narrate my daily gaffes. They say: La Senorita!!! My heart aches because I will truly miss them...Rosita ceremoniously gave me a picture of herself when she was a little younger, so I gave her one of my pictures. She put it in a frame..."

Mardi 28 Avril 1992
"9:15 pm in the plane.
"I hear Peruvian music in my head.  Mujer de la Luna, I think. It plays itself over and over again and I feel like singing too. I am actually singing it quietly. I feel tired and a little strange....This morning, as I was about to leave...Maria asked me if I thought her daughter could have been deeply affected to the point of nightmares and increased startle responses, by the recent explosion which killed and wounded several pupils [in her school]....

Welcome back Pallav: I can't wait to talk to you about your trip.

Till Later,

Anne











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