Gastrology

Yesterday was the start of my first full week at the hospital. We got there around 9:30 AM and met up with Claudio. He was a little rushed, because apparently he had an emergency with one of his patients. But he took some time to tell us to get our ID badges made, and then dropped us off at each of our departments. Because I had shadowed Claudio for a few days last week already, I decided to go to a new department this week, and picked the Gastrology, as did Chris. We both walked down to the second floor and introduced ourselves to the department nurses. They were really nice; I was struck by how close knit of a unit they were. Everyone seemed to be really friendly with each other. The main person in that department in "charge" of us was a male nurse name Fernando. His english was pretty good, and he was very talkative. He had been a nurse for 15 years or so, so he was pretty well informed about the healthcare system in Portugal and Europe in general. More importantly, he was willing to answer any questions we had. Because Chris is also a nursing student, him and Fernando talked a lot about practices, etc.

The Gastrology department does mainly Endoscopies and Colonoscopies. Yesterday there were no colonoscopies scheduled, so all we would see were endoscopies. Fernando informed us that in Portgual, people didn't really use anesthesia for procedures (unlike in the United States, where they knock you out for pretty much anything). This included dentists, (some) operations, and nearly everything the did in the Gastrology department. The reasoning was that 1) anesthesia cost a lot of money and 2) the patient would be pretty much useless for a few hours after regaining conciousness. Even though most people didn't mind not getting anesthesia and were used to it, if the patient really couldn't tolerate the procedure, they could request it.

Anyway, we saw 3 endoscopy procedures, all sans anesthesia. Also one of them was a 90 year old woman. I'm guessing this has something to do with the machismo culture here (see: bullfights) . For those that don't know, during an endoscopy the nurses stick a camera down your esophagus into your stomach, and can go until the duodenum. It's used mostly as a diagnostic tool, to see what's going on down there. One of the patients needed a tissue biopsy from her pyloric sphincter (the spinchter separating the esophagus from the stomach), so the doctor used a claw-like appendage to grab several chunks of tissue for analysis. After the procedures, Fernando talked with us some more about healthcare practices, giving us a tour of the department and whatnot. (btw, colonoscopy tubes are terrifyingly large)

During our conversation, he mentioned that a bed at the hospital here would be around 150 euros a night. That's about $200. That's a LOT cheaper than in the US. I told Fernando that, and he said that that was because the insurance companies here did not play as big as a role in deciding healthcare options as they did in the States. However, he said that Portugal was trying to copy the US system (can't imagine why...), so healthcare was getting more and more expensive.

As mentioned before, the whole Gastrology department seemed really close knit and friendly. As I had seen in other areas of the hospital so far, the amount of time that these doctors spent with their patients was large, way more than in the US. Also, they are VERY good at what they do. I'd be hard pressed to find a more efficient and effective department anywhere else.

After we got out of the hospital, Aisha and I walked with Vanessa up to the University of the Azores so Vanessa could pay her housing deposit. It's starting to warm up, and the days are becoming warm and sunny...the island is becoming even more of a paradise. We took the scenic route to the University, along the cliff overlooking the Atlantic Ocean.

Afterwards, we came back to the Residencia and hung out for a little bit and did some work (I finally got started on those med school apps. word.). Later we went out to dinner, to the same place we went our second day here. The waiter remembered us, although I guess it's kind of hard to forget a group of 10 obvious tourists.

After dinner, a few of us went to the beach (about a 5 minute walk from the Residencia) and watched the sunset.

Overall, a pretty good day I'd say.