Otavalo, Guayasamin, & Good-Bye

My last post for Ecuador is being written as I sit comfortably in my home in the US!
Despite the impossibility of recounting every great point of the trip, I do feel like Mr. Guayasamin and Otovalo deserve a few words.

Guayasamin is the most popular artist in Ecuador and we visited the museum that exists in his honor in Quito. He painted the suffering of the Ecuadorian people. The hands of his figures are my favorite part of his works. I bought one of his famous prints, the Mother and Child, but lost it in the airport during my four hour delay. I'm glad to have the pictures and experiences to remember at least.

Otovalo is a market situated about 45 mins from Quito. We visited one weekend on a tour and bought lots and lots of handicrafts and gifts. We visited a biscotti factory and scenic point on the way there and we visited a family who makes traditional musical instruments,the store of a family who weave carpets/ other products, and a waterfall on our way back.

Ecuador was a wonderful experience because of the people. It feels great to be back home, but I miss adventure already. Looking forward to the next one to come.

Thank you for reading and best wishes for your own pursuits :-).

The Amazon in Pictures

The Amazon in Words

My last days in Ecuador are upon me and I certainly feel a mix of excitement for return and sadness for leaving great adventures behind. It has been the great adventures that have kept me from posting with frequency and regularity.

Tuesday night was Ami's last night in Ecuador and we had an amazing dinner in Mariscal (the newer part of Quito). The food was delicious, the conversation was long and deep, and the bill was higher than any we've had in Ecuador! But we left happy that we had at least dined in elegance in Ecuador, where it costs about 1/3 of what it would cost in the US. We also left amazed at the experiences we have shared together in this short time.

We watched our first surgery together: a laproscopic cholecystectomy at Hospital Milital with Dr. Cadena's brother...the other Dr. Cadena. Both of them are phenomenal doctors; they share a kindness in their eyes and a professional, yet personal bedside demeanor that puts patients at ease. We were accompanied by 3 third year medical students, and we were really impressed by their attitudes. They were very humble, pleasant, and accepting; very chill and very helpful. Quite different from the stereotypical stressed third yr student in the US who has a prominent superiority complex.

We started our Amazon adventure the day after the surgery. The Amazon is really what has kept me from the blog...surprise, surprise - there are no internet cafe's in the Amazon. But there is an amazing assortment of wonders to keep one from even thinking about a computer.

From the Amazon, I wish I could bring back the stars as they lit up the night sky. Our canoe ride back from a "night hike" through the jungle has to be my favorite part of the trip because we drifted down the Amazon River and stared at the spectacle of the night sky. The stars were amazingly numerous and bright and the sky was crystal clear. The more we looked into the darkness, the brighter it became.
Ami and Kenny saw the same shooting star and were too speechless to make a wish. I remembered all the people in my life and made a wish for each one.

My second favorite Amazon adventure was swimming in the Cuyabeno River (which eventually feeds into the Amazon River). The water was warm and soft, and our tour guide assured us that the piranhas, cayman, anacondas, and giant fish did not swim in this part of the river. I was the first to jump off the boat, after the guide of course.

We walked through the jungle for 4 hrs on the first full day we were there. Ami was a real sport during this time because we were romping through mud and balancing on logs as we walked through water-filled areas of the forest.

I caught an anaconda, we saw baby cayman (two of them), an anaconda, a giant grasshopper, a tarantula, squirrel monkeys as they jumped from tree to tree and ate fruit, black sacky monkeys as they lounged lazily on trees, marching wasps, lots and lots of insects, parrots, and prehistorical turkey birds.

We also saw a different kind of animal while in the jungle - the machismo man. Our tour guide was a perfect case study of the machismo culture among Latino men. Although I am no expert, I have come to know the idea: a macho man who is all talk and no follow through. These are also the kind of men who beat and abuse their wives.
Our tour guide, whom Ami and I affectionately named Pendejo, kept promising us that he was going to show us "the most amazing thing ever," and was not able to find any animals in the end. He found some insects and showed us a cool Sable tree, but we only saw an anaconda because we followed another group, Kenny spotted the monkeys, Ami found the snake, and I caught the piranha. Our guide was busy preying on some other things during the tour...

I'm writing as we watch the Mexico vs. France World Cup game at Archie's, an Italian restaurant in Plaza de las Americas. France is losing by two points and I am eating pizza with extra Parmesan cheese - two things a French friend we made in the Amazon would not be happy about. She was awesome - she had been traveling Latin America for 4 months and she is the first French person I have met who does not like cheese - heresy!

Our tour group in the Amazon was great: we had a 20 yr-old German girl, a 21 yr-old 1/2 Columbian & 1/2 "American" guy, our French friend (28), Ami, Kenny, and me.

A great experience.

Ami just bought a month's worth of Malaria meds for $0.48...I bought mine in the US for $134...

Some of My Fave Pics

Thank you Kenny for taking the pics!!

2 Volcanoes in 2 Days

I talked to a man in the car for four hours straight today...

Our tour guide to Quilotoa was quite the talkative man. I sat in the front seat on the 4 hr car ride back from the volcano, Ami & Kenny passed out in the back seat, and I talked to our gregarious tour guide about everything under the sun: we talked about how erosion from the mountain drainage is the reason for the horizontal holes in the road, whether Japanese cars are better than American cars, how Ecuador has had 8 presidents in the past 11 yrs (one of which was an Ecuador-born Arab guy who studied at Harvard and then came back to serve as Ecuador's president and corrupt the economy of the nation to the best of his abilities...blew me away), about the dollarization in Ecuador (and how he thought dollarization, although ultimately not good for Ecuador, may have been the best alternative in the light of the uncertain political situation), how sheep were introduced into Ecuador by the Europeans, how the machismo culture is prevalent in the indigenous communities, how Ecuador's natives have become smarter in their business interactions, about baptism, the Bible, and the Quran, about Michael Moore's movies, about how the city of Quito is 45 miles long and only 4 miles wide in some areas, how only 10% of Ecuadorian medical students who go to public universities graduate, and so, so, so much more (4 hrs worth of so much more). Kenny bought original artwork from the woman who painted the picture herself, Ami rode a donkey back up the crater, and Kenny and I hiked back up our second volcano in two days. The crater lake is named Quilotoa because Quilo was the name of a native pricess and "toa" means "teeth." They called the crater lake Quilotoa because it was the native pricess always smiled (showing her teeth) when she went to the crater. It was a full day and we were absolutely eshausted when we got home. This weekend has been so amazing and I am so thankful for the once-in-a-lifetime opps!

To the top of Cotopaxi

Hiked to 4800 meters above sea level on Cotopaxi today. The last time this volcano erupted was in 1904 and it is now snowcapped. The hike was exilerating and the views were beautiful. The altitude made it hard to breath. We had tea, hot chocolate, and sandwiches at the 4800 m point. The black Patagonia coat I am wearing belongs to a Brazilian Japanese couple who came on the tour with us but who did not treck up the volcano with us because the wife got altitude sickness. It was the first time since school ended that I felt like I was really relaxing and enjoying myself. It was wonderful.

Colorblind?

The hypocrasy of a conversation we had with a native Ecuadorian at dinner last night blew me away. We were talking about racism, and she was explaining how some Ecuadorians have darker skin and features representative of indigenous peoples. She was critisizing the idea that lighter skinned people are "better" than darker skinned people, and yet, she herself was lighter skinned, had almost no "indigenous" characteristics, and was dating a Caucasian man with blond hair and blue eyes. It seems the racism is between the shades of "white" here, and I don't know that I believe the words that were coming out of the mouth of the lady we spoke to during dinner because her mannerisms, actions, and the way she chose to live her life indicate that the idea that "lighter skinned" people are "better" than darker skinned people is ingrained in her.

Skipped Class and Went to the Middle of the World

We took a trip to Mitad del Mundo = the Middle of the World yesterday. It was amazing. Water goes straight down instead of swirling, you cannot walk in a straight line, and you can balance an egg on a nail when you're on the equator. There's also more force acting on you so you cannot resist other forces as well.

We were late to class, so we called and cancellled, and then went to the Andes mountains. We took the telecabin up and met an engineer who works on medical imaging in our telecabin.

Amazing!

Today was just amazing!
Kenny, Ami, and I were saying things like, "This was so refreshing!" "I saw more in three hours than I did this entire year!" and "This made me understand I'm doing what I want with my life."
Today was our first day of clinic. We shadowed Dr. Cadena in the ER and we were all very impressed with the entire experience - the doctor, the residents, the nurses, the hospital staff, and the health system worked much more pleasantly than we expected. A staff member walked up to us as we were waiting in the information line and asked how she could help us; she then proceeded to walk us to the Emergency Department and all the way to Dr. Cadena's office. Would the staff at a US hospital take the time to provide such service?
We walked into Dr. Cadena's office to find his nurse taking information from a patient at the computer as Dr. Cadena himself sat on the examination table writing on a tablet of some sort. He greeted us with a warm smile, shook our hands, and introduced us to his nurse. He then took us to the locker room where we could change into our scrubs. Dr. Cadena asked us our names and our year in medical school as we walked back to his office, and then the intensity of the day began! There were at least 10 patients waiting outside the Dr.'s door and we met with 5-6 patients along with the Dr.
The patients entered the room with one relative, sat down at a desk with a computer, and gave the doctor a sheet with their name and identification number. The doctor pulled us right into the interaction and asked Ami to read the patients' information to him. Ami was amazing! She jumped in, whipped out her Spanish abilities, and ended up writing the prescriptions and lab tests for all the patients! All of the patients medical information and previous medical visits are pulled up through their identification number (Our host daughter says that Ecuador has a mix of public and private systems for healthcare, so I'm thinking the database and identification number we observed show only the information from visits to public hospitals). A focused history is taken and then the patient is asked to go to the examination table, "Por favor, vaya a la camia." A focused physical exam is done, the prescription is written, and the patient is out the door as the next patient enters.
Dr. Cadena asked Kenny and I to present the patients' cases to him as he was performing the physical exam - this was preeeeeetty hard with our limited Spanish, but still awesome. We saw three cases of costocondral pain due to 1. kidney stones, 2. general gastritis, and 3. epigastritis. We saw a classic case of Bell's Palsy!!!!! We saw a patient on dialysis, a rectal exam, and herpes. Amazing, amazing, amazing. A couple things we noticed were that the Dr. did not change the bed cover for each patient and that the patients were in very severe pain. An 86 year old man who had previously had three hernias was asked to position himself on his hands and knees for a rectal exam - it was painful to watch someone in such pain. A patient who had previously been in a car accident and who was having ear pain and secretions from his ear was asked to walk up and down stairs to get a CT. But...overall, the service was quick and practical.
After seeing a few patients in his office, Dr. Cadena gave us a tour of the hospital (Hospital IESS - the Social Security Institute Hospital). It was newly renovated and very clean (except for the parts that were under construction). It seemed to have every wing that a normal hospital would have, and had a church on the top floor. After seeing a historical church out a hallway window as we were walking back down to the Emergency Department, Dr. Cadena asked us if we follow any particular religion and each of us had a different answer. As Kenny said in a later conversation, "The three of us are like a walking cultural experience from around the world."
The tour ended with a trip to the emergency room. We saw the critical care unit, surgery unit, and general emergency area. One of the medical students/ residents (he is in his 6th year of med school) let us assist in a catheterization of older female patient. We all wanted to comfort the patient because she was shaking, and Ami did end up putting her hand on the patient's shoulder, but it was obvious that the patient's comfort was not high on the resident's priority list.
The interaction between the doctors and residents was very interesting for all of us. They shook hands, hugged, and laughed together, and there was no visible sign of the condescending attitude we are taught to expect from our mentors while in residency.
The day ended with dinner in Old Town. We went to a posh rooftop restaurant called Vista Hermosa (beautiful view) and really enjoyed the atmosphere. "Old Town" looks like a European city and has beautiful buildings lined along winding streets on steep hills. I had a pina colata for the first time (virgin version) and really enjoyed it. Although the restaurant was much more expensive than the average restuarant in Quito (you can buy a good lunch from a touristy restaurant for around $4), the total for my meal, drink, tip, and tax came out to a little less than $15! The price is amazing for the experience: live music, rooftop view of the city, and good food & friends.
The picture is from our dinner table. Ami has better pictures and I will post hers when I get them.