A Night in the Life of Ke$ha

Last night the whole group decided to go to a bar and then go out to club face. We had heard from the session 1 students that the club was a lot of fun and that girls also get free admission and drinks! (Score!) (Also any family reading this can't judge me for this because I am in Europe where I am of drinking age.) The bar that we all met up at was a little less than a good time. By being there, we were bringing down the average age of the customers by a long shot. There was a live singer who was good but her choices were karma chameleon and the likes. I finally ordered a Kypee black which i had wanted for weeks now. It is a seriously delicious, sugary, and Brazilian drink. They also gave us complimentary popcorn instead of peanuts (score!) 

After hanging out at this bar for a bit, we didn't want to stay at any longer so went to hit club. We couldn't yet got to club face because it didn't open until 3:30 am, so Hit club which opened earlier seemed like a good compromise. The place was nice but there was literally nobody in there. It was us and an older couple intensely making out and touching at the bar. We tried to make our own party but even that failed because the DJ's idea of dance music was a remix of Rihanna's stay. I mean, I love the song, but how could it ever pump you up? Manny, another student in a homestay, called his homestay brothers who are our age, and we met up with them a few roads away.

We went to a place that was obviously just for locals. It was awesome. It was this bar/cafe that I think should have been closed for the night, but some guys decided to hang out in later on. This place was on the upper level of the building, and when you walked up the stairs, there was this creepy mirror directly above you. It was so weird to see yourself upside down and all. It kind of felt like a funhouse. The place had a balcony where you could step out for fresh air (something that is really refreshing because every azorean smokes) and beyond the bar was a room with pool tables, darts, air hockey tables, fooze ball tables, and a boxing glove machine. Surrounding the room on all sides were glass cabinets filled with trophies after trophies after trophies. All the chairs of the tables were placed on top of the tables, indicating that the place should have been closed for the night. I feel like that during the day, they would have tournaments for all of these game tables. After spending some time here, it was finally time to make our way over to club face. 

I was super exhausted at this point and kind of wanted to call it a night, but I also really wanted to see

the club. I am super happy I powered through!!! The club was packed and had the best dance music ever. A lot of it was Portuguese songs with some American songs thrown in (all of which were only the top of the top American songs to dance to). The dancing music literally never stopped. One song rolled straight into another without even a three second break. They also never played any slow songs in the mix. I really broke it down as far as the dancing went. Haha gave it my all all night long. (Corinne, you'd be proud.) For some reason, the European men really

had it out for me (which I wasn't much of a fan of because I don't like dancing with strangers). If only American men were as interested as these Europeans seem to be (or interested at all...) Even though the main reasons they probably at all take any interest are 1) because I am American 2) because I am blonde and 3) because I am a dancing queen. Still, any attention is flattering (though also unwanted for longer than a song.) Overall, the night was so much fun! Never a dull moment. The only downfalls of the place were that everyone smokes cigarettes and I was burned by them twice (I still have a battle scar on one arm) and that it opens so late. My lifestyle can't handle this time schedule. I definitely want to go again some time, but I'm thinking that power napping  until 2 am is a necessity.

When we ended up leaving the club, it was 6:30 am, and we already had missed sunrise. I felt like I had just experienced a Kesha song in real life. Afterward, I got home reeking of smoke and went straight to bed. I didn't get up until 6 pm, catching up on any sleep I missed this week. Though I really want to go back to club face again, I also don't appreciate missing a good day to go to the beach or hike. It's all about striking that balance, I suppose!

In the six hours I've been up today, I've eaten another fantastic dinner, pretended to blog a lot more than I actually did, reexamined my class schedule for the fall since I am now premed again, did my laundry, and watched three episodes of grey's anatomy season 1 with Erica. Who wants to take a bet on how many seasons we can get through on my last three weeks here? ;) (Also three weeks is way too short. I'm having the time of my life.)

Please Ignore all the Funky Fonts. After an hour of trying to fix it, I JUST GIVE UP.

Day #6 at Hospital: Save the Ta-tas

July 5, 2013

Today I took the bus to the hospital by myself because Erica wasn't feeling well after our long night last night. I knew my doctor had consultations all day on Friday, so I asked the other doctors in my department if there were any surgeries going on. I was in luck because right at that moment a mastectomy was about to start.

I headed down toward OR to change into scrubs, but I accidentally walked into the MALE'S CHANGING ROOM. How embarrassing is that!?! After I finally got myself settled, I made my way into the operation room. The woman having surgery had a large tumor in her right breast that I got to feel. Even just from feeling on the outside, you could tell how big and rigid it was. The doctors injected two kinds of dyes into her body: a green one and a blue one. Both dyes would travel to the lymph nodes and stain them. The green one would make the lymph nodes fluoresce in an ultrasound and the blue one would actually dye them blue so you could see them when you cut the breast open. The lymph nodes are important because when the cancer starts to mestastasize, it will first travel to the lymph nodes. By finding and removing the lymph node closest to the tumor and then sending it off to the pathology department, the doctors can find out if the lymph nodes had cancerous cells in it. If the lymph node does, then the doctors have to remove all the lymph nodes in the surrounding area (a lymphadenectomy) and if the lymph node doesn't, then they can sew the woman back up after removing the breast. Luckily, the lymph node tested negative.

After this mastectomy, I got to see another one, except this time the woman had already had chemotherapy. (Note- they don't do any chemotherapy or radiotherapy in this hospital except on very rare occasions. They always remove the tumors.) The doctors already knew that this cancer had mestastasized, so they needed to do the lymphadenectomy. 

Miscellaneous Thoughts:

- I will never get used to seeing a body part removed and then just thrown into the trash. It is still so weird seeing a breast just sitting there in the bin.

- I would never wish this upon myself of course, but as I watched these mastectomies, I realized that if I ever needed one, it would take a quarter of the time because I'm so small chested.

- I'm not sure if a resident student here is just being really friendly or he's trying to flirt with me. He keeps winking at me except it's always one of those winks that makes him look like he's twitching. 

Happy Fourth of July!!!

Happy Fourth of July!!

Being out of the country for the Fourth of July is such an odd feeling. Normally, there are people everywhere celebrating, barbecuing, hanging by the pool, beaching it up, etc.. There are American flags everywhere and there is so much spirit in the air. It was pretty sad to not see any of that this year.

This year back home,  my family went to my grant aunt's house on Lake Ontario to celebrate. I have been there twice before on the Fourth of July, and each time was such a blast. I have a huge family and since there are so many of us, we all set up tents on her property and sleep there. It is so much fun. Lake Ontario is beautiful with the stars and the moon over the lake... Breathtaking really. Then when the fourth comes around, there is a spectacular display of fireworks accompanied by a toasty bonfire and some delicious s'mores. Of my family, I am probably the one who is most in love with the place. Every summer, I practically beg my mom to visit! To my dismay, this was the year my family decided to go and I am out of the country. But hey- though I'm sad, I can't complain because I'm in the freaking Azores islands (which coincidentally enough my great aunt has also travelled too! I found this out via email yesterday.)

Also to all my family reading this, I hope you had an amazing time! Miss ya!

  

We Americans couldn't let the holiday pass without celebrating of course. We had a huge plan! We went to a restaurant by the marina that had a deal running for the Americans in town. For 10 euros, we got unlimited food, sangria, wine, beer, dessert, and coffee (warning: I probably indulged a little too much. But I always feel I need to get my money's worth!) We also planned to set off fireworks at the beach and have a bonfire with s'mores. But sadly, bonfires are illegal on the beach and we couldn't find the fireworks. The dinner was a lot of fun. In this day and age with so much technology, inevitably we all ended up sending each other weird snapchats while sitting at the same table. Eventually during the night, Erica and I went exploring. Because I'm always up for an adventure, I may or may not have shimmied and climbed across a gated area to get to this really pretty dock. The dock was completely gated in and the area I shimmied across was this platform over the water. Eventually more people came out and joined us. We had a mini photoshoot and were having a grand old time when two cops on segways showed up. They may or may not have threatened to arrest us if we ever did that again. (Though the segways were mess than intimidating.) I'll have to save my adventuring for areas that are not gated in, I suppose.

After the dinner, some people wanted to go out to a bar and some wanted to go back home. I was part of the latter group, knowing I had hospital the next day, but all the kids in homestay were going to the bar so I had to come along unless I wanted to walk back home by myself in the wee hours of the morning (not the best idea.) 

On the way to the bar, we sported our American flag and sang the Star spangled banner and god bless America. We were those Americans. But hey, it was the Fourth of July so how couldn't we? At the bar, manny whipped out some serious dance moves I didn't know he had in them. Hahaha it was so great. He's got no reservations when it comes to dancing. A true life of the party. He especially likes the berney.Eventually the night came to a close, and Erica and I walked back home. 

Overall, a great Fourth of July!

Day #5 at Hospital: Even Coffee Couldn't Wake Me Up Today

July 4, 2013

Today Erica and I decided to get to the hospital a half hour or so later because all we do for the first hour is wait around anyway. When we did arrive at the hospital, however, I found out that all of the doctors in general surgery were in a meeting for the next three hours. I figured I would go to administration and officially get moved to another department for the day, but the administration is awful and told me to just wait around for three hours. Therefore, I took it upon myself to unofficially walk around the hospital anyway.

I saw a group of students in the hallway, and it turns out a lot of the students had a slow day because a lot of main doctors had taken off for some reason. I felt like I somehow got appointed unofficial leader/tour guide of this group, which I wasn't a fan of because walking around in groups in the hospital= not a good idea when you're trying not to draw attention to yourself. Also, the orthopedics doctor who I was about to search for to ask if I could shadow him today walked by in that instant, and I couldn't ask him when I was in a group of five people. I was deeply upset, half because I really want to go to orthopedics and half because I really wanted to spend time with him because he is literally the most beautiful man I have ever seen in my entire life. He could be a Calvin Klein model. Even his scruff is perfectly trimmed. Anyway- Eventually, we finally split up, and I made my way over to pediatrics.

As soon as I walked through the doors, I had mixed feelings of smiles and sadness. The children's ward is decorated with some of my favorite Disney scenes from Hollywood and there are toys and playrooms around. As far as the decorative atmosphere goes, it aims to inspire happiness. But being in a children's ward is just so sad to me. I could never be a pediatrician. I try to think back to my childhood days, and I realized how impressionable I was and how impressionable kids are in general. I feel like a lot of the adults I interacted with at that age had a big impact on who i turned out to be. If I had been sick in a hospital, I feel like that doctor would have had a huge impact on my growth, development, and even just memories because that hospital visit would have been one of the most important pieces of my childhood. I don't want that role on these kids' lives if that at all makes any sense... I also think its just sad seeing kids so vulnerable. When I was wandering the halls looking for the doctor, there was a baby on a bed just crying. No one was around to soothe it. Seeing that baby alone crying, without being able to help it out really broke my heart. It reminded me of that scene in Harry Potter at the train station. I know why JK Rowling chose to write that part.  It's complete vulnerability and it broke something inside me.

When I finally found the doctors, I found out there wasn't much going on in this department as well. However, one doctor (who actually turned out to be the neonatologist I met the other day) had three consultations. In addition to being a neonatologist, she's a pediatric cardiologist. Nico (who is in pediatrics) and I got to see ultrasounds of the hearts of two babies who had had some heart problems when they were born. Thankfully, they are okay now. It would be weird having a patient who you couldn't communicate with (like a baby.) I also saw an ultrasound of the heart of a five year old girl and, she was so cute. 

After my brief visit to pediatrics, I wandered the halls a bit more. I met a neurologist who invited me to his department some time. I might have to take him up on the offer! Though I'm not particularly interested in neurology. I then visited the mother insane give birth yesterday, though the nurses were busy with her so I couldn't really spend much time there.

At this point, it was around noon and the surgeons would be out of their meeting. When I went to go check on them, I learned that there would be no surgeries today and that had another meeting to go to. Sigh. I then went down to the ER for a bit, but apparently I had just missed a morning full of action. I felt like I was always jut a beat off today. Erica and I grabbed some coffee (am I turning into a coffee drinker?) we were dead exhausted after spending too many nights staying up late blogging (which wouldnt have been a problem if we had kept up with it from the beginning!) Then we went upstairs to OB/GYN. Afte waiting a bit, we got to see a c-section!

The c-section was really interesting. It took a mug shorter amount of time then the natural birth I saw, and it was also a lot less bloody. (Then again I had seen an abnormally bloody natural birth.) First they pulled out the foot, and it was so tiny!  I realized how premature this baby must have been! They then got stuck getting the baby's head out for what seemed like the longest three minutes of my life. It was probably normal for c-sections, but it really scared me shitless. Once the baby was safely out, the neonatologist (u saw her everywhere today!) took the baby to bring it to her ward.

I am not kidding when I say that during the c-section, Erica and I were literally falling asleep. It was embarrassing. But we just couldn't stand any longer. I had a pounding headache and my eyes were itching for sleep. We called Alberto to pick us up because we couldn't fathom walking home, and then I took a five hour "nap" (if you can call it that.) Afterward, I got ready for our Fourth of July fiesta!

Day #4 at Hospital: The Most Amazing Day of My Life

July 3, 2013

Today was the most incredible day of my entire life. I spent more 12 hours in the hospital and loved every second of it. I was able to witness the most beautiful things I have ever seen, and it left me feeling on a high all day. If something can instill those kind of feelings, I feel like I need look no further for signs of what I want to do with my entire life. If my day was half as interesting as today, I would be happy.

Today I firsts spent some time in the ER doing consultations, and then I got to shadow Joana's surgery on the patient we saw yesterday who got the endoscopy. They cut open the patient and the intestines came spilling out. (The textbooks are right: there are so much intestines.) The tumor was in the colon as known from the endoscopy, but when they found it, it was in a different place than they had originally thought, and it was also much bigger. Usually, they would able to do a lot more testing before surgery to figure this out, but the surgery was urgent because the patient's bowel was completely full and would burst if it weren't fixed immediately. They cut and sutured the part of the colon with the tumor (as well as all the blood vessels that go along with it) and then attached the intestines to the wall of the abdomen. From now on, the patient's poop will collect in a bag on the side of his abdomen. However, before this, the doctors pushed the feces in the intestines back up into the stomach and then a tube was put through his nose to the stomach. The tube then sucked out the feces. Yes, this means that the patient was essentially POOPING THROUGH HIS NOSE. I know this should be really gross, but I just thought it was absolutely incredible.

After the surgery, I went to OB/GYN to see if there were any births today. The doctor there (who I can understand because she speaks Spanish instead of Portuguese) told me that there would be one in 1-2 hours. After my experience yesterday, I knew that this estimate was merely guesswork and that it could happen much sooner than that. So, I grabbed a quick lunch, changed out of my scrubs, and waited in the break room in OB/GYN. I love the OB/GYN department because it is so small and so homey feeling. In the break room, I used my friend's nook to pass time with reading. She only has super girly books on it, and I ended up reading Chelsea Handler, which wasn't even that funny. (Her Are You There Vodka? book is so much better.) I pretty much finished the entire book because the birth didn't start until more than three hours later.

The woman having the baby was German, but she also spoke English and Portuguese (and pretty much every other language.) It was her first child, and she had an abnormally long and painful labor. They had to cut open her vagina further using scissors, and seeing that snipped away like that was a little shocking. She was screaming bloody murder. This was more blood than I have ever seen on my entire life, and after the birth, there were further complications because they could not get the placenta out. Still, all the gore was perfectly okay because I was witnessing a miracle that has been happening since the beginning of time. Childbirth is beautiful, and I almost felt like God was in the room.

They attached this tool to the head of the baby and then used that to pull the baby out. When the baby finally came through, I experienced one of the most weird gut feelings. I can't explain it exactly, but I couldn't believe that baby was in there the whole time. It just didn't seem possible. He was curled up, super white and covered in blood. It almost looked unreal or maybe it still just looked like a fetus (I know this is wrong but it almost looked alien-like when it first came out.) Still, it was all shockingly beautiful, and I couldn't help myself from crying. I was just standing there with makeup streaming down my face, and I thanked the lady for letting me witness that. She almost looked at me curiously, and I'm not sure if it was the drugs or the shock of labor, but she almost seemed indifferent to having the baby in her arms. But eventually, she began to smile more and was really interested in having me in the room. She obviously realized what a profound effect the birth had on me. She even let me help maneuver the baby so she could breast feed. It was amazing, and her baby was just absolutely the most precious munchkin.

I ended up learning that the mother was actually a 22 year old girl who has been traveling the world for the past four years (literally everywhere you can imagine), living off of minimum wage and the excitement of adventure. The father of the baby was from England and told her three months ago that he wasn't going to raise the baby with her. Sad. So, her father was in the room with her instead. The two of them were some of the most awesome people I have ever met. I had a long conversation with the father, and the daughter really wanted me to come visit her tomorrow. That is an offer I will absolutely not turn down. I will tell you a little more about the two of them tomorrow.

Miscellaneous Thoughts:
- I was so happy I had Joana today who explained everything to me during and after the surgery. After the surgery, she even drew diagrams and spent time talking to me about anatomy to make sure I really understood everything that went on.
- I was surprised that Joana, who is a resident, was able to perform surgery on a patient, especially a surgery as large as this one. She was also doing all the consultations in the ER. I don't believe residents in the US have this same kind of power. She was certainly very capable though.
- It is absolutely crazy to think that one day a man finds out he has cancer and then less than 24 hours later, he has the tumor removed. Everything happened so quickly.

Day #3 at Hospital: Looking in with a Camera

July 2, 2013
Today, Erica and I arrived to the hospital right on time! An accomplishment we are both proud of. After talking with my doctor Teresa yesterday, I learned that there were no surgeries in our department today so I was hoping to check out the neo-natal department just for the day. Before heading to the administration for approval, I wanted to ask for my doctor's permission. I spent a good hour waiting around for her, and no one knew where she was. Yet, for some reason the administration told me that they called her, and I had to go find her. After an hour without luck, I gave up. Thank god because she ended up not coming to work today (something I learned at the end of the day.) That whole debacle was a little annoying, but it was okay because it led to an adventurous day.

While searching for Teresa, I met an intern named Joana who spoke perfect english and who was really trying to help me out on my search. Eventually, she asked me if I wanted to go to the ER to see if anything was going on down there, since there were no surgeries at all today. I was taken to the ER where they mostly work on patients with abdominal pain (and big accidents). Only small surgeries are done in the ER. When I got downstairs, there was a woman who has having a lot of abdominal pain, and the doctors were trying to figure out what was causing it. They suspected it had something to do with her gallbladder, and they used an ultrasound to check it out. She ended up having stones in there. This was my first ultrasound and it wasn't even looking at a fetus! It was still freaking awesome though! Originally, they were going to remove the gallbladder of the patient before finding the stones, but then they changed their minds. I wasn't around long enough to discover what their final decision was. There was nothing exciting going on in the ER, so I went back upstairs. (Note- during all of this, I had the fourth coffee I've ever had in my life. I was falling asleep and needed the caffeine. I feel like I will not be able to prevent coffee drinking any longer if I go to med school and become a doctor.)

When I got back upstairs, I met Joana again who was on her way to watch an endoscopy, which she then invited me to see. There were so many people in the room so it was pretty cramped, but I was so glad I got to be there. The patient had been having a lot of pain and was constipated for four days or so. The doctors suspected that the cause was either one of two things: 1) There were these little pocket defects that developed in the colon that became infected or 2) There was a tumor. They really did not know which, so they used the endoscopy to figure it out. Endoscopy procedures are really quite incredible. They put the tube with the camera on it through his anus, and we got to see the entire inside of his gastrointestinal track. There was so much fecal matter inside his body. The camera came up to one of the pocket defects, but there wasn't an infection seen in this one. It turns out that these defects are not much to worry about unless infected. The camera continued to search through the track, and sadly came up to a tumor. It was such a weird feeling to be in a room when it was just discovered that a patient has cancer. Until that moment, he was mostly healthy as he knew it, but now there would be a shortened timeline for him. I thought maybe that the patient found out this way (since he was conscious and also yelling in a good amount of pain) and was a bit horrified. But the doctors said that he did not know yet, and they would have to soon break the news to him. Once the tumor was reached, the camera couldn't pass any further and was removed. The surgeons then left, the head surgeon looking pretty grim, and went to discuss how to best approach how to remove the tumor.

The rest of the day in the general surgery department was paperwork, so I used this opportunity to explore the hospital. I went over to OB/GYN to see if there were any births, but none were happening. However, there was an abortion consultation going on that two of the other students went in to shadow.  (I found out that they do abortions in the same department that they have births in. But, they also only do abortions up to week 10 of pregnancy, which I think is a good thing. Sadly, the doctors were also joking about the abortion for a woman coming in. They joked that she was past 10 weeks and told the father (another doctor) that they could no longer do the procedure. He freaked out. I just can't believe a doctor would be so irresponsible to impregnate a girl.) (Erica (who is in that department) and I were left out, so we did some more exploring (which technically isn't allowed by the administration.) We went to the neo-natal department and learned from the doctor there. We looked in at the pre-mature babies, and I was really happy I got to experience this. Erica and I then moved to the neurosurgery department. The doctor here also spoke great english, and he gave us an intensive lesson of brain surgery using pictures and such. However, we couldn't go into the brain surgery with him because his two interns were already there. I was glad we met him though because now he knows us, likes us, and might let us see a future surgery. He also grabbed our arms after the lesson and told us to marry rich husbands. Thanks.

At end of all of that, Erica and I went back to OB/GYN to check up on the births. They said that there would be one in 1-3 hours. We figured it would be closer to three hours because another doctor had originally said it would be 5 hours. So, we took our lunch break (finally tried Wok to Walk!) and came back, only to find out two births happened 20 minutes after we left. I was so upset!! After that, we walked home to start our adventures with Alberto.

Thoughts on Public Health Care
I believe that it is super incredible that every citizen in Portugal has access to healthcare. Surgeries, therapies, etc. do not cost citizens any money. That shocks me, but it also makes me really happy. It is horrible that in the US, people can't get a life-saving surgery done because they can't afford it... or sometimes even worse... they bust their back to afford it but it puts them in a stressful financial situation for years to come. However, it's still crazy to think that everything is completely free. This (as well as other things) has also unfortunately been part of the reason for Portugal's gigantic financial crisis. So there is a downside to it. And like I said, doctors only get paid for 40 hours a week, but sometimes work an additional 80 hours when it is really busy. They don't get paid for those ones.