íAdiόs y vaya con Dios!

I can’t believe it’s our last day in Mexico! The last couple of days have been amazing as we have been soaking up as much of Mexico as we can. At the same time it has been painful, having to say goodbye to every single person we have met in the last month, one at a time. I finally got around to photographing as much of the facilities as they would allow, just to prove that I actually did do work this month. ;) The facilities are very nice here at the school. All of the labs are brand new and the equipment is state of the art. Here are some pictures of the medical school and simulation lab:

Doctora Magda! I LOVE her!!!

Ciencias de la Salud - la Facultad de Medicina UDLA

SIM lab

This morning I got to spend one more day in the hospital, and it was an amazing day!  Franco and I went back to Orthopedics and Trauma and spent all morning and afternoon. I got to do a lot of hands on work today. We split up and I helped one of the residents and Franco helped another. Today I got to set a plaster cast, learned how to splint long bone fractures, remove sutures and staples, got pretty good at reading x-rays, and single-handedly bandaged about 30 long bone fracture surgery sites. Sounds pretty heroic huh? Yeah it does ;) Rounds went by quickly and we stayed in the residents quarters for a long time afterward, just talking to the residents and pretending to be doctors….well, Franco did, I passed out on the bunk beds. I’m exhausted from this amazing month in Mexico. I’m going to miss wearing my lab coat and being called Doctora.

Jorge! El mejor amigo de Mexico

Big Pete!

Bernardo, Juan, Matt, Cesar, Jorge

Alba

Man I'm gonna miss these guys!!!

 Well it was our last night in Mexico so of course we had to…fiesta! They had a going-away party for us at Juan’s apartment and everyone was there-so much fun! In fact I think we may have had a little TOO much fun our last night, but the details will have to be a mystery forever ;)  It was so sad to say goodbye, but such a great way to spend our last night in Mexico. We had to leave around 2am to get a taxi to Puebla, catch the bus to Mexico City, and fly out at 6am. The trip home was…well…crazy. We definitely missed the bus, and nearly missed our flight to the U.S. But when it was all said and done we made it. I think the hardest part was saying goodbye when we split up in Dallas. Matt and I have become really good friends this past month. Thanks for sharing this amazing adventure with me, Amigo =]. I’m gonna miss all my friends in Mexico. Hopefully I’ll be back to visit again someday. Until then, nos vemos y vaya con Dios!

Oh, just another day in Mexico...

After class today my profesora, Magdalena, and her son Saul took me out for dinner to the Fonda de Santa Clara. The Fonda is a classy and very old restaurant in downtown Puebla. They are known for their intoxicating atmosphere and comida típica. We were there for one reason…Chiles en Nogado or Chile Poblano, a dish that Puebla is nearly famous for and which is only served when the local chiles are in season (a month or two out of the year). It’s early in the season so it was pretty hard to find a place that was serving this but I HAD to try it, one last thing to check off my bucket list just two days from leaving… it was…interesting. It is a pretty strange combination of tastes but surprisingly delicious. Chiles en Nogado is a little bit different wherever you get it but generally consists of a Chile poblano stuffed with a beef filling. It is covered with a sweet nut sauce (pecans I think?) and sprinkled with what I was assured was not pomegranate seeds but what seemed to me was definitely pomegranate seeds. The best part about this dish is that it is beautiful…and it has all the colors of the Mexican flag…yummyyyyy, thanks Doctora and Saul! 

Saul and I

making tortillas

La Fonda de Sta. Clara

Chiles en Nogado

Otro día, otra fiesta

Today we got to hang out with the new exchange students, who are mostly American. They are starting their second summer session…I’m not gonna lie, I would LOVE to spende the rest of the summer here, if not a whole semester or year. I would give anything to have another week to travel and see some of the things we didn’t get to see. Oh well, we are making the most of our last few days. Matt, Pete, and I cooked dinner for some of the amigos internacionales and the intercambios…Some kind of magical italian pasta dish that Pete made, green been caserole, and fresh watermelon and plátanos fritos for dessert. We had a little fiesta in my dorm (which is pretty sad these days with my roomates gone on vacation). Mannn I’m gonna miss this!

Cuanto cuesta para ir a....?

That turned out to be one of the most useful and necessary phrases we have learned. And even though taxi drivers can tell from the first word out of our mouths that we’re Americans, asking how much the taxi fare is forces them to give us a little respect and a fair quote. Not always fair, but we’ve learned to always ask before we get into a taxi to avoid getting ripped off. Which has happened more than once.

Class was interesting as usual. I’m working on this research project. It’s an epidemiological research study on obesity in Mexican adolescents. I’m basically learning how to do an epidemiological study and using journal articals and statistical databases for the research. Of course it’s all in Spanish so it takes 3 times as long for me to do the work, but it’s good practice and I’m learning many new words. Obesity is an emerging health concern in Mexico. Until now it has not be a problem that most of Mexico has had the privilege to experience. But with development of the economy come the affordability of food and the opportunity for an increasingly sedentary lifestyle. And on top of the that the whole world is facing and epidemic of processed and generally fattening foods. So the younger generation, especially, is being faced with a new problem which is more comfortable than malnutrition but equally dangerous.

This evening I got bored, Matt was busy in lab and all of our American friends have left. So I got bored and got a taxi to the mall in Puebla. The mall in Puebla is like a zoo. Seriously. I was actually impressed by how much it was like an American mall and was pretty classy and clean. There was even a food court with a bunch of American restaurants: MacDonalds, KFC, starbucks. I have not seen a taco Bell anywhere in Mexico though. I get the idea that Mexicans in general do not appreciate Taco Bell. Anyway, clothes shopping was interesting. The sizes seem to run about a whole size smaller than U.S. sizes. And everything was about the same price as it is in the U.S. And yes, everything there is "made in China" too. When I got back I hung out with Matt and Pete. Pete made us spaghetti and meat balls with garlic bread. It was sooo yummy. Pete is seriously my hero right now. My stomach is feeling better (I guess the meds are helping), but it was nice to give my stomach a break with some yummy, familiar homecooked food. Pete is a grad student with a BS in biochemistry. He came from the U.S. to play football at UDLAP because here, you can play for 6 years. He's been a great friend to Matt and I while we've been here, showing us all the good places to eat and making us feel at home. Thanks Pete, you're the best!

Montezuma returns...

I woke up tired and very sick this morning. Once again it feels like mono; I don’t feel like doing anything except sleeping and hoping to wake up without this aching all over, fever, and nausea. I pulled myself together and went to the doctor this afternoon. Luckily I haven’t gotten the full experience of Mexican healthcare this month but I sure got enough of it today. I went to the campus health clinic which is free for us as international students. It’s very nice: clean, up to date, and all of the nurses were helpful and nice. The doctor I saw was pretty young and she had blonde hair (a pretty rare site in Mexico) though I’m fairly sure she was Mexican because her English was very limited and her Spanish seemed pretty typical. In fact we started the consultation in English because I was having a hard time describing stomach cramps in Spanish but it turned out that I could understand her better when she was speaking Spanish. That’s beginning to be common (that I can understand native speakers better when they are speaking Spanish). I guess that means my understanding has improved a lot since understaning Spanish was definitely my biggest challenge when I got here (pretty proud of myself, not gonna lie =). Anyway, the checkup went well. She thinkins that I’m still dealing with traveller’s diarrhea since I have a fever and also that I may have run into some food poisoning in our travels this weekend. That’s not surprising, the bus station food yesterday was pretty sketchy. She also gave me some medicine for acid because we think I may have a gastric ulcer. This would make sense because after basically every meal this month I have had about 30 to 45 minutes of pain in my upper abodomen and heartburn. I’ve come to expect it unless I eat a really bland, American meal like pizza. And so she sent me home with orders to not eat any meat or anything spicy or fried: anything they eat in Mexico. Later I got the Mexican pharmacy experience. They filled my prescriptions while I waited, in about 3 minutes. Non-generic prescription antacid, cipro, pain meds, and a gatorade cost $300 pesos. Not bad. I went home and napped most of the day. I would REALLY love for my stomach to chill for a while so I can enjoy my last days in Mexico. I'm getting really sad about leaving...

The ruins at Teotihuacan

This morning we got up and went to the other side of the park with our new friends. We went to the grutas, a cascade stone pools built down the side of the mountain. The water was hot and you could sit in the sun and look out over the mountains…SO BEAUTIFUL!!! 

We also swam in the waterpark pool even though the slide was closed. We also got to try barbacoa today…AMAZING! Probably my favorite Mexican food so far. They make it by digging a pit, burying a sheep that is marinated and wrapped in leaves, covering the sheep with coals and dirt, and letting it cook all day. When they take it out it is so tender it falls off the bone and you can scoop it up with a tortilla and cover it in salsa and fresh lime. It smells amazing when it’s cooking and  it is SO  yummy. Definitely a win. 

Barbacoa!!!

We were really sad to leave our new friends. It was a sad goodbye but like everyone else here, we hope to come back and visit our new friends sometime in the future. We took a camioneta back to Pachuca, from there a bus back to Ixmiquilpan, and from there a bus to Teotihuacan. We got there in the early evening just as a storm was coming and had just enough time to climb the Pyramid of the sun and halfway up the Pyramid of the moon. The ruins are extensive; The pyramids are in the middle and are surrounded by many smaller pyramids and ruins of old buildings, tunnels, and alters. It was breathtaking but hard to describe, so pictures are a better description. 

Pyramid of the sun

Pyramid of the Moon

Cat sculpture

On top of the Pyramid of the sun

Snake head sculpture

We had to take a bus back to Mexico City and from there a bus back to Puebla. We got in late and we were exhausted, but it was an amazing adventurous weekend!

Las Grutas de Tolantongo

We got up early this morning and headed to Tolantongo. It was sad to see our friends leave but this weekend is going to be an adventure! We took a taxi to the Capu station in Puebla and from there caught a bus to Ixmiquilpan. In Ixmiquilpan we got on another bus to Pachuca. We had lunch in Pachuca and saw the zocalo. It’s a pretty little town and had a gorgeous fountain in the zocalo. Everywhere you go in Mexico you can find a pretty little town with a cathedral and some interesting little bit of history. 

We walked to the edge of town where Pete had told us we could catch a camioneta (van) that runs to Tolantongo. For about 40 pesos each we crammed into a passenger van without seat with about 20 other people and took the sweaty, bumpy, hour long ride up to Tolantongo. I hadn’t realized what we were getting ourselves into until we started to climb the mountain. Pachuca is down in the flatland and the camioneta just kept climbing after we left town. Up and up and up through ugly cactusy desert until we got to the top of the mountain range and came over the ridge and then in front of us was the most amazing, lush, green, mountain gorge I have ever seen. The mountains went on and on and on and looked like they were covered in green carpet. The valley was so far below us and the windy road hugged the side of the mountain…it was a scary ride down, but almost so beautiful you didn’t notice. 

The resort was about halfway down into the gorge and built on the side of the mountain. It was a pretty expensive, touristy place but we were the only foreigners there. In fact most of the Mexicans we have asked don’t know about this place. It’s like a paradise for the few who do know. It was pretty busy though and the hotel (which looked REALLY nice) was already full. So we rented a tent and some sleeping mats and set up down by the river with the hundreds of other people who were camping out. 

The water here comes from hotsprings under the ground; it’s hot (almost 38 degrees C), beautiful blue, but cloudy and dusty from all the minerals. Waterfalls from above bring cold clear water, so when you stand under the waterfall it’s a weird sensation; the water youre standing in is like a hot tub but the water falling on you is freezing! There are pools that go into caves behind the waterfall and you can swim under the falls an into the almost dark, hot cave. And watch the water falling in front of a beautiful mountain view. It is absolutely MAGICAL. This is without a doubt the most beautiful place I’ve ever seen in my life. It’s like something from a painting or a  movie that you would never believe is real. 

The rivers below the camp are dammed so you can swim and relax in the therapeautic water. The rocks are white with minerals and you can scrape the mineral off to make a masque. The resort is pretty big with a hotel, several restaurants and stores, multiple pools, and a water slide. We ate at one of the restaurants and of course the food was amazing. Later we made friends with some high school kids who were camping next to us (Oscar, Andress, David, Maite, and Stephanie) and had a pretty awesome time. The whole place was having one big fiesta down by the river. This is one day I’ll never forget!

The call me "doctora"

Today was an exciting day in the hospital! Franco and I went to Puebla Ortopedia y Trauma hospital which is a public IHSS hospital. IHSS is the healthcare program for workers in Mexico. O&T is a mid level teaching hospital. It’s definitely nicer than some I’ve seen, but still subpar compared to most hospitals in the U.S. When we got there we met one of the attending physicians and three of his residents. Residents at O&T go through three rotations over the course of four years: emergency, columnar (spine), and long bones. The residents we worked with today are doing their rotation in long bones. (I’m sure there’s a better translation but that’s what they call it). We started with morning report where we sat in a 5^th floor conference room overlooking puebla and listened to the residents report on the new patients who had arrived during the night. The residents had x-rays for the new cases and explained to us how to read long bone x-rays, how to find the angles of broken bones, and how to name fractures. The naming system is different in Mexico. In Mexico they use numbered quadrants. For example the upper arm is one, lower arm is two, thigh is three, calf is four. Then each quadrant has three numbers; for example the upper arm shoulder end is one, mid upper arm is two, and elbow end is three. So a fracture in the middle of the upper arm would be a 1-2. After morning report we went on rounds with the attending doc and residents. One of the residents reported on each patient (old cases and new) and the doc gave orders for care. After rounds the residents split up to see their patients. We went with one of the residents and helped him see his patients. Most of the patients in long bone have closed fractures or complete breaks and many have screws, plates, and open wounds. Most are motorcycle or car accidents. A few are falls or severe osteoarthritis. So most of the work was bandaging, setting casts, and assesing x-rays for surgery. We saw around 30 patients today. Most of them needed fresh bandages and we got really good at cleaning wounds and wrapping broken legs; the resident we worked with showed us how to do everything, from cleaning and dressing wounds to setting a plaster cast. I loved the hospital today because I felt like I actually got to do a lot of hands on learning. The hospital itself was a little scary. Except for the resdidents and Franco and I, I never once saw anyone wearing gloves or a single plastic bag (trashcans don’t have liners in Mexico). I’m not saying it wasn’t safe, it was just different: in the U.S. you can’t TOUCH a patient without gloves. Like the other facilities I’ve seen in Mexico, it was crowded, I don’t know how better to describe it. There were very few private rooms. There were long hallways with 10 beds, curtains between each bed, and a common bathroom. There were a handful of private rooms for the most severe cases where patients had been living in the hospital for months. The atmosphere wasn’t bad though. All of the nurses were happy and friendly and wearing spotless white uniforms and caps. The residents really impressed me too. They were just kids (not any older then me) but were very mature, quiet, respectful doctors and always talked to their patients with compassion and patience. It was a great experience. I’m not gonna lie, I really enjoyed doing rounds with the residents in my bata blanca, my labcoat. And they call me doctora here =)

Later we spent the evening with the international students who are all leaving tomorrow…it was a sad day. It’s making me think about how we only have a little more than a week left in Mexico. Time is going by so quickly and a month just isn’t enough…I never want to leave!!!             

Los fuertes de Loreto

We got up this morning...tired, sore, and a little sick from sleeping in a freezing cabin...and took the bus back to Cholula.

After class I got a personal tour of historic Puebla with Fili, a fourth year med student at UDLAP, and a couple of his friends. We saw los fuertes de Puebla, the forts, and toured el fuerte de Loreto, where the battle of Cinco de Mayo took place.

From the forts you could see most of Puebla and the governor's house, where helicopters were constantly coming and going, and policia with machine guns swarmed. This part of Puebla was completely different than anything I had seen. There was a huge park with modern artwork, a lake with paddle boats, a gift shop and Punta del Cielo coffee shop, a coliseum, and a business park. This is obviously where all the money in Puebla is. It seemed like a pretty good representation of Mexico in general. All of the money is concentrated in one place and in the hands of very few people. But, there was a nice view!

We also went to the cathedral in Puebla but they were having mass so I wasn't able to take pictures. It was the biggest building I have ever been in. And everything inside was gold. Quite impressive! I can't get over how old some of  these cathedrals are, yet what great shape they are still in. Mexico takes great pride in its cathedrals and keeps them in good shape. Later we had Chinese. It was nice to have Chinese again and nice to hang out with college students for a night.

La Malinche

After everyone got out of class we headed out to La Malinche, one of many dormant volcanoes in Mexico. It has been dormant for 3,000 years and at 14,636 feet Malinche is usually snowcapped. It took us 3 hours to get there, most of which was by bus. For the last hour or so Jorge's friend Yoho was kind enough to pick us up and take us the rest of the way. For this we were very grateful but I cannot say that the ride was comfortable, with 11 of us packed into a two-door explorer (which I didn't even know existed). The first of many trials at Malinche. By the time we got there it was already 4 o'clock. The sign said not to go up after 2 because we wouldn't get back before dark. So what did we do? Of course we went up. Some of us (I won't say who) made it 20 minutes, others 2 hours, and Erick, Meaghan, Skyler, and I made it to the top...or within shouting distance of the ones who made it to the top. It was a little disappointing because once we got to the treeline we were in a really thick cloud so there was no view whatsoever. It was super cold up there and very hard to breathe. At the treeline it got really steep. The mountaintop was all ashy sand and loose, pink volcanic rock so it got really hard to climb and at times we were on all fours. Definitely the most physically challenging thing I've ever done. It took us 2 and a half hours to get to the summit from our campsite but it was starting to get dark when we got to the top so we basically sprinted to the bottom. We got back just before it was dark. I'm gonna be soooo sore tomorrow!

Our cabin was nice. We had bunkbeds for everyone and a kitchen and fireplace. Two hours later Skylar and Yoho managed to get a fire started which was lucky becuase it was very cold up there. It was a good night, a good getaway from the civilization of Puebla.