Last day

It´s my last full day in Brazil and my excitement for exploring just a little bit more of Sao Paulo before I take off will not be dampened by the rain that is forecasted to fall all day. Sorry my posts have been a little skimpy on the photos - not having a working computer to store and upload photos from really stinks! I promise to add the fun ones of weekend trips once I get some computer power back again.

Wrapping Up

"You know, I like the feeling of waking up in the morning in an unfamiliar place. Over time, you get to know the butcher and you master the art of ordering breakfast for yourself. That's always a deeply satisfying thing, even if it's only two weeks." - Anthony Bourdain in an interview from Eater National.


It´s funny, I both love and hate my solo travel experiences. The first time I traveled solo was also for "work" in that I spent my days working on a research project and the rest of my time exploring the city (Paris). I had tons of fun and really got to know the city well. I had my favorite bakery near my house where I would pick up a demi baguette every other day and ate Nutella for breakfast. I really enjoyed the feeling that I was actually living there for a short time, and not just a perpetual tourist. It was fun making friends randomly with French people from work and in the apartment... but a part of me that summer really longed for a friend I already knew who could experience this with me and take it back to remember together.

Another thing I realized about going to a foreign non-English speaking country the first time is that it takes about 1-2 weeks for me to start to feel comfortable in a place. It can be incredibly frustrating - but I think it´s this initial struggle to assimilate and work through the challenges that make the experience even richer. In France, it took me about that long to get comfortable venturing out to explore and talking to strangers with my French, which undoubtedly improved while I was there. This time around, it definitely took about a week to finally feel settled, in part because I didn´t even have a sure place to stay until about a week in. Unlike the previous solo trip, though, language skills were not on my side, and I spent a good amount of time lost in translation. Actually most days I still go home tired just from focusing the majority of my brain energy on listening hard to discussions and trying to understand all the Portuguese.

Today, however, I finally felt like things gelled. I felt happy and satisfied that I understood the great majority of journal club, and was able to figure out most of Chagas clinic patient interviews before they were summarized and explained to me. I even got a few jokes (yay!). I suppose this rotation is ending just like many others - just when I feel most comfortable with the patients, challenges, and tasks at hand, the rotation is over... and it´s on to the next thing.

The great thing about tomorrow is that it´s my last day of medical school, and I am finishing it right here in Brazil. I´ll still see patients tomorrow, but the next thing is a couple weeks of nothing and then graduation! And then a month of respite (but actually a bit more traveling) before the real work truly begins. I am a bit ambivalent about my emotions surrounding the end of my time here in Brazil. I have truly grown to love the country in all its inefficient, crowded, and wonderful ways. It is one of the few countries that Americans can relate to with respect to its size and its melting pot of ethnicities and cultures. And Brazil is just full of amazing things to see, eat, and do. I will miss the friends I have made here, who have shared a lot about their lives and taught me much. Despite my still poor grasp of Portuguese, I find the language quite beautiful... and listening to it more and more makes me wish I knew it better. Perhaps next time I will be able to do more than just order food and ask where the buses leave or how much they cost.

O banheiro

One thing I am looking forward to when I arrive back in the US is our bathroom culture. Sounds weird, but it's because here people don't dispose of toilet paper in the toilet bowl before flushing. All toilet paper, whether it's #1, #2 (in my surprise I actually asked my roommate this...) goes into a stinky trash can next to the toilet. Same goes for domestic living quarters and public restrooms. I have to say it is really difficult to remember this rule. Also it somehow doesn't seem super sanitary to keep stinky used toilet paper in the bathroom. But... That's how it is.

Also, I also can't comprehend smoking in the restroom. While at a restroom at the airport, I was engulfed by thick cigarette smoke while in my stall, trying to understand why anyone needs to have a smoke while sitting on the john or even washing their hands. Gross.

Offline

Are Apple products not what they used to be anymore? My computer stopped working two nights ago and it has only turned on twice since then, and stopped an hour or so after. Aside from the inconvenience of not having a functioning computer abroad, I am afraid it also means these posts will be a bit more sporadic. Too bad, since there were so many things I wanted to share since the weekend, including an awesome trip to Iguaçu and some observations. Will try to add some pics via my phone soon, but it won't be optimal. :T

Here's one of the many alarm/problem messages I got on my computer.

And then there was rain

Rain in a tropical country is unlike anything I've seen in cities I've lived in the US. Growing up in California, I experienced rain as a rainy day here and there when I was growing up, but it wouldn't really change in intensity too much, and when it was over, it was over. Then I moved to Boston and learned that summertime meant keeping an umbrella in my bag at all times or risk being caught helpless in a torrential downpour while trying to cross a slippery bridge on my way home. Luckily, save for a few close slips on the slippery stones, I never completely wiped out in the rain. Rain would start suddenly and pour intensely, but it almost always stopped just as abruptly and it never lasted too long.

Here in Brazil, when a rainstorm is forecast, I know now that it's serious business. The past few days, it's been raining here and there, sometimes intensely with a lot of thunder and lightning. Luckily I live very close to the hospital so my walking commute is pretty short, and I've been going home at times when it hasn't been too bad. Yesterday when it started to really pour, thunder and lightning and all, a resident was taking me to see a recently admitted patient with leptospirosis. We talked about the development of the disease, arising from a bacterial infection in which a human is exposed to contaminated animal urine containing the spirochete bacteria. Then we went into the room to see the patient, and he displayed and relayed a textbook picture of leptospirosis and its severe form, Weil's disease. He was very jaundiced, was recovering from intense calf pain (myalgias esp. in the calves are common), and spoke of his flu-like illness which began a few days earlier. He was also recovering from acute kidney injury - prior oliguria resulted in a reduced urine output that he described as "like gasoline." Luckily for him, timely treatment and signs of recovery suggested that things would end up OK for this patient, but my resident emphasized how serious his illness could have become, and how she's seen a patient die of leptospirosis because of pulmonary hemorrhage.

Today I thought of that patient with leptospirosis when I was caught in an intense thunderstorm. I had high hopes of visiting the Mercado Municipal today because clinic finished a little early, but my plans were foiled when I exited the metro station. I probably got as far as a block when I had to duck into a jewelry store to avoid the literal flood of rain coming down. Not only was I a bit lost in the area, but within 3 minutes I watched from inside the store as the street became a river with the water level creeping up the sidewalk. More than half the sidewalk was flooded with water and in some cases the whole thing was submerged. The few cars that drove by while I attempted to wait out the rain seemed to float slowly by. My sneakers weren't able to avoid submersion into a few areas of the sidewalk as I made my way back to the metro station, resolved to visit the Mercado another day (my umbrella hadn't really helped me stay dry in the least). I also couldn't help but think of the deep puddles of rain and my resident talking about the rat urine contaminating flood water in the city's periphery and people wearing sandals and how it would be horrible to see a small spike of leptospirosis pop up in 2 weeks (the incubation period). Would they fare as well as the man I saw yesterday?