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La Extraccionista

Two days ago when I got a message from Robyn,  a volunteer in a nearby community, that she needed translators for a visiting medical brigade, it felt like the right thing to do and I knew it’d help shake me out of my recent, single-minded pursuit to complete the 242-page English manual that I’ve been working on for months. Like I said, if ever in doubt about your priorities and place in the world, take a day and give it to someone else. Who knows what new perspective you’ll be granted. In a stroke of genius (patting myself on the back with one hand as I type), it occurred to me to accept what will ever be known as “the medical translation challenge” as long as I could bring an advanced English student to “job shadow.” Robyn thought it was a great idea and we even started brainstorming how we could match future brigades with bright, young Nica English speakers to give them work experience and English practice in a professional setting. Like any great idea, we’ll see where it goes. Anyway, I called Victor, English teacher extraordinaire and my beloved teaching counterpart. He recommended I take 17-year-old Hamilton, an advanced level student from Prime English Center who graduated last year, and so I did.

And now to the most fascinating (and exhausting) day I’ve had in a long, long time. Hamilton and I arrived at Hotel Café, the nicest hotel in Jinotega, at 6:45AM where I met Lou, the dentist; Max, the surgeon/anesthesiologist; Mark (Max’s twin), also a surgeon; and Gary, who is Max’s son, Lou’s son-in-law, and a jack-of-all-trades. The twin doctors were doing surgeries for hernias, gall bladders, and “lumps and bumps.” The hospital San Rafael del Norte recently acquired one of those fancy laparoscopic units that allowed doctors to perform “closed” surgeries instead of the far more evasive, dangerous, and time-intensive “open” surgeries of old, although they did a few of those, too, when circumstances called for it. The health clinic down the street where Lou the Dentist was working had just received one of 20 dental chair units distributed throughout the country by the government. It’s just like the chair I’ve sat in all my life during dental visits with slightly less functionality because some parts were installed incorrectly. More about that later . . .

After “doing rounds” with the doctors at the hospital where I visited small rooms of 8 to 10 patients and learned what they had done or needed to have done—just a tad less glamorous then the scenes of “Grey’s Anatomy”—we parted ways with Max, Mark, and Gary, and made our way to the clinic where the Lou had been working all week. I’d be lying if I didn’t tell you there was a lot of vocabulary that Hamilton and I had to learn but that’s life. You don’t get to be 100% prepared for all of the situations you’re thrown into—or in our case, volunteer to be thrown into. Anyway, all of that “translator prep” was a great learning experience for Hamilton, and Lou was so kind to include him in everything.

We worked in a small room with a dental chair, a large desk, a sink, a red plastic lawn chair (like I have in my living room) and a counter for materials. Additionally, there was a chair at the desk, a chair in the corner, a chair for Lou, and a chair for me. I’d be remiss if I didn’t mention that there were also a minimum of eight people in the room at all times:  two dentists (one Nica, one American), two Nica teens who functioned as secretaries/assistants to the Nica doctor, myself, and Hamilton—oh, and the two patients.

Let’s discuss this two dentists detail:  Lou was using the chair because he was doing fillings and intensive cleanings. Doctora Myrna was doing tooth extractions—it’s all she’d been doing for about 16 years. Because regular dental services (the kind we know) had not been available for, well, over 15 years, people lived with whatever problems they had until the tooth was so far gone that it had to be extracted. Doctora Myrna, expert in extraction and henceforth known only by the name, La Extraccionista (The Extractionist), saw people of all ages, comforted them with kind and gentle words, injected them with the going painkiller, and then yanked their teeth out as they sat with their necks uncomfortably crinkled against the wall yet supported by the small sink. A trash can was placed nearby for spitting. She extracted at least 20 teeth, occasionally displaying the tooth to all present company if the roots were especially large or if the tooth was terribly decayed. There were some tears, some moaning, and in the end some hugging—by folks who’d been in such great discomfort. Some people came with shiny, white front teeth but had molars that had to go. Others came with three, maybe four teeth and left with one or two. In the words of Forrest Gump, “That’s all I’m going to say ‘bout that.”

On a related topic—stop reading, get up and go brush your teeth, and then floss—twice. Please do it now. I’ll wait. . . .   . . .   . . .  Let me just add that I have never felt more blessed to a) have been born in a developed country b) have had access to dental care (parents with jobs with great dental insurance and c) parents who prioritized oral hygiene and took me to probably a hundred visit to dentists and then orthodontists who gave me the no-cavity, straight, white-toothed smile that I have today. To the extent that Nicas have stopped me mid-sentence to ask how I get my teeth so white. “Oh, it’s just because I’m so tan that my teeth look so white (wink, wink).”

Back to Lou though—he said the first thing was always to ask the patient what was bothering him/her. That seemed simple enough. Then he said, “If they’ve got a lot of pain and are really sensitive to hot and cold that probably means they’ll need a root canal but we don’t have the equipment to do that right now—maybe in October on the next tour.” My job then was to tell the people they needed a service the Lou couldn’t provide and then ask them if they had a smaller problem that he could fix such as a tooth that didn’t hurt quite as badly. As gifted a dentist and nice of a person as he was, I could tell that Lou felt helpless in a lot of ways because he could see the problems and see where they were headed (to La Extraccionista) but he couldn’t do anything about it. Of course, the conversations got technical—the patient had the shell of the tooth but nothing inside and so Lou made me a great drawing (See video to follow—tooth extraction to toe-stomping ranchera music. Just kidding) and we labeled it and used it to give patients a better idea what was happening. On the day, Lou saw about 10 patients and did or replaced fillings for each of them. In a couple of cases, he did just a cleaning but by hand as the suction unit did NOT suck nor did the water shoot out fast enough to knock off the 15 years of built-up tartar. Go ahead, you can go brush again if you’d like.

Ultimately, I put Hamilton in the chair by Lou. Hamilton had no trouble explaining to patients what Lou wanted once he understood what Lou was saying. To non-native speakers, each of us has a different accent. In my line of work, I’ve naturally started speaking slowly and more simply just like on public radio’s “Voice of America”—a radio program that offers audio files and written transcripts using “Special English” or what they’ve deemed to be the most commonly used and therefore more important “word bank” for English language learners. Lou, for his part, had some trouble understanding Hamilton’s accent in English and so my job at that point became serving as translator between Lou and Hamilton who were both speaking English. All things said, it was a wonderful learning experience for Hamilton, and obviously for me, too.

We worked from 8:30am to 1:30pm and again from 2:30 to 6:30pm. When we got back to the hospital around 6:45pm, the doctors were still in surgery. Buses had long stopped running to Jinotega plus we felt compelled to stick with the team, so we waited. We finally got home at 9PM having as graciously as possible turned down repeated dinner invites from Max and Mark. I was simply exhausted. They must have been going on pure adrenaline having performed surgeries from sun up to sun down for a solid week. It was so fascinating to work with these dedicated doctors and see exactly what happens when American medical brigades visit developing countries. Certainly, one day can’t reveal the big picture, but the glimpse I got was memorable, nauseating, and above all inspiring.

I tell you, it’s almost impossible to give something to another person and get nothing in return. Inevitably, I end up thinking that I got so much more than I gave. It’s just what Gandhi said (and I’ve mentioned in my emails before), “The best way to find yourself is to lose yourself in the service of others.”


( 1 comment — Leave a comment )
Nov. 3rd, 2011 01:07 pm (UTC)
found your site on del.icio.us today and really liked it.. i bookmarked it and will be back to check it out some more later

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