Initial challenges

Today is day 3 in Guadalupe, a beautiful and peaceful town.  We are fortunate to be here.  Inevitably, though, there are growing pains.

If you are going to seek out an experience like this, you have to be willing to roll with it, and to operate in the "plans are made to be broken" mentality.  I have been well aware of that -- and sure enough, we have had to roll with quite a bit.

Our initial plan was to arrive in Quito, take care of our visas, and then come down to Guadalupe with a week or two to set up our lives before I was to take over seeing patients at the clinic.  So much for all of that!  In order to get our visas, we have to get some paperwork from the big Catholic church office in Ecuador, saying that indeed I am performing a legitimate service, not getting paid for it, they are providing us housing, etc.  They also send someone from the Catholic office over to the visa office to help us out with the process.  Alas, that office was closed for vacation for the entire month of August -- so we will have to return to Quito in September to get that accomplished.

The bigger item is that I have had to take over the clinic duties ahead of schedule.  There were 2 doctors (a husband and wife team with grown children) who were scheduled to be here through early September.  As the clinic often only sees 5-10 patients per day, they were wanting more work -- so the clinic coordinator scheduled several day and evening trips to surrounding towns, where they could see extra patients.  Unfortunately, the daughter of these doctors had some complications of her pregnancy at 30 weeks or so, and they had to fly back home unexpectedly at the last moment.  The clinic coordinator apologetically emailed me and asked if there was any chance we could come down a little early, and whether or not we were willing to do these outings.  They sounded kind of fun, so we said OK.

As it turns out, it has all felt a little bit overwhelming.  On my first day in the clinic, we were scheduled to leave a little early and go to the larger town of Zamora for the evening.  It turned out that I had 12 patients to see before we left, on my first day with a brand new clinic system and EMR, not knowing what meds were in the pharmacy, etc.  I managed to get through it (though with many charts still open), and then we went and saw at least 15 more patients in the evening.  All of this on my first day!  Whew.  Yesterday I also saw 12 patients in the clinic, and managed to catch up and get all the charts closed from the previous day.  We then have an all day outing planned on Sunday, which I suspect will be VERY busy.  I'm not sure how to feel about it -- we will see how it goes.

Really, this is kind of the worst time for me to be doing all this extra work.  We need to investigate schools and get the kids signed up.  I have not even really had time to walk around the town, and figure out where to buy things.  Honestly, I am feeling a little overwhelmed.  I'm sure it will sort itself out, and I will probably need to ask for some time off to arrange our lives.  It's just hard to set those sorts of limits when you're the only doctor in the place.  There is always a balance to be struck between service and self-preservation.  I feel this particularly as a parent, wanting to not only set myself up for success this year, but the kids as well.  They are troopers who are indeed "rolling with it," and are really making the best of things.  But the balance of responsibilities is a challenge!