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A Little Walk in The Mountains…

Submitted by on July 27, 2012 – 8:41 PM One Comment

People always say that when someone is about to die our life flashes before our eyes. Something similar happened to me. I saw my entire career, my 7 years of studying and practicing medicine, flash in front of my eyes. I was not going to face any extreme danger, neither was I on the verge of death, I was just walking… walking towards one of the most difficult moments that I have had to face as a doctor.’
I will give you a little bit of context so you can understand this experience. In my country, Peru, after graduating medicine school, we have the possibility to work in different isolated places within the country, far from technological advances and with really basic health services. So right after graduating, I packed the necessary clothes, my books, my stethoscope and I went to live one year to a small town named Azangaro, located at about 10 hours from the capital city.

 
Azangaro is a town of about 500 inhabitants where the main economic activities are agriculture and livestock holding. My job there was to give basic health care services to the people, preventive medicine, give information about health related topics, etc. I was also in charge of the emergencies. It was a very gratifying experience but at the same time it was really demanding. I can say that none of my years at medicine school prepared me enough for the things that I had to live there.

 
One night, when I was living there for about three months, I was preparing to go to sleep when a sudden constant knocking on my door started. I rushed to the door and opened it only to found a girl of about 12 years old that, very fearful, said “My mom has been in labor for about two days now and no one has been able to help her”.

 
I couldn’t waste any time, I got ready and left the health center as soon as I could. The path from the health center to the patient’s house was not easy; it was about an hour walking, with only the moonlight to guide us (and a little flashlight that helped me many times). That hour walking has been, until now, the most stressing time of my life and I remember it as if it were yesterday.

 
All I thought about during that time was “What did I have to go through to be in this situation? Did we learn how to manage a situation like this in medicine school? What were all those chemistry classes for? What about my workshops about strange illnesses? What about the internship in the hospital?”. I read a lot during my years studying, I was a good student, and during that hour walking I tried to remember what the doctors taught me about how to deliver a baby and what I saw during my internship. My thoughts came to an end just as we reached the patient’s house and after that, everything was just action; there was no time to keep on meditating. Surprisingly, all my previous nervousness and worry transformed into a deep calm and certainty in my abilities.

 
It was just a small adobe house with straw for ceiling, the floor was the same ground from the mountains and there was no water or electricity; it was a typical house from the andes. I had to bend down to enter through the door but there was no much space inside, just two rooms, one for the kitchen and the other for the family to sleep. And was in this small space where I found the woman, kneeling and in contracted with pain, with her husband and children trying to make her feel better. Now I understand how relative time can be, the walk to the house looked like ages but those moments in the house seemed just a few seconds.

 
It felt like time was flying. First, I tried to listen to the fetus heartbeat and thankfully they were fine. Then I tried to feel the head and it was in a good position and to my surprise, it was almost complete. I had to wait a little bit for clean cloths to receive the newborn, but when the woman felt the pain increasing she put herself in a kneeling position (which is typical for woman in the highlands), I put my hands under her and received the baby as it was falling, supporting her in my arms and then I proceeded to clean her.

 
The woman was exhausted and she sat down. At that time I remembered that I didn’t took a scalpel with me, nor even a clamp to knot the cord; something so simple and common in childbirth and I completely forgot about that. Fortunately, the father had thread and a razor blade so I knot the cord and cut it really carefully. I finished cleaning the baby, examined her and gave her to the mother.

 
I am sure I will have loads of stories and learned lessons during my professional career as a doctor but I know that I would always remember that walk, maybe nothing will mark me as it did. In the next years that I have to practice medicine, I may have doubts about why I became a doctor but then I am sure I will remember that night, that calm that filled my body when I stepped in that woman’s house. I will remember that sensation that made me comprehend that I was there, in that town, at that precise instant for a reason: to save and protect the lives of the people living there.

 

 

About the Author : Fiorella Lipari Sebastiani studied medicine at San Martin de Porres University in Lima, Perú. After graduating medicine school, she worked one year doing community service in a vulnerable and difficult to access town. Currently, she is doing her residency in otorhinolaryngology at Puerta Del Mar Hospital in Cadiz, Spain. She can be reached at:  [email protected]

About this article: This article is competing for the JPMS International Medical Writing Contest 2012 for the theme: Becoming Better Doctors

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  • Angela Sebastiani

    Good article!