by: Carol Sullivan, Trip Scribe
Medical students aboard a chicken bus in Ecuador—What do you get?
Trip Journal, February 17-25, 2018
Note: A retrofitted bus bore us from one village to the next in the Ecuadorean Andes. This type of sturdy vehicle is nicknamed a “chicken bus,” akin to trucks that take live, squawking chickens to market. A physician wrote in the group’s journal that ours was a noisy bus. In the clamor on and off the bus, something happened that each person on the trip cherished… Unless otherwise noted, students in their first year authored these reflections. —Carol Sullivan, trip scribe
“Throw together a group of diverse people from different backgrounds, of different ages, with different ideas of teamwork, each with their own personal goals, add a dash of sleep deprivation with a few shots of local liquor at the end of the day, and what do you get?” Austen Anderson posed that question during the trip to Ecuador February 17-25, 2018.
Dr. Jacqueline Woodrum’s first impression was hardly auspicious: “Wow! These students (some of them) are very loud, self-centered, and obnoxious until….” The moment the students saw patients, the doctor saw the students become “caring and compassionate beings who are learning to put the patients’ needs before their own.” How does that happen? “This is the magic of medicine: to love unconditionally and give of yourself to those around you, regardless of the level of need, language barriers, or personalities.”
Austen Anderson described the transformation: “An awesome team of people miraculously come together with a common goal of giving care to people who truly need it! The one thing that unites us all, even the wonderful folks who aren’t medical, is a passion for helping people.”
Idealistic expectations soared before the clinics. Jen Daniels wrote about the start of her first trip to South America: “We hardly slept, having arrived at the hotel in Quito after 2 am. But we were well fed and caffeinated by Hotel Cuba. I am looking forward to my first time empowered as a ‘clinician.’ I hope to refine some Spanish phrases and to connect with the people I see in clinic on a personal level.”
Julia Craig expressed her hopes: “This trip will be an excellent combination of personal growth and an improvement of health and morale for the community members that we meet. I hope to bring a sense of compassion and genuine care to the patients I meet. I expect to be challenged medically, to enjoy a brand-new culture, and to have a better knowledge of how short-term medical trips should be approached.”
Not surprisingly, expectations bumped up against challenges.
Parker Stocking wrote, “The first two days in the communities were a little rough. I nervously saw patients, helped translate, operated the ultrasound machine, and performed some OMT. I most definitely felt overwhelmed after Dr. Bentley tore apart my SOAP [medical] note (for good reason!). Days three and four in the clinic and pharmacy were a lot better as I was helping in wellness checks of adorable children and seeing women patients and a 14-year-old. I saw this boy’s callused, hardworking hands, and he told me that he works the farm with his mother. I gave him a pair of sunglasses and said they would proteger tus ojos. Immediately he put them on, smiled big, and gave me five while saying, ‘All right!’ He was a rock star! Even though the sunglasses were secondary to his chief complaint, they could help him avoid vision problems and headaches.”
The country itself entranced Parker. “It’s easily the most beautiful place I’ve ever been! The green in the Andes surrounding Guaranda is a green I’ve never experienced anywhere else. The bus rides to and from the sites were safaris through incredibly steep and fertile mountains majestically enveloped in mist and clouds. Mount Chimborazo was awesome—the roaming vicunas in the foothills remind you that you’re in the Andes as you look at the giant snowcapped volcano. For the people, the purpose, and the scenery, I sincerely hope to come back!”
Students came from the Colorado campus as well as the new Utah school. They had heard one another’s voices asking questions during virtual labs, and now they were face-to-face. Would they become a medical team?
Taylor Sirrine said yes, students from the two campuses bonded. “My favorite part of the trip has been strengthening the relationships I already have with friends from Utah as well as creating new friendships with the amazing people from the Colorado campus. I lived in Argentina five years ago, and this is my first time returning to South America. I’ve missed it. The Ecuadorean people are some of the most generous people I’ve met. I’ve loved this trip and look forward to more!”
Students wrote of self-discoveries, building self-confidence in the practice of medicine, the warmth and fortitude of Ecuadoreans, the skill and kindness of the attending physicians, and the joy of being with fellow medical students in a beautiful country. There was a sense of radical shift in time, place, and perspective:
Conner Roggy —"The people in Ecuador are kind, patient, and tough. They can adjust to pain much more readily compared to the average American. I felt helpful to them in at least a small way, and they taught me so much about patient care. The physicians, students, and other support workers that I worked with were selfless and kind, and they all treated me so well and gave me a new appreciation for medicine and for my colleagues.”
M. Tysen Nickle—“¡Que linda esa experiencia! This trip has been a wonderful opportunity. More than anything else, it taught me about myself and the sort of physician I plan to be. I was encouraged by the amount of trust and responsibility the attendings gave us with our patients. Thank you to everyone involved for your patience, support, and friendship!”
Naz Dubchak—"It has been a humbling adventure full of new knowledge in medicine and in the Spanish language. It was very important to develop friendships with a wonderful, diverse group of selfless individuals who work together in various capacities to help those in need. This is why I left behind a fruitful career, and every day on this trip affirmed my choice to pursue medicine.”
Boris Joutovsky—"Witnessing the villagers walk to our clinics for simple treatment was humbling. Their access to basic healthcare is limited, and they deserve more than what we can give them. Yet Mario Carrasco (our Ecuadorean guide) proclaimed how wonderful it was for us to travel to these villages, giving up our own time/spring break in order to give back to others. He said many young villagers have access to education, but not basic health services.
“At the last clinic, as we set up our medical stations in the school, there were complex algebra equations written on the board. The new generation of students seems relatively educated in algebra, but certainly not in healthcare. Patients told me their livers hurt—as they pointed to the wrong side of the body. Little kids sat next to me for up to two hours, and they would swipe a pair of sunglasses we were giving to patients.
Most importantly, this trip taught me how to become a better doctor and a more caring person.”
A.J. Olson— “I found myself suffocated in textbooks before the trip, and as first-year students, I believe we lose sight of the humanistic side of medicine and need to be reminded why we worked so hard to get to where we are now. This trip did exactly that. My passion for medicine and patient care came alive, and I cannot wait to treat patients for the rest of my life
“I enhanced my palpation skills and discovered the importance of the human touch in palpating bounding aortic pulses and large ovarian cysts. I auscultated pneumonia and bowel sounds, and scanned gallbladder stones and pulmonary effusion.
“Lastly, I rode this high of excitement from the first couple days and continued that ‘high’ up to 16,500 feet above sea level as I climbed Chimborazo. The experience on the mountain was spiritual and reminded me that we are just a speck on this earth, and it’s hard to believe that we made a profound impact on the country. Yet to those few patients we treated who have never received any or scant medical treatment, we may have meant the world.”
Trisha Tucker exclaimed: “A life-changing trip for me! At first, it was stressful because of all the traveling and lack of sleep. But our first clinic made it all worth it! Connecting with the people of Ecuador, hearing their stories, and having the privilege to help them has reminded me of why I push myself so hard and why I am going to school. This is what I want to do the rest of my life!
“This was also my first experience speaking Spanish for medical care and having the opportunity to connect with Ecuadoreans in their own language, to learn more from them and build a relationship. Because I connected so well with the children in Ecuador, I realized during this trip that I had a keen interest in pediatrics.
“The opportunity to work with physicians who truly love what they do and have such passion for their patients was amazing. As mentors they allowed us to practice and helped us to think critically. Seeing each physician’s approach helped me to realize medicine isn’t black-and-white but an art.”
Alexa Tyler, a fourth-year student, expressed the pith of what comes from an arduous journey:
“Such an honor to get outside ourselves and to remember that there are other lives and stories being told every day! And there are many lessons to be learned from the Ecuadorean people: intense care for each other, pride in their heritage, and a great way of moving through time with ease.”
Cold showers, muddy roads, great things
A sense of pace, place, and peace comes from these reflections by a physician, a nurse, and two community volunteers, who are sister and brother and offspring of Dr. Woodrum:
Scott Smith, D.O.—“I arrived in Ecuador one week ago. Everyday has been cold and rainy, the roads muddy and treacherous, the showers cold, the coffee lukewarm, the internet slooowww…Because of the magnificent rugged beauty of the land, I did not notice the inconveniences, and the cold was warmed by the hearts of the local people.”
Heidi Smith, R.N.—"I’ve been working in the pharmacy doing wound care, injections, and occasional diagnostics. I’m so impressed with the students and their skills even as first years, especially their ability to accommodate every situation without grumbling. My thrill is teaching them. For some it’s their first experience of giving injections or taking blood. One student’s hand was shaking as he gave the injection.
“My husband Scott and I have been on mission trips to Kenya, Nepal, India, Brazil, Haiti and Tanzania. Our daughter-in-law Carina is from Quito, and she’s working as a translator on this trip, and her husband, our son Scotty, is here as a community volunteer. We have in our heart to give to people.”
Isabelle Woodrum, community volunteer—I want to turn international service work into a career. This trip offers an exclusive look at that type of work in action. Seeing the impact that we can have on a community or even one person is truly magical. They say that Disneyland is the most magical place on earth, but I would take volunteering ten times over that.
Andrew Woodrum, community volunteer—"This was my third trip to South America for a medical brigade, but perhaps my favorite. The lush green mountains dotted by flowers of purple and yellow were hidden beneath the clouds of spectacular locations.
“The ceremony with the shaman on Chimborazo was a powerful experience. The connection with the rest of the planet is strong there. This mountain is not just an inactive volcano but a wise teacher. I fear the wrath and anger of this teacher who sees the lack of respect we humans have for the planet, though I feel the mountain’s willingness to guide us.
“We may be small, but we are capable of great things, and this medical trip is proof. These students’ kindness and desire to help others will ripple through this land and remind others in Ecuador and back home that a little love goes a long way.”