The Snaketarium

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I´m finally caught up with the blog. Only took 1 and a half weeks. Except for the pics. Hopefully that doesn´t take me another 1 1/2 wks. I´m so tired sitting here, but I´m pushing it out for one more blog just to keep it current. So today, we had another day of seeing the local healthcare system. Yesterday we didn´t see many patients. It was kind of unfortunate. I was expecting something similar. Today, however, we went to a pretty nice hospital and actually had some really good teaching sessions. We split up our giganto group of 30 into 2 groups, and each went with a peruvian doc to see some interesting patients. We had a few case presentations (like watching an episode of House where you have to try to figure out what they have, but it´s never something like pneumonia, or appendicitis, or something common like that). Our first pt had Hansen disease (leprosy). Very subtle and a recent diagnosis. It was cool to see in person. The next was a guy with a big mass in his stomach (and on xray, his lung) filled with echinococcal cysts (that actually WAS on house). It´s a dog or sheep tapeworm that forms cysts in your body, often your liver or lung, but anywhere. It was a HUGE mass and the xrays and CTs were impressive. We had another case of echinococcus in the tibia on xray. Very different. Also had a case of ruptured bowel (now that´s my specialty!). Lots of things it could have been, but turned out to be TB (I think, now I can´t remember that one). After we saw the patients, we walked over to the leischmaniasis lab (I think I mentioned this before, but the little parasite transmitted by the bite of a sandfly in either India and the middle east, or south america). Was interesting, and got to see some patients who had different stages of disease and treatment. They are one of the few places who does outpatient therapy (it´s an IV med once a day for 42days). They don´t have PICC lines, either, so it was a new IV every day for those poor people. That sucks!

Aferward we were dropped off at the hotel for lunch and a short bit of downtime. I went to lunch with 1 other person (our program leader who used to live here) and we had a GREAT lunch! It was a sandwich place called Tanta which was owned by the same guy who owned La Mar. Really good food! We then headed back to the hotel and hopped on the bus for the next outing: The Snaketarium. Technically the serpentarium, but much more fun to call it the snaketarium. We pulled up at the gate, and all I wanted to do was get a picture of the sign at the gate which said it was the national institute of health (I think, now I can´t even remember, there was so much commotion). The exact moment that I ran to the front of the bus to take a picture, the guard came over. Apparently their stupid gate is a matter of national security or something (I´m pretty sure it was just a bored gate guard). They insisted on taking all of our IDs, shaking a finger at us, and telling us more than a few times that we can´t take pictures. If we did they would confiscate our cameras (and in another country like Peru, I´m sure they would have). Whatever. I didn´t want a picture of their stupid sign anyway. Unfortunately some people didn´t bring ID (I know what you´re thinking, and I was thinking it too). Lucky for them a couple of us had extra IDs, and the guards weren´t really paying attention -- just counting the number of IDs and people. Retarded. We were finally let in through the incredible security (slight undertone of sarcasm...) and made it to the snaketarium. There is an AWEFUL lot of hurry up and wait in this country. They were never ready for us in the mornings, and the snaketarium was no exception. After standing in the lobby for way too long, we finally went into the room, which consisted of a little glassed in standing area by the door, and a big open lab with boxes with airholes (I´ll give you one guess...) We were safely enclosed in our little glass cage, and watched as snake after snake was explained and paraded around. A few venomous, a few not. I was trying to get some good pics. My face was right up to the glass for a really mean (and angry) looking viper. As I was staring, he struck at my face. Fortunately the glass was there so there was never any real danger. However, my body didn´t instinctively know that. I was crouching at the time, and didn´t think it was possible to jump backwards straight from a crouch, but I did. After vaulting backward, about half a second after it happened, I had a massive jolt of adrenaline hit my heart (felt like i got stabbed in the heart with one of those adrenaline pens like in Pulp Fiction). I stood up and tried to run but couldn´t go anywhere. My eyes started watering (ok, it was tears... but I couldn´t help it! What a dork) It was the most intense flight reaction I´ve ever felt in my entire life. Wasn´t entirely bad, but I could see how if I had a heart condition it would have sent me over the edge. Now I wish I had THAT on tape!

They also had some spiders that we checked out, which were not as interesting, except for the little plastic tub (like a margarine tub) with their version of a brown recluse with little babies in there. The only problem is that the babies are just a bit smaller than the air holes poked in the top. It was funny... for a minute, then I thought about it and wanted to leave the room as quickly as possible. I should have mentioned that the main purpose for the center is to develop antivenin. In order to do that, you need lots of venom (from live snakes or spiders), and horses to inject it into. The horses make antibodies and you harvest them. So in addition to the snaketarium, they had a big open barn (really just a HUGE horseshoe of stalls) filled with horses. Nothing special, just retired racehorses who are now eating lots of corn stalks and being used for their antibodies.

By the time we got back to the hotel it was almost 5, but we weren´t meeting for dinner until 7:30, so we had some time. Edwin, Sylvia, and I (Sylvia is the dermatologist and is mad cool) ventured out for some shopping. Edwin was in the market for a leather jacket and had found this place earlier that makes leather jackets to order. So we grabbed a cab and headed into the center of the city. At first the leather place looked really sketchy (cheap stuff outside like bootlegged movies and bad CDs, then you go up these scary stairs and around a corner at the top), but inside it was a very nice little leather jacket store. They had a couple of people working at a sewing machine and doing other leather work. On the wall were lots of leather jackets, all different. Edwin picked one out he liked, and we translated his entire transaction (he doesn´t speak any spanish, which will mean that for our week-long trip coming up, I´m supposed to be bilingual. Hold on to your sombreros...) They´re making him a complete leather jacket, from scratch to his exact specifications and size. It´ll be ready by Friday (3 days) and only cost s/ 350 (about $120). I was so impressed with the store and what he was getting for the price, that I actually had them make me one too. So on Friday, I´ll pick up my awesome new brown leather jacket. Very psyched. It makes me question my potential alpaca shawl purchase. Did a $120 jacket just cancel out my $380 Alpaca shawl? I don´t know. I still REALLY want the shawl... What to do, what to do.

That was about all we had time for before dinner, and made it back to the hotel JUST in time for dinner. Most of us walked to a nearby Italian restaurant. It was incredible! I want to say it was the best food I have tasted, but the sad fact was that I couldn´t really taste it. Yesterday, I started to slowly come down with a cold. It built steam pretty quickly, and by dinner it was full blown with completely stuffed sinuses. We were at this gourmet Italian restaurant (with a very famous chef who is all over the wall in magazine articles, and actually served our dinner!), and I couldn´t smell or taste. What a waste. They were known for their desserts, and by that time I was completely stuffed up. I was so pissed. I picked up my purse and walked outside -- right down the street was a CVS like place. I walked up the counter and asked for Affrin (a nasal steroid that is usually prescription only in the states). $6.50 later I walked out with a bottle. And about 3 minutes after that (that´s how long it took me to open the stupid thing), I had streams of Affrin squirting into my sinues, and I was IMMEDIATELY clear (and am still clear at the writing of this blog later the same night). I can´t believe I never used it before. Really a miracle drug! I walked back in just before everyone had their amazing desserts delivered. I added my dessert order. When mine finally came out, I can´t say it was the best thing ever, but at least I could taste it. I´m sure it NORMALLY is the best tasting dessert you can ever find. However, I still couldn´t taste very well. Only time will make it pass apparently. All in all, the meal was fantastic. That makes 3 days of delectable meals, all on Dr. Martin´s suggestions. I wonder what tomorrow has in store!

Tomorrow morning we go to the Pueblos Jovenes (the slums or projects), then take a 4-hour bus ride to Ica for our little stay in a resort which is rumored to be nicer than this hotel. I´ll be the judge of that... We were supposed to stay until Friday, but there´s going to be a strike in the southern part of the country on Friday, and being on the road is dangerous (they can smash in car windows and all kinds of stuff). If the strike is on, we´re set to come back to this same hotel (Las Americas) on Thurs night. Either way it´ll be a nice night´s sleep! Not sure what the internet is like there, but look for pictures with my next installment...

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