Day 23

Well I jinxed myself, and it wasn't even at the expense of the mango shake I thought about getting while in Sorsogon the other day (because let's face it, I'm too chicken to drink it). But anyway after dinner I started feeling really under the weather, and even tried my best to stay up and do another round of videoke with everyone before I was forced to call it quits. It was the roughest night ever. I had a fever for half of the night with crazy chills that were preventing me from really sleeping, on top of having to get up like every 10 minutes to run to the bathroom. It's like my infectious diarrhea PBL presentation from last semester came back to haunt me in the worst kind of way. At one point I thought I would just shrivel up like a raisin because it couldn't be humanly possible to lose that much fluid from my body. Heather was up and saw me at one point in my state of misery and gave me some Tylenol to take which kicked in after an hour or so and broke my fever. But I was still so miserable. My stomach was killing me and since I couldn't sleep I just laid in bed curled in a fetal position trying to decide if this was cholera or salmonella or e.coli or what. I've been so careful since I've been here and haven't had new foods over the last week that I could think of that would give me this. I know what you're thinking...TMI, but being around med students nothing is TMI. Frankly we enjoy talking about the symptoms and presentations of illnesses quite thoroughly. 

Anyway by the time morning came, there was a knock on the door from Dr. Schuster to get up because we would be going to Sorsogon Jail to provide medical care for the inmates, who otherwise don't receive any healthcare while they serve their time. Most of the prisoners are also in there for minor offenses, such as not being able to pay off a debt because they are so impoverished, or stealing to provide for their families. For instance if one gets into a car accident and cannot pay off to repair the other person's car they crashed into then they would be put in jail. You are guilt until proven innocent here, and the majority cannot afford the court fees and a lawyer to defend their case so they serve their time.

I thought long and hard about what I should do. I'm not a good sick person. I pretend I'm not sick and act like I'm in denial. It's kind of funny when I see some of my friends and family being such babies about being sick. Man up! Plus I really wanted to work at the jail, so despite feeling like crap I got up and ready to go. And I justified my reason by the fact my fever broke so I must be getting better right? 

We took the Jeepney to the prison with all our nurses and pharmacists and set up clinic around 9am. Janine, one of the Filipino nurses gave me a keychain with my name carved into it as a gift. I loved it! I love all of them. We took shifts while some of us walked to the local market across the street to shop around since there wasn't room for all of us there. It was quite an experience. There aren't really individual jail cells, just one big one and they all sleep in these small box shaped rooms that go from the floor to the ceiling (pictures describe it better). They all seem like they get along too. Definitely not San Quentin. I walked around the market in the morning with Alex and Sean. I got some hand carved Filipino machetes (one is for you Matt Stevens!), a few more $2 RayBan sunglasses and a shoulder bag for all my stuff. Everything is so cheap, it's wonderful. When I got back I saw a few patients before Dr. Schuster. Brigitte and I left to go to a meeting with the medical director at the private hospital in Sorsogon to start our TB project. We will be going tomorrow in the morning to collect our data. 

By the time we got back, it was almost time for lunch. I started to give the inmates B12 shots and before break Rob gave me one of the B12 shots. I guess I can now say a friend of mine gave me an injection in a prison...and leave the rest up to imaginations, which will work unless they've read this blog. Then they'll know I'm a dork and not so much a badass.

We went to lunch in Sorsogon city and ate at chow king. I had the delicacy of white rice which I picked at with hesitance due to my lack of appetite and fear of having my stomach start going crazy again. And let me tell you the public restrooms are horrible. I try and avoid them. If you think they're bad in the US, you have no idea. First off most don't supply toilet paper, if they do they are a higher class place. A lot of our patients don't use toilet paper, they wash themselves. Second, most of the toilets don't have toilet seats, so yes I've become quite an expert on the third world squat and my quad muscles and calves are in impeccable shape. Third, they don't have a handle to flush, you have to pour water into the bowl until it is clean. Fourth, no soap. I never go anywhere without hand sanitizer or without someone who has hand sanitizer. Last, no mirror. If I didn't take pictures I wouldn't have any idea what I look like at this point. So all the laws of women in bathrooms taking forever is defied in the Philippines. We are as fast as humanly possible, even with all the extra steps. Surprisingly though chow king had the best bathrooms that I've seen thus far. Seats, soap, toilet paper and a mirror! But I managed to get through the day without getting real sick again which was a blessing. I had moments where I started feeling like I would pass out and nauseous but they came and passed in waves so I fought through the day.

We got back to clinic and I spent most the rest of the afternoon giving B12 injections to all the inmates. I must have done over 200. If there is one thing I have gotten good at and enjoy doing, it is sticking sharp things into people for their benefit, be it needles, sutures, scalpels whatever. If you need any of these things, I'm your girl. Everyone commented on my state of sickness to while I was back. One of the nurses said I looked "so dehydrated", Ashik said my face looked sick, another person said my eyes looked sunken. Pretty much all very polite ways of telling me that I looked like crap. It was kind of funny. I saw a few cool cases, and some abscesses drained which is always exciting before we closed up to head back home.

We all relaxed before dinner, and refreshed ourselves. Mamma Tess made some American burgers tonight and some Filipino classics which was nice. Too bad my stomach wasn't cooperating much, otherwise I would have indulged. I stuck to rice again, tried a piece of plain chicken and a piece of the hamburger roll. Food is not my friend. I've taken cipro already so hopefully this will be over and done with soon. 

Half of the boys are leaving tomorrow. All of Tulane med frat boys (Rob, Brant, Dave, Alex and Zach) are leaving tomorrow since most of them have rotations starting on Monday. They will be missed. For one thing it will definitely be a lot quieter around here. Just means we'll definitely have to plan a trip to New Orleans to visit them this year. As under the weather as I feel, I'm still going to push myself to have a great time and celebrate their last night here. Videoke and debauchery as per usual. 

The night hit a high note at 12am when it marked the Fourth of July and we all put on the song "Proud to be an American" on the videoke machine. In a tightly packed circle, embraced in one another's arms, we belted out the lyrics to that song over the speakers, chanting our love for the USA. Happy Independence Day America all the way from the Philippines!!

The prison 

Zach is the tallest prisoner

Shots for everybody!

Tour of the prison

The inside of the "cells"