Friday, October 7, 2011

Second Week - Obrigado !!!

The weekend:

I spent most of the weekend exploring Porto. I had bought tickets for one of those open top two story tourist tour buses from the Porto Visitors Office for the weekend. It included 3 different hop on hop off bus routes, short river cruise, and a trip to one of the wine cellars. Great way to see the city in a weekend. The plan was to meet another visiting student I had met at Casa De Musica metro station and then take the tour bus to the beach and walk along the coast to the river at 11, so I gear up and take the metro there. However, his phone is off and I cant find him any where. Its 1130; guess I got ditched. (It turns out he went out too hard on Friday and didn't wake up) More on the Portuguese Nightlife in future posts. I find the stop for the tour bus and it happens to come with in a few minutes of me finding the stop, a good sign since they run every hour. I climb up top and enjoy the view around the city to the beach. I get off at the first stop along the coast and take in the view and the sea air. There's so much to do; scramble on the rocks, check out the tidal zone, walk along the board walk, eat at the many cafes there. I pretty much spent the rest of the day walking along the coast towards the river, where I hop back on the bus at another stop. Which takes me towards the city center and Gaia, the town across porto with all of the wine cellars. Perfect evening for an early dinner and river cruise.

The Portuguese Coastline

View From The River Cruise

After the fantastic day at the coast, I take the bus back to Aliados (the main promenade in Porto) to catch the metro. As I get of at trinidad, I decided that now would be a great time to get my monthly student metro card. They close at 1630, and its 1600 plenty of time. I go in to get a ticket for the number being served system and they cop handing them out says that they are closed. I would soon learn why they where "closed."

I return the next morning at 10:00 when the metro office opens to get my pass. Already at number being served at 130. My number is 239. I'll wait it out. It should go fast right? I would get my pass, then get on the bus and do the other tourline up to the port and check out some wine cellars in the afternoon. I should have left and done my tour or gotten lunch, 2.5 hrs later and a few levels of angry birds, finally its 239. Make sure you have the following to get the card....the form from erasmus, a copy of your passport (luckily I carry one around instead of my passport here, and a small picture). No one told me about the picture, and there was no way I was going to wait in line again. Luckily the lady was able to use my picture of my NC drivers license. Thank you NC.

Now, back on track. I decided to reverse my touring plans and go back to Gaia, have some lunch and tour a wine cellar with some sampling for Port wine, and then take ride around on the other line to the port and old fort.

The Calem Wine Cellar (above)

The Private Hospital:

On Monday, I was scheduled to visit the private hospital, Hospital Cuf. It was built last year, and looks like everything is from IKEA. It offers the same services as Hospital Sao Jao. However, the difference is that most of the patients that go to the private hospital have private insurance that covers the cost or they pay out of pocket. While the care at the public hospital is mostly free, patients have little choice in who they will see and there is often a delay for surgical procedures. I meet with the doctor from the private hospital at Hospital Sao Jao who drives me to Hospital Cuf in the morning. There I meet the rest of the team consisting of two medical students Andre and Luiz, and two other attendings. The med students here also rotate at different hospitals since the main one affiliated with the med school can't fit all of them. Andre and Luiz show me around the hospital while the doctors finish up their morning work. I see the cafeteria with a view of the Atlantic Ocean, the ED, the wards with patient rooms that are nicer than the place I'm staying, and the ICU. We have one patient in the ICU that we are seeing. She was a lady who had a knee replacement and who subsequently had bleeding after PT and needed to get 4 units of blood and be monitored. At this hospital the internal medicine doctors take care of most patients after surgery. They also are responsible for the patient no matter where they are in the hospital, ICU or the ward. We also have a new admit to work up on the floor. I go with Luiz and Andre to take the history. What I gathered from the Portuguese history and physical was: fat, fertile, and forty with right upper quadrant abdominal pain....gallstones. We go back and present to the attendings who discuss the case. That's essentially it for the day there after taking care of the rest of the work, I have lunch with the attendings. One of whom drives me back to a metro after a brief car tour of the city.
ICU in the Private Hospital
Back to the ward:

The rest of the week goes by pretty fast at Sao Jao, since Wednesday is republic day, and it's a day off. I am back with my team, and we have some new patients and some that leave. I found that, unfortunately, the 103 year old lady passed away over the weekend.

This week most of our admits have psyc or social work issues and thus have interesting HPI's, like the 75 year old lady who was found by neighbors in her house walking around while her daughter was unconscious and unresponsive and her husband on the floor, dead for 2 days.

My favorite patient this week is an 89 year old lady that was transferred to our service from neuro ICU. She suffered a MCA territory stroke and had partial hemiparesis of her right side. However the only word she could say when we first examined her was, "Obriagado," which means thank you. Luckily, her speech has gotten better over the week and she can move her leg. The plan is to have her evaluated for rehab once the nurse in charge of rehab gets back from vacation on monday.

Having been around the city over the weekend. After work most days, I decided to venture out on my own and go back to some of the places I have seen. I walked across the top of the Ponte Luis Bridge linking Porto to Gaia, which was a great experience. I went to a couple of cool coffee and tea shops with the other med student on my team, Flavio.

I also met the other erasmus medical students this week. We had a small orientation meeting organized by the hospital and med school. Even though I am only here for a month, it was nice meeting the other students and making plans to hang out later.

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