Reflections on Healing Peru
By Dr. Golam Noaz

"There are moments and events in life that can serve to cement and fortify what you know and value as true.  My experience in Peru provided a number of these moments in many facets of life and medicine.  The bonds that were forged in such a short period of time with a group of amazing people with diverse backgrounds certainly left a mark that will not soon be forgotten.  Certain experiences were not necessarily rewarding in a conventional sense due to predicted outcome but served to bolster the importance of compassion for people.  The reminder that medicine is a universal art and no one can take it from those who own it, not even Sallie Mae.  The trip served to demonstrate a number of similarities in practice that I’ve learned throughout the rural family medicine residency in Bogalusa, as well as values that have been instilled by family and friends.

Attempting to describe the group in words would not do us justice nor is there time to tackle everyone.  The manner in which our team came together around a common idea was at once organic and intricately planned.  Through years of building Healing Peru Dr. Seeliger has had the insight into what makes for a good team.  By collaborating with Dr. Russo, Dr. Andrade and other leadership primary teams were formed to carry out our mission.  Prior to these teams being assigned others from the group made it a point to bring the group together.  Scotty and Penny both made it a deliberate point to split apart during meals and sit with people that they had not had an opportunity to work with or chat with.  This set a tone and example whether or not others were aware of it.  Our team had the unimpeded enthusiasm of four excellent first year medical students.  Each and every single one was eager to learn as much as they possibly could, medically and culturally.  Their idealism is refreshing and served as an excellent reminder of why I love what I do.  Lynda’s enthusiasm and humanity throughout the trip demonstrated the balance of what our work was.  The near nightly campfires with Cuzqueno served as a time to unwind and reflect as a group, through music and conversation.  Sharing cases with other residents near graduating, Pants Matt in particular, served as a great reminder that medicine is collaborative and that the sharing of information leads to growth.  The compassion of Gill and Tom was palpable and if it weren’t so contagious should cause one to reconsider and have a come to God moment.  The courage of David and Vicki, 8 weeks s/p MI with stents speaks volumes about his heart and mind being a health care professional and wanting to help others. All of the interpreters volunteered their time to us from their regular duties, none of which had a medical background but all believed in service to their fellow man/woman.

The medical aspect of the trip was challenging as it was rewarding.  There were some cases that were truly heartbreaking and left me needing time for self-reflection.  One such case involved a 35 year old woman on dialysis for what was likely APKD.  She presented with hematuria and dysuria and had expressed that she had been hospitalized a year prior for what seemed to be pyelonephritis.  The woman expressed her sorrow in her understanding of her chronic disease and that she has 3 young children whom she is responsible for.  The patient has Tuesday, Thursday, Saturday dialysis scheduled and we saw her on a Friday.  The best we could do was give her IM Rocephin and document what we had done so that she could inform her doctor and dialysis tech so that they could make a medical decision and hopefully do what we would at home and admit and treat her.  Unfortunately she returned to clinic that Monday having worsened as she began passing blood clots in her urine.  Aside from the antibiotics what this woman needed was compassion and understanding which our team did its best to do.  Listening to her history medically and otherwise is an example that patients need to be viewed as a sum of their parts, as a whole, not a constellation of symptoms.

The reward of practicing medicine in Peru was exactly that, practicing medicine.  Relying on taking a good history and performing a good physical exam to confirm or rule out differential diagnoses felt liberating.  I felt confident in my abilities and more prepared for the next step of my career and that if I were dropped anywhere in the world I could have an impact using the knowledge I’ve accrued and will continue to gain.  Sharing the knowledge that I am privileged enough to have with the students was a reward in and of itself as well.  Watching Jo, Fitz, Logan, and Lee transform and develop in front of our eyes is indescribable, but they were all rock stars.

Bogalusa and the rural family medicine program provided me the tools to be effective on this trip.  The patient population in Peru reminded me greatly of where I practice currently.  The biggest issue seems to be access to care for both patient populations.  We have to do the best we can with what we have available to us in every situation and strive to do better and put forth extra effort in many cases.  Every life has value regardless of station in life and all deserve care, especially those that seek it out.  This is a valuable lesson that my parents have taught me that I am privileged to carry out on a near daily basis and carry over to Peru.  The medical system and pitfalls can become wearying and Peru served as a reminder that those obstacles are less important than the person sitting in front of you and doing what is in your ability to do.

The value of going to Peru for me was priceless.  The preceding words are only a minimum of how to describe my experience.  I will always be grateful to Dr. Seeliger and Dr. Russo. I am grateful to Dr. Seeliger for his work over 10 years establishing and organizing Healing Peru and the opportunity to get to know him better through the trip.  I’m grateful to Dr. Russo for his efforts in making this a part of my medical education and a part of the curriculum for the residency program overall.  I would highly recommend that everyone who has the opportunity to participate in Healing Peru to go and experience it for themselves."