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| Julianne and Elizabeth |
At 6:00 a.m. Brent awakens to the proclamation of “Daaaad, I have to pee”. Julianne feels the need to announce this and serves as the morning alarm for the household. Four kids to get up, dressed, fed and teeth brushed. Somehow Jennifer is able to do this without a hitch, but for Brent it is always a challenge. Jennifer won’t be home from the hospital until about 9 a.m. The kids know the routine, but still feel the need to deviate at times, depending on who needs a little more Daddy attention on a given day.
At 7 a.m. Ingrid arrives, our house helper, who makes this chaos a little less chaotic. With Greetings of “Buenos dias,” a few instructions and an update on the activities of the day, Brent heads up the small hill, leading from the house, with Christopher and Elizabeth in tow, backpacks on, and their “chicken mask” school projects in hand.
Christopher and Elizabeth wave to Hospitalito, knowing that Mommy is somewhere inside and will be at school to pick them up at the end of the day. No time to walk today, as Brent is on OB call and needs to be at the hospital at 7:30 a.m. for morning report. They catch a tuc tuc.
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| Tuk Tuk |
The tuc tuc ride is like some racing car video game as the driver swerves around pot holes, dogs, and puddles that resemble mini lakes this time of year. Christopher and Elizabeth squeal with joy as the tuc tuc is forced into one of these “mini lakes” by an oncoming "chicken bus" headed for the capital. After climbing the hill to the parochial school, Colegio Catolica Padre Apla’s, the kids and Brent have arrived, a little wet and all sleepiness cleared from their heads.
The kids enter their class room with a “Buenos dias, Maestra” and a “Buenos dias, Compañeros” and with a “Buenos dias, Cristobal” and “Buenos dias, Elizabeth” from their teacher and classmates, the children proceed to sit down at their desks. The walls are lined with the alphabet, numbers, and words written in a mix of Spanish, Tz'utujil and English. Brent is reminded of Christopher’s protest during study time at home for their last exams, “It’s not fair we have to study three languages!” Brent leaves the kids with a kiss on their heads and a quick checkout with their teacher, Juanita.
It’s the rainy season, but more so this year than in the past few years. The rain seems relentless at times. Downpours last for days at a time, a constant drone on the metal roof. Roads resemble rivers more so than streets. Mudslides have replaced villages with mud and boulders and there is a general sense from the populace of a heavy coat blanketing all the senses. But even with all of the rain a "Buenos Dias" is never far from the lips of all we pass by.
Miguel’s parents were up with their child late into the night reflecting on the past few days. It started as a runny nose, followed by a dry hacking cough and then the rapid breathing, each breath an effort to get more air. They went to the local health center and received various remedies that seemed to help initially, but now, as their child looked up at them with a plea for help and fear of the unknown, they knew he was getting worse.
They say an asthma exacerbation is like trying to breath through a straw, as it worsens the diameter of the straw grows smaller and smaller........
Jennifer had just laid down in bed during a 24 hour in-hospital call. She’d seen and treated numerous patients that day. Routine stuff mostly, but now as she laid down at 4 AM she heard the unforgettable "clack, clack, clack" of the tuc-tuc coming down the dirt road to Hospitalito. At this hour of the day it could mean only one thing -- a patient in need of acute care.
She gets up before the guardian can knock on her door, fumbling around in the dark in a place that is becoming less foreign each day. She hears a rooster crow, a dog barking at some unknown nemesis as she puts on her doctor’s coat --loaded with all the “essential” paraphernalia from 15 years of practice. She grabs her stethoscope, a close friend since her days in medical school, and heads down the stairs to the ER.
Andrea, the nurse, had already placed oxygen and gotten vitals when Jennifer entered the room. Miguel’s eyes were bulging and wide with panic as his chest wall heaved with every breath. Sensing the acuity of the situation, Jennifer questioned, examined, and gave orders almost simultaneously -- pulse oximetry, intravenous access, nebulizer treatments, I.V. steroids. With treatment, Miguel’s pulse oximetry began to rise from the low 80’s to low 90’s. His respiratory rate began to drop from the 80’s to 50’s and his lungs began to open up. He looked a bit better now.
It was almost 7:30AM and time for morning report.
We wanted to share with you an article from the Hospitalito, July Newsletter.
"We don't need Sherlock Holmes to figure out that Brent Burket and Jennifer Thoene don't event fit the description of your usual medical volunteer. The evidence is everywhere upon entering their home: two pairs of kids-sized rain boots, swirly blue and pink, a bookshelf of children's literature, tables loaded with crayons and coloring books, the movie choice of the day is Toy Story 2, and the final clue, a small voice saying, "mama, it's not fair".
So, why do two US physicians with four children under the age of eight, choose to move to highland Guatemala..." read the rest of this article interviewing Brent and Jennifer on the Hospitalito July Newsletter.
