Mis Aventuras

Our homestay mom took us to a church festival where they were celebrating el dia de San Judas Tadeo. We were served mole and had a cumbia band play while we ate. I’ve been feeling extremely home sick and couldn’t shake the feeling. Being in the family atmosphere and the family party atmosphere really helped bring comfort. I think I’m home sick because I miss my family. I love my family and always have, but being in Oaxaca has made me realize my family is my greatest treasure in life.

Last week I had the opportunity to see another C section. The baby born was male and adorable.

Currently in the process of picking a research project for my individual paper. I think I’m going to study alcoholism and the resources available in Oaxaca. I’d like to do a literature analysis to potentially find any information about alcoholism in pueblos- do usos y costumbres change alcohol rates? if these laws exist, do they change the dynamics of the family, where the man is typically thought of as “head of the household”? 

My project idea was inspired (triggered?) by a patient interaction I saw at Hospital Civil in urgent care. A man was there for chronic alcoholism. He was hallucinating and yelling fervously at the doctor to remove his urinary catheter. It was a Thursday, and the man stated he had been drinking since Sunday. When the doctors came to his bed to do rounds, as ill as the man was, he stood up, and shook the doctors his hand. His son, who had been standing by his bed, was told to leave the room.

The handshake symbolized pride. Pride that, even in his dire situation, did not escape the man. The need to be presentable. In many ways, it reminded me of my dad & when he had his bouts of drinking. No matter how drunk he was, if a situation came up where he had to “be a man,” he would immediately step into the role. What saddened me the most was seeing his son there, who looked to be about 15 years old. When the doctors asked the man if that was his son, he stated it was, that he loved his son and he was his favorite. The man went on to mention that his wife had cancer. 

I wondered if the man started drinking because of his wife’s cancer. But most of all, I worried for his son. 

Since coming to Oaxaca, my diet has changed pretty dramatically. I wouldn’t say it’s been a good or a bad change, but it definitely has had its perks. For one, we eat desayuno and comida at the same time everyday, which my metabolism appreciates TREMENDOUSLY. Thinking about being back home, my eating schedule is super irregular.

One downside has been the amount of carbs we consume here... for breakfast, we typically have fruit, yogurt, granola, and a slice of toast with jelly... on rare occasions, we’ll have half a tamal instead of toast (mmmm tamal de mole negro, sooooo delicious) I appreciate the fruit and yogurt, because that’s typically what I eat back home. Except I can’t have large amounts of yogurt here :( it’s either lactose free or whole fat... I haven’t really come across skim, 1%, 2%, etc. like they have in the U.S. so that’s something I’ve been bummed out. I can drink lactose free milk, but lactose free yogurt does bad things to my digestive system (I think it’s because it has all of the fat & maybe that’s what upsets it? not sure but my theory so far)

For comida, we always start with a sopa de fidio, conchitas, etc. On a good day, la sopa es de vegetales (which I lovveeee). For the main platillo, we eat a piece of meat with rice, or sauteed vegetables with rice, a chile relleno con frijoles, tostadas with rice, flautas with rice, etc. - essentially the food has few vegetables which has been the hardest adjustment for me. Our host family serves a basket of tortillas, and I try not to eat any, but depending on the food, I’ll usually have 1-2 tortillas. Back home, I have a plate of leafy greens with lunch and dinner. So I can most definitely 200% say I miss kale and spring mix </3 I do appreciate that our host family uses little meat, so many times our comida is vegetarian.

For dinner, Monica and I bought sandwich materials so I’ll usually eat a sandwich (with only one bread b/c by that point I’ve had a lot of carbs). As a midmorning snack between desayuno and comida I’ll have a multi-grain granola bar that is packed with fiber (yum) and a piece of fruit. 

overall, I’d say my diet is healthier, but unhealthier. Healthier because of the regularity of meals, unhealthy because I wish there were more leafy greens incorporated into comida, but in no means am I complaining. I am extremely grateful and IN LOVE with our host family’s cooking... 

This weekend we had a chance to go to Calpulálpam de Méndez, a pueblo in the Sierra Norte in Oaxaca. We had a chance to learn about traditional medicine and about limpias. The woman who did my limpia said I had mal de ojo (caused by jealousy/envy), aire (probably cause I leave the gym sweaty and go out into the cold, woops), and she also said my huevo showed that I had been having family problems (which blew me away b/c that’s what I’ve been stressing about lately). I also had a chance to go into a temascal, which was sort of like a sauna and was super relaxing. Although an earthquake did hit during the time right after the temascal, I felt unfazed because of how relaxed I was from the temascal. I have gained a much much greater appreciation for medicina tradicional and really appreciate those who practice it to a great extent. If there is ever a chance for me to learn about it more in depth I would gladly take the opportunity. Dr. Abel gave us a lecture about traditional medicine, and something that made an impact on me was when he told us to never stop being human. He told us that becoming a doctor tends to dehumanize us as people, but he told us to always remember why we became doctors in the first place, so will definitely strive for that and keep myself grounded.

Question: Based on what we learned with Dra. Adela, what are the social determinants that affect your health? What are sources of privilege that protect your health? If we conducted an intersectional analysis of your health, what would be important key factors that your physician should consider?

Some social determinants that affect my health personally are income, sex, and ethnicity.

My family is classified as low-income and my mom is a single parent. Ever since I can remember, Medi-Cal has been my insurance (until I went to UCLA, then had the extreme privilege of being insured through UCLA Health for 4 years, god bless). Now that I’ve graduated, I will be enrolling once more in Medi-Cal. Compared to the expensive, quality UCLA insurance, Medi-Cal sucks. Patients on Medicaid have to wait many weeks for referrals to get approved. Many services aren’t as widely covered, so the red tape that one has to get through when on Medi-Cal can be very frustrating. As a woman, I am prone to more illnesses such as breast cancer. As a Latina, there are certain chronic illnesses that occur more readily in my ethnic group, such as diabetes (it also runs in my family), hypertension (also runs in the family), and obesity (I was considered “obese” up until I got to middle school). Looking forward, when I plan to have kids I am certainly more at risk for gestational diabetes, especially if I plan to have my kids at a later age (which I do b/c who is really trying to have a kid during med school?! definitely not me).

However, I have the extreme privilege of having a college education (protecting factor) and having a wonderful family. Although I suffer from anxiety & PTSD due to childhood exposure to my dad’s drug addiction, my family is my biggest support system. Having an education and being fluent in English will allow me to be able to navigate Medi-Cal with greater ease, a privilege most people who are insured through Medicaid might not have. 

If conducting an intersectional analysis of my health, one super important factor that would have to be considered is that I am a child of a mixed-status family. My mother and brother are both undocumented, and I am the first in my family to be documented. Things such as my documentation status, education, and income level should also be considered. 

During clinic, I was taken aback by the way people perceive us as foreigners of the United States. I feel that people assume we are entitled and rich- which is completely not the case for me. I grew up eating sopa maruchan y comprando en la 99. I was hurt because by making assumptions, people were discounting my story, the way I was brought up, and where I come from.

I think it’s really taught me not to make assumptions about others because I now feel how hurtful it has been for me for people to assume things about my life.

It’s also slightly amusing when people say “pues hablas el español muy bien” when they hear me open my mouth (lol) I mean my Spanish isn’t perfect, but it’s pretty damn good (tooting my own horn).

I also get called “güerita” pretty often, which I think is endearing. 

The week of October 1st was the first week of clinical rotations. I had a chance to sit in during a consult for a woman who did not speak Spanish, she spoke Mazateco. It was interesting to hear her life story and about her journey as a mother. She was married at age 12, and had kids until about age 50. It was interesting to hear the narrative of someone with such a traditional background and upbringing.

It was also saddening to witness her medical care be affected by money (she was unsure whether she would get an endoscopy because it was so expensive). The woman initially asked for yerbas, or herbs, instead of an endoscopy, as she was looking for a cheaper alternative within traditional medicine. The doctor replied abrasively and said she did not know of any.