Some days, it seems like nothing happens. Yesterday, it seemed like everything happened. First thing in the morning, I teleconferenced in to grand rounds at Rochester General Hospital for a fascinating case presentation on sarcoidosis. Two doctors at the hospital here attended with me.

Then, I assisted on surgeries with Dr. Pott, one of which was an open cholecystectomy (gall bladder removal). Although I saw many cholecystectomies during my Surgery rotation last year in medical school, they were all done laparoscopically. Yesterday was the first time I saw it done as an open procedure (we don’t have laparoscopy here in Dangriga), and seeing the internal organs rekindled my wonder and fascination with the human body and general surgery.

In the afternoon I drove to Belmopan, the capital of Belize, to meet with the CEO of the Ministry of Health, Dr. Peter Allen. This meeting was incredibly productive for me. For the first time, I felt like my services were actually welcomed in Belize. From the day I arrived in Belize, I had the impression that the doctors and staff at the hospital didn’t really want the telemed program I’m trying to implement. Early in the project, one of the people I needed help and cooperation from most seemed set on working against me. I won't go into details, but suffice it to say I was encountering unnecessary barriers. One important one was that I was told I couldn’t see patients unless they were referred by a Belizean doctor. And getting referrals from doctors here is like pulling teeth. My project seemed doomed in this context. As a result, I spent much of the last few months feeling frustrated, like my hands were tied, like I wasn’t making any impact.

However, Dr. Allen informed me that there is no need for doctors here to be involved in order to do a telemed consult. This changes everything! My project as I had imagined it in the beginning is actually possible after all. Dr. Allen gave me the OK to set up clinic here at the hospital, to triage patients for telemed consultation. This could dramatically increase the use of telemed, because although doctors are less than enthusiastic about telemed, patients are desperate for it. Sometimes when I’m walking around the hospital in my scrubs, especially if I have a stethoscope around my neck, people waiting in hallways are begging me to see their family member, and when I tell them I’m a medical student and not a doctor, they don’t care.

I only wish I had met with Dr. Allen earlier in my fellowship, because at this point I only have 2 months left here. However, I’m going to make the most of these next 2 months. And, over the last seven months, I have succeeded in building relationships with hospital staff, and likely, over time they will warm up to telemed once their patients start requesting it.

Finally, at the end of the day yesterday, I was able to obtain some x-rays to send to a Rochester surgeon, for a desperate young woman that we’re trying to bring to Rochester for a surgery to save her leg. That story, to be continued...

Photo: Workers loading oranges from a smaller truck into a larger truck. The scent of fresh citrus wafts through the air!