MUSC student writes about value of Global Health Certificate

By Thomas Larrew

I spent six weeks at the Clínica El Bosque in Bogotá, Colombia helping out and watching whatever I could, whenever I could. I remember thinking beforehand how medicine was going to be practiced in Colombia. Was it going to be in a wood shed? Would the doctor have nothing but his hands and stethoscope to do the healing? I may have been naïve, but for the most part this is how some think medicine is practiced in Central and South America.

For many places, this may be true, but I was astonished when I arrived in Colombia to find their system very similar to ours. The hospital where I completed my observership, Clínica El Bosque, had a beautiful facility with a learned staff and modern diagnostics such as MRI and lab tests. I was right about one thing, though: the doctors certainly did know how to use their hands and stethoscope. Seeing the health care providers practice in Colombia showed me how such a robust amount of knowledge can be gained just from interacting with the patient and inspired me to focus on the fundamentals.

I went to Hospital El Turnal on a Saturday to see if the city’s south side is really as rough as everyone says. Hospital El Turnal in south Bogotá is a public hospital, meaning they have to take every patient they receive. Patients covered every inch of the hallway. These patients were different from the ones at Clínica El Bosque (the private clinic and site of my observership) - these guys were really sick. By just passing each patient you could tell that they desperately needed help. In the triage, I remember seeing a patient with his hand cut open, sure that he would bleed out any minute.

Whether I was ready for it or not, the day painted a picture of mankind’s mortality for me. A Colombian medical student rushed me over into a room from outside the hall. I watched as a dozen health care providers attempted to resuscitate an elderly man. After tons of work and willpower, he was stabilized. A few hours later, I returned and stood by his side. He seemed as if he were in an unsteady state, teetering back and forth between life and death. In those short moments while I stood there, he died.

A doctor told me that he died from stomach hemorrhaging. The scary thing wasn’t witnessing a patient pass away, that twinkle in the eye disappear, but how he looked exactly the same as he did when he was alive with his chest still filling with air with each pump of the ventilator. I always thought of life as something clearly defined; I never expected to see it slip away without even knowing. What the doctors had worked so hard for, so long for, was something they weren’t able to grasp. But then again, it’s something no one can hold onto forever.

Being a physician is something more psychological than some would like to admit. You must strike a balance between distance and intimacy to be an objective, compassionate provider. Essentially, you have to care, but not wear your concern. Doctors face death every day, trying their damnedest to make sure it doesn’t happen, but are expected to move on whenever it does. We have to remind ourselves that for every one death doctors save countless more lives. This is why I chose this profession: to save lives and change the world.

I am pursuing MUSC’s Certificate in Global Health to continue exploring how medicine is practiced around the world. The global health certificate not only gives you perspective about your life in comparison with other cultures but also insight into different aspects of medicine. There are people in some places of the world with deadly illnesses uncommon but treatable in the western world—sadly, people are dying from these diseases. I hope to use the knowledge I gain from obtaining this certificate towards healing these people in the future. Whether you already have a passion for global medicine or you’re just in the health care setting and have a curiosity in other cultures, the global health certificate can help nurture that interest.

Thomas Larrew is a first year medical student at the Medical University of South Carolina.

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