I should be writing this from Guyana’s Georgetown Public Hospital ED, where I spend two to three months each year. However, I unexpectedly took a detour, but more about that in a moment.
I spent the end of September and early October in San Juan, Puerto Rico. Rather than the great vacation I’ve had there before, I was with Arizona’s component of the Disaster Medical Assistance Team (DMAT). In that capacity, we slept on cots in large crowded rooms (rather than elegant hotels) and ate military-grade Meals Ready to Eat (rather than lobster and fancy rice dishes). However, it was worth it since our team helped a new hospital that had not yet opened initiate all the multiple systems needed to accept overflow patients from the public hospitals. That was a novel experience, both for me and for DMAT, which had never had that mission. There’s a good chance that I’ll be returning to PR in January when we’re again on call.
My next trip, started only a few days after leaving PR, was to Rosario, Argentina. I had been invited to be the keynote speaker for the country’s first prehospital medicine meeting. In the U.S., prehospital primarily includes paramedics, but in Argentina, physicians and nurses also staff ambulances. The 1,000-person auditorium was packed with all three groups. Aside from providing some insight into the early days of modern prehospital care (pre-EMT, EMT, early paramedic), I also gave talks on tactical medicine and, of course, improvised medicine. I was then able to travel to Buenos Aires and give EM faculty some insights into addressing ethical issues that they face, which aren’t too dissimilar to our own.
While the Maclean Center for Clinical Medical Ethics at the University of Chicago is no where near an exotic country, I did have the opportunity to give a unique talk at their annual meeting about bioethics in Antarctica. The ethicists in attendance were awed — not my me, but by a very dramatic air rescue video from the South Pole that illustrated our difficulties there.
So why am I not writing from Guyana? I visited another exotic place that stopped my Guyana trip. That was the Banner – UMC Tucson Emergency Department. If you don’t understand how going there as a patient is mind-numbingly strange, just wait until you have that experience. I can only say that the care I got was excellent. Thanks Drs. Tolby, Stea and team. I’m now on the mend.
For my next installment, I expect to have lots more international adventures to relate.
Ken Iserson, MD, MBA, FACEP, FAAEM, FIFEM
Professor Emeritus, UA Department of Emergency Medicine