There are not enough words to describe climbing up Pico... I can however say that we started off as a Fellowship of 6 and were able to conquer Pico together as 6.
Friday, August 5, 2011
The Fellowship of Pico
There are not enough words to describe climbing up Pico... I can however say that we started off as a Fellowship of 6 and were able to conquer Pico together as 6.
Tuesday, August 2, 2011
Hitchhiking
Friday, July 29, 2011
The last day of class...
A couple kids brought balls to play with, so we played games like volleyball, basketball and knock out. We had the party on a playground that is very near the place where we hold lessons, so it was very convenient. The three hours of class time that day went by VERY fast!
We also gave out evaluations at the beginning of the class and 100% of the students said they would take this class if it were offered next year!
The local newspaper also did an article about us on Wednesday. We had a picture and a blurb on the front page, and then another picture and a whole article on the inside. You can find the link here:
http://www.auniao.com/noticias/ver.php?id=24724
It's in Portuguese, but you can google translate it!!
The advanced group of students (me and Carissa's class)
The teachers of the camp (minus Matt).
Playing Knock Out
The food!
Here are a few pictures of our students in the classroom! Madeline came in and took a bunch of pictures one day during class. She got a lot of good ones!
Thursday, July 28, 2011
“Scrub in, you are performing this surgery”
This morning started out to be a day like any other. I woke up, got dressed, and walked to the hospital excited to see the removal of varicose veins in a 50 year old patient; however, when Dr. Timmy (the vascular surgeon I’ve been shadowing this week) saw me in the surgery room he asked me if I was prepared to perform the surgery with him. I thought he was joking and laughed it away but as soon as I stepped into the OR I realized that he was not kidding about having me scrub into surgery. He got one of the scrub nurses to take me into the wash room where she spent 15 minutes teaching me how to wash my hands up to my elbows. I never thought washing my hands would take 15 minutes, but the nurse showed me how to scrub my finger nails and the spaces between my fingers. She made sure I was scrubbed completely clean before she led me into a second room where I got to put on a scrub coat just like all the general surgeons. She helped me put it on because I was sterilized and was not allowed to touch anything except the patient and the sanitized green sheets around the patients. She helped me put on my gloves and tied my coat on me and at this point I felt really giddy and blessed that I was having an opportunity that not even medical students in America get a chance to be exposed to. When I walked into the operating room Dr. Timmy was waiting for me and re-explained the purpose of the surgery. He showed me the markings he made on the skin of the patient (something I saw him do yesterday) and he explained that he was going to remove every single one of the varicose veins. The biggest vein we had to remove was the great saphenous vein which extends from the bikini thigh region all the way to the ankle. After he explained everything and all the incisions the surgery began – and the people conducting this surgery were Dr. Timmy, a surgeon from Spain, a nurse, and me. The patient had varicose veins that covered both her legs completely so the doctors split up – one on each leg and I started out assisting the Spanish doctor while the nurse helped Dr. Timmy. I repeatedly told Dr.Timmy that I was not in medical school yet but he told me that he wanted to expose me to the medical world so I would work harder to get it. He said that he would have done anything to receive an experience like this when he was in medical school and he understood that the best gift he could give me was this experience so he told me to pay attention and start the surgery. The Spanish doctor started the surgery by making a small incision in the bikini area of the patient so that we could unveil the saphenous vein. During this process he held the scalpel and told me where to cut the patient (I surprised myself because my hands were not shaking as badlly as I thought they would be!) and then we started to dig through the tissue to find the point where a rubberband like vein existed. He then handed me strings that looked like sewing thread and scissors and showed me how to tie up the two areas of the vein so that we could cut it later. The surgeons always make sure to tie the regions that they want to cut before they actually cut it so that the blood does not squirt directly into their faces after they make the cut. After we tied the areas he gave me the scissors and said “corta” which means cut. I looked at him seriously shocked and he said be careful of the artery because if you accidentally cut it the blood will squirt directly on your face. So I prayed to the gods and made a cut exactly as he told me. The doctors were happy that I did that and began to trust me more during the surgery. To remove the saphenous vein, Dr. Timmy sent a long needle like tubing from the ankle and he pushed it into the vein until it ended up coming out of the bikini area of the thigh. He asked me to help him push the metal rod through the patient and this was an experience in itself. When the tubing goes through the patient you can see it move on the skin and it looks like there is a snake that is literally travelling inside the body of the patient. When the tubing popped up on the other side he had me cap it and then he told me to count to three so we could pull out the tubing. When the tubing was pulled out from the ankle the saphenous vein was wrapped around it. This was the first time I had ever seen a vein- I’ve read about veins, watched Grey’s Anatomy, and done my fair share of youtubing but seeing a vein outside the body is a unique experience in itself. The vein felt so rubbery and you could actually see the valves that were half closed and nonfunctional. He let me hold it and all the doctors were amused at how entertained I was by a vein that was seriously half a meter long. I could put my finger into the same tubing that held blood just moments ago and I felt so, so blessed to have that opportunity. Dr. Timmy told me to keep the surgery going and he asked me to pull out the veins with him. It was incredible because he knew exactly where each vein started and ended and would poke the skin at precisely the point where a tiny blueish-grayish vein would pop out. I was mesmerized and could not stop staring at how patient and quickly he worked. After all the veins were removed he wrapped up the leg with a compression wrap so that the bleeding would stop and then waited 5 minutes on each leg before he removed the wrapping and started putting tiny bandaids on each of the holes that he poked on the leg. He showed me how to put the bandaids using tweezer and told me to put them perpendicular to the wound. He gave me his bandaids and aided me as I put them on individually. Next, he asked if I wanted to suture the cut he made on the bikini to remove the saphenous. He did two sutures to show me how they were supposed to be done. First you have to connect the ends of the skin and then you wrap the suture thread around the scissors twice and pull to make a tiny knot. He made it seem so easy, but when it was my turn I couldn’t do it with the same technique that he did so quickly. It took me 30 minutes to get one suture into the patient the doctors were so kind that they didn’t even mind that it took me so long. They talked me through the whole process and wouldn’t let me give up half way. I had to make six knots on each suture and on the first knot I didn’t understand how the scissors opened (since it locked when you closed it) so the doctors made me step away and took a moment to show me how to squeeze the scissors so that it could unbuckle. It was only after the surgery that I realized that my white gloves were covered with blood and my scrub coat was covered with blood that squirted out when the doctor hit the artery instead of the vein. The surgery that started at 9 am ended at 1:15 pm and is an experience that I will remember for a lifetime. My first surgery was the removal of varicose veins and I think the experience made me feel more mature about the medical world. Surgery is an artform that requires patience but above all I think its something that requires humility and a lot of risk taking. It’s about breathing deeply and keeping your feet apart so that you don’t get a cramp in your neck from straining down so long. It’s all about the technique, but it’s also about keeping yourself sane by taking each cut one step at a time. It was in the OR today that I realized that being a doctor is more than merely cutting people open and saving lives. It’s all about the passion. After the surgery Dr. Timmy asked me to remember this experience when the path gets bumpy and when I have to spend late nights in the hospital during residency. He asked me to remember my joy in the OR when I have to study for my exams in undergrad. I think that’s why I am writing this long blog post, to remember forever my first day in surgery.
Francesinha: Not for the weakhearted.


What is francesinha?? Ridiculous meal typical of Portugal (specifically Porto)... I had one the other day, and it is unlike anything I’ve ever had! It is a White bread sandwich with ham, roast beef & chorizo on the inside and on the top the sandwich has melted cheese with a fried egg, then the entire concoction is doused in a special sauce and served with yummy crispy, greasy fries swimming in the indeterminable red sauce. It's a heart attack on a plate, but I've never welcomed clogged arteries so gleefully. Here are photos and a recipe, for anyone who dares try this at home.
http://www.food.com/recipe/francesinha-super-indulgent-portuguese-sandwich-370897
Puppies!!
The most rewarding experience I have had while on Terceira has been my involvement with the City Kennel. The kennel holds up to 26 dogs, though in very poor conditions. The dogs are kept indoors all day without walks or baths and are in obvious need of human interaction and socialization. The dogs—ranging in size, breed, gender, age, and personality—are all very friendly and adorable! I am going to try and post pictures in a minute :)
- Claudia
"Urgent Care" Patients
GI + Endoscopies + Colonoscopies = Pretty interesting stuff
Wednesday, July 27, 2011
Dental Clinic
Perception
My grandpa has always said that it is smart to listen to others and take what they have to say into account, but it is intelligence to use that knowledge to either reinforce your opinions or to reevaluate what you had previously thought. In reference to what Madeline said about the smoking here on the island, I cannot say I agree completely. I do not smoke, nor would I advocate smoking however I believe that we must really consider our perception on the individual life around us. One of my professors at UNC spoke of how perception is a lens of individuality. The culture in every corner of this world is its own and people choose to live their lives with the knowledge and environment they have grown up with. We cannot say that it is hypocritical to smoke whilst advocating for the safety of our world without acknowledging our cultural bias. Smoking is more commonplace but we cannot compare the individual decision to pollute our bodies with the tremendous lack of consideration for our future generations when we throw trash on the street. Yes, it might be funny for an environmentalist to pollute their body while trying to de-pollute our world, but there are many things that people in the U.S do that they would consider funny or even completely irrational.
But that in itself is the beauty of travel. We meet others, others that we would at home never dream of meeting and our bubbles of perception intersect.We all strive to better this world in our own way whether it be with medicine, politics, advocacy, or any way we see fit, but what is important is that despite any differences in ideologies or culture, we are all in hope for a better future.
Tuesday, July 26, 2011
Save your body... then the environment
I feel like I'm on Cloud 9- Literally!
A side of empathy served in cardiology
The Unknown Known
Gruta dos Balcões is the name of this very special place which lies in the Freguesia of Biscoitos. Like the other Grutas on the island it is a labyrinthine network of tunnels which criss cross each other - ascending and descending - with lava carving out magnificent patterns and structures within the walls of this geological masterpiece. Its beauty remains in almost pristine condition - unharmed by humans - with crystals glistening on the sides of the walls and strange fungus spreading itself across the walls. Occasionally shards of light illuminate this dark, damp cavern - helping to delineate between the sharp rocks and the thick earthy red coloured mud.
An air of mysticism and intrigue will undoubtedly come to define ones experience of the 4km of caves which have so far been uncovered by a combination of Portuguese and Spanish excavators. Excavators are confident that more lies beneath and one would assume that it is merely a matter of time before more of this remarkable part of Terceira is discovered. In which case, this great unknown may well soon become the great unknown known.
How to make a complete arse of yourself in public...
The first happened on Saturday. We went out for the day with one of the government workers, who wanted to take us mountain walking, but the weather was too dangerous, so instead he chose to share with us his other passion: caving. He took us to a huge labyrinthine cave system in the middle of the island; a system of lava tunnels which extends well over 4 km in length, and which is not open to the public due its being largely unexplored, and dangerous. With no helmets, and just a parafin lamp to guide us, we followed Jose Antonio into the darkness, at times crawling through the tiny tunnels, hoping he had memorised a route in the underground maze. At times, I had to go first to see if the tunnel was viable (one of the downsides of being thin), and on one of these occasions, I found myself in quick mud. Underground. In the middle of God knows where. I sank up to my neck before I managed to pull myself free in the dark. When we eventually found out way out, we emerged through a tiny hole, barely visible, into the middle of a field. The farmer standing a short distance away looked pretty surprised to see a girl/yeti-like creature emerging from the apparent ground in the middle of his field. I was CAKED in an inch-thick layer of mud all over, and probably didn't even look human. We then ended up driving to a nearby public area with toilets, and I had to brazenly walk through a group of tourists, as if I looked completely normal, and strip down to wash off the now solidified mud. Excellent. We also then had to go to Jose Antonio's house, to sneak some of his wife's clothes for me to wear rather than walk through Angra looking like a mythical creature. Unfortunately, his wife must have been a little bigger than me, so I had to walk back through Angra holding the trousers up with both hands.
Incident #2 was last night- another one of the government worker's is a dancer in a local folklore group, and so he took us to watch his group dance in Sao Sebastiao. This was all very fun until I found myself being dragged (literally kicking and screaming) to the dance floor, and being made to dance a traditional Azorean folklore dance with 12 random, sweaty, 50yr old, drunken men wearing traditional costume, in front of a very large audience. Half of the bloody island was there filming it. I would like to point out at this point that I actually wasn't that bad- but sadly one of the men I was supposed to be dancing with couldn't count to 3, and so danced in 2, so we ended up just stumbling around for a while, until another man came over to relieve me of the drunken man with a bad B.O. problem. My life mission is now to find the films of this, and destroy them. If only I could wipe the image from my memory...
Monday, July 25, 2011
Lovely weekend, lovely teaching
Saturday, July 23, 2011
Dog Pound
Since our boss in the government internship also happens to be a veterinarian, we have gone out into town to do various jobs. Currently, he’s treating a horse with pneumonia, which had been sick for months, but the owner didn't call until a couple of weeks ago. In the same estate, he treated another two horses for deworming. It’s funny to see the way these horses react every time they see him. They all gallop away as far from the gate as possible whenever we pull up.
We have also gone to the dog pound a few times now. The conditions of the dog pound are not good at all but the greatest problem is the size. There are only 26 cages, some of which are doubled. That doesn't seem like a problem until I mention that they receive 80-100 dogs a month and only 150-200 are adopted every year. So there are many perfectly good dogs that have to be put down because they can't find a home for them. Obviously the oldest and weakest go first but it’s heartbreaking every time. Pitbulls have the worst luck of all because it costs more to own a pitbull because of their aggressive nature hence they are often overlooked. One of the days we were there we had to put down four dogs one of which was a beautiful, perfectly healthy pitbull around 4 or 5 years old.
However, there is hope for the future. The City Hall has a plan to construct a bigger pound within the next couple years. A better facility means there will be more space for more dogs as well as an area for them to run around freely. Currently, the only way they see light of day is if we give them a bath or take them for a walk. Other than that they are just waiting to see what happens with their uncertain future. Whether they will be one of the lucky few that will be adopted or one of the many that will be put down. And if they are adopted, try not to be part of the 20% that are returned.
Friday, July 22, 2011
Travels within the islands!
This last week has been very busy! Last Thursday we left for another island in the archipelago, called São Miguel. São Miguel is the largest island in the Azores and it's capital city, Ponta Delgada is also the largest city.
Since we are staying in the residencia in Angra and paying for that, we were able to stay at the residencia in Ponta Delgada for no additional cost! It was a great deal! There are a lot of things to see in São Miguel, so we all chipped in to rent a car for 2 days. It ended up being 13 euros per person.
All of us squeezed in the car (except the driver)
On a beach in a town called Mosteiros in São Miguel
Cows crossing the street
The day that we had the car, it was very cloudy out. So we went to the first landmark in São Miguel, Sete Cidades, and it was literally a HUGE cloud. We could have been at the end of the earth. You could not see a THING. Then we drove to a tea plantation, but since it was Sunday, it was closed. :( That was disappointing. Then we went to Furnas, which is a town that has all these underwater boiling lakes. Its really crazy! People will bring pots and dig a hole and bury the pots in the ground and then cover them and cook food for 5 hours and it actually cooks!
The pots that are cooked in the ground at Furnas
We went to a restaurant in this town that sells that food, but it was 13 euros for a plate, so I decided not to get it. Yes-- I am cheap. We also saw the lake called Lagoa do Fogo, which is a lake at the bottom of an extinct crater.
Lagoa do Fogo
After that, we drove around São Miguel some more and saw some beaches and other pretty places.
A beach near Capelas (in São Miguel) with volcanic rock
There were 2 other highlights of the São Miguel trip: Harry Potter 7.2 and the MALL. It was so nice to be able to have civilization!! There was McDonalds, Burger King, chinese food. But I did not find iced coffee. However, I did hear that there is a coffee shop (American) in the American base, I would LOVE to get an iced coffee from there.
Burger King
Harry Potter!
We have also had a lot of progress with our class. Being a teacher is soo interesting. The students in our class have started to feel comfortable enough with us that they will write really personal essays. We have gotten essays about self-image, family deaths, future plans and even their own behavioral disorders.
This students have a lot to say and I am so proud of them and the way they express themselves. There are some 14 year olds that are very wise beyond their years. It is great to be able to encourage and talk with them.
We only have one week of class left! That's crazy! I will be home 2 weeks from today! I am excited about being back at home. I like Terceira a lot and I am having a great time, but I also miss home!
Wednesday, July 20, 2011
Random Azorean Dancing
Imperatives
Tuesday, July 19, 2011
Harry Potter & São Miguel!
It is interesting how many of the friends I have made in Terceira were worried that we Americans would love São Miguel over Terceira. Yes São Miguel is more modern (there is a mall and a theater) but there is something magical and beautiful about Terceira... its become a home away from home.
