Las buenas y las malas: Or how Clinica Reina Sofia tried to kill my dad


Long time readers know that I have spent the last 13 years of my life evaluating, writing about and promoting medical care in Colombia. In addition to this blog, I have written multiple papers. presentations and books about my experiences and direct observations of care in the various facilities in Bogota, Colombia. The majority of experiences have been excellent.

I have been bringing clients here several years, including my own mother – who had a life-saving TAVR for critical aortic stenosis in 2019 at Fundacion Cardioinfantil. If she hadn’t had that procedure then, she would be most assuredly dead now. Instead, she is a vibrant 84 (almost 85) year old female who continues to run several miles every day, participate in a multitude of exercises (aerobics, zumba, dance etc.) and sports (pickleball, running group). 

Of course, when you are taking about something as vast and varied as health care, it’s never going to to be 100% all of the time, for every condition at every clinic, office or hospital. As part of the process of writing a book about healthcare and surgery in Bogota, I have spent literally thousands of hours in hospitals and hundreds of hours in the operating rooms around the city. I have interviewed hundreds of doctors and staff members. Some of these experiences have been so-so, some have been below average, and a very few have been bad.. Our recent experience at Reina Sofia on Calle 127 falls into the incredibly bad category. It was so bad and potentially life-threatening that it almost sounds like farce. Until it’s your dad. And the nurses that are ignoring the patient are ignoring your dad as he experiences crushing chest pain.. The clueless ER doctor is just irritated by your very existence because she wants to get back to chatting on What’s App – and continues to talk down to you. (I am fluent in medical spanish – and cardiology/ cardiothoracic surgery) and that seemed to anger her.)

When the nurse performing your dad’s EKG gets angry when your bradycardic, pale and dizzy dad doesn’t get his shirt back on fast enough so that he can dump you back in the waiting room and he can go on his break. Then when the cardiac enzymes are positive, they move you to the observation area and never check on him again. I had to check his chest pain/ vital signs/ everything while we wait, futilely for someone to help us. 

Nevermind oxygen saturations in the mid 80’s.. Seems like the plot of a bad 1980’s movie – as you realize that they are ignoring you, because you are a crappy old gringo, and that they would rather and leave….

Until you have to call a friend to help you leave the hospital so you take your family member to another hospital because the staff keeps ignoring you – and telling you “wait ten more minutes” hour after hour.. Until the so-called specialist rattles off a prepared speech, and doesn’t seem to listen when you dad explains that he still has chest pain (after receiving only tylenol in the ER). It was a devastating experience – and a terrible learning experience.

I freely admit it was my mistake. I initially wanted to go directly to Clinica Shaio when my mom called me – but after thinking about the distance – I made the (wrong) clinical decision that if my father’s clinical status looked poor – that I shouldn’t risk the trip – and should take him to the closest well regarded facility. Clinica Reina Sofia is just minutes from my house, and my dad looked eminently bad. So much so that I rode in the backseat of the car with him in case he needed CPR on the way.

Photo by Pixabay on Pexels.com

But I trusted that ER staff would know how to manage a common and basic emergency condition like this. After all – it’s part of basic life support classes – you know, the classes that lifeguards and babysitters take. That assumption almost cost my dad his life. It’s particularly hard for me because I have been to Reina Sofia before (in the operating rooms, etc.) and the care was pretty good – good enough that I took my dad there in the middle of the night. Maybe they (Reina Sofia) do know how to treat this very common emergency condition.Maybe they know that time is the essence.Most likely they do.Which means that they just don’t care.Because they certainly didn’t care about my dad.They just wanted him to sit down and shut up.

As I write this, I am waiting for the cardiologist to tell me about my dad’s cardiac catheterization – here at Clinica Shaio, where the care has been wonderful and immediate! 

New podcast: Kristin in Colombia


Readers, friends, colleagues and even family often ask, “Why Colombia?” They aren’t asking about the logistical reasons I’ve presented in previous posts. They are asking an entirely different question. They are asking why I’ve uprooted my life, to start again – on the road to citizenship in Bogota, Colombia.

I could have continued to visit and live in Colombia periodically, and post my stories, pictures and adventures. Especially after I realized that all of my academic efforts in the field of surgical tourism wouldn’t amount to much, despite years of effort.

But I didn’t. I moved here – lock, stock and barrel as they say. I sold my house in Memphis, Tennessee, packed up or sold all of my belongings and re-settled my live in South America. I have no regrets – and I would do it again. In fact, I only wish that I had taken the leap earlier.

I decided to start a podcast called Kristin in Colombia to talk about this, and all the other experiences and adventures in my life – as a middle-aged woman starting a new life in a new Country, with a new culture, language and everything else it entails. I just finished the first episode, and it’s a little rough technically speaking. I am not a public speaker, nor a sound editor.. But bear with me as I get a little more experience – and enjoy the ride.

https://podcasters.spotify.com/pod/show/kristin-eckland/episodes/A-most-unusual-origin-story-or-how-did-I-get-here-e270kkm

We Love Carlos Vives! The King of Colombian music..


It’s been a while since I’ve had an opportunity to sit down and write but that doesn’t mean my adventures have stopped.. In fact, it was a little hectic for about six months. I have been working with an Interior Design firm doing specialty apartments.

The first apartment is the We Love Carlos Vives penthouse apartment. It’s an adorable apartment in the family friendly neighborhood of Cedritos in North Bogota. If you want all the hustle and bustle of downtown Bogota, then this isn’t the place for you. But if you are staying in Bogota, or working here – and want a nice, safe but lively (not noisy) neighborhood with restaurants, bars, grocery stores, banks, parks and shopping in close walking distance – this apartment may be ideal for you.

It has 3 bedrooms, 2 bathrooms and two large balconies with views of the city. It’s comfortably outfitted with modern amenities and decorated in rural Colombian style. It pays homage to one of Colombia’s greatest musical artists, Carlos Vives.

(If you’d like to rent the apartment – click here!

If you don’t know who Carlos Vives is – don’t worry! I have included some videos for your enjoyment!

https://player.pbs.org/viralplayer/3071811576/

He’s an amazing performer – and he (and artist Diomedes Diaz) popularized Colombian music around the world.

This link below plays his 20 most popular songs.. So click, relax and enjoy.. You can come back and read more about Carlos Vives, and the We Love Carlos Vives Apartment once you’ve immersed yourself in his music.

For many people outside of Colombia, he is best known for some of his collaborations – and for his song in the Disney movie, “Encanto”

Of course, if you really want to know about Carlos Vives, best to hear it from the man himself.. Here’s a brief interview.

Now that you love Carlos Vives’ music as much as I do – you might just enjoy the We Love Carlos Vives penthouse apartment.

I also made a little video.. It’s total amateur hour (because – yeah – I am a total amateur) and the music is nowhere as good as Carlos Vives, but here it is. I think the apartment is as colorful, charming and Colombian as the man himself..

I am going to try and get back to posting regularly – I’ve been traveling around Colombia recently – to the lovely coastal city of San Antero, to the pueblos of Cundinamarca, like Pacho and areas in between so I will post some pictures and descriptions soon.

In Capitol City


Long time readers know that I am addicted to the capital city of Colombia.  So there was no way that I wasn’t going to take a few days to head over to Bogotá the moment I had a chance.  I just got back – and before I head off on my adventure to La Macarena tomorrow, I thought I’d post an update.

Charlie’s Place

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Usaquen

Since I was just stopping in for a few days, I decided to forgo renting my usual apartment.  It’s a good thing I did or I would have missed out on getting to know the folks over at Charlie’s Place, a boutique hotel and spa in Usaquen.

CharliesPlace

It’s probably not for everyone – people who want to be in the middle of the tourist areas of Bogotá should stick to La Candeleria.  Business travels on large expense accounts can head to the big-name chains.  But for people like me, who want to be in the north side of Bogotá, around Barrio Chico and Usaquen, Charlie’s Place is ideal.

With just 22 rooms, the hotel is very cozy and accommodating.  The manager, Wilson, is a Minnesota native and is delightfully charming and easy-going.  The rest of the staff including Daniela and Javier are equally polite, friendly and helpful.  (There’s a reason Charlie’s Place is consistently rated as excellent by Trip Advisor for the last several years.)  The best part is that the rates are fair and the service is excellent.

Once I was comfortably settled, it was time to get back out and enjoy the brisk weather.  (The weather is one of the reasons I love this city!)  My first stop was over at SaludCoop where the doctors and nurses were nice enough to answer some questions about the ongoing healthcare crisis.

The Colombian Public Health Care Crisis

Right now, the public health system, EPS and SaludCoop are going broke.  Basically, much of the money paid in by members of the health care cooperative has disappeared (been embezzled), leaving hospitals with bare cupboards.  Hospital staff are feeling the pinch as payroll arrives late, in diminished amounts, or in some cases, not at all.   (There are rumors that the money was funneled into the purchase of luxury apartments, fancy vacations and the like).  There have been some protests and work stoppages by health care workers, but unfortunately, the local unions have been unwilling to support their efforts.

Unfortunately, the government seems apathetic to the concerns of the healthcare workers and their patients. The Minister of Health, Alejandro Gaviria went so far as to say that the health care crisis was a “lie” in a recent press conference, following up on his previous twitter (June 2015) and blog comments (Feb 2015), even going so far as quoting Christopher Hitchens in his defense of the health care system.  Of course, no where in his statement does he talk about healthcare workers going without pay or operating rooms without suture.  But he’s not alone in his apathy.

Most of the local politicians  couldn’t even be bothered to show up to a legislative session on the issue.  Only 9 members of the House of representatives (out of 166) attended.

This financial travesty has wide-spread implications beyond just the public health sector (of hospitals and clinics throughout Colombia).  Many of the private facilities also rely on payments from the healthcare cooperative.  (Imagine if medicare went broke through criminal mismanagement – it would affect a lot more that general and county hospitals).  In many cases, these hospitals are forced to write off millions of dollars of nonpayment from the health cooperative.  In fact, one of the largest hospitals in Cali (a city of 2.5 million people) will be forced to shut it;s doors, mainly due to losses incurred from nonpayment by EPS and SaludCoop.  So it’s a huge mess that will probably only get worse without government intervention.

On the flip side of the Colombian Health Care Crisis and the declining peso (over 3200 pesos to the dollar this week) – Hospital Santa Fe de Bogotá  appears to be thriving.

Santa Fe de Bogota’s new emergency department

Yesterday evening I had the pleasure of a guided tour of the new Emergency department at Santa fe de Bogota with the current Chief of the Emergency Department (and trauma surgeon), Dr. Francisco Holguin.

Fans of the Bogota book know that I spent quite a bit of time at Santa Fe de Bogotá in the past – and that it is one the highest ranked facilities in all of Latin America, so it was fantastic to see all of the improvements.  (The ER was still under construction the last few times I was there).  The first thing I can say – It’s big! Big, spacious, brightly lit and airy (especially for an ER).  The is good work flow with several large workspaces for the doctors and nurses, instead of the typical traffic jams that occur in older facilities.  It’s on the same floor as diagnostics (CT scan, radiology), the operating rooms and the intensive care units which means that critically ill and injured patients can be rapidly transported to where ever the need to go.

The spacious department now has 56 beds with an overflow unit for critically ill patients.  Several specialists are on-call, in the ER and available 24 hours including orthopedics, trauma and internal medicine.  Downstairs from the main ER is the fast track – for all of the non-life-threatening general medicine problems.

After spending two days interviewing and talking to people about the SaludCoop problems and EPS – it was nice to leave Bogotá on such a nice note.

Crazy days!


It’s been a couple crazy, busy days here in Medellin.  I have a bit of a backlog of posts – from a day learning to finger crochet in a group crochet class, the festival of flowers, a visit to Clinica Medellin Occidente and the ALAT conference.  It will take me a little while to post everything before heading home in just a few short days.

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The ALAT conference was fantastic.  In addition to numerous wonderful, learned speakers from all over Latin America, it was a great chance to connect with innovative thoracic surgeons from practices all around the world.  We also re-connected with surgeons we’ve interviewed in the past – to hear what they have been doing since my last visit.

One of these surgeons was Dr. Andres Jimenez at Fundacion Santa Fe de Bogotá (SFdeB).  As astute readers of the Bogotá books may remember, our encounters haven’t always been as collegial as they could have been.   However, he did grant me an interview, and permit my ingress into the operating room.  To my surprise, I found that while he was a hesitant interviewee, he was also a promising young surgeon.

With that in mind, I re-connected with Dr. Jimenez briefly to ask about the program.  Dr. Jimenez reports that they have started a lung transplant program and recently performed his first lung transplant at SFdeB.

Dr. Carlos Carvajal (right)

Dr. Carlos Carvajal (right)

Dr. Carlos Carvajal, who was a thoracic surgery fellow when we first interviewed him – is now a practicing thoracic surgeon at Hospital Santa Clara in downtown Bogotá.

Dr. Ricardo Buitrago continues his work in robotic surgery at Clinica de Marly.  Caught up with Dr. Luis Torres, the young and charming thoracic surgeon from Clinica Palermo.

But the biggest surprise at all – was the twinkling brown eyes of Dr. Cristian Anuz Martinez.  (The twinkling brown eyes above a surgical mask are all I remembered from my 2012 trip to the operating room with Dr. Frnando Bello in Santa Cruz, Bolivia).

with Dr. Cristian Anuz Martinez

with Dr. Cristian Anuz Martinez

We spent some time over coffee talking about the current state of cardiothoracic surgery in Bolivia, his private practice and his colleagues.

The conference itself was phenomenal – the amount and range of topics covered – from sleep medicine, tuberculosis, critical care medicine and pulmonology in addition to thoracic surgery.

The Festival of Flowers

The festival of flowers, one of the largest events in Medellin also started August 1st.  The event which is expected to draw 19,000 visitors to Medellin this year – celebrates the floral industry of Antioquia with ten days of events.  The events are staggered through out the city and include musical concerts, singing contests, parades, flora displays, children’s events and arts.

 

 

Festival of Flowers displays in Plaza Mayor

Festival of Flowers displays in Plaza Mayor

Tomorrow: Clinica de Medellin – Second time is the charm!

Crochet, crafts and traditional arts in Colombia


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One of my latest crochet projects – American flag scarf

Since learning some basic crochet (very basic) from my (very patient) roommate, Iris in Cartagena, I have continued to crochet.  I find it’s an excellent activity for all the waiting that goes along with travel.  I crochet in the car when we drive from assignment to assignment.

Hat and scarf

Hat and scarf

I need to learn some new stitches but I am getting a lot of practice with my basic stitch.   I have switched to a very large crochet hook (15mm or an “S” hook) and cuddly soft bulky yarns (types 5 and 6).  It makes it easier to see when I make errors and it works up quickly.  Plus, the yarn is so plush and soft feeling.

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I made a couple things for my friend’s new baby in Bogota.

My tiny model wearing the first hat I made

My tiny model wearing the first hat I made

 

So when I went to see her – I spent an afternoon in Chapinero checking out the yarn situation.  I was in a large bookstore in Chapinero when I met Ligia Morena Vega.  I was looking at some new sewing pattern magazines (since I am a sewer who crochets) and she was buying crochet magazines.

So I asked her if she knew where I could find some yarns in the neighborhood.. Not only did she know – she took me with her to meet the proprietors and learn more about the crafting classes offered.

That’s one of the things I’ve noticed in Colombia – pull out a crochet hook or start asking about crochet, and instantly you make friends.  I was on the bus to the airport in Rionegro when this happened the first time.  (It’s a long bus ride to Medellin, so I pulled out my crochet..)  Very quickly I made friends with several women  on the bus as we talked crochet.

 

with Ligia, shopping for yarn in Bogota

with Ligia, shopping for yarn in Bogota

Ligia crochets professionally.  She was buying magazines to use as catalogs for customers who want custom-made clothing, including formal style and elegant ankle length dresses.    Ligia’s husband runs a coffee and chocolate shop nearby on Calle 57 and Carrera 16 – so I will have to stop in and visit on my next trip to Bogotá (and get some pictures of her latest crochet creations too!)

We walked a few blocks to a short street, Calle 56 (with Carrera 13) where there are several stores selling a variety of yarns.  While there was a lot of Red Heart and Lion Brand (especially the Homespun USA – my favorite, at home), I was able to find some beautiful yarns that are made right in Bogotá.

I fell in love with some of the yarns from Lanas Arvi.

Lanas Arvi

One of the yarns is a beautiful tan and turquoise mix..

some of my new Colombian yarn.. with my gigantic crochet hook.

some of my new Colombian yarn.. with my gigantic crochet hook.

It’s destined to be a scarf.. This time I might even keep it.  So far, I have gifted away everything I’ve made with the exception of a camera lens bag..

Several of the shops offer crochet and knitting classes.  Todos Lanas and Almacen Mutifibras even print the class schedules on the back of their receipts.

The prices are about the same as Wal-mart (since JoAnn’s and some of the craft stores mark up the yarns quite a bit.)  I also bought two small skeins of a lovely dark purple to make a gift for a friend – and two small skeins of a variegated yarn with the bright yellow, blue and red of the Colombian flag..   All of the other yellow/ blue / red yarns were sold out just about everywhere we looked.  Several owners told us that between Colombian Independence Day (today) and the World Cup – they haven’t been able to keep any of the patriotic colors in stock for the last month.

Embajada de la Coca

During my visit to Bogotá – we sampled some delicious Andean style cuisine at the Embajada de la Coca.  (To read my article on the experience, click here.)

welcome to Embajada de la Coca

welcome to Embajada de la Coca

Meet the artist: Isabella Klein

The next day, I spent the afternoon visiting the Klein family.  If the name sounds familiar – it’s because one the sons, Albert Klein, PharmD is a close friend and my co-writer on several of the Hidden Gem titles.  (The Kleins are a talented family; the younger son, Alex plays piano with the Bogotá Philharmonic Orchestra and the daughter, A. J. is an occasional model.)

(For more about the Bogotá Philharmonic – read this post by a blogger from the University of Texas at Austin.)

His mother, Isabella works as a professional translator as well as teaching English.  But that’s just her job – art is her life.  She works in multiple platforms – mixed media, paintings, photography and artisan crafts.

On today’s visit – we talked about some of her craft work as well as the large craft fairs here in Colombia.  We discussed my ideas for ‘artisan craft style tours‘ where visitors could learn more about the crafting process and Indigenous cultures of Colombia.

She showed me some of her more recent projects – making decorative wooden boxes.  Instead of using the traditional Colombian patterns, she designs her own.

Some of the wooden boxes designed by Isabella Klein

Some of the wooden boxes designed by Isabella Klein

Her mixed media paints are arresting to look at.  Unfortunately, I was too busy admiring them to take any pictures..

But I do have a couple more pictures of the boxes.

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I think the next box is just fantastic.. It’s a design that just catches the eye.  I like the combination of blues.

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For a portfolio of some of Isabella Klein’s work – click here.

After too few days – it was time to say goodbye to my Bogota friends (new and old) and head back to Medellin to prepare for Colombia Moda..

with dear friends, Camila and Flavita.

with dear friends, Camila and Flavita.

Of course – it wasn’t all bad – these lovely ladies were at the airport in Rionegro to greet me..  The Aguardiente Girls!!

Welcome to Medellin!

Welcome to Medellin!

 

Sunday in La Candelaria


I am visiting Bogotá this week, before heading back to Medellin..

Bogotá is one of those cities that climbs into your heart – despite initial misgivings; too big, too cold, often rainy; becomes gloriously interesting and wonderfully cool..

I was armed with just a camera phone, so my friend, Camila Togni assisted in my photo-taking endeavors..

Sidewalk in downtown Bogota

Sidewalk in downtown Bogota

Despite its large size – the city manages to be hospitable and friendly to visitors – and I missed my Bogotá “home”.  So I headed back for just a few days to check in and enjoy all the things that make me love this unlikely city so much..

While Barrio Chico (where I live) is pretty quiet – La Candelaria is always quite a bit more lively.

I normally tend to avoid the Candelaria area because of the ever-present crowds of people, which is a shame because there are a lot of interesting places to visit and some beautiful architecture in this part of town.

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Alvaro Palacio & Claro Lozano in front of the Cathedral de Bogota

But this weekend is the celebration por el nino del 20 de julio (and the ORs are closed) so when my friends invited me to go downtown with them – it was an opportunity not to be missed!

First we headed to the Iglesia de nino de 20 de Julio since this what the holiday weekend was all about.. It’s a huge church – a campus, actually – and it was packed with people.

Iglesia de nino del 20 de Julio

Iglesia de nino del 20 de Julio

Even though it was crowded, it was a lovely service – and the church itself is quite pretty.

el nino de 20 de Julio

el nino de 20 de Julio

The church has a lovely glass dome and several stained-glass windows with religious scenes.

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The church is so large, the domed area actually isn’t part of the central church, but an overflow area with a jumbo screen television so worshippers can see the priest conducting the service in the main chamber.

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You can see the crowd milling in the foreground of this photo.

the crowd at the church

the crowd at the church

After the service, we wandered around the large flea market just a street away from the church before heading to lunch at a famous but tiny, and old restaurant called, “La Puerto Falso.

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While the rest of my party had their famous tamals, I was up for a bit of a culinary adventure, so I had a soup called Changua.

Colombian Tamal

Colombian Tamal

While the description of a soup made of milk, eggs, bread, mild local cheese and cilantro didn’t sound that entices – it was actually quite good and is part of Bogotá regional cuisine.

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Links for additional information about sightseeing in Bogota

More information about La Candelaria

Virtual tourist – La Candelaria

Video of LA Candelaria

Cathedral de Bogota

Most guides are going to send you to the Museo de Oro “The Gold Museum” but that’s not my favorite..

Museo de la Policia – probably my favorite of all the museums, thus far, in Colombia.  It’s free – guides welcome you in from the street – and you can see the bloodied, bullet-ridden jacket of Pablo Escobar, from his last moments on a rooftop in Medellin.  (It’s considered rude to ask about Pablo Escobar in general conversation) but if you hold any fascination about how a rural boy from an impoverished background managed to hold Colombia hostage, and gain international infamy – it’s a must.  The guides also offered free candy, and played a game of ‘rana’ with us.  (The are guides for multiple languages).

Anthony Bourdain does Colombia


It’s not his first visit – he’s done several other programs highlighting Colombia, but tonight’s episode on his new CNN show, “Parts Unknown” is definitely his best.  It’s the first time I think  he actually ‘got it’ and was really able to convey a real sense of Colombia to his viewers.

While his previous shows were primarily about food, and local food culture – his episodes on Colombian cuisine were always very wide from the mark..  Sure, he had the names of dishes and such – but he didn’t really bring home the feel of Colombia and it’s people.

http://www.youtube.com/watch?v=qNiF0R1QJpk&feature=share&list=SP6XRrncXkMaVZxpButSnMywWvtINMmjXv

Or that Colombian food isn’t really about intense spices, it’s about the intense and rich flavors that comes from the rich textures of the foods themselves – without overpowering curries or heavy sauces..

Better quality, fresher ingredients and a wide variety make for richer flavors

Better quality, fresher ingredients and a wide variety make for richer flavors

Know before you go: Medical tourism and patient safety


The file download for the latest radio program, “Know before you go” with Ilene Little is available.  It’s from the Christmas broadcast with Dr. Freddy Sanabria.

Image courtesy of Ilene Little

Image courtesy of Ilene Little

(I am on the periphery of the show – introducing Dr. Sanabria and talking about safety guidelines and intra-operative safety protocols.  (Same stuff I talk about here – just a different medium.)

Sanabria, breast implant

Dr. Sanabria, plastic surgeon

Dr. Sanabria joined us to talk about his experiences, and his clinic in Bogotá, as well as his ongoing projects and  patient safety protocols.  It was nice to be able to share some of my observations from my visits to his operating room.

safety checklist

Click here to connect to the Radio show archives

Techo por mi pais with Team Sanabria


Just a week ago, I was ankle-deep in mud in the southern-most reaches of Bogotá, with ‘Team Sanabria’ as they completed another house as part of “Techo por mi pais”, which is an organization very similar to Habitat for Humanity.

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A couple of weekends each year, they donate their time (and hard labor) to build homes for many of Bogotá’s poorest residents.

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It’s arduous work – which is more difficult given the frequent rain and adverse weather conditions in the hills above Bogotá.

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I wrote a short story about their efforts over at Examiner.com  – but I wasn’t able to include all of the pictures, so I wanted to post some of them here.

Juan Jesus' grandson stands in the doorway of his modest home

Juan Jesus’ grandson stands in the doorway of his modest home

The family they were building the house for on this occasion was exceedingly sweet, gracious – and willing to wade into the muck with the rest of the team.

OThe organization, is much bigger than just Team Sanabria, so all in all – about fifty houses were built that weekend.

Volunteers carrying supplies to another site

Volunteers carrying supplies to another site

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laying foundation for Juan Jesus' new house

laying foundation for Juan Jesus’ new house

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It costs about 1500 dollars to construct one of the basic 3 meter X 6 meter homes.

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Here the foundation, and flooring has been completed – and they are getting the walls into place.

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Luckily, the rain didn’t start again until most of the walls were completed.

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It was an excellent chance to see a side of Bogota that most visitors never to get see – and to meet many of the residents of the neighborhood, so I was very glad they invited me to join them.

a group of beauty school students stop by to check on the progress.

a group of beauty school students stop by to check on the progress.

It also gave me a chance to get some other pictures of the neighborhood – of things we don’t often think about when we see or hear about poorer neighborhoods (or slums).

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Like the rose bushes that residents plant to brighten and beautify their homes.

well kept home with flowers

well kept home with flowers

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Or the full herb garden, Juan Jesus’ neighbor planted (and shared with us) in her immaculately kept and fenced yard.

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I think sometimes, the overwhelming poverty makes it hard for outsiders to notice the little spots of beauty in places like this.  But it gives me hope – and it shows the resilience of human nature.

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I think it’s also important right now, while our own country is hurting too.. With all of the divisions and politics – particularly in the aftermath of the elections, sometimes we forget to put a face on the people who are living in more marginal circumstances – due to unemployment, etc.

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We hear so much about fraud, waste and abuse of social programs that we forget about the real people who desperately need these services.  Now, I am not some hippie advocating for radical political change.

I am just a nurse, trying to find the people who sometimes get forgotten in the middle of all this.

kids in the barrio

kids in the barrio

Talking to Wilmer Villa Miranda of Arte & Glamour


I am back in Mexicali (for the time being) but I was so busy during the last few weeks that I didn’t get to finish some of my posts talking about the interesting people I’ve met – and places I’ve seen..  I certainly don’t want to skip over Wilmer Villa.

Wilmer

He’s not famous, nor is he a surgeon – but just like so many of the people I’ve met in Colombia – he has a story to tell.  It’ didn’t start as an interview, but then it rarely does – it started out as a visit to a salon on Calle 115 No 59 – 35 with a friend.  But as Wilmer talked about his new salon (his first), and we celebrated the one month anniversary of his shoppe, a story started to  form.

No, he hasn’t invented a cure for cancer – or even a way to arrest the  relentless aging  process.  But he has managed to create a tranquil little spot in the middle of Bogotá for people to come and enjoy themselves for a few hours.

It hasn’t been easy – but with the help of a good friend (and long-time client), Alcira Acosta de  Chaves, Wilmer was able to move out of the previous salon where he had a chair to establish his own salon.  It’s a dream that has been several years in the making – which is obvious as soon as you enter the salon.

Everything is immaculate; organized and set out in a classically elegant black/white and silver scheme that evokes the 1940’s heyday of glamour.  But it’s more than just a place for a haircut or a manicure, Wilmer. 27, states.  It’s the entire package – the total experience, he explains, as he pours a client a cup of herbal tea.

“People can come here and get away from all the negative, and the stress [of their daily lives.]  We are here for more than just hair, and make-up. we are here for laughter, smiles and good times with friends.

His cheerful attitude is infectious, and as clients come in, he and Almira take time to explain the philosophy of the shop, and the experience.  “I want this place to be different” – it’s not a place for catty remarks, or cutting down of self-esteem.  It’s not about malicious gossip or sarcasm, ” We don’t need any of that here,” he says.  “It’s a place for people to form long-term relationships, share celebrations, milestones and happy events,” he adds.  And he means it – as each person enters, he greets them by name, they share a smile or a silly story.

It’s nice – and certainly different from many of the other salons in the area.  It isn’t about the up sell, or preying on women’s insecurities about their looks to sell services*.  They seem to genuinely enjoy their customers and in making their clients look and feel their best.

wilmer2

About Wilmer:

Wilmer, the child of a Colombian mother and a Venezuelan father, was born Cucuta, near the border.  He grew up in Chinacota, Colombia near the border with Venezuela.  He attended cosmetology school in Perico before coming to Bogotá.

After finishing school, he come to Bogotá to apprentice with several well-known stylists such as Hernan Abandano, and received a scholarship for additional training as a colorist.  He eventually received international certifications as a stylist and colorist – and has been a stylist for seven years.

He talks about how these experiences have shaped his life, and his outlook.  “I like to meet people from different places, and hear more about their lives.  I am learning English because I enjoy meeting and talking to Americans – and hearing their ideas and perspectives.”

Maybe Wilmer isn’t changing the world – but he is making it a more pleasant place.

*There is nothing more disheartening in my opinion than going for a manicure than being offered, “How about if we fix your hair” or “some Botox for those wrinkles”.. Or some other, more personal reminders that beauty, particularly in Latin America, is sometimes seen as more important that what’s inside.

J. O’Shaughnessy


Some of you have heard me talk about my friend, Jo O’shaughnessy before.  She’s a fabulous photographer that I met here in Bogotá.  (Told you there are always interesting and great people to encounter in this city.)

O

Jo has started a new blog, but she’s still getting the hang of it – so when she sent me one of her pictures of ‘Bogotá life’ – I told her I will be thrilled to share it.  She is more than a photographer – she has the instincts and the artist sensibilities to see what other people overlook.

The next picture is a perfect example of that.  On a rainy day in Bogotá – Jo looked out the window of a coffee shop and saw this man.  He’s one of hundreds of scrap collectors in the city – people who make their living, and eek out a survival by collecting and reselling much of what the rest of the city regards as garbage.  Like garbage, most people don’t even see the scrap collectors. They just become part of the city landscape, pulling their carts through traffic and enduring all sorts of conditions.

Few people stop to think about it. Fewer still can capture that daily struggle.

DSCN5381

And then there’s Jo – whose heart is so big – and is practically chasing the man down the street to offer him her husband’s coat..

Going home..


After a whirlwind three months that included trips to Chile, Bolivia and different cities in Colombia, I am getting ready to come home in a few days.  As always, leaving Bogotá is bittersweet.  I miss my friends, and my family but I will also miss the city and all of the nice people I’ve met here.

I am posting a map of Colombia, so even though I’ve taken several trips – you can see that I haven’t really explored the country at all. (I’ve posted little push pins on the areas I have visited.)  I excluded Facativa and some of the closer towns since they are really just suburbs of Bogotá, and it would just clutter the map.

Map of Colombia, courtesy of Google Earth

As you can see – I haven’t explored the southern part of Colombia, or the pacific coast at all.  My Atlantic adventures have been confined to Cartagena.  So, I guess this means, I still have a lot of work cut out for me on my next visit(s).

map showing central Colombia

But I hope that readers have enjoyed reading about my travels, the people I’ve met and the things I’ve seen.  Now – I know this is a medical/ surgery blog but since much of the surgery I write about is in this part of the world, I think that including some of my experiences is relevant/ interesting for people who read the blog.  Once I get back home, I’ll post some more articles on medical quality control and standards – and more of my usual dry fare.

Dr. Alberto Martinez, Sports Medicine/ Orthopedic surgeon


Dr. Martinez (right) in the operating room

(Out of respect for patient privacy – I’ve done my best to crop the patient ‘bits’ from the photo.)

Spent some time last week with Dr. Alberto Martinez of Med-Sports Orthopedic Clinic here in Bogotá.  Dr. Martinez specializes in arthroscopic surgery of the hips, knees and shoulders.   As we talked about before, shoulder surgery is its own subspecialty in orthopedics due to the increased complexity of this joint.

We talked a bit about hip arthroscopy,which is still a relatively new procedure in orthopedics and the fact that one two surgeons in Bogota are currently performing this procedure.

Arthroscopy is the orthopedic minimally invasive counterpart to general surgery’s laparoscopy or thoracic surgery’s thoracoscopy.  It involves insertion of a camera and several tools through small (1 cm) incisions in the skin.  Arthroscopy itself has been used in orthopedics for many years but it is just now making inroads in hip procedures.

I’ll be publishing an upcoming article based on my observations over at ColombiaReports.com

For more information

Rath E, Tsvieli O, Levy O. (2012).  Hip arthroscopy: an emerging technique and indications.  Isr Med Assoc J. 2012 Mar;14(3):170-4.

Haviv B, O’Donnell J. (2010). The incidence of total hip arthroplasty after hip arthroscopy in osteoarthritic patients.  Sports Med Arthrosc Rehabil Ther Technol. 2010 Jul 29;2:18

The authors found that 16% of patients in their study eventually required hip replacement after hip arthroscopy during seven years follow-up.

Nord RM, Meislin RJ. (2010).  Hip arthroscopy in adults.  Bull NYU Hosp Jt Dis. 2010;68(2):97-102. Review.

Bogota’s castle


Some of you may notice that I have temporarily changed my header – to show Bogotá’s castle.  I found it the other day as I wandered some of the carerras.  (Residents of Bogotá know that once you get into the single digit carerras – all logic and inference regarding standard directions goes out the window.)  Once you cross Carerra Septima (Cra. 7) the lovely city layout that makes Bogotá such an easy place to navigate changes into a labyrinth of twisting, winding streets reminiscent of San Francisco..

It’s part of what makes the city so interesting – and at times (such as yesterday, when I was making my way to an appointment) – a bit frustrating.  Just when you think you ‘know’ the city – you stumble upon something completely different from what you were expecting..

Not what I was expecting

The castle which is located at Cra 3 – 74 was the brainchild of Dr. Juan Osorio Morales and is called Castillo Mono Osorio.   While it has the appearance of antiquity, it’s actually only about 100 years old.

Bogotá’s castle

The creator, a local eccentric – was  Colombian cultural attaché to Brussels.   Upon his return to Bogotá, he spent the next twenty years creating the castle which later served as home to his own personal theater troupe.

Like the work of many unconventional artists, after his death the castle fell into disrepair until it was rescued in recent years by one of his descendents and repaired to its current state.

It currently houses several stores including a banquet space, a gift shop and a pharmacy.  Best of all – there is currently space for let.  A new, whimsical office, anyone?

Talking with Andres Barrientos, Colombian film director


He lives at the top of the world, I think as I climb the hills of Bogota to his studio.   In a sliver of the window of his modest work space, the whole of Bogota is laid out beneath me.  I wonder how this affects the Bogota native’s work; which is dark, profound and futuristic in nature.

Film Director, Andres Barrientos

In a city where chance meetings are common, I had the good fortune to sit next to a charming and attractive young man at a friend’s dinner party.  As we made the usual small talk, he mentioned that he was a filmmaker.

Now, growing up in California, I had met my share of ‘filmmakers,’ all of who were the self-proclaimed ‘next Scorsese’ or ‘Tarentino’, and all of whom were waiting tables.  So we talked about YouTube and the like, along with one of his current projects, while I remained mainly grateful for the timely rescue his appearance made from the boorish oaf on the other side of me.  He was interesting and charming enough that I offered to interview for him for my modest little blog.

Imagine my surprise to find out that he’s not the next Clint Eastwood.  Or even Tarentino. No, he’s the Andres Barrientos, one of Colombia’s youngest critically acclaimed directors with over fifteen films (and numerous awards) to his credit.   Despite my appalling lapse, he was delightful, kind and prompt.  (The last is especially notable in Colombia, where time has its own interpretation.)

Andres Barrientos, working in his studio

It will take several days to unravel the complexities of Mr. Barrientos and his work – but I’ll be talking more about him and the three projects he is currently working on over at the Examiner.com.

Update: the full article can be seen here.

Christmas comes to the foothills of Bogota


Like I’ve said in a previous post – one of the great things about living in a city like Bogotá, is all of the interesting people..  Some of them are lifelong residents, some are visitors like myself – and others are making Bogotá a temporary home, like my friend, Johanna and her husband, Paul.

a true photographer, my friend, Johanna

Johanna’s a talented photographer (I’ve much admired her photos for a long time) so I am hoping to enlist her in some of my efforts..  She took several of the pictures here (the good ones!)

Yesterday, we went to La Calera which is a picturesque community just outside of the city.  Sundays are a particularly popular day for city residents to get a taste of small town life just twenty minutes outside Bogotá.

leaving the rainy city behind for a day in La Calera

But our excursion yesterday was a bit different from some of the lovely, and lazy afternoons I’ve had wandering the villages surrounding Bogotá.  This time, we were there for a cause.

nope, still not in trouble.. just hanging out

We joined Colombia’s Civil Defense – Cundinamarca division for a toy drive to benefit children in one of the outlying villages.

Civil Defense 4 x 4 division toy drive

They will deliver the toys by 4 X 4 next month..

with the Colombia’s Civil Defense

While they were collecting toys – they also had some activities for the local kids – including a ‘Paint the Car’ activity which proved popular with kids and adults alike.  (After all – how often do the police hand out spray paint?)

Civil defense officer helps a small child paint

It was a lot of fun – for a good cause, so I’ve written some more about it over at Examiner.com.

Hoping to do some more interviews this week – to bring more of Bogotá’s residents to readers..

Checking in at Santa Fe de Bogota


After a year and a half – it was time to stop in at Santa Fe de Bogotá and see what was new.

Dr. Roosevelt Farjardo, MD (general surgeon) has been instrumental in implementing some of these new and exciting changes such as the ‘Virtual Hospital’ that I will be writing about (soon).  He was very nice about taking time to update me on some of his new programs at part of the Center for innovation in education and health.  Telemedicine is just the tip of the iceberg as far as some of the cool things they are doing.

Unfortunately, the same can’t be said of the International Patient Center  – or rather – I can’t report anything other than the fact that Ana Maria Gonzalez (the previous director) has left for a position in the United States and that Dr. Carolina Munoz has taken her place.

I was hoping to get some statistics and report back about some of the specialty programs for overseas travelers – but Alas!  I am unable to bring this information to you.  I waited over 70 minutes after my scheduled appointment with Dr. Munoz – and despite several calls from her staff, she never showed up and never attempted to reschedule.

I wish I could say this is an isolated incident – but I am afraid this is more like a clash of “cultures”.  I say this because I met with Dr. Munoz  previously; during the writing of the book (when she was the Director of the International Patient Center at rival Fundacion Cardioinfantil.)

At that time, (if I remember correctly, she introduced herself as a cardiac surgeon who had retired to “spend more time with her children.”)

Of course, my obvious question – was “oh, and how many children do you have?**”

I thought we were making polite conversation – because at the time, I was less familiar with Colombian customs, culture etc.   In reality, she was reminding me of her elevated stature in comparison to mine (as ‘just a nurse’).  Dense as I was – it became obvious as the interview progressed – as she made sure that I knew that she had replaced her rival (Ms. Ana Maria Gonzalez – RN) who had also worked at Fundacion Cardioinfantil in the past.  I’m sure she resented having to answer questions about the Executive Health Program and other aspects of their medical tourism program from someone she found to be inferior to herself.  (She made that pretty clear at that initial interview back in 2011).

So I guess it is no surprise that she didn’t bother to show up to our appointment this week – which is a shame, as I had looked forward to finding out more about the evolving International Patient Center at Santa Fe de Bogotá.

Luckily for me – there was another nurse there, Sandra Salazar – who could give me some basics.   She was delightful, helpful and dreadfully embarrassed about the whole thing.  She was even able to give me a list of some of the American insurance companies they have worked with in the past.  I had lots of questions about the HIPEC program, which she couldn’t answer – but she outlined the entire medical tourist process – and answered a lot of other questions.  She showed me how they streamline the process for their international patients, and the process for medical and surgical evaluations.

Now, there’s some good news for readers:  You aren’t nurses.  You are paying customers – so I am sure that Dr. Carolina Munoz will put aside any of her personal feelings (whatever they are) towards foreigners and will make time for you.

**The answer as none – as she is not married, and was not planning to be married in the foreseeable future.

Now when I am talking about culture – I am not strictly talking Colombia – America.  I am talking about Doctor – Nurse relations.  Watch some old Turner Classic Movies sometime and you will see what I mean..

Now I debated writing about this, but after talking with some other non-Colombians here in Bogotá, I felt it was important to pass it along because it illustrates quite a few things about my work:

1.  It’s not as easy as it looks (I spend a huge amount of time waiting..)

2.  Cultural differences can cause a lot of problems – so be prepared to be tolerant.

3.  If there is a chance that patients may get poor service – I want to know about it!  (And part of readers need to know about – is my experiences.)

Calle de Mascotas – avenida Caracas


Just a few more weeks here in Bogotá before heading back to the United States.  My days are crammed with interviews – so I haven’t been posting as much as usual.

Right now, I am making copious notes – and taking plenty of photos so I can starting writing up several articles in the next several weeks.  Much of my  work will be published over at Colombia Reports.com so I will attempt to keep from duplicating it here.  (Also – I won’t have the time..)

I’ll still try to post pictures and stories here – about Bogotá life in general, to give readers a sense of the city, and the people here since that’s something that they won’t get with my (rather) dry surgical descriptions/ evaluations.

But – I am already working on plans to return to Bogotá, (and other parts of Colombia) this spring.  Once I have some concrete plans, I’ll post them here for readers and (potential travelers..)

homeless in Bogotá

I wandered around Avenue Caracas (Carrera 14) for a bit this afternoon.  It’s not the best area because there are a lot of homeless people, and it has a reputation for quite a bit of crime (muggings and such) but I couldn’t resist walking by the “Calle de Mascotas”  or the three blocks (from Calle 53-56) on Avenue Caracas that hold about a dozen pet stores..

The man crouched down in the photo above just finished stamping out his cooking fire as I came by..

kittens in a pet shop window

It was particularly heart-wrenching for me – while I’ve been down here in Bogotá, my long-time friend and companion – my 17-year-old cat passed away.  (Don’t worry, he was surrounded by loved ones, and died in my husband’s arms).

This inquisitive little fellow here reminded me quite of a bit of my cat (though they do not look-alike.)  So it was hard to keep walking – but then next to one of the pet stores, I watched two artists create this mural..

a work in progress

Hard to believe all this detail came from spray paint (no brushes!) but it did..

working on the mural

This artist, and his assistance were really nice, and didn’t mind me taking their pictures.

I’ll post some more stories soon.. In the meantime, you can read more about my recent interview with Ilene Little here.

New venture with Colombia Reports


While I have written several books about surgery and surgeons in Colombia, much of this information I’ve obtained from my research has been consigned to sitting on the shelves of various bookstores.

But, now with the help of Colombia Reports, I am hoping to change that.  As I mentioned in a previous post, Colombia Reports.com and it’s founder, Adriaan Alsema have been amazingly supportive of my work, ever since they printed my first article on Cartagena in 2010.

Since returning to Colombia, I have kept in touch with Colombia Reports while we discussed ways to bring more of my research and work to the public.  Colombia Reports is a perfect platform – because it serves a community of English-speaking (reading) individuals who are interested in/ and living in Colombia.   With this in mind, Colombia Reports has created a new Health & Beauty section which will carry some of my interviews and evaluations.

It is an ideal partnership for me; it allows me to bring my information to the people who need it – and continue to do my work as an objective, and unbiased reviewer.  We haven’t figured out all of the details yet – but I want to encourage all of my faithful readers to show Colombia Reports the same dedication that you’ve shown my tiny little blog, so that our ‘experiment’ in medical tourism reporting becomes a viable and continued part of Colombia Reports.

This is more important to me that ever – just yesterday as I was revisiting a surgeon I interviewed in the past (for a new updated article), I heard a tragic story that just broke my heart about a patient that was recently harmed by Dr. Alfredo Hoyos.  While I was unable to obtain documents regarding this incident – this is not the first time that this has happened.

Previous accusations of medical malpractice against this surgeon have been published in Colombian news outlets including this story from back in 2002.

The accusations are from Marbelle, a Colombian artist regarding the intra-operative death of her mother, Maria Isabeth Cardona Restrepo (aka Yolanda) during liposuction.  These accusations were published in Bocas – which is part of El Tiempo, a popular Colombian newspaper, in which the singer alleges that Dr. Hoyos was unprepared, and did not have the proper equipment on hand to treat her mother when she went into cardiac arrest during the surgery.

story about the death of one of Dr. Alfredo Hoyos' patients.

story about the death of one of Dr. Alfredo Hoyos’ patients.

Kristin 002 Kristin 003 Kristin 004

Now – as many of you remember, I interviewed Dr. Alfredo Hoyos back in 2011, and followed him to the operating room, giving me first hand knowledge of his surgical practices.

Readers of the book know he received harsh criticism for both failure to adhere to standard practices of sterility and patient intra-operative safety (among other things.)  I also called him out for claiming false credentials from several plastic surgery associations – and notified those agencies of those claims..   In the book, readers were strongly advised not to see Dr. Hoyos or his associates for care.

But – as I mentioned, my book is sitting lonely on a shelf, here in Bogotá – and in the warehouses of Amazon.com and other retailers.. So, people like that patient – didn’t have the critical information that they needed..

This is where Colombia Reports – and I hope to change all that.   So in the coming weeks, I am re-visiting some of surgeons we talked to in 2011, and interviewing  more (new) surgeons, more operating room visits..

The people of Bogota


I’m actually out of the city for a few days – but during my long flight, I reflected on some of the reasons I enjoy this city so much.

Why do I enjoy Bogotá so much?

Well, the people, of course!  Now, I know that people are shaking their heads – but for a small-town girl like me,  a cosmopolitan city like Bogotá is very exciting indeed.   So many festivals, events, galleries and museums**.

But it’s the people who are the heart of the city – and what really brings it alive.   Just this week, I had the opportunity to rub shoulders with and talk to a Colombian film director, a geo-petroleum engineer, a civil rights (labor) attorney  and one of the executives of Caracol.   It’s just that kind of town – like Washington D.C. but down-to-earth and accessible.  [Now, my little eight-year-old friend, Flavia has met President Santos just walking on the street one day, but I haven’t.]  But there are still wonderful opportunities to meet and talk to interesting people who I might not cross paths with in my ‘normal’ life in the hospital.

For example, I found myself sitting next to the film director, Andres Barrientos at a birthday party for a mutual friend. (Of course, the guests at the party were a like a small UN delegation – but less protocol and more fun;  it included Colombians,  two delightful ladies from Venezuelan, a British gentleman, and the guest of honor – another American like myself –except for her beautiful Argentinean Spanish.)  These are all just people and friends I have made wandering around the city..

Of course – talking about the ‘extranjeros’ or foreigners living in Bogotá is an entirely different topic – and one we will get around to one of these days.  But as I chatted with the very normal, very nice Mr. Barrientos (and he politely refrained from laughing at the ridiculousness of my YouTube efforts), it made me consider how many film producers I met in Danville, Virginia, Mexicali, Mexico or Reno, Nevada during my various moves.  (The cumulative answer is: Zero.)  And why would I – on the streets of my small southern town?  But Bogotá is a different matter entirely – it is a global city, with its tenacles on the pulse of Colombia, Latin America and the world.

Global positioning and perspectives

Talking with labor attorneys and several petroleum company officers just brings home some of the amazing lack of insight we (as North Americans) have on some many issues affecting the rest of the world – and our roles within this context.

While Americans are often accused of being willfully ignorant – this just isn’t true.  The reality is that: we are intentionally blinded as citizens to much of the outside world.  I mean, I make a continuous, specific concerted effort to find English language information about issues facing Latin America (for this blog) and it is exceedingly difficult.

What we do see on CNN, BBC and our nightly news and read has already been translated (and censored) for our consumption.  As a result – if it isn’t a  sensationalized report about a bomb going off somewhere – or a huge drug seizure, then there just isn’t much information available – whether we are talking about our southern neighbor, Mexico, the economic powerhouse of Brazil, Colombia, Peru, Chile or any of another dozen countries.

But when you live somewhere like Bogotá – you become more globally informed just by meeting and interacting with all of your fellow Bogotá residents – from UN representatives, other foreign nationals on down to your every day taxi driver.  (Always talk to the taxi drivers – they are usually exceedingly nice, have a wealth of information and different perspectives on everything from affordable healthcare, the American presidential elections, the environment and Latin American economic policies.  You will be surprised what you will learn.)

That’s just something I can’t get on Main Street, Danville, Virginia..

**Speaking of which – they are offering my book for sale at the Festival de Librarias in Parque 93 this weekend.

Back in the OR with Dr. Sergio Abello


Clinica Shaio

Spent part of yesterday back in the operating room with Dr. Sergio Abello.  Dr. Abello is an orthopedic surgeon who specializes in foot and ankle surgery.  (He also have a specialized computer system in his office for truly customized orthodics).

Dr. Sergio Abello de Castro, Foot & Ankle Center 

It  was a chance meeting in the hallway, but as always, with the gracious and genial surgeon – it led to the operating room.  He apologized, “it’s just a small case,” but everything went perfectly.

Dr. Sergio Abello (right) with orthopedic resident, Dr. Juan Manuel Munoz

 

Patient was prepped and draped in sterile fashion, with no breaks in sterile technique.  Case proceeded rapidly (previous surgical pins removed).

The was no bleeding or other complications.

Yvonne (left), surgical nurse

Anesthesia was managed beautifully by Claudia Marroqoon, RN – with a surgical apgar of 10.  The patient received conscious sedation and appeared comfortable during the procedure.  There was no hemodynamic instability or hypoxia.  Oxygen saturation 100% for the entire duration of the case.

Sunday in Usaquen


Sunday streets open for pedestrians

Since I am always talking about Sundays in Bogotá – I thought I would post some photos..

Today we walked along the streets (Carrera Septima) to enjoy the sunshine in Usaquen.

Streets closed to auto traffic to allow Bogotanos to enjoy the city, walking, on bikes, skates, skateboards – and strollers as families enjoy the sun.

We walked to the marketplace and enjoyed the park.  (One of things I particularly love is that when you go to the park – kids are playing soccer, not with their iPhones..  (of course they have iPhones- they just put them aside for a few hours.)

Flavia in park,, kids playing in background

Teaching Flavia some basic gymnastics today – cartwheels, handstands and such..

in the park

A girl offering puppies in the park (with parents, not pictured)

vintage rides in Usaquen

This guy was minding his own business – but he just looked cool (James Dean style)..

 

 

you can see the tips of the marketplace stalls (white tent tops)

 

Thoracic surgery and sympathectomy


Clinica Palermo,

Dr. Luis Torres, thoracic surgeon

I went back to see Dr. Luis Torres, thoracic surgeon and spent the day in the operating room with him for a couple of cases.   He is a very pleasant, and friendly surgeon that I interviewed last week.  Dr. Torres just recently returned to Bogotá after training in Rio de Janeiro for the last several years at the Universidade de Estado de Rio de Janeiro.  He completed both his general surgery residency and thoracic surgery residency in Rio after graduating from the University de la Sabana in Chia, Colombia.  (He is fluent in Spanish and Portuguese).

I spent some time out in Chia last year with the Dean of the medical school (and thoracic surgeon, Dr. Camilo Osorio).

The first case was a sympathectomy for hyperhidrosis.  I’ve written more about the surgical procedure over at Examiner.com, and I will be posting more information about the procedure – potential candidates and alternative treatments over at the sister site.

 

The second case was more traditional thoracic surgery – a wedge resection for lung biopsy in a patient with lung nodules.  **

In both instances, cases were reviewed prior to surgery, (films reviewed when applicable – ie. second case) and visibly posted in the operating room.  Patients were sterilely prepped, draped and positioned with surgeon present.  Anesthesia was in attendance for both procedures – and hemodynamic instability/ desaturations (if present) were rapidly attended/ addressed / corrected.

Dr. Torres utilized a dual-port technique for the sympathectomy, making 1 cm incisions, and using 5mm ports.  Each side (bilateral procedure) was treated rapidly – with the entire procedure from initial skin incision and application of final bandaids taking just 35 minutes.

Dr. Torres, performing VATS

The second case, proceeded equally smoothly, and without complications.  There was no significant bleeding, hypoxia or other problems in either case.  Surgical sterility was maintained.

** Both patients were exceedingly gracious and gave permission for me to present their cases, photographs etc.

Just as the second case ended – Dr. Ricardo Buitrago arrived – and performed a sympathectomy on one of his patients – using a single-port approach.  (I am currently working on a short YouTube film demonstrating both of these techniques.)

This week in Bogota


Finished a short film on robotic surgery yesterday and posted it to YouTube.

Going to the operating room this week with Dr. Torres, the nice young thoracic surgeon I spoke with last week.

Fashionistas beware!

I’ll be assisting Bogotano fashionistas this week – co-hosting a fashion party with my friend, Camila.  She is moving to Miami so she has to liquidate all the stock from her popular store on Calle 95.  It will be an afternoon of wine, cheese, fashion and fun – as she hosts a mini-fashion show for some of our friends on Saturday.

Closets by Camila is hosting a fashion event

A reggaeton group is playing down on Calle 83 this Friday – so we’ll be down there to check it out..

There’s also a big hip-hop event in Parque Simon Bolivar this weekend.  It’s the 16th year for this event – and it sounds like a lot of fun.

Still hoping to hike Monserrate but haven’t gotten around to it yet – but when I do, I’ll post some photos.

Robotic surgery at Clinica de Marly


I hope everyone is enjoying some of the changes in format – after all the wonderful experiences I had writing the Mexicali book, I thought I would start incorporating more local culture and content in the blog when I am in Bogotá.  (I have always enjoyed Bogotá – but my writing tended to be rather dry and uni-focal so from now on, I’ll try to include more local information about the city since I am in the midst of it all.)

Barbie display at Andino Mall, Carrera 11 No 82-01

It doesn’t mean that I am any less interested in crucial issues in medical tourism, quality measures or surgery – I just won’t focus on these topics exclusively.

I spent yesterday over at Clinica de Marly with Dr. Ricardo Buitrago to watch one of his robotic surgery cases.  They’ve been doing robotic surgery over at Marly for several years – but Dr. Buitrago just started the first robotic program in thoracic surgery in Colombia.  (Previously the robot was used exclusively for urology and gynecology surgery).

Robotic surgery with Dr. Ricardo Buitrago

Dr. Buitrago trained with the renown robotic (thoracic) surgeon, Dr. Mark Dylewski – and has been a thoracic surgeon for over 20 years so it is always interesting to watch one of his cases – robots or no robots..

Just published a new article about robotic-assisted thoracic surgery over at the Examiner.com along with photos and a short film clip that shows the robot in action.  I am working on a longer film that provides a better look at what robotic surgery really is/ what it entails.

 

Photo shoot day 2


In National news today – sure don’t know what those Nicaraguans were thinking to ‘wander’  [ie. smuggle] into Colombian waters and cause an international ‘diplomatic’ incident..

Police found a truck literally full of drugs.. It was a construction vehicle – and when they examined it – it was literally stuffed with drugs that came pouring out when they pierced the body of the truck..

Completely hooked on the ‘El Patron’ series.. My Spanish must be getting better because I can actually distinguish the Medellin accent. Going to have to find a boxed set to bring back home with me since I missed the first season.

Can’t help but love this fabulous city – always something going on – something to see, people to meet and talk to..  (and Bogota loves all its citizens..)

street art

Met some LDS missionaries from California today.. Such nice kids – said they are enjoying the city.

Back in the studio with the fabulous Aj for another dramatic photo shoot.. Two different looks today –   the first is 1920’s theme – aka “Betty Boop

Like I said – I’m not the professional photographer – he’s just nice enough to let me take some pictures while I’m there.. so these are the unretouched, unaltered versions.. He’ll probably do something really fabulous with the ones he took..  I just though y’all would enjoy seeing another facet of my daily life here in Bogotá.

The Betty Boop pout

I have a picture of Aj with the photographer – a great guy named Edgar Bernal.  He has a shop on Calle 64 No 7 – 38 (and a great eye for style.)

Aj gets a touch up – as if perfection needs any help!

One more Betty Boop –

For the next set – more of a traditional 1920’s Bob, if you can call fuchsia traditional.

getting ready

She has such the perfect face for this look –

Then a quick stop – just to pop-in and say hello to German Encino and his wife, Else.. They are the owners (and operators) of a little corner restaurant called the Superdeli on Calle 64 No. 8 -04.  I didn’t stay for lunch this time – but it’s definitely one of my favorites – just a laid back place – good food, nice atmosphere, and nice people..

German Encino and his wife

I do a lot of wandering / exploring/ adventuring around the city – so I end up at different little cafes and kitchens everyday but I wanted to mention Superdeli for a couple of reasons – one – the food is good enough that I’ve come back several times (and the Lulu juice!)  and secondly – they are always friendly and welcoming in a neighborly way – not a ‘hello tourist’ way…

On that note – of wandering – a little advice to fellow wanderers…

If you can see the mountains – you are never really lost..

If you can see the mountains – you are never really lost, and can always find your way home.. The carrera starts at the base of the mountain (carrera 1) – so if you walk a few streets – you’ll hit carrera 7 (septima) which is a main artery for the city..

The calles run in the opposite direction – Calle 1 is in the heart of town (not a particularly nice area but some interesting stuff is located here – like Hospital San Juan de Dios) and heads outwards in both directions..

they only look fierce –

Of course, if you are really LOST – these guys (above) are always happy to help.. Even if you don’t speak Spanish.. (Just keep a note card with your local address on it – it’s also good for taxicabs..)

Had a great day in the operating room today – so I’ll post something tomorrow (with pics)..

Typical Day in Bogota


Just another typical day in the busy city..

Spent the morning talking to a very gracious young thoracic surgeon named Dr. Luis Torres.  He’s Colombian but spent several years studying in Brazil.  He’s now back in Bogotá and working at Clinica Palermo.  He was delightful to talk to; I’ll tell you more after a visit to the operating room with him next week.

Then I stopped by to visit a friend during her photo shoot.. The vision was supposed to be “The Virgin Queen” aka Elizabeth the First of England but after a few modifications – she made a fantastic Veronica Lake..

The photographer/ make-up artist was fantastic – and let me peek over his shoulder and take my own photos.. Here’s my favorite one..

the fabulous Aj , Colombian model endures the flashbulbs of an enthusiastic press

I know, I know, I should have cropped out the light and blended the shadows – but I kind of like the feeling the light evokes.. (it reminds me of those old-time flashbulbs..)

Several more great photos 

I thought about editing some of the pics – but then I figured – that’s for the experts – and Aj is so pretty, my poor photography can’t take away from that..

Aj – Colombian model

Veronica Lake

After the shoot – we went to another one of the random sidewalk cafes before window shopping at one of my favorite boutiques –  a little vintage shop called Chiros Elegantes on Carrera 11 No. 67-32.   Vintage shops are few and far between it seems around here – but this space is fabulous..

On the way – took a picture of some random graffiti – just because the slogan amused me..  haha.. now substitute ‘cojones’ for ‘conejo’ and it almost makes sense..  (Conejo is rabbit – as in ‘bunny rabbit.’

Ay carumba! who will save the conejos??

New International Terminal to open October 18th


Returned to Bogotá after a conference, and I am happy to report that the massive airport construction project at Bogotá Airport (El Dorado International Airport) is almost finished.  The first flight from the new terminal will be on October 17th – with full operations commencing in the new terminal on October 18th, 2012.

As one of the busiest airports in Latin America – and a hub for Avianca, Copa, LAN, Satena and EasyFly – (offering 6,000 flights per week on Avianca alone) this new terminal will ease congestion and improve traveler comfort..  I am flying out again later this month – so I will update everyone on all the details soon.

Want to wait in style?  Check out the VIP lounges.

Thank you, Dr. Francisco Cabal


I would like to thank Dr. Francisco Cabal – an orthopedic surgeon and director of Clinica del Country/ Hospital de la Mujer.  A few nights ago, a Colombian friend was seriously injured in a motorcycle accident – and the worried family asked me for help, so I called Dr. Cabal.

He was absolutely fantastic in making sure the family was up-to-date on the status of their loved one while she was in surgery, addressing all of their concerns and helping to relieve some of their anxiety.

I wanted to be sure to thank him on this (semi-public) forum, because I want readers to realize that medicine here is very different from the United States, in that  – most often, if you ask for help; people will go out of their way to provide it.  (I suspect given the time of day when I contacted Dr. Cabal – he was probably enjoying a nice supper or time with his family) but he had information for the family in just a few minutes..

Sometimes, at home, (the USA),  there is a barrier, or ‘gatekeeping’ that keeps us from our providers – and can make situations like this more difficult.  But here in Colombia, as I’ve said before – the doctors give you their cell phone numbers and emails because they want you to call if you have questions or concerns..

And when you do call – you are getting their personal phones, so you won’t be routed to a secretary or left on hold for twenty minutes.. [the only exception is during surgery].

Does this privilege get abused at times?  Certainly, which is what makes it more impressive that these doctors stay accessible to their patients.  [We’ve all  encountered obnoxious customers in all lines of work – medicine and health in no exception.]

What is home? (and where is home?)


One of the questions I am asked frequently when I travel is “Where do you live?” or “Where are you from?” and sometimes, “Where is home?”

While these questions seem the same – they aren’t.  For someone like me who travels often for extended durations – the answers are often deeper than the questions.  The nature of the question of home changes.  Of course, I am from the United States – and I always will be; a born and bred southerner from Virginia.  But is it home?  Probably not, as my extended family lives in several different points of the globe, and without a job or a house in Virginia there is very little reason to return.

the neighborhood I call home..

Where do I live?  Not so easily either – unless you are asking directions to the apartment here in Bogota where I am staying for the next several months.  But is that home?  The answer is yes, and no.

I am not a native Bogotano and never will be.  My trips here are always too brief stops before heading on. But at the same time, in many ways it does feel like home.  Just yesterday – as I took my Sunday stroll, I ran into a friend of mine, so we walked a bit and enjoyed the sunny day.  Then as I was coming back, two people asked me for directions – (which I was able to give)..  Today, I am helping teach an English class and tomorrow I will be doing more research..

if home is having a favorite restaurant, then this is certainly it..

So in that sense, Bogota is more my home than several other places I’ve stayed.  I have favorite places to lunch, to shop, to buy groceries – all of those things that come with familiarity, with belonging. I can hop on and off Transmileno like a native and navigate myself through this busy city.  But in a few months – I will leave again – and don’t know when I will return.. so I guess Bogota is not home either.

Maybe home is the place a person longs to be.  But even that is fraught with complexity.  While I love my friends here, and always look forward to being here, for example,  I am also ‘homesick’ for many of my friends back in Mexicali..

or is this (the operating room/ hospital) home? Because I am certainly there a lot – and I miss it when I’m away..

I guess in the end, home is defined as my personal comfort zone.. so where ever my laptop and I end up – for how ever long – that must be home.

Back in town..


Back in town just a few days, and already in the swing of things..

After arriving late last week, I was just in time to attend a conference on lung cancer and mesothelioma at the Hotel Tequendama.  There were some great presentations by several speakers on advances in the treatment of Lung cancer.  It was also an opportunity to catch of with several of the thoracic surgeons I’ve talked about here; including the always classy and amazing Dr. Stella Martinez, who was one of the surgeons giving a talk on surgery for mesothelioma.

Dr. Rafael Beltran and Dr. Ricardo Buitrago were moderating the event, which was put on by the National Cancer Institute.   Dr. Juan Carlos Garzon, Dr. Barrios, and Dr. Mauricio Palaez were also in attendance.

But the biggest and nicest surprise was seeing Dr. Edgard Gutierrez (Cartagena).  Those of you that are familiar with my Cartagena writings know that Dr. Gutierrez (unwittingly) took a large role in shaping my career.   It was great to sit down and catch up with him for a while.  But I’ll post more about my visit with him over at Cartagena Surgery so I don’t confuse my Bogotá readers..

(I’ve posted some photos from the event at my sister site, http://www.cirugiadetorax.org)

Bogota revisited


Finishing my first week in the doctoral nursing program before heading back to Bogotá in mid-September.  (I’ll be keeping in touch with my professors via Skype, Scopia and a variety of on-line media.)

I am exciting to be coming back to a city that I have come to know and love!  In fact, my only regret is that I didn’t devote enough pages of the book to the city itself.  At the time, I rationalized that people who were interested in the city would be able to find plenty of information in the existing travel guides (and I am not a traditional travel writer) – so I devoted myself wholeheartedly to medical tourism, hospitals and surgery.  But as time has passed – I regret not sharing the city more with readers, since after living there for almost six months (and traveling all over the city daily), I certainly became intimately familiar with much of it.

So, readers will be happy to hear that I haven’t made that mistake with my latest book on Mexicali, MX – but I am just happy to be going back to Bogotá, a city that truly has captured my heart..

It’s insidious, you know.  The things that I initially didn’t like (like the ‘eternal autumn’ weather) become some of the very things that make me enjoy the city so much.   Bogotá is a city that has to be ‘known’ to really be appreciated.  If you don’t scratch beneath the surface of this vibrant, amazing place, then you really won’t see (and love) the city.

For example; that cool, mild weather, that had me groaning the first few weeks also made it possible for me to spend much of my time outdoors – exploring the city, walking miles everyday.  Spend a week sweltering in Cartagena (or Mexicali, in August, for that matter) and you will see what I mean.

The food that seemed plain and unspiced at first, became something to savor.  All of the exotic and tangy fruits, and ‘real’ food taste – unmasked by heavy additives let me appreciate how wholesome and unaltered it really was.  It made me appreciate the subtlety and complexities of the meals I was enjoying.  (If you drown everything in ketchup or hot sauce – what are you really tasting?)

So, in just a few weeks – I will be back in this wonderful, charming, whirlwind place that has claimed a little corner of my heart.

Vice President Angelino Garzon undergoes surgery


Bogotá’s neurosurgeons are certainly staying busy.   Several days ago, the mayor of Bogotá, Gustavo Petro underwent emergency neurosurgery at Fundacion Santa Fe de Bogotá.  Now comes news that the vice-president of Colombia, Angelino Garzon underwent a similar surgery this week for a hematoma at Clinica Reina Sofia.  Details on English language news sites are somewhat sketchy as to his actual medical condition (which sounds like a hemorrhagic stroke), the surgery itself and his prognosis.

VP Garzon, who has a history of cardiovascular disease, underwent emergency heart surgery with Dr. Hernando Santos at Clinica Shaio just two days after he (and President Santos) took office in 2010.

Most recently, he was being treated for a urological condition and it was during follow up medical examinations that his condition was detected.

Update: 23 June 2012

The mayor of Bogota – Gustavo Petro is back at work after successful neurosurgery.

Meanwhile, Vice-president Angelino Grazon remains in guarded, if stable condition after being placed in a medically induced coma while he recovers from a recent stroke and subsequent surgery.

 

Hidden Gem returns to Bogota: calling all surgeons!


Calling all Bogotá surgeons – if you missed the first chance to be interviewed for the first edition of Bogotá! a hidden gem guide to surgical tourism – don’t worry..  I’ll be back in the city this September (2012).

While my primary purpose for my return to Bogotá is research-related (I am working on a doctoral degree), I always have time to talk to surgeons about the new and innovative things they are doing in their practices.

Contact me through the site if you are interested..

 

in the operating room with some of Colombia's finest surgeons

in the operating room with some of Colombia's finest surgeons

The daVinci and Thoracic Surgery


Clinica Marly, Bogota – Colombia

 

Dr. Ricardo Buitrago, Thoracic Surgeon

Dr. Ricardo Buitrago, Thoracic Surgeon is now performing robot-assisted thoracic surgery with the daVinci robot at Clinica de Marly.  He began performing cases with the robot in Bogotá early this month.  The daVinci robot has been heralded for enabling surgeons to perform more precise procedures through smaller incisions.  While I’ve interviewed several surgeons over at Cirugiadetorax.org about use of the daVinci for thoracic procedures (aka RATS), I’ve yet to see it in action.

In related news – I am planning to return to Colombia for a few months this Fall, and hope to bring you more first-hand information about Dr. Buitrago and his robot!

Adventure Tours to Colombia


Want to see the lush beauty of Colombia without the surgery?

The tram to Monserrate

Ready to explore the sophisticated city of Bogota, combined with the historic jewel of Cartagena?   What about the sandy beaches of Santa Marta?

Overseas Adventure Travel is offering a new tour of Colombia for interested travellers.

If this whirlwind tour of Colombia isn’t enough for you – there are Bolivian and Panama add-on options.  Or you could always rent an apartment and stay a while (like I did.)

Overseas Adventure Tours

For a more tailor-made tour of Colombia, contact Mantaraya Tours.  This Colombian travel company offers a multitude of options to fit your budget (and your dreams!)

I wrote this post for the friends and family who were fascinated by my travels to Colombia – and wanted to see for themselves.  I have no affiliation or relationships with either of the companies listed.  (But if they are reading this – hope they buy a copy of the book).

Dr. Giovanni Castano, opthalmologist


Another story on the tireless efforts and surgical excellence of Bogotá surgeons – this time, Dr.  Giovanni Castano, an opthalmologist.  While I have never had the opportunity to interview Dr. Castano personally, I am not surprised that he donates his time and services to patients in remote parts of Colombia.

This tireless dedication to service is an integral part of Colombian medicine and Colombian surgeons themselves.  As part of their health care training, Colombian doctors and nurses spend anywhere from several months to a year in rural parts of Colombia as part of a government service program.  This serves as a foundation for a lifetime of service for many of these individuals and is a hallmark of the care I witnessed and received during my time in Bogotá.

The latest HIPEC headlines


More ongoing research trials to validate HIPEC as a potential treatment for ovarian cancer.

The University Hospitals of Cleveland, Ohio recently started several new clinical trials to test the effectiveness of hyperthermic intra-peritoneal chemotherapy  in women with ovarian and endometrial cancer.  Unfortunately, the trials are small (around 60 woman) which means that even positive results will be far from definitive for researchers involved in the HIPEC debate.  It also offers only limited opportunities for patients with ovarian cancer to receive potentially life-saving treatment.

Medpage recently published a nice overview on ovarian cancer and the current treatment modalities – which can be seen here.

More on HIPEC: here at Bogota Surgery:

What is HIPEC? What’s it used for?

Who does HIPEC?

HIPEC updates:

Update #1

Well mannered folks..


Received a nice thank you note from President Juan Manual Santos in the mail this afternoon for the copy of the book I sent..  I may not be politically active, but good manners are always appreciated – and President Santos is certainly well-mannered.

Thank you, President Santos – for making my day!

Mr. Juan Manual Santos, President of Colombia