October 2009

Saturday, October 03, 2009 9:51:23 PM

Dengue, also known as fiebre quebranta huesos (breakbone fever), is a mosquito-borne infection that is currently afflicting the population of Havana, Cuba.  The teaching hospital “Dr. Salvador Allende,” located in the neighborhood of Cerro, has been assigned to admit anyone that presents symptoms of this viral infection.
 
On September 14th, I started my first day of clinical training at “Dr. Salvador Allende” hospital and that same day I came face-to-face with the disease; that day marked the beginning of my journey inside the hospital.
 
My day at the hospital begins at eight in the morning Monday through Saturday.  I was assigned to room sixteen of the geriatrics pavilion along with my classmate, Blanca Céspedes, from Paraguay.  Due to the outbreak of dengue in Havana, the geriatrics pavilion is exclusively reserved for patients that present symptoms such as fever, muscle and joint pain, which are characteristic symptoms of the dengue infection.  Each room of the pavilion has three beds, which means that Blanca and I are responsible for the wellbeing of three patients.
 
In the past couple of weeks, many patients have occupied room sixteen; most of them returned home happily after their treatment, while others were transferred to the intensive care unit of the hospital and one patient, unfortunately, died on our third day of being at the hospital.  This patient died because of heart failure.  I clearly remember walking into room sixteen that morning and the room felt completely empty, his bed was empty and my patient wasn’t there.  Later that day my professor gave us the news of his death.  At the moment I could only think of his family, his loved ones, and of the suffering that they must have been going through.  After receiving the news, there was nothing I could do but to say a prayer.  I just wish I could have accompanied him during his final moments.  I know that as a future physician, one of my responsibilities will be to accompany the terminally-ill patients during their final stages of life.

Dengue can present itself in a number of ways.  A severe form of the disease is known as dengue hemorrhagic fever.  I will never forget my first encounter with one of my patients that presented with this severe form of the disease.  He was in his mid 40s and he had recently been admitted to the hospital.  When I came to see him, I was shocked.  I could not believe what was in front of my eyes.  It appeared as if his body was beaten severely yet he was still walking.  Covering his frail body were numerous blood deposits under his skin of various forms and sizes.  He seemed so fragile that the slightest touch between his skin and my stethoscope seemed painful.  This is the patient that I will always remember when I think of dengue hemorrhagic fever.

I am excited for what awaits for me in the future.  Now that I have started my clinical training at the hospital “Dr. Salvador Allende,” I will be spending many hours there learning the art of medicine.  I am aware that I will continue to encounter numerous pathologies like dengue and I will have to overcome many obstacles but I also know that, with God’s strength and guidance, I will succeed.
 
Sincerely,

Alejandro Bernal
Email: alex238209@yahoo.com

Website: www.pnhpwesternwashington.org