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Havana Clinic #11
Ramon and one of his patients
ELAM students taking BP under nurses's supervision
November 2007
How many times have you felt so ill that you couldn’t even leave your home to go see a doctor? The reality is that many of us have been in this situation. The Cuban patients, however, need not worry about leaving their home because the doctor comes to them when they can’t come to the doctor. I was fortunate enough to accompany Dr. Vilma Berro to a home-visit and thus experienced one of the advantages of the Cuban healthcare system.
Medicina General Integral
This month I received a three-week introductory class to Integral General Medicine (Introducción a la Medicina General Integral). Two days out of the week were spent in the classroom and the rest were spent at a clinic in Mantilla, a neighborhood of Havana. My experience was very enriching and it reinforced my desire to become a doctor.
Consultorio #11
The clinic, located on the first floor of a three-story building, was a very humble place. Dr. Berro, my mentor, was a great physician. I, as well as 4 other students, spent 3 weeks at her clinic where we were taught the basics of medical hygiene, such as washing our hands (using three different methods) as well as the taking of vital signs. In that period of time, I had the opportunity to interact with the patients, a student from Uruguay in his sixth year of medical school (he was also under the supervision of Dr. Berro) as well as countless doctors specialized in different fields of medicine that came to the clinic to consult with Dr. Berro’s patients. Each physician took the time to explain each case, as well as their approach to the different modalities of treatment for each patient. The clinic also had a nurse on staff and she was very helpful. This nurse was responsible for the execution of many procedures and she always invited us to watch her as she performed these various tasks, which varied in complexity. Through my experience, I have learned this: nurses have a tremendous amount of responsibility and they are very competent and well respected.
Doctor-patient relationship
Dr. Berro knew most of her patients by name. She has been working at clinic #11 for many years and, hence, has seen all of her patients numerous times. Aside from knowing them by name, she knew their medical history by heart. I was really impressed. The patients, as you might imagine, love her. There is a window next to her desk (well, now there are only remains of what used to be a window) and many of her patients stop by the window to salute her as they go about town.
Home-visits
A couple of weeks ago while Dr. Berro was consulting a patient, a woman who claimed that her elderly father was in need of medical attention at home interrupted her. Dr. Berro, not knowing the severity of the problem, immediately left the office to go see the elderly patient. The other doctor (the 6th year medical student) and the nurse stayed at the clinic while Dr. Berro was out. As we walked to the patient’s house, which was about two blocks away from the clinic, everyone greeted Dr. Berro. Aside from seeing her as the doctor, people see her as a friend and as an important member of the community since she lives in one of the apartments above the clinic.
Upon arrival at the patient’s house, we found the patient surrounded by his family members. He had fallen earlier that morning; hence, they did not want him to move. The arrival of Dr. Berro totally changed the atmosphere of that house. The members of that house were now able to smile, knowing that their doctor was there to help their loved one. After tending to the patient, Dr. Berro recommended that he visit the hospital for further evaluation, testing and supervision. She gave him some medications and asked that the family members prepare for him, a meal, before taking him to the hospital. Overall, I found this brief experience to be quite inspiring and it has definitely strengthened my desire to become a compassionate and caring physician.
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