An Experience in Local Primary Care

Not a good way to start a 5 day week of school:

Starting around 1 AM Monday morning, I (Allan) woke up and was unable to fall back asleep because of stomach pain, a headache, and general discomfort. I tossed and turned for hours in my hot, dark room listening to the roosters starting to celebrate Matins, as they do every day. Falling back asleep at this point was a futile endeavor because my skin had become sensitive that even my sheets felt like they were conspiring against me. After a few visits to the bathroom, I knew this wouldn't just blow over. During one of those visits I think the Sumerian god Gozer conjured up exactly what had "popped" in my mind at that very moment because seated upon the toilet, I glanced into my shower, noting that a black spot that I had seen just hours before was no longer there. As soon as that thought had drifted away to make room for more pressing issues, I felt a small cucaracha crawling on my leg. In my 4 AM stupor, I clumsily missed my chance of ending his "short, pointless" life of terrorism, and he scurried under the closed bathroom door into my darkened room to haunt me for the few remaining hours I had.

Poorly rested and somewhat nauseated, at 6:13 AM I climbed onboard the bus headed to Mayatan. Luckily for me, Mondays are my easiest days of the week because my students have several "specials" like an assembly, P.E., and library. At school, I learned that Michael was taking a sick day because he was suffering similar symptoms but to a greater degree. I survived Monday fairly well and napped as soon as I could get to my bed. Well, right before closing my eyes for a wonderful afternoon siesta, I noticed a black spot in one of the far corners of my ceiling. Abby identified the spot as nothing less than the little, spontaneously generated cockroach from the night before. I took a stick and pushed him so hard into that corner hoping he'd never come out. Well, quite literally, he may never come out. I tried to remove his remains with the stick and then a towel, but they had somehow adhered permanently to the wall. I left him there because I didn't have the strength and also because I liked the message he sent about cockroaches in my room.

The next day, I felt a great deal better and decided to go visit the doctor after school. I probably just had some bad food that my body had cleared, but because I like certainty more than probability, I decided to visit the local doctor. Michael had symptoms that made some people suspicious of Giardiasis, and since we had eaten the same meal on Saturday night (free food for the band!), I wanted a some sort of test to rule this out. I went to a local doctor thathad been recommended to me earlir, who seemed to have quite a bit of extra time. I walked in, told the receptionist that I wanted a consult, and waited about 1 minute before the doctor was getting my history in his office. I told him my suspicions, but he didn't seem to pay them much heed. He then gave me a very cursory physical exam in which he checked my pupil reflex rather extensively and swung my legs back and forth for a few minutes.

At the end of the consult, he said very little about what he observed or what he thought might be my ailment, but he did assure me he would give me some pills. He offered no explanation of what the pills were or what they did; he just told me to buy them from his own pharmacy in the front. (Maybe it wasn't until after the physical that he really started "pulling my leg.") This, I've found, is definitely a common trait in the Honduran idea of medicine: if you go to the doctor because you feel ill, you will receive a medication of some sort, and most commonly it will be an injection. I don't know how this requirement came about.

Maybe they haven't been taught about the placebo effect, or maybe the doctors just capitalize on it. Maybe the doctors will be ridiculed if they admit that they can't find a problem, or maybe doctors think that incorrect, unnecessary, or over medication is better than none. Anyways, after perusing the internet to find the actual chemicals in these Honduran-brand pills, I saw that he had given me trimethoprim and ranitidine. The former is an antibiotic, but he gave me a somewhat antiquated form of it called co-trimoxazole in which it is mixed with a sulfonamide antibiotic. First off, this drug has been used mostly for urinary tract infections, but also this mixture of antibiotics was restricted in the U.S. in 1995 because of bad side effects and toxic effects to bone marrow. On top of that, the combination was not proven to have any extra benefit in general clinical use. The other drug he gave was basically Zantac, which helps reduce stomach acid.

I did not use either drug for obvious reasons, and by Wednesday, I was feeling normal. I'm not positive I don't have a parasite (though I doubt it), but I hear the lab in town is even worse than the doctors (I didn't know that the lab was a completely separate entity before I spent 5% of my monthly stipend, i.e. $15, on the drugs and the consult). I think I'll just stay away from the doctor as much as possible until we come home.