The lines were even longer today!

As I write this I am “on break.” It’s Wednesday about 1:15 pm and we are short on translators at the moment. It’s easy to see how important our translators are to our productivity-- the “doc room” is running at 75% right now. I worked with Socrates, the reincarnated Greek philosopher and also our tour guide for the trip to Machu Pichu trip on Friday. We have really great translators. They have been with us so much now and heard us take so many medical histories that if the complaint is say, constipation, we can almost say, “Marco—cue constipation follow-up questions aaand—GO.”



I have officially brought pain medicine to Cusco. I’ve injected trigger points, occipital nerves, tendons and a couple of sacroiliac joints. I even had a perfect opportunity to do an epidural steroid injection today but like a dummy, I didn’t bring any of the needles I needed. I started to try to McGyver a block together but finally decided it wouldn’t work. The patients seem amazed every time. One little man with headaches and upper back pain walked out smiling and saying, according to the translator, “It’s unbelievable—my pain is GONE!” Unfortunately at this point, since the docs have kind of been competing for procedures like joint injections, various yucky aspirations and so on—we are running out of needles, syringes and anesthetics. I resorted to using a 22 gauge which was the smallest needle I could find on a guy today for trigger point injections. But as I said, these folks for the most part are not complainers. He was very happy to be having a doctor do an injection to help his pain regardless the size holes I put in his back.




This was the "It's unbelievable. . ." guy.


The people were lined up down the block today when we arrived today. We triaged 250. Only 220 came through. I must have played my cards right today. I only saw a couple of kids. I also treated among the many a family of Quechua people (hope I spelled that right). They are decedents of the indigenous native people and Inca. They come down from the mountains. They are farmers and have their own very distinct dress. The women customarily wear thick skirts and hats. They are a very simple, docile people. We had two translators going for this family: Quechua to Spanish to English. It was labor intensive.