5 Harsh Truths You Learn as a Doctor in the Third World
The following was constructed from an interview conducted by Cracked.com.
I trained as a doctor in Caracas, Venezuela, the third most violent city in the world, just behind Deadwood and Rage Virus London. I worked every day to stem the tide of murder and suffering. So the next time you get miffed at the wait time and the weird stains on the chairs in the free clinic, spare a passing thought for us Third World doctors, who deal with stuff like ...
Intense On-the-Job Training
In an ideal situation, doctors go through years and years of training before they ever touch a person's insides. If you're learning to be a surgeon in Venezuela, for example, it's not until your fifth year that you're allowed to scrub down and be present for a surgery. At least ... that's what it says on paper. The first time I operated, I was a third-year and had stepped into the operating room to tell my colleagues that dinner was ready.
In hindsight, pasticcio was an awful choice.
Before I could run down the specials, the attending physician screamed, "Why aren't you scrubbed in?" and pulled me into the room. In an instant, I was washed down, dressed in surgical garb, and operating on a gunshot victim. They literally threw me some of his intestines, saying, "Hold this." Eventually, the actual doctors in the room realized that none of them recognized me, and I explained that I was just some third-year, and by the way, dinner is ready.
I want to be clear and say that it's not because these guys are shitty doctors and don't care -- we're just so understaffed and overworked that they needed help wherever they could get it.
"I'm not just the janitor. I'm also chief of radiology."
During that same year, another student and I found ourselves in charge of the entire minor surgery wing, all by ourselves. We weren't qualified or prepared, but we knew enough to get through the night, and we did our best to save some lives. Imagine an internship where all of the employees walk out on the first day and they name you manager for the next 24 hours. Now imagine that internship is at a nuclear power plant. It was a bit like that.
Supplies Are in Short ... Supply
People go to the hospital because trained doctors have the expertise that your average citizen doesn't, but you can't underestimate how much doctors rely on their supplies. Even the best doctor in the world couldn't stitch a wound with nothing but dental floss and really sharp fingernails. Since Venezuela's economy is sort of in the shitter, it's getting tougher to import the supplies we need to keep people alive.
Criminals no longer deal cocaine -- they sell antibiotics and insulin.
But necessity breeds MacGyverism: One time a guy walked in with gunshot wounds to the head, arm, and leg, and he was literally holding his brains in with one good hand while his other limbs just ... well, if this were a video game, he would've been on his last hit point. We didn't have any of the dozens of supplies we needed to fix that, so we took some cardboard and packing tape, put the pieces of his limbs roughly where they were supposed to be, and did our best to get this bleeding man-package to another hospital.
When I arrived, the doctors at the new hospital asked me where I was coming from. When I told them, they said, "Oh, you come from hell." That's how I found out the hospital where I worked was known as "hell." Did I mention this was my first day on the job?
"That's why all of our wings are shaped like circles."
Another time, two guys came in after they both somehow managed to lose a machete fight against one another. The doctor on call had to keep them together while waiting for the ambulance to show up and take them to another hospital, because, again, we were out of supplies. He used the stapler from his desk.
Another, more pressing problem is electricity: Sometimes we don't have it.
"Shit, the battery is dying. Get the candles."
This picture is the J.M. de los Rios hospital, a national reference center for children. These noble doctors are doing rounds with flashlights. Do you think hospitals should have backup generators? Ha! The joke's on you! It's also on the children, and the punchline is that they don't receive medical care.
It's ... not exactly a knee slapper.
Sometimes You Have to Hide a Corpse
Hospitals all around the world regularly interact with police and firefighters, obviously, since they're the ones most likely to be delivering us our clients. But in Venezuela, they're just as overworked as we are, so we don't generally see each other at our best -- I mean, I wouldn't go so far as to call the firemen my adversaries, but I was a bit peeved when they dropped off a corpse without so much as a "How do you do, here's a dead dude."
It's like whoa, where's the fi- oh, wait.
I stepped out into the garage where the firemen park, just in time to see them flop a body onto our one and only gurney, then take off. I spent a good portion of the night calling the police, hoping they'd swing by for some pickup, until finally I had to admit that we had living people to deal with, and like it or not, we had to sort this problem out ourselves. Even Frankenstein needed electricity to bring the dead back to life, so that was out of the question.
What else could we do? Some of my colleagues and I hid the corpse in a closet and went about our evening as best we could.
It looked like this supply closet, except without the supplies. And with a dead guy.
It was awful that we didn't have the means or the time to pay the body the utmost respect, but the choice was between that and clearing up a gurney and saving a few more lives that night. All I can do is hope that if I could have a beer with the deceased right now, he'd agree that I made the right call.
Sometimes You Might Be the Corpse
I have a job and an education and the opportunity to come to America for a while. I'm better off than the majority of people in my country. But violence is commonplace in Venezuela, and some folks start seeing every problem as a nail and murder as just the hammer they need.
"I'm in the mood for a fruit salad; better get out the chopping guns."
A friend of mine in another hospital once faced down a bunch of gang members who brought in their mortally wounded buddy and told him "Save him, or we'll kill you." There was nothing he could do, so he pretended to operate on a dead guy until he was able to get the "patient" to another hospital, where he hoped the police would intervene. Pantomiming surgery for an audience of gangsters is just part of the job description.
But even when you're not getting threatened by your patients, everyone in the country is threatened by "colectivos" -- organizations that aren't even trying to sound like the good guys.
Or look like them.
They're "unofficially" armed by the government and tend to silence people they disagree with by shooting their guns really loudly, so nobody can hear what they're saying. And also by killing them.
The Living Conditions Are Even Worse Than You Think
One morning, a woman asked me how to keep her son from being bitten by rats.
Oh, stop weeping: That's not even the bad part yet.
Sorry, rabies. You're going to have to settle for second place this time.
I got halfway through the explanation I really shouldn't ever have to have prepared ("elevate the bed, put out rat poison") before she stopped me and explained that she didn't have a bed, and hadn't since 1999, when there had been a flood and the government moved her to a shipping container. That's where she'd been living ever since. On the floor of a cargo container full of rats.
It's easy to feel like your work is futile -- we're patching up soldiers on the frontlines of a war that no one is actually fighting. People are so desperate for basic necessities that standard behavior is "If you see a line, get in it, because it's going to be for something you need."
"Wait, this line is for wrist tattoos? Whatever, I'll take two."
Once, a representative from the government gathered a bunch of us to go on a penetration (a needlessly graphic name for a publicity stunt that also delivers poor people a whole bunch of medical care, so I'm on board) to "Sector 7." Ignoring the clearly ominous sci-fi title, off we went.
On the ride, I saw a lot of trucks in the distance and smelled a weird, sickeningly sweet odor. But it wasn't until I arrived that I realized we were going on a penetration into a dumpster -- and a whole shitload of people lived there. Nothing says "I'm making a difference!" like treating a guy for a sore throat, only to watch him walk back home to sleep on a pile of diapers.
Related Reading: Speaking of the third world, here's an article about life in cartel-run Mexico. Cracked also spoke with a undercover agent and another doctor with some harsh truths to share. If you've got a story for Cracked, message us here.