Hola! I survived my final week of Costa Rican rotations in the interventional cardiology department at Hospital Calderón Guardia (where I previously rotated on hematology). Despite having a bout with “la gripe”(the flu – but not COVID!) and missing two days of work, I was still able to spend three full days on the cardiology service. I worked with Dr. P and scrubbed into his angiography, angioplasty, and stent placement cases—I haven’t been in the cath lab before and I loved it!! For one of our patients with complete heart block, I saw both her angiography case with interventional cardiology, and then her permanent pacemaker placement with cardiac electrophysiology.
Dr. P is one of only 14 interventional cardiologists in all of Costa Rica, with 4 of the 14 being at Hospital Calderón, a large tertiary care center. The equipment (x-ray machinery, ultrasounds, TV displays, stents, balloons, catheters) are all state-of-the-art, similar to what one would find in a comparable interventional procedure room at UCSD. Patient cases are completed in order of urgency, with many patients coming from outside hospitals for this advanced level of cardiology care. Upon completion of their procedure, patients are sent back to their “regional” hospital for after-care.
On my last Saturday in San Jose, two members of my UNIBE team (Dani and Luis) took me out for lunch at Mirador Tiquicia, a beautiful traditional restaurant in Escazú overlooking the whole city of San Jose. And on Sunday before my flight, my house mom Mayra bought me special breakfast from the bakery! I’m now home safe in Los Angeles (my new home, where I will be working as an internal medicine resident at UCLA). I already miss my Tico family—a group of parents, teachers, organizers, drivers, and physicians—who made this experience so special. The Costa Rican people I met were so kind, patient, and inclusive despite my cultural missteps and rudimentary Spanish. I hope I come back a little more Tico—a little more easygoing, a little more understanding—than when I left.
In reflecting on my experience over the last 4 weeks, I am impressed by the high quality and consistency of care afforded Costa Rican citizens through their nationalized healthcare program. While certain limitations do exist (like long waiting times for a specialist visit, or difficulty accessing very expensive cancer drugs), it seems that the system does an excellent job of managing population health overall. There is a clear emphasis on building inter-disciplinary teams that include social workers and psychologists, for example.
Now looking forward to graduation in just two short weeks back in San Diego! Thanks to those of you who followed along on my GHAC journey 🙂