¡Buenos Días! from San Jose, Costa Rica! My name is Jordan. I am a MS4 in the Global Health Academic Concentration (GHAC) at UC San Diego School of Medicine. I am so excited to tell you a little bit about my adventures in San Jose, Costa Rica.
I am working in San Jose for 4 weeks at various hospitals and clinics through a collaboration between UC San Diego School of Medicine and UNIBE. Universidad de Iberoamérica (UNIBE) is a private university in Costa Rica. Their international study abroad program is expertly run by the wonderful Elizabeth. Elizabeth organizes “study/work abroad” programs for medical students from around the world. I have truly enjoyed my last two weeks in San Jose. I arrived at the San Jose International Airport (SJO) on a Sunday. As I walked up to the arrival passport office I tried to scrounge up any Spanish I could remember. The passport official laughed at my terrible Spanish and welcomed me to Costa Rica. Outside the airport, I was picked up by Luis, my driver for 4 weeks. Luis is a kind, bi-lingual man that greeted me with an ID and my new UNIBE White Coat. He dropped me off at my home for the next 4 weeks. My house mom, Vera, is a wonderful and warm woman. She welcomed me into her beautiful home on the outskirts of San Jose. I thanked her in broken Spanish and promised my Spanish would improve during my stay. She smiled.
I was lucky enough to spend my first week in the hospital with Doctora Acon. Doctora Acon is a hematologist at Hospital Calderon. I had the opportunity to meet many patients with ALL, AML, CLL, and CML. I even saw my first case of Castleman’s Disease. Doctora Acon completed clinic visits in the morning and then rounded on the Hematology wards with Residents. Despite the language barrier I found myself quite comfortable. Having spent hours, days, months in the medical wards in San Diego; the medical wards in San Jose felt like home. Every medical presentation, regardless of the country or language, has the same structure. In many ways medicine is an international language. Human ailments affect us all.
On Thursday we read through blood smears and bone marrow aspirates of patients that required a diagnosis. She spent hours helping me to identify neutrophils, eosinophils, erythrocytes, etc (a skill I never quite became an expert in during my MS2 pathology course). I really appreciated her patience with me. I learned so much about hematology and the Costa Rican health care system (Seguro Social) during the week. I will miss working with Doctora Acon!
Last week, I had the opportunity to work with Doctor Chinchilla at La Clínica de Pavas. Doctor Chinchilla is a General Practitioner. He treats patients for chronic illnesses such as Diabetes, Hypertension, and completes their annual check-ups. During my week with Doctor Chinchilla, we completed home visits for patients with dementia. The home visits are paid for through Seguro Social. Over 4 hours, we visited 12 patients across San Jose. Many of the patients were non-verbal due to the impact of their Fronto-temporal dementia, Alzheimer’s dementia, and Lewy Body dementia. Home visits allow these patients to receive high quality care without forcing them to undergo challenging transportation to clinics.
As an economics major with a passion for learning about health systems, I am always interested in learning about the systems that exist in countries that I visit. Costa Rica has a national health system, Seguro Social. Seguro Social was developed in 1948. Seguro Social provides free health care for the entire population (paid for through taxes). This was made possible due to the fact that Costa Rica disbanded their military in 1949, significantly reducing costs. Seguro Social is considered by the UN to be among the top 20 health care systems in the world (higher than the US health system) and #1 in Latin America. It’s been wonderful to learn about Seguro Social over the last 2 weeks. I hope to bring some of the ideas from Seguro Social back to the United States. There is a lot to learn from their efficiency, universal access, and preventative care.
One of my main goals for these 4 weeks is to improve my Spanish skills. After 7 years of Spanish education in middle school and high school, I haven’t used my Spanish in years. Every time I saw a Spanish speaking patient in San Diego, I would be so scared that I would make a mistake with my Spanish that I wouldn’t even try. One of the biggest areas I have been working on is my fear of failure. Fear of failure held me back from speaking Spanish in the past, but it will not in the future. I know I will need a translator for the majority of my patient interview, but I hope to be able to greet all my patients and ask basic questions in their native language.
Vera, my host mom, has had the largest impact on my Spanish during my trip. We only speak in Spanish in the house. She teaches me new words everyday. We talk about life, differences and similarities between the US and Costa Rica, food, travel, and our family. She makes the best food. For breakfast everyday, we have fresh fruit, gallo pinto, omelets, and Costa Rican Coffee (which really is the best). I look forward to our meals together when we catch-up on the day! She was kind enough to take me on a trip to Cartago, a city relatively close to San Jose, where we visited Basílica de Nuestra Señora de Los Ángeles.
After 2 weeks, I had the opportunity to be a tourist for a day. UNIBE organized a trip for me to the Poas Volcano, Doka Coffee Plantation, and La Paz Waterfalls. I had to remember how to speak English. I traveled with 15 other tourists up into the mountains around the Central Valley. I loved learning about coffee production, the crop that put Costa Rica on the international map in the 1800s. I had the opportunity to see the Poas Volcano, one of many volcanoes in Costa Rica. The rich soils allow for the cultivation of delicious fruits and vegetables along its slopes. The strawberries they grow are some of the best I have ever had. My favorite part of the trip was La Paz Waterfalls, which were breathtaking. If you ever visit Costa Rica, I highly recommend a trip to see these beautiful waterfalls in the middle of the jungle!
Well that’s it for now. I’ll check back in 2 weeks after I finish my final rotation of medical school. ¡Hasta luego!
