This is Nicole again! Dr. Monica was nice enough to clear everything up with Estomatologia and introduce me to the chief in that department, Dr. Bruno. It is like dentistry back at home because it is dealing with the diseases of the mouth, but they have not had dental schools until very recently so typically the oral surgeons in the hospital have a medical degree and then specialized in estomatologia. I have grasped some things on the first day:
They do tooth removals, occasionally they go to surgery to remove small tumors in the mouth, but mostly tooth removals are done unless they are young then they will try to root canal, but I did not see any root canals today. The dentist has a separate clinic to fit prosthetics and do things that don’t have to be done in a hospital.
Particularly the poor Portuguese people do not give much of any attention to their oral health. The first patient we saw when I arrived had to have his last three teeth removed, and they were almost all black. One tooth cracked in half with the slightest pressure of the pliers. The one man who came in with almost perfect white teeth was such a breath of fresh air, and he only had problems with his bite that the doctor was able to help him with.
Dr. Bruno has to compensate for general neglect in this area in the hospital. The nurses are busy in other parts of the hospital most of the time. For at least an hour, one oral surgeon not only managed two patients in two rooms at once, but had to do all the cleaning up as he went. I was so happy that I had already observed surgery for two days last week, because he asked me to take some wrapped sterile tools and compressors and open them onto the table which they do a lot of in surgery! Dr. Bruno said that pretty soon I’ll know where everything is and I can prepare the table for him. I’m not studying to become a nurse, but this is a step up from putting sticky labels of patient information on exam request sheets like I did for Dr. Mónica! What was strange was that he told me not to take the trash on the floor and put it in the trash can because he said he knew how this hospital works and you need to leave something for people to do. He said you always have to have a plan B as well. One of the off buttons is broken on a tool he wasn’t using, so he sticks a piece of gauze into it to stop it. Also a cabinet door won’t stay open so he uses a shoelace and ties it cleverly around another handle of the cabinet next to it to hold it open, and some lab coats are hung on handles of water pipes sticking out of the wall instead of their personal lockers which are filled to the brim of papers.
Aside from what may or may not be areas of improvement, the highlight of my day is all the operations I get to see. I love all the teeth extractions so much that when the doctors asked me if I’d be back on Monday, it didn’t even occur to me that I should be shadowing another department. I felt, and still feel as I am writing this, very comfortable in this area not only because it is more focused and small, but I am actually more fascinated with techniques with pulling teeth than anything else I've seen aside from surgery. When the doctors are doing paperwork or typing reports with two fingers (which I can't help but laugh at to myself because I'm a computer science major and I also want to tell the doctor that hitting the computer is not the proper way to wake it up after it went to sleep), I enjoy sitting and reading the dentistry books they have written in English. I feel at home.
The kind of care is also a lot less stressful. In cardiology, for example, I was not very happy treating a typical elderly patient who was very, very fragile. The doctor described to me if you do one thing, this level goes higher, but if you do another thing, her blood pressure is too low or high, and the list goes on and on. I’m usually empowered by a challenge, but something about keeping such an old person alive for so long sitting in the same bed, attached to machines keeping them alive, and staring at hospital walls messes with my morals. I’m sure it’s just the beginning of an ongoing question I’ll have for a long time.
No comments:
Post a Comment