Sweat

Fall is truly here. Friday was the first rainy day we have had since we’ve been here. Throughout the summer we had a few thunderstorms; dark clouds rolled in announced by thunderous cracks followed by flashing bursts of light. Heavy rain might shower down for 15 minutes or so but never any longer than 30 minutes. In contrast, the Friday sky was grey and cloudy all day and reminded me of the beautiful fall weather back home that makes you want to curl up by a fire with a good book and a cup of hot chocolate.

After a few hours of training at school (we’ve been learning self-defense and use of force to defuse violent situations by a former cop. I thought it was going to be a class that would teach us methods of de-escalation (i.e. non-violent forms like mediation) to defuse tension, which in my perspective would have been more helpful. Instead the course was geared towards those situations you avoid where a student resorts to violence. At times this may happen, and has happened to various degrees, in the school here. Remember, these kids come from damaged homes where physical violence or at least verbal abuse is common. Often, our students may not learn the healthy forms of self expression we all take for granted. In some ways, this class was a direct consequence of Columbine, and the factors that contributed. In that sense, it is important. Also, knives and guns are very common in the rural Montana culture because the majority of people hunt-and usually to put food on the table. I am not trying to make a moral judgment of that culture in any way. However, I think the majority of our time and effort, including our training, should focus on what we do during 99.9% of our work hours, if not 100% of the time on the job: Creating an environment where kids learn healthy, non-violent ways to deal with intra- and inter-personal conflict, stress, and emotion. We need to set our students up to make the good decision, so they do not feel they have to resort to a situation where violence is necessary.) Anyways, enough about that… So once again, we journeyed to Billings to run errands, shop for groceries and to pick up Meredith’s Mom, Diane, and her friend, Carol, for the weekend. The entire time it drizzled and we had a cozy drive in to town.

On Sunday, we went trail riding for a few hours. I had so much fun-it was one of the best things we’ve done so far, and I could not get over how beautiful the country is-the Cottonwood leaves were dressed in their Autumn best-shades of orange, yellow, red, green and brown, and the green pines stood out against the golden wild grasses. We climbed a bluff West of the school to a beautiful lookout where you could see both valleys stretching out below. To our East you could make out the Tongue River, snaking its way below, lined with blooming Cotton woods, and to the West the golden valley floor stretched for miles and miles until it reached a “mountain range” in the distance (the mountains in SE Montana rise like the foothills in Washington). My horse, named Max, was a little antsy, so when I first got on he was a littler ornery and didn’t want to listen to directions. He trotted off in all different directions and I had to really rein him in. But, this just got my blood pumping and made the experience a little more fun. Most of my housemates had never ridden before, though one of them is a pretty experienced rider. She and I would hold back occasionally, giving our horses plenty of space to take off and trot or lope for a bit. It tried our horses’ patience, but I hope they also had fun getting a little speed. We both also offered to help out around the rancher’s place, take care of his horses, and even ride them (hint, hint… ;) ) if need be. He thought he could find some work for us, so hopefully there will be more riding in the future!

Richard Tallbull took us to Medicine Rock on Saturday and also coordinated the trail riding the following day. Richard is a Southern Cheyenne Indian who was born and raised in Oklahoma by white parents and Indian grandparents. As such, he did not really learn about Cheyenne culture until he moved out to Montana and the Northern Cheyenne reservation. Since then, he has learned the language, culture and history of the Cheyenne people. Medicine Rock is the site of numerous pictographs, pictures and symbols left behind by Indians who lived near here or passed through the area. Richard showed us all number of animals: elk, deer, bear, turtles and lizards, human people, teepees, medicine bags and other symbols. The tribal identities of human figures are differentiated so that Cheyenne are distinct from Arapahos, women are distinguished from men, and holy men from warriors. One of the more “famous” pictographs on Medicine rock is the depiction of a vision Sitting Bull had at a Sun Dance ceremony before the Battle of Little Bighorn: “Soldiers and some Indians on horseback coming down like grasshoppers, with their heads down and their hats falling off. They were falling right into [their] camp.” Sitting Bull interpreted this as a sign of success in the ensuing Battle of the Little Bighorn, Custer’s Last Stand.

Richard has also invited us to participate in sweats in the local community. Sweat lodges have been used in numerous cultures throughout history. When I traveled in the NW highlands of Guatemala two summers ago, I saw concrete and earthen sweat lodges used by the indigenous people. In contrast to the Plains Indians, it is my understanding that the Guatemalan people use their lodges to relieve pain, hitting themselves with reeds in sore areas. The sweat lodges of the Native American people are places of prayer, chapels of God’s creation close to Mother Earth.

Richard estimated that sweats have been around since the 16th century. The lodges, where the sweats take place, are round domes made of willow branches lashed together and covered with some type of insulated material. Historically, sweats were only used by medicine men; these ceremonial sweats, as Richard calls them are much smaller, fitting only a few men. They are still in use today, “off in the hills” for certain ceremonial purposes. Often, these spiritual men pray for the tribe or the needs of certain individuals. With time the modern co-ed sweat evolved for warriors who desired a place to pray before heading out on a war party. The young man’s sweat, as Richard commonly refers to it, is much larger (fitting 12-15 individuals if everyone slides in together) and is a place for all to pray: men, women, young old, Indian, white and everyone in between. It has been a very special privilege for me to attend the sweat that Ernie and Mary Jane Robinson put on every Sunday. Mary Jane is a teacher at St. Labre and Ernie works at the Cheyenne tribal housing authority.

Historically, sweat lodges were covered with buckskin. The Robinson’s sweat lodge is covered by large blankets and comforters and the dirt ground is lined with carpet. Everyone sits around the edge of a three foot pit that is dug in the center. The hosts of the sweat sit near the front door that faces to the East and the women sit on the Southern side. Going around the circle, the men sit on the Northern side, and any holy men sit on the other side of the Eastern door, along with the rock man. The rock man uses a pitchfork to gather large lava rocks that have been heated for a few hours in the fire and brings them in the center pit before each of the four ‘rounds.’ The rocks are called the Grandfathers, because they are so old, too old to really know their age, born long before any of us. Ernie reminds us that they will also live long after us, part of the Maheyote’s (God) creation. Each of the four parts of the circle (the hosts, the women, the men, the holy men and rock man) takes a round to pray. One may thank and pray for the host, the rock man, those who helped to prepare the sweat (chopping wood, gathering rocks, etc.) or prepared food for the potluck afterwards. One may also pray for their own needs and special intentions.

I have found this experience to be so special. Whatever is said at the sweat remains in that circle, and MJ often reminds us that the rocks are so old that they have experienced more than anything we will tell them and so we should not have fear. A deep sense of community is created as people bring their vulnerable selves-sharing their needs and brokenness, as much or little of their humanness as they choose to. Cedar is sprinkled on the rocks, emitting a fragrant smoke for everyone to bless themselves and the doors are pulled shut, sending everyone into complete darkness. The men lead the prayer songs, shaking a gourd to keep time and singing in their native language as the women sing along, while members of the circle give their pray aloud, or in silence, whatever they desire.

The heat reaches higher than any sauna I have ever been into. We estimated the temperature from 125-130º. (On a side note: I know you’re probably thinking, “Is this safe?” This is spiritual practice that has been around for hundreds of years. In fact, it is believed the Native people even used sweating as a form of medicine; I read somewhere that bacteria and viruses cannot survive at a temperature much higher than our internal body temp. The organic ingenuity, the practice of sustainable practices (like the respect for Salmon that causes Indian to return the filleted body to the streams, enriching the forest and stream beds with important nutrients) or medical knowledge they have accumulated, of Native cultures continues to astound me.

Richard has often reminded me to pay attention to what we are here for in the sweat, to our prayers and to whom we are praying to, God. I have found this focus on my prayers or the music helps to make the heat more bearable during the 6-10 minute round. My first time in the dark and music of the sweat was a surreal, almost psychedelic experience. The stark contrast of complete darkness shocked my body as I began to feel the extreme heat waves flow over my body. Then, the music began; songs that sounded as if they had been around from the beginning of creation, in a language that was as organic as the rocks in the center of the pit, the gourd shaking moving these prayers out of our bodies as the sweat ran down our skin. I found my head starting to spin from the sensory overload and I had to close my eyes (most of the time now I sweat with my eyes closed), and focus on the rhythm of the music so I would not pass out. The heat feels much less harsh after 3 weeks of sweating and in a way, is therapeutic. Every sweat is different. Sometimes the rounds are longer, sometimes the heat is more intense as an entire bucket of water is poured over the rocks. Richard tells me that for him, certain sweats may be draining if not everyone is singing and he feels like he has to sustain the entire circle for four rounds. I can very much see how that could be, and am very grateful for those who sustain the sweats-Richard, MJ and Ernie- though for me (and this is part of why I am so grateful), every sweat rejuvenates me and heals me. They say the sweat exiting our pores is the poison and bad spirits leaving our body and soul. I find this to be very true, similar to how a good run or workout can rejuvenate you mentally and emotionally, though I do not diminish the spiritual importance of the sweat.

Again, I just have to say how grateful I am for the invitation to this community-the sweats, the culture, the lives of this people.

Tragedy and Hope

Miercoles, 22 Julio 2009

Today was my first day at the clinic in about a week. When I got there, I learned that yesterday there had been a birth in the clinic. The mother had come in very weak. The baby was born feet first and the mother had no strength to push it out. One doctor had to pull on the baby’s legs while a nurse had to apply pressure to the mother’s stomach. The baby was born asphyxiated and purple. It took 4 or 5 minutes before they could get the baby to start breathing. (Lack of oxygen for this long causes serious brain damage that affects one for the rest of their life; from learning to walk to performing in the classroom.) This morning the little girl had a fever (around 39 ºC) when I came in, and after nursing a bottle of warm, purified water (the family couldn’t afford milk) she began to vomit it all back up, a brown mucus along with little bits of blood. We had to put a tube down her throat to her stomach to help siphon out the fluid because she didn’t have the strength to cough it all up. The doctors believe she has an infection from inhaling some of her feces as she was born (hence the brown color…) She fought the fever all day and at times the antibiotics quieted her crying. But, before the end of the day the fever came back and the poor little girl was burning up. The family decided they are going to take her home, while the doctors want her to stay or even go to a hospital. Part of the family’s wish may have to do with money. Dr. Rivas had no idea if the family was going to be able to pay for the medicine and treatment they had received over the past two days. (He also told me that at some clinics, they don’t let the patients leave until the bills are paid. This is not the case at the Clinica Bethesda; his first concern is the well-being of the patient. He figured the Clinica Bethesda has lost 3-4 million quetzals over the past 2-3 years from patients who have not been able to pay. Because of this, the clinic cannot buy the equipment they would like to or improve the clinic as fast They are currently constructing a new operating room, X-ray room, and lab room; the expected completion date is pretty far away.) It is expected that the baby girl will die without the medical care she needs as she has not been able to quit the fever, a sign of the infection she has. As I left the clinic tonight, I saw the father outside waiting to take her home.

While much of my blog has been touched by striking stories of poverty and hardship, there are two stories I wish to share that capture the hope that I have seen (which I also hope has been evident in my reaction to HFPF’s work.) Today I had lunch with a 10 year-old boy named Marcos. Every weekend, Marcos works on the street shining shoes to support his family. He used to do this every day until a woman came down with an HFPF group. While I don’t the name of this woman I do know she changed his life. After asking why he was out on the street and not in school and learning of his story, she ensured a fund was set up so that Marcos could go to school. This fund provides for his uniform, school supplies, and buys him lunch every weekday. We got ice cream after lunch and Marcos told me that he likes school; he eventually wants to go to college to read and ultimately become a professor or teacher.

On our journey to Barillas from Guate, Marco and I stopped along the way at a small aldea. We got out of the car and walked down a muddy path between two houses to get to the residence of Don Sebastian. Don Sebastian is a talented artisan wood carver. When he was young he had some sort of accident or illness and he can no longer walk. Still, through his beautiful craftsmanship and hard work he has put all 5 of his children through school and 3 are teachers. Don Sebastian is a great big man with a soft face and eyes that twinkle when he smiles. His giant hands lovingly carve beautiful figures of the Guatemalan people, capturing their struggle. A woman carrying water on her back or her head, a man hauling a huge load of firewood, a young girl carrying her little sister, wrapped in a shawl on her back.

Today I saw a woman give birth...

Martes 7 Julio 2009

Today I saw a woman give birth. Rather, I saw a doctor pull a baby from a woman’s stomach by means of a Caesarian section surgery. This is basically what happens. I never really understood what a C-section was until now, though I knew it involved some type of surgery and a cut related to an abnormal birth.

Well, Doctor Gonzalez got a call (I’m guessing from the Center for Public Health in Barillas. They’re funded by the government, but don’t really have the capacity to do a whole lot so they outsource most of their patients. They had to refer another woman to Dr. Gonzalez last week because they don’t even have an ultrasound) today to expect a woman needing a C section. She arrived around 11:30 and was wheeled in on a stretcher to one of the examination rooms (aka the doctor’s office. There was another patient in there at the time, but they were escorted out after their prescriptions were filled out. Only one of the two examination rooms/doctor’s offices are large enough for the stretcher) where her blood pressure was checked, Dr. Gonzalez listened to the heart beat of the baby (Remember how I said 135 was normal for the womb, but high for a born person? Well this baby’s heart rate was 150.), and examined her vagina. He found that the umbilical cord was starting to come out, which is not a good sign. He then had me put on a glove so I could also palpate the umbilical cord and understand what was happening. The reason the placement is so dangerous is because if the baby comes out of the birth canal umbilical cord first, the cord can wrap around the head or stomach of the baby and it can suffocate to death. A normal birth is head first, feet first, or knees first. So, with the consent of her husband we prepared for surgery. There is a clean, surgery room in an outbuilding to the clinic. Outside the surgery room in small closet-like space, we robed up with pants, shirt, cap, mask, and shoe covering for me. The two doctors (including Dr. Arribas, the other clinic doctor who had returned from a short vacation/descanso) had other, surgery shoes. Once in the surgery room, the future mother was hooked up to a machine to record her blood pressure and pulse. Her blood pressure was about 150 over 100 or 120. I asked if this was a bad thing (normal blood pressure is 120/80, though here the norm is higher due to the geneology-140/90) Dr. Gonzalez said no, it would lower after they started surgery and some pressure was released. However, it is bad if the pressure is too low, that is when the mother can bleed to death. Her pulse was also very high, 80 or 90, I think? The surgery site (her abdomen, just below the belly button) was cleaned and prepped for surgery-covered with multiple cloths to make the clean-up process easier. And the doctors and their assisting nurse (Dr. Gonzalez’s wife) washed and robed up with sterile robes and gloves. Gonzalez informed me that this surgery (c-section) is usually not performed in Guatemala because of the lack of supplies or technicians (such an anaesthesiologists), but because of his specialty (he’s specialized in surgery in medical school) they could perform the operation.

So, away they cut going from the epidermal layer (skin) past two inches of cellulose (fast) into the gastrointestinal cavity (where all the major organs lie-we saw the small intestine, large intestine (stomach), as well as a small organ they called the trompa? (I didn’t quite understand what it was or did, but it was somehow related to the duodenum, I think. All this is in Spanish, so I didn’t always catch everything.) Then, Dr. Gonzalez cut into the placenta and the blood started gushing. The placenta is rich in blood and nutrients for the growth of the baby. Next, he stuck his hand inside the placenta, fished around a little bit, and with one hand pulled out a baby by its head. He then turned it upside down like a trader showing off a rabbit he had hunted (a strange metaphor, I know, but it really captured how he was holding the baby) patted it a few times on the back until it started to cry. He then took a little suction bulb to pull some liquid from the baby’s nose and throat, to clear the airways. Then he handed the baby off to the nurse like a football and she continued to “work-up” (for lack of a better word) the baby, cleaning her, pulling more liquid from her nose and throat until she produced a nice, healthy cry. The doctors then pulled the placenta from the woman’s stomach and further cleansed the uterus. After sufficient cleaning, mostly by means of suction, they stitched up the uterus cleaned the gastrointestinal cavity some more, and stitched up the stomach lining and skin over the mother’s stomach.

Overall, the entire procedure took about an hour, and just twenty minutes to extract the baby girl. There were a few complications as the woman’s blood pressure would often rise to high and they would have to administer medication then wait for it to act before proceeding. The mother was 35 years old and was having her first child. She had not been in to see a doctor, have an ultrasound, and hadn’t been taking pre-natal vitamins or folic acid, which are very important to the success of a healthy pregnancy. So, the placenta hadn’t attached well to the uterine wall causing insufficient blood flow to the baby. The woman’s poor health contributed to a condition they called “preeclampsia.” I don’t know exactly what it is (symptoms-high blood pressure, swollen ankles…), I couldn’t find it in a LARGE medical dictionary, so while it sounds familiar, I guess it translates into something completely different in English. Then, later in the surgery her heart rate greatly fell and she had stomach fluid come up through her throat. Then, her heart rate started to skyrocket (because I’m guessing she couldn’t breathe). This had something to do with a reaction to the surgery and may also be related to what they called “eclampsia.” (I have a little research to do when I get back) In the end, everything went okay and both the mother and baby girl are fine, but there were a few complications either because the family didn’t have access to the necessary basic medical attention prior to the birth, or couldn’t afford it, or didn’t know/think visiting the doctor during the pregnancy was necessary. Possibly all three could have been true.

Just call me Dr. House...

I haven't exactly been able to post my thoughts as I write them. This is from yesterday.

Jueves 2 Julio 2009

It’s 7:30 at night now. Because I’m not too tired I think I will try and give a brief description of the Mission House, my experience the last few days in the clinic, and the other things I’ve been doing. I feel like every day thus far, I have woken up with the sun and have been busy until I am serenaded to sleep by the music pouring from the Taberna across the street. What great neighbors! Good thing I have earplugs…

First, I’ll go over Barillas. It’s a town of about 6-8 thousand people apparently, though it doesn’t seem like it at all. There is a elementary school, high school, a few clinics and doctors, and a public health office (also functions as a clinic). There is the main road into Barillas which is lined with both houses and businesses. Often, one building serves both purposes. I bet somewhere along this avenida one could serve whatever interest they had: food, auto repair, supermarket, ice cream, clinic, police station, army outpost and ferreria (bus stop, really more of a bus hub; the sidewalks are usually lined with people waiting for a bus, van, or pick-up truck to somewhere. Many of these people are indigenous Indians that have come into Barillas to pick up something, see the doctor, etc. There are over 250 aldeas (small towns or villages) that surround the vicinity of Barillas. And many still wear the “traje tradicional,” the traditional dress complete with hair wrap, long skirt, belt and shirt. It is not uncommon to see someone carrying a baby wrapped in a large piece of fabric and slung around their back, balancing water or food on their head, or hauling a bag of good on their back or strapped to their forehead. The fabric of the traje tradicional is brightly colored with beautiful patters.). There are also a few busy streets that branch off from the main street that are filled with restaurants and stores. I don’t think any of the streets have names and if they do I haven’t seen any street signs to identify them. There is an open air market about 5 blocks off the main drag which is surrounded by many stands selling clothing, toys, food, etc. And business is certainly not constrained to any official store building. Many houses blocks from other business centers sell firewood, homemade ice cream, and more.

The Mission House, where I am staying, is just 4 blocks from the main square-park, Centro Municipal (town center, I don’t know exactly what goes on there, probably tax and business information, but this morning there was a long line to get in) and ferreria. And like I said, there is a tavern kitty corner to the house. Today I explored the furthest into Barillas that I have been to find a restaurant that brought food to a Rotary meeting I was at last night. I only knew its location because when a family drove me home in the pitch black night during a HEAVY rain storm and we stopped on the way to pay. I was lucky though because I walked past the President of the Rotary club and his wife, who let me know I was a block off and a few blocks past the restaurant. The food hasn’t been that great at the restaurant I am at, my waitresses cold has been a little unsettling and I just couldn’t finish the breakfast yesterday morning so I needed a change of scenery. I had ordered fried and breaded chicken breast, what I think was a lunch dish, and it came with cold beans and rice. Furthermore, the hot milk in my cereal (similar to the sweet milk in the mush) seemed overcooked and the coffee tasted a little off. Usually I am fine with meals in foreign countries, but this meal was just a little too foreign. But, enough about food…

For the past three days I have been working with Dr. Guillermo Gonzalez. Gonzalez lived in El Salvador but was born in Guatemala. He is now married to a woman of indigenous blood. Today we went to his clinic in San Mateo, a neighboring town about an hour drive on the dirt road out of Barillas, and stopped at her family’s house on the way back. While his wife wears no indigenous dress and speaks both Spanish and Q’anjob’al , the local indigenous language, everyone in her family over the age of 12 wears the colorful indigenous dress and speaks mostly Q’anjob’al. This also happened to be all women, the men and older boys were out working. I have noticed at least in Barillas that the indigenous dress is mostly conserved by the women. The characteristic indigenous, Guatemalan outfit for a man consists of a cowboy hat, and colorful (though less so than for women) cowboy outfit. I have seen the hats on many men, but not so much the rest of the traje. I began in the clinic on Tuesday (we spent all Monday traveling) at 8 am and worked until noonish. It was a ferriadia (sp?), a holiday for banks and schools and the clinic was only open half the day. Dr. Gonzalez works in two clinics in Barillas and we even drove between the two to see different patients. The clinic founded by Dr. Aller and HFPF is called Clinica Medica Bethesda. It’s a pretty large operation for such a small town. Gonzalez has two nurses, one indigenous woman who has translated for one patient who knew absolutely no Spanish. This was a surprise for Dr. Gonzalez, but there was more translation needed in San Mateo today; the people there speak Chuj. Gonzalez has hired a woman of indigenous decent in San Mateo to help, but his wife can also translate ads Chuj and Q’anjob’al are somewhat similar. There is also a young lab technician who runs all the tests in a room down the hall. He is equipped with pretty basic equipment, a microscope, centrifuge, microcentrifuge, test tubes and pipets, and a handful of commercial tests, dies, and chemicals.

Most indigenous patients have come in with some sort of gastrointestinal infection accompanies other pain that is the real cause of their visit. For example, one woman today had pain in her forehead, especially when she looked at the light, felt a little dizzy at times, and a cough with phlegm. But, upon palpation she also had pain in her stomach and a positive urine sample confirmed a stomach bacteria. There have been a few pregnant women who have had ultrasounds which I have watched. It is so neat, wonderful, and amazing to see another human being living inside of a woman and see its heart beat; and then to measure their head and femur to figure out how old the baby is and when the projected date of birth will be is astounding! After performing the ultrasound on one patient Dr. Gonzalez used a tool (I forget what it is called-it uses radio waves) to project the heart beat, which I then counted as a check of normal heart size and growth development. 137 beats/minute, wow! It sounds really high, but don’t worry, babies have higher heart rates. (There was an interesting case yesterday- a women 29 weeks pregnant, who was bleeding and have slight contractions. Gonzalez prescribed medication to slow both in hopes that the baby would have more time to develop. Babies born before the 36-37 week normally don't live and before the 40th week are considered premie. All of their organs are underdeveloped and they haven't had the proper time to grow and strengthen. The woman will return in a few days. I hope the drugs work...)I was able to watch an electrocardiogram of an overweight man, not common in Barillas at all, which measured the electric activity of his heart. For this procedure, the nurse attached cuffs to his wrists and ankles and then 6 metal electrodes around his heart. Then, Gonzalez analyzed the results and showed me where the indicated block occurred in the heart beat image. I have been able to watch a lot; consultations by Dr. Gonzalez, lab procedures, other examinations and even been able to check some blood pressures and pulses and listen to a few irregular breathing sounds in patients’ lungs and see a few ear infections. It's very interesting to see the entire medcal procedure all happen in one place, from consultation to medical administration and prescription "pick-ups." I can actually see the tests occur that confirm whatever diagnosis Gonzalez determines from his examines. (The eliminated wait time is very helpful for this. He can order a urine test for H. pylori, a common intestinal bacteria and have the results in 15 minutes. It is also very interesting to see globalization at work. The clinic does not have sufficient supplies or the latest models of equipment because it is things can be so expensize. The lab techinician may wear the same set of thin, latex gloves all day, and today (Friday) the nurses inserted an IV and none of them wore gloves to do it. However, drug companies have been able to make simple and expedient, one-time use tests for things like H. pylori, E. Coli and AIDS that they use here in the clinic. Today, Friday, there was a SIDA test. Thankfully it was negative!) Dr. Gonzalez also takes care to explain everything he’s doing, why he’s doing it (what symptoms he’s checking for and how he does this, why it might lead to a certain diagnosis), what drugs he’s prescribing, why and what they do. He’s even had me read through a large dictionary of pharmaceuticals that contains the indications for why one might prescribe a certain medicine, what drugs it contains (if multiple), what it does and side-effects. It has been a very FULL experience. The one challenge has been that it has all been in Spanish and much of it that I don’t understand, because of lack of Spanish medical terminology, a limited Spanish vocabulary, of just handling a conversation. The hardest part is that many Spanish medically related words don’t translate to similar sounding English words, and I don’t have an in-depth Spanish-English medical dictionary. Still, because of my past exposure to medicine, medical and scientific procedure, and limited medical and scientific education I understand for the most part what is going on.

Today was an especially interesting day. Usually the clinic in Barillas opens at 8am, but today we left at 7am for San Mateo. We drove into town and parked at the edge of a stretch of market, right next to a crowd of people. It wasn’t until we got up to the clinic and looked down from the porch that Dr. Gonzalez explained that the well dressed man in the center of the circle was selling some yellow solution (probably a mixture of water and oil) as a cure-all medicine for ailments commonly endured by the indigenous people, skin irritations and other infections. A complete scam. As it was early and no patients had arrived yet, we walked down between a few buildings and through the rest of the market where you could find fruit, vegetables, spices, clothes, baskets, toys and more, to an old, old Catholic church. The architecture was not spectacular, but I wish I had gone inside to see what the church held as it was so old. Outside there was a metal cross mounted upon a large (about 10 feet tall) metal stove with open sections about stomach height. A older couple was adding some sort of oil or grass to the fire as a form of prayer. I don’t think it was exactly Mayan, but there are still some people who practice Mayan rituals in and just outside Catholic churches. As Gonzalez said, the conquistadors came with the metal armor and swords and if you didn’t convert you were killed, but the result was a somewhat intertwined faith at times. Now, there is an evangelical Christian movement sweeping the country. Gonzalez also pointed out a overgrown area of grassy mounds a few blocks away that he said were Mayan ruins that the people have not protected from all foreign exposure and exploration, archaeologists and anthropologists. It would have been cool to see up close… Still, Gonzalez also told me the hills in the area have gold and showed me proof at his house which I could swear is fool’s gold (though I didn’t question it openly). Still, he may be right. Above all, I wish I had brought my camera as the scenes were beautiful and would have made captivating photos. Maybe another time…

That’s all for now.

Spanish word of the day: ear of corn=elote
Q’anjob’al word of the day: Ish-sman=man Ish-sall=woman