It is an interesting thing reflecting on the nature of care I saw in Guyana. I found myself struggling to keep up with state of the art techniques while practicing in a setting having to comply with the status quo. My favorite mental exercise while practicing down in this resource poor environment was “what drug can I give this patient today”. So much of the time in the States the answer is fairly easy and has a protocol behind it. Often the hospital in Georgetown would run out of a typically used drug, which forced me to stop and think. I feel this made me a better physician.

Again, I would like to compliment the practitioners. All too often they would come ask my advice on certain pathology and they knew more about it than I did. Yet, when I spoke, they took my advice humbly. This was quite refreshing to work with very intelligent individuals who are eager to learn and willing to absorb constructive criticism.

Lastly, I find it necessary to reflect on the patient population. In my world, one of a major academic institution, patients are often upset if they do not get a private room in the ED. In Guyana patients who have strokes, sepsis, COPD exacerbations and much more would be moved from beds to chairs frequently to make space for examination of others.

This hospital has very sick patients, and a lot of them. I am not sure what I expected, but it has surpassed my expectations in acuity. With a limited supply of gloves, radiology abilities and only one ventilator, I would expect nothing but turmoil. Fortunately, the system (albeit with a few hiccups) works for them. It is a very well orchestrated chaos. Additionally, the patients are incredibly kind. Some wait around for hours to receive basic laboratory studies and they will always greet you with a smile. I am thankful for this.

I would like to personally thank the Guyanese people, Residents and Hope Through Healing Hands for allowing me this eye opening opportunity.