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Letters (Continued)

Continued from the previous page.

Fine by me. I took advantage of the opportunity to delve into the mess of papers, boxes, old file cabinets and such that were all piled up in the far front corner of the clinic.

Elmer, Edgardo, and Sulmira all pitched in and did a tremendous amount of cleaning, hauling out piles of dust, dirt, cucaracha and other insect droppings, spider webs, and general grime, and I sorted through many years’ worth of papers. I am keeping all the patient registers, and our statistical reporting, and all the weekly reports that show cases of malaria, poisonous snakebite, dengue, and other diseases of interest; but I tossed all the weekly reports that were empty of reportable illnesses.

Port I also gathered together the notes on the patients who have died at the clinic over the years, and they are thought-provoking. I find to my gratification that my notes are pretty thorough, and that I can reconstruct the cases as they happened. There was the young man who died of what might (or might not) have been yellow fever, or if not that, then some other nasty virus. There were the two children, many years ago, from the same family who died within hours of each other, cause never to be known. And there were many notes on very young patients who arrived in the nighttime hours with respiratory and/or diarrheal illnesses, with my grim midnight assessments, followed by the notation in the morning that they had in fact not survived to daylight. What was intriguing to note was that there were many more of these patients in the 1990’s than we have now, which suggests that perhaps progress is being made, after all.

This progress is of course not solely due to the Clinica Yanamono. There is better access to other medical care than there used to be, there is better and faster transport, there are more children who have been vaccinated, etc. But I like to think that we play a part, and that is a very encouraging thought.

Then, a 34 year old woman came in, new to the clinic, who said she had been hospitalized in Iquitos for pneumonia, and was still feeling run down. She had fortunately brought her records with her, and when I looked them over, there was no mention of antibiotics being given, which was odd, for someone with pneumonia. But a chest x-ray had been taken, and she had that with her, too, and by gum, she has a huge cyst, a big balloon partially filled with liquid, in one lung.

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