Wait, Did we just drive over the Rio Grande???

Every morning I look to my left and there is the amazing Atlantic.  I am about one week into my rotation, and I've now been to the Annotto Bay and Port Antonio Hospitals.  The commute from the resort to Port Antonio is about two hours, I can't tell you for certain because I was completely distracted as we were driving through the rain forest.  Crazy lush foliage going up hills/mountains, crossing over the Rio Grande and the Atlantic Ocean is pretty much always just over your left shoulder. This is all in a day's commute.  Mr. Campbell,who is one of the adminstrators at Port Antonio, drove me on Friday I used this time during the commute to learn about the quality of life in Jamaica from education to shopping to roads. 

Once at Port Antonio, I had a chance to visit their Pedi Wards.  They are set up differently than ours in the US but they utilize what all of the resources are available.  There is definitely a need present.  Their facilities have relied on a lot of international donations, I am at total a 4hr flight from home and technically Hawaii or California is further but the difference in resources is night and day, Seeing how they are functioning on minimal resources(no code cart, limited number of nebulizer machines(like 2), no cardiac monitoring or unreliable pulse oximetry).   I never thought I'd actually be recommending the use of oral Albuterol, but the need forces your hand.  It forces you to rely on clinical judgment which I guess is why its the practice of medicine.

A common theme, seen both in the US and here in Jamaica, is the difficulty in chronic care management of our children with cerebral palsy and what to do when families become overburdened with their care.  I had a good discussion with Dr. Barrett about how best to optimize their care with simple interventions such as benzos and stretching to improve spasticity to increase their ease of care.  

Life back at Couples is fantastic, the staff is amazing.  It is the weekend, so I have tons of free time.  Between just enjoying the sun so far today I've been kayaking and sailing on a "Hobie" in the Atlantic.   I am pacing myself because all of these water adventures occur between delicious meal times and sunbathing.  Well cocoa bread is calling me and there is still some sun left, I will tell you guys more later.