As I prepared for my trip to Bolivia, I thought a lot about the weird and wonderful medical conditions and health problems I would encounter. What would it feel like to come across my first case of Chagas’ disease? How would I deal with the causes of typhoid? Would I remember to think about rheumatic fever as a differential diagnosis? I also knew that I would need to spend a large proportion of my time in rural outreach clinics talking to the people about the importance of sanitation, safe water supply and other simple health issues in general.
For the first few weeks of my year in Bolivia, I am living in the large city of Cochabamba, having Spanish classes in a language school. The school has a list of families with whom students lodge during their time here. I am staying with a delightful old couple. Being a perceptive young doctor(!!!) I quickly noticed the shuffling gait and uncontrolled tremor of the Father identifying his advanced Parkinson’s Disease. I also couldn’t help but notice the Mother occasionally rubbing her swollen knuckles in the morning and I listened as she told me about her arthritis. It was also clear that their adopted teenage son suffers terribly.....from being a teenager! Last weekend, I visited the village where I will be working and I had my first patient. A young man had received a bit of an elbow in the ribs whilst playing football – my first prescription in Bolivia was for simple analgaesia!
So as I search for the new, the unusual, even the spectacular, I need to ensure that I don’t forget one important aspect of medicine. Despite the change of continent, the altitude, the new language and culture.....common things are still common.