Mis Primeros Pascientes (My First Patients)

Today was our first full day at el centro medico. I spent the morning seeing patients with the doctor. First, we would review the patient's chart. Next, we would speak to the patient about their concerns and then the doctor and I would talk to determine a treatment plan. Finally, we would discuss the treatment plan with the patient. I will highlight a few of the most interesting patients, de-identified for privacy reasons of course.

A 2 year old boy presented with tinea capitis (for my non-pharmacy friends this is a "ringworm" of the scalp). When the mother was asked if she had attempted any treatment for the tinea, she responded that she had been using ampicillin or ampicillina. In addition to the fact that ampicillin is an antibiotic, which treats certain bacterial infections and no fungal infection such as tinea, the mother was opening the capsules of ampicillin and sprinkling the contents onto the boy's head. My initial thought was that my Spanish must be far worse that I originally thought, but the doctor reassured me that the patient's mother was indeed emptying ampicillin onto her son's head!

A 4 month old infant presented with pneumonia and a skin infection covering the majority of her back. The infant was very lethargic and exhibited rapid, shallow breathing with a temperature of ~103F and a HR of 167 bpm. The infant was clearly in need of hospitalization and IV antibiotics. However, the mother responded that it was not an option, because she had four other children and no one to watch them. She moved to Santo Domingo from Columbia and her husband had recently deserted her. The only family she has is her parents and they refuse to watch her children. She can barely afford food and clothing, as her only source of income is washing clothes. The mother broke down crying during the appointment, and it was truly heart-wrenching. Since the doctor knew that the mother was not going to take the advice and go to the hospital, he prescribe the best alternative antibiotics possible while taking into consideration cost. The mother must bring the infant back to the clinic in the morning.