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A Music Major Trying to Understand Public Health

Wednesday 17, 2018

     Now that I have been in Portugal for a few days I feel like I'm ready to do my first blog post! There are so many different things that I would like to share from interesting aspects of the Portuguese healthcare system, to some amazing Portuguese foods that I've never seen before, to suggesting some of the most beautiful places around Cascais that are must sees if you ever make it to Portugal. 

     I think that I'll start by sharing what I've learned about the Portuguese healthcare system seeing as this is the main purpose of the blog. There are two hospitals in Cascais, but I am at the Hospital de Cascais Dr. José de Almeida. This hospital is fascinating to me for many reasons, but one of them is that this hospital is public but run by a private entity. You can think of it sort of this hospital as if it were a government entity run by a private contractor. The hospital is actually ran by United Healthcare (an American company). I have yet to figure out exactly how this impacts the hospital, but hope to learn more about how this affects the care that patients receive. This week I am shadowing a cardiologist and the first thing that I learned about cardiology, was that almost everyone that walks through the door for a consultation is older. There hasn't been anyone that has met with the cardiologist that is under 60 years old. I realize that part of this may have to do with the aging Portuguese population, but I feel like it also has to do with the nature of the specialization. Since I am trying to figure out if I want to pursue a career in medicine as well as which specialization I would be interested in, understanding my general clientele is an important part of my decision. 

     I look forward to better understanding the healthcare system in Portugal as well as how different specializations in the field of medicine work! While I'm learning, however, I'm taking the chance to experience everything else that Portugal has to offer which includes some of its amazing food. I have just been here for a few days, but I have already found a dessert pastry here that I absolutely love which is called a travesseiro (pillow). It has a little bit of peanut butter in it so if you have peanut allergies steer clear! Otherwise, I would recommend trying it if you're ever in Portugal. 

     

     As far as places around Cascais to visit, there are so many! I haven't had much time yet to do a lot of sightseeing, but I have already made it to the beach at Guincho, which is beautiful. I have also gone to Cabo da roca (the most western point in continental Europe) and the lighthouse near the old citadel. My recommendations about these sites would be be that first, make sure that you go! Second, I would suggest try going to Cabo da roca during a week day because it gets very busy on the weekend. It is also extremely windy at Cabo da roca, so if you get cold easily, bring a jacket! 

Cabo da roca

The lighthouse

Sunday May 20, 2018

     The first week of the Atlantis program has been incredible! I do shadowing at the hospital from Monday through Thursday each week which leaves Friday and Saturday open for exploring Cascais, and leaves Sunday open to attend my weekly church services. On Thursday I had the most interesting discussion on Portuguese healthcare so far. There was a decent time gap between appointments at the hospital on Thursday so I was able to ask a lot of questions about how the healthcare system works here. For a full analysis of what I learned on Thursday, the rest of the week, as well as the rest of the time I am here, you'll have to wait for my final analysis of the Portuguese healthcare system which I will post here. That way those of you that are interested in an in depth explanation of how the Portuguese healthcare system works will be able to read it at the end of my four weeks, but those of you that are more interested in a little healthcare information, a little travel information, and a little food information won't have to be bombarded with too much healthcare analysis. What I will say here is that different doctors have very different opinions on how well the healthcare system is working in Portugal as well as how a public healthcare system affects the quality of care. Some doctors that I have spoken with this week are very positive about the future of the Portuguese healthcare system while others are more pessimistic. Furthermore, there are varying opinions on how the doctors feel about working in a public hospital that is run by a private entity. As I stay here for the next few weeks I will do my best to separate the facts from the political rhetoric. This can be a tricky thing to do, but I feel up to the challenge!

     On Friday since I didn't have any shadowing to do at the hospital, I went to Lisbon. It is about a 40 minute to 1 hour train ride from Cascais to Lisbon depending on if you catch a more or less direct train. For those of you wondering how to know if your train ride will be more on the 40 minute side or 1 hour side you'll have to ask a local about each train time to know. The train times online do not give any indication as to how long they will be, but the locals know. The only train that I know takes 40 minutes leaves at 8:52 am Monday-Friday. Any other time of the day you'll have to ask the locals to know. I was able to see a lot on Friday. I got used to walking through the various neighborhoods of the city and even got to see an old moorish castle. The castle itself is hard to miss because it sits on a hill and can be seen from most of Lisbon. On Saturday I returned to Lisbon again to see the aquarium and science museum. If you have the time I completely recommend it! As far as I understand the aquarium here in Lisbon is one of the biggest in Europe! 

     As far as food goes I have had a lot of great food, but one specific food sticks out above the rest. It is called octopus salad. Some of you may be familiar with octopus sushi, but octopus salad has a very different taste. I'll add a picture of it at the end of this entry so you can see what it looks like. If you want to order it at a restaurant here, it is called salada de polvo. Starting with my next entry I'll add the names and pictures of restaurants that I have been that I would recommend! 

Downtown Lisbon

 

 

St. George Castle in Lisbon

Octopus Salad

Wednesday May 23, 2018

     This week has been a whole different experience. Shadowing with a cardiologist last week ended up being primarily consultations but shadowing an anesthesiologist has meant seeing a multiplicity of surgeries. The anesthesiology department also has given me new insights into the Portuguese healthcare system. I have also had the chance to eat some more amazing Portuguese food. Tomorrow I will be going to Belém and Friday there is a planned excursion to Évora so when I post on Sunday there will be a lot to say about important tourist sites in the Lisbon area. 

     As far as the Portuguese healthcare system goes, I was shocked to find out the average salaries for doctors in Portugal. For example, the average salary for an anesthesiologist in Portugal is around 25,000 dollars per year whereas the average salary for an anesthesiologist in The United States is around 270,000 dollars per year. This means that anesthesiologists in The United States make around 10 times more money than anesthesiologists in Portugal. Another thing that I focused on this week as far as understanding the healthcare system is trying to evaluate how doctors feel about their jobs. I wanted to understand how satisfied doctors here are with their work environment. I became interested in trying to understand how doctors felt about their jobs because, at the end of last week, I was sitting at breakfast watching the news when I noticed that there would be a strike in hospitals in Portugal beginning on the 25th of May. The news said that the cause of the strike was poor working conditions, bad hours, and bad salaries. It was for this reason that I researched the average salaries for different jobs at the hospital and began asking doctors how many hours a week they work, how their working conditions are, and if they're happy with their salaries. Based off of asking various doctors how they feel, I think that conditions for doctors could be greatly improved. That isn't to say that conditions couldn't be improved for doctors in The United States or other industrialized nations, but understanding that doctors are generally unsatisfied with their working conditions is cause for concern. For the causes and specific complaints of doctors, you'll have to wait until I post my comparative essay on European healthcare. Until then I think it is sufficient to say that there an issue with Portugal's healthcare system is that doctors are dissatisfied with working conditions. 

     As far as the food goes, I have had the chance to have some amazing food! There are two restaurants in particular that I would recommend. The first isn't so much a restaurant, but rather, an ice cream parlor. I don't want to sound like I am making a commercial and no, I did not in any way receive money to advertise this ice cream parlor, but this place is amazing. I have been here three times already and I would gladly recommend this ice cream shop to anyone that loves ice cream. The ice cream shop is called Santini and it has been in Cascais since 1949 if I'm not mistaken. They have a lot of flavors to choose from. Some are classics while others have a Portuguese twist. Personally, I am a fan of mixing a scoop of maracujá (passion fruit) with a scoop of nata (cream). No matter which flavor you choose, however, it will be delicious. There are multiple Santini's in Portugal, but the original is here in Cascais. At the end of this entry I will include a picture of the store front. It might not look like much from the outside, but this is one ice cream shop you do not want to miss! The other restaurant that I would recommend is a Portuguese restaurant that serves tapas. No the concept of tapas was not created by the Portuguese, but the idea of tapas works great here if you want to try a little bit of various different Portuguese dishes. The restaurant is called Dom Diniz and is located near the center of Cascais. If you want to try various types of Portuguese foods all in one go, this is a great restaurant to try. 

     I haven't gone on any excursions this week so far, but stay tuned because on Sunday I will have a lot to say about Évora and Belém.

Santini Ice Cream Shop

 

 

Dom Diniz restaurant with the Fam!

 

Tapas at Dom Diniz (octopus salad and ceviche)

Sunday May 27, 2018

     On Thursday of this week I was able to shadow an anesthesiologist while simultaneously learning about orthopedics from orthopedic surgeons that were working in the same operating room as the anesthesiologist. Before Thursday I didn't really have a good understanding of what an orthopedic surgeon does. My understanding even still, is quite cursory, but I hope to be able to shadow with an orthopedic surgeon in the future because their job seems fascinating. The aforementioned strike occurred on the 25th and many medical professionals across the country did not go to work. The government quickly promised to raise wages at the public hospitals throughout the country in order to end the strike and not cause a national health issue. Hopefully, the government is true to their word. 

     As far as traveling goes, on Friday of this week we went to Évora with our program coordinator. This was quite an amazing experience because our program coordinator studied at the University of Évora and as such, he was familiar with everything in the town. Évora is a bit out of the way from other places in Portugal, however, there is a train that goes directly there from Lisbon. Évora has a fascinating history with strong ties to its Roman past. In fact, there are still Roman ruins in the city, including an aqueduct, a city wall, and temple. Nearby there are relics of Évora's prehistory in the form of odd stone statues. Needless to say, this is one fascinating city. We went on a tour of the University of Évora which dates back to the 16th century. The architecture of the university was breathtaking. What was even more fascinating to me was realizing that this historical building was still being used as a university even today. 

     On Saturday we went to Belém. Belém is between Cascais and Lisbon meaning it is very close by. It is also perhaps the most touristy city in Portugal. That being said, if you haven't been to Belém, you haven't really been to Portugal. Belém has various touristic sites ranging from historic buildings to massive museums. Belém is even home to one of the most famous foods in all of Portugal. The type of food that is famous here is known as a pastel de Belém. This pastry is only made in one store in Belém and has been made there since 1837. Only 3 people in the whole world know the recipe. If you want to try these delicious pastries be ready to potentially wait in quite a long line. I would recommend either going in the morning before starting your sightseeing for the day or waiting till after a long day of sightseeing to buy these pastries. The line in the morning and late afternoon is much better.

     Upon arriving in Belém our first stop was to the Monastery of Geraldo. This monastery was one of the most beautiful buildings I have ever seen in my whole life. The building was created with such care that upon a careful observation of the various pillars in the courtyard, it is possible to notice that each of the numerous pillars has a special and unique pattern. The monastery houses the graves of some of the most important people in Portuguese history such as Fernando Pessoa and Camões. Half of the monastery is an archeology museum which houses archeological artifacts from Portugal as well as Egypt. For anyone that is interested in the history of Portugal, the archeology museum is a must see. 

     The next place that we visited was the Belém tower. It is located on the water and is breathtakingly beautiful. Tickets to go up into the tower can be purchased at the same time as the tickets to enter the monastery and archeology museum. After seeing the Belém tower, we went to the modern art museum in Belém which houses art by famous artists such as Warhol, Pollock, and Picasso. Personally, I thoroughly enjoyed it. There were so many museums that we didn't go to because of time such as the museum of aviation, the museum of coaches, and the museum of warfare. There are a lot of tourists in Belém, but that's just because it is close to Lisbon and has some amazing things to see! I can't wait for next week when we go to Sintra and Coimbra! 

     

On our way to Évora

The Roman ruins in Évora

Pastel de Belém

 

Tower of Belém

Wednesday May 30, 2018

     This week I realized that the Atlantis program ends next week, which made me so sad! It feels like I just got here and there are so many other specialties that I would love to learn more about. Everyone at the hospital has been so nice to me and been so helpful. Some of the doctors today were trying to convince me to go to medical school here. Although I won't be going to medical school here, an 1,000 Euro a year medical education is quite tempting! I have gotten used to the Portuguese accent as well as many of the words and phrases that are different between Brazilian and Continental Portuguese. At this point I feel like I'm able to ask whatever questions I want and fully understand the answers. I also feel like I am able to joke around with the doctors and get to know them on a personal level. This week I am shadowing the pediatrics department and I couldn't be happier shadowing these doctors. I thought that the other doctors in the hospital were friendly, but now that I have met the people working in pediatrics I realize that the most friendly doctors are definitely the pediatric doctors. In the hospital pediatrics encompasses everything from pediatric surgery to neonatal care. During my few days in the pediatrics department I have been able to learn quite a lot about the Portuguese healthcare system functions. 

     While talking to the pediatric doctors, I found out that despite working overtime on a regular basis as well as working on holidays, they are not paid overtime. The pediatric doctors call what they earn during overtime hours or holidays a "ninharia" which could be roughly translated to a pittance. They explained that overtime is not really paid for by the hospital because there is a specific amount of money allocated for their salaries. Since the hospital is public, they cannot go over their budget meaning that although they need employees to work overtime, they're not really compensated for their extra labor. When I write my comparison essay between The United States healthcare system and Portuguese healthcare system,  I will attempt to understand this with greater detail. For now however, I think it is sufficient to say that doctors here don't really seem to earn extra money when they work overtime or on holidays. Another interesting aspect of pediatrics is that children only go to pediatricians if there is a strong need for the child to be examined by a pediatrician. Otherwise they only see a general practitioner. I can't be sure but I believe this happens because there is not near enough space in the hospital to help all of the children in the area that need medical care. Even during my 3 days in pediatrics the general trend seems to be they will pick the least sick child and send him home because there isn't enough space for all of the kids. Most of these kids are sent home only to return again because they weren't completely treated. I think that perhaps this happens because when the hospital was built there weren't very many children being born, but, with a lot of Brazilians coming into the country recently, there has been a rapid increase in the amount of children living in Portugal. 

     As far as food goes, I have had some amazing food this week! We were taken out to dinner twice this week already. On Monday the Atlantis program got us dinner, and yesterday Dr. Page took us to dinner. Monday's dinner was a restaurant that specialized in Octopus dishes and was called Polvo Vadio (Stray Octopus). Personally I love seafood so I was very excited for dinner!I ordered the Octopus fillet and it was delicious! The ambience of the restaurant was great, although it was a small restaurant. While we were eating lots of people came in trying to get a table only to be told that they needed to get a reservation to eat there. So my advice is look up the restaurant beforehand and make a reservation. Otherwise, there is a good chance that there won't be any tables available. On Tuesday we went to a hamburger restaurant with the Pages. I was ready for some American food after having octopus the night before. The hamburger restaurant we went to, Os Bordallos, was another great dining experience. I chose the Bordallo hamburger (their signature burger). This hamburger had a hamburger patty, bacon, steak, caramelized onions, and a mushroom sauce. It was honestly one of the best hamburgers that I have ever had! I would recommend both of these places to anyone that is looking for some great food in Cascais. 

     As far as traveling goes, we'll be going to Sintra tomorrow and Coimbra on Friday. Stay tuned for some beautiful pictures of Sintra and Coimbra as well as some advice about the must sees of each place. 

Polvo Vadio Restaurant

Fried Octopus at Polvo Vadio

Octopus Fillet at Polvo Vadio 

Bordallos Burger at Os Bordallos

Sunday June 3, 2018

     I can't believe I am going home this week. I wish I could stay longer and work with doctors that have specializations I am not yet familiar with. The rest of my week with the pediatrics department was fascinating. On Friday I had the chance to shadow doctors in the nursery where the mothers and babies stay for 48-72 hours after the babies are born. One thing that surprised me about how the hospital in Cascais functions is that they allow the medical students to be the ones that analyze the newborns for any potential complications. They only go to the pediatrician office and ask for an actual doctor to see the baby if the medical school student is concerned about the health of the newborn. The tests that are performed are relatively simple in nature. They evaluate the reflexes of the newborn as well as check for any anatomical anomalies. They also ask the mothers if the baby has been able to breastfeed. If the baby appears to have a fever it may be a sign of an infection caught by the baby during birth. Thus, if the baby took over a couple of hours to be born, the baby is tested for common infections via a urine test. I thoroughly enjoyed being in the hospital this week and am excited to shadow the ENT doctor this week. 

     This week was also filled with traveling! On Thursday we went to Sintra, which is a UNESCO World Heritage Site. It was one of the most beautiful places that I have ever seen. They Vila of Sintra looks like it could be the fairy tale land coming right out of a Disney movie. The buildings and landscapes can only be described as magical. There is a sense of wonder mixed with mystery at every location of Sintra that we visited. If any of you ever are in Sintra take my advice: you will need an entire day to visit all of these beautiful places. We arrived in Sintra a little before 9:30 when everything opens and didn't leave the Vila of Sintra until 8:00 pm. Even still, we weren't able to see everything that Sintra has to offer. We started off the day by visiting Quinta da regaleira. Quinta da regaleira opens at 9:30 am and at 9:30 it is pretty empty because everyone goes to the Pena Palace first thing in the morning. In my opinion, however, Quinta da regaleira was more fascinating than the Pena palace. The Quinta da regaleira had the most beautiful garden I have ever seen. Within the garden there were natural springs, caverns hollowed out by moving water, as well as the various towers which led to different levels of the garden. I will attach a few pictures of Quinta da regaleira so that you'll be able to see exactly what I am talking about. Quinta da regaleira is very close to the actual Vila of Sintra, so if you were to take public transportation to the Sintra train station, it would be totally possible to walk to to Quinta da regaleira. 

     Although Quinta da regaleira was by far my favorite, the Pena palace and Castelo dos mouros were also very interesting. The Pena palace is high up in the mountains and usually offers a stunning view. When we were there it was quite misty so we weren't able to see very far. On a clear day though, it would be totally possible to see Lisbon from the top of the Pena palace. The Pena palace was very busy so, if at all possible, buy your tickets ahead of time. Some people working at the hospital suggested that going to the Castelo dos mouros wasn't necessary, however, I found it very interesting. The only place that we went that wasn't particularly amazing was the Capucho convent. It is a long ways away from the Vila of Sintra and there isn't all that much to see. I am glad that I went, but if time is limited, the Capucho convent is a place I would skip. 

     On Friday we went to Coimbra! We went to the University of Coimbra, the Monastery of Santa Clara, The footbridge of Pedro and Ines, as well as the fountain of tears. By far my favorite place was the University of Coimbra. The old library was astounding as were the curiosities housed in the zoology department. One negative of Coimbra is that it still isn't totally ready for tourism yet. There are no Ubers available in Coimbra yet and the tourist information is outdated. We not only visited various places in Coimbra but also heard traditional Fado music, listened to a Portuguese pop concert, and listened to a Portuguese folk music organization foundation sing traditional Portuguese folk music. I don't know how much the others liked this part, but for me it was one of the highlights of the trip. There are a lot of pictures that I took in the past couple days because we had such a big weekend, but I'll try to narrow down the amount of pictures so as to not overwhelm you guys with wanderlust. 

Quinta da regaleira

Quinta da regaleira

Quinta da regaleira

 

Coimbra at night 

Coimbra with the fam

Coimbra pop concert

     

Coimbra folk music group 

Tuesday June 5th, 2018

     For my last week in Portugal, I am shadowing some otorhinolaryngologists! I am so excited to shadow these doctors because their area of expertise focuses on a part of the body that I am very familiar with! I thought to myself that finally, for at least one week I will understand the anatomy associated with the particular specialty I am shadowing. I am especially excited to see how they handle issues with the vocal chords and what they do with people that want to remove nodes. So far we haven't seen that side of of otorhinolaryngology yet, but I still have two more days to see either a consultation or surgery that covers those issues. I wish that the internship here in Portugal was at least 4 more weeks because there are so many more specialities that I would like to learn about. I would also like to repeat a few of the specialities to learn more about how each speciality works. As far as traveling and eating goes, I have had great meals and plan to travel around a bit on Thursday. The week that we went to Sintra we saw so many things, but there are a few more places around Sintra that I would like to go. If the weather permits, my final day of the internship will be spent traveling. I also still want to try some of the famous pastels from Sintra that I haven't tried yet. 

     During my time attending the branch in Cascais we have become friends with some of the members in the ward and I am sad to have to leave them. I have gotten some of their information on Facebook and Instagram and I hope that sometime they will come to Utah and I will be able to show them around. Actually today we got to go to one of the member's houses for dinner and we got to get to know them better. We also had the chance to get to know some other members from the branch that are from Brazil. It was pretty interesting because the Brazilians didn't really speak English and the American family that we were eating with dint really speak Portuguese. Because of this we spent most of the dinner translating back and forth what was going on. I personally did not do a good job at translating, but I think that the other two guys there from BYU could be professional translators. 

   I'm really excited for tomorrow because we're having our final dinner at surprise location in Lisbon. Supposedly it is a traditional Portuguese restaurant and also one of our director's favorite places to eat. One thing that I learned while I have been in Portugal is tat Portuguese food is absolutely delicious. It is too bad that I have never even seen any restaurants in Utah that are Portuguese restaurants. I suppose that the population of Portugal is too small to have lots of Portuguese themed restaurants around the world. Perhaps with rising tourism however, this will change. 

     After my final day of shadowing on Thursday, I'll tell you my thoughts on how I feel about potentially being an otorhinolaryngologist. I will also let you guys know if I ended up getting to see what vocal chords look like. So far we have seen a lot of ears and noses but no throats. 

I don't want to have to return this badge on Thursday because it means that my internship is over! 

Thursday June 7th, 2018

Well, I go home tomorrow and I can’t believe that it is all over. I have had the opportunity to make new friends, see some amazing places, eat some spectacular food, all while learning about what it is like to have a medical career, and how the public healthcare system in Europe works. Before I go into some of my big takeaways from these past couple weeks, I want to talk about my experiences this week! On Wednesday there were multiple consultations that resulted in looking at the patient’s vocal chords. It was so fascinating to see how similar, and at the same time different, they were. Everything that I had learned in vocal pedagogy about the vocal chords became so much more real when I saw them firsthand as well as saw many of the common problems with the vocal chords that we learned about in my class. For once I didn’t feel like I was out of place! On Thursday we watched some surgeries, which was a different experience for me, because up until this point I had mostly only seen adults being operated on. I think that otorhinolaryngology would be an interesting field for me to pursue if I decide to pursue a career in medicine.

     I also had the chance recently, to talk with an Uber driver that works during the day as a pharmacist in Lisbon. I learned a lot about the healthcare system from him. There are a whole lot of loops to go through to get your prescriptions. It seems, at least compared to him, that the government only approves generic prescriptions. This wouldn’t be a problem if the generic medications were identical to the original versions of the antibiotics, but apparently there is such a large amount of pressure coming from the government to produce generic medications, that the generic medications end up not being the same as the original antibiotics. Due to this, many people are taking medications that are not near as effective as they could be. He also explained that he frequently would call the doctors that prescribed medications to patients because they would prescribe medications that interfered with other medications that the patients were taking. He believed that this was due to the time restraints put on consultations. First consultations are only supposed to take a max of 20 minutes and subsequent consultations can take no longer than 15 minutes. I asked some of the doctors at the hospital about this, and they confirmed that this is the case.

     In a less depressing note, dinner on Wednesday was amazing! I’ll attach some photos of the restaurant as well as the address, because if you only have time to visit one authentic Portuguese restaurant while in Portugal, this would be the one that I would recommend. The food and service are incredible, and the location is pretty close to the Caís de Sodre train station. All in all it is an outstanding restaurant that serves smaller portions of various Portuguese dishes so you can try a little bit of everything.

     As I said on Tuesday, I was planning on going to Sintra today. Unfortunately, the weather has been terrible today and going to see some of the gardens that I wanted to see would not be a good idea. I suppose I’ll have to go back to Sintra the next time I am in Portugal.One cool thing that I did, however, was on Wednesday night while in Lisbon, we went to a light show called Lisbon Under the Stars. This light show told the story of Portugal in a laser light show. I absolutely loved the show and would recommend it to anyone that loves history. 

     There are so many things that I learned during these four weeks. I can’t remember the last time I learned so much in such a short time. I still have a few more posts that will be coming in the next week so stay tuned! In the next few posts I will discuss topics such as an overall picture of the American and European healthcare systems, as well as my final reflection on my experience here.

Our last family dinner!

 

The location of the traditional Portuguese restaurant 

 

Our last Santini run!

Lisbon Under the Stars

A Day in the Life of a Global Health Intern in Portugal

     Trying to piece together what a typical day as a health intern is a bit like trying to assemble a puzzle where the pieces are constantly changing. The picture on the box that is used as a reference to put the puzzle together remains the same, but the individual pieces are constantly transforming. That being said, I will try to do my best to describe a typical day of what it is like to be a Global Health Intern here in Portugal.

     A typical day begins at around 7:00 am when I wake up, shower, get dressed for the internship, and then walk a couple blocks to a breakfast place across the street from the bus stop that I use to get to the hospital. Usually by around 7:30 am I’m already at the bakery. I get a cup of juice, a ham and cheese sandwich and a pastry. The pastries at this bakery called Doce Canela, are so delicious that just the thought of eating one gets me out of bed every morning. After I eat breakfast, I wait at the bus stop across the street until the bus to the hospital arrives at around 8:08 each morning. I use a preloaded bus pass with just enough trips for my time as a global health intern. When we get on the bus it’s usually very full despite the fact that most people in Portugal use cars. I would have taken a picture of me on the bus, but when a bus is this full it would be quite rude to do so. I usually arrive at the hospital at 8:28, just two minutes before I am supposed to start my shadowing at the hospital. I go as quickly as I can without running through the lobby of the hospital and down the stairs to the basement where my lab coat is located. After putting on my lab coat, I go back up the stairs to the floor that I had arranged to meet the doctor that I would be shadowing that particular day. Sometimes the doctor would be at that particular location, sometimes he simply forgot that we would be meeting there, or he simply decided to start work later that day. If everything went well though, at around 8:30 I would already be with the doctor I would be shadowing for the day.

     Exactly what was done during the hours of shadowing varied greatly depending on the day. Some days we would go to the operating room, other days the doctor would have consultations with patients. What was shocking was how long the doctor would have to spend typing in information between patients. On a day with consultations generally the first consultation would begin around 8:45 am and end around 9:00 am. Afterwards, the doctor would spend about 20 minutes typing up the information acquired during the consultation and would then ask if I had any questions. After my questions were answered, he would call in the next patient and the cycle would continue until around 12:30 or 1:00 pm when I would go to lunch with the doctors at the cafeteria located in the hospital. After lunch I would shadow the doctors until sometime around 2-3 pm when they would dismiss me and I would head back to the house via the bus. Sometimes I would have to wait for a good 30-40 minutes for a bus to arrive that would drop me off near the house.

     After I got home I would start to write my blog posts and daily log. Then I would, if time permitted, go to the beach for a few hours or go to the mall if weather was bad. Around 7 or 8 pm me and the other fellows would get dinner and then call it a night when we got home. I averaged walking over 6 miles a day so if you want to get in shape then this is the right internship for you! The first couple weeks I wasn’t ready to be walking so much, but after a week or two I got used to it! I would usually end up falling asleep around midnight or so. This meant that I got around 7 hours of sleep a night, which for me is pretty great! Not every day was like this, but it was the most general version of a day as an global health intern that I could think of. 

Word Count: 758

Feeling pretty awake for 7:15 am

 

 

A pastry worth waking up for (mile folhas) 

Waiting at the bus stop to go to the hospital 

                       At the hospital (no photos allowed in the operating area of the hospital)

At

    At the Hospital

Heading to the beach

Dinner time with the fam!

You Are the Gift

   After reading Sister Sharon Eubank’s forum speech, I realized that I can’t “stitch a relationship as well as [I] stitch a quilt”. (And I am terrible at stitching) I am the type of person that is likely to donate money to charitable causes or even volunteer at charitable organizations. What I am unlikely to do, however, is be the gift to other people. The purpose of the forum speech, in my opinion, is that we need to give of ourselves to other people. While throwing money at problems may help somewhat, helping the spiritually sick is only possible when we become the gift that we give to others. I was able to read this talk before leaving for Portugal, but before getting there I wasn’t exactly sure what I should do to be the gift to other people while on my internship.

     In my case, for the internship that I did, I was shadowing doctors. I couldn’t be the one to mend the wounds of the afflicted or give food and water to those in need. All I could do was help to feed the spirits of those that I came into contact with. Before I go on to explain exactly what I did, I want to share an experience that I had while on the internship that changed the way I viewed this sort of humanitarian service. During my third week of the internship I was able to shadow doctors in the pediatrics department. Part of the time that I was shadowing in this department I was with doctors working in neonatal care. Most of the infants that were there were very sick. Some would likely not make it. While the doctors made sure that the babies were warm and being fed, it seemed like their greatest concern was that people were giving the babies attention. The doctors told me that if the babies could learn to use a bottle and cry then the chances that they had to survive were much higher. Using a bottle isn’t something that could be done with a machine because no one could verify if the baby was actually getting nutrients from the bottle. If no one was checking on the baby it would have no reason to cry for attention or food. If the baby didn’t feel that anyone would pay attention to its cry then there would be no point to cry. These two factors were two of the most important parts of their work. They could feed the babies via the umbilical cord to keep them sustained, but without human interaction they had a lower chance of survival. I kept thinking about what the doctors said all day, and when I got home that night I realized that in many ways we are very similar to the babies that I saw during shadowing that day. Each of us can receive food, water, a comfortable home, and other nice things life has to offer, but if we don’t have human interaction the likelihood that we will survive spiritually is so much lower.

     With that in mind I felt a much stronger desire to be the gift to other people. What I did to be the gift during my time in Portugal was to give people the humanitarian work their spirits needed. With so many different kinds of people this seems like a vague answer. How can someone ascertain what humanitarian work was needed? I would suggest that through listening it is simple to figure out what each individual needs. When I listened to their words and the spirit it was simple to know what they needed. Some had sick spirits because of loss, others loneliness, and still for others doubt. Each day at the hospital I would talk with lots of doctors and nurses. Although they were caring for so many people physically, they themselves needed help spiritually. Many of the doctors worked over 40 hours a week and never saw their families. They were so lonely despite being in rooms filled with people. All I had to do was ask if they had children and then right away their eyes would light up and they would begin to show me pictures of their children. They would tell me about how much they missed them, and as we talked they would realize for themselves that they needed to put a higher priority on family time. I didn’t do much; I just listened and cared enough to care about them.

     What I realized in doing this type of service is that it isn’t hard to help our brothers and sisters. The results of these simple conversations were so powerful that it was shocking. The power listening had to remind people of their family or of their worth or even of their God was incredible. Listening alone had the power to heal hearts, because to listen is to care.

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