1st 48: a glimpse into porto… and medicine

hospital são joão

so, by now i’ve gotten settled into my new place, so to speak, as i’ll only be there for a month, and i need to make it to my place of work, so to speak. fortunately, porto has a great public transit system. to get from world spru to hospital são joão one must simply take the metro to trindade station (any line going away from estadio do dragão will do) and there transfer to the yellow line in the direction of hospital são joão. no problems there. after a decent night’s sleep and a renewed confidence in my abilities to navigate a foreign city, finding hospital são joão is no overwhelming task. once there, i am picked up from the main entrance by dr. pestana and his current team which includes two residents (joana number 1, and katerina, one resident is actually on vacation when i first arrive) and two medical students (joana number 2 and margarida). the two medical students just happen to be in their final year of medical school, as well, which is not as fortunate as it seems, as 6^th (final in europe) year med studs have to not only complete and present there thesis during this year but also study for what i take to be the equivalent of our step I & II combined. awful, yes, i know. my sympathy goes out to al the 6^th years i encountered at hospital são joão…

reading any of my “predecessors” blogs will inform one that normal days, start at around 8. the residents and med studs see their patients and write notes in the hardcopy charts. afterwards there’s a coffee/snack break, and then the team checks with the nurses and looks over the nurses’ notes and proceeds to write the electronic notes. the attending will see the patients after the team, but before break, when he is not seeing consults that morning.

i meet the team at around 1020, which means their in the middle of their day, but it’s cool. the have already seen their patients, and it’s not time for a coffee/snack break, so we head to refeitória (the cafeteria). we all get snacks and then head back up the office. this is where all the planning, note writing, discussing, and [most of the] teaching takes places. it is here i learn that the 4^th floor medicine team is divided into 4 teams that share the 4^th floor office, and it is here that i meet everyone from all 4 teams…

the rest of the “workday” is spent writing notes and discussing patients, until around 2 o’clock.

downtown (centro do) porto

after i leave the hospital i head downtown. for one, i want to see a bit of the city, and two, there’s still enough time in the day to stop by the international students office. so from the hospital, i take the tram (and i use the terms tram and metro interchangeably here because the porto metro system is more accurately characterized as a tram and not a metro) down to aliados (on the yellow line) and manage my way up to reitoria. finding reitoria was not exactly easy. porto is one of those city’s which is comprised of dozens and hills which means that sometimes if one thinks one knows where one is on a map, one can’t really tell from one’s surroundings how to get where one is going. that being said, i actually did make it to reitoria (where the international student’s office is located) without walking in a ridiculously circuitous route. however, i did stop and ask for directions about every 100 meters. thank goodness for the little bit of portuguese i knew and the hospitality of portuguese.

i get to the reitoria and find the international student’s office within. i get there and i notice two guys sitting in the reception area. i sit down, and what do i notice but that they are speaking french to each other, and not drawled, nasal french of montréal nor the leisurely articulated french of the swiss but true french of france. naturally i butt in and insert myself into their conversation, and who have i met but two parisians here, studying pharmacy for a few months. health care workers unite! lisa dequech finally has everything ready for us and now comes to invite us in to her office. apparently i was supposed to have made an appointment to meet with her, but since one of the other students hadn’t shown up (which had kept the parisians waiting for the last couple hours), she gladly adjusted the packet and presentation to fit me in. in this meeting we are introduced to porto through lisa’s presentation, given the rundown about how erasmus (including myself even though i’m from america) can stay plugged into what’s going on in this city, given a packet with maps, lots of useful information, and our temporary student cards. if you find yourself at this meeting in the near, or far, future make sure to opt in for the moche card. that way you can keep in touch with all the international students for free (minus the cost of buying a cheap european mobile, ~20euros).

after the meeting the parisians and i exchange contact information and head our separate ways. i take a little stroll around downtown before heading home by foot, just to take in a little more of the area, and i must say that porto is a beautiful place to be. world spru is about half an hour’s walk back from downtown, which is not bad at all with such beautiful weather as we have right now.

when i get back to world spru, i’m certainly hungry but in no mood or disposition to go grocery shopping, so i head to one of the local restaurants around the corner. the local eateries in campaña are decent to good, as i just ended up getting a spinach omelet and fries (which they threw in some rice and bread) with wine of which they gave me half a liter—they really know how to have dinner here in porto.

getting to world spru

sometimes one can find that once on has arrived at a place, one isn't really there yet. i, myself, have had this experience, and thus i will tell you all about it. it all starts with my decision to participate in unc som's (university of north carolina school of medicine) advanced-practice selective in porto (oporto), portugal, and the following chronicle's my arrival in said city.

the evening of april 2, 2011, i'm making the final leg of my journey to portugal, flying overnight from toronto. i sat in the airport right before boarding the plane, gearing up for this journey, i take a special concoction of medications that will prepare my body and mind for the experience. first is taking some anti-inflammatories (NSAIDs), as being cooped up and cramped in the sitting position for 6 hours straight is no fun time at all on an old guy's knees and lower back. for the mind, to aid in my adjustment to the five hour time difference, i managed to acquire some sleep aids: one in the form of a long acting benzodiazepine and the other simply (or not so simply, depending on your level of knowledge of chemistry) melatonin. it's key to take melatonin several hours before you want to start your new sleep-wake cycle so that your body can make the proper adjustments, but i'm going to go into too much detail about that. you can ask your doctor about it... so, fueled for the glorious six-hour slumber i'm about to embark upon, while on a plane crossing the atlantic ocean, i take my seat and promptly pass out... six hours later, "hello, portugal!"

now, i had skimmed over the blogs of my "predecessors," as one preceptor so interestingly described them, and the directions to get to the lodgings (i.e. world spru, which you should absolutely look into) seemed pretty straight forward:

step 1 - fly to porto

step 2 - take metro from airport to campaña

step 3 – take a right out of the metro up to world spru (only taking about 2 minutes and something or other about a glass wall and some taxis and buses)

it is on this third step where an inglorious journey began. step 1, check. step 2, check. step 3… i make a right out of the metro and head up the street. coincidentally, or providentially, i run into a missionary, a group the missionary’s working with, and the missionary’s wife who happens to be from shelby, nc (my hometown). i kid you not. as i would ordinarily stop here and make commentary about shelby, this is neither the time nor the place for such. just google and/or wikipedia it.

“where are you trying to get to?” says the missionary

“world spru…?” i reply. he goes and takes the flabbergasted i-have-no-idea-what-you’re-referring expression, then he calls up someone on his cell who further has no idea to where i’m referring, even getting nowhere when asking the members of his group, some of whom are from the area.

“are you sure you’re going the right way?

“sure. the directions say make a right and go up the hill on the street where the taxis and buses are.” but i don’t really see any taxis or buses.

“oh, but there’s another main road over by the metro that also goes up the hill…”

if ever God had given me a sign, and i refused to acknowledge it, that was the time.

longer story shorter, i ignored a pretty fair warning from the universe that i was going in the right direction, and please spare me the gross-overgeneralizations about men not asking for directions. i ended up walking in quite the circuitous route to basically end up exactly where i had gotten out of the metro, which is where world spru is located. right beside the campaña center, the residence is literally connected to the metro. maybe it was the benzo still in my system. maybe it was the fatigue of not having slept well for the previous week and a half finally catching up to me. maybe it’s the fact that i’m not the sharpest crayon in the box (i know i’m usually not a fan of clichés, but i particularly like that one for some odd inexplicable reasons). when i think about it now, it seems so simple. “when you get off make a right… taxis… and buses to your right behind the glass” doesn’t mean get off the tram and make a right. it means when you get out of the metro station (campaña) make a right, onto the road that is parallel with the glass wall…