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My Summer Experience in
Fortaleza, Brazil
By LIAM PATRICK HOWLEY
My July trip to Brazil was a time of many "firsts": my first
trip to South America, my first time living in a foreign country and my
first experience as a medical student outside of the United States.
Though I was very nervous about breaking so many boundaries at once I
had an amazing experience I will never forget.
 I spent time in
four different hospitals in Fortaleza and observed many operations and
procedures that I never had seen before. First, in the OB/GYN
hospital I saw my first cesarean section, hysterectomy, and hystoscopy.
Then at the university hospital I watched several amazing head and neck
surgeries, including the intricate removal of a large benign mass from
the maxillary sinus. My favorite hospital experience was observing
a mitral valve replacement because it was amazing to watch the heart
transform from an extremely animated organ to a completely static one
while keeping the patient alive. Finally, at the general hospital
I saw my first neurosurgery
In addition to the many medical firsts I experienced, I also had many
novel cultural experiences. I learned to dance forro, a Brazilian
style of dancing, and samba in a Fortaleza dance hall. I saw
capouela, a Brazilian sport that combines martial arts and gymnastics in
a dance-like motion, in the secluded beach town of Jericocoara. I
ate tapioca, a pancake-like bread, in a real Brazilian home.
By far the most important cultural lesson I learned was that it is
difficult to be in a place where the customs and language are not
familiar. But the kindness of strangers can help one get through those
trying times. This summer venture to Brazil will help me be a more
accepting, understanding doctor and human being to those who are brave
enough to come to the United States to make a new lives for themselves.
Japanese Health care: Different
Twist, Similar Problems
By ANDREW COMPTON
Japan during the month of July was a truly uncomfortable environment in
which to spend my last summer vacation ever. It was between 85 and
105 degrees everyday with humidity so high, it felt like you were in a
sauna. Mot atsui deshite! Fortunately the people, the
culture and all of the sights to see made it an absolutely wonderful
experience. I spent five weeks in Japan, with three-and-a-half
weeks of that spent south of Nagoya at Mie University Hospital in Tsu
city. My weekends and a few days at the beginning and end of the
trip were spent visiting Nagoya, Hiroshima, Kyoto and Tokyo, all
culminating in an all night hike up Mt. Fuji to the summit by sunrise.
As you can imagine these once-in-a-lifetime experiences were amazing and
truly gave me a cultural, historical and social perspective on the
Japanese people. Having a university hospital as a host gave us
the opportunity to meet many Japanese medical students and faculty who
were eager to practice their English. They spent many meals with
us discussing the many political and social issues facing their country.
We discussed the many health care issues and compared their system,
where the government pays 75 percent of the bill and you are required to
pay the rest, to the American health care system. Picking up that
25 percent can really mean a lot of money though when you are talking
about an expensive operation with a lengthy hospital stay. Of
course if you are truly unable to pay, the government will assist you
with the burden. This system may be heading for some rough roads
ahead though with a large population of the same age as the baby-boomers
and an insufficient number of children to eventually support them.
This is because many young adults are unwilling to get married and
convert to the traditional lifestyle so strongly promoted in the
culture. Many men prefer their current bachelor lifestyle and are
unwilling to take on the extra financial burden of a family. Many
women are unwilling to give up their careers to care for the home and
children as would be expected of a married woman. These dilemmas
have created a situation in which neither sex wants to get married,
which has sent the birthrate through the floor. The problem of
supporting the baby boomers will face us here in the United States also,
but it will not be quite as severe as it will be in Japan.
The health care system has also set up an environment in which there is
virtually no family practice medicine. Mie University has one of
the only available family practice rotations in the country. Most
of the health care is delivered through the hospitals and well visits
are virtually unheard of. If a physician decides to open an office
apart from the hospital, he must relinquish hospital privileges and is
then considered a separate entity. This means that physicians did
not have private offices in which to do initial interviews or follow up
care, they used the hospital facilities for everything. Another
interesting fact is that wages are determined by seniority, not by
department, so thoracic surgeons are paid the same as their colleagues
in pediatrics. Even though I have spent little time working in the
hospitals here, these were some of the most obvious differences that I
noticed between the two health care systems, which will hopefully allow
me to critique the US health care system more effectively.
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