sometimes you just have to laugh...

today my clinic day started with a local midwife bringing in five of her patients to be seen. we see this midwife, who leslie has fondly nicknamed petunia, monthly with whichever patients she has decided to bring in. and while she obviously has a desire to see her patients deliver healthy babies, i am reminded of the times and culture in which she learned midwifery skills as she always helps me out with each consulta. this morning she placed the second patient up on the exam table and helped her get prepared for her ultrasound as i turned it on and started the exam. at the end, i was able to tell the patient that everything looked find with her baby on ultrasound and that she was going to have a little boy. petunia looked at me with a knowing smile and said, "i knew it was a boy also." surprised, i asked her how she knew. in response, she knowingly nodded her head at the ultrasound and said, "i saw it on there." too surprised to hide my amazement, i "congratulated" her and got the next patient ready. as i performed the exam, i was unable to tell the sex of the baby, but happily told the patient that her baby looked okay. as we helped the lady up, i heard petunia say the word "baronsito" (little man) in a quiche explanation, and the patient quickly turned to me and asked if she was having a boy. i told her that the baby wasn't in a good position for seeing this area, and i was unable to know what sex it was. petunia looked at me again and said, "i know what it is." again surprised, i asked her how she knew what it was. she once more smiled knowlingly and nodded her head at the ultrasound. now i was also smiling as i asked her what part of the exam let her know what the sex was. she then informed me that she was able to tell by looking at the head. before i could question it, she proceeded to let me know that if it was a girl, we would have been able to see hair that came down below her ears during the head shots; therefore, since there was no hair that could be seen coming down below the ears, we could safely assume that this was a boy!

yesterday, i led a patient to sit down on the seat of a pregnant girl that had just walked out of the room. as she went to sit down, i noticed that there was two safety pins lying there, one that had unclasped and was sticking straight up. i quickly grabbed them up, but turned to leslie and told her that this patient had almost sat right on the tip of this safety pin that had somehow ended up on this chair. she asked if my last patient had been pregnant and when i answered yes, she told me that they must have fallen out of her clothes as it is common for many pregnant women to pin two safety pins to their slip to keep their baby from having a cleft palate. along these same lines, i have also seen them put some type of metal, usually a coin, over their belly button to also prevent birth defects. i suppose that when it comes to the health of your baby, something as simple as pinning two safety pins to your slip is not a big deal in comparison to the risk you face should this belief prove to be true...

last week, i had another young girl come into the san andres clinic and solemnly sit down in the chair in front of me. without breaking a smile, she informed flor (one of our spanish-quiche translators) that when she smiled her "pulmones" hurt. while still trying to take in the full reality of the complaint, i realized even further that when this girl used the word pulmones - which means lungs - she was actually refering to her shoulders. i couldn't help but think of what a doctor in the states would have done if a patient had walked into his/her office and told them that when she smiles her shoulders hurt. i gave her some tylenol for her shoulder pain and told her that this would help with her pain and i hope she would be able to smile easier this week :)

and there are few things that bring out more laughter and smiles than a birthday party! last wednesday, abi celebrated her third birthday. we were all very happy to see that she made it to her third birthday despite all of her accident-proneness and non-food items she likes to put in her mouth. we also enjoyed the birthday dance (which involves hopping around the room on one foot), eating the pancakes and cupcakes after she blew out her candles (using a little more spit than we would have liked to see), and exclaiming over each gift she received. true to her name, meaning father's delight, she truly does bring joy and laughter to the room and seeks to make sure that you too are laughing as she now asks leslie if "her mommy is happy" before she admits that she has done something she knows she wasn't supposed to :) here is a picture of one of her happiest situations... a table full of family and a huge stack of pancakes with birthday candles!