Day Four: Hello Cipro and Liver fattening

I resumed regular volunteer activities at San Jose this Friday, after being off last week to participate in a mission trip to Mexico. As with every Friday afternoon at the clinic, there was very little to do, so my first hour there was spent reading a physician reference book; it mainly dealt with different prescription drugs and I took the opportunity to check out information on Ciprofloxacin. Cipro, a fluoroquinolone with the empirical formula C₁₇H₁₈FN₃O₃,  is regularly mentioned in my Medical Microbiology class as a potent antibiotic against a wide spectrum of gram positive and gram negative bacteria. Cipro acts by inhibiting the action of DNA gyrase in bacteria, thereby preventing the organism's DNA from unwinding and consequently failing to be replicated. The director of the clinic saw me reading about it and praised Cipro as "the best drug in the world." Another medication I also read about was Panhematin (hemin) whose mode of action required recalling knowledge on hemoglobin, porphyrins, and prosthetic groups.

It almost seemed as if this particular visit to San Jose was a review in molecular cell bio, med micro, and biochemistry! The second half of my shift that day, however, was much more interesting.

I was asked to help a doctor translating what the patient was saying in Spanish to English. This particular lady had had arthritis for ten years (since she was 21), and described how the medication she had been on was causing her liver to become abnormally large. Doctors at a different clinic apparently told her to stop talking the medication for arthritis, which did help reduce liver inflammation, but in turn resulted in such pain that she was unable to work and contemplating suicide. The doctor I translated for was not familiar with this type of medical case, and after prescribing some antidepressants she referred the patient to a specialized doctor that volunteer at the clinic once a month. I can't say that I wasn't moved by this patient's situation, and can only hope that she gets help soon enough. This experience reaffirmed to me that communication among doctors can be unnecessarily inefficient at times: this patient was unable to explain the doctor why she was there, and the information she was carrying from her previous doctor was not clear enough as to indicate why today, March 26th of 2010, after 10 years of arthritis, she ended up at San Jose Clinic to see a doctor that had no clue of how to treat her condition. I wonder if doctors do not have an online network to document a patient's condition and why they have been referred to other physicians. 

At the end of my shift, the volunteer coordinator asked me to participate in a project to prepare a poster and materials to inform parents of obesity in children, something very common in most of the children taken at San Jose. So far I know Kirolos, Faraz and Janice will participate on this project, and I will share more details about it as I receive information from Samantha on what data to share with parents of obese children. 

Yamal