Consult day

Hello friends,
just a brief note tonight as I"m crawling into bed...it was a sweet long day today, we saw 87 or so patients and will do about 36 surgeries this week. A few beautiful young women gave me permission to tell you a bit about them and show you their beautiful selves. I've decided not to use their names for privacy sake.

 This stellar young woman, born with spina bifida and paralyzed from the waist down, until last year (age 19) needed her mom to give her enemas and catheterize her or she needed to use diapers. she really wanted to go to college, but until she was independent with these things, she couldn't go. Last year she had a surgery which created a channel between her bladder and her skin (using her appendix) and so can catheterize herself, and had another surgery connecting her bowel to her belly button, so she can flush out her bowels once/day and have no more accidents.  she just finished her first year of college!!

 The sign greeting patients to the outpatient pediatrics clinic.  "by and for the children of Guatemala"

 the waiting room, filled with folks waiting to bring their case to the pediatric urologists

This beautiful young woman is Quiche and from a very rural area outside of Chichicastenango.  She would like to become a doctor. she was born with her bladder open to the outside of her body.  5 years ago she had a procedure which created a pouch from her intestine, and her ureters were brought into this pouch, so that now she can wear a bag and be completely continent. until that time she couldn't go to school because her family couldn't afford diapers all of the time and she would smell like urine.  she just finished primary school and is hoping to start middle school next year.

lots more stories, but the most moving one today was two parents from a very rural area, the father spoke Spanish and Quiche, the mother only Quiche, who brought in their child who was born with ambiguous genitalia. we had an hour discussion about how gender identification is best decided when it is not clear (basically the major tenet is to wait until the child can tell you how they identify and what gender they feel they are). they didn't know anything was wrong with their child until a neighbor told them that all little girls do not look like their 3 1/2 year old. their little girl in fact has a condition where the body does not fully have receptors to testosterone, and is thought to have testicles (in her abdomen) and a small penis,  but has been raised as a girl thus far. it was an amazing conversation to have, and my brother Martin did a fabulous job of explaining what was happening. The parents asked awesome questions and now have more understanding of what is going on and how to proceed.  What an honor to be there!

Sleep well my peeps. see you tomorrow!
Maria