This past week the Catholic Medical School in Loja visited us, bringing a dozen physicians and 50 medical and nursing students over the week. Things got pretty snuggy, both in the Hospital where there was a premium for exam rooms, and for housing. The volunteer house grew from 1 resident (me) to 8, with 15+ gathering here for lunches / dinners / evening guitar music. It was fun if at times hectic to be around all the 20-somethings.

I usually had 2 students with me in clinic, who took turns consulting patients while I watched. This was the school's first such visit, but with the promise of more to come, and eventually performing surgeries with the medical residents.

On Tuesday Padre José requested I make a home visit. Padre, the catechist and I drove 10 minutes in his SUV (you really need one here) to a tiny farm with two buildings. The cinderblock house had a kitchen and two bedrooms; the tin roof was raised 2 feet above the walls, for air circulation, however no birds flew in while I was there. Their 40 year old son with hemiparesis greeted us when we arrived, victim of a fall with intracranial bleed some years before. Their other 10 children left home years ago.

The patient was an 86 year old man, Andres, sitting astride the wooden bench in the kitchen, saying his knees hurt so much he could barely walk. His left femur was broken years before, with a large bony deformity just medial to the knee. He had bone-on-bone in the knee that was painful just to feel. The family showed me pills from a recent visit to the government doctor, including some for prostatitis (he also had problems with incontinence). I told him to come to the clinic tomorrow, take a taxi, and I could give him knee injections.

Padre told Andres, God wants a clean heart to receive communion, so the wife, catechist and I went outside while Padre heard the man's confession. His wife talked to me nonstop in the back yard, about their trip to the bank to get money for the roof, their plot of land, trouble growing food. She apologized for speaking in Shuar to her husband instead of Spanish (I only understood a third of what she said anyway, but I kept that to myself). We all returned to the kitchen, where Padre gave Annointing of the Sick to the wife, son, and Andres, and communion just to the husband. On the way home I told Padre I wasn't expecting to see two sacraments during the visit. He corrected me: no, three. The next day Andres came in for injections of both knees. I also wrote for an alpha-blocker for his prostate, they were happy with the care. Even though there's no cure here.

This weekend is the calm after the storm. Chance to catch up on emails to the local med school, to the ENT docs coming next Friday from Germany, to the dentists arriving in a few weeks. I'm finding out, if you're a good listener, it doesn't matter if you miss some of what's said, it's the time you spend that's most important.

Rusty