Daily Archives: June 25, 2014

Oi, from Rio Grande do Sul

June 20 – June 25:

Jack, Trevor, and I hit the ground running when we arrived in Porto Alegre after 24 hours of traveling. Our third and final flight landed in the city at 12:30 AM, and only hours later we were in front of Internal Medicine residents at Santa Casa hospital, teaching them the first of 8 topics we will cover in our Introduction to Bedside Ultrasound course. Santa Casa, which is affiliated with UFCSPA (“oofk-spa” to the locals), will also be the site of our research project, where we are looking at potential differences in learning outcomes between students (the residents) who practice with SonoSim ultrasound simulators and students who don’t. All of the residents will receive lectures and hands-on training with live models from Jack, Trevor, and me. We are also teaching our course to residents, professors, and other faculty at Hospital de Clínicas, but they will not be included in our study. Each topic will be taught 3 times in order to accommodate the residents’ and their limited availability.

That’s enough talk about our research protocol. Our first few days of teaching have gone very well — to be honest, far better than I expected they would go. The students are learning extremely quickly and are really enjoying both the hands-on training and the SonoSim. And because our students are already well-trained physicians, we teachers are lucky to be learning quite a lot from them in return. It has truly been a collaborative experience thus far.

More to come on Porto Alegre, the World Cup, our invaluable host Dr. Ana Claudia Toneli, and other cultural experiences in Brazil (spoiler: beef, and more beef!)…



Trevor (top), Nate (middle), and Jack (bottom) teaching Knobology and the FAST scan at Santa Casa hospital in Porto Alegre, RS, Brazil

Trevor (top), Nate (middle), and Jack (bottom) teaching Knobology and the FAST scan at Santa Casa hospital in Porto Alegre, RS, Brazil


Some professors and attendings using a SonoSim ultrasound simulator at Hospital de Clínicas in Porto Alegre, RS, Brazil

Some professors and attendings using a SonoSim ultrasound simulator at Hospital de Clínicas in Porto Alegre, RS, Brazil

Narayana Institute of Cardiac Sciences

We have been very fortunate to spend the past three days at the Narayana Institute of Cardiac Sciences located in the Bommasandra Industrial Area of Bengalaru. Dr. Colin John, Head of Paediatric Cardiac Surgery, welcomed us with open arms upon our arrival. A towering man with an international reputation as a leader in his field, Dr. John’s warm demeanor and passion for teaching were immediately evident as he invited us into the operating theatre and carefully explained each step of various surgical procedures. We were able to observe surgeries for repair of: Total Anomalous Pulmonary Venous Circulation, Ventricular Septal Defect with Patent Ductus Arteriosus, and Tetralogy of Fallot among others. The hospital is the largest pediatric cardiology center in India and among the largest worldwide; 53 pediatric cardiology surgeries were performed here in the last 6 days alone.

Downstairs on the ground floor, the clinic lobby was bustling with families from all over India and the world. It is not uncommon for patients to flock from near and far to Narayana to receive care. To accommodate the sacrifice these families have made, the clinic is set up to gather a clinical history and examination, perform necessary radiology studies and ECG’s, and form a decision regarding the medical and/or surgical management of the patient all in a single day. The doctors and staff were all incredibly warm and kind; we were very lucky to spend time in this truly special place. Starting tomorrow we will spend the next two days at the Mazumdar Shaw Cancer Center here in Bangalore, before traveling to Mysore Friday evening.

Touched down in Bangalore early early Wednesday June 18. Set out to get a little lost in city jungle and traffic before meeting Shaun and Michelle for a trip up to central Karnataka to visit the 14th-16th C. Hindu temples and palaces of Hampi. Memory bank: whipping around in three-wheeled auto rickshaws with Shaun, Michelle, and our caterpillar backpacks. The first sip of chai after a bumpy, full bladdered-sleeper bus. Walking past rambles of monkeys (who, by golly really do like bananas) in the wee hours of the morning and glancing behind to see a painted elephant named Lakshmi following us down an outdoor staircase, making way to her morning bath. A river basket navigated by palm frond. Knocking knuckles on thin stone pillars (various ratios of Ca, Fe, and bauxite) built to be played for a queen who liked to dance. Being blown to bits by warm wind. Watching the sun set over an impossible landscape of rice patties, coconut palms, and Arizona desert red earth, shrubs, and boulders. And finally meeting Lesley, our ambassador to South Indian culture, back in Bangalore.

And most recently, eating with my hands.