International Meetings: Lima   7,8/94

by Del Meyer, MD

Our annual combined July/August Summer issue of this Journal has been devoted to what our physician members do during summers, vacations, and their interests at times when not involved in their practice. For many of us remote meetings are a significant diversionary activity, even though the primary purpose is intensive class room academic re-tooling.

One of my more memorable experiences some years ago was going to the Pan American Chest Meeting in Lima, Peru. This was followed by an altitude pulmonary physiology session at Cuzco, a short flight and about two and a half miles higher, near Machu Pichu.

At that time my brother Ray was doing research at the International Potato Center in Lima, next to Lima University. He had joined the Peace Corps for a three year term. When the Peace Corps became politically persona non gratae after one and a half years, he was hired by the International Center for five additional years. It was then that his furniture and car were moved from storage at Lubbock, Texas (Texas Tech Univ where he was a research professor) to Lima and we were privileged to stay with him and his family.

Ray drove me to the Sheraton for the meetings every day for five days while my daughters got re-acquainted with his two children, approximately the same age. One morning as they were driving me to the Sheraton, another car jolted our car a bit. I started to open the door to assess the damages, when my nephew assured me that those things happen and one would "never stop in rush traffic."

The entire family except for Ray flew with us to the sessions in Cuzco. We took a train and toured Machu Pichu. After the evening Altitude sessions at the small hospital, we returned to our pancione for the night before flying back. During the night I awakened suddenly with extreme dyspnea, bolted upright in my bed, grabbing the headboard as I pushed my head and shoulders skyward. The gurgling respirations gave me the cold clammy realization of my left ventricular status. My sister in law called the pancione owner who came upstairs to our room. I told her I needed to go to the hospital for some oxygen. She said the hospital didn't have any oxygen. As I pushed my head and shoulders higher above the headboard I was clutching, with my back halfway up the wall, the headache I had all night which I thought might be from the altitude, became indescribably severe. After what seemed like an eternity, having put my spiritual house in order, and having told my family I loved them dearly, I began to have less noisy respirations, less dyspnea, and within ten minutes began to believe I would get out of pulmonary edema without oxygen or diuretics and survive. My gluteae gradually returned to my pillow.

I tried to sleep in a semi upright position but must have slid down when a similar episode happened a couple of hours later. Thereafter, I sat upright the remainder of the night having decided, should I survive, that I could catch up on my sleep later on--at sea level.

The next morning our 9 AM flight was delayed due to strong winds. We were told that if the winds didn't die down by 11 AM, all flights would be cancelled until the next day. What a relief when our plane took off at 11 AM.

We stayed a second week during which time my brother arranged through a pediatrician he knew, a tour of Peru's largest hospital, San Juan, an 800 bed facility. The chief radiologist gave us a tour of his department. He was elated at having three of seven x-ray machines working on the same day. He stated this was the best that he could hope for. He normally had one or two rooms functional... The ICU seemed on first glance to be well equipped. However, the monitoring equipment was not working. They had recently replaced their old cardiac monitors with new ones from Eastern Europe which had not worked since delivery. The pediatrician explained that the doctors had no input into the specifics of the order except the generic type of equipment--ICU heart monitors. The specific decision was made by the department of trade. They exported anchovies to Eastern Europe in return for hospital equipment... The rounds on the Pulmonary service were conducted by a Thoracic surgeon. He presented a patient in his fifties, heavy smoker, with a thoracic mass. When I asked for the bronchoscopic findings, he said they didn't have a bronchoscope. But, he quickly added, they had requested one each of the past seven years and he was optimistic that he would have one to use prior to his retirement. He stated that he would probably do a thoracotomy for diagnosis and, hopefully, resection. During my medical school days twenty years earlier in Kansas City, even 200 bed hospitals had a bronchoscope. They also had oxygen.

Coming home on Braniff with those Calder paint jobs, I was happy to be where health care was based on patient needs, not on government priorities. It was also pleasant to realize that this international excursion also turned out to be less expensive than sending my daughters to summer camp and it gave them a global experience that certainly exceeded any other summer diversions.