On Life and Health: Not in New Haven anymore, or am I?

The more time I spend in Cali, the more I realize how close it is to being at home, and the world feels just a little smaller. This point was particularly driven home this evening, as I sat in a large movie theater, in Chipichape, the biggest shopping mall in Colombia, wearing 3D glasses and watching George Clooney and Sandra Bullock stare down at the earth in the movie Gravity (Gravidad). It was a bit surreal leaving the movie theater after an hour and half of floating in outer space in 3D, to find myself in a large food court, in an even larger shopping mall, with thousands of Colombians walking from Tommy Hilfiger to Zara to the huge tank of plastic balls with jumping children. I forgot for a brief moment where I was.

Earlier this week, I went to a teaching a session at the hospital, La Ventana Cardiaca (the cardiac window), a weekly tradition for the residents. Each week, cardiology cases are presented, in full Power Point fashion. In front of a packed lecture hall, an older cardiology attending, stops the presenters every few words, to bring out a teaching point or randomly call on people in the audience to answer a question. When he likes the answer, he’ll ask the whole room to clap, which they will in one resounding single, “CLAP!” If he doesn’t like your answer, there may be some teasing or joking. Later in the week, we had radiology rounds, also with the expected PowerPoint presentation to the attending, and the usual random questions directed at the residents (Contrast or non-contrast? Blood vessels or nodules?) I even got my assignment for next week, to present on the radiographical findings of aspergilosis. Lots of Spanish radiology translation coming my way.

On Thursday evening, the Center for Infectious Diseases here in Cali held a meeting , which brought together adult and pediatric infectious disease specialists, to present interesting clinical cases. Aside from the discussions about treatment of free-living amoeba infections, the hot topic of the night was…multi drug resistant bacteria and ICU acquired infectious with otherwise rare bacteria. They highlighted case reports from as far away as India and China with these specific infections. If I had the time I would actually love to do an epidemiological study of the infections and resistance patterns happening at Cali’s hospitals. The ICUs I’ve seen are impressively modern compared to what I was expecting, and although I see nurse’s wearing gowns, hats, gloves, masks, it does not seem quite as routine as at home. The rooms do not have those huge signs, “STOP. Gown and glove before entering this room!” I wonder if that makes the difference. I wonder if the prescribing practices of the ID attendings in this city matter more. How do you not use meropenem as your standard, first step, broad-spectrum antibiotic for sick patients in the ICU when you know that so many infections here are so resistant? We face similar questions at home.

Last night also felt like a very typical night of hanging out with other residents and yet, it was so much more exciting. Put a bunch of residents together anywhere, and the conversation will be the same: work schedules, difficult patient cases, fellowship and job applications. But last night, these conversations took place during the walk over to Tin Tin Deo, one of the best Salsa dancing clubs in Cali. Cali is particularly known for Salsa, and I think that every child is born knowing how to dance it like a pro. Walking into Tin Tin Deo felt timeless. Dimly lit, with hanging Chinese lanterns, black and white photos of great Salsa singers look down upon a large space, lines with small tables on the edges, and well-dressed couples dancing salsa in the middle. I’m sure it looked the same in 1950. The music is not live, but the energy is very real. Great salsa songs from the decades play continuously throughout the night. Each song has a very definite beginning and end. The dance floor clears after each dance. Some people return immediately for the next dance, others take a break to sip some Club Colombia beer, or perhaps a shot of Aguardiente, a Colombian rum with an Ouzo-like flavor. I asked the residents, “do they teach this to you in school when you are kids?” No, they just know how to dance, and dance they do. The higher the heels on the high heeled shoes, the better they can dance. One particular woman, dressed in an elegant yet sexy red top which was low cut in the back, a short denim skirt, and 4 inch heels, danced beautifully for hours with multiple dance partners. The men were lining up to ask her to dance. I managed to dig up some basic steps I had learned years ago in Cambridge, at the weekend Salsa lessons and dancing, and was further helped by a Colombian dentist who came out with us that evening. I probably did okay for a first night of salsa dancing in Cali, but I’ve a long way to go to 4-inch-heel chica.

Today I got to explore even more of Cali. After a grueling class at the gym this morning, which involved 30 minutes of spinning, and then another hour of a track style workout- outdoor running, sprinting and jumping up stairs on the edge of the mountain, I couldn’t possibly imagine moving again. But somehow, after a good Colombian power lunch, I got up the energy to spend the rest of the afternoon winding my way through artisan boutiques, the colonial streets of the San Antonio neighborhood, and its hidden courtyards. Every street in San Antonio is as first somewhat plain, old shuttered houses with solid wooden doors. But then you may come across a bohemian store selling jewelry and clothing made from recycled materials, or a vegetarian/vegan restaurant, or an art gallery. The most amazing home furnishing store I have ever been to was an unassuming corner house. But inside, a hidden garden and fish pond served as the centerpiece around which antique and modern tables, chests, lanterns and ottomans graced every corner of the house. I would live in that house if I could.

One more word before I close, on food. The people of Cali are quite proud of their traditional foods. I had the pleasure of trying some of these this week.

Cholado- Take all the tropical fruits you can think of, crush them up with ice, pile them into a glass with layers of fruit syrup and sweetened condensed milk, top with a wafer cookie. Sweet yet satisfying. Our resident happy hour on Thursday involved ten residents enjoying cholado at a street side café a 5 pm Cali traffic rushed passed. Pretty happy hour if I do say so myself.

Pandebono- Bread with cheese inside. How could you go wrong? Almost like a Bialy, only better. Every corner panedaria has them, and the smell of fresh, hot , baking pandebonos permeates the streets at all times of the day.