Intern Journal: Nick Bettencourt - MEDLIFE

Intern Journal: Nick Bettencourt

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When I think back on my first few months working with MEDLIFE, some experiences stick out more than the rest. Experiences that challenged me in new ways, or made me think about why I decided to spend a year doing this work. One of those experiences came a few weeks ago, while visiting a new patient with one of the nurses.


As Carmen, Leigh and I rose higher into the community of Pamplona in a tiny mototaxi just barely wide enough for the three of us, I wondered what our next patient visit would bring. As we arrived to the address listed on our patient form, I noticed that something about the neighborhood seemed off. Although most of the houses in the area were nicely painted and appeared to be well maintained, there was one house at the end of the lot that stood out. This house seemed to be a patchwork of whatever the owners could find: wooden boards, political signs and anything else that most people probably throw in the trash. The house had no number, but after a quick process of elimination we realized that this structure probably covered our new patients. We knocked on the lopsided wooden door, and before long a string from the inside pulled it open. Carmen, the nurse, hesitantly mentioned our patient’s name and the man responded “mi esposa,” that the woman was his wife. He said that she was at work, and offered to walk us down the street to the comedor where she spent her days cooking in exchange for food for her family. The main hobbled out of the house and led us down the street. Although he wasn’t the patient we had been called for, the man’s obvious and severely inhibiting limp made all of us wonder what this new patient was going to tell us.

He led us down the street to a staircase, and pointed to a building a little ways down the dirt road at the bottom of the stairs. He seemed to indicate that he would not be coming down the stairs with us, so we thanked him and walked over to the building. We walked up to the comedor and Carmen again mentioned our patient’s name. This time we had the right place, and a 70-something year old woman ascended the stairs from the kitchen to greet us. We were there on a follow up visit, meaning that this woman had been treated at a mobile clinic, and identified as needing more follow up care. Although she had been chosen for follow up care due to difficulties managing diabetes, the real root of her health issues were much more severe.

The woman was hesitant to give us any information at first, but she eventually opened up and launched into her true story. She began by explaining that 10 years ago her husband and her daughter had been involved in a horrible moto-taxi accident. While this explained her husband’s inability to walk normally or shake our hands, she explained that her daughter had suffered much more. The crash had left her daughter with severe brain damage which required heavy medication to accomplish even the most basic activities. Without this medication, her daughter could not get out of bed in the morning or speak more than her name. Although it allowed her to function normally, the medication sometimes caused her to have manic episodes. During one of these episodes, the daughter attacked her mother and ran away from home. Although we weren’t told how long she was gone, the mother explained that while away from home the daughter was raped and had a child. Unable to care for her child, she eventually returned home so her sister could take over raising her son.

The woman continued to recount her tragic story, struggling through tears to continue drudging up these painful memories. Her friend, the owner of the comedor, spoke up for a moment while the woman took a break to compose herself. Her friend explained that since the accident the woman and her family had been stuck in a cycle of poverty with no way of escaping. She told us how they didn’t have proper food, clothes or even a working telephone. She went on to say that the family had lost their health insurance 4 years ago, and despite their severe medical needs, no one in the family had seen a doctor since then. This is when we realized the impact we could have on this family. Carmen explained that on Monday she would walk the woman over to the next town, reinstate their health insurance and make doctors appointments for her and her daughter.

The dynamic of the situation changed right then and there. We were no longer pitying this woman who was recounting some of the darkest times of her life, but rather working with her to ensure that she didn’t have to continue living in the shadow of the accident that had so drastically affected her family. As we got up to leave, I could see that the woman’s face was different. Although I couldn’t pinpoint the change in that moment, she seemed to finally be hopeful that her situation was going to get better. She had been stuck in the cycle of poverty and desperation for so long that even this simple act of aid had given her hope. We walked away from the comedor and Carmen began to explain the story and highlight some specific parts to make sure that we understood exactly what we going on. Before long, however, we were walking down the street in silence, each one of us wrestling with that we had just heard and trying to process the intense suffering that this woman had felt.


When I am scared or nervous about a new experience, it can be easy to focus on the negative, and forget about the amazing people and opportunities in front of me. After being in Lima for almost 3 months, it was easy for me to only think about how I missed my life in the states: my family, my friends and everything I take for granted at home. This patient visit forced me to step back and realize the importance of what I am doing here. This woman had essentially given up on the healthcare system and thought that no one, not even us, could do anything to better her situation. Seeing the hope in her eyes as we left, however, made me believe in what MEDLIFE does and gave me a chance to see the real difference we can make in people’s lives.  Although it can be hard at times, every once in a while something comes along that refocuses me, helps me remember why I am here, and allows me to see the real impact that our work can have on others.

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