Panama 2019 Day 16: More on Gabrielito’s Medical Visit

Gloria arrived on Friday radiating relief and gratitude. Their cardiology appointment was with the doctor who attended during Gabrielito’s surgery in 2014 with a visiting medical mission team from the United States. They still don’t do Tetralogy of Fallot surgery here, but this cardiologist — a man in his 60’s — could not have been more kind and was a sharp contrast to the young female cardiologist who managed, in under five minutes, to terrify Fani about the prognosis for her little boy.

He gave them a whole hour. He welcomed everyone into the exam room: Fani, Gabriel, Gabrielito, Alia [they had no one to leave her with, so she came], Gloria, and Gabriel’s new woman who happens to be a pediatric intensive care nurse and asked Fani if she could come just to listen. This is not the woman who the family feels broke up Fani and Gabriel’s relationship, and oddly enough the two women get along reasonably well.

The doctor was very familiar with what had happened during Gabrielito’s surgery. Apparently the surgical records exist in paper form, not electronic, and are at the Seguro Social hospital Santo Tomas [the charity hospital] under this cardiologists name. The cardiologist they saw a few weeks ago apparently could have accessed the records and looked at Gabrielito’s history, but she’d have had to know the name of the colleague who attended to find them — or so Gloria understood. And the doctor would have had to take the time.

She was seeing Gabrielito for the first time, hadn’t read any of his records, and likely had little to no experience reading an echo of a child who’d had Tetralogy of Fallot surgery. That, offered the cardiologist, may have been why she over-reacted.

Well, it’s an explanation of sorts….

That said, the cardiologist examined Gabrielito, did an EKG, tested his arterial pressure and found it normal, and was most reassuring about the child’s prognosis. The doctor says that Gabrielito may never need more procedures, and if he does, they made be done with cardiac catheterization and not open heart surgery.

The doctor hadn’t seen the echo, which is at Seguro Social. Gloria asked, just to be sure, if he would see them there and read the echo and assure them that all is fine. The doctor, who does rotations in the charity hospital, wrote the order for them to see him there in three months.

Apparently all of Gabrielitos’ records are in paper form, not electronic, so the doctor couldn’t access the echo from his office in the private pay system. He will have to go to Seguro Social hospital to get it and review. He said he would give Gloria and Fani a paper copy, which Gloria said she would send to me via WhatsApp.

They came away happy and reassured. The doctor complimented them on having such a strong family, and Gloria specifically on her perseverance in asking questions. Gloria apparently did most of the talking. Fani and Gabriel were quite intimidated. The other woman remained silent out of respect for her awkward position.

I told Gloria that her work now is to teach her daughters-in-law how to speak up for themselves and their children, especially since in the charity system only one person is allowed in the exam room with the patient. I reminded Gloria that ten years ago she was not the confident, outspoken woman she is now, and that Fani and Lynette can learn too.

Gloria shared an interesting fact. Although her husband Luis is always supportive and never criticizes her for speaking up, her sons do. They call her “muy peleona”, very argumentative.

I told her that happens in our country too when men are threatened by strong women, and it’s simply something we all have to push through. 🙂

4 thoughts on “Panama 2019 Day 16: More on Gabrielito’s Medical Visit

  1. for Phyllis: What concerns me is that the doctor who gets it is 60-ish, and the dismissive one is the younger, and female. Feels as if medical education going in wrong direction.

  2. Yes – one would think it would be the other way around. But the 2nd one is older and wiser, and it probably helped that he knew G’s history. Good of him to stop the other center for the echo done there.
    One wonders how younger doctor would behave in a private setting.

  3. for Phyllis: I am particularly vexed that the younger doctor gave such dire news after a 3 minute visit without even looking at the history. Useless. Quite sure she is different in her private practice, or she won’t have one.

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