Motley Moose – Archive

Since 2008 – Progress Through Politics

Where I'm at

I’ve been having an internal struggle ( spiff vs. spiff cagematch) on where I’m at and what my contribution to this great blog is. For those that don’t know me I’ve got a …err…peculiar …

My “diaries” will be rants for the most part, unstructured and a bit different. I’ll probably regret a lot of what I’ll write and I’ll let you know when I slip up. But I’d rather just write and not think about it to much. Serious stuff will be written ( like today for example) but for the most part I’ll just ramble about whatever the fuck is on my mind.

With that being said. Here goes.

Quick background info. I’m not getting into finer details to protect the privacy of the patients and out of respect to the country which has trusted me with treating their people. I also might not use great technical terms and might mention the wrong names. Sometimes translating in my head is slow and like I said before. These are more off the cuff than any other thing.

I work in a pediatrics hospital in a country a lot poorer and with a lot less than the U.S. Great medical staff that does a lot with less. Don’t get me wrong. It’s not a bombed out war torn hospital. It has some state of the art shit and it is a very nice looking building. Its burn unit is one of the best I’ve ever seen ( in the US or elsewhere) for example. But a lot of times. The amount of patients that visit the hospital makes overcrowding (2 to 3 patients per bed) a real issue. We run out of everything. A new small shipment can be located in the morning but when it is 3 AM and its not there it makes things very hard for both docs and patients. We use cheaper drugs for the most part because for the most part, all patients are very, very poor. For instance. A lot of them don’t have enough money to buy blood or platelet packs for their family members. Maybe they’ve got to eat only bread and milk with a bit of plantain and salami for weeks in order to have enough money for the basics. The hospital provides most services free of charge but even the smallest thing, paying for a 5 dollar test, becomes hard on the patients family. I’m just giving those still reading an idea more or less. I’ll expand as I go along or mention things here and there.

What do I do?


Whatever the hell is needed from me. I’m not a surgeon so I don’t operate and I’m not a nurse so I can’t get the life saving needles and catheters in veins of patients. But I do just about everything else.

This is another important detail. Every single person. From the lab technician who analyzes the samples. The janitor/cleaning peeps who maintain everything as clean and sterile as possible. The dude who runs the pharmacy. Those who wash the sheets and clean the beds. For young docs such as myself, sometimes (most of the time) the most important person in that room with you is an experienced and well trained nurse. I know our buddy Rage is getting into this field and I can’t begin to tell you how important nurses are to hospitals and they should get even more respect than they get. My ass has been saved and I’ve been able to provide better service and comfort to patients because I had a great nurse on shift with me.

Like in all proffesions a lot people suck at their jobs. A lot of bad doctors everywhere.

A lot of bad nurses. Ect. But these are in the minority.

The most important thing to remember is that even if it is 4 AM and you are manually getting some blood into a kid …


SLOW. **

Even if you are desperately trying to save a kid with a 1 in a 10,000 chance of making it by working on him for hours at God knows what our of the night …

Even if you are doing rounds ( going all over the hospital and getting to know the patients history and making sure they are on the right meds and have had the correct tests among other things) and once you finally see everybody you are told the dozens of new patients have arrived and they need your ass A.S.A.P. in the E.R. for some heavy lifting.

Even when all this is going on and you haven’t slept a wink or eaten in hours …

You’ve got to remember that while it sucks to be doing something so tedious, challenging, hard/boring, easy/fun when you’ve been up all day and all night …

the patient is going through what you are going through ….


they are sick and scared. They’ve been there for weeks or days sometimes sharing rooms on a daily and nightly basis with strangers without being able to understand why they have to suffer so much. All I do is for my patients and I always try to remember this. I’m human and my mind does drift into being annoyed at some situations and angry.

Sometimes building up a shell, becoming desensitized to pain of others is the only way to help them and get through the night/day. This has been my biggest struggle and what I will probably talk about in my next “diary.”

Dealing with this is an adventure I’ll share with you guys.

It’s going to be interesting to see the vibe of my comments and , Where I’m at a year from now.

Questions are very welcome ( help me jog my brain and think better) as is advice or whatever.

This is a SpacemanSpiff diary which means they can be treated as Open Threads. Jacking the comments and going off topic is fine by me and welcome.

I didn’t read this after writing it which is kind of the point of this exercise.

Editors please fix it up (typos and other errors) as you see fit please (pretty please?).

I’m off to bed. Have to get up early tomorrow.

Gotta go help save some lives!

p.s. Any ideas on what I should name these rants/journals/thoughts?  


  1. sricki

    to comment or diary of late, but I feel the need to comment in here.

    Spiff, what you’re doing is incredible. And we are so lucky to have your voice here on The Moose. Never let it fall silent. I know you’re terribly busy, and every second that you take out of your week to post here is tremendously appreciated. Thank you for sharing some of your work with us. You’re doing an amazing thing, and clearly a very difficult one. Best of luck, always, and please keep posting about this. It keeps us up to date on how things are going with you and makes for an enthralling read.

    You make The Moose proud, Spiff.  

  2. Jjc2008

    I enjoy reading your stuff (diaries, comments, etc).  I like your “from the heart” style.  But then, I think it reflects my own emotional response style.

    It’s revealing of who you are, what you do and it comes off as real to me. I think your style as well as the researcher style are equally important.  The real world sometimes does not jive with, fit into some statistical niche and often, I think (just an opinion) intellectuals need to be reminded.

  3. Kysen

    Hey there bro….good to see you writing of your adventure.

    I want to (LOUDLY) second sricki…you do the Moose proud, my friend. You are a good man doing good things in a rough and trying environment. You are making a difference in many lives, Spliff…and that is a wonderful thing, indeed.

    I don’t have any clever ideas for a name for your Lounge diaries, but, for your more serious diaries…how about “Deep Space”?  😉

    Much love out to you, bro…while you are taking care of others, don’t forget to take care of yourself.

  4. Thoughts (or ramblings) from the Isle of Enchantment?

    Keep up the good work, space. The site would certainly be poorer without you.

    We’ve only started to discuss the main issues this country faces. We’ve begun to talk about education and we’ve touched on health care. As that issue heats up, we will be needing your first-hand experience to balance the discussion.

    Here’s a question. Has anyone suggested that a national health care plan include PR? And, if we aren’t willing to extend it to the territories do we have any right to keep them in territorial status?

  5. DeniseVelez

    Don’t you dare.  Keep feeling it.  It is what will make you a superb doctor-person.  Rant on hermanito.

    And most important is don’t buy into the mierda that somehow being a physician places you at the right hand of God.

    Aplausas pa’ ti for recognizing those who work with you – nurses who have trained many a doctor, the cleaning staff (my padrino was one of them for 30 years)- the patients who will place their lives in your hands (some will be pretty irritating too) and others will treat you as someone god-like.

    I will share with you my experience in Bayamon with a dying young woman who lived in a “chutin”(heroin shooting gallery) who was refused an ambulance – she lived in a caserio ( public housing project) and the medical team on the ambulance didn’t want to touch her to carry her to the hospital to die because she had “El Monstruo” (street slang for AIDS). A young doctor from Centro Medico doing outreach intervened, with the help of the local drug lord (owner of the punto (drug spot) and the workers were bribed to carry this emaciated young woman off to a heaven of clean white sheets where she could die in dignity.  That doctor cared.  No matter she had only a few more days to live.  No matter she was an addict.  No matter she was a prostitute.  Dammit – she was human.  

    My experience with the medical system as a participant observer over the years has made me aware of all the flaws of colonial care, whether in PR or the barrios here in the States, yet somehow, some individuals manage to keep their sanity and humanity and do what is right and good – in spite of the system.  

    This is your challenge, and obligation to the tenants of your profession.  It ain’t gonna be easy hermano.  Know that we hear you,  and are moved by what you write/feel/think/observe/experience in your journey.

    Keep sharing with us.  

    Much love.  

    Su companera en la lucha.


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