.gay charades and pelvic exams.

first off, i'm having a great time in lima, which is why i haven't reported more on work and fun, but i hope to record more, primarily because i don't want to forget some of my more memorable experiences.

today was a full day of experiences. i had been told in the States that i didn't need a yellow fever vaccine for my work out in the amazon by two doctors. everyone here basically said that that was foolish and if i wanted to risk encephalitis, or worst case scenario, death, then i could forgo it. it's an expensive shot in the states, but being in lima, i had been told that you could get it in most clinics for cheap (30 bucks or so). well, i did a google search (the internet is wonderful) and came across this hospital that is a public health entity in central lima that happens to have recently started giving free vaccinations to ex-pats only on wednesday mornings. i found this quite fortuitous as i was googling last night (tuesday). i should have taken my camera, but decided against it pre-trekking this morning because i didn't want it to get snatched (and didn't think there would be much to photograph). the hospital, named loayza, was very large. there were more than a dozen buildings and it was crawling with people/patients, etc. of course, i had no idea where i was going in this large, somewhat dilapidated, complex. it turns out that the small vaccination office is located on the second floor of the pediatrics building. the peruvian patients could clearly tell i didn't know what the hell i was doing, so they very graciously escorted me and directed me to the folks i needed to talk to. the nurse spoke at a rate of about 1000 words per minute, and after finally figuring out that she was saying there would be a bit of a wait, i obligingly took a seat at the benches she directed me towards with her eyes. sitting amidst a sea of mothers and their adorable children left me A. thinking about how it would go if i tried to return to the States with a peruvian baby at customs and B. wondering how so many youngsters were so calm with what i presumed were various maladies and immersed in a sea of noise and crowd. i've always had a bias of thinking asian babies are the cutest, but peruvian babies got a lot higher on that list today. the wait wasn't horrible, but to pass the time, i decided to read my book--franny and zooey by salinger--which probably only cemented foreigner to anyone curious as to my status in the country. once i was called into the small room space, i was handed a small blue piece of paper recording my vaccination status, jabbed in the deltoid, and sent on my way. i barely had time to attempt small talk, which has become my full-time hobby. there also happened to be a toddler sitting in front of me getting a vaccination or check-up and another chico next to me awaiting his turn. needless to say, hippa policies seem scarce.

i'll post more about the clinic that i'm working at later, but i absolutely adore the staff that i work with. they are so patient with my spanish, and while i'm eager to learn, i can only imagine what they think of us medical student tourists that barely know how to communicate the basics to patients. martha, one of the two main doctors i work with, and i get along swimmingly; i believe i provide her humor with my stories of embarrassment and stark contrasts of our cultures. she lets me do all of the pelvic exams, which i like to think is due to a sense of trust, although in reality i bet she's happy to have a break and not do any. we're trained in medical school to really emphasize and provide patient modesty and verbal communication to alert the patient of the steps of any procedure. being as there are no gowns, and in the small offices that are divided by a curtain, desk on one half and exam table on the other, many of the women who are sex workers either are practically naked from the waist down before i can even get my gloves on or are wearing skirts without underwear which means no disrobing necessary. if my patients in the u.s. could only follow suit the pelvic exams would be 5 times quicker. and being told that talking to the patient isn't necessary cuts entire process of a pelvic exam down to about 2.5 minutes. naturally, i'm a bit uncomfortable just diving right in, so i use my three phrases of "poco fria" (for the cold speculum), "toco" (i'm touching), and "empuje" (push, which is my primitive way of telling them that they are about to feel some pressure). the couple of times when i actually know it's uncomfortable or a bit of skin gets pinched, they never complain, but of course, i feel horrible as if i've severed a part of their bodies (hasn't happened yet, fortunately). my brain can't conjugate and complete the holding of the speculum and reaching for cotton swabs and making slides, so those little phrases are all they're gettin' from me, which is actually three more phrases than the doctors usually give during the exam. as long as you report the findings afterwards, that's all that matters, i'm told.

this evening, accepting an invitation from a friend/semi-co-worker at the clinic, a venezuelan-american from san francisco, who volunteers at the gay community center called epicentro, found me doing gay charades. before i launch into my role, i must say that this ucla-funded "gay support center" is wonderful and i'm glad that it exists. about twenty limenos attended, which was more than i thought would be there, and participated in a discussion about the basics of hiv and scenarios in which it might be warranted to be tested. the workshop culminated in a gay charades of sorts that was supposed to encourage discussion about what they saw. now, as proud as i was to understand about 40% of what was being said in the 2 hours, peruvians get a little squeamish when it comes to charades apparently, at least this group did. after one scenario converying when one person "wants it" and the other isn't interested, no one volunteered for the next. my friend, amaya, leads the workshop, so when the second scenario needed actors she volunteered me in front of the group: "daniel will do it." the other person, another volunteer at the center, named david, likes to act so he did the first charade and volunteered for the second. we went into the hallway to read the proposed scene and come up with a plan of brilliant non-verbal acting. the scenario: "things are heating up, and person A wants to have sex without a condom, and person B is resistant." this ain't your typical charades. this ain't no "...two words...first word...sounds like **points to ear**." and my lack of spanish and his lack of english made it even more difficult to get a plan so we basically came up with the idea that i'm an aggressive slut who wants it NOW and he pushes me away. if you can imagine trying to simulate making out with a peruvian in front of twenty gay men, a u.s. medical doctor from ucla, and straight, heterosexual amaya, while then trying to convey insistence of intercourse without a condom, hopefully it will leave you either laughing and cheering at the actual aggression/discomfort of the scene, which was the response of the gay men, or if you're anybody else, horrified at this "charade" purporting and fostering sexual education. needless to say, i wasn't expecting to have to bend anybody over today, but it was fun. a gay man's got to do what a gay man's got to do for his fellow community in the name of safe, consensual sex.