# Couple Of Questions As A Young Adult Expat In Mexico



## GimpLostAndLovinIt (Jan 15, 2013)

Hey guys, 

Been lurking for a while and wanted to finally post. I've got a couple questions if you don't mind. First, here's the deal... I am a 27 year old business owner who is also considering going to medical school in Guadalajara... but first I want to spend some time perfecting my Spanish and getting squared away before I pursue that. 

I live in a mostly Mexican neighborhood now in SoCal, and I LOVE It... and Mexico has long had my heart... mostly because the people are so open, and the lifestyle is so much more in line with what I see for myself. Someone on here questioned if they had been Mexican in a past life, and I think that's me. In fact, most of my friends regularly chuckle and say roughly "There is no way you are a white girl, even though you are technically a white girl." 

Anyway... I also have some neurological issues and recently an orthopedic issue that has been as yet unresolved in the states... (Not shocking) and will be most likely coming down through Tijuana in Feb... with the intention to stay for at least 4 months, (though not necessarily IN TJ... I have considered a lot of places from reading on here but want to be up close and personal before I decide.) 

I have some questions though... 

1. I don't currently drive, and use... at the moment forearm crutches to get around... public transport is an option, but do you think it's possible/advisable to hire a driver or someone similar to help me explore/get squared away? I do speak Spanish, but it's not to the level I'd like it to be at the moment... and I will be traveling alone. I travel alone a lot, but traveling somewhere and wanting to lay the foundation for a new life are different animals.

If so, what is the best way to do that?

2. Does anyone have any suggestions for places to live for someone in my situation... i.e. limited mobility? I mean, it's not really a big issue, especially within the culture of a place like Mexico... but until I get the hip problem resolved, I think about it more than I usually do. I know I will eventually end up in/around GDL... but at the start, I would like to spend time somewhere peaceful and coastal, if possible.


3. Does anyone know of a decent orthopedic doctor who deals with sports injuries and perhaps arthroscopic surgeries? Location is not important, I just need to see someone ASAP, considering that the hip situation is getting worse and not better... and between the HMO bull**** and the fact that the doctor won't spend more than 5 minutes with me in the US, they have yet to figure out what's wrong... but I have my suspicions....and it's a problem that usually requires surgery. 


And also, just a word on how awesome it is the approaches differ culturally toward someone with a mobility issue... when I've approached medical schools in the US, they all tell me I am competitive, but would worry about "my situation" and thus perhaps should not apply or something like that. 

When I bring up the subject with Mexican universities, or even some housing situations... they look at me shocked as to why I would even ask such a thing or consider it a difficulty... and then discuss all the different ways that various issues could be worked around while welcoming my presence. Simple difference to most people perhaps... but incredibly profound.


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## mickisue1 (Mar 10, 2012)

If I were you, and I'm not, I'd head to GDL first, because the medical care there will be head and shoulders above anywhere on the coast, given the size of the metropolitan area and the presence of med schools in the city.

Have any of your docs in the US pursued looking for progressive diseases, VS looking for the results of a sports injury? I don't want to be the bearer of bad news, but what you describe sounds like it deserves to be thoroughly checked out for that. If nothing else, before you head for MX, insist that you be referred to both a geneticist and a neurosurgeon, and throw in a neurologist and an internist who specializes in hematology for good measure.

Before you go, also collect ALL of your records from all the medical care you've received in the past few years. You may get the run around, but they are YOURS, and you have the right to them.

Best of luck!


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## GimpLostAndLovinIt (Jan 15, 2013)

mickisue1 said:


> If I were you, and I'm not, I'd head to GDL first, because the medical care there will be head and shoulders above anywhere on the coast, given the size of the metropolitan area and the presence of med schools in the city.
> 
> Have any of your docs in the US pursued looking for progressive diseases, VS looking for the results of a sports injury? I don't want to be the bearer of bad news, but what you describe sounds like it deserves to be thoroughly checked out for that. If nothing else, before you head for MX, insist that you be referred to both a geneticist and a neurosurgeon, and throw in a neurologist and an internist who specializes in hematology for good measure.
> 
> ...


Hi!

Thanks for the reply! Sorry I wasn't more clear. The neurological issues are unrelated to the hip problem. The hip issue is new, and related to an injury I sustained while in an accident.... I suspect a tear of the labrum, which is hard to diagnose if you don't know what you're looking for... and as it stands at the moment... I can barely walk... thus do not have time or patience to wait for my HMO and PCP to get around to referring me to an orthopedic.

My neurosurgeon ( unfortunately not where I am living currently) was educated in Korea actually, and mentioned to me that perhaps I should start looking offshore for quicker/better care for any issue that might arise... as did my former PCP who... was educated in Guadalajara... and a former client from Colima... I figured it was worth a shot since... I am already wanting to come down... and since all the US system has been willing to do so far is give me large doses of narcotics, which don't work, and tell me to stay off of it... which... is not compatible with my life...still waiting on a referral, self pay specialists are backed up for months, and no one was forward thinking enough to prescribe steroids or anti-inflammatory meds... and it's been about a month like this. 

I asked for a sports medicine doctor (orthopedic with sports medicine experience) because... the hip injury... a tear like I suspect is most common among people who play sports, and engage in activities that result from quick twisting or pivoting. 

The neurological issue is non progressive and I've had no real issues with it, other than it effecting my balance... which was made worse by a concussion from the same accident (prolonged post-concussive syndrome)... but again...I have been waiting a while for the proper referrals and would still need to pay $$$$$. 

Otherwise, I am very healthy, slim and fit... play various sports and do all kinds of stuff. People barely even realize I have the diagnosis I have, when I am able to walk normally, and it's due to a lot of physical therapy and "bucking" traditional advice on my part. Haha... I have all my medical records, I've always been kind of weird about that.


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## RVGRINGO (May 16, 2007)

I can suggest a very good orthopedic surgeon in Guadalajara:

Dr. Jorge Alvaro Gonzalez Urzua
Tarascos #3432 (adjacent to Hospital del Carmen, in the tower)
(333) 813-2161, (333) 813-2033, (333) 813-2005 or (333) 813-2107

He also comes to the Maskaras Clinic at Lake Chapala on Fridays.

I think you might benefit from a consultation with him. He is personable, patient and very accessible. His English is fluent.


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## GimpLostAndLovinIt (Jan 15, 2013)

RVGRINGO said:


> I can suggest a very good orthopedic surgeon in Guadalajara:
> 
> Dr. Jorge Alvaro Gonzalez Urzua
> Tarascos #3432 (adjacent to Hospital del Carmen, in the tower)
> ...



Awesome, thanks RVGRINGO! I did (I think, still in process) manage to get an appointment with Dr. Dario Garin in TJ, but frankly I am open to more than on opinion on this issue so would love to meet with the Dr. you suggested. Would the best bet to just be to show up at the clinic on a Friday?

Also, do you have any idea of his costs? Garin will be $100 dlls (which, while presumably expensive due to his location... is still 5x less than what the self pay orthopedic guy in the US wanted for an initial consult...


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## conklinwh (Dec 19, 2009)

GDL is certainly a good choice. Another might be Queretaro. I was just there at a new hospital TEC100 to visit a friend in their ICU and was very impressed. I also met one of her doctors, Dr. Jose Rogelio Sanchez Garcia, who is an internist. He is one of a group of four that cover a range of specialities. All speak great English.
I was going to mention that very few US insurance policies work here so would be out of pocket but if out of pocket in the US, than a whole lot less.
QRO also has a great range of universities.


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## GimpLostAndLovinIt (Jan 15, 2013)

Thanks Conklinwh,

Yea, I am basically uninsured in the US right now... well, not really I just have a horrible HMO so am used to paying out of pocket for access to good providers.. but have in general become very turned off by the US medical scene... and the US in general frankly... in terms of living there. 

Plus, Mexico is doing some really cool things medically speaking, which the FDA and various policies/unions within the US will not allow... and as a future medical student, that's really exciting.


I miss being by the beach (Lived briefly in Santa Monica, CA last year, and while great it was so dirty... now am living in Long Beach and it's cold...) and worry about the air quality in GDL frankly... but I suppose it can't be too much worse than living in the San Fernando Valley of LA smog wise? I survived that, and the smog mingled sunsets were incredible...


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## GimpLostAndLovinIt (Jan 15, 2013)

By the way... does anyone know if there is some kind of loophole to be able to go to school on an immigrant visa if you're a business owner with substantial investments in Mexico? 

I'm going to come in on an FMT and not worry about it right now... but in the future I would like to follow the path toward residency, and my business will allow me to invest a fair amount.... 

And yet...when I enroll in medical school... they need a student visa it seems like... or have to work it differently... and I don't want to mess anything up/would like to have any time I am in country (while not on FMT obviously) counted.... since med school there is 5 years... 6 if required to do a service year.


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## AlanMexicali (Jun 1, 2011)

GimpLostAndLovinIt said:


> By the way... does anyone know if there is some kind of loophole to be able to go to school on an immigrant visa if you're a business owner with substantial investments in Mexico?
> 
> I'm going to come in on an FMT and not worry about it right now... but in the future I would like to follow the path toward residency, and my business will allow me to invest a fair amount....
> 
> And yet...when I enroll in medical school... they need a student visa it seems like... or have to work it differently... and I don't want to mess anything up/would like to have any time I am in country (while not on FMT obviously) counted.... since med school there is 5 years... 6 if required to do a service year.


Here med school in 4 years and 4 years mandatory intenship at a Seguro Popular hospital [low pay and long hours] of their [gov´ts] chosing and can be anywhere in Mexico if you enrol in the state university system, which is inexpensive. After that there is an exam before you are cut loose. So 8 years total for specialists/surgeons etc. and longer for speciality/vascular etc. Surgeons/Phyciatrists etc.


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## GimpLostAndLovinIt (Jan 15, 2013)

AlanMexicali said:


> Here med school in 4 years and 4 years mandatory intenship at a Seguro Popular hospital [low pay and long hours] of their chosing and can be anywhere in Mexico if you enrol in the state university system, which is inexpensive. After that there is an exam before you are cut loose. So 8 years total for specialists/surgeons etc. and a bit longer for Phyciatrists etc.


Hi Alan, 

There is a special program in GDL which is 4 years in Mexico, plus 1 in the US, plus an optional social service year back in Mexico IF one wishes to practice in Mexico full time before going back to the US...(as a Mexican GP)

If you choose the US then you take the USMLE and go back to the US for residency...(3+ years) and then can have your US specialty validated in Mexico if you'd like as well, so you're not just a GP. 

They set this up, with the help of the US government and California medical board to attract Canadians and US students who wanted to be able to be bilingual, and to save money. 

It costs more than just enrolling in a Mexican medical school... but it's still substantially cheaper than US med school, and the first 2 years are taught in English.... it's kind of a unique thing I guess. I've been speaking with them for a while, and they are very proud of their program, though some changes have taken place recently. 

It graduated a ton of US/Mex doctors in the 70's and 80's, and I've met quite a few of them who recommend it even to this day... so I figure it's at least worth investigating. 

I am not against enrolling in a "regular" Mexican medical school program, but my Spanish is not to such a level yet to go full speed with medical terminology and complex topics like Bio-chemistry and etc from day one.


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## RVGRINGO (May 16, 2007)

GimpLostAndLovinIt said:


> Awesome, thanks RVGRINGO! I did (I think, still in process) manage to get an appointment with Dr. Dario Garin in TJ, but frankly I am open to more than on opinion on this issue so would love to meet with the Dr. you suggested. Would the best bet to just be to show up at the clinic on a Friday?
> 
> Also, do you have any idea of his costs? Garin will be $100 dlls (which, while presumably expensive due to his location... is still 5x less than what the self pay orthopedic guy in the US wanted for an initial consult...


You should make an appointment, in either location, for sure. Clinica Maskaras, at Lake Chapala, is at (376) 765-4805.
I suspect that a consultation will run around $600pesos.


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## mes1952 (Dec 11, 2012)

From what I've learned from Mexican nationals living in Baja (including Tijuana) is that medical care there is more expensive than on the mainland including Guadalajara, etc. The reason is that there are many Americans living in Baja (especially age 65+) which has resulted in higher prices than other parts of Mexico.


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## TundraGreen (Jul 15, 2010)

kristinakenway said:


> it great to know about it


Kristinakenway, You are welcome to the Mexico forum like everyone. But, I am curious. Your profile says you are from New Zealand, living in New York and an expat in Andorra. What is your interest in Mexico?

Parenthetically, your country of expatriation (Is that a word?) prompted me to learn a little about Andorra. The Wikipedia page, https://en.wikipedia.org/wiki/Andorra, is very interesting.


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## GimpLostAndLovinIt (Jan 15, 2013)

You guys have no idea how much I appreciate the feedback here!

As I mentioned, I am going to come in on an FMM, but I have interest in starting at least one business there...

It looks like I could form the MX equivalent of an LLC and qualify for a work visa which would allow for a number of things... or I could come in/qualify similarly as a registered/trusted agent of a soon to be formed MX company.... and either option is feasible for me... depending upon which angle I'd want to approach first for the first business... but my situation is a little bit complicated by my future educational plans (most likely...) 

Can anyone recommend a good immigration lawyer either in the Baja Norte area, or surrounding areas of GDL?

Muchas Gracias!


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## mickisue1 (Mar 10, 2012)

Not to beat a dead horse, but if your immediate goal is to get excellent medical care, I would target GDL or another large city with well respected medical school, for now.

The beaches can wait till you can run on them, yes?


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## GimpLostAndLovinIt (Jan 15, 2013)

Thanks Mickisue1! Indeed the beaches can wait until I can run on them to an extent, but I will not be living full time, or really part time in GDL due to a need temporarily to be close to San Diego (business reasons)... so my time in the GDL area will be short trips for medical care or interviews with clients...or whatever... 

I have an appointment with a specialist in TJ already who specializes in the minimally invasive type of surgery I suspect I might need... 

Also I will shortly be scheduling an appointment with the Ortho that RVGringo suggested who comes to Chapala... once I can line up my schedule for a jaunt in that direction... so maybe it's crazy but I'm going to try and get my bearings in both places, with more focus on Baja Norte for the moment.


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## cuylers5746 (Mar 19, 2012)

*Medical School in Mexico*

One nice advantage too of going to school in a Medical School in Mexico.

It used to be you didn't have to have an undergraduate degree before you enrolled.

What should you have to? Doctors are nothing more than Technicians, that "are practicing"
and the only technicians I know that get paid to "practice" with positive results are not.


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## cuylers5746 (Mar 19, 2012)

*Hospitalization in Baja Norte is more expensive than GDL.*

Having lived there and having friends and family that have had bills from 
Hospitals in T.J. and Ensenada. It IS more expensive than in GDL. Maybe
some of that increase in cost is because the cost of living in Baja Norte is
only about 25% less than in San Diego, while the interior of Mexico and 
GDL is generally speaking 50% less expensive?

I think it's also because some of the Doctors and owners of the Hospitals also
have licenses to practice in USA? They expect more. You can wrack up a 
$10,000.00 USD bill at a hospital in T.J. in just a few days.

Go to the source; Guadalajara for that Medical Care. That's where the top
Medical School is located.

Another point that should be of very much importance to you. Generally speaking 
P.T. and O.T. is very limited in Mexico. Like 25 years behind the times. Speaking
as a husband from one of the top O.T Assistance in the USA with 23 years experience
(the ones that actually perform the Therapy instead of mainly doing the Medicare, Private 
Ins. paperwork those are the P.T. and O.T.s). BUT you're in luck they have
some excellent Therapists in Guadalajara. Outside of D.F. and GDL I don't think you'd
be happy with the results?


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## GimpLostAndLovinIt (Jan 15, 2013)

*GDL, PT and Med School*



cuylers5746 said:


> Having lived there and having friends and family that have had bills from
> Hospitals in T.J. and Ensenada. It IS more expensive than in GDL. Maybe
> some of that increase in cost is because the cost of living in Baja Norte is
> only about 25% less than in San Diego, while the interior of Mexico and
> ...


Interestingly enough, I HATE the standard western model of physical/occupational therapy... (at least in the US) and have had the best experiences when I combine older techniques, sports massage, a bit of intensity with the right providers, and a holistic approach...

Using that combination, I actually accomplished something in less than a month that people said I wouldn't do, due to "my age" (I say that because I am still very young, and it makes me laugh) so I kind of take the road less traveled and it's served me well. 

I also know a fair amount of the doctors in GDL especially and some in TJ are trained in the EU and Israel (it used to be very common for US doctors to go overseas to add to their training as well... but that has fallen out of favor) and those places are actually on the cutting edge of a number of things... which as a patient and potential medical student looking at the school in GDL... it's really an exciting time.... 

I think I am going to re-arrange my trip, and hit GDL first and poke around... then if I still feel the need, I can keep my appointment with the sports ortho guy in TJ before I head back to CA to get my stuff. 

Also, for anyone thinking that Mexican Drs have to repeat medical school in its entirety to practice in the US... that's not actually true.. what it is, is that their residency/internship periods after that initial period of schooling... is not recognized, whether they are a specialist or a GP, so if they want to practice with full rights in the US, they must have their initial medical education validated, and then take the US licensing exams, and then apply for medical residency, find a spot in their chosen specialty... and complete that program with US credentials, which can be anywhere from 3-8 years in addition to the 4-5 prior. This is NOT a requirement limited to Mexican doctors, pretty much ANY med school grad who is educated offshore who does not complete an approved residency program in the US... cannot practice in the US long term. 

There are certainly differences in the Mexican medical education system...and bad apples exist everywhere.... but there is something to be said for learning in less than ideal situations... without an inbred reliance or dependency on modern technology... (proficiency in technology is so important, but dependence on it for diagnosis.. is dangerous in some ways...)

Plus, from the moment after the white coat ceremony in the US... there is such a heavy union component, big pharma has their hands in the pot, fear is instilled from day one in terms of malpractice rates, plus anxiety over the debt load in relation to salary... and it's a very disease/singular symptom oriented system... and such political indoctrination from the AMA exists in the US that, it can be pretty miserable for US med students and the doctors that kind of environment produces... they are basically taught to be myopic in many cases through no fault of their own.... sometimes this produces greatness.... other times it produces the kind of doctor who can't stand to actually listen to his/her patient and just sees them as a series of dollar signs.

The US medical school burn out rate is very high, and job satisfaction in many specialties is low.... it usually has very little to do with academic difficulty...or selfish motives.... and I am going to **** it now but that's just something I've found in my research, and having grown up amongst medical professionals in my immediate family... as well as in relation to my own situation.


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## RVGRINGO (May 16, 2007)

Very well put.
My cardiologist and my retinologist did their residencies in the USA and both are at the top of their fields, often traveling around the globe to learn more or to present at conferences.
My last retina surgery, in Guadalajara, was observed by a youn visiting MD, who plans to enter the field, and I had an opportunity to chat with him for half an hour, prior to surgery. He has been following my retinologist for some time, and for good reasons. It may surprise many to find that this is not unusual.
there is a local anecdote about a woman who needed surgery, but would not trust her Mexican doctor to do it. So, she made arrangements to have it done in Houston, TX and flew there for the operation. Guess who the surgeon was? Yes, some of them practice on both sides of the border.


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## cuylers5746 (Mar 19, 2012)

*Mexican Doctors practicing in USA*

Actually there are quite a few Doctors in Mexico that practice a few months in USA. I think they want to stay abreast of the latest techniques and have access to talk with their fellow pires while practicing in mainly Houston Medcenter.

Our Orthopaedist is one of those here in Tepic.


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## mickisue1 (Mar 10, 2012)

Not surprisingly, given the popularity of having cosmetic surgery done in MX for the much lower costs, many of the best plastic surgeons in GDL also have US practices.

But in GDL, according to their websites, you can get your surgery and a stay in a four or five star hotel complete with frequent f/u visits by a nurse for about 1/3 of what my mother in law paid at the Mayo.

One other thing I've observed in the US, and am not sure how it plays out in MX.

When I was in nursing school and my brother in med school, I was told tales by older RNs about the servile behavior required towards doctors. Head nurses, carrying all the charts as they walked a little behind the doc making rounds, and scribbling down orders for his (of course, HIS!) signature.

All the staff being expected to rise in respect when a doctor approached the nursing station.

In contrast, my brother was trained, from the time he first interacted with a patient, to think of himself as DOCTOR. They were supposed to identify themselves as "student physicians" not "medical students."

And the feeling that one knew more than anyone else was encouraged. I see it, still, in my interactions with doctors my age and a little younger. I was fortunate to find an OB doc who was collaborative, not directive, when I was having my babies. Working with most of the practicing OB/GYNs in St. Paul in L and D, I could observe the way they treated people.

Today, though, perhaps because more of the professors in med schools are female, I see younger doctors treating their patients and their patients' knowledge with respect. It's about time.


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## GimpLostAndLovinIt (Jan 15, 2013)

*Attitudes, Respect, And Competence*



mickisue1 said:


> One other thing I've observed in the US, and am not sure how it plays out in MX.
> 
> When I was in nursing school and my brother in med school, I was told tales by older RNs about the servile behavior required towards doctors. Head nurses, carrying all the charts as they walked a little behind the doc making rounds, and scribbling down orders for his (of course, HIS!) signature.
> 
> ...



I am not quite sure about how the gender dynamic plays out in MX either... there are varying degrees of machismo of course... but according to one of my friends who is in the MX national program at the med school in GDL, the class is about split between males and females, so I think on that level they've been experiencing the growth and attitude shifts in similar ways to the US.

All of my Mexican friends, male and female have been incredibly encouraging to me in terms of pursuing a medical degree... dare I say much more than my US friends, particularly some of my male friends who may still feel threatened by a woman in that kind of position. I don't know. I realize that kind of thinking is antiquated, but it doesn't mean it doesn't still exist.

I also know that in MX in general, the medical profession is very respected... the population views a doctor as someone who is worthy of listening to and they place that trust in their provider accordingly, on an honor system of sorts until something gives them reason not to.... and the doctors, know this, but don't take it in an egotistical way. They are proud, and because they know they're trusted, do not want to mess up. That said, it's very collaborative in the sense that there are certain other cultural factors that can be played upon to help a patient and their families comply. 

These are of course some basic generalizations, based on what I've seen, heard and experienced... and there are people who practice and fall well outside of this mindset.. but the above is the basis of so many things. 

Women are also very respected, in spite of having to deal with the machismo flirting of the other gender... and my friends have told me stories of retaliatory violence between narco groups and gangs... because one side dared to/accidentally injured a woman or Dr. which apparently is a huge violation of "the code."

As far as the US... the mentality you speak of is getting better to some extent... but it still exists...and it's mostly among (usually male, but sometimes not) doctors toward nurses, in thinking that nurses are inferior. 

My mom was in nursing school in the late 70's and 80's... and she dealt with a lot of crap.... then dealt with crap still during her entire 30 year career, first as an ER nurse and then in L/D. Even the Dr. she was married to for sometime... was derogatory toward nurses when they first started dating. I think that there's still the tendency for US doctors to forget that they're dealing with their fellow humans, as opposed to just a series of symptoms, maybe a disease, and a diagnosis... but that's not always true.. thank goodness.

I find it insane to think nurses insane frankly, because a good nurse can save patient lives, and also teach and save the behind of a newly minted doctor who doesn't quite have their medical wits about them yet... good nurses are an invaluable resource. Bad ones of course, like anything else... can be a nightmare. 

Recently I sat in the ER and got to watch quite a dichotomy going on... one incredible nurse (mine) and another three nurses who... I probably would have run away from, or told off had I been "blessed" with their presence because... they didn't have a clue and between them had used this one woman next to me as a pin cushion because they lacked the skills they needed to do basic things.... and with another patient, they were both completely unsympathetic toward her being in extreme pain and basically told her to "get over it, be quiet and let the medicine work."  Those two were women, but I also witnessed a male nurse, in a hurry because they were busy.... improperly and abruptly jam a child's neck back and mouth open to give her medicine... which... of course she promptly spit out, after which time he was upset that he had something to clean up... and then proceeded to speak about her father behind his back and chastise him for "not helping...." 

Females who wanted to be MD's had a similar road back in the day... so horrible... and frankly, while it's changing.. the US medical system is still not entirely woman friendly in the context of women who want to be Dr's and moms... that will take a while to get where it needs to be, and I don't think on that front it will ever be like the EU or MX in terms of being mom/child/career friendly... partly due to a legacy mentality... and partly due to the US workaholic mentality... but that's just my feeling after studying the political systems and social infrastructures of many places in the world, and how attitudes shape those things.

Sorry I wrote a book, but yea these are things I find very intriguing.


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