Santiago R&R time

Today was time to relax and enjoy the views. Chile is a spectular country. There is a great mixture of valleys and the Andes. The weather was great. We visited a winery for a nice tour and scenic views. The city of Santa Cruz also provided a museum with an interesting variety of artifacts and history. The displays of the Chilean rescue of the 33 miners trapped in 2010 is an inspirational one.
Our hosts here in Chile have been very welcoming and friendly. We really enjoyed the clinical and research project ideas. We also enjoyed their culture, cuisine and landscape. We are very greatful of Veronica, Juan Carlos, Sergio and the rest of the staff and residents that we met and shared ideas with.
Gracias.
Now Buenos Aires for our last leg.

Santiago, Chile

We landed safely and were picked up by a great host Sergio Vial.  We had a great exchange yesterday.  We went to their two public hospitals and saw a SCFE fixation and an adductor tenotomy for DDH.
Then, off to have fish, finally another protein for our arteries... a stroll around downtown and up the funicular for a spectacular view of the whole city.  Then back to work at the hospital Roberto del Rio for another talk and tour of the facility.
From there, straight to dinner at Buenos Muchachos.  Great show with folkloric dancing and yes, back to meats and else.
Today we have presentations to the Chilean Pediatric Orthopedic Society.  then, site seeing.  More photos to download.  Long day

 

26 September

We wrapped up the Brazil part of the fellowship today with a travel day.  Since we didn’t leave until noon, there was time in the AM to visit the art museum, the local bakery and generally go walkabout.  We reflected that the trip so far is teaching us about another health care system, about understanding different perspectives on pediatric othopaedics and about our own development as surgeons and educators.  On to Santiago!

Oh, for those of you wondering about the football match – we had a great time. The stadium was electric with excitement and loud unified cheering. The Corinthians had to have a win as their last hope of making the South American cup.  The match started well, with the home team dominating the action, but they were unable to find the back of the net on several strong chances.  The second half saw sloppier play and still no goals, with the game ending in a dreaded zero zero.  Perhaps the only thing as impressive as the level of cheering and excitement throughout the game to me as a novice fan was the suddenness and completeness of its ending when the ref blew the final whistle.  Despite the disappointing outcome, it was a very memorable experience for us.

these trees only bloom a few days a year

Sights of Sao Paulo

Go Corinthians!!

Wearing Jerseys given to us by our host Alexandre de Lorenco

Wednesday September 25

Today we visited the Hospital Santa Casa  hosted by Dr. Patricia Fucs and Dr. Miguel Akkari.  The hospital is historic, and has a completely different style of architecture from the other two we have visited this week. We joined their morning case conference which was very well organized and presented.  The morning clinic patients we saw had impressive pathology, and the staff have taken great care to try to maintain follow-up with their patients in order to track the true long term outcomes.  We saw two DDH patients aged 23 and 30 that had been treated by them as young children. It certainly helps give perspective as our profession tries to be more attentive to these results.  We had a very traditional Brazilian lunch of feijoada - rice and beans and pork.  Delicious, but it made some very sleepy for our talks and more case discussions in the afternoon.  Tonight is sure to be a highlight of this segment as we head out for an important football match for one of the local clubs, Corinthians.  Watch out for details soon.

Dr. Janicki enjoys a morning coffee

Beautiful historic architecture of Santa Casa contrasts with new modern hospital 

Santa Casa Hospital

Our gracious hosts from Santa Casa

23 year follow up on bilateral DDH presented at 6yo

Can you tell these are 'orthopaedic' shoes?
(note 2cm lift on left)

lunch of feijoada

24 September

On Tuesday we visited the Federal University of Sao Paulo with our very gracious host Alexandre Francisco de Lourenço.  We gave talks in the morning on Open treatment of sequelae of SCFE, Children’s Bone Health, and Obesity in Pediatrics. We saw interesting clinic patients and toured the hospital.  In the afternoon we visited the football museum, which gave a very cool presentation of the history  of football in Brazil, including their 5 world cup championships!  Dinner was at an amazing restaurant built around a giant fig tree. There were many discussions regarding how to address the almost universal problems in health care of how to match patient needs and locations to availability of physicians and resources.  After we solved that together, we moved on to more lighthearted discussion.  We continue to be grateful for the very warm reception of our hosts.

23 September

With hosts at State University of Sao Palo

Kids are Kids

Do we look like tourists?

Morning Conference at State University of Sao Palo

Interior of Medical School at State University of Sao Palo

Monday September 23

The fellowship is off to a great start! We had mostly smooth travels to Brazil (no missed connections or lost luggage). After a late dinner last night, we were all a little tired at the beginning of the day. Fortunately, there were lots of interesting cases and strong coffee waiting for us at State University of Sao Paulo (Dr. Rui Maciel host). All our hosts provided a stimulating morning that included pre-op case conference and a busy clinic with challenging pathology including bilateral PFFD, Larsen’s syndrome, metaphyseal dysplasia, arthrogryposis, SCFE and AVN. Also included were tours of the orthopaedic hospital and the beautiful medical school buildings. The afternoon included our talks on DDH, complications of SCFE and angiogenesis in bone repair. The hosts provided thoughtful and insightful questions and comments and shared from their research and experiences, which are considerable. All total it was a terrific day of interchange of ideas.
In case friends and family are wondering, they are also feeding us well (too well). Traditional barbecue restaurant for lunch today (meat anyone?) and a great pizza place tonight. In case our wives are reading, nevermind this paragraph, we’ve been eating celery and hitting the treadmill at the hotel gym.

Having an amazing time so far. POSNA could had not pick a better duo to travel with. However, I am the smallest one in the group if you can imagine... so the driving experience is a bit tight in the back seat.
The breadth of pathology and knowledge in Sao Paulo is second to none. The hosts have been super gracious and the residents did not sleep during our talks.