The morning was moving along smoothly yesterday, when I was called from lunch to see a man with a snake bite on his hand that happened while he was cultivating his yuca. Josue the nurse technician was already starting an IV to give him antivenum. Amist evaluating him, another man walked in who accidentally cut his forearm with a machete. He has a bloody towel wrapped around it. Inside, we found the laceration to be covered with a cut chunk of human hair. This is a common home remedy here to stop bleeding until medical care is sought. As I finished sewing his arm up, a lady was brought in on a stretcher with severe headaches, fever, and weakness for 10 days. I had just enough time to get her history before I was called in for in impending delivery. When I arrived, Lucilida had been pushing for over an hour and the head was not descending, and the heart tones were dropping. After a failed vacuum attempt, we decided to do a cesarian section. Mom and baby are doing well! The man with the snake bite doesn't have too much swelling and although his bleeding and coagulation time are very prolonged, he will do just fine. The woman with fevers likely has pyelonephritis and the man with the machete wound was sent home with followup tomorrow. Overnight we had a different woman with pyelonephritis and hypotension, maybe urosepsis. She responded to 5 liters of fluid and is much better today. I was so exhausted by this afternoon that I napped from noon to 4pm. There is never a dull moment here at the Centro de Salud!