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Ordinarily Extraordinary
It occured to me that readers may enjoy seeing a sampling of an "average" day at our center. I picked a random Thursday from a few weeks ago. Below is a list of presenting problems, per review of our Electronic Medical Record (EMR), which is an iPad based system, drChrono. (we don't necessarily have a strong preference for the particular system... they happened to have a free version when we opened the clinic and we do tend to have a strong preference for "free" :) Total Pa
Zachary Self
May 31


I Should Not Be Here.
We recently went to the beach. I almost didn't come back. My father-in-law, Papá Juan, turned 70. To celebrate his birthday he wanted to go to the beach. So, we went to a beach a couple of hours from our home... 30 of us. Josefina and our kids, her parents, her sisters and their spouses and children. We had a brief, but fun stay that included playing in the pool, strolling on the beach, splashing in the waves, and celebrating Papá Juan's 70th. But, things got dicey a c
Zachary Self
May 30


Wachalal in the News! VC Reporter Article
A few weeks ago I had the pleasure of conversing with Alex Wilson, a journalist for the VC Reporter. Alex was working on an article highlighting the Ventura County Family Medicine Program and wanted to use our site as an example of the positive impact the training provided via the VCMC program can have both locally and globally. That article was recently published and, while I am certainly biased, I believe it is a superb piece of writing and we are honored to be included.
Zachary Self
May 29


Broken Heart... & Liver... & Kidneys
On Valentine's Day, somewhat ironically, we spent most of the day caring for a patient with a broken heart ... and a broken liver... and broken kidneys. Jose, pictured below, is a 57yo male with a history of cirrhosis and symptomatic ascites. (in case you're curious, his sweatshirt reads: "Apparently I have an attitude problem" : ) Unfortunately, liver disease is not his lone pathology. He also suffers from heart failure. A sampling of his echocardiogram on day of p
Zachary Self
Apr 4


LEAN IMPACT: How to Innovate for Radically Greater Social Good
For the inaugural post of 2026, we'll look at what is arguably the holy grail for nonprofits: IMPACT. Specifically, we will explore some of the highlights of Ann Mei Chang's challenging and inspiring book, Lean Impact: How to Innovate Radically Greater Social Good . (1) The book is divided into three parts. Part I, "Inspire," makes that case that audacious goals and a relentless drive to maximize impact are as important as, if not more important than, altruism in our p
Zachary Self
Feb 8


Improving Healthcare Access in Rural Guatemala: Kevin's Story
Understanding Malnutrition in Guatemala According to the World Food Programme, Guatemala has the highest rate of malnutrition in Latin America and the Caribbean. Nearly half of the children under 5 suffer from stunting. This alarming statistic is even more pronounced among children from rural, indigenous communities. Kevin, a bright 4-year-old boy, recently visited our clinic. He weighed just 23 pounds, which is a little over half of what an average 4-year-old should weigh. T
Zachary Self
Nov 19, 2025


Trip to the Mothership: Direct Relief HQ in Santa Barbara, CA
Direct Relief HQ, photo from Google Maps Since before our site registered its first patient, we have been blessed to receive support from Direct Relief- a nonprofit organization based in Santa Barbara, California doing incredible work all around the globe. Direct Relief helped us equip our center and since opening our doors we have received several shipments of medicine and supplies from Direct Relief each year. In October of this year, we had the opportunity to spend a
Zachary Self
Nov 14, 2025


Man-Eating Worms = New Fear Unlocked
Guatemala, like many of its neighbors in Central America, has enjoyed a nearly four decade run without cases of myiasis (maggot...
Zachary Self
Aug 24, 2025


Cold Chain = Care Amplified
What is the "cold chain"? Thought you would never ask... per our friends at Wikipedia: A cold chain is a supply chain that uses...
Zachary Self
Aug 17, 2025


Ambu + Med Student Mash-up
A few days ago in a rather unexpected twist we combined two of our site's featured services: Ambulance/EMS and Medical Student...
Zachary Self
Aug 10, 2025


Sterile Straw = Life Extension
Earlier this month I saw a patient, Encarnación (pictured below), who I had not seen in several years. She and her husband...
Zachary Self
Jun 28, 2025


Cardiac Arrest á la APQ: Our Current Resus Protocol
All modern international protocols guiding management of cardiac arrest revolve around more or less the same recipe: High quality chest...
Zachary Self
Jun 15, 2025


Ode to the Original Doctor Self
This special Father's Day entry deviates a bit from some of our typical clinical fare to pay tribute to the original Doctor Self ...
Zachary Self
Jun 15, 2025


Global Health & Asymmetric Rewards
A couple of weeks ago a 40yo female presented to our clinic with lower abdominal discomfort. Physical exam was notable for abdominal...
Zachary Self
May 26, 2025


the teaser...
Here's a brief sampling of the short film Big Picture Media Company put together after a recent visit. Enjoy! Stay tuned for the full...
Zachary Self
Apr 28, 2025


(Another) Diabetes Program Success Story
Meet Manuel (pictured above). When he first presented to clinic he weighed 107 pounds and had a blood glucose of over 400mg/dL. Upon...
Zachary Self
Apr 6, 2025


Heading Back to School!
Some exciting news arrived in my inbox recently. I will be heading back to school this July! To paraphrase ( very loosely ) Lebron...
Zachary Self
Mar 30, 2025


Suture Closure of Possibilities
A couple of weeks ago an adolescent male patient presented accompanied by his mother. Our patient had reportedly managed to lodge a...
Zachary Self
Mar 16, 2025


Oura Ring vs. Splendid Torch
One of our foundational goals is to improve access to high quality healthcare in rural Guatemala. As highlighted in a prior blog post,...
Zachary Self
Mar 9, 2025
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