International traveller and medical student, Cordi, spends rotation in Redfield

By Shiloh Appel

The tight knit community of Redfield has been a new experience for New York native Raymond Cordi, a fourth-year medical student with Saint James School of Medicine. Cordi served a Rural Family Medicine rotation at Redfield Community Memorial Hospital and Clinic from January 1st to 31st, 2020.

As for what brought him here, Cordi says it is “kind of a long story.”

“I needed a rotation, and I was kind of interested in rural family medicine. Not that I have a whole lot of experience. I just wanted to get a taste of it. So my wife works with Dr. Owens and they are on a Disaster Board together,” said Cordi. “So my wife hooked me up with Dr.Owens and Dr.Owens said, ‘if you would like to do a rotation here, it would be a good experience.’”

So Cordi did. According to him, the experience may have changed his career direction.

“It’s funny, because before I did this I was an emergency department nurse and I worked a lot of emergency department stuff. With my training, that is where I thought I would be headed. I thought that once I finish medical school I would go right into the emergency department,” said Cordi. “I have kind of taken a little detour from doing that by doing this. I like the very rural family medicine stuff. It’s something I could pursue.”

Cordi isn’t a stranger to new surroundings, however. He has done extensive traveling as part of his career. Cordi has been to India, China, Africa and Sri Lanka to do mass-casualty incident drills, treat Ebola patients and help earthquake survivors recover mentally.

“In India, we trained the nurses and the doctors how to respond in the hospital [to mass casualties] and we taught the EMS personnel how to respond on the outside of the hospital. We taught according to the Incident Command System,” said Cordi. “The second part of it was a major drill. So we had somewhere upwards of 100 people who were mock patients. We first treated them on the scene and then we transported them to the hospitals. So, first, we would see if the EMS was able to treat that many patients and then we evaluated whether the hospital had the ability to accept all of those patients and treat them and get them safely to their rooms. That was interesting stuff. It was fun.”

In Africa, Cordi served Ebola patients during the height of the Ebola crisis.

“Those were small towns, but it is kind of hard to say that was a small-town experience because at the time, life was completely different there. They closed all of the churches and all of the beaches. The roads were all deserted. You weren’t supposed to congregate. So it was a different world. I can’t say I actually saw the community there,” said Cordi. “…The treating patients for Ebola is very similar to what is going on now with the Coronavirus. The one thing about Africa, the place where I was, Sierra Leone…the temperature was incredible. It was well over 100. You had to have your whole body covered. Your body, your feet, everything. Unfortunately, it was in plastic. So just think about wrapping yourself up in plastic and having to go work in over 100 degree weather. It was incredible. It was awful. The patients were very, very sick. Because there was so much water in the area we were working in, we were wearing boots up to our calves. And when you were finished, you would take the boots off and it was literally about a quarter quart of sweat that you would pour out of the boots.”

Because Ebola virus is a a hemorrhagic virus without a known cure, Cordi would treat patients by administering fluids.

“Unfortunately, fluid is not blood. So there comes a point when the fluid is not sustainable. But that was our job- to see if we could keep the patients with enough fluid and keep their temperatures down,” said Cordi. “Fortunately, this strain of Ebola virus didn’t have as much bleeding as the rest of them. People were bleeding, but it just didn’t seem to be as bad. It was profuse, profuse diarrhea. So you would have to do comfort measures and keep people clean.”

In China, Cordi was with a disaster management team in Chengdu following an earthquake.

“It devastated the people’s psyche. They weren’t able to perform their normal daily stuff. So we were working on how to treat that post traumatic feeling in the general population,” said Cordi. “We were in the psychiatric hospitals. But, obviously, we are medical people, so we were doing that and touring the hospitals as well. We were in the Third People’s Hospital in China.They boasted in the hundreds of thousands of patients per year.”

As for how Cordi began his journey into the medical field, a journey which would later take him around the world, it all began with him serving as a paramedic. He then became a nurse, followed by a nurse practitioner.

“Working as a nurse practitioner, I was working at a very busy hospital in New York called Lincoln Hospital. They see an incredible amount of patients.The level of responsibility for the nurse practitioners …was a lot of responsibility to see patients, treat the patients, and then move on to the next patient. I never felt comfortable seeing that many patients.You only have like ‘X’ amount of time to make a decision medically,” said Cordi. “You are treating someone and you are treating them quickly. Maybe if I did it for 50 years I would be okay, but the truth is, I would go home at night and review my patient notes and make sure I didn’t miss anything. I don’t like that feeling of ‘perhaps I didn’t treat the patient to the best of my ability.’ Which is why I went back to medical school.”

While here in Redfield, Cordi said he has enjoyed the community atmosphere.

“The truth is, I like doing this. I like being part of the community. I like treating patients and seeing the same patients again. There is a continuum of care that I really like. That is more ‘medicine’ to me. That is what I prefer to do,” said Cordi. “I come from someplace where it is very, very busy. But it is a good feeling of community here. I like that. It is something that is desirable. It is more than everybody knowing each other. People know each other, but they care about each other. That is the difference. That is what I’m getting at. The nurses are great, but again, they are part of the community. They are not just working. They are working on their neighbors and their friends.”

During his time here, Cordi has worked in the clinic, saw patients on regular clinic visits, treated patients in the ER, tended to ‘people with general complaints,’ evaluated people with chronic diseases like diabetes and hypertension, and more.

“We saw a lot of sick patients. We saw a couple people with strokes and a couple people who had heart attacks, a number of traumas, and a handful of patients who had to get transferred out by helicopter. We also saw couple of patients who were transferred out by ambulance,” said Cordi. “We went into a few of the nursing homes and I haven’t done that at all (previously). So going to the nursing homes here was a new experience for me. It was a good experience, because the patients are well taken care of, so I got to see how that kind of environment was.”

As for challenges, Cordi said a big one for him was the South Dakota weather.

“New York is on the same equator line, so we get the same kind of weather, but the weather here is a little bit different. We get snow there. We get a lot of snow, but they plow it and it is gone. Here, you get a little snow and you battle it for weeks because it blows. The roads are a little more treacherous,” said Cordi.

However, overall, Cordi said the community of Redfield has left a lasting impression on him as a community.

“I love New York. I am a New Yorker. No matter what people say, people are very friendly in New York. But there is a big difference here. People are a community here, and I have always wanted that.

This is not just a clinic. This is not just where people get healthcare. It is part of the community.

It may be hard to see from the inside, but from the outside, it is evident,” said Cordi. “I am going to miss it.”