Buzz free day

Tuesday, January 20, 2009

Today began with bad news: the guesthouse coffee maker was on the fritz. Wow. Not cool. Not cool at all. I had no idea how much I relied on coffee until today. My spoiled Starbucks-loving-self moaned the fact that there is NO WHERE to drive-through, to stand in line, to sit down and order COFFEE in Haiti. Everyone drinks coffee here (even the children), but it is such a basic household item that it isn't available anywhere but in the home. Not at work, not in stores, not in restaurants. Home. So if home doesn't have it, you are caffeine free all day. Kind-of like the way water used to be until we marketed it in the States. Now you can drive through Starbucks and just order water. Ah the land of the free to market anything. I missed it today.

I sleepily arrived at CONASPEH. Mere moments after putting my books down, Francois came running into the clinic looking frazzled and asked me to accompany her to her son's school across town. She had just got a call that he fell and probably broke his leg and potentially had a bad head injury as well. In my coffee-less daze, I wondered why a school would call and say, "come get your kid with a head injury and take him home." I hopped in the car with Francois thinking it must just be my uncaffenated state that made me question such reason. Arriving at the school, we found her son sitting on a chair sort of stuporous with bandaids all over the side of his face. I commenced with my exam while the nurse gave me a report. The school nurse told me she thought his pupils were unequal immediately after the accident (the sign of serious brain damage). Why hadn't he been taken to the ER? --again, lack of coffee was making me confused. He mumbled when I'd ask questions, but I had my suspicions. I commenced with examining his knee (the secretary said he wouldn't/couldn't walk on it after the fall) which he was hesitant to let me lift, but when his mom distracted him, I was able to mash around just fine with out any significant wincing. So still impressed that he was really quiet and mumbly, and not having completely abandoned the US "must rule out the worst case scenario first", I thought maybe I should suggest we go to the ER at great expense to Francois. The boy was carried to the car by a 10-foot-tall security guard since he couldn't walk. I wasn't done with my exam. We started talking to the boy in the car as we were driving away. He was able to speak up if prompted. And my neuro exam was stone cold normal. I told Francois that I thought he might have had a mild concussion--it was obvious he did a face plant while running through the playground. And I recommended that he not play any sports for a month so as not to risk another head injury. This prompted the boy to speak RIGHT up... wiggle himself to the edge of the seat and look at his mom with wide eyes, "no sports?" AHHH. Cured. "No riding bicycles?" he asked me. "How are you going to ride a bike when you can't walk??" So miracles of miracles, he was able to walk himself right out of the car into the CONASPEH school without problems. He definitely gimped it up for all to see, but Patrick observed a quite normal jog after he turned the corner. :) I guess I CAN practice miraculous medicine after all!

So then back to preparing for my classes. Let me reiterate again how much I'm NOT a natural teacher, ESPECIALLY without coffee. I'd probably enjoy it better if I could speak freely the language, or write notes without hours of diving through english-to-french, french-to-creole dictionaries, or have to teach medicine to students who don't have easy access to text books. If I don't give the information to the students, they don't get it. I can hardly comprehend this as most of what I learned in medical school was what I read which was then perhaps HIGHLIGHTED in class. I know I need to let go of certain expectations. But I still feel like the students have a right to learn well.

So Tuesday I was in sort of a funk in clinic as I prepared for class. I had some kids come into the clinic with headaches and stomach aches, had a couple of pastors come in for simple evaluations, but mostly it was pretty slow. Then I heard a child screaming and crying outside. I looked out the window above my desk to see his mother whipping the child in the middle of the school yard with a leather belt. Whipping whipping whipping. I about threw up. I couldn't take it. I hid in my office trying not to cry only to have the sound of the child's screams follow me in the room; I then went out to say something which also felt completely wrong (like telling someone they have bad manners in their own house... its not my country, its not my rules). Thank goodness one of the women of the school beat me to it. All she did was yell from the door way about what was going on. And the mother walked over to her and talked while the child sobbed. Would you believe that later that very morning, I heard another boy crying, and before I could see what was happening, he ran into the clinic followed by his enormous father whipping him as well with a belt? It could have been the same kid, but I can't say for certain. This time I felt just fine saying, "NOT IN HERE." I know that whipping is a broad cultural practice, and that many people I know had to pick their own switch, but it was shocking to see it in such a public way. It shook me. And I worked hard to not be judgmental while waging an internal battle on what was right and wrong and where my responsibilities like in speaking up and out. I mean seriously, whipping in a school?

So that didn't help my caffeine-free funk.

Class went well. It always goes better than what I dread might happen. I like the students although I am very certain they make fun of me constantly. I have no pride any longer, so I am unfazed. And the basic math problem I put on the board as an example became the rest of my lesson. So the information I was supposed to get through on day one is now taking 3 days to teach. So much for getting through a text-book full of information. Makes me realize how I need to prioritize the information I give. Teaching is hard. I like my job better. Yes, I teach every day, but it is one-person centered and I can read my patient's face and see if they understand or not, and rephrase if they don't. A whole class is overwhelming, knowing there is a quiet one in the corner who isn't saying anything because they are shy, and a loud one in front saying everything is easy when its not consensus. I tip my hat to you teachers everywhere.

After 2 1/2 hours of class, Patrick picked me up and dropped me off a the guest house to meet up with the Creole tutor while he ran to the airport to pick up Felix--our regional director from GM. We had a creole lesson, painfully after a day without coffee, then afterwards went to Felix's hotel for a meeting. And Felix asked us, "how has your time been here?" I'm Haiti-i-fied enough not to have responded based on how I was feeling in that moment.

I really like Felix. He's hard not to like. And he is smart and political and a beautiful person. And he kept telling us we were doing too much, that we needed to slow down, that our focus was to be on language and culture. That we needed to "land." Yes, I agree. Agree to all. But seriously. That is not the partner's expectation. That is not what the partner has asked of us. That is not what the people are impatiently tapping their foot for. And Patrick and I are very very very very very bad at saying no. So I suppose ultimately we came into this all a little naive and we are learning by fire. And I honestly think we are too far into the mess to "slow down" now. If I pulled out of class because it is ridiculous that I"m teaching at this stage, a class full of students would suffer because there is no replacement. If I pull out of clinic, the woman I saw today with high blood pressure and heart failure will wonder why her doctor, who told her to come back in a week, isn't following through when she DID at the expense of tap-tap fair or a long, hot walk. And its fine. I can start saying no now to new "will you do's." Maybe.

So now, back in the room, I'm tired. I blame it all on lack of coffee. Seems reasonable enough. Tomorrow maybe the coffee Gods will be kind and I'll have my dark cup of perspective to get through another day.