I had one of those moments today where all of a sudden I see subtle change, progress, all at once.
I am just back from a 10 day vacation to recoup and revitalize... today was my first day back to work. This is the last week of my nursing school class. The class officially ended in June, but we extended some class hours to cover information we just couldn't fit in prior to the semester ending. The class has already started their clinicals, and now they drag in hot, sleepy and tired after blazing through clinics all morning, but they are gracious enough to stay awake and ask questions despite the afternoon heat..
I am amazed at the difference their encounters in the clinical, hands-on system makes in their interest in class work. I was exactly the same kind of student, so I can identify. Nothing makes you want to learn faster than looking a patient straight in the eyes and wanting to DO something smart for them.
My nursing class is smaller than just a month ago, the students who didn't hack the class work mysteriously absent. But the class before me are the students who studied, who asked questions, who learned... and who are moving ahead with their education, more motivated than ever before. Some of the faces had horrible first test scores, but buckled down and brought their grades from F to A. That's motivation, folks.
The classes in July have been a rapid fire, "this is what I want to expose you to before I set you free" information overload. But my new class can handle it. And after a few weeks in clinicals, I can hardly keep up with their questions, now more sophisticated, now more thoughtful, now clearly reflecting newly molded scientifically thinking minds. Sure there is still the, "Dr. Kim, I heard this story on the radio, do you think its possible or is it a lie?" The difference is when I say, "in my experience, I don't know of this happening, but I certainly don't know everything" I can see for the first time students thinking for themselves, considering different options instead of just taking whatever the radio or the teacher in front of the class has to say. And that is the most exciting thing ever.
So today, I was suddenly hit by a realization that my nursing students are growing up... in only 7 short months, they've gone from barely being able to speak the language of science to asking critical questions and thinking for themselves. You can see in their questions the patients they want to help with their newly acquired knowledge. If I wasn't excited about the nursing school before, I sure am now.
Today, being a new single mom as Patrick is now in the States visiting his family and friends, I brought Solomon into the class with me. Now no longer shy about wanting some of his affections, my students quickly grabbed him so I was free to work at the chalk board. But today two beaming students sat him on his own in a chair between them; Solomon looked back and forth at their adoring faces, and then at me as if to say, "go ahead Mom, teach already!" He has gone from a little baby in a car seat, sleeping and crying and eating mid-class (thanks to the patience of my students) to the tiniest little student in a class, sitting in a chair holding his own, gazing up at me with his big beautiful brown eyes self contained around a room-full of acquaintances.
Wow, 7 months can hold a lot of change.
My students have learned and matured. My little boy has grown from infant into pre-toddler, clapping and giggling and saying "papapapapapapa" and other baby verbiage that I'm just to dense to figure out.
Not everything we do here is measurable. And not every day holds moments when I can take stock. But today, in a moment, standing in front of a class, fielding questions and looking in love at the most adorable "ti elev" in the class, was one of those days.
Monday, July 27, 2009
Monday, July 13, 2009
Patrick’s Musings #12
1) Last week we received some sad news; the CONASPEH seminary administrator and our friend Pastor Richard had suffered a stroke. He has been in the hospital for over a week now and is unable to move the left side of his body. A few of us visited Pastor Richard this week and we were happy to see that he had his brother and a friend from his church taking good care of him. Pastor Richard seemed to be doing all right and he was speaking without a problem, but he was visibly depressed about his situation. Please keep Pastor Richard in your thoughts as he deals with his health issues.
2) The big news pertaining to Haiti this week is the World Bank and the International Monetary Fund have agreed to forgive $1.2 billion of Haiti’s debt to the two organizations. In turn, a third organization, the Inter-American Development Bank has also agreed to erase some debt that the Haitian government owed them. Currently Haiti has around $1.9 billion in debt, so this means that about 2/3 of the country’s debt has been forgiven. In general, this seems to be a good thing for the people of Haiti. Ideally the Haitian government will use the money they have been spending to repay their debt on programs that reduce poverty and strengthen things such as the infrastructure inside the country. However, I would like to draw attention to a couple of things that should be considered when thinking about the IMF and World Bank, as well as the debt of impoverished countries like Haiti.
First, we should all be conscious of the fact that the IMF and WB are two organizations that are lacking in moral integrity. Both of these organizations have historically provided poor nations, such as Haiti, with high interest loans that are virtually impossible for these countries pay back. These loans have often functioned to increase debt and further place desperate countries in the hole.
Secondly, both of these organizations are notorious for giving loans to countries run by dictators and other political leaders who do not have the best interest of their people in mind. Haiti serves as an illustration of this sketchy practice. When Papa Doc and his son Baby Doc were running Haiti they were both recipients of large loans from the World Bank. This money was used to line their pockets while the suffering masses in Haiti rarely saw a dime invested in improving their plight. Instead of taking a moral stand on this practice, the World Bank merely continued to hand out money to these dictators without any sort of requirements as to how the money was used. I can tell you that most of the Haitian people we have talked to have little to no confidence in their current government’s ability/willingness to use this new money in a manner that will help the people. Let’s hope they’re wrong.
Thirdly, the World Bank and the IMF have continuously been criticized for the level of cronyism that exists within their organizations. For example, while both of these organizations traditionally give out loans to impoverished countries for projects pertaining to improving infrastructure, it is wealthy companies from the North that are usually contracted to do the work. Time and time again both the WB and IMF have been charged with providing friends, family, and close business associates with opportunities to do business in these poor nations while turning an enormous profit that gets paid for by the poor (think Dick Cheney and Halliburton).
I say these things not because I want people to stop celebrating the recent debt forgiveness, but because as a people seeking to be in solidarity with Haiti we must be knowledgeable about the forces and structures that contribute to the oppression of Haiti. So let us be hopeful that the WB and IMF are undergoing a shift in consciousness that will benefit the people of Haiti now and in the future. Let us also be hopeful that the Haitian government will make positive choices about how to use this money. But while we are patting the WB and IMF on the back for their recent decision to forgive Haiti’s debt, let us not be ignorant of the role that they had in creating this debt in the first place.
3) Many would argue that Haiti is a much more challenging place to live than the United States, but Haiti has some unique things going for it too. While it is true that the U.S. may not have piles of burning garbage around every corner that turns your snot black, it is also true that the U.S. does not have people that swim in the ocean while wearing stocking caps. Haiti does. The majority of people living in the U.S. may have electricity to light the room while they change their infant’s dirty diaper in the middle of the night. However, if you want to get your shoes shined in the U.S. can you find someone ringing a bell and calling out his services below your bedroom window at 5am? You can in Haiti. Finally, if you are attending church in the U.S. in the middle of the summer and it gets too hot you may be able to turn on an additional fan to help with the heat. But can you remove part of the church wall made of metal to provide a larger area for the wind to blow through? I don’t think so. My hope is that Kim and I don’t get too attached to the various amenities that Haiti provides us before someday moving back to the States.
4) The t-shirt of the day goes to a woman wearing a “Pat Buchanan for President” t-shirt. Talk about missed opportunity for America. I once had the privilege of hearing Mr. Buchanan give a speech at the Iowa Caucus. One memorable moment was when Mr. Buchanan insisted that his first order of business as president would be to call the leaders of China and tell them, “You had better stop persecuting Christians or you have sold your last pair of chop sticks in the U.S.A.” Now there’s a man with the cultural awareness and sensitivity that the U.S. needs to move forward in an increasingly global world. Maybe next time the American voters, like this Haitian woman, will recognize a visionary leader such as Pat Buchanan when they see him or her.
5) To conclude I would like to present a quote from my favorite author, Tom Robbins. Robbins is the most unique and challenging thinker that I’ve ever encountered, although that Joel Osteen has some good ideas. Robbins is adamant that to live well, to truly live, one should approach life with a reckless abandon filled with curiosity, awe, and most importantly, a willingness to laugh at all that life throws our way. This is a truth that Haiti is insisting that I relearn over and over again. Robbins states, “A sense of humor is superior to any religion so far devised.”
2) The big news pertaining to Haiti this week is the World Bank and the International Monetary Fund have agreed to forgive $1.2 billion of Haiti’s debt to the two organizations. In turn, a third organization, the Inter-American Development Bank has also agreed to erase some debt that the Haitian government owed them. Currently Haiti has around $1.9 billion in debt, so this means that about 2/3 of the country’s debt has been forgiven. In general, this seems to be a good thing for the people of Haiti. Ideally the Haitian government will use the money they have been spending to repay their debt on programs that reduce poverty and strengthen things such as the infrastructure inside the country. However, I would like to draw attention to a couple of things that should be considered when thinking about the IMF and World Bank, as well as the debt of impoverished countries like Haiti.
First, we should all be conscious of the fact that the IMF and WB are two organizations that are lacking in moral integrity. Both of these organizations have historically provided poor nations, such as Haiti, with high interest loans that are virtually impossible for these countries pay back. These loans have often functioned to increase debt and further place desperate countries in the hole.
Secondly, both of these organizations are notorious for giving loans to countries run by dictators and other political leaders who do not have the best interest of their people in mind. Haiti serves as an illustration of this sketchy practice. When Papa Doc and his son Baby Doc were running Haiti they were both recipients of large loans from the World Bank. This money was used to line their pockets while the suffering masses in Haiti rarely saw a dime invested in improving their plight. Instead of taking a moral stand on this practice, the World Bank merely continued to hand out money to these dictators without any sort of requirements as to how the money was used. I can tell you that most of the Haitian people we have talked to have little to no confidence in their current government’s ability/willingness to use this new money in a manner that will help the people. Let’s hope they’re wrong.
Thirdly, the World Bank and the IMF have continuously been criticized for the level of cronyism that exists within their organizations. For example, while both of these organizations traditionally give out loans to impoverished countries for projects pertaining to improving infrastructure, it is wealthy companies from the North that are usually contracted to do the work. Time and time again both the WB and IMF have been charged with providing friends, family, and close business associates with opportunities to do business in these poor nations while turning an enormous profit that gets paid for by the poor (think Dick Cheney and Halliburton).
I say these things not because I want people to stop celebrating the recent debt forgiveness, but because as a people seeking to be in solidarity with Haiti we must be knowledgeable about the forces and structures that contribute to the oppression of Haiti. So let us be hopeful that the WB and IMF are undergoing a shift in consciousness that will benefit the people of Haiti now and in the future. Let us also be hopeful that the Haitian government will make positive choices about how to use this money. But while we are patting the WB and IMF on the back for their recent decision to forgive Haiti’s debt, let us not be ignorant of the role that they had in creating this debt in the first place.
3) Many would argue that Haiti is a much more challenging place to live than the United States, but Haiti has some unique things going for it too. While it is true that the U.S. may not have piles of burning garbage around every corner that turns your snot black, it is also true that the U.S. does not have people that swim in the ocean while wearing stocking caps. Haiti does. The majority of people living in the U.S. may have electricity to light the room while they change their infant’s dirty diaper in the middle of the night. However, if you want to get your shoes shined in the U.S. can you find someone ringing a bell and calling out his services below your bedroom window at 5am? You can in Haiti. Finally, if you are attending church in the U.S. in the middle of the summer and it gets too hot you may be able to turn on an additional fan to help with the heat. But can you remove part of the church wall made of metal to provide a larger area for the wind to blow through? I don’t think so. My hope is that Kim and I don’t get too attached to the various amenities that Haiti provides us before someday moving back to the States.
4) The t-shirt of the day goes to a woman wearing a “Pat Buchanan for President” t-shirt. Talk about missed opportunity for America. I once had the privilege of hearing Mr. Buchanan give a speech at the Iowa Caucus. One memorable moment was when Mr. Buchanan insisted that his first order of business as president would be to call the leaders of China and tell them, “You had better stop persecuting Christians or you have sold your last pair of chop sticks in the U.S.A.” Now there’s a man with the cultural awareness and sensitivity that the U.S. needs to move forward in an increasingly global world. Maybe next time the American voters, like this Haitian woman, will recognize a visionary leader such as Pat Buchanan when they see him or her.
5) To conclude I would like to present a quote from my favorite author, Tom Robbins. Robbins is the most unique and challenging thinker that I’ve ever encountered, although that Joel Osteen has some good ideas. Robbins is adamant that to live well, to truly live, one should approach life with a reckless abandon filled with curiosity, awe, and most importantly, a willingness to laugh at all that life throws our way. This is a truth that Haiti is insisting that I relearn over and over again. Robbins states, “A sense of humor is superior to any religion so far devised.”
Thursday, July 9, 2009
Time after time
After a long day yesterday, I was almost grateful to get the call that our mobile clinic for today was canceled. Unfortuntately a road had been washed out by a recent rain making the route impassible for the time being, so we wait for another day to take our portable health care to that community. Taking an advantage of a unexpected free day, the Bentrott family escaped to the beach for a little quiet time, fun and reflection.
On the trip this morning while radio surfing, we discovered an old Cindy Lauper tune on one of the stations. "If you're lost, you can look and you will find me, time after time. If you fall, I will catch you, I'll be waiting, time after time." Several decades ago, I used to passionately sing these lyrics into my hairbrush shortly after spraying my bangs to astonishing heights. This morning, they brought me to tears.
I feel like a scab has been pulled off. The little boy last night has unearthed feelings and emotions that have been long riding under the surface of my existance here, that ebb and flow depending on what a day or week brings.
At times over the last 8 months of living in Haiti, I can become too accustomed to the things we see here, to the inhumane conditions under which masses of people live. Sometimes out of self-preservation, I have to put my head down and focus on the little things I'm working on, narrowing my scope to a project I can influence, things I can control. One can only witness pain and suffering for so long without a pocket full of magical solutions before starting to become numb, or worse, accept crazy situations as "the way it is" for lack of no other alternative in a given moment. When answers aren't forthcoming, resources not readily apparent, and you have to stare that hunger in the face without a meal to give, it sometimes is easier to retract or look away from the realities that swirl huge and looming around us. When the real enemy feels too hard, too abstract to defeat with your own two fists, it is easier to get caught up in more trivial concerns and frustrations with faces and organizations you can see and touch; it is even easier to pull away, to focus on all you can't do instead of what you can. And when I'm tired, emotions are pulled inward, callouses are built up, scabs are formed.
But a little boy named Gito pulled them off last night.
We pass children every day who have life stories full of suffering, and who bravely take on their plight doing the best they can. Some we've befriended, give casual high-fives at a stop light choosing not to cry outright at the fact that they work for pennies on a dangerous, heavily trafficked intersection without shoes, without good nutrition, without water on a hot day, without a home to return to. Yet it took an encounter with a child not yet hardened by his situation to rattle me out of my numbness. And I've had a hard time getting the tears to stop falling ever since.
Kids should not have to work for change. Children should not have to be left alone in the street fending for themselves, should not have to be alone and scared as darkness falls in an unfamiliar city. Families should not have to be forced to make the choice to send their oldest to the city to work as an indentured servant for some form of income when the crops don't come in. School children should not have to sit with growling stomachs, babies should not have to have fevers untreated. Young men should not have to live like invalids because they didn't have basic health care to prevent a catastrophic stroke. Injustice does not just live in Haiti.. but its more inescapable here. The reality of suffering is all around us every day.
It is hard to look suffering in the eye and not have an immediate solution, not have the money, the pills, the house, the education, the structures needed to say, "here, I can make it better." It is really hard not to say, "come home with me, it will be ok" when that suffering you see is in the face of a little boy in your car window, tears streaming down his face, a backpack on his back, looking like he got lost walking home from school. What we can do is be a friend, be willing to do what we can every day. We can accompany that scared boy to the police station, be an advocate in a complicated system. We can give a cookie or a pair of shoes when we have them. We tell a joke, hold a hand, listen to stories, laugh, work in our little corners of knowledge for a better overall system of outreach. Some days it never feels like enough, but what is important is that we keep doing it, time after time. There are always 5 more kids at the intersection waiting.
I can choose to feel helpless, choose to sink into despair or rise with hope that maybe our love can make a difference in some small way. I pray that the small things we do day after day are a part of a series of events. I settle on believing that we don't work alone, but as a community of people all doing our tiny share in order to bring about bigger change. I pray that the police commissioner last night took Gito under her protective arm, gave him shelter, reassured him despite his harsh surroundings. I pray a shelter he slept in helped him eventually reunite with his family in the country, that through one hand held after another he was able to get home. I have to trust in that unseen community, knowing full well sometimes it doesn't work, but often it does.
When I'm frustrated with my own limitations, I have to remind myself that we can't do it all on our own. We trust in strangers, we trust in structures, we trust in community and in the fact that our own efforts are augmenting a larger community movement underway to bring about change. I trust that if we call out, our voice will eventually be heard. By someone. Even if that someone doesn't have all the solutions to end the suffering. Because we are not alone. We must answer calls when heard. The hard part is living with the limitations of your abilities. Is holding hands enough? Some days it has to be. And with enough hands reaching out, it will be.
On the trip this morning while radio surfing, we discovered an old Cindy Lauper tune on one of the stations. "If you're lost, you can look and you will find me, time after time. If you fall, I will catch you, I'll be waiting, time after time." Several decades ago, I used to passionately sing these lyrics into my hairbrush shortly after spraying my bangs to astonishing heights. This morning, they brought me to tears.
I feel like a scab has been pulled off. The little boy last night has unearthed feelings and emotions that have been long riding under the surface of my existance here, that ebb and flow depending on what a day or week brings.
At times over the last 8 months of living in Haiti, I can become too accustomed to the things we see here, to the inhumane conditions under which masses of people live. Sometimes out of self-preservation, I have to put my head down and focus on the little things I'm working on, narrowing my scope to a project I can influence, things I can control. One can only witness pain and suffering for so long without a pocket full of magical solutions before starting to become numb, or worse, accept crazy situations as "the way it is" for lack of no other alternative in a given moment. When answers aren't forthcoming, resources not readily apparent, and you have to stare that hunger in the face without a meal to give, it sometimes is easier to retract or look away from the realities that swirl huge and looming around us. When the real enemy feels too hard, too abstract to defeat with your own two fists, it is easier to get caught up in more trivial concerns and frustrations with faces and organizations you can see and touch; it is even easier to pull away, to focus on all you can't do instead of what you can. And when I'm tired, emotions are pulled inward, callouses are built up, scabs are formed.
But a little boy named Gito pulled them off last night.
We pass children every day who have life stories full of suffering, and who bravely take on their plight doing the best they can. Some we've befriended, give casual high-fives at a stop light choosing not to cry outright at the fact that they work for pennies on a dangerous, heavily trafficked intersection without shoes, without good nutrition, without water on a hot day, without a home to return to. Yet it took an encounter with a child not yet hardened by his situation to rattle me out of my numbness. And I've had a hard time getting the tears to stop falling ever since.
Kids should not have to work for change. Children should not have to be left alone in the street fending for themselves, should not have to be alone and scared as darkness falls in an unfamiliar city. Families should not have to be forced to make the choice to send their oldest to the city to work as an indentured servant for some form of income when the crops don't come in. School children should not have to sit with growling stomachs, babies should not have to have fevers untreated. Young men should not have to live like invalids because they didn't have basic health care to prevent a catastrophic stroke. Injustice does not just live in Haiti.. but its more inescapable here. The reality of suffering is all around us every day.
It is hard to look suffering in the eye and not have an immediate solution, not have the money, the pills, the house, the education, the structures needed to say, "here, I can make it better." It is really hard not to say, "come home with me, it will be ok" when that suffering you see is in the face of a little boy in your car window, tears streaming down his face, a backpack on his back, looking like he got lost walking home from school. What we can do is be a friend, be willing to do what we can every day. We can accompany that scared boy to the police station, be an advocate in a complicated system. We can give a cookie or a pair of shoes when we have them. We tell a joke, hold a hand, listen to stories, laugh, work in our little corners of knowledge for a better overall system of outreach. Some days it never feels like enough, but what is important is that we keep doing it, time after time. There are always 5 more kids at the intersection waiting.
I can choose to feel helpless, choose to sink into despair or rise with hope that maybe our love can make a difference in some small way. I pray that the small things we do day after day are a part of a series of events. I settle on believing that we don't work alone, but as a community of people all doing our tiny share in order to bring about bigger change. I pray that the police commissioner last night took Gito under her protective arm, gave him shelter, reassured him despite his harsh surroundings. I pray a shelter he slept in helped him eventually reunite with his family in the country, that through one hand held after another he was able to get home. I have to trust in that unseen community, knowing full well sometimes it doesn't work, but often it does.
When I'm frustrated with my own limitations, I have to remind myself that we can't do it all on our own. We trust in strangers, we trust in structures, we trust in community and in the fact that our own efforts are augmenting a larger community movement underway to bring about change. I trust that if we call out, our voice will eventually be heard. By someone. Even if that someone doesn't have all the solutions to end the suffering. Because we are not alone. We must answer calls when heard. The hard part is living with the limitations of your abilities. Is holding hands enough? Some days it has to be. And with enough hands reaching out, it will be.
Hard Realities Up Close
Yesterday was an taxing day.
The morning started with a mobile clinic assignment to a small little neighborhood not to far from our house. I had to weave the awkward Galloper through tiny streets, markets and around sharp turns to end up in a place I could drive no further, wedged as a street narrowed to only a foot and motorbike path. We got out with boxes of supplies in our arms and marched single file through a labyrinth of concrete, squeezing between homes and shops, walking along a water sewer line (I had to at times hold my breath the smell was so intense), past all sorts of life-in-motion until that narrow route ended at the door of the teeny tiny church we were to have clinic in. The pastor had moved all the benches to the side, and thrown up some sheets to make a division. My "consultation table" was an old fashioned school desk with a mickey mouse blanket thrown on the seat for cushion. Of course they had the consultation area tucked so deep in the church that there wasn't a chance a breath of air could make it past all the sheets and people to carry life and coolness into the morning.
We had a steady stream of patients. Although we ask for 50 gds for consultation and medications (eqiv of $1 US), we had many who couldn't pay. Miss Fano would usher through those she thought needed an exam regardless of ability to pay. Of course they were the sickest folks of the bunch. I saw a lot of severe malnutrition... something that doesn't fail to leave me disconcerted when folks are living in an active, bustling city with fresh food markets at every turn. Another woman had one whole half of her lung sounds occluded by something that prompted her to complain of "weakness." Pneumonia? TB? Cancer? Who knows... but the fact she looked as good as she did with what the exam revealed told me a lot about her strength of spirit.
We finally emerged early afternoon from the depths of the miniature church, hauling all the mobile clinic supplies back through the foot path. Passing houses, you couldn't help but see people congregated to talk, children playing with rocks, women wrapped in towels after their bath, dominos played, naps taken, and wash water dumped along the gutter that we so carefully teetered along.
I then drove to pick up Patrick, Solomon and two girls from CONASPEH to go on a hospital visit. The director of the seminary recently suffered a stroke, and has spent the last week in a hospital. We had just learned of his stroke Monday after hearing he was "sick" over the weekend. We all smooshed in the car and drove out to a catholic hospital nestled in a community on the outskirts of the city. The hospital was beautiful, well taken care of, clean, and boasted lush tropical vegetation creating an almost resort-looking atmosphere.
We found the pastor sitting in a room, face drooping, being spoon fed from his brother who was attending to him. Other family members crowded around. They family is in charge of bringing in food to the patient, attending to basic needs. The pastor, who we have known as a jovial man full of laughter, sat sadly on the bed looking forlorn. I offered him my best words of encouragement, the CONASPEH girls asked the details of what he felt, what the doctors said, and finally Patrick got him to laugh by telling him what he REALLY needs is a beautiful Haitian nurse to attend to his every need.
This afternoon I witnessed EXACTLY what Patrick does with everyone everyday: he makes smiles out of gloom, he connects with humor and genuine care. You can't measure that, you can't describe it in a job description, but it is beautiful to witness. Patrick has a way with people. And watching the pastor's face break into a half grin (battling the partial paralysis) for the first time all day was evidence.
But the visit left Patrick and I haunted. Haiti isn't a place for the old and the sick, not a place for the lame. The pastor is getting good care in the hospital, but will soon have to return home to live with his ancient and tiny mother. Rehab hospitals, intensive physical and occupational therapy aren't an option, if they exist. Not for the common man in Haiti making $2-5 a day. You could almost see the worry over what to do next on the pastor's gloomy face. Will he loose his job? A job that he seemingly loved and that kept him active in the networking of pastors and churches across the country? Will he be able to make it? Dreams of his strong, young life have hit a brick wall, and now this man, only in his mid 40's, likely is battling how he will survive long when half of his body doesn't move. I wonder this as well.
I delayed the evening's run until the very last minute due to the breathless day, the hot overhead sun and my own fatigue from being out in the elements all day. Uh. what a run. Even the leaves on the tallest trees were deathly still. Nothing moved. Nothing. Not the dog sprawled out at turn two, not the goat staring at blades of grass too tired to munch, not a single leaf. Even the children on the rooftops were quiet. A large fire burned near the track outside the walls, and the smoke hung in the air, anchored to the ground, crawling along and choking any oxygen around it. Of course it happened to sink right over half of the track. The first mile I thought I was going to throw up. I eventually sank into a limp around the track motored only by the power of will. It was not my most inspired and refreshing runs, despite the fact the sun sank from overhead and darkness fell, the cool did not come with it.
Patrick and Solomon mercifully picked me up. We stopped to refill our water bottles, and as we were crawling back into the car (myself dreaming about vats of cold icy water) Patrick saw a young boy crying in the shadows of a tree. He went over to him, and the boy told him his story through chokes and sobs. From what we could gather, his family all lived in the countryside several hours away. He had been living in the city with a woman, but she had just threw him out and he's been sleeping in the street for the last 4 days. He begged to come stay at our house; he was so frightened of another night on the street that taking a chance on the kindness of complete strangers was a gamble he was all too willing to take.
The kids on the street are a rare breed. The ones at the intersections we see on our daily commute are toughened by life, almost jovial in their pursuits for "lajan" from cars that pass by. They "earn" coins by wiping off dust from the vehicles stopped at red lights with their filthy rags, and some days they give up the guise of earning a day's pay and resort to simple begging. They are sinewy, tough, and run in packs. They smile and joke with us at our window. But the child last night had not yet been hardened by the street. Although certainly having to deal with more "adult" situations than his 10 years should allow, he still had the softness about him of being cared for. And to see him dissolve in tears was too much. But what could we do? Patrick got on the phone and called a friend of his from the orphanage to ask for advice. He knew of an orphanage we could take him to in the morning, but suggested we find a police station now to help him find a place to sleep tonight.
The boy was too willing to jump in our car. We drove him through the dark streets, handing him some cookies from the glove box and watching him wolf them down. He bravely walked with us up to the threatening police station, tears now dry. Our situation earned us a meeting with the Police Commissioner, a friendly-faced woman who clearly was running things around the office. She greeted Patrick and I like old friends, and we told her the situation as we understood it. She then had the boy tell his story. I didn't catch it all, but the police officer clearly understood. "Did she beat you?" She asked. The boy showed her evidence of bruises and cuts under his chin. The previously relaxed and jovial cop turned cloudy with anger. She had what she needed. She thanked us for intervening and told us the boy would be taken care of.
I'm sure Patrick and I came face-to-face with a restavik situation... And clearly the police woman was infuriated with such reports.
It was hard leaving that little boy in the big police station all lit up at night, full of trouble makers and threatening men in uniform. But I was reassured that the person taking charge of his care was a big, powerful woman who exhibited some preserved passion about her job. We can only hope it wasn't an act for the concerned blans. Patrick's friend from the orphanage said the police have relationships with some shelters and that the boy will eventually have a safe place to sleep. Or maybe they'll help him return to his family in the country. And maybe the woman who had the nerve to turn a 10-year -old out on the street will have to face her ugliness. I can only hope.
We got home last night physically and emotionally spent. We didn't even have enough energy to make anything for dinner. Solomon was equally as tired after entertaining all the orphanage staff for the second time this week. We gathered as a little family on the bed after baths and showers and lots of water (and milk). Solomon seemed to know Patrick and I needed a laugh. He started doing his new trick of wide-open-mouthed screeching that dissolves Patrick and I into giggles. Solomon crawled all over us, singing and screeching and giggling. He helped melt away some of the tensions and sadness from the events that had transpired over the day.
I don't cry here often... I think I try to rise to the same willful courage of the people around me. But tears have emerged a couple of times recently. The first was when I was sinking in to that special piece of heaven which is Solomon's night time routine. After baths, and books and play on the bed, I pull him into a cuddle against my body, his head resting on my shoulder, his big round brown eyes looking up at me, blinking the slow blinks of sleepiness, binky in mouth, and cooing beneath. I then sing to him until he falls asleep. I'm always amazed how few songs I know all the words too. Each night the collection is a strange mix of camp fire songs, pop music, old show choir tunes, and Christmas hymns. But a couple of nights ago, I remembered, "You are my sunshine" and sang it to his loving face looking up at me. I was in tears by "...my only sunshine." Not sure what memory is so strongly linked to that song, but it is one of pure love. I felt overwhelmed with emotion, homesickness and adoration over this little boy in my arms.
Last night tears fell when seeing another little boy, age 10, crumble into tears over the telling of his story, under the fear of another night alone at night in a big, loud city. As I held our protected and chubby little Solomon in my arms, the injustice that a child ANYWHERE has to face such fears left me equally furious and heartbroken.
People often tell us, "Solomon is such a lucky little boy." I always poo-poo it thinking, "it is US that are lucky" for all the joy he brings us. But maybe Solomon is lucky. Maybe we ALL are... all of us who aren't lost, aren't alone in the night in a strange place without a hand to hold.
The morning started with a mobile clinic assignment to a small little neighborhood not to far from our house. I had to weave the awkward Galloper through tiny streets, markets and around sharp turns to end up in a place I could drive no further, wedged as a street narrowed to only a foot and motorbike path. We got out with boxes of supplies in our arms and marched single file through a labyrinth of concrete, squeezing between homes and shops, walking along a water sewer line (I had to at times hold my breath the smell was so intense), past all sorts of life-in-motion until that narrow route ended at the door of the teeny tiny church we were to have clinic in. The pastor had moved all the benches to the side, and thrown up some sheets to make a division. My "consultation table" was an old fashioned school desk with a mickey mouse blanket thrown on the seat for cushion. Of course they had the consultation area tucked so deep in the church that there wasn't a chance a breath of air could make it past all the sheets and people to carry life and coolness into the morning.
We had a steady stream of patients. Although we ask for 50 gds for consultation and medications (eqiv of $1 US), we had many who couldn't pay. Miss Fano would usher through those she thought needed an exam regardless of ability to pay. Of course they were the sickest folks of the bunch. I saw a lot of severe malnutrition... something that doesn't fail to leave me disconcerted when folks are living in an active, bustling city with fresh food markets at every turn. Another woman had one whole half of her lung sounds occluded by something that prompted her to complain of "weakness." Pneumonia? TB? Cancer? Who knows... but the fact she looked as good as she did with what the exam revealed told me a lot about her strength of spirit.
We finally emerged early afternoon from the depths of the miniature church, hauling all the mobile clinic supplies back through the foot path. Passing houses, you couldn't help but see people congregated to talk, children playing with rocks, women wrapped in towels after their bath, dominos played, naps taken, and wash water dumped along the gutter that we so carefully teetered along.
I then drove to pick up Patrick, Solomon and two girls from CONASPEH to go on a hospital visit. The director of the seminary recently suffered a stroke, and has spent the last week in a hospital. We had just learned of his stroke Monday after hearing he was "sick" over the weekend. We all smooshed in the car and drove out to a catholic hospital nestled in a community on the outskirts of the city. The hospital was beautiful, well taken care of, clean, and boasted lush tropical vegetation creating an almost resort-looking atmosphere.
We found the pastor sitting in a room, face drooping, being spoon fed from his brother who was attending to him. Other family members crowded around. They family is in charge of bringing in food to the patient, attending to basic needs. The pastor, who we have known as a jovial man full of laughter, sat sadly on the bed looking forlorn. I offered him my best words of encouragement, the CONASPEH girls asked the details of what he felt, what the doctors said, and finally Patrick got him to laugh by telling him what he REALLY needs is a beautiful Haitian nurse to attend to his every need.
This afternoon I witnessed EXACTLY what Patrick does with everyone everyday: he makes smiles out of gloom, he connects with humor and genuine care. You can't measure that, you can't describe it in a job description, but it is beautiful to witness. Patrick has a way with people. And watching the pastor's face break into a half grin (battling the partial paralysis) for the first time all day was evidence.
But the visit left Patrick and I haunted. Haiti isn't a place for the old and the sick, not a place for the lame. The pastor is getting good care in the hospital, but will soon have to return home to live with his ancient and tiny mother. Rehab hospitals, intensive physical and occupational therapy aren't an option, if they exist. Not for the common man in Haiti making $2-5 a day. You could almost see the worry over what to do next on the pastor's gloomy face. Will he loose his job? A job that he seemingly loved and that kept him active in the networking of pastors and churches across the country? Will he be able to make it? Dreams of his strong, young life have hit a brick wall, and now this man, only in his mid 40's, likely is battling how he will survive long when half of his body doesn't move. I wonder this as well.
I delayed the evening's run until the very last minute due to the breathless day, the hot overhead sun and my own fatigue from being out in the elements all day. Uh. what a run. Even the leaves on the tallest trees were deathly still. Nothing moved. Nothing. Not the dog sprawled out at turn two, not the goat staring at blades of grass too tired to munch, not a single leaf. Even the children on the rooftops were quiet. A large fire burned near the track outside the walls, and the smoke hung in the air, anchored to the ground, crawling along and choking any oxygen around it. Of course it happened to sink right over half of the track. The first mile I thought I was going to throw up. I eventually sank into a limp around the track motored only by the power of will. It was not my most inspired and refreshing runs, despite the fact the sun sank from overhead and darkness fell, the cool did not come with it.
Patrick and Solomon mercifully picked me up. We stopped to refill our water bottles, and as we were crawling back into the car (myself dreaming about vats of cold icy water) Patrick saw a young boy crying in the shadows of a tree. He went over to him, and the boy told him his story through chokes and sobs. From what we could gather, his family all lived in the countryside several hours away. He had been living in the city with a woman, but she had just threw him out and he's been sleeping in the street for the last 4 days. He begged to come stay at our house; he was so frightened of another night on the street that taking a chance on the kindness of complete strangers was a gamble he was all too willing to take.
The kids on the street are a rare breed. The ones at the intersections we see on our daily commute are toughened by life, almost jovial in their pursuits for "lajan" from cars that pass by. They "earn" coins by wiping off dust from the vehicles stopped at red lights with their filthy rags, and some days they give up the guise of earning a day's pay and resort to simple begging. They are sinewy, tough, and run in packs. They smile and joke with us at our window. But the child last night had not yet been hardened by the street. Although certainly having to deal with more "adult" situations than his 10 years should allow, he still had the softness about him of being cared for. And to see him dissolve in tears was too much. But what could we do? Patrick got on the phone and called a friend of his from the orphanage to ask for advice. He knew of an orphanage we could take him to in the morning, but suggested we find a police station now to help him find a place to sleep tonight.
The boy was too willing to jump in our car. We drove him through the dark streets, handing him some cookies from the glove box and watching him wolf them down. He bravely walked with us up to the threatening police station, tears now dry. Our situation earned us a meeting with the Police Commissioner, a friendly-faced woman who clearly was running things around the office. She greeted Patrick and I like old friends, and we told her the situation as we understood it. She then had the boy tell his story. I didn't catch it all, but the police officer clearly understood. "Did she beat you?" She asked. The boy showed her evidence of bruises and cuts under his chin. The previously relaxed and jovial cop turned cloudy with anger. She had what she needed. She thanked us for intervening and told us the boy would be taken care of.
I'm sure Patrick and I came face-to-face with a restavik situation... And clearly the police woman was infuriated with such reports.
It was hard leaving that little boy in the big police station all lit up at night, full of trouble makers and threatening men in uniform. But I was reassured that the person taking charge of his care was a big, powerful woman who exhibited some preserved passion about her job. We can only hope it wasn't an act for the concerned blans. Patrick's friend from the orphanage said the police have relationships with some shelters and that the boy will eventually have a safe place to sleep. Or maybe they'll help him return to his family in the country. And maybe the woman who had the nerve to turn a 10-year -old out on the street will have to face her ugliness. I can only hope.
We got home last night physically and emotionally spent. We didn't even have enough energy to make anything for dinner. Solomon was equally as tired after entertaining all the orphanage staff for the second time this week. We gathered as a little family on the bed after baths and showers and lots of water (and milk). Solomon seemed to know Patrick and I needed a laugh. He started doing his new trick of wide-open-mouthed screeching that dissolves Patrick and I into giggles. Solomon crawled all over us, singing and screeching and giggling. He helped melt away some of the tensions and sadness from the events that had transpired over the day.
I don't cry here often... I think I try to rise to the same willful courage of the people around me. But tears have emerged a couple of times recently. The first was when I was sinking in to that special piece of heaven which is Solomon's night time routine. After baths, and books and play on the bed, I pull him into a cuddle against my body, his head resting on my shoulder, his big round brown eyes looking up at me, blinking the slow blinks of sleepiness, binky in mouth, and cooing beneath. I then sing to him until he falls asleep. I'm always amazed how few songs I know all the words too. Each night the collection is a strange mix of camp fire songs, pop music, old show choir tunes, and Christmas hymns. But a couple of nights ago, I remembered, "You are my sunshine" and sang it to his loving face looking up at me. I was in tears by "...my only sunshine." Not sure what memory is so strongly linked to that song, but it is one of pure love. I felt overwhelmed with emotion, homesickness and adoration over this little boy in my arms.
Last night tears fell when seeing another little boy, age 10, crumble into tears over the telling of his story, under the fear of another night alone at night in a big, loud city. As I held our protected and chubby little Solomon in my arms, the injustice that a child ANYWHERE has to face such fears left me equally furious and heartbroken.
People often tell us, "Solomon is such a lucky little boy." I always poo-poo it thinking, "it is US that are lucky" for all the joy he brings us. But maybe Solomon is lucky. Maybe we ALL are... all of us who aren't lost, aren't alone in the night in a strange place without a hand to hold.
Tuesday, July 7, 2009
Just another day...
Its hot. Good news is that the winds from yesterday have held on which helps alleviate the 110 degree humid day a bit.
Things have slowed down a lot for us. July is "vakans" for the schools here. The heat tends to drive people out of the cities into the countryside or by the water if they are able. Since the last group left, and with the Villiers gone for vacation, Patrick and I are enjoying a schedule that is relaxed and more open for a little while. The seminary is closed for the summer, so Patrick is having to find a little structure to his days in order to work on his Creole and some lesson plans he wants to make for the upcoming new semester starting in August. We've had a hard time filling mobile clinic sites, which seems strange to me, but as Miss Fano says, "its to hot, no one wants to work." Yesterday we were supposed to have a mobile clinic in a neighborhood church; we drove an hour through the twisty turny city to get there and meet the pastor. He had been excited to have a mobile clinic, says Miss Fano. But apparently he was so excited he forgot to tell anyone. Neat. So we changed plans and had a little spur-of-the-moment planning/brainstorming meeting back at my apartment with coffee and ice water. Its all about being flexible.
We found out today that the director of the seminary had a hypertensive stroke... the reason why he was "sick and in the hospital," per reports from pastors over the weekend. According to the girls at CONASPEH today, he has lost movement in a side of his body and can't speak. I worry about him because he is a big man, lives with his waif of an elderly mother, and there is no 'nursing home' for him to go and recover, no intensive physical therapy. What happens to him? I have no idea. The girls at CONASPEH say he's lucky because he goes to a big church and likely they'll raise money to help him out. But I imagine that can only last so long.
It also makes Patrick's job instantly more challenging.
I went to CONASPEH clinic this morning. No patients were waiting, the building was eerily quiet without students. I enjoyed visiting with Valena and Gouka in the office and updating some notes and paperwork for the clinic. Valena started to tell me about her mother who has a ton of untreated medical problems including having suffered a hypertensive stroke in the past that has left her weak in her right side and with a foot that swells, etc. She wanted me to recommend what medicine she could give her since she can't walk into clinic. eiii. So I told her I'd rather make a house call.
Valena directed me through this little neighborhood where her mom lives, up a little foot path between concrete houses, through a sheet covered opening in one of the cinderblock shelters to visit her mother. The "house" was one room with a double bed taking up about 50% of the space, a shelf with books and clothes and a television on it, a little desk, a chair in which she was sitting and a lamp. There was about enough walk space for two people to comfortably stand. I imagine the "kitchen" was outside as was the "toilet" But the room was neat and tidy, decorated with this's and that's, pictures of children and silk flowers.
The mother seemed happy to see me. I introduced myself, told her what a great daughter she had, and commenced doing an exam. She's not in great shape considering she is only 50. We discussed what her disease meant, what she NEEDED for good treatment, what was realistic for her to be able to do, and how at least we could start scratching the surface. So I gave her some blood pressure meds and aspirin. I'll go back next week to see if I need to adjust the dose. I likely will have to do so since her blood pressure was 220/110. That gets someone a hospital stay in the US. But she apparently felt fine. Sheesh.
On our return to CONASPEH, I finally had patients waiting for consultations. Three of the patients were follow-ups which makes me SO VERY HAPPY. One of the things I love about family medicine is the chance for continuity, to follow patients through their lives, helping with health matters that arise. Up until now, such continuity has been only a dream. But now that I'm showing up to the clinic with regularity on Tuesdays, people are catching on.
I puttered along in the clinic by myself, taking vitals, figuring out symptoms and trying to read stoic faces to see if any of the teaching I was attempting was registering. The CONASPEH clinic tends to be slow and sporadic, but I've noticed over the weeks a more reliable stream of faces.
Now I'm catching up with paper work with a napping Solomon at my side. He is really close to crawling, I think. Also close to pulling himself up to a standing position. He just can't get his leg positioning right. I'm patient. I'm savoring these days where he is minimally mobile because our lives will CHANGE after that ends. Patrick left for a scheduled meeting with one of our highschool translators--Freno--who is trying to learn to drive. Patrick is going to take him out in a field and give him some private lessons. I can't imagine learning to drive in Port-au-Prince. He registered for official classes, but was thrilled beyond measure to get a chance to get some practice in before the real deal. So that should be a story.
Just a day in the life.
Things have slowed down a lot for us. July is "vakans" for the schools here. The heat tends to drive people out of the cities into the countryside or by the water if they are able. Since the last group left, and with the Villiers gone for vacation, Patrick and I are enjoying a schedule that is relaxed and more open for a little while. The seminary is closed for the summer, so Patrick is having to find a little structure to his days in order to work on his Creole and some lesson plans he wants to make for the upcoming new semester starting in August. We've had a hard time filling mobile clinic sites, which seems strange to me, but as Miss Fano says, "its to hot, no one wants to work." Yesterday we were supposed to have a mobile clinic in a neighborhood church; we drove an hour through the twisty turny city to get there and meet the pastor. He had been excited to have a mobile clinic, says Miss Fano. But apparently he was so excited he forgot to tell anyone. Neat. So we changed plans and had a little spur-of-the-moment planning/brainstorming meeting back at my apartment with coffee and ice water. Its all about being flexible.
We found out today that the director of the seminary had a hypertensive stroke... the reason why he was "sick and in the hospital," per reports from pastors over the weekend. According to the girls at CONASPEH today, he has lost movement in a side of his body and can't speak. I worry about him because he is a big man, lives with his waif of an elderly mother, and there is no 'nursing home' for him to go and recover, no intensive physical therapy. What happens to him? I have no idea. The girls at CONASPEH say he's lucky because he goes to a big church and likely they'll raise money to help him out. But I imagine that can only last so long.
It also makes Patrick's job instantly more challenging.
I went to CONASPEH clinic this morning. No patients were waiting, the building was eerily quiet without students. I enjoyed visiting with Valena and Gouka in the office and updating some notes and paperwork for the clinic. Valena started to tell me about her mother who has a ton of untreated medical problems including having suffered a hypertensive stroke in the past that has left her weak in her right side and with a foot that swells, etc. She wanted me to recommend what medicine she could give her since she can't walk into clinic. eiii. So I told her I'd rather make a house call.
Valena directed me through this little neighborhood where her mom lives, up a little foot path between concrete houses, through a sheet covered opening in one of the cinderblock shelters to visit her mother. The "house" was one room with a double bed taking up about 50% of the space, a shelf with books and clothes and a television on it, a little desk, a chair in which she was sitting and a lamp. There was about enough walk space for two people to comfortably stand. I imagine the "kitchen" was outside as was the "toilet" But the room was neat and tidy, decorated with this's and that's, pictures of children and silk flowers.
The mother seemed happy to see me. I introduced myself, told her what a great daughter she had, and commenced doing an exam. She's not in great shape considering she is only 50. We discussed what her disease meant, what she NEEDED for good treatment, what was realistic for her to be able to do, and how at least we could start scratching the surface. So I gave her some blood pressure meds and aspirin. I'll go back next week to see if I need to adjust the dose. I likely will have to do so since her blood pressure was 220/110. That gets someone a hospital stay in the US. But she apparently felt fine. Sheesh.
On our return to CONASPEH, I finally had patients waiting for consultations. Three of the patients were follow-ups which makes me SO VERY HAPPY. One of the things I love about family medicine is the chance for continuity, to follow patients through their lives, helping with health matters that arise. Up until now, such continuity has been only a dream. But now that I'm showing up to the clinic with regularity on Tuesdays, people are catching on.
I puttered along in the clinic by myself, taking vitals, figuring out symptoms and trying to read stoic faces to see if any of the teaching I was attempting was registering. The CONASPEH clinic tends to be slow and sporadic, but I've noticed over the weeks a more reliable stream of faces.
Now I'm catching up with paper work with a napping Solomon at my side. He is really close to crawling, I think. Also close to pulling himself up to a standing position. He just can't get his leg positioning right. I'm patient. I'm savoring these days where he is minimally mobile because our lives will CHANGE after that ends. Patrick left for a scheduled meeting with one of our highschool translators--Freno--who is trying to learn to drive. Patrick is going to take him out in a field and give him some private lessons. I can't imagine learning to drive in Port-au-Prince. He registered for official classes, but was thrilled beyond measure to get a chance to get some practice in before the real deal. So that should be a story.
Just a day in the life.
Saturday, July 4, 2009
Happy 4th of July!
We spent the hot tropical 4th of July surf-side. It is much easier to enjoy a cloudless blue sky in the heat of July when the ocean is at your fingertips.
Solomon loves the ocean and this time he discovered the joys of sand, splashing in the water and naps in the shade. 
Patrick and I rented a snorkel and had our first snorkeling experience around a small reef by the beach. Although where we were snorkeling probably doesn't even come close to the scale of "snorkeling spots" in the world, we loved swimming through schools of fish that rose around us like a cloud, had fun spotting yellow and blue striped tropical swimmers between the rocks, and finding colorful shells on the ocean floor. 
I am ever amazed at the joy and ease of letting hours dissolve into the rush and tumble of surf over sand, in simply being present watching your little boy discover the sensation of bubbly waves over toes and the salty taste after a surprise splash.
As the day wore on, clouds over head started to accumulate, and the hot mid-day rays were subdued. We enjoyed the late afternoon cooling off in the shade and savoring the last rays of day with our toes in the sand. 
No fireworks for us this year, but we found the same ooh and ahh factor in the meditative roar of waves over rock, the rustles of ocean breezes in the palm trees, the smell of salt in the air and the taste of it on our skin, the splashes of pinks, golds and silvers in the sunset, and the feeling of cooled-off peace. 
On our country's holiday of independence, we celebrated our freedom and pursued our happiness where the land meets the sea.
Friday, July 3, 2009
Day Off
Today, we escaped the heavy heat of the concrete jungle of Port-au-Prince and headed up the mountain for the afternoon. As we goaded the galloper gently up the mountain (with just a teensy big of steam rolling out from under the hood), we thrilled in feeling the air cool. We headed to a baptist mission which caters to foreigners with its American-diner style food, and enjoyed french fries and milkshakes at altitude where the air felt lighter, smelled cleaner, and the view was incredible. The land that rises up around the mission is decorated with fields and terraces that cover the mountain like a patch-work blanket of various hues of green.
We soaked in hours with no agenda, a few sweat-free moments, and the joy that is chocolate ice cream and milk all mixed together. Good day.
Reaching for what appears to be a tasty treat
Solomon's First French Fry
Not A Big Fan
I prefer tables, Mom
After enjoying fries and shakes, we took a little drive further to see the mountain range open up revealing crests and peaks far into the horizon.
The pine treas are feathery up on the peak... a tropical version of pine. And the air smelled fresh and clean. 
We bought produce on the mountain since we were in a heavy agricultural area. Getting the produce at the source sure makes a difference. No bruises or over-ripeness due to the bumpy trip down the mountain in tap-taps to arrive at the city markets below.
I went on a run at sunset after our return from the mountain. I watched a couple of soccer matches with little 1/2 pint kiddos being played in the center field and appreciated the distraction from track running. A cloud bank had settled over the city, pushing a breeze through the air, rustling the heavy humidity and driving down the temperature from sizzling to a simmer. Just as I thought I was going to internally combust with heat, nature provided me with a spectacular new diversion. In a burst of orange fire, the setting sun fell below the roof of clouds and lit up the evening with a bronze glow. It reminded me of a harvest moon... a huge orange orb on the floating on the horizon. There were several big fires burning around the city (usually burning trash) and the smoke rose between me and the sunset making the whole sky appear to be smoldering.Tonight we are back in the apartment, having just enjoyed the miracle of water that quenches thirst and washes a days worth of sweat away. Ah Haiti in July. But despite the heat, today was a great day thanks to a mountain escape, chocolaty treats, stunning views, a fiery finale for the day in the setting of the sun, and priceless moments enjoying it all together.
Wednesday, July 1, 2009
Oasis
I just joined a gym.
I don't think I've EVER before joined a gym. The last time I worked out in a gym was at KU and that came "free" with my medical school tuition.
But I am the happiest gym member ever because today after 9 months, I ran. After 6 months, I worked out. I can't say I haven't SWEAT in 6 months since I sweat on the drive over to the gym, sweat filling out the paperwork for membership, but you don't get the adrenaline rush from simple Haiti heat.
I found the gym after a recommendation from Dr. Charcot after I was bemoaning the fact that I didn't have my normal stress-relief outlet of running.
The "gym" is actually a sports center. It has a huge center building full of weights and weight machines, a floor where they have aerobics classes, and a ping-pong table. Outside the complex includes a gravel track, basketball court, soccer field, tennis courts, a playground, trees, flowers and a view of the mountains. They even have a gift shop and a restaurant (that served fried fish... LOVE it).
I smiled for the first two laps around the track. After that I was doing more huffing and puffing, but smiling on the inside.
I could literally feel my joints groaning to life.
It will be a while before I'm back in shape again, but I've never felt so happy getting ready for the effort.
I've never been a work-out-a-holic, but exercise has been my alternative to prozac, liposuction and triple bipass. And in Haiti, I needed the prozac effect.
I feel like I found an oasis in the city. Tonight I went and signed up, then went for my first run. There was a nice breeze and the center was full of people. People jogging, walking, a soccer game going on, a basketball practice. There was an aerobics class underway and beefed up dudes lifting big heavy things. I have to admit it was lovely to be emmersed among a community of athletic, healthy Haitian people.
Today was a good day. After really struggling this last week, today things shifted.
Now I'm going to go grab a cold glass of water and watch the sunset with my cute son who greeted me with a gummy smile.
Happy Day.
I don't think I've EVER before joined a gym. The last time I worked out in a gym was at KU and that came "free" with my medical school tuition.
But I am the happiest gym member ever because today after 9 months, I ran. After 6 months, I worked out. I can't say I haven't SWEAT in 6 months since I sweat on the drive over to the gym, sweat filling out the paperwork for membership, but you don't get the adrenaline rush from simple Haiti heat.
I found the gym after a recommendation from Dr. Charcot after I was bemoaning the fact that I didn't have my normal stress-relief outlet of running.
The "gym" is actually a sports center. It has a huge center building full of weights and weight machines, a floor where they have aerobics classes, and a ping-pong table. Outside the complex includes a gravel track, basketball court, soccer field, tennis courts, a playground, trees, flowers and a view of the mountains. They even have a gift shop and a restaurant (that served fried fish... LOVE it).
I smiled for the first two laps around the track. After that I was doing more huffing and puffing, but smiling on the inside.
I could literally feel my joints groaning to life.
It will be a while before I'm back in shape again, but I've never felt so happy getting ready for the effort.
I've never been a work-out-a-holic, but exercise has been my alternative to prozac, liposuction and triple bipass. And in Haiti, I needed the prozac effect.
I feel like I found an oasis in the city. Tonight I went and signed up, then went for my first run. There was a nice breeze and the center was full of people. People jogging, walking, a soccer game going on, a basketball practice. There was an aerobics class underway and beefed up dudes lifting big heavy things. I have to admit it was lovely to be emmersed among a community of athletic, healthy Haitian people.
Today was a good day. After really struggling this last week, today things shifted.
Now I'm going to go grab a cold glass of water and watch the sunset with my cute son who greeted me with a gummy smile.
Happy Day.
Follow-up
This morning I drove to the CONASPEH clinic at Carrefour. As I was entering the little walkway between houses that leads to the clinic, a man I had seen weeks ago greeted me with a smile and a handshake. Several months ago, he had been hit by a car. He had approached me in the street outside of the clinic to show me an open wound on his leg that wasn't healing. So we had met weekly for about a month doing wound care and education, treating an infection and checking on its continued healing.
With a smile, the man showed off his leg is now completely covered with healthy pink tissue despite the bumpy scar left as a reminder of the accident.
He asked me if I had a moment to see his son who had "hit his head."
So I followed him into his house and came into a room with a single bed in it. A grown young man was lying on the bed. "Hit his head" actually meant "Hit by a car and injured really bad." But this had happened several weeks ago. He had spent significant time in the hospital, had a face full of stitches as well as some on his leg which were apparent by many jagged but well-healing scars. But my friend wanted me to see his son because he suffers from headaches often, has a hard time working and still has some swelling around his eye.
By the looks of the roadmap of scars on the young mans face and skull, it was a miracle he is still alive. I said as much, and the whole family threw up their hands in unison and thanked God.
Knowing there wan't much I would be able to do (and glad not to be evaluating an acute head trauma), I examined the young man, took a history and was reassured that despite continued suffering, he was getting around, thinking, working, eating, sleeping and continuing on with his life. In fact he was recovering remarkabley well, all things considered, and I couldn't find much wrong with him aside from a few inflammed scars.
So I pulled out some Ibuprofen, talked about wound care and scar massage, and congratulated him on surviving.
I felt honored to have been pulled into the family's home, was glad that I could help celebrate one more incredibly strong survivor in this country full of hardships, and happy to be able to give a little reassurance if not miraculous medical care to a famliy who has had its share of bad luck with on-coming traffic.
The father of the family walked me to the door, shook my hand and thanked me. I hadn't done much, but I was grateful for his apparent satisfaction with the time we spent together.
I needed that smile today. Life sometimes squeezes in a special moment just when you need it. Its hard not to focus on doing what you can after witnessing relentless survival and strength that so many people exhibit here. At the very least, I can try to be strong to in my cush, protected life.
So my clinic day felt a lot more positive, a lot more hopeful. I handed out vitamins with a lot of education, encouragement and hope that somewhere along the line at least my positive presence in the lives of my patients will mean something. I won't win any medical society awards for the medicine I'm practicing, but if I focus on the humanity of it, maybe I'll fight the fingers of frustration that try to sneak their way into my spirit. I'm just greatful for little moments of clarity that shake me out of the darkness.
With a smile, the man showed off his leg is now completely covered with healthy pink tissue despite the bumpy scar left as a reminder of the accident.
He asked me if I had a moment to see his son who had "hit his head."
So I followed him into his house and came into a room with a single bed in it. A grown young man was lying on the bed. "Hit his head" actually meant "Hit by a car and injured really bad." But this had happened several weeks ago. He had spent significant time in the hospital, had a face full of stitches as well as some on his leg which were apparent by many jagged but well-healing scars. But my friend wanted me to see his son because he suffers from headaches often, has a hard time working and still has some swelling around his eye.
By the looks of the roadmap of scars on the young mans face and skull, it was a miracle he is still alive. I said as much, and the whole family threw up their hands in unison and thanked God.
Knowing there wan't much I would be able to do (and glad not to be evaluating an acute head trauma), I examined the young man, took a history and was reassured that despite continued suffering, he was getting around, thinking, working, eating, sleeping and continuing on with his life. In fact he was recovering remarkabley well, all things considered, and I couldn't find much wrong with him aside from a few inflammed scars.
So I pulled out some Ibuprofen, talked about wound care and scar massage, and congratulated him on surviving.
I felt honored to have been pulled into the family's home, was glad that I could help celebrate one more incredibly strong survivor in this country full of hardships, and happy to be able to give a little reassurance if not miraculous medical care to a famliy who has had its share of bad luck with on-coming traffic.
The father of the family walked me to the door, shook my hand and thanked me. I hadn't done much, but I was grateful for his apparent satisfaction with the time we spent together.
I needed that smile today. Life sometimes squeezes in a special moment just when you need it. Its hard not to focus on doing what you can after witnessing relentless survival and strength that so many people exhibit here. At the very least, I can try to be strong to in my cush, protected life.
So my clinic day felt a lot more positive, a lot more hopeful. I handed out vitamins with a lot of education, encouragement and hope that somewhere along the line at least my positive presence in the lives of my patients will mean something. I won't win any medical society awards for the medicine I'm practicing, but if I focus on the humanity of it, maybe I'll fight the fingers of frustration that try to sneak their way into my spirit. I'm just greatful for little moments of clarity that shake me out of the darkness.
Imperfect Medicine
I need to step back. I need a recharge. I need to shake out of a pattern of negative thinking and emotional reaction.
My busy clinic schedule running all over the city and countryside initially left me feeling energized and useful. But lately all complaints sound the same, and I'm left feeling frustrated trying to differentiate one person’s malnutrition from another persons depression from another person’s fabrication in order to get some colorful free pills.
I’ve started feeling exhausted by the complaints, the reports, the misery and my helplessness to interceed. As I look at one patient after another wondering what an intervention I might offer will do to change their plight, I start to sink.
The medicine I practice is in no way sophisticated. Sometimes I entertain myself with running a list of possible diagnoses through my head as I examine my patient, listing off the tests I would order if in the States, the specialists I’d consult, the care I’d prescribe. Some days I’ll write out such recommendations because the patient deserves to know what they need; yet I know full well I’m essentially just wasting a piece of paper.
The reality of Haiti is harsh. I knew this coming in, I've known it and learned it each day I"ve been here. But sometimes I loose footing and perspective.
There are no shortage of medical clinics in Port-au-Prince. I pass about 5 on my commute to work. The Haitian doctors here hanging their shingle and ask for a little money for consultation, pharmaceuticals and lab work. They can't work, live, survive without it. But a little money tends to be prohibitive to most patients.
Volunteer medical teams are a frequent occurance in Haiti, so much so that my white face can sometimes draw a crowd by itself. Surely there is something free waiting to be handed out. The longer I'm here, the more I start becoming associated with CONASPEH and an organized program of outreach, the numbers have started to dwindle. Because really, what can I do to change chronic and systemic problems that cause so much of the disease and suffering? I think the patients I see know more than they let on. As they list their complaints, I'm sure they know that if they had regular food and clean water, maybe their stomach wouldn't hurt all the time. Maybe they get tired of recommendations of labs, of drugs to buy, of specialists to see that they can't afford to follow through on. Maybe they don't want to worry about that mass in their stomach that they don't have the money to have a surgeon remove... its easier not to know it might be cancer. And they look to me to hand them something in my little pharmacy that will give them strength, take away pain, and likely erase years of suffering settled into their bones.
I remember in residency having moments of nearly resenting some of my chronic pain patients. I was not alone in that sentiment and such feelings were talked about often in processing sessions the residency coordinated. Why would a group of doctors dedicating their life to “helping” people feel anger and resentment toward people asking for help? Usually it was because we felt manipulated for drugs, got tired of having to be an investigator—sniffing out real pain from addictive drug seeking behavior. But I think ultimately the fact that we didn’t have an easy fix to our patient’s suffering, whether it be from chronic pain or addiction and depression, was what left us all frustrated. And as a defense mechanism, we sometimes turned our frustrations on our patients out of fatigue and feelings of helplessness. Residency helped us recognize those defensive reactions and deal with them before walking into a patient encounter. I'm finding that I'm pulling out such self-evaluating tactics even here in Haiti.
Yesterday I saw a 96-year-old woman, which is a feat in and of itself in a place where the average life span is 52 years. She sat and told me, “my whole body hurts, my head feels empty, my stomach crawls up, I can’t sleep, my bones are hot, I can’t eat, my mouth doesn’t have good taste.” Her list of complaints was almost exactly what her daughter had reported and the patient before her and before her….
I gave her a thorough physical exam, commended her on her sinewy strength, and then opted to do no harm and gave her a couple of little sacks of vitamins, Tylenol for joint pain, and Tums for reflux.
But her daughter had gotten cough medicine, and she really wanted that.
In fact, she kept asking for more medicines. She laughed when I tried to explain why I wasn’t just dumping the pharmacy into her outstretched hands, but she was not to be appeased. Miss Fano smiled and gave her a couple of Halls Cough Drops. They have enough vapors in them that they resemble pretty strong, magical medicines, and that seemed to make my ancient patient happy although clearly disappointed in the blan doctor.
With this elderly woman, we were able to laugh. Of course she was suffering, and in all reality at the end of her life. There wasn’t much I could (or should) do to change that fact. But similar situations happen with patients of all ages. Regardless of my best teaching, my most protective use of pharmaceuticals, sometimes it comes down to how colorful the medicine are and how many a patient will get which determines how good of work I do in the eyes of my patients. I’m left unsatisfied knowing what diagnostics they would benefit from, what intervention, what lifestyle changes, what tertiary care could truley change their health situation. My patients are left unsatisfied when the pills I hand over don’t have the magic to erase the misery.
One patient who had diarrhea several months back keeps asking me for more of that “force” powder (Gatoraid) that I had given her when she had diarrhea and fatigue. I have since ran out, and tried to give her a recipe for a homemade concoction, but she was disappointed that the sugar/salt water rehydration mix isn’t a magical blue color, and is sure it is not as strong.
So I find myself frustrated, just short of loosing patience with patients who don’t and can’t understand the pharmacology behind the colorful pills, angered at a pervasive system that allows such inefficiencies and negligence of care, frustrated to at best be offering a little bandaid treatment for anemia and gastritis when the true healing medicines would be clean water, food, jobs, income, mosquito eradication, environmental rehabilitation and education.
So this morning I march off to another clinic. I am trying to meditate on the morning, on the service of being present, finding perspective in the very imperfect work I am doing.
My busy clinic schedule running all over the city and countryside initially left me feeling energized and useful. But lately all complaints sound the same, and I'm left feeling frustrated trying to differentiate one person’s malnutrition from another persons depression from another person’s fabrication in order to get some colorful free pills.
I’ve started feeling exhausted by the complaints, the reports, the misery and my helplessness to interceed. As I look at one patient after another wondering what an intervention I might offer will do to change their plight, I start to sink.
The medicine I practice is in no way sophisticated. Sometimes I entertain myself with running a list of possible diagnoses through my head as I examine my patient, listing off the tests I would order if in the States, the specialists I’d consult, the care I’d prescribe. Some days I’ll write out such recommendations because the patient deserves to know what they need; yet I know full well I’m essentially just wasting a piece of paper.
The reality of Haiti is harsh. I knew this coming in, I've known it and learned it each day I"ve been here. But sometimes I loose footing and perspective.
There are no shortage of medical clinics in Port-au-Prince. I pass about 5 on my commute to work. The Haitian doctors here hanging their shingle and ask for a little money for consultation, pharmaceuticals and lab work. They can't work, live, survive without it. But a little money tends to be prohibitive to most patients.
Volunteer medical teams are a frequent occurance in Haiti, so much so that my white face can sometimes draw a crowd by itself. Surely there is something free waiting to be handed out. The longer I'm here, the more I start becoming associated with CONASPEH and an organized program of outreach, the numbers have started to dwindle. Because really, what can I do to change chronic and systemic problems that cause so much of the disease and suffering? I think the patients I see know more than they let on. As they list their complaints, I'm sure they know that if they had regular food and clean water, maybe their stomach wouldn't hurt all the time. Maybe they get tired of recommendations of labs, of drugs to buy, of specialists to see that they can't afford to follow through on. Maybe they don't want to worry about that mass in their stomach that they don't have the money to have a surgeon remove... its easier not to know it might be cancer. And they look to me to hand them something in my little pharmacy that will give them strength, take away pain, and likely erase years of suffering settled into their bones.
I remember in residency having moments of nearly resenting some of my chronic pain patients. I was not alone in that sentiment and such feelings were talked about often in processing sessions the residency coordinated. Why would a group of doctors dedicating their life to “helping” people feel anger and resentment toward people asking for help? Usually it was because we felt manipulated for drugs, got tired of having to be an investigator—sniffing out real pain from addictive drug seeking behavior. But I think ultimately the fact that we didn’t have an easy fix to our patient’s suffering, whether it be from chronic pain or addiction and depression, was what left us all frustrated. And as a defense mechanism, we sometimes turned our frustrations on our patients out of fatigue and feelings of helplessness. Residency helped us recognize those defensive reactions and deal with them before walking into a patient encounter. I'm finding that I'm pulling out such self-evaluating tactics even here in Haiti.
Yesterday I saw a 96-year-old woman, which is a feat in and of itself in a place where the average life span is 52 years. She sat and told me, “my whole body hurts, my head feels empty, my stomach crawls up, I can’t sleep, my bones are hot, I can’t eat, my mouth doesn’t have good taste.” Her list of complaints was almost exactly what her daughter had reported and the patient before her and before her….
I gave her a thorough physical exam, commended her on her sinewy strength, and then opted to do no harm and gave her a couple of little sacks of vitamins, Tylenol for joint pain, and Tums for reflux.
But her daughter had gotten cough medicine, and she really wanted that.
In fact, she kept asking for more medicines. She laughed when I tried to explain why I wasn’t just dumping the pharmacy into her outstretched hands, but she was not to be appeased. Miss Fano smiled and gave her a couple of Halls Cough Drops. They have enough vapors in them that they resemble pretty strong, magical medicines, and that seemed to make my ancient patient happy although clearly disappointed in the blan doctor.
With this elderly woman, we were able to laugh. Of course she was suffering, and in all reality at the end of her life. There wasn’t much I could (or should) do to change that fact. But similar situations happen with patients of all ages. Regardless of my best teaching, my most protective use of pharmaceuticals, sometimes it comes down to how colorful the medicine are and how many a patient will get which determines how good of work I do in the eyes of my patients. I’m left unsatisfied knowing what diagnostics they would benefit from, what intervention, what lifestyle changes, what tertiary care could truley change their health situation. My patients are left unsatisfied when the pills I hand over don’t have the magic to erase the misery.
One patient who had diarrhea several months back keeps asking me for more of that “force” powder (Gatoraid) that I had given her when she had diarrhea and fatigue. I have since ran out, and tried to give her a recipe for a homemade concoction, but she was disappointed that the sugar/salt water rehydration mix isn’t a magical blue color, and is sure it is not as strong.
So I find myself frustrated, just short of loosing patience with patients who don’t and can’t understand the pharmacology behind the colorful pills, angered at a pervasive system that allows such inefficiencies and negligence of care, frustrated to at best be offering a little bandaid treatment for anemia and gastritis when the true healing medicines would be clean water, food, jobs, income, mosquito eradication, environmental rehabilitation and education.
So this morning I march off to another clinic. I am trying to meditate on the morning, on the service of being present, finding perspective in the very imperfect work I am doing.
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