Christmas in Haiti

*forgive the late posting... just getting caught up after the holidays*

Merry Christmas!

The sun once again shines and the streets have rebounded after the rain with mobs of people, vendors and traffic.

Life doesn't look a whole lot different here despite the date on the calendar. The big bank near by has a 2-story blue tinsel Christmas tree and gaudy balls decorating their fence. If driving at night, a few restaurants and dance clubs show off a string of lights or two. In the piles of used clothes, shoes and plastic housewares sold on the streets, you can now find tinsely decorations for sale. A man on the corner is selling Reindeer made out of pinecones. Silvia called them large rabbits when I asked her their name.

In preparation for a new year, December is a time when people put a little extra time and care into their homes. If a little money has been saved, walls will be painted, construction continued, improvements made. Now that we know to pay attention, freshly painted store fronts and stuccoed walls covering previously exposed concrete blocks are evidence as we pass by familiar spots. Silvia tells us everyone spends extra time in the week before Christmas thoroughly cleaning their homes and preparing for a fresh start to the year. Maybe she was just indirectly hinting at us to clean our closets or scrub the couch liners.

Last night we spent the evening with friends, sharing a pot-luck style meal that was full of savory flavors, roasted vegetables, homemade cornbread, pumpkin soup, and lots of christmas sweets. We sang carols around candle light, and slipped into easy conversation. One of the couples there has two children, their oldest a 3 year old girl. She and Solomon became fast friends and walked hand in hand all over the house and yard while the grownups did their boring grown up things. Although we haven't known this group of people long, their company has become familiar over the month and the atmosphere warm. It was a perfect way to spend Christmas Eve.

On the drive home, the streets were a buzz with activity. Usually, if driving home after 10 in Port-au-Prince the streets are wide open as the city sleeps. But no one sleeps on Christmas Eve. Like New Years, Christmas eve is a night when young and old stay up through the night and welcome the holiday at the stroke of midnight. Many of our friends, including Silvia and her family, went to church in the evening and spent the entire night there, dancing, singing and celebrating with friends and family.

As we drove down Rue Delmas, we passed masses of people dancing in parking lots and along the side walks, rum and Klerin being sold by the cup full to people walking down the street, vendors hovering over their baskets full of food despite the late hour, fritay vendors selling their hot fried food. The street kids were still out and about, a few sporting Santa hats, wishing us a Jwaye Noel and seemingly caught up in the energy of the night. The music and party-making lasted 'til the break of dawn and was accented with bursts of fireworks and carols sung over megaphones into the wee hours of morning.

Silvia reported she went to bed at 2:30am after coming home from church, was up at 4 to pray, but couldn't go back to bed because the neighbor was slaughtering a hog and the "streets were hot" with activity at the early hour.

We, however did not see the 4am hour arrive. Just removed enough from the street, the Bentrott family enjoyed the rare treasure of sleeping in. I immagine there won't be many Christmas's that we have the option of sleeping in with kids, so we enjoyed this our first, and maybe our last.

Tonton Noel found Solomon. We opened a few presents and mostly watched Solomon bang on his drum with Santa hat on and smiles abound. I'd worry about what the what the neighbors will think, but their little angels got a karaoke machine and have been rocking on it since 7am. Maybe we'll all start a band.

About the time we were getting ready to sit down for breakfast, Silvia surprised us at the door to declare that she wanted to make us our Christmas gift--homemade Pumpkin soup. She chopped and simmered, stewed and stirred our surprise Christmas feast. She has quickly learned a quick way to our heart is through our stomachs!!! She couldn't have wrapped anything more delicious!

Pumpkin soup is a special soup for the Haitian people, symbolizing freedom and hope. It is packed full with vegetables and meats as if to celebrate all the produce Haiti is capable of making. It is fragrant and delicious. She told us stories of her all-nighter at church with family and friends while patting around the kitchen and drinking cocoa with us. She is planning another late night tonight at a different church, but would take a nap before starting round 2 of Christmas celebrations.

Nothing on the agenda for us tonight aside from maybe a movie and some quality time before I pack and catch the early flight out of Port-au-Prince tomorrow morning. Our tummies are full, the lights are glowing illuminating the dark room in primary colors, my little elf is reading a book with his dad and we all are cuddled up on the couch. A perfect Christmas day. The traditions are new, the scenery a little unusual, but the day full of the most important ingredient of the season--time with those I love.

Merry Christmas and Jwaye Noel

Chill in the Air

Its beginning to feel a lot like Christmas...

This Haitian winter, we've had nearly 4 weeks of no precipitation. The end of the hurricane season left the skies clear and the days hot and dry. Humidity returned 2 days ago, but last night the rain finally started to fall. Fall and fall. And the wind blew. At about 3 am, Patrick and I actually crawled UNDER the comforter because... get this... we were cold! What has long been decorative finally had function as we pulled the blanket under our chin and snuggled down for a few more zzz's. I woke this morning partly wanting to stay in bed all day, but too giddy to have a cup of coffee and need its WARMTH as much as I needed its dark aroma and flavor (caffeine). So out from under the covers I crawled to savor a steamy cup of Joe, curling up in a sweatshirt I dug out of deep storage and gazing out the rain-spotted window. Palm trees danced and waved in the wind, silvery puddles crawled over rooftops shimmering in the morning light, raindrops pitter-patted on tin and concrete, in puddles, on palm leaf as the world wriggled awake under the wet overcast morning.

Joy.

The sensation of "cold" here is about as luxurious to this Midwesterner as Ben and Jerry's icecream or hot showers.

Solomon slept soundly and late this morning, cuddled under two blankets. Patrick, though, was soon up to join me, just as giddy about the chill in the air as I. We were like two kids on a snow day. Too excited to sleep in perfect sleeping weather. ;)

And the rain kept falling for hours, chilling the air and blocking the sun with wet grey clouds. Rain storms here are usually fast, hot and furious flooding streets and raging to the sea. Today was an unusual "ground soaker" as Papa Steve would call it, slow and steady, spanning a full night and most of the following day. Life in the streets yielded to the steady shower.

With windshield wipers wiping, I drove to work this morning traversing a bizarro Haiti. Cold and rain to Haitians is like snow and ice to Americans. People stay in unless they absolutely HAVE to go out. So my commute had no traffic jams, no police stops, no herds of humanity crossing through traffic, no kids with rags polishing the windshield at the stoplights. Sidewalks were empty their usual masses of vendors. Faces peered out of windows and doorways. Even the tap-tap traffic seemed light. Instead I slowed only for giant puddles to splash though with Monty.

During my commute, a radio program read Christmas letters to Tonton Noel (Uncle or Old Man Christmas) from children all over Haiti. Jean wanted a toy car; Katiyana dreamed of a doll. Several children asked that Tonton Noel remember the kids in the street this Christmas, and one little child asked for a home and a mom. That one had my eyes as misty as the weather outside.

No one braved the wet roads to show up to clinic this morning in Carrefour, so I kicked back with the nurse and the lab technician and visited in our rare empty clinic, sharing about our plans for Christmas as the rain tumbled over the roof. We watched the neighbor catch roof-run-off in a buckets and bottles, seemingly storing up for a long dry spell. Since most Haitians have to walk to the public pump every morning for water, a heavy rain can offer a rare surplus of water to store leaving a few mornings to follow with a lighter work load. I left after an hour, all too happy to make the 35-minute miraculous no-traffic drive home, officially kicking off my Christmas vacation. WAAAHOOOOO and Ho Ho Ho.

I picked up my boys and we went up the mountain to run errands. I don't remember the last time Patrick and I were in such a good mood in the car. On the way home, we decided to try out a Chinese restaurant some friends had recommended. Rainy cold day? Chinese take-out sounded all-too perfect.

While Solomon and I waited in the car for Patrick to get our orders-to-go, a gaggle of street kids surrounded our car. Despite being absolutely soaked to the bone and shivering, they were in remarkably high spirits. In my best motherly tone, I scolded them for standing out in the open and not ducking a single raindrop. Laughing through chattering teeth, they told me that even the trees were dripping on them. Instead of running for cover under the closest overhang, they demonstrated some scenes from a Jet Li movie for me complete with "hieeee-yah" sound effects, drew pictures in the mist on the car window, quizzed me about Solomon--inviting him to join their little gang of boys--, and asked for my phone number. I had to give the kids credit for their sunny disposition while sporting cold wet hands shriveling in the constant moisture. Despite my joy in an overcast, rainy day, I am glad that such days are rare here in a place that lacks enough sturdy roofs to keep many-a-head warm and dry.

In our luxurious lives this afternoon, Solomon drifted to sleep to the lullaby of raindrops on pavement. Patrick and I enjoyed delicious hot Chinese food and steaming tea that tasted AMAZING (any variation from Creole food or our bland home menu is quite exciting). With bellies warm and full we snuggled together to watch a movie in disbelief at the still-falling rain. This afternoon we made cookies and Skyped my Mom and Dad who are socked in at home in Kansas with an ice storm. Apparently weather is reeking havoc in many parts of the world today. Dad wasn't as happy about limbs crashing into his lawn under the weight of layers of ice as I was in our rainy-day in.

Santa couldn't have packed anything better in his sack of toys for Kim in Haiti than a chill in the air. A cold day in Haiti. I should be worried hell is freezing over, but so far, no ice. Just a cool, wet, rainy, overcast GORGEOUS day appreciated by this Midwesterner who misses the changing of seasons... or any simple variation from relentless summer.

Its beginning to feel a lot like Christmas...

Advent: Joy

Joy.

This is what I'm supposed to be focusing on this week for Advent.

Quiet honestly, over the last few days I've instead felt annoyed by traffic, uninspired by work, heartbroken for kids in the street, frustrated with fatigue, worried over news of family falling ill and overly anticipatory about leaving Haiti for home--letting the light-splashed American landscape and the jingle-jangle-jing of holiday tune piped over Musak in airports and shopping malls overtake what my spirit should have been doing all along.

"Annoyed to the World" doesn't have the same pick-me-up that the original song gives, now does it.
Joy.

It sounds like such a BIG emotion to feel. One reserved for the occasions of party hats and silver bells.

Happiness is one thing; happiness can describe a general state of being that umbrellas all the moment-to-moment scuttle you have in its midst. But joy--joy feels to be a whole other animal. Joy, to me, is a little euphoria that takes over everything, holding you completely present. Its easy to be happy while feeling a lot of other things. But Joy demands you to pay attention to moment where eyelash to toe-tips feel abuzz in smiles. Joy means happiness all-consuming. Even if it lasts for a second, an exchange, a moment. Joy means the soul is involved.

In my Advent meditations, I get how you can make yourself HOPE in the worst of situations. I understand how you should find PEACE even amidst the chaos. But JOY? Can I really be joyful while driving through Port-au-Prince break-and-weave traffic, can I find joy in hopeless diagnoses dolled out, in the stink of sewers filled with trash, in the claustrophobia of a walled concrete world, in the frustration of cross-culture communications? Maybe it isn't to be a constant state of being, but choosing to find the joyful in a day, finding reasons to celebrate even the smallest of beautiful things.

When I think of the moments in my life when I've felt true joy, they are usually the GREAT moments of my life: Dancing at my wedding where everyone around me seemed intoxicated by the party and me feeling intoxicated by the love and future I felt with Patrick. Finishing medical school despite the odds and knowing that I earned the diploma I had in my hands more than I had earned anything else I'd ever before worked for. Helping my first baby to be born--CATCHING that baby and with tears in my eyes celebrating with all the family in the room the miracle we witnessed together. Residency where I finally felt JOY in the job I had always dreamed of doing but hadn't yet had the opportunity to love... realizing that what I'd been working towards was what I was meant to do all along. Seeing my brother be a Dad for the first time and watching the best in him rise out of himself in all its protection, humor and love. Becoming a parent myself and feeling overcome the first time Solomon stopped crying when he cuddled next to my heart.

I have experienced Joy... in the grand as well as in the moments you don't always remember to write home about.

Joy:

Falling in a snow bank with friends while snow shoeing, laughing hysterically over a joke I don't remember, but the laughter still lingers.

Joy:

Running (in a previous life) with my dog at sunrise, watching her sniff curb sides, delighting in the chase of an illusive prey. Feeling the endorphin high of exercise mingled with watching the pink and orange break of morning painting the cityscape before me.

Joy:

Reveling in Solomon's laugh, and no matter what we did to inspire it, doing it over and over and over again just to hear that hysterical, little boy belly laugh one more time.

Joy:

Sledding over frozen farm fields, bumping, wiping sleet from my eyes, tumbling off, Duke barking at our heals, falling into the kind of child-like giggles with my brother, my dad, my nephews, my sister in law, my mom that make us breathless and uncertain over bladder control.

Joy:

Sharing a celebratory moment with a patient when both of our fears were dissolved thanks to healing taking over despite our most realistic fears.

Joy:

Finding myself awake in the quiet of morning, before Solomon or Patrick have stirred, sipping the first cup of hot-brewed coffee and finding an inbox full of e-mails to open like presents.

Joy:

Looking over mountain peaks today as we traversed Haiti's western ridges, seeing mountains giving way to mountains and the life that rises up from its valleys. Recognizing incredible beauty in the world around me that so often only shows me its suffering side. A sense of knowing that despite all the doubts and fears, I'm where I need to be and its beautiful to be on the adventure.

Joy:

Sharing an inside joke with Patrick, in the middle of a group of people, trying to keep a straight face while delighting in the instant connection I feel with him.

Joy:

The anticipation of seeing the faces of friends, of family that I've missed so hard and for so long. Looking forward to hearing their voices tell me about their days instead of having to read it in print. Snuggling in to a moment, a warm, cozy, twinkly-light moment.

Joy:

Unexpected laughter. Surprise.

Joy:

Unexpected kindness.

Joy:

Unexpected resilience you find in yourself.

I'm not sure I'm advanced enough to know how to experience joy as a permanent condition, but I've learned to recognize it in moments. Those are the moments that I polish like jewels in my life's collectables

The truth is it is easy to let the realities of life diminish joy, from headlines to headaches, trivial frustrations to the kind of heart aching situations that seem too big to solve. It is all too easy to look at all that is wrong with people, the world, our governments... the endless cycle of mistakes made over again, violence and corruption.

Yet despite it all, life can be inexplicably beautiful. I'm always surprised when the beauty catches me in the midst of the messiest of places. Life springs up from dust, trash and rock.

Advent asks us to recognize Joy in our belief in all that is bigger and better in the world.

So I turn to what I have faith in.

I believe in a God that bubbles up in the laughter of a child, breathes through the beauty of a landscape, flutters on a dragonfly's wing, lives in the sweat and breath of a moment LIVED, delights in loving the person or people you are with.

I believe in a God, in life, that pulses with the beating of our hearts, blooms in the earth beneath our feet, blows through the air we breath, lights the sun and stars above. I believe in a God that is bigger than war, bigger than fear, hunger, suffering, pain. I believe in a God of hands held, who lives in us even as we die. I believe in a God of Justice, who empowers us through our very core to stand up to the wounds of this world and let His healing power work through our fingers. When it comes down to it, I believe in a God of Hope, of Peace, of Joy and of Love.

Maybe that is what Advent asks us to do... take stock in what we believe in and rejoice in what we hope, what we know, what we feel to be true. So tonight I'm pledging to take a better look of joy all around me—in the faces of children, the twitter of birds in the morning, the lights lit after dusk in the markets, the music beating from drums, in moments when I forget to take myself too seriously, in the gathering together of family and friends.

Merry Christmas.

Mobile Lab

*At the "lab" in Carrefour

I admit, I was hesitant to celebrate. We've been through a couple of lab technicians over the last 6 months who came, looked confused and left before the microscope could get warmed up. So when someone seemingly perfect showed up for the job, I sat back and watched for a bit. She asked for all the right reagents, trained quickly in materials she wasn't used to, and didn't so much blink at lack of electricity or running water. We've compared findings over slides and shaken hands in agreement.

I think (pray) Everose is here to stay. She's reported for duty faithfully for 7 weeks now, showing up two days a week at CONASPEH and one day a week at Carrefour. She has even offered to travel with us on mobile clinic rides if deemed helpful. When our lab doesn't have what a patient needs, she refers easily and helps follow up with patients.

*mobile lab powered by a small solar panel

She's a kind, easy-going woman who takes initiative, has taken ownership of the lab and works cleanly, efficiently and for very little money. She makes due with the roughest of circumstances and still manages to make a well-stained slide and follow hygienic precautions. Miss Fanor and I find her an excellent addition to our team, and our clinic has suddenly broadened dramatically in outreach and capabilities. My own therapeutic strategies have thankfully become less shoot-from-the-hip and now have a touch more diagnostic back up which I am thrilled about.

The community is catching wind of her presence and already her lab is filling with people not only referred by me, but who come in with orders from other doctors in clinics nearby. After only a few weeks, she is now fielding a constant stream of patients of all ages waiting with veins exposed, urine and stool samples ready.

*At work in the CONASPEH lab space

So in this season of celebration, I give thanks for two more hands taking part in the effort. Our clinic has dramatically broadened in outreach with her presence. In the true spirit of Haiti, once again what once seemed impossible is well underway.

Advent: Peace

"Peace does not mean to be in a place where there is no noise, trouble or hard work, it means to be in the midst of those things and still be calm in your heart."

When life gets too busy, too complicated, too frustrating, too uninspired and I find myself in a slump, my habit always has been to retreat into nature, to places where peace flutters on every branch, flows through water, blooms up from the ground, stretches across the vast sky, rustles in the landscapes. In med school, my friend and I would evade piles of text to memorize for the solace of the ample public parks in Kansas City, laying in the grass and listening to the breeze whistling through the trees. In residency, I found myself escaping up the mountain at every free chance I got to hike, camp along a mountain stream, breath in the fresh scent of pine and let the quietness of the wilderness sink in. In Haiti, Patrick and I retreat to the beach to let the surf wash over us, and the cool blue horizon absorb all the tension we've carried on our shoulders through the week.
For rest supreme, I can always find it home, on my parent's farm where the nearest neighbor is a retired dairy farmer and his dog living 2 miles away. There I walk long stretches of road and never happen across another vehicle or person, can talk out loud to God when I need to work some things out, can listen to meadowlarks whistling on a prairie fence, to cows calling to their babies across rolling fields, or to the squabble of wild turkeys I've disturbed along my walk. On the farm, no lights from a city pollute the darkness, and with the setting of the sun in wild splashes of color, the night gives way to a velvety landscape of stars, the milky way spreads out like a silvery ribbon across the sky, Mars glows red and Venus bright. Only the moon can dim the skypscape of stars, and when it does, we rarely complain. The moon itself has a majestic presence on the prairie, sometimes shedding enough silvery light to illuminate the shadowy corners of nightfall.

In these places I can always find peace, breathing in fresh air, reveling in the tranquility away from masses of humanity, on open roads or curvy paths, great stretches of the world that allow the soul to expand and breath. Usually my worries, concerns and preoccupations are exposed as trivial and the greater questions of my life grow quiet as I stand in a state of simply being.

Yet I always struggle with how to take the tranquility I find in such places into my existence every day, allowing it to soak into the hustle and bustle of life, seasoning the moments of stress and struggle, coloring the routine and maintaining balance.

Because peace should be experienced no matter how many millions of people fill a city, how loud the cars honk and trucks rattle. Peace can exist in a morning with room full of patients waiting with their aches and pains and needs. Peace should take over when I have to figure out how to say no once again to an outstretched hand looking for a handout that I cannot give. Peace can exist in the pollution, in the confusion, in the suffering and celebration. Peace can exist in laughter, in tears, in the living, breathing and dying of every day.

This Sunday, we celebrated the second Sunday of Advent, and lit a candle for peace.

In our time of community gathering, we meditated on that which blocks peace from entering into our hearts. Anger, ambition, control, mourning, struggle, impatience, redefining self, frustration, disappointment, loneliness. We allow such intrusions into our presence in the moment; they disturb our homeostasis and irritate our happiness.

The world itself hurts for peace, in all its definitions. The heart of the world is tainted with struggles for power and money, misunderstandings and unbalance. As a result wars are waged, environments are stripped, poverty and starvation pollute populations, disparities perpetuate, illness overtakes, racism, nationalism, religion-ism get in the way of a peaceful global operations. Yet how can we expect the world to fall into Utopian peace if we, as individuals, still struggle with maintaining simple peace in our own hearts?

So in this year’s advent, I recognize the real challenge of peace. It starts with me. It begins with the individual. Advent reminds us God brings peace, faith and belief in that which connects, makes whole, unifies and heals. If we trust in that, then we start the process of pulling down the walls of unrest, agitation, fear and injustice.

I have a long way to go, to harbor that peace that passes all understanding. But I’m thankful for the moments in life that I’m able to grasp it with both hands, breath it in deeply, catch its scent on a breeze, hear its whisper in the wind. This advent I focus on the barriers to peace so I may hurdle them, may discard them, may put them in their place and let the peace of God in.

First BIG haircut

"Mom, this stuff HAS to go. Its HOT, I hate washing it and brushing it and everyone keeps confusing me for a girl."
One last shot of a full-head of hair. "Don't cry mom, its just hair. It grows back."
Fun with haircuts as we BRIEFLY experiement with a Mohawk.
After the clippers wouldn't work and scissors left Solomon's head looking like a rusty lawnmower with a flat tire had mowed into his locks, out came the shaving cream, a razor and a steady hand to create a Bald and Beautiful look. Solomon wasn't a fan of the shaving cream, but held still enough so that NO SKIN got nicked.
THAT was exhausting
"I still look REALLY good"
"And it feels GLORIOUS!"

Making Cremas

Today Solomon and I headed over to Silvia's house to take part in their annual day of making Cremas for the holiday season. Each year their family, like others in Haiti, gets together to make this celebratory Haitian drink to share and sell for Christmas and New Years celebrations. Cremas is a sweet, creamy liquor, often made in the home with a mix of "klerin"--a strong alcohol made out of sugar cane (an "everclear" version of rum), coconut milk, sweetened condensed milk and loads of sugar.

We arrived to Silvia's house to find Yvertha sitting in front of a tub full of coconuts ready to start the process! Most of her family and friends had congregated in their small, two room cinder-block house to take part in the day-long undertaking.

The first step was harvesting the coconut from the hard brown shells so only the white tender meat remained. This step in the process took over an hour and had many people filtering in to trade shifts in shelling and peeling the coconut meat from the hard exterior.

After it was all said and done, beautiful washed coconut meat remained.

Three of Yvertha's brothers (Silvia's sons) commenced into shredding coconut with cheese graters. Only one minor casualty happened with a grated knuckle, but was noticed before the precious coconut meat could be tainted. Good thing I brought a first aid kit!

After all the coconut was grated, almost two gallons of Klerin was added to the meat to help extract the coconut milk and give major alcoholic KICK to the drink.

A team effort was required to wring out the Klerin and Coconut Milk from the mixture.

Then lots and (headachy) lots of sugar was added by the sack full.

Stirring, stirring, stirring commenced to help the sugar dissolve into the mix.

Silvia helped me to keep a certain trouble maker occupied so curious hands couldn't sully the mix.

A case of Carnation condensed milk was adding and the stirring continued.

A case of Neslie sweetened condensed milk was then added and still ever the stirring (happened in shifts by everyone in the room trading off when arms started to cramp or tire.)

Limes and another citrus fruit were grated to extract the essence, juice was squeezed in order to add special flavor to the drink.

Spices and lime juice were added at end.


Two bottles of medical Grade 95% alcohol were poured in (on top of the Klerin), the spices and lime juice were sprinkled on top, and then it was time to taste for perfection.

After all ingredients were added and the stirring had created an evenly creamy mixture, all hands were in for a drop of the liquid to be poured on the palm for a room-wide taste test. Children to grandparents took part in the sampling. "What's missing" Yvertha asked without ever tasting the mix for herself.

"Its perfect" said her sister. "No, No, No" said Silvia, "it doesn't have any kick." Several of the men agreed. Good flavor, but no kick. More Klerin was purchased, poured into the mix and the re-taste commenced. Ah yes, kick was found. (in fact my nose hairs were burned clean off). Perfect. A room full of approval
Prior to bottling, the mix was strained to remove any hard bits of spices or pulp.

FINI!! After all was said and done, they filled two 5-gallon buckets full of the creamy mix. Bottling commenced and the work was done after 7 hours peeling, grating, sweating, stirring and talking together as a large family. Each of the workers got a little bottle of the creamy treat to take home. No wonder there were so many volunteers!

The celebrations may commence.

Healing Date Night

This Saturday morning cool air breezes in my balcony window and I'm ready for a coffee refill. :) Saturday is Patrick's teaching day at both CONASPEH and Leogane, but this morning he didn't have to to leave until later due to a teaching change up, so we had a big family breakfast of pancakes and eggs. Solomon LOVES pancakes. I love leisurely family breakfasts. It did take me a few painful minutes to fro-pic out the syrup from Sol's curls afterwards, but so worth it. (right Solomon?)

Yesterday was a big day.

We went to Solomon's orphanage in the morning. We were supposed to take Solomon to the child psychiatrist to start his dossier for the adoption. I was pumped because things seemed to have been happening fast as of late: our dossier was translated and approved in the States, it arrived in Haiti and is in the US embassy. But we got news yesterday that we have to put everything on hold until I turn 35 in September since Haiti has a rule that at least one person in the couple has to be 35 years old. We are also supposed to have been married for 10 years, but apparently the marriage thing isn't a big deal if we write a letter about how long we've known each other and been dating. Apparently the age rule is iron clad without wiggle room. I was so annoyed. UURRRR. Now? After all this time? A 10 month road block? We've been talking about adopting another child before we leave Haiti, but really wanted to have Solomon's paperwork close to done. Now we have to consider whether we want to and can afford to work for a second adoption before Sol's paperwork gets done and getting pregnant gets pushed farther back. Big bummer for the day.

There was a new little girl at the orphanage who had just arrived last week. She was 2 years old and I swear she was about the size of a tall 5 month old baby. TINY. Horribly horribly malnourished wearing skin like a little old man. My heart broke in two. I haven't had so much maternal pull come over me since taking Solomon home for the first time. I seriously almost said, "lets take her home and get her healthy." The staff at the orphanage had similar maternal feelings and were extraordinarily careful in picking her up as if they might break her, preparing formula for her, nurturing her. When I held her she held with her whole body: her arms, hands, fingers, legs and even toes clung on. Everything gripped me. This little life that in two years had so much hunger, so much loss and zero growth. We are not supposed to want to fix the lives of people and patients around us, right? But with kids here, I just want to take so many of them home. Especially the little and abandoned ones. Throw an over-active uterus and end-of-reproductive-age hormones into the mix, and the urges almost take over.

So yesterday I was annoyed about the adoption, heart broken about the little girl, wanting to figure out in an afternoon what our plans were for life and family. After a nap I made afternoon coffee while the boys slept and settled into some sitting in the quiet house just thinking, meditating on being here, being present, being witness, being parents.

Last night Patrick and I got dressed up and we had our first date night since Solomon came home. Silvia came over at 5pm and stayed all night. We left and picked up Ben and Alexis who showed us this beautiful restaurant in the "Latin Corner" in Petionville. The food was excellent, the conversation stimulating, the wine hit the spot, and the dinner music was JAZZ. I seriously felt like I had left Haiti in a luxurious moment. It was the first restaurant we've gone to that didn't have house music blaring, black lights and otherwise darkness creating the "atmosphere." We sat in the outdoor dinning area under thatched umbrellas, twinkling lights and pretty silver stars hanging and swinging in the warm night breeze creating a beautiful ambience. A musician played quiet jazz on a saxophone at the bar. It was perfect.

On our way home, Patrick and I had a last minute inspiration to keep the night out going a bit, and we ducked into a little bar on the way home to share a couple of night caps at another spot we looked up in our Lonely Planet book that came highly recommended as a place for atmosphere and live music. When we arrived to the bar--decorated with newsprint as new as Michael Jackson's passing, red-painted ceilings, warm cozy-pub like atmosphere--they were playing JAZZ again, and Christmas jazz. I about cried. We sipped on drinks and listened to the live music that got a little more lively with a Latin feel as the night deepened. Lots of people started dancing and we watched while indulging in the kind of conversation that can only happen outside of the walls of home and routine, nurtured in an atmosphere of relaxation and fun. By the end of the night, we were dancing and reminiscing about the night our feelings were first discovered on a dance floor a block away from our volunteer house in Washington D.C.

Dream date. I smiled all the way home.

When we got back (at midnight) Sol was still up and Silvia looked EXHAUSTED. So we grabbed him, and literally seconds after I had him in my arms, Solomon slept. It was as if he was waiting for his safety net to come home before throwing in the towel. Talk about a heart breaker. I love that little boy.

After everyone the house slept in this morning, shared a big nurturing breakfast, I am happy to reflect and celebrate a night that was the most fun I've had alone with Patrick for a while. I couldn't have asked for anything more perfect under the Christmas tree. Its good to still find yourself absolutely in love with the man you married. Makes all the bumps along the road easier to bear and the celebratory times in life all the more fun.

Continuity Day

This week in the CONASPEH clinic, amidst countless new faces with fevers, coughs and new complaints of aches and pains lasting months to years, I celebrated a record number of people following up for care, whether for acute problems or chronic illness. For a family doctor who enjoys the relationships built with patients over time, this was no small reason for me to celebrate.

In Haiti, regular health check-ups and follow-ups aren't something that has traditionally been valued or economically possible. When people follow-up at our clinic, a clinic that asks for a small "participation" (as CONASPEH calls it) in exchange for medication, a clinic where no free drugs, food or goodies are handed out, it means that these people have risked enough trust in our medical recommendations and are investing time and a few goudes in their health and wellbeing. In a country where every goude is important for food, water, clothing, schooling and other trappings of life, I feel honored by such participation.

Among the faithful patients coming back for more this week, I saw:

* A baby with diarrhea. Last week I met this tiny two-month-old girl and her desperately thin mother who reported that baby had lots of diarrhea and tummy pain. After gathering a bit of a history, we found out mom had been supplementing her breast milk with powdered cows milk and broth. We chatted for a long time last week as both Miss Fanor and I tried to convince mom to rely and trust in breast feeding, informing her of the perfect nutrition she alone makes for her baby. Not knowing if she would trust a white doctor with such crazy information (how can LESS be MORE??), I held my breath as I said goodbye and asked for her to bring her baby in the following week so I could keep a close check on her. Today mom came in beaming. HER FOOD saved the day. The diarrhea was gone, baby was eating vigorously, and mom was eating a little better thanks to money she was saving on powdered milk. She nodded full of smiles when I asked to see her and baby weekly for weight checks, if for no other reason than to celebrate a little baby thriving despite the poverty that surrounds her.

* An elderly woman with diabetes. This bright smiling grandmother of 9 was accompanied once again this week by her daughter who has been helping with medications and blood sugar checks since we started treatment a month ago. We all had reason to celebrate today when after several weeks of adjusting insulin and doing diet education, the glucometer finally gave us a reading in the normal range. My patient was just happy she could SEE again as the high blood sugars had been reeking havoc on her vision.

* A young woman following up for wound care. While making dinner for her family a few weeks ago, this patient accidentally spilled hot oil and bean sauce on her legs and suffered horrible 2nd degree burns over her calves and feet. She was faithful about wound care and vigilant with medications. Today she practically danced in, bandages gone, skin pink and healthy.

* A pregnant woman. This mother of 3 is now 7 months pregnant. She came in to do a routine follow-up for her pregnancy, talk about how she's feeling, refill her vitamins, show me her lab results and listen to the heart beat of her little growing child. Every time a pregnant woman comes in for care, it gives us the chance for a little teaching, a lot of encouragement and hope that mom can understand how best to care for self and body.

* A teenage patient with a troubling type of cancer. K came in today with her pastor to talk about plans to go north to Milot in January where volunteer physicians will evaluate her and potentially give her a surgery to remove the cancerous tumor overtaking her mouth. After receiving news about a possible surgery, she doubled over in tears. Seeing my confusion and concern, the pastor reassured me that she was overcome with happiness because she has been suffering so long and praying for a reason to hope. They assured me she could find a way north. She talked with her hand covering her mouth that no longer closes completely due to the bulk of the tumor. Both Miss Fanor and I were shocked at how quickly the mass is growing. I was grateful for a secret stash of narcotics donated by one generous visitor or another willing to part with their powerful post-surgical pain pills if they could offer someone relief. Today they did. I rarely use the medications for pain, but this week I was happy to hand over a month's supply to the girl who bravely suffers with such a painful and disfiguring condition. Medications and possibility thanks entirely to a network of friends.

*A 50-year old woman. I see this easy going woman monthly for blood pressure checks and medication refills. Today she came in earlier than her scheduled appointment to show me her lab results that revealed a recent bout of high fevers was due to malaria. Once again my patients amaze me with their incredible ability to suffer through illnesses that would leave most of us moaning in bed.

*A CONASPEH teen concerned with a possible STD. I often field frequent visits from teenage students in the CONASPEH school wanting advice over weight gain, acne and "infections" (that always mean genital). When I insist on a formal consultation and exam for such "infections" and elaborate on why I'm not just passing out antibiotics for what could be a natural physiologic process or a prophylactic for free love, I don't always get a faithful following. But yesterday a shy girl came in, braved an exam she had never had before and took my efforts on sexual education like a little girl growing up too quickly. Miss Fanor is the sexual education and health teacher for the school which makes her instantly popular with all the teens. I prefer the one-on-one setting where I can encourage self-preservation and respect in an age of consequences marring each "in-the-moment" decision. I'm always grateful for a moment with a young woman not yet sure of herself to celebrate all she is capable of and the power she has over her life. Although blushing with the subject material, our young patient sat steady and came back today to discuss lab results. One teen at a time.

*A 65 year-old woman with hypertension. I've treated Madanm C for 6 months now for staggeringly high blood pressure. What bothers Miss Fanor and I the most is her obvious depression. Once in a while we make her laugh. LIfe is hard, she tells us. She can't always pull together the time or effort to come in for a blood pressure check, and often misses a few months of medications and follow-up. Eventually, though she faithfully wanders back. This week she checked both herself into clinic as well as her grandson with a chronic cough.

* A young woman with a swollen leg. She had come in last week suffering with significant swelling in one of her legs. I was immediately concerned about a blood clot yet also worried over evidence of cording and inflammed lymphatic channels. She had told me she would TRY to get an ultrasound to look for clots, and in the meantime I treated her for lymphangitis. Today she came in to let me know that her pain is finally gone. She hadn't yet gone for an ultrasound prompting me to once again rehashed my concerns that she might be toting around a life-threatening condition. She seemed more concerned that her hugely heavy leg makes it hard for her to walk in heels. If her fashion sense is what helps her find her way to the hospital, than so be it!

* A little boy with fever and diarrhea. Despite having been seen in an emergency room over the weekend, the boy was brought in on Monday by his concerned dad who wanted "his doctor" to check the medications and make sure I agreed with the treatment plan. I felt honored that he trusted my judgement and proud that the father was being so careful with what kind of medications he administered to his son. So often I see patients taking medications without any real understanding of what they are or why they are taking them. After discussing why each medication was indicated, I reassured Dad that the hospital had given excellent advice and prescriptions and that likely he could trust in their care if another such situation should arise. I smiled to myself, happy with a patient protective enough to seek out understanding and glad that our clinic functions as much to treat as to educate.

Continuity means continued chances to encourage, teach, re-adjust treatment plans, and accompany patients through life that is riddled with challenges to health and well-being. Sometimes continuity means suffering with people through situations no one can fix. Other times it offers reason to celebrate. Most of all I savor the simple relationship that takes shape, the trust between doctor and patient, face to face that evolves. It is why I became a doctor and what keeps me inspired to mush on ahead.

Advent: Hope

This Christmas season I find myself reflective and content. A year ago lonesome and homesick, Patrick and I practically wished our favorite time of the year away for longing of friends and family. But this year, we find so many reasons to celebrate, to be grateful, to embrace the season of Advent rich with tradition and ceremony. A year gone by has created a home of sorts, a new family, friends evolving, and months full of experiences that inspire us to keep working, and dare us to hope.

With lights strung all over our apartment, stockings hung under a window that allows soft tropical breezes through and a little Christmas elf making home time all the more fun as we chase him around, delighting in his world of discovery and easy entertainment, we find ourselves joyously slipping into the Christmas spirit.

Last night Patrick and I accepted an invitation from some MCC missionary friends to join them and their larger circle of friends for a kick-off to Advent. We were invited back to Alexis and Ben's house (the people I shared Thanksgiving with) for an Advent service. A gathering of other Americans living and working in Haiti were there, some new to the country, others with a year or more under their belt and all working for development, global awareness, political action, peace, and justice in the spirit of love. When we arrived, scents drifting from the kitchen triggered strong olfactory memories of home and transported me magically to my parents' home where spiced apple cider always brews in the kitchen welcoming us home after a usually cold and long trip home for Christmas. Instead of cider, one of the guests was simmering mulled wine on the stove, and sending spiced warm scents into the night air. I nearly cried. I've always been highly influenced by my senses. Smells can transport me through time linking me instantly with favorite memories or moments. In a breath, my whole mind and soul was home for Christmas, and emotionally I was prepared to begin meditations on Advent, the celebrations of family, friends, life and spirit.

With hot tea or spiced wine, we all gathered outside under white Christmas lights strung above, swinging on hammocks or lounging in chairs visiting and getting to know each other. Alexis and Ben put together a beautiful worship complete with mini bonfire, an Advent wreath, Christmas carols and readings from the Bible centered on hope. One participant brought his guitar to softly accompany our songs and everyone took turns reading from the program. I felt immediately filled with the contemplative spirit, settling into the traditions and reflections of my faith during a time when I feel the most hope for new-beginnings, when the presence of God for me is in every flicker of candlelight on faces around, every soft glow of twinkling lights, in every prayer and heavy in song.

I’m glad to have this outlet to meditate on the Christmas season. Not only was the service intimate and meaningful, but it was really fun to get introduced to some new people. Makes life here feel more like LIFE when you are interacting with people you can slip into easy conversation with.

A week behind in the Advent calendar, the theme of our first night together was hope.



In truth, I am a Christian by culture. I believe God works in the world through all life, residing in the hearts of all, regardless of religion or creed. I feel the spirit riding on the wind, blooming in the earth, whispering into the ear of those who honor life and love through whatever context they understand the world. I don't believe in a exclusionary God and trust the spirit is bigger than human interpretation can comprehend. There have been times I've found myself struggling with my identity as a Christian when frustrated by certain things preached or done in the name of Christ. So to stay sane in a world of radicalism and intolerance, exculsionism and fights for power, I tend to focus on the spirit of God and life that I believe exists in all things.

Yet I grew up knowing Jesus. Ultimately I see the world through a Christian context, no matter how much I can appreciate some other truths and traditions of the world's beliefs and religions. I grew up inspired by the life of Jesus, by his radical teachings on how we should treat each other, on social justice and on our relationship with God. I have been heavily influenced by how I understand Jesus's message on how to live and work in a way that moves our world closer towards God's Kingdom on Earth.

With Christmas and the season of Advent comes the reminder of what I like the very most about the faith of my birth. During Advent, Christians are reminded to recognize God in the most simple, the most humble of creatures and moments. Advent reminds me that the spirit of God and Life is everywhere, in even the ugliest of human situations, the poorest of conditions, the darkest of corners. The stories of Christian Advent tell us that angels sang for the lowly shepherds on a hill, doing their rancher's duty of tending to sheep while cold, tired and under-appreciated in their society. Advent reminds us that God can be found in a barn, a manger surrounded by the organic scents of livestock. God cherishes even the couple too poor to deliver in a hospital or home. God exists in the heart of an infant child, the most innocent and vulnerable condition of our humanity. If God lives in the homeless, the rejected, the vulnerable, the tired, the war-torn, the poverty-stricken, the dirty, the smelly, the exhausted, than there is always hope. I like that best about Christmas, that simple reminder that I need not look to a church with the fanciest of stained glass windows or to the richest and most powerful of home, country or situation. I am challenged to hope when reminded that God is in everything, the spirit all around me, and I just have to see it, feel it, breathe it, believe in it, take hold of it and live it.

So despite life suffering under the conditions of our unbalanced societies, politicians not living up to our expectations, corruption that seeps through our institutions and war that dirties interpersonal relationships as well as the relations between countries, we are challenged to hope. That challenge forces us to see the world differently, to recognize the spirit of God in all things, and to react accordingly.

After a year of witnessing some of the most heartbreaking of conditions, the most vulnerable of victims, I cling to the hope of the season. Hope that one day we, as humans, will get it right. Hope that one day no child will go to sleep hungry, no roof will leak, no person will feel alone in this world packed with humanity, no landscape will be abused, no foreign policy will focus more on economic gain than compassionate understanding. I dare to hope. I dare you to too.