Tuesday, July 7, 2009

Oof...

Seattle international beer fest down in Seattle Center on Sunday.
A third of our intern class on the top of Mount Si's Haystack on Saturday, the 4th. Rainier's hanging out in the background.

Don't let these pictures fool you; I'm in a bad mood. Today was really rough. I had a couple moments of perceived competence today and the rest of my 14-hour day was like a bad day of middle school: I was late to class (morning report), my homework (patient reports) sucked and it got read aloud (by me), I tripped over the desk in the lunch (call) room and spilled water, my shoes smelled (true), the other kids knew way more about the Mayans (ICU patients), and I felt fat. It might have made it worse that everyone was nice about it. If they were mean and disappointed I could have gotten mad and externalized this crap. Being a doctor sucks!

I'm not really up for this, but let's play the "perspective" game:
- It's really hard learning to be a good doctor; I'd be pissed, bored, and disappointed in the system if it were easy
- My attendings, senior residents, and co-interns can make me feel dumb by comparison and that's awesome; I got into a wonderful residency full of remarkable people doing solid medicine and I get to grow here for three years
- It took me nine days to feel like crying at work; that's not bad with all this new responsibility and challenge
- I'm doing exactly what I want to be doing in life
- Today was partly hard because I had a full weekend off and had to learn new patients' stories this morning; having a sunny holiday weekend off to hike, party, and go to a beer festival is wonderful
- I got home to a roommate who bought me beer, gave me a hug, told me I was where I was supposed to be, and is cooking up some fish in the kitchen right now
- I know a lot more today than I did last week and I'll know a lot more next week, not to mention next year
- Not only were the other 8 days non-tear-inducing, they were pretty damn wonderful and exciting
- Tomorrow I'm not on call, have didactics and balint (intern-huddle-and-debrief) in the afternoon, followed by happy hour
- Wednesday I have my second clinic session -- which I loved last week and which gives me the opportunity to hand out business cards sporting my name and some funny initials afterwards -- and then we have a good group going to pub trivia at the Kangaroo and Kiwi to regain our rightful championship title while watching rugby
- Thursday I'm playing soccer with an old high school friend

OK, that's enough perspective. Dinner time.

Friday, July 3, 2009

Up too early


These goofballs are some of my co-interns.

I got up at 5:00 by mistake, which was pretty dumb. Today is a "weekend day" at the hospital for the 4th of July holiday so I need to be there at 7: pretty cush. So, here we are, a week into being a real, live doctor, and I'm feeling much less like a useless fraud than I thought I would. The sun's still low and beautiful, the coffee is tasty but ineffective against the sleep debt and circadian confusion I've acquired this past week, and my new mattress is super cozy. But after one more long day I get both weekend days off - my one golden weekend this month. This learning curve is exhaustingly steep and I'm managing to enjoy it by not thinking more than a few hours ahead. Sometimes it's best to keep it to fifteen minutes if I'm feeling overwhelmed.

I'm posting this morning, not because I have the energy for funny stories or even mundane descriptions, but because, having started, continuing will be easier. And I miss writing about life.

Saturday, May 23, 2009

En Francais, maintenant...

The French is coming back pretty quickly, actually, helped by the amusement and patience of the thirtyish wonderful people Julia and I have already met in the last three days.

So, I left myself very little in terms of time cushioning for the task of getting back to Ithaca with a Volvo wagon full of Boston belongings. I was making great time and keeping my eyes solidly open despite the hour and a half of sleep I had gotten while packing up the night before. Just after I got on 88 I heard a magnificent POP, looked in my mirrors expecting either the kayak or one of the bikes to have blown off, and saw only a hubcap rolling nonchalantly away. I pulled over with that awful thud-thud--thud---thud of a flat tire and knew for sure I couldn't make my plane in 4 hours from Ithaca. I called Phil who activated a tow truck and then talked me through changing the tire. I had to unload half my stuff including removing the bike rack and my kitchen contents onto the shoulder. I got a little greasy and the lug nuts were a little stuck, but the spare went on well and the air I put into it in Duanesburg lasted until the Ithaca airport where I arrived 40 minutes before take-off (PLENTY of time for that one-terminal hublet). Rebekah Carpenter and her friend Johann were there for the key hand-off and Julia drop-off and the two of us giggled our way to Newark and then on to Charles de Gaulle, getting there the next morning.

After a quick Croque and cafe au lait we hopped a couple trains to Dijon and on to Grenoble, where we ate dinner, walked a little, and passed the *@&$ out for eleven hours. The next day we got a bus to a little Gite d'Etape out east in the mountains, watching the peaks grow and get snowy around us as we climbed higher and higher. Our Gite, La Breche, could NOT have been better. It was super homey, stuck down at the base of La Meije (big peaks), populated by a handful of lovely hikers of many ages who were a bit baffled that two americans had found their hideout, and stocked with amazing food and accurate maps with folks willing to drop us at trailheads. We hiked yesterday on the GR-54, a portion called the Plateau d'Emparis, which started with tons of switch-backs and finally topped out on some snowy fields with two little lakes and 360 degrees of snowy mountains. Mon dieu!

We have to run to get some snacks and our train to Digne. From there we'll take the Train des Pines to the Gorge du Verdon for some seriously vertiginous hiking. Yay! So much more to say, but I've got to go. Whoopee!

Tuesday, May 12, 2009

Heathrow installment...

The nurses and ward attendants of the female medical ward who so kindly sent me off with this traditional Basotho hat.
Drs. Phil, Fadya and soon-to-be-Drs. Liz and Joe all lookin' pretty sweet.
Mr. Joyner protected from several kinds of droplets.
Knerdy knitters, Liz and Camille, on the way to Kruger from Jo'burg. She was knitting socks with hand-dyed Scottish yarn.
I thought I was pretty funny. The real view was spectacular.
The third deepest gorge in the world? This is where the big ol' potholes were, carved out over time by trapped pebbles in eddies.


I know these lions from Day 3 look little but they were big. I apologize for the lack of videography skills. There was a group of six or seven cubs over to the left, with a babysitting female. The adults and cubs took turns tearing at the water buffalo. Further to the right (not in film) were the sated lions lying in the grass and keeping the hyenas in check.

Monday, May 11, 2009

A photo upload from Jo'burg Airport

The compulsory ("ary"?) zebra crossing shot.
My crew on the bridge across the Olifants River -- the only place we could dismount outside a picnic area.
A very tall and handsome fellow.
A few Kruger pics and, if there's time to upload before boarding, a Basotho hat photo or three...


Except for, and perhaps a little bit because of, thirty minutes of the singing professions of love from a certain member of LeBoHA who shall remain unnamed, my departure from Moshoeshoe was nothing short of beautiful. That airport is so relaxed that, when I got through "security" and found myself in a waiting room unattended, I walked out to the prop plane and started chatting with the nice South Africa pilot before she kindly suggested I go back to wait in the queue. Oops. The sun was dipping under the clouds as we took off and for twenty minutes I could see the firey red disc through peepholes of pink puffiness. The flight is only an hour and a little and we landed easily in Jo'burg, hopped the bus to the main terminal, and now I'm waiting with what may be my last Windhoek lager for a long while.

Heading home -- GULP!

Ooh, here's a picture of me with the nurses who gave me a goodbye Basotho hat last Monday morning! They called me "Lerato" all morning, the Sesotho word for love, and the name they gave me several weeks ago. They are so wonderful. They gave me one to take home to Kevin, as well, and we are going to be the best-shaded and most stylish residents of Seattle. Hmm... pictures may have to wait until Heathrow internet.






So this sad day of departure has finally come. I'm glad to have had a full week away from Motebang adventuring at Kruger; the weaning has been a bit gentler than it could have been. This may be an abbreviated post since I still need to grab lunch and my bags before catching a ride with Tlalinyane to Moshoeshoe International Driveway. Sooo... where to begin.

Mrids dropped me in Maputsoe (site of my fighting stick purchase) and I walked across the border to Ficksburg and the waiting stand of combis. I got stuck in the same damn spot - back right over the wheel well - with my backpack on my lap containing my knitting and Dickens novel (can I get whiter?). The ride was about four hours to Jo'burg and by the time we took a lunch break after two hours my knees, jammed into the seat in front of me, were throbbing and I could barely feel my left buttock. I pretended I was outlasting a group of hateable opponents on Survivor and travelled back in time to hang out with little Master Paul Dombey. At the lunch stop two men asked me for my American number (not an uncommon experience, but more likely outside of my little town) and one explained that he hadn't spoken with white people much even though they lived in his town and officially nothing was segregated. Interesting. We arrived at the totally overwhelming Jo'burg bus station (Maseru's got nothing on this madness) and, happy that I'd made an English-speaking friend on the ride, fought my way through the crowd in pursuit of his red hoodie as he rejected overpriced taxis and eventually found me a van that could drop me at the Ritz Backpackers. I had thought that was going to be easy and was really grateful that I didn't have to spend an hour as the only foreigner in a sea of white unlabelled vans. Luckily, I had a map that showed an outline of my route to the Ritz and, yelling out "Stop!" just in time, tumbled out through the full house with four bags onto a street corner a block from the hostel. yay!

I haven't done much hostel-staying but this place was nice enough if populated and owned by strange characters. I found a Pick-n-Pay down the street and had apples, cheese, crackers, and bottled water for dinner, watched a little rugby, avoided sensationalist stories of gun violence told by a drunk carpenter in a (successful) effort to impress 18-year-old gap-year girls in affected gypsy clothing.

I woke up at 5 and was picked up with Claire, also from the Ritz, by Gideon ("Chchchchideon" in Afrikaans) at 5:30 for the 12-hour scenic drive to Kruger. We picked up Camille on the way who turns out to have been an English major at Cornell graduating in 2002, to have brought her knitting, and to sleep in an "Ithaca is Gorges" t-shirt. She's working in London in international higher education. Then we got Chris, who just quit his banking job in London to travel and reassess what makes him happy -- perhaps DJ-ing? Then we got Lucinda, an Afrikaaner just done with both a course in nail care and a stint in rehab after a suicide attempt, the details of which she was bursting to tell us at lunch. So we five happy campers travelled to a few scenic pull-offs and finally to a camp just outside of the park for drinks, a foot-dip in the pool, outdoor dinner, traditional dancing, and a nice night of sleep in permanent tents.

We woke up at 5:30 to head into the park, meet our guide, Sam, and the other members of our tour group, and begin what turned out to be three full days (since I extended my trip by a day) of driving around Kruger and having a generally exciting and jolly time.

If this internet in the Maseru LeBoHA office will let me, I'll upload a smattering of pictures, but let me just say that I was worried that 30 years of zoos and Discovery Channel specials would dull my awe at seeing the park. I could not have been more wrong. It was completely different to see 150 giraffes on the first day, to yield to zebras, impalas, elephants, wildebeest, and kudu, to happen upon a pride of lions feasting on a recently killed water buffalo, and to guard my breakfast from southern yellow-billed hornbills and glossy starlings.

Daddy, I had the whole land rover looking for pangolins but Sam said he'd only seen two in seven years, so I guess we didn't have much of a chance.

On day two we saw the big five plus a pair of cheetahs before lunch. Ridiculous. The Romanian designer of children's handbags living in Milano stood up at 9:00 and yelled, "loooook, loooook!" and we all followed her excited gaze to a dark, skulking leopard following a herd of impala through tall yellow grass.

On day three we returned to where we had, the prior evening, seen a freshly-killed water buffalo and found four female, four male, and seven lion cubs taking turns basking in the sun and tearing the hooves off the remains of the buffalo. Hyenas made wide, impatient circles around the group and vultures waited in nearby treetops.

By night Chris, Camille, and our day-two friend Ben, sat around the campfire getting to know each other, drinking beers purchased from the shop inside the park, and listening to the sound of buffalo, lions, and impala in the bush just beyond the electric fence. Once, while searching the camp for wood for the fire, Ben and I followed the sound of a snorting male impala only to discover--to the near wetting of my pants-- that it was a snoring male Afrikaaner.

On our final morning, Friday, we all got up at 5 for a dawn bushwalk. We followed Gordon and Thomas and their rifles --single file and silent-- down a white rhino path into the bush, stopping for wonderfully informed explanations of giraffe and elephant prints, scratching posts coated in mud, engorged ticks, and rhino blood, collective spider webs, the sighting of a Verreaux's (giant) eagle owl, the sound of a male lion roaring in the distance, a demonstration of the anaesthetic properties of the leaves of the silver cluster tree and the strength of the rope made with its bark. Gordon grew up in Kruger, went to the primary school in the park, and is some kind of head guide. He seems to know everything about kruger flora and fauna, had stories of killing charging elephants, of fighting poachers in search of rhino horns, of leading training exercises for bush guides, of treating wounds with medicinal plants, and was the first person in years to make me really yearn for a parallel life. I could have made a very happy rifle-toting bush guide, I think.

After a final breakfast at our initial cushy camp, Timbavati, we piled back into the van with a wonderful couple from Brussels -- Philippe teaches international law and human rights and Luis does nanotech research -- and Pastor, our new guide and driver, and took the more direct route (8 hours) back to Jo'burg. I spent another night at the Ritz and, much to the delighted surprise of my black drivers ("A white girl in a van?!") took the hostel shuttle back to the monster combi stand and compressed my femurs for the 5 hours it took to get me back to the Ladybrand/Maseru border. I waited in the darn passport stamping line for an hour, told two men it was no use asking for my American phone number, schlepped my bags across the bridge, and threw it with great relief and some shoulder pain into the awaiting LeBoHA van driven by Kat and passengered by Aude. We dropped my stuff at the intern house, picked up Carrie and Taryn (a visiting BU public health professor) and headed to Mimmo's, the Italian restaurant where I had my first dinner in Lesotho, for a final sup-sup and chat. It was really nice to have a table full of friends a new (to my life, not to Lesotho) and interested ear in Taryn to whom I could babble on about how much I've learned and felt changed by my time here. On the eve of departure I realized I was grateful to be asked to summarize my experience and attempt to make some forest from my new trees.

In an hour I'll pack up and fly out to Jo'burg, Heathrow (with a quick chance to catch up with a ninth grade friend from our London year and her very new son) , and then Boston, arriving Tuesday evening. Thursday Laurel and I will have a graduation party in our back yard (she has mulched and planted and I can't wait to fire up the grill and just BE THERE under the tree with friends), Sunday I will graduate from medical school (sorry, what?!), and Monday I will drive home to Ithaca a doctor with a ten-day trip to France promising wonderful talks and laughs with my old high school friend Julia and the Southern Alps giving us time to reflect. In early June Kerry and Ross will have a baby girl in Ithaca and, after smelling her head and promising to visit as often as I can, I'll drive my whittled-down belongings in and strapped to the outside of my Volvo through Huron City and on to Seattle, land of Swedish family doctors, old friends, and new mountains. What a trip this all is...

Sunday, May 3, 2009

Dangling by a rope at 206 meters or hovering over a dirty, unflushable toilet? You choose.

The night, drifting seemlessly from the candle light of an "It is DONE, Meh; we turn light out now" Leribe Hotel to the Milk Stout-supported candle light of Jay's Canadian, blue-tiled palace, had so deteriorated into drunken debauchery and card games with fuzzy rules that my gently cramping stomach the next morning surprised me but a little. Eschewing (that one's for you, Amanda Lake) the second cup of coffee and enjoying my cream cheese with cucumber much less than I expected, Joe and I hitched a ride to the combi stand in Maputsoe with Libby and set off to Maseru, amusedly crammed into the back of a 15-seater van with Aude, Thibeau, and 12 Basotho. The ride got ugly quickly and I tried to sleep in an effort to ignore the rising sensation in my esophagus, the sweat creeping through my clothes, and the taste of bile in my posterior oropharynx. This was clearly no mere hangover; I now suspected the ham on my tropical pizza. I was in the farthest seat from the door (back right corner) and my mouth was out of reach of any window. Fear led me so far as to take my knitting out of its zip-lock (TM) bag to prepare for what felt like it might be an inevitability. Fortunately, I survived the 2-hour, twisty (and totally beautiful) journey without tossing my cookies. Joe and I explored the outdoor bus/combi/taxi hub of Maseru for a few minutes, turning down a hundred offers for hair clips, chicken feet, accordion music, games of pool, 40's of beer, green apples, green bananas, newspapers, socks with toes, I heart Jesus hats, and rides all over the country, and finally found the line for the 4-hour bus ride to Semonkong. Just as we settled our bags between our feet a man walked up to us and offered us rolls of toilet paper. A febrile wave came over me, the sun seemed to attack from all directions, I inexplicably waved him away, and instead walked off decisively to find the bathroom, all the while wondering whether the next thing to escape my body would be gas or liquid. After a sickening little walk around the now-illness-magnified outdoor-smellodrome of this Basotho Grand Central, I found the barred window where I could pass a woman half a Maloti in exchange for a small wad of toilet paper and the opportunity to wait behind six women while employees and their children dumped small buckets of brown water from the sink into the two "working" toilets to encourage them to "flush". Ay-ay-ay, Bimbo! I finally made it to the front of the line and repositioned the awaiting piece of paper towel which then tenuously kept my single-hinged stall door shut. As soon as I had dropped my pants to hover over the toilet which had clearly not been attended to, several people started knocking on my door. Good lord. There was no getting me up once I had so hovered but I was sure their knocks would dislodge my paper lock. I yelled out, "just a minute", heard laughter and increasingly bold knocking, finished my awful business, and came out, pale and shaky to face my entertained audience. I still don't know what exactly was so funny but I had made it clear to myself that the ride to Semonkong would be good for nobody. Joe called Semonkong to see if there was a way we could arrive the next day at noon (the next bus available) and still get him back in time for work on Monday morning but we ended up having to cancel, much to the anger of the European rappellers, the disappointment and queasy guilt of Liz, and the gracious understanding of Mr. Joyner. Thibeau picked us up and dropped me, with a glass of water to sip, into the cool, waiting arms of the guest room futon at the public health intern house, and went with Joe and Thibeau to some international food festival that I wanted to hear NOTHING about.

I slept for over three hours, waking only to visit the bathroom and once to notice that Zinnia, the owner of the intern house, was standing on my futon closing the curtains and placing an extra blanket over me (oh, sweet mother figure, she). I got up at dinner time to this sunset and felt like I could handle a little salty broth from Peace, the karaoke Chinese restaurant I'd heard so much about. I have never been in a place like this. It was clearly closed when we got there - lights dim, door padlocked, no tables in sight, display counters nearly empty of food, no staff visible. But Aude said, "Oh good, it's open!" and yelled through the gated door. A man came up from the shadows of the next building and pressed the door bell for us which played Fur Elise. In Pavlovian response, three Chinese employees appeared laughing, one running apologetically with a key to lead us to a large empty table with a lazy susan just past the side gambling room. There was no sense of apology, however, for the cockroach in the dining area, the bathroom door off its hinges or the lack of hand-washing supplies. Our waitress managed to take our order wrong despite the traditional numbering system of the menu, the waiter had an enormous tuft of black hair sprouting from his chin mole, the soup was thick and eggy in contrast to its description, and the steamed chicken was sweet, goupy, and reminded me of Christmas cookies in a blender. Strangely, I had a quite wonderful time, finding everything amusing and making a game of keeping all my utensils off the table for the duration of the meal. We barely touched our main courses so were able to provide a serious dinner for the two nice homeless men warming by a trash fire in the parking lot on our way out.

After the soup my stomach felt it could even handle tea and Joe and I stayed up watching _The Good Shepherd_ and sipping Rooibos herbal tea until retreating to our guest rooms.
Feeling 92% Kat and Aude drove us across the border into Ladybrand, the Free State border town adjacent to Maseru. Living Life is a gorgeous farm-house restaurant with fresh herbs, flowers, and veggies, a varied and delicious European brunch menu, a mixed-race clientele where even Afrikaaners look truly friendly while sipping berry juice and watching their children play on the jungle gym, and a very satisfying bathroom sink carved crudely of yellow stone and attended by --not one!-- but three clean hand towels and moisturizing "white cedar" soap.

After purchasing a six-pack of coconut Amarula balls to last me the week, we grabbed our stuff from the intern house and hopped a combi back to Leribe. This combi ride was so incredibly different from that of the previous day, rife with the fear of personal explosion as it had been, that I experience three hours of unadulterated health-happy joy despite the fact that my femur was longer than the distance to the seat in front of me, the guy next to me for the middle hour smelled like he had bathed in last year's Halloween pumpkin, and the Sesotho narration of the football match between the Orlando Pirates and the Kaiser Chiefs was blaring from the speaker an inch from my right ear. The whole thing was wonderful. The whole world seemed happily and curiously amused by my presence and my insistence on knitting in my tiny corner of the combi, our fellow-passengers all felt like it was a good day to practice their English and ask about my iTouch (I showed them pictures of my friends and family, scrolled through my music albums to much oohing and aahing, and oohed and aahed at the cell phone pictures shown to me in response), and the sunset blew my little American mind. My only complaint was that I got the line "purple mountains majesties above the fruited plane" stuck in my head. The mountains were indeed purple and stretched farther than my neck could rotate in my cramped seat. The clouds glowed pink and orange, the nearby rocky outcroppings were golden and outcroppy enough for a noble appearance by Simba, and the wheat in the fields along the road had dried to a rich maroon. I was grinning like a true Lahoua, unable to contain myself.

The final combi dropped us at the bottom of our hill and we cooked up a couple chicken burgers from Spar, shredded some squash to stir up with butter, salt and pepper, diluted the guava juice, and watched the end of _Return of the King_, the final movie of _The Lord of the Kings_, as Aude calls it. Oh dear...

So with Gollum and the Ring destroyed, the hopes of men regained, and Sam and Rosie self-propogating happily in the Shire, I had my penultimate sleep at the convent and the first of my returning home anxiety dreams. Life is so complicated in the place I actually live... But it also involves really good hugs and talk with people I love, wonderful and necessary pieces of my journey for which I have longed and worked hard, and adventures I can't yet imagine. But first: carrot cake!