Immediate Prayer Request

Today (20th of September) is a National Holiday for Zambia.  It is voting day.  There is political tension all over the country.  We've been told to keep a low profile.

We're locked inside our mission compound, so we're safe.  But please pray for a peaceful election in this country.

"Recent political rallies have been accompanied by incidents of violence between rival activists and the trading of verbal insults between the ruling Movement for Multiparty Democracy (MMD) and the PF (Patriotic Front.)" -Travel Security Email.



For more information:
http://www.africanews.com/site/Zambia_elections_set_for_September_20/list_messages/39313

The Journey

[the journey]

(can anyone else hear that Sleeperstar song in their head?  “I’d walk a thousand miles for the promise of your soft and steady touch.  But I won’t count the distance because the thought of you would carry me there…If I said that I was wrong, If I wrote you this song, would it bring you back to me…”)

I arrived to DFW around noon on September 16^th.  After eating a delicious Eatzi’s salad that Ryan picked up for me, I made my way to the ticket counter to check in, weigh my bags (49 lbs and 52 lbs that they let slide by), and then make my way through security. 

After traveling 8 hours by plane, I reached Amsterdam.  I took a picture of tulips in the airport, because you always hear about the tulips.

[tulip picture]

Then I got on a second plane and flew 12 hours to Johannesburg.  I was terrified of what Johannesburg would be like, I heard scary things about the Johannesburg airport.  But don’t believe the scary things.  It was actually just fine.  I picked up my two bags from the baggage claim, made my way through passport control and got 2 new stamps, then headed towards customs.  I was afraid that they might stop me with my 2 huge bags full of medical supplies and donations, but customs was closed. 

I guess no one brings shady stuff into South Africa after 10:30 pm. 

I walked out to the main airport and some nice man named Peter had my name on a laminated piece of paper.  Sweet.  Because lugging my 2 bags around along with carrying my backpack through the airport was getting heavy.  My friend Frances had told him to pick me up.  How sweet.  He parked in the first parking garage and carried my bags to his car, a Mercedes Benz.  Then I tried to get in on the passenger side and he laughed at me. 

Turns out they drive on the passenger side.   

Good to know.

We traveled to the hotel, a fancy place in a residential area of Johannesburg about 45 minutes away.  Cab fare was expensive (450 Rand, which is about 60 dollars) but the hotel was beautiful.  I took a hot shower and then slept in a soft, fluffy bed.  It felt so good to sleep after traveling for so long.

We ate breakfast at the hotel.  I had rice krispies topped with a banana and then I ate a papaya slice.  Delicious.  Coffee was a disappointing blend of instant grounds.  Then we hopped back in the Mercedes and drove to the airport.  Finding our check-in counter was a mess, but we got our tickets, made our way through security, got a third stamp at passport control, and found our terminal.  We got on a bus that took us out to our plane.  The plane was much bigger than I expected.  It had at least 20 rows of people 5 across.  I expected a 20-seater plane.  The plane ride was short, about two hours.

Then it took us another hour to get through passport control.

After passport control, we picked up our luggage in the same room, walked through customs in the same room, and met Lorna Sarra and her driver, Henry.   The lady at customs didn’t even look through our bags.  She asked Frances what was in her bag, and Frances just said clothes and shoes, which was true, so she let her through.   I just said “I’m traveling with her” and she let me go through.  Easy enough.  Because I had no idea what they would have done when they saw all the donated medical supplies in my bag…Thankfully, God had all the details under control.

We stopped in town for a drink of water.  Most shops were closed because it’s Sunday.  It’s like Chick-ful-a, everything is closed on Sunday.  Then we arrived at our guest house.

Complete with separate bedrooms, bathrooms, a living room, dining room, kitchen with a fridge and a microwave and a stove.

And wireless internet.

And flowers out front.

And a real, live lizard on the couch.

[lizard picture]

I know he doesn’t look that mean and scary, but if you were about to sit on him because you thought he was part of the design of the couch, he’d give you a heart attack.

It’s a whole house, just for us.

[house picture]

This is my room.  It’s huge.  Bigger than our hotel room last night.

[room picture]

I’m not actually sure we’re in Africa though.  It might be just a rural part of America that has Banana trees in the back yard.

[hut top]

Oh, no, wait, there’s a hut, we drove over about 30 speed bumps to get here, there are annoying roosters, and we have to boil our water.  It’s got to be Africa.

We unpacked a bit and then sat down to relax.  I’m getting sleepy though, which is funny because it’s 9:45 am in America.  But jet lag is kicking me.

We’ll have dinner at 6 and find out our schedule at dinner.  I’ll update you all when I know more of the details about what my month will look like.

And I think my toe is definitely broken.  Its all purple and blue and it still hurts.  Meaning I traveled with a billion pounds of luggage and walked through 4 different airports with multiple terminals (except the last airport, Ndola, which was only 1 building) with a broken toe.  Ouch.  I wish I could take a picture of it for you, but it doesn’t look the same.

For more funny stories, you can follow my friend, Frances: Francesinafrica.wordpress.com

Defying the laws of physics :)

The chaotic mess below was me "mostly packed" yesterday.  The pink bag was full of toothbrushes, toothpaste, crayons, candy, paper, and fun stuff for the kids at the orphanage.

The Blue bag covered in clothes had all of my clothes (scrubs, a few skirts and shirts) and snacks (granola bars, fruit snacks, beef jerky) for the trip.

I thought I was packed.

THEN I met up with someone from school who gave me 3 boxes of donated supplies to take with me to the  hospital in Zambia.

Awesome...

...Until I had to make room in my bags for the contents of the boxes...

...which is when it was time to defy the laws of physics and make room for supplies.

Two of the boxes were bigger than my suitcases.  I had to make room for all of the new stuff PLUS the already donated soap, toothbrushes, toothpaste, and crayons.

I might loose sleep if I had to leave some crayons at home.

Because you can't deny a precious little orphan child crayons.

So I packed.  And I stragegized.  And I danced around my room a little bit to some music.  Because that's what I do when I'm stressed.

And the end result was this:

Empty boxes...that's good! 

I really like that I was able to be color coordinated with all the IV catheters!

And I'm thankful that there was foam, because I was getting close to my 50 lb weight limit.  I made room for all the donated supplies!

Now I just need to find room for my clothes... :)

Deep Breath.

It's time.

I'm SO ready to go back, but at the same time, I'm not ready at all.  I've been "getting ready" for about a year.  I've taken an international medicine class, registered with the state department, paid for airfare, found a dog sitter, and started packing.

But I just realized this morning how much I will miss while I'm gone.  I love the fall.  I love my Church in America.  I love Pumpkin Spiced Lattes, bubble baths, and air conditioning.  Am I ready to leave all that behind for 2 months??

I have to be.

And I'm sure it will be worth it!

I'm so excited for this opportunity, it's crazy.  I'm ready to learn how medicine works on the other side of the world.  

I'm ready to hold precious children in my arms and smile at them.

And give them hershey's kisses.

Yeah, I'm ready.  Will you pray with me for a safe journey?

In a world without deadlines:

There are no blog posts.

If there is nothing I am dreading, writing (or studying) for school, I don’t have motivation to avoid it.  And so I don’t make blog posts.

I’ve been busy away from the blog though.  Since last post, I’ve gotten engaged and planned a BIG trip to Zambia and Tanzania.  Wow.  Exciting crazy things that would have been fun to blog about.  And fun to read about.  But there’s no blog post because there were no deadlines for me to avoid.

However, on my trip, I have to keep a blog as a requirement for the people sending me, so there will not only be plenty to read, but plenty to write. YAY!

Look forward to it!

(I have a half way finished blog post about my last rotation: psych.  I’ll back blog it and blog a bit about Family Medicine, which I’ve loved, before I leave the country!)

I got malaria pills and sleeping pills and 2 kinds of anti-diarrhea pills and a neat thing called typhoid fever pills that you refrigerate and then eat 1 hour before your meal that protect you from typhoid fever.  The only unfortunate thing about today was the amount of money I spent on medicine (130!) even with insurance.

Can you guess what motivated me to write?? How many things are due tomorrow??

AA Meeting

Humid air, spun around by a rickety old fan that provides the only hint of refuge because there is no air conditioning unit. The atmosphere creates an illusion of stepping back in time to a building that has seen better years. Ceiling tiles sag, paint is peeling, the AA posters on the wall are faded; clearly this place has seen better days.

The people seam friendly enough, but just like the room, they appear well worn, tired, the look in their eyes saying they've seen better days too.

I walk in timidly. Do I belong here? Is it too late to turn around and pretend like I just realized I'm at the wrong place?

Then, just like they show in the movies, the guy in charge said, "hello, my name is _____, and I'm an alcoholic." What do I say? I introduced myself as a student observer, and they cheerfully said, "Hi Shannon," just like they greeted everyone else.

Introductions were followed by a moment of silence, serenity prayer, 12 steps, and 12 traditions.

After introductions, they introduced the discussion topic from the big book. A list of blessings. And people started sharing their stories about things they count as blessings, and the way their outlook has changed as far as blessings are concerned.

Many of them remarked at how they have so many blessings they can't even begin to list them. They would sometimes tell a story, sharing how much they have lost, but they still have their life, and they have so much to be thankful for. It was humbling to see people share about how much they've lost. It never occurred to me that by the time people finally turn to AA, they've lost ties with family, they've lost their house, jobs, the will to live, everything.

And suddenly, the patients I've had at parkland now have faces, have stories, They're more than "that drunk/high guy that's been in the psych ER 14 times in the past 3 years." They became real people with real problems. People who actually needed the social workers to find them a place to stay. People who really were planning to kill themselves. Crying for attention because they had nothing left to do. Literally, no one else to turn to.

Making me think? What are the blessings in MY life? I really do have more than I can count.

People continued sharing stories about how messed up their life was, how close they came to death, and how AA saved them. Taught them how to find the strength to stay sober, and gave them people they could turn to.

As we closed by holding hands and saying the Lord's prayer, my mind was open to an incredible resource I can use for patients of mine struggling with alcohol and drug addictions. I think it is a great place to send people who feel ready to conquer their problems, but are unable to.

I have seen the social workers in the Psych ER send people to halfway houses, boarding houses, the salvation army, as well as numerous inpatient facilities. Below are some of the websites for resources.

http://www.aa.org has information for healthcare professionals (including pamphlets and a section on "how to refer a problem drinker) at http://aa.org/lang/en/catalog.cfm?origpage=223&product=11

http://www.na.org/ has information for specifically narcotic programs. (although several people at the AA meeting identified themselves as alcoholics and drug addicts)

Many churches, including my church have programs for all kinds of recovery. Our church's website is http://www.celebraterecoverynorthwest.com/

Infectious Reflections

My very first patient had malaria.  It turns out, he went on a mission trip to Africa, forgot to take his malaria prophylaxis, and subsequently got malaria.  It was so interesting to see what his disease course looked like in contrast to the children I have seen in orphanages in Africa with the same disease.   What a great way to start the rotation!

I was excited to learn about HIV/AIDS.  I told the fellow this, and he gave me a patient about half way through our first week that I followed pretty much the whole rotation.  I got to learn more about what his specific HAART drugs were, and watch what we ended up switching the drugs to and why.  I also got to research more about what we diagnosed him with, and how the treatment differs for someone with AIDS.  We were very involved in his care. Watching him ender respiratory failure, get moved to the ICU, lose all ability to communicate with the outside world, and then recover helped me see a little more about the deep struggles and immense hope you have to think about when you deal with an illness like AIDS.  I also learned a lot more about tailoring drugs for renal failure and drug side effects.

I learned more about antibiotics (the best drugs for specific diseases) and how to look up new guidelines in the Sanford guide.  I used that book a lot!  I also got to listen to an ID conference on the growing amount of antibiotic resistance, which was fascinating!  I think in the future we’ll have to worry about that a lot more than people do now, so it was great to see that there is research about what works, what doesn’t, and what we can try next.

I was surprised at how good I got at thinking like someone in ID.  I got great at creating a plan and making recommendations to the teams, especially about things we talked about a lot: narrowing drug spectrums and picking a reasonable treatment length.

I liked being on a consult service and being the person primary teams came to with questions.  We were much more involved in care than I thought we would be!

I honestly wish we had gotten to see more diverse cases and gotten more teaching from our attending doctors.  The service was set up so that we had a new attending all the time, and I feel like that made each attending feel less responsible for teaching us.  It took me a long time to get comfortable with antibiotics and antiretrovirals, most of my learning was on my own which I don’t think is as effective as learning by caring for a patient.  I think the rotation was good because everyone will be exposed to infectious diseases no matter what practice they are in, but I wish it was set up differently.  It would have been neat to spend time at the Dallas County Health Department to see TB treatment or STD treatment, or to be at Amelia Court to see more AIDS treatment and care. 

Overall, I learned a lot, but I don’t think  I’ll want a job working on an ID consult team at a hospital!