Thanksgiving

Happy Thanksgiving Everyone!

I cannot begin to explain how much I am missing home right now. I had the hardest time falling asleep last night because I kept thinking about everything I would be missing today: waking up early to cook with my dad, lounging at home watching tv and baking with my mom, dinner with family, etc, etc. I'm extremely blessed and thankful to be in Belize and I am looking forward to Thanksgiving dinner tonight with everyone here, but I still wish I were home.

This morning Adam wished me a Happy Thanksgiving and it took all my willpower not to cry. It's hard enough that it's the last week here and I'm ready to come home, but adding the holiday to that just makes me infinitely more emotional (and of course you all know how emotional I am anyway).

I want to thank all of my family and friends for supporting me on this trip and throughout life. I'm grateful for the abundance of opportunities life has presented to me. I'm thankful to be coming home in 2 days.

I may not post again before I return to the states, but I'll be thinking of all of you on the way back. See you soon!

Tom Owen's Island

Well we're back from an amazing weekend. Left Friday afternoon and headed out to Tom Owen's Island in Sapodilla Cayes. Just relaxed and had a delicious dinner of stew chicken, mash potatoes and rice and beans. Later we set up a bonfire and made smores. Saturday morning we got up and went snorkeling around the island. Then took the boat out to do some tubing and finally ended the day by doing some fishing and island hopping. That's when I got the picture of the starfish. For dinner Saturday night we has lobster, conch, and grouper that we caught and barbecued. It was so good. Another bonfire and more smores ensued. This morning we just relaxed on the island before heading home.

The island is tiny and we were the only people on it. You can see every side of it from the middle. There's a main house with 3 bedrooms and 3 cabanas out on the island with beds in them. It was a fun time but I'm glad to be back to running water and flush toilets. Not to mention I'm getting ready to head home. It'll be a decently short week: mobile clinics Monday and Tuesday, Clinic here on Wednesday, half-day in Barranco on Thursday (ending with Thanksgiving dinner), and a half day on Friday.

See you all in a week or two!

Settlement Day

On November 19, Belize will celebrate the anniversary of the arrival of 500 Garifunas to the country in 1823. A national holiday, Garifuna Settlement Day, is celebrated with food, song and dance throughout Belize, but mainly in the southern areas. From their infectious music and dancing to their colorful clothing, Garifunas have no doubt left their blueprint on the Caribbean and Central America.

HISTORY

While Garifuna Settlement Day remembers the exodus of the Garifunas to Belize in 1823, their history dates back to nearly 200 hundred years before, to the year 1635. This was the year when two Spanish ships carrying African slaves for transport to their buyers were shipwrecked off the coast of Saint Vincent. Soon the Yellow Caribs were created, a mixture of African, Venezuelan Caribs and the indigenous island group called Arawaks. By 1750, a new race called the Garifuna was born - a combination of African, Arawaks and the Yellow Caribs - and which remains to this day. The Garifunas are sometimes called Black Caribs and Garinagu as well.

In 1797, after decades of fighting the British invading forces, many Garifunas were deported to the Bay Islands of Honduras while some remained. Some of the deported Garifunas, unhappy with their small area to live, pleaded with the Spanish authorities to allow them to live on the mainland. Soon they were employed as soldiers and spread throughout the region. Today, approximately 98,000 Garifunas live in Honduras, and in coastal regions of Nicaragua, Belize and Guatemala.

CULTURE

The Garifunas' strong African and Carib roots allow their culture to thrive, with very little change throughout the centuries. Garifunas, depending on their region, speak English, Spanish or Igneri, a Garifuna dialect with Arahuaco, Swahili, French and Bantu roots, or all three.

Music and dance are a huge part of their culture. Punta, a Garifunan secular class of music and dance, recreates the cock and hen mating dance. Its movements are composed of the intense shuffling of the feet and the quick motion of the hips and buttocks, while the upper torso remains still. The music is generally accompanied by two drums, rattles and conch shell trumpets.

Dew Point

I'm sitting out on the front porch this morning in my scrubs, eating my oatmeal and drinking my coffee (yay starbucks!) and waiting for my laundry to be ready to put out on the line. The sight this morning is one I haven't seen before down here in Belize: there's dew all over the cars. We've had some mornings where the grass has been a little wet, but that's mostly attributable to the rain. This morning there is definitely dew everywhere. It's so weird. I cannot believe how incredibly lucky we have been with the weather. It hasn't been unbareably hot, in fact most nights are pretty cool. I slept with a blanket on all night last night. I know it's no comparison to how the weather is fairing in Wisconsin, but personally I think the weather so far has been absolutely perfect.

Yesterday after clinic (really, really slow day in Laguna), Hailey, Liz, Christy and I rode into PG to head to the Western Union (THANKS MOM AND DAD!) and to check out the "Chocolate Center of the Universe" We got a free tour covering how they make the chocolate and some free samples. They make these chocolates that are shaped like barrels and bottles and they contain rum and coconut rum respectively. They are delicious. I'm trying to figure out a way to get them back to the US without them melting and making a huge mess - any suggestions?

Today is clinic in the morning and then lecture. This afternoon I get to help old people exercise - hahaha. It should be fun though.

Back to breakfast and laundry: Tchao!

Guatemala

The whole group went over to Guatemala today. We spent the morning laying out on Playa Blanco enjoying the sun and the sand. Roberto BBQ'd some chicken and grilled some hotdogs for us. We played a little beach volleyball too. It was awesome. I could have stayed there all day. Afterwards we headed to the Seven Altars which is a series of waterfalls. Unfortunately rain has been scarce so the waterfalls we more like trickles, but we had fun anyway. I went up to jump off the falls into the pool below and ended up being pulled down by Adam (jump raped). After the falls we rode over to Livingston to do some shopping and just see a little of Guatemala. Got back tonight after 8 hours out with Roberto and we're all completely beat. I'm almost ready for bed right now and it's only twenty to seven.

I'm starting to get some color which is nice. Not enough to avoid the "Hey white girls" comments though. Monday starts week 3 in Belize. We have a holiday on Thursday and I personally plan on doing absolutely nothing all day. Aside from the Adam, Becky and I get to go hang out with old people on Wednesday and help them exercise and take their blood pressures; should be interesting... Next weekend is the big trip to Sapodilla Cayes. Can't wait! If this weekend is any indication the caliber of the next trip we're going to have a blast.

Anyhoo, Adam is whipping up some delicious smelling chicken parmesan again. Time to eat!

It's the Freakin' Weekend Baby

So despite all the previous talk we stayed in town this weekend. Yesterday Hailey, Mirek, Liz, I, and 2 of the nurses went out with Roberto on his boat the "Wild Thing" to go snorkeling at Snake Cayes, search for dolphins and manatees in the mangroves, and go tubing. It was so much fun. I saw hundreds of fish and am really excited to dive now. Parrot fish, barracuda, etc. I even held 2 starfish and saw dozens more. It was incredible. Unfortunately I neglected to reapply sunscreen so I am paying for the whole adventure dearly, but I still had a blast. After snorkeling we went to an island to eat lunch (bologna sandwiches, apple, plantain chips, and a fig newton-like bar made with pineapple). The snake cayes are known for the red-tailed boa so Roberto found us some to see and HOLD. Liz has pictures of all of us so I have to make sure I get those from here to share. We searched for manatees and dolphins for a long time but came up with nothing so we headed back towards town to go tubing. When I say tubing I mean just like at home only this was on the ocean, with twin outboard motors, and a tube the size of a love-seat. I wiped out pretty good after staying on through 5-6 ridiculous turns.

Last night we had comfort food again for dinner (vegetable soup and grilled cheese) then packed 10 of us in the van once again to head into PG. THe whole country is celebrating Garifuna settlement this coming week (actually holiday on thursday) so there was a battle of the drums last night. So cool. I have some pictures and a video that I'll post when I get home.

Today it's off to Guatemala for cliff jumping, waterfalls, and shopping. Then back to clinic on Monday.

Tchao!

Scorpion

Bet you can't guess the first thing I saw when I set up the pharmacy at the mobile clinic this morning... a scorpion. He even had a friend with him on the floor. Thankfully after a few photo-ops, Adam and Mirek took it upon themselves to kill them and Maria was kind enough to throw them out. Clinic went well after that - extremely busy though. We saw 63 patients in about 4 hours with 1 pharmacist (me). It was insane. I'm going to miss the autonomy I have here. I can change scripts if we don't have a drug or the amount seems incorrect; every prescriber listens intently to my recommendations. Coming back to the U.S. is going to be rough.

After clinic we went to dinner at Gomier's. This guy moved to Belize from St. Lucia in 1996 and opened his restaurant in 1997. He's big into health food: vegetarian, makes his own tofu and soy milk. Amazing story teller too. He told us tons about his life and his adventures, he likes and dislikes, his theories and thoughts about life and about health. He's an amazing man and an even more amazing cook. I had the vegetarian lasagna which was spectacular, the curried fish was delicious as well. Also tried his chocolate ice cream. And the whole meal cost me a whopping US$10. And afterward he picked fresh lemon grass for us to take home and make tea. He also showed us his dreadlocks that he has been growing since 1980. The end of his hair is older than I am. It's taller than he is and we could pass it around the table. The ends are dark brown while the top is stark white. We're heading back there next Tuesday for cooking lessons.

The plans for this weekend now include snorkeling, drumming and Guatemala. Next weekend we'll attempt the dives the following weekend at Sapodilla Cayes.

Wednesday

Well we’re halfway through another week in Belize. It’s hard to believe I’ve been here this long already. Monday was a mobile clinic to Blue Creek – we had a pretty late start as usual but things got up and running smoothly enough. Hailey and I were masters in the pharmacy yet again. And no worries about the creek flooding this time :-D Monday night we relaxed and Adam made Mac ‘n’ Cheese with BBQ chicken for dinner which was really good comfort food after a long day. We also watched the Hangover after dinner (pirated movies rock).

Tuesday was mobile day in Big Falls, but Christy and I were in charge of teaching kids about hand-washing and general health all day. We started with little kids: kindergarten and first grade in the morning then worked with older kids in the afternoon (up to 6^th grade or so – they use the British system here so I have no clue how old some of these kids are). We had an amazing Belizean lunch at a buffet called Coleman’s in Big Falls – curry chicken, kahune cabbage, beans and rice, fried plantains, and bread pudding. We did have some excitement on Tuesday in clinic. A volunteer from the Mennonite church stopped by with a pre patellar abscess that we incised and drained and then gave him some ceftriaxone. Then in the morning before lunch we had a little boy who needed to be transported to PG via “ambulance” because he was having trouble breathing. It was a big snafu though… no equipment, no meds, the doc was rushing people inappropriately. Tuesday night we needed to get away so we went to Marian’s for dinner. The ride in we fit 9 people in a mini-van that traveled about 5 miles an hour the whole way there – but for US$4 roundtrip we couldn’t go wrong. Marian cooks delicious food – fish, veggies, and help yourself to Belikens. The restaurant is also right on the ocean with tables on the balcony overlooking the water.

Today we had clinic here. Nothing too exciting to tell you the truth. Ran into town to try and order meds but didn’t have all the right information. Yummy lunch and dinner yet again – care of Miss Janice and Adam respectively. Now we’re watching I Love You Man. Tomorrow night we’re going to Gomier’s for dinner which should be amazing and I think we’re planning to do a cooking class with him next week.

Internet might be up tomorrow – could be awesome!

Sunday

I’m sitting on the porch writing this post, listening to the sounds of the night. Crickets are chirping, frogs are ribbiting, and Maurice the security guard is listening to the radio. Inside everyone is laughing and talking. We had an amazing day. Got up around 8:30 and had a leisurely breakfast. Around 10:30 or so everyone was ready so we biked into PG. The ride seems much shorted the second time around. Once in PG 4 people went kayaking and Kristin, Christy and I rode downtown. We were ridiculously hot at this point so we stopped at Brad’s convenience store to get a cool drink and biked down to the Coral House. There we ran into Emily who is a JVI and works as a counselor at the high school. Christy has connections to the JVI’s here in PG so we’re trying to meet up with them for dinner at some point. The Coral House is gorgeous. The pool was refreshing and shockingly deep. The Inn is right on the water so you can look out onto the ocean. The bar is fully stocked and the honor system works quite well. We spent the entire day there lounging in the sun, swimming in the pool, and drinking Belikens for a whopping BZ$14 (BZ$10 for the day and BZ$4 for the beer). We biked back to the clinic around 4pm – the ride back still seems really long and hard. Took a relaxing break to read/watch Pirates while dinner finished up – enchilada soup! Mirek and Kristin also made a no-bake cheesecake which was a delicious dessert. I’m well on my way to being nicely bronzed after just one day in the sun – can’t wait for the rest of the weekends!

Oh, and internet is shitty again – We think all of PG might be without right now because we couldn’t get it at the Coral House either. Hopefully it’s up sometime soon so I can post my last 2.

Saturday

Got up this morning after a glorious night sleeping – I actually had to use a blanket. Unfortunately the sun is super bright here in the morning so I didn’t really get to sleep in much (I know, I know, I never do anyway…). We all went into town and had breakfast at Grace’s. They have these fried dough things called Fry Jacks that are amazing! They’re kinda like elephant ears and you dip them in either jelly or beans. We didn’t try the bean combo, but I can see how it would be good. After breakfast we drove to Lubaantun: Place of Fallen Rocks which is a nearby site of Mayan Ruins. I rode in the back of the pickup with Hailey, Meredith, and Liz. Actually we were all in the back of the truck for every trip today. At the ruins we had a guide show us around and tell us all about the site. It was really quite amazing to hear all about the history and the excavation because our guide actually worked on the digs. After the ruins we drove to Blue Creek which is the place where the bridge flooded this week. We took a small hike to a dock and hung out there to have lunch. A bunch of us jumped off the dock into the water which was amazingly refreshing. It was nice and cool and clean. The current was ridiculously strong though. We tried to swim up to the waterfalls but couldn’t make it. It got to the point where we were swimming and not getting anywhere. This evening we had delicious taco salad for dinner – care of Adam yet again. We’re getting ready to head over to the bar in a few and relax for the night. Internet is shotty yet again so I’m sure this post will be late.

P.s. I really, really, really like reading email so you should send me one!!!

Internet is Not so Hot

Good Morning - just wanted to update on the whole internet situation. we haven't had a connection for 5 days now and I don't see it getting fixed anytime soon. So posts will continue to be sporadic. There are a few internet cafes in town so hopefully I get on at one of those. I'm teaching hygiene and health at a school in Big Falls today with Christy and we had some downtime so they let us use the internet. My inbox was completely flooded, however not with fun emails from friends - soooooo:

SEND ME EMAILS PLEASE!!!

End of Week 1

It’s the end of week one. I was up in the pharmacy for clinic this morning. Lots of chronic medications – metformin, glyburide (glibenclamide), simvastatin, amlodipine. The toughest part today was trying to figure out how to provide meds for everyone that needed them when we hardly had enough of anything. It was pretty busy upstairs too. We’re supposed to have one of the PA students up with us, but they keep calling them back down. It’s kind of annoying actually. I really like that everyone is willing to learn from pharmacy and to teach us the clinical/diagnosis aspect of everything they see. But it would be nice to be able to give them more information about pharmacy up in the pharmacy. Hopefully next week is better…

After clinic and finishing up pharmacy work (evals, home meds, etc) we road into town to go to dinner at Grace’s and watch a cultural talent show put on by the highschool teachers. John and Mary Pat and 3 of the nurses joined us for dinner (p.s. major drama within the nursing group). The show was good, very funny, but really long. We were having tons of fun living vicariously through 15 year olds. The show was really sexual though…

Tomorrow we’re doing breakfast at grace’s then heading to Blue Creek/Lubaantun/RioBlanco. Sunday is hopefully still dive day, keep your fingers crossed that Ida is passed by then.

Internet is back in action so I may be able to update more often!

Did I mention that Andy fell last night and hurt his neck, practically broke it actually. He’s been in a soft collar all day, poor guy. Still managed to cook us lunch though.

Things I miss...

- Being Dry: it’s ridiculously humid and rainy here all the time. my clothes are never dry, my hair is never dry and I never feel dry.

- Feeling Clean: it can be a grand total of 20 seconds after my shower and my hair feels greasy and dirty. I don’t know if it’s the water or my shampoo or just the environment down here, but it’s crazy. Plus I feel greasy and oily after just 5 minutes out the shower (plus I’m still wet).

- Milk: so we’ve been drinking “shelf milk” lately because it last longer. the stuff in the jugs claims it is pasteurized but it goes bad in a few days. the shelf milk comes in a box, doesn’t need to be refrigerated and is written in Arabic… I miss my skim milk.

- Internet/Cell Phone: I know this is an experience; an immersion, but I miss being connected to the universe. I miss being able to be online whenever I want to be. I miss talking to people. Even just picking up a phone to call the clinic about a prescription instead of walking to find the person would be wonderful. I’m adding a set of walkie-talkies to the list of donations the clinic should receive, so if you have a set and are willing to part with it, let me know.

- Bug-Free Environments: there are ants in the kitchen, in my room, on my bed, on my computer. there was a spider in the kitchen, in our room, in the bathroom. I know bugs are “important” in the whole scheme of things, but I miss knowing that I wasn’t going to wake up in the morning with 5 new bug bites of unknown origin.

Being Barefoot: carpets are amazing. cherish them while you have them. I am so sick of constantly wearing my flip-flops everywhere. I want to walk around barefoot but there’s so much dirt and so many bugs it just isn’t practical.

Friends and Famly: you knew you guys would be on the list somewhere.


Things I Don’t Miss from Home:

- Insurance Companies: all prescriptions are free at the clinic = no insurance ever. I can’t even begin to tell you how much better this system is.

- Angry Patients: the people down here are so nice and so appreciative of the care we’re providing. I haven’t had a single patient yell at me, swear at me, threaten me. It’s a true Godsend.

- Internet/Cell Phone: I know I griped about this already, but I do think it’s a good thing to be disconnected a bit too. it’s hard to deal with, but I’m learning. I’ve wanted to rely on my cell phone less lately so this is a really good excuse for that.

Wednesday and Thursday

Wednesday was our first day of clinic at Hillside. I was downstairs in the clinic in the morning and upstairs in the pharmacy in the afternoon. Clinic was good – did quite a bit of recommending as well as working out the kinks in workflow. The afternoon was really slow but it was nice to actually consult patients.

We ran to the market in the morning before clinic and got the makings for salsa, a couple red snapper (fresh – filleted), and potatoes as well as the beginnings of guacamole. Adam (medical resident from St. Louis) is an amazing cook and has been making meals for us. Wednesday night was Red Snapper marinated in a lime butter and pan seared and covered with fresh cilantro lime salsa with a vegetable medley of zucchini, carrot and onion and mashed potatoes. Thursday night was Chicken Parmesan with rotini and fresh tomato and garlic bread. This guy is amazing!

Wednesday night we also hooked up the projector to watch a movie (Gone in 60 Seconds) – but I was too tired to make it all the way through. I feel like I’m almost always tired here. It doesn’t matter how much sleep I get, I’m still drained at the end of the day. Part of it is probably the humidity (the heat has actually been rather bearable) and part of it is the work we do, but I still feel like I am more tired here than I have been in a long time. (Just killed an ant running across my computer screen).

Thursday most of us went to the mobile clinic in Aguacate (literally miles from the Guatemalan border). We saw 46 patients in 4.5 hours in a building with 3 rooms total. Pharmacy filled roughly 55 prescriptions with 2 people working. We were crazy busy all day. On the way to Aguacate we went over a bridge over Blue Creek. The water was already rushing pretty fast and high on the way into town. On the way back the bridge was completely flooded. So instead of a tiring 1 hours ride back to the clinic on bumpy dirt roads with 12 people, we went on a 2.5 hour detour.

The countryside was beautiful and it was a fun experience – but my legs and butt are so sore from sitting. Not to mention we were all gross and sweaty from the day. Thankfully Adam had dinner in the oven for us when we got back, aaaaand fruity drinks were had. Tonight has been low-key. I needed to shower and put laundry away, plus write for all of you. :-D

Day 4 - Tuesdaay

Well it’s day 4 in Belize and we went to our first mobile clinic today. We went out to San Marcos which is about 30 minutes from the clinic. We left after 8am – which was way late, but that’s kinda the way it is here. Hailey and I were in charge of the pharmacy which was placed on a pile of 2x4’s. We got 2 boxes and 2 bags of drugs from the Ministry of Health which consisted of a lot of amoxicillin, sulfa, some APAP, and hydrocortisone along with a few other random drugs. Hailey and I took turns running the pharmacy and consulting with the PA students. IT was great being able to offer suggestions to the other students not just based on clinical guidelines but also based on what was available. We’ve also been lucky enough that the PA students haven’t really written prescriptions before so we’ve been making them into better Rx writers: allergies and dx included on every script.

About halfway through the day the kids got off school for lunch and then they came back again after school was out. They are all ridiculously adorable and fun to talk to. They’re really interested in our names and what we’re doing. They also like to talk about us in Mayan so we can’t understand them. It’s really cute. They’re also huge hams and love to smile for the camera.

After the clinic we came back and changed and got a ride into town to have dinner at Grace’s. I got the shrimp fajita with a side of white rice and stew beans (which is different from beans and rice). Dinner was delicious. My dinner mate – Renauldo the Lizard – hung out above me for most of the meal. Then we walked around and caught a bus that got us maybe a quarter of the way back and then had to walk the rest of the way. Second night in a row with a decent work out.

Tomorrow I’m downstairs in the clinic in the morning and then upstairs in the pharmacy for the evening clinic. We’re planning to bike into town in the afternoon between clinics to take a dip and pick up some chips for guac when we make it tomorrow.

Time for fruity drinks with the group (p.s. these people are awesome).

Day 3 - Orientation

Woke up early – as per usual – showered and had breakfast. We went to the market at 8am for produce. Packed 10 people into the car – there will be more like 12 people in there tomorrow for our first mobile clinic. We had a little extra time while we were down there so we checked out a few supermarkets too. When we got back to the clinic it was orientation all morning. I still need to manage to write something up for everyone about good old Dr. Dick. But anyhoo. Hailey and I got to check out the pharmacy (air conditioning!!!) and talk with John and Maria about our goals for the rotation. I’m still a little lost as to what exactly goes on day-to-day, but I guess I’ll learn it as we go.

We got a quick glance at the hospital and polyclinic in PG this afternoon. Also got to check out the Coral House Inn – we’ll be there a lot, I guarantee it. They charge BZ$10 to use the pool and wi-fi, and the bar is on your honor. More grocery shopping was also done this afternoon – we spent a whopping US$40 for groceries for 8 people. I can currently smell our coconut curry chicken baking in the oven. I’ll let you know how it turns out.

Liz, Hailey, Becky, me and Merik biked 6 miles into PG tonight to jump off the dock and swim in the ocean. It was like bath water it was so warm. Then we went all the way into PG to pick up some rum for the group and biked back to the clinic. I can definitely say I’ve had my workout for the day. But jumping in the ocean off the dock was a great experience – I’d do it again in an instant, I’d just take the bus into town instead…. :-D

John has managed to set up a dive for the 4 of us who are certified. We’ve got a divemaster lined up to work with Liz and I so I think things will be good and I’m pretty excited about it. The plan is to head out this weekend to the Cayes and dive from there on a day trip. We’ve got to work out the details but I think everything will go well. I’ve really adopted the Belizean idea of “go with the flow”. There’s no reason to get worked up about things down here. It’ll all work out in the end.

Internet is still spotty, by the way. We have 1 computer with access. So I may or may not be able to post this tonight, but I hope I’ll get to soon.

Day 2 a day late

I had the best continental breakfast I have ever had in my life this morning: A huge glass of OJ and a made to order egg sandwich. We had no troubles at all this morning. Made it to the airport with plenty of time to spare. Security went fine (I did have to surrender my safety scissors ☹ ). Once we got let out onto the airstrip Hailey, Merik and I boarded a 6 passenger plane. That’s right six passengers (pictures to come). It was only the 3 of us and the pilot. The entire flight was 50 minutes over the coast of Belize. It was gorgeous. Ran into a little ran along the way (which managed to make it into the plane on Hailey’s side), but nothing too serious. At the airstrip in PG we met Aprill. She’s the student coordinator at Hillside. She was born and raised in PG. She doesn’t look it, but she speaks Creole with the best of them. I’m considering asking for some lessons. The Creole dialect apparently came from the East Indians that settled in this area and lost their language, creating the Creole instead. It’s still difficult for me to understand most of the time, but I can catch bits and pieces. Aprill got us all to Hillside safe and sound and showed us around a little. We were the first ones here so we staked out our rooms and got settled while meeting Dr. Dick and John and Mary Pat. Dr. Dick deserves his own entry, so I’ll write more on him later…

John and Mary Pat took us up to the Bazaar held by the nuns. We had delicious, although mysteriously flavored, ice cream. Saw the church and school and hung with the locals for a while. Once back at the dorm we had PB and Gooseberry Jelly sandwiches so we could take our chloroquine. Hailey and I checked out the student log then ventured out on a walk down the road. Not 15 minutes later: downpour. We walked back to the clinic completely soaked. On the way we did meet a nice women who lives at the end of the road who invited us down to use her pool whenever we want. More students arrived at about 4pm – 4 girls in PA school at Marquette. We seem to get along with them pretty well. Aprill arranged for pizza to be delivered for dinner which was amazing! Then Meredith (med student here with Dr. Dick) told us about the local bar so we decided to head down for a drink. Meredith and Adam (medical resident from Indiana/St. Louis) arrived around 6pm. We befriended an adorable (although not quite as cute as Atty or Sprout) kitten at the bar, along with a couple stray dogs. Hailey and I both drank for a grand total of US$5 tonight – did I mention I love this country?

Tomorrow starts orientation. We get to go to the market in the morning and tour the polyclinic in town in the afternoon. We may also check out a mass at the cemetery in the afternoon too. We’ve already got a ton of plans for things to do throughout the week and I can’t wait to try all the places in and around PG. We’re planning on heading out to an island for the second weekend we’re here with Aprill’s husband. We’ll get the entire place to ourselves and the snorkeling is rumored to be amazing. I’ve also found 2 other divers in the group. Merik is Advanced Open Water certified and Liz just finished her Open Water certification a week ago – so with any luck John can get us a good deal on a couple of 2 tank dives.

Well, it’s 10pm and we’ve got a fairly early morning – especially with 16 people getting up in the morning. Expect more soon!

Did I mention no internet? That’s why this was late, sorry!

Arduous Journey

I kinda guessed this journey might be off to an interesting adventure when our first flight was canceled before we even got to Minnesota. Thankfully American was nice and got us rescheduled on a 0705 flight. So, at 0400 this morning we woke up and had an amazing fresh coffee cake compliments of Jason (Hailey's stepdad). At the airport we were lucky enough to run in Kris Jetzer who got us amazing seats on our first flight. After a nice 1 hour and 49 minute nap - we landed in Dallas and spent the next 3 hours walking around. On the bright side - the bar at Bennigan's was showing the Badger game, so we got to see the game up until half time. The flight from Dallas to Belize City was delayed about 15 minutes because it was being inspected by "security". Once in the air we were excited again to be leaving the country. Touching down in Belize it was a blamy 78 degrees farenheit (I need to work on my ability to convert from celsius...). Once through the ridiculous clulster that was immigration and customs we stood in line for at least 45 minutes waiting at the Tropic Air counter to get our flight to Punta Gorda. There was this one guy working the counter who was extremely nice and helpful. He took our bags, helped us get our flight - really took care of us. After all this waiting, it started down-pouring and our plane decided not to come to the airport... So with some help from the extremely nice staff we ran into another student headed to the clinic too (I'm actually sitting in the hotel talking with him and Hailey). We got a ride to the Global Village Hotel in Belize City where the staff was also extremely helpful and got us into the hotel safely. With the free internet up and running, Hailey and I headed out in search of dinner. Attempting not to get run over (Belize has no sidewalks) and avoiding the hooligans at the local bar, we ducked into a chinese restaurant about a block from the hotel. There was ordered our food and had our first Belikens (Belizean beer). Also got to see our first lizard on the wall there. Walked back to the hotel again trying not to get run over and ran into some people we had met at the Belize International Airport. First thing she said, "Where'd you get the beer?". The entire hotel lobby is full of people we met at the airport who also had their flights canceled. So we ate dinner with them. Now we've been chilling in the hotel talking with the other student. We've got a flight to Punta Gorda in the morning - 1030 and will hopefully not have any further troubles. It's been a very interesting trip so far and we're only on the first day. I can't wait for the rest.

Finally

Well I did it. I got everything packed (Qualifier: my backpack is not packed but it is meant to be the last thing to be packed). I'm actually fairly proud of myself. I've only got 3 bags total: 1 checked bag at 54 linear inches and 40lbs, 1 carry-on at 34 linear inches and 25lbs, and 1 personal item (i.e. backpack). I don't think I have ever packed this light before. And as far as I can tell I haven't forgotten anything. Although I guess I'll know that for certain once I get down there.

I can hardly believe that by this time on Saturday I will be in Central America. Hailey and I are leaving WI tomorrow, then saying "goodbye" to the US on Saturday. We've got a 0845 flight on American from MSP to DFW, then a 1305 flight on American from DFW to BZE!!! I feel like I've been waiting forever for this trip to get here. These tickets were purchased back in August, and that was after months of following ticket prices on Kayak.

This may be my last post while in the US for awhile. I'll make sure to update as often as possible - hopefully there will be a first night/morning post when we arrive.

Wish us safe travels!

Packing

I'm currently living on a couch in the living room of "my" apt. It's tough not having your own space and trying to pack up things for the month you're not going to be in the country while at the same time deciding what you're bringing to Belize and how you're going to find everything you need in the mean time. I feel like I'm in this strange limbo. This isn't really my apt, it's not even my couch, and yet it's my bedroom. I've commandeered a space behind the couch too that currently holds the disaster that is my attempt at packing. I'm such an organized person that I can't even look at the mess behind the couch without shuddering. I have no clue where to start, and with T-minus three days to departure I need to get to work on packing: NOW. I've resolved to keep it simple - not take more than I need - not over pack. I'm limiting my luggage to 2 medium bags and 1 carry-on. I think I can manage... right? Most of you know me and my packing abilities (or lack thereof) - any comments? :-D

Reflection

I think the thing I am most apprehensive about is just being “on my own” in a foreign country. I’ve never traveled abroad before; I’ve barely traveled within the U.S. without my parents, and never without a large group of friends. I know I’ll have Hailey and John and Mary Pat which is helping to calm my fears quite a bit. But there’s still a part of me that is nervous to be in another country so far away from the familiar. I suppose it could be excitement as well. This is one of the greatest opportunities that have ever been presented to me. Not only am I going to a beautiful country with amazing people; I also get to experience a completely different style of health care and learn and grow from those experiences. Hopefully I can bring the knowledge I gain at Hillside Clinic back to Wisconsin and share it with others to help us to realize the awesome advantages we have here and to acknowledge ways in which our practice could is different from other practices (both for the better and for the worse). I guess I’d have to say that that is really what my overall goal is for this rotation. I want to experience a different perspective on medicine and patient care and then find the best ways to apply that experience once I get home. Because what good is it to travel to an exotic location if you can’t learn something to share once you get back.

On the topic of goals I’m very interested in prescribing patterns in Belize (and any foreign country for that matter), especially in the context of differing disease burdens. I remember learning that many of the commonly seen disease states in the U.S. are beginning to be more prevalent in other countries (diabetes, hypertension, hyperlipidemia), but I know there will be a diverse new set of illnesses in Belize that I may or may not have encountered before. I feel like our schooling, while adequate for practice in the U.S., lacks a thorough base of tropical diseases and health in foreign countries in general. I’m not sure if I’m entirely prepared to work with “novel” illnesses, but I know I’m ready for the challenge they’re sure to present. This is another place where I feel extremely lucky to have John and Mary Pat as my preceptors. Their extensive work in Mexico and Belize is sure to come in handy and help Hailey and I to learn more and see more than we might have with other preceptors.

Speaking of John and Mary Pat I again feel fortunate that they are coming along to Belize. I’ve had the chance to meet John (and give him his influenza vaccine) and even in the short time he was back at the pharmacy I’ve learned a ton. To top off his amazing wealth of knowledge, he’s spectacularly funny and easy to talk to and get along with. And while I haven’t yet met Mary Pat I’m sure she’ll add another fascinating layer to the dynamic of the trip.

Of course, while my main goal focuses on health care and pharmacy, I also hope to learn more about the culture and the people of Belize. I’ve already heard interesting stories of weekend trips, adventures with translators, and multitudes of new friends. And it isn’t only the people of Belize who can provide me with another dimension to my education. My fellow colleagues at the clinic may also be from other countries. Not only will the health care in Belize itself be different, but the way in which each of them practices will most likely vary from both my own idea of health care and that of the people of Belize. The many dimensions to this trip will make for a gratifying experience if approached with the right frame of mind. I’m planning to head into the venture with a completely open-mind, practically a blank slate (tabula rasa), to ensure that I have the greatest ability to gather and apply new information. At the same time I hope that those around me will find some of my knowledge and practices useful as well, and will take them back to their homes to share.

Ultimately I believe that this experience is about sharing all forms of knowledge. It is an amazing opportunity that I hope will present itself many more times in my life as I continue to shape my career and my practice.

Heart Walk 2009

Rho Chi, the academic pharmacy fraternity, is putting together a team to walk in the Heart Walk at Warner Park on October 10th. I won't be able to participate, but I want to help out as much as I can. So I'd ask that you follow this link and check out the website and walk details. Consider joining and fundraising if you can or possibily make a donation. Send this link on to your friends, family, coworkers and ask them to do the same. I know my life has been personally touched by heart disease and I'm sure many of your lives have been too. Please take the time to look at the website and consider making a donation to fighting heart disease so we can all live healthier lives!

http://heartwalk.kintera.org/faf/donorReg/donorPledge.asp?ievent=300038&lis=1&kntae300038=8588108F236244248772263EF3467F66&supId=0&team=3512431

Influenza Challenge

All right friends:

You all know I'm an immunization "freak". I want all of my friends (most importantly those of you who are health care professionals and/or deal with the young/old on a regular basis) to get an influenza vaccine. I'm not talking about the H1N1 vaccine - that's your own decision based on personal beliefs (although I do recommend it, regardless). I'm talking about the seasonal influenza vaccine that is already available from your doctor/pharmacist/etc. Please get vaccinated to keep yourself and those around you safe from seasonal influenza this season. The injectable vaccine is a completely dead virus: you CANNOT get sick from it so that is no excuse! Let me know when you get your vaccine and I will update the thermometer below. I'm aiming for 100% - help me get there!

Platonic?

When Harry Met Sally - It's the epitome of romantic comedies focusing on the concept of platonic relationships between women and men. I first watched the movie in some high school class (a part of me wants to say it was psych, while another part thinks it must have been an english-related class). I liked it, I bought it, I watch it from time to time. Usually if I'm channel-surfing and happen upon it I'll take 5-10 minutes to watch whichever part is on (especially if it's the scene where Meg Ryan fakes an orgasm in the middle of that diner, I've always wanted to do that). I've never been bothered by the idea of platonic relationships, until recently. Now I think about it all the time.

I don't even think people really know what platonic actually means. We all have a vague idea of the well-used adjective as it related to relationships between men and women that are not physical but purely "friendships". The American Heritage Dictionary defines platonic as:

1. Of, relating to, or characteristic of Plato or his philosophy: Platonic dialogues; Platonic ontology.
2. often platonic Transcending physical desire and tending toward the purely spiritual or ideal: platonic love.
3. often platonic Speculative or theoretical.

I'd never thought to put it in quite that way. I guess I should have considered the whole "Plato Thing" but I'll be honest, it never even crossed my mind. I can't say that I actually consider any of my so-called platonic relationships "spiritual" or "ideal". I guess I see them more as guy-friends. What I mean to say is that while I have friends who are guys there are a select few (and they should know who they are) that I'm exponentially closer to. These are guys that I ask genuine advice from. The ones I tell my secrets to. They're the guys I hug on a regular basis. The guys I miss when we're apart. The ones I've slept next to knowing that I'm safe and loved in a much different way than when you're dating someone; maybe a much better way.

But the point of my musings is to wonder if these relationships are ever really platonic. There's always the potential that one person (or both people) is (are) feeling something more. Maybe these feelings are never shared, but that doesn't negate their existence. Once felt, the dynamics change. Words spoken, actions felt, and glances cast take on new meaning. A fine line separates platonic relationships from other relationships (friends with benefits, romantic relationships, mistakes...or not). I've walked this tight-rope at one time or another in most of my platonic relationships.

So based on the fragility of these relationships and the human propensity to make things much more complicated than they need be, can men and women ever truly be "just friends"?

Let's face the facts here: Harry and Sally end up together in the end, don't they?

Whatever Happened to True Fortune Cookies?

Pet Peeve: I'm at the end of a delicious meal at a Chinese restaurant. The waiter brings the bill and the "fortune cookies". I take my cookie, break it open, and am immediately upset by what I see written on that little slip of paper. Whatever happened to true fortune cookies? If I wanted a "wisdom" or "advice" cookie, I would have asked for one. I don't need my cookie to tell me that life is a gift and I should like in the present, or that I should look both ways before crossing the street. I want a fortune cookie that tells me my fortune. I finally got a good one from Chin's the other day: "You're in for a pleasant surprise tonight". Now that's what I would call a fortune. The "lucky" numbers on the back were even 12 and 14. How much more of a sign could I have gotten? And my surprise for the evening - winning pong v. my roomie with his bestie. Couldn't ask for a much more "pleasant" surprise if I do say so myself!

Reality

The clouds don't look real tonight. As the storm rolls by they look more like an impressionists rendition of clouds than the real thing. It's the second time tonight I've been in awe of the atmosphere tonight. Sitting in my car I gazed off into the west to see the beginning of the sunset framed by two tall buildings. For a moment a beautiful dichotomy existed between the natural glow of the setting sun and the man-made depth of the brick buildings. Take a moment to thank God, or whichever deity you believe in, for the glory all around you every day. We don't always see it; we see "reality" instead. The dirt and the grime rising off the pavement. Instead, cast your eyes toward the clouds and admire the artwork.

C

I'm working on being better. On worrying less and enjoying life more. On being more open and tolerant of others. There are some things in life I cannot control and I need to learn to accept that - it's the little things that drive me nuts though. The things that most people would ignore, or overlook, that I can't seem to get out of my head.

Why did that happen? Why is that there? What is he thinking? Why isn't he thinking?

Well really, they're little big things. The action itself isn't so important, but it's the consequences that matter. People talk about how head-strong I am. How I'm a leader and a bully and a bitch. Usually I agree. Typically I'm not afraid to say what I need to say to get what needs to be done, done. But not in these instances. No, now I cower. I'm afraid. I'm worried to hurt feelings when it's my feelings that are being hurt. That thick-skin that everyone keeps talking about is a myth. A figment of their imagination.

I'm not sure this is going to work out as planned. I'm afraid it's going to be much, much worse. I'm worrying.

Decisions

Life is full of decisions: Should I wear the black or the blue pants? What do I want to have for dinner? Which tv show am I going to watch tonight? What do I want to do with the rest of my life?

I guess that's why life has seemed so incredibly impossible at times. I'm horrible at making decisions; and just about the time I think I have my mind made up, something comes along that makes me second guess it all.

When I decided to go to college I picked my last choice school because I couldn't decide which of the other ones I wanted to go to. Granted I think this was one of the best decisions of my life and if I had to do it all over again I would still choose to be a Badger. When I decided to study pharmacy and went through the agonizing process of applying I secretly wished I would get denied so I would have to choose a different career, simply because I wasn't entirely sure pharmacy was what I wanted to do. And yet, I don't think I could be happier with my chosen career path. Except that I'm not sure what that career path is just yet. Until this Monday I had it all figured out: I was going to go out west and complete 1-2 years in a hospital residency then come back to WI and work at a hospital/outpatient clinic in the Madison area. It was a perfect plan... or so I thought. Then I started Block 2 and my precious plans were shattered. You'd think I'm about to tell you that I failed out, or that I'm in a hospital and have unfortunately discovered that I actually hate hospital pharmacy. Alas, that is not the case. In fact I love my rotation site. I couldn't be happier. The personnel are an amazingly laid-back group of some of the coolest pharmacists I have ever met. The building and work space are gorgeous. The technology available is up-to-date and easy to use. The other problem: it's not a hospital, it's not a clinic, it's not even a pharmacy at all. I'm at a Pharmacy Benefits Manager and I love it.

Watch as my plans fly right out the window. What do I do now?

Solitude

I should be better at this. I have plenty of experience. I even tout that I prefer it; claiming that at times I could be described as a hermit.

So why am I suddenly so desperately lonely?

I've lived by myself before and loved it. Coming and going as I please. Knowing that everything is where I want it to be because there's no one else to mess it up. Never having to worry about fighting with my roommate or being unable to sleep because he/she is too loud, too crazy, too annoying.

I've only been here 4 days and I'm craving that "roomie" companionship. Maybe it's because of who my roommate is this time. Maybe it's because I had high expectations for the move back and now things are falling short. Either way, I want my roommate back. Sure I have other friends and yes I've been making plans and spending time with them. But at the end of the day it can be so depressing to come home alone. The dynamics are different too. The relationship I have with my roommate is on an entirely different plane than the relationships I have with other friends. It's almost more intimate. You share your interests, your hobbies, your stories, your ups and downs with your friends. With a roommate you share your space. A roommate has to be someone you can trust with some of your deepest, darkest secrets. You're sharing your home with this person and you don't do that with just anyone.

My time alone will end shortly. I wonder if I'll feel the opposite when my roommate returns. Will I feel stifled, suffocated, overwhelmed? What about the happy medium? Is it something you can ever actually achieve? I guess that's a whole other issue to mull over. For now I'll remain lonely, although maybe not entirely alone. I'm living with myself, that's some sort of company... isn't it?

An Introduction

There are many reasons why people choose to blog. Some like to share their thoughts and opinion with the world, often wishing to persuade others to their own way of thinking. Some just like the freedom and anonymity afforded by the veil of the Internet and feel safe "posting their mind" as opposed to speaking it. Then there are those people like me who have a fairly plain and simple motive to creating a blog: I want to be able to keep in touch with family and friends and let them know what's going on in my life. I know, it's not the most interesting of reasons to write, but it's a reason nonetheless. Besides, I can still choose to write my thoughts and opinions, to attempt to sway your thinking, and to hide safely behind the veil and speak my mind.

The decision to write was mine to make, the decision to read is left up to the audience...

Prior Actions

Have you ever wished bad things on someone else? Like hoping a cocky friend will fail the final exam, or wishing your gorgeous classmate would suddenly get horrible, incurable acne. What about wishing bad things on yourself? Maybe you do it because you feel you deserve it. A kind of personal punishment for the wrongs you feel you have committed in life. Perhaps it’s because you want the attention of those less fortunate. Aren’t they the ones who always get the help and the sympathy and the love? I’m not sure if I believe we can wish things true. This isn’t a fairy tale. This is the real world. And while magic and miracles and wonder exist at every turn, I’m not sure how much control we should actually think we possess. But what about a higher power – whichever one you happen to believe in – who does have the control? Call it fate, divine intervention, or karma, but perhaps in the end we really do get what we deserve. Maybe I earned this through my own rash decisions and less-than-perfect behavior. That’s actually a fact, isn’t it? There really isn’t any other good explanation for why this would be happening. I did this to myself. I have no one else to blame. It’s my own inability to control even my own actions that set these events into motion. And now I’m left with the consequences…ironically all alone now. If only I could have been okay with that before – then this never would have happened in the first place. Or would it?