A different kind of crazy

(NEW SECTION! ->) Word to the wise: When setting out on new adventures, imagine the worst possible series of events that do not include member death and then imagine yourself enjoying it. Maybe these terrible events will transpire, maybe every thing will go according to plan (god forbid, knock on wood) but either way you´re guarenteed a pretty good time.

The bus to the small frigid town of Uyuni took 11 hours and left at 7pm. Sleep was elusive. Enough said. 

Ann Marie (think cute, terrified, fiesty rabbit) and I (think sleep deprived doberman) hung out* for a while while waiting for further instructions after we arrived at 6am. The rest of our team of weekend expeditioners had been early birds in getting their tickets and were taking the 'nice' bus that had the luxurious amentites of central heating, bathrooms and a decided absence of adorable wailing children.
*in this instance should be interpreted as made up a game involving a dictionary and froze in direct sunlight.

After reuniting and breaking our fasts, we hightailed it out of town in a 'fancy' jeep that had the incredible attribute of playing music from iPods. FIRST TURNING POINT. While jamming to some very deep and spiritual music by Travie McCoy and Bruno Mars, we began to feel that our much anticipated adventure into the desert wilds of the south had finally begun, when we stopped not five minutes out of town at the Train Cemetary to pay our respects to these icons of industrialization. FIRST TURNING POINT ABBREVIATED.

 

 

Several hours later, we slathered on our sunscreen to hit the Salar de Uyuni, the famous Salt Flats. The only formation of its kind in the world (Our Guide, 2011) the Salt Flats are a remainent of an ancient lake that has since vanished but left hundreds of thousands of tons of Salt behind. It looks exactly like snow, and like good scientists, hypothesis testing is the rule we live by.

The salt of this region is shipped around the continent and is used in industrial, culinary, construction and decorative uses but they leave some here for the tourists.

 

That evening we stayed in a hostel with four walls and a floor (as expected) and beds! with blankets! pillows! and hots showers! SECOND TURNING POINT. After a delicious meal we were all so exhausted we fell asleep immediatly.

The next day we increased our altitude (think SOB, everyone feels a little sick, need less wine for a good time) and past through the valley of the rocks to reach the Laguna Colorado, a lake red from its algae with a community of flamigoes in residence. I cannot describe this day in much detail because after taking a NONDROWSY dramamine for nausea, I could not be roused from sleep. Unfortunatly, I didn't perk up until a fellow adventurer mentioned charades later that night, and as I'm sure many of you know, laughter is simply a wonder cure. I will bring my field tested methods back to the hospital with me.

Following a night of  hanging out*, we were greeted at 430 am by pancakes from our cheerful guide Edwin. As often happend on trips into the wild, my distaste for pancakes disappeared and they seemed the most delicious thing I ever ate. (I have since tested this new found 'like' of pancakes and can only attribute it to adventure induced temporary insanity) 
*should be interpreted here as many rounds of charades dominated by yours truly, some perfect stargazing at a foriegn sky accompanied by disney acapella, and huddling together in sleeping bags for warm but forgeting we each needed more oxygen at this altitude and readjusting to our own beds in the middle of the night to prevent suffocation.

Climbing even further the next day, we reached the hot springs and the Green Lake, before turning back all the way to Uyuni and boarding the last leg of our four day journey. Although this bus was cold, the toliet door refused to open, and Lydia snored, I couldn't help smiling as I drifted to sleep. An adventure shouldn't be defined by how many new and unique things you see. Or by how much longer or harder this trek or car ride or bike trip is from the last one you took. Its a strange collection of moments that you thought would be awful, that you knew would be hard, but some how that you knew would be worth it anyway and in fact turn out to be the ones you want to remember for the rest of your life.

Surgery, A Team Sport.

On Monday I walked into the hospital incredibly excited. It was to be my first day in Surgery, arguably the most competitive, driven and intense field in medicine. Anthropology has given me many things to question about surgery and its aggressive approach to healing but I couldn't help the anticipation building to witness my first surgery in person. It was to be only a simple umbilical hernia but as they say, those begging at the bottom of the surgery observation totem pole cannot be choosers.

It turned out to be nothing like I expected, including the patient. A baby girl a little over a year old had a benign tumor on her neck, that was nearly larger in size than her own head. I had seen this patient last week, in the neonatal unit when my oncology doctor was consulting on her case. It struck me then how much I wanted to help this tiny tiny person who squirmed, cried, and swatted at this enormous literal weight on her sholder. Its difficult even for me to understand my comparatively strong emotional reaction to this particular patient because I knew that once this tumor was removed, in all probablilty this child would live a long healthy life, that complications would be unlikely and that is not a statement that can be made for many patients in this ward of the hospital. But it was her who had me blinking furiously while pretending to read growth charts in a foriegn language and failing.

So when I walked into the OR and saw her lying on the table I was overjoyed. Here we would help her, these talented folks would take away the bad things and leave her healthy and whole. And they did. But Surgery, among other things, is a messy business. It requires emotional disassociation, for a short time to look only at the task and hand and forget that every cut is into skin, every tear into flesh,  every stitch into a tiny helpless infant, and precision was a pipe dream. And with this little girl that was a momentous task for me.

I have observed six different operations, simple and complex, interesting and heartwrenching, since this patient. And I can say it is getting easier to look at the task at hand, and I am beginning to become at least sensitized to the violence that is surgery in chaos. It is necessary, it is well intentioned and these surgeons are talented. And for the remaining day I have decided to take comfort in the buddist proverb, 'There are only two mistakes one can make along the road to truth; not going all the way, and not starting.' I have started in my journey to find something like a true calling, so I guess there is no turning back. But if I meet the buddha on the road, I may have to kill him.

Burgers, Blockades and some good, old, south american Fútbol rivalry

Fact of the day (at this rate more like week): Near the shores of the mesmerizing Lake Titicaca sits the ruins of one of the most significant civilizations in south american history. While the structures of Tiahuanacu (also known by the spanglised Tiwanaku) may seem dimitutive today, they mark the center of a major state power that is believed to have begun more than a thousand years ago. When asked where the stones that made of the walls of these once great structures have gone, our guide pointed in the distance to a rust red catholic basilica. Hey Colonialism, you ruined everything, but thanks for hamburgers and the postal service.  

Just returned from a great day trip to the ruins of Tiahuanacu that lie just an hour outside the city limits of El Alto, and we got off early enough to avoid the demonstration blockades. Oh yeah I forgot to mention, once every six seconds some one in Bolivia arranges a protest. All jokes aside, you have to admire this nation's respect for civil and political rights. Interestingly enough the only things these city wide protests seem to effect is the public transport known as minibuses, and provide plenty of footage for the local news to set to melodramatic music. Apart from the occasion firecracker for theatrical effect, many people who work in professions outside the unions simply go on about their day but might walk farther than usual, as the blockades are set up around the plazas that connect the main arteries of city traffic, making it difficult to get anywhere central. Note to parents, all is well these protests are very peaceful whatever shows up on the news!

Another great note from this week at the Hospital, Children's Day! After my emotional day in Oncology I was in my scheduled pulmonology and arrived just in time to celebrate sortof a birthday, but for everyone. With clowns, cake and plenty of toys to give away, the entire atmosphere of the hospital was transformed. The worry and stress was still there, but overlaid with such joy and real hope it is hard to describe. It didn´t hurt that many of the children in my ward were on the very tail end of their recovery from severe pnemonias, so after more than 3 weeks in bed they were ready to get up and play. In other parts of the hospital, we even got some surprise visits from the local futbol team, which I am told caused quite a rucus among children old enough to recognize them. And so the rollercoaster continues.

While many of the crew are away in Copacabana, a fellow student and I will be at 'El Classico' the highly anticipated matchup (if two people count as a representative sample) of La Paz's two futbol teams, Bolivar and The Strongest (that is really its name, you should hear with a bolivian accent). As they made the children of my hospital very happy I feel inclined to root for the underdog, the Strongest. Sneak peek: Our treacherous bike ride to Corico will take place next weekend and I can't wait!

Weekend Update on rollercoasters

Fact of the day: From La Paz to Corico is a trail known as the North Yugas, or as it is labled by the Inter-American Development index, the worlds most dangerous road. Although 69km in length most of the road is no wider than 3.5 meters, has dropoffs of 600m and since 1980 more than 120 people have died navigating the road on bike, car and bus. At long last in 2006 they finished a new road for commercial traffic and now the road is mostly used by mountain biking enthusiasts and deathwish burdened thrillseekers. Three guesses what my plans are for next weekend.....

This weekend consisted of some ups and downs, great highs big big lows and my first day in oncology has suggested that this may be a ongoing thing.

On thursday, we hit the peña known as Marka Tambo, a traditional dance and music venue, that while the performances were incredible and the restaurant was classy, there were not many people there leaving the ambiance a little to be desired. This was also one of our last nights with Lisita Bonita, who would head back on Saturday morning.

I havent spoken much about the hospital yet, mostly because it is difficult to find humor in the respiratory distress in infants, a five year old with heart failure, or tuberculosis meningitis. But my last day in Infectious Disease was a fun one with the other medical students from Bolivia. But late in the afternoon, after many cute kids who never hesistated to give 'un beso por el doctor' to every white coat in the room, a women in a government vest walked in with a beautiful baby girl. The other students gave me the lowdown, and brace yourself for a tearjerker. Luisa was four days old, and had been abandoned by her mother in the hospital the day after she was born. While they suspected schizophrenia in addition to other mental illness, they did know that her mother was HIV positive and as no measures had been taken, Luisa now has a one in four chance of being HIV positive aswell. It was hard to believe as she looked like an incredibly healthy baby girl, she had gained weight after birth and her skin was flushed. I hope I can tell you the rest of the story as I learn how Luisa fares in the social system here in La Paz. But as sometimes happens when faced with humbling story like this, I felt the need to head out an sieze life in La Paz like never before.

One of the ways that this weekend fluctuated, was in the size our little crew of LaPazian expats  We were connected with some other do-gooders, public health students from california affectionately named the beach boys, who would also be in La Paz for the next few weeks on a training rotation. After grabbing dinner and some drinks, most were ready to head home to get ready for our trip to visit the Tiwanaku ruins the next day, but myself and a few other decided to see how the other half, where bolivians of La Paz celebrated life and drank their sorrows, as your week may have gone.

Cada d'agua was the type of place I had expected of a peña, a packed crowd in an old basement, where you ordered your beer for the table and they gave you a bowl of coca leaves to chew to keep you awake for hours of music. Although the dancing to philosophical discussion ratio was alarming, we had an incredible time and I can't thank our 'local' Yeri for suggesting it.

Unfortuntly the coca could not keep me awake long enough and I missed the bus to Tiwanaku, and I blame my inner archeologist for the severity of the hangover that followed that day, as I expect it was some form of punishment for missing one of the pre-emminent historical sites of an early civilization. I shall remember his wrath the next time I choose between a visit to the past and another Paceña (local brew). Spending the next day or so in recovery, I also mourned the loss of my guide, roommate and friend by watching every romantic comedy in Mercedes collection, including the spanish ones.

Apparently that was not enough language practice for the weekend as I spent today straining my ears and had to remind myself not to tune out the foriegn language. I was rotated to oncology as my scheduled doctor was out of town and it took me by surprise how different it made me feel from Infectious disease. Infections can be just as fatal as any cancer, but our treatments for cancers can be as hard on the body as the disease. I also saw more infants and when they have tumors bigger than their own heads, it becomes pretty hard to maintain a mask of professionism, and the prognosis is pretty grim.

Tomorrow, I head back to by scheduled pulmonology and shall see whether the week takes an upswing or a down. I guess thats the thing about rollercoasters, the uphill has all the anticipation, but the easy part wasn't why you got on the ride in the first place.

Orientation

Fact of the day: Nuestra Señora de La Paz is the world's highest Capital sitting at an altitude of 3660m or 11900 ft. This means that walking anywhere leaves you short of breath, everyone is a cheap drunk and foriegners tend to faint when working in tall buildings.

Friday will end my first week at Hospital des Niños in the Infectious disease department, and much to my surprise I understood most of it. Although two weeks ago I knew less of this language than can be found on a Wendy's menu, I am happy to say my comprehension of spoken spanish has far surpassed my ability to speak, which is at least picking up with practice.

However, my work at the hospital (observation, notetaking, occasional wittism) is nearly the least of my cultural immersion. My wonderful host, Mercedes is a young pharmacutical ___(name of job I do not understand yet) has welcomed me into her apartment in the trendy Sopocachi district of La Paz, and has been my introduction to the best latin music in walking distance. Her house-lady (it doesnt really translate) Vicki, has tirelessly tried to broaden my culinary horizons, which I continue to insist are quite wide enough without including the tongue, liver and heart of every animal raised in a 50km radius. But by far the most significant in orienting me in this city of a thousand hills has been my roommate Lisa, a PA student from NC who studies in NYC, and who braved the city two weeks solo before my arrival.

In just these two weeks together we have found the best deals on everything from Matè to salteñas to massages, seen the sun set on the birthplace of a few incan gods, braved street food I would probably die for (and some of us paid for it), spent way to long trying to convince a chilean we are not decended from ancient aliens, danced to some incredible salsa music, and after all that discovered the perfect girls night in (Wine+coke, chocolate, chick flick =incredible).

And tonight we will be braving the haunted Calle Jaen to teach me the difference between pene and peña (dont google it. I warned you). Unfortunatly, Lisa will be heading back to the states on Saturday so this weekend will be a sendoff to remember. Thankfully the other CFHI students have arrived just in time and we will see what misadventures we can get up in this beautiful city.

I can't wait until I can upload some pictures! Hasta luego!

Diamonds and Diplomas (who cares if theyre pretend)

As Andrew Carlyle once said, and has since been regurgitated repeatedly by my e-reader, no pressure, no diamonds. So as you read on, you can thank my mother for this diamond (at least a rough one) of a travel blog.

Most would say a journey should start at the beginning. But to be honest I would rather not start there and it is probable that with these folks I would have to disagree. For me, the meaning of a journey only fully forms at its close, as it approaches its end, when reflection and fondness reach their peak, and we are suddenly confronted with those things we never expected to miss from a place we barely knew.

But I´m getting ahead of myself. I am only trying to explain that this journey into the stumbling but endearing healthcare system of Bolivia must really have begun several weeks ago, in a dusty school in Northern Tanzania, or perhaps even half a year ago, when I crossed the stage to accept a pretend diploma. Like thousands that day, I was eagar to be free of what seemed irrelevantly themed papers, intentionally tricky tests and certainly friday morning lab, but begrudging the reality of adulthood that was sure to follow.

What did follow was (...is following, will follow-geez all this spanish is messing with my grammar) not the typical twenty-somtheing stumble into responsiblity, and I am thankful that in some ways this is only the beginning of my nomadic, medical, cultural, culinary, and romantic (linguistically of course) quest to save the world.

Bienvienidos al relateo humorístico de mis adventuras