First Impressions

View from street en route to work

My first impression of K is that it is dry and dusty. The surrounding mountains blend in with the brown landscape and brownish air. (I’m not sure if the air is brown from pollution or dust, probably both.)  Like so many other parts of the world I’ve been, in traffic is crazy with no obvious rule or reason: cars, trucks, people on foot and on bikes, herds of sheep – all trying to make their way along or across the roads with no signals. Most of the roads are in poor condition. If once asphalted, they now are potholed and dusty. So travel anywhere takes a lot longer than it would at home. 

View from my roof

Of course, as a woman, I immediately noticed all of the women in blue burqas or long black coats, some completely covered except for their eyes, others wearing scarves that show their faces. Even the young school girls have long black robes and white head coverings. Though I’ve seen plenty of pictures and knew what to expect, it is different to experience it in real life.  I have not yet gotten used to wearing a scarf over my head, and still haven’t figured out how to keep it from slipping off. Fortunately, there are places I can take it off - inside the guesthouse or in the female residents’ room at the hospital. It is nice to see my colleagues face to face, though it is amazing how much personality can be expressed with just the eyes. In some ways, I appreciate the safety of anonymity that comes with covering up; in fact, I wish I could wear a burqa just so I wouldn’t stand out as a foreigner.  On the street, even wearing my black coat and scarf, keeping my head down and avoiding eye contact, I feel vulnerable. 

View from my roof

In general, I still feel very uncertain about how to act and interact here. As a western female, I am considered a “third gender.” Supposedly I have more freedom to interact with both western and local men than the local women do. With my fellow expatriots, I can relate more or less as I would to men back home.  And I should be able to talk to my local male colleagues at the hospital more or less as equals. But I don’t quite feel comfortable yet. It is hard to be constantly aware of my expressions, gestures, tone of voice, eye contact, body language, head covering, etc. Do I greet everyone I pass in the hospital? How friendly should I be? Since I don’t speak the language, it’s hard to do much more than say hello anyway. At least with the women, I know I can be more relaxed, so I’m focusing on that for now.

Getting Here

I know you are all eagerly awaiting exciting blog posts from "K" (no specifics for security purposes). There is plenty to tell, and I promise to tell it bit by bit. So bear with me - one story/experience at a time.

Despite having lists upon lists to organize my preparation for international travel, my last few weeks of getting ready were pretty much chaotic.  Being on in-patient adult medicine service (my busiest rotation) made it a bit more challenging. The week before I left, I was on the night shift. In a way, that actually made things easier, since I could use the daytime hours to run errands (at the expense of sleep). It had the added benefit of helping me shift time zones with less trouble. In addition to getting packed, I had to finish discharge summaries, dictations, clinic notes and other work-related tasks to make sure I didn't leave any patients hanging.

I’m so grateful for my parents, who drove up to Wichita on the Thursday before I left to help me get ready. They ran all sorts of errands, bought last minute items, and kept me calm and well-fed. On Friday night, some dear friends hosted a gathering for prayer and blessing to send me off. So by the time I got on the plane, I was feeling as ready as I could be – at peace and encouraged.

On a side note, unfortunately, I think I wore my parents out. My father ended up in the hospital with pneumonia the day after he left Wichita. They didn’t even make it back to Houston but were stopping to see my sister and her family in Dallas on the way.  Though I know they would prefer to be home, I’m so glad they have had family support throughout this ordeal. I can’t help feeling somewhat responsible, since I may have overworked them getting ready to go. But I think Dad is on the mend, and I’m so grateful for the ability to talk face to face with them over the internet despite the thousands of miles that separate us right now.

 

The trip here was quite long. 14-plus hours to Dubai (got lots of sleep and watched three movies!), not to mention several hours of lay-overs.  The Dubai airport was quite interesting. I listened to the Muslim call to prayer while sipping coffee in the airport Starbucks. Then I had to take a taxi to change terminals for the final flight.  Everything went smoothly though, and it was to have a travel companion who is also staying at the guesthouse here in K. Everyone at the guesthouse, who all work for the same organization, has been very helpful and welcoming, and I already feel at home (at least in the guesthouse).  More to come...

Count down 13 days

13 days until I leave for my international rotation. There's still a lot to do, and I'm tempted to get overwhelmed with the details. But then I think, I'm only going for 4 weeks. I can do without a lot of things for 4 weeks. Plus, I'm going to be in a big city, so I should be able to get the essentials.

The only hitch is that I am on the adult medicine inpatient service this month, which is probably my busiest rotation. Generally I work from 6 AM (more like 5:30 since I like getting there early) till about 6 or 7 PM every day. This coming weekend the third-year residents are covering everything as the 1st and 2nd-years are on a retreat for 5 days. So basically I don't have any days off until I leave. Oh, and I am on the night shift the week I leave so that should be fun. At least I won't have to worry as much about jet-lag and shifting time zones!

Actually, I've had a great month so far on medicine - interesting cases, great patients, great attendings, great teammates. I haven't been on adult medicine for several months, and I'd forgotten how mentally stimulating it is - the challenge of figuring out what's going on with the patient and how to balance all the systems that are out of whack - heart, lungs, kidneys...  It's always rewarding to "fix" someone and send them home in better shape. For example, I recently had a patient who came in completely out of it due to liver failure. She was unresponsive, completely disoriented when she did wake up, and her all of her labs were abnormal. By the time she went home, she was awake, oriented, back to her baseline. I had the chance to talk to her and her family about her liver failure and what it would mean for her down the road. She is very motivated to stay "sober" (the cause of all of her problems is alcoholism) and I believe she will. We talked about the importance of having help - namely asking for God's grace every day. I got to pray for her before she left the hospital.

Of course, you can't fix everyone. I had another patient with a drug abuse problem that got him kicked out of his living situation. Unfortunately, he's in denial and won't admit the extent of his drug problem. How can you help someone who doesn't think they need help?

Sound like I'm running a psych/drug addiction ward?  Maybe. But I've had lots of other cases too:  pancreatitis, diabetes, UTI, a huge thyroid goiter filling the patient's whole right chest, pneumonia, ruptured ovarian cyst, chest pain...some of them text book cases, others not so easy to figure out. Every day I discharge one or two patients and get a couple of new ones. There's always a more to learn - keeps it interesting.

Please continue to pray for me as I prepare to head overseas. Pray that I will not become caught up in the details but be able to focus on the big picture - the opportunity to serve and learn in a different country and culture. Pray that I will be able to give my patients here the compassion and care they deserve in the next two weeks despite having a lot to do to get ready to go.  And please pray that God will use this experience to guide my next steps in life. I have a couple of job interviews when I get back, and I want to choose the best path to whatever it is that God wants to do with my life. Proverbs 3:5-6 assures me that the Lord will direct my steps if I acknowledge him and trust in him.

Have a blessed week!