On to Peru!!

By way of introduction, this blog is now serving as the official receptacle for all thoughts and ponderings of my voyage to Peru for the purpose of learning general surgery from a physician in Huancayo, Peru. Huancayo is a town of about 300,000 at 10,700 feet in the Andes Mountains east of Lima. I arrived here in Lima last night.

After an uneventful flight and passage through customs,
(How long will you stay? -47 days.- *stamp* Welcome to Peru. -Gracias.-)
(I'm not sure if I was supposed to get my luggage searched, but no one stopped me)
I was greeted by Omar, a friendly taxi driver who has somehow arranged to pick up all the medical students that visit Lima through my contact here. We had a great conversation, by which I mean I spoke slowly and awkwardly and he filled in the gaps, and took a drive down the coast to Hostale Pukara.

It looks like most of the houses here, but had a lobby, warm shower, clean beds, free internet and complimentary breakfast. After partaking in all three, I am now sitting in said lobby awaiting my friend Mario who I met on my neurology rotation at Harborview. He is (thanks God!) from Huancayo and is vacationing from neurology residency. I think we may travel together this week.

So I'm excited, getting back into international travel mode and ready to take on all that God has to offer here in Peru (hoping for a little less adventure than my last trip). I should be writing quite a bit more frequently now, so stay tuned! Love all you guys!

(also, check out my last post, as I just put that one up this morning too. I'll try to take a break and reflect on the interview trail at some point here too.)

Is there a doctor on board?

So this is my first post from Peru, but I actually had a blog that I didn't finish that I'm going to post first as it seems fitting.

Flying back from Alaska after Thanksgiving break, I was enjoying some solo time on board the airplane. Flying for me is not hours wasted in boredom, but a beautiful reprieve from duty, conversation and the pursuit of recreation, all good things, but all good things to take a break from as well.

Shattering my solace and simultaneously revving up and relocating my heart to somewhere around my stomach, a voice came on the PA: "Is there a doctor on board? One of our passengers at the front of the aircraft is unconscious and needs assistance." Banish the thoughts of heroics that you see on TV and now imagine a medieval page training with a wooden sword and shield being sent off to face the dragon.

Naturally, I instinctively ducked my head, peering around the seat to see... no one in the aisle. I braced myself for a few seconds, praying that I was not the most qualified person on board and then unbuckled and started to walk up the aisle.

"Are you a doctor?" the flight attendant inquired, fittingly so as I was in "Alaska mode," a.k.a. unshaven and in comfortable clothes.

"No, but I am a 4th year medical student," I replied. I'm not sure how I missed it, perhaps the whole hiding incident, but she pointed out to me that a REAL doctor was already with the would-be patient. At this point I was committed, however, and still crept up to peer over his shoulder. All I could see of the patient was an arm, which was moving in a very non-seizuresque fashion. My ABCs ran through my head (Airway, Breathing and Circulation) and I realized that if any of those were missing, that arm would not be moving. Whew.

I offered my assistance to the doctor, who tacitly ignored me. I returned to my seat relieved. I may not have saved the day, but I DID later score a free cheeseburger from the grateful flight attendant.

(The patient turned out okay too)

Healing

Late summer in Alaska means that it starts getting dark-ish and the air cools off substantially in the evenings. That's why I was shivering as my friend and I prayed together down by the Kenai River that night in 2006. I was getting ready to start medical school and he was blessing me before I started. Now before I go on, realize that I had spent months and years leading up to a fairly new-to-me belief in the supernatural, stemming from examples of regular people doing incredible things through the name of Christ all throughout history even up to some events that summer that I had seen for myself. I know it's a stretch for those that don't believe in miracles, but I was preparing myself for a lifetime of seeing and being a part of the divine and miraculous.

My friend had the gift of seeing and speaking truth, so when he told me that night that I would not have the gift of healing, I was more than a bit disappointed. However, he quickly added that spiritual healing would be mine to share with those around me. What that meant at the time, I didn't really know. As I have come to understand medicine, however, it makes sense. Doctors really just remove obstacles so that the body can heal itself. The actual healing takes place over hours to days to months to years as the slow, intricate process restores normality. Spiritual healing, on the other hand, is both an active and passive process involving confrontation of lies believed, encouragement of truth known deeply and faith in the redeemability of any circumstance.

Today was a day I recommitted to experiencing Christ in my life. Something I've done somewhere between 100 and 10,000 times, probably closer to 10,000. Seems I can't ever stay on track, but I keep going for it anyway... So when I saw my patient's husband reading her the Bible this morning, I offered to pray with them. As I said, "Amen," he looked at me and said something to the effect of the following:

"You are an answer to prayer. We have people all over the country praying for her," and went on to describe miraculous healing that he had been a part of and continued, "God wants to use your hands to heal people, but more than that, he wants to use you for spiritual healing. He wants to pour out these things through you if you are willing and have the boldness to follow."

He didn't know my story. He didn't know that I would be using my hands in surgery or that years ago, my friend had spoken very similar words to me. I ascribe glory to God for looking at me and seeing that even with my tendency to veer off in all kinds of directions, He would make use of such a broken and fallible tool.

To top things off, just last Sunday I had whispered a prayer that I almost had forgotten, "God, please send some one to show me that I am still walking your path."

P.S. I apologize to those of you who didn't know I put faith in such weird stuff. You don't know because I'm scared to share some of the things I believe in, but this is me and I'm in love with God.

I love crazy people

I have lots of good blog-worthy material saved up from my excellent moose hunting/camping trip to my Chicago-South Dakota-Texas roadtrip with Daniel to the emotional rollercoaster that is living in Seattle, but what inspires me tonight are the crazy people of Harborview.

It's been kind of rough working in the ER... long hours, difficult patients... a lot of unrewarding medicine interspersed with some really great chances to help people. So two nights ago I was hanging out in ED Green (read: the least sick patients in the ED) when somehow, a slew of crazy patients ended up in there all at once.

The most consistent of them wasn't actually crazy, but a teenager who had ingested a few too many 'shrooms and no matter how persistent we were, would not believe that he was still alive. I say consistent because every 3 seconds or so, he would loudly question: "AM I DEAD?!?!?!?" Which we answered in the negative the first few times, but after around number 50, we just let it go. Some one may have even tried convincing him that he WAS indeed dead, but that didn't pacify him either.

Next to him was a good old boy (if you've ever seen Strange Brew, think Dave Thomas's character) who just randomly shouted funny things. I can't remember most of them, but a lot of them made me laugh... none so much as a simply shouted, "ONE TIME! I SURVIVED FOR A WHOLE MONTH ON NOTHING BUT APPLE JUICE!" He was definitely my favorite because he was funny and completely harmless, and only piped up every so often.

And next to HIM, was a guy who was MAD. He stayed quiet mostly, but every once in a while he would get riled up and start cussing at anyone he could: the kid shouting about being dead, the pleasantly crazy guy next door, his nurse walking by, the doctors hanging around... And man, this guy could swear. He was practiced, no doubt and even had my ears burning a little.

The last guy was across the room from the others, but it didn't seem to bother him. He let loose with the eeriest, crazy laughter at the strangest times and would kind of mumble to himself and occasionally yell at nurses. But mostly, he contributed the creepy laugh. He actually was in the ED two nights in a row and was my patient the 2nd night... Pretty entertaining guy.

So it may not sound that funny from the outside, I dunno, maybe it does... but after working for 11 hours and having all 4 of them piping up at once:
Young Guy: "AM I DEAD??!! AM I F***ING DEAD?!?! SOME ONE ANSWER ME! AM I DEAD??"
Happy Guy: "Sometimes tomatoes are PURPLE!"
Mad Guy: "SHUT THE $%@!* UP YOU PIECE OF $%$#@ing *#%@!!!!"
Laughing Guy: "EEEEEEEEHAAHAHHHAHHAAHAAAA!!!!!"
Young Guy: "AM I DEAD?!?!!!"

You get the point. I couldn't fill out charts. I just sat there at my desk and laughed. Good ol' Harborview...

Duck hunting

Just to catch up a bit, since May, I've finished 3rd year of med school, done two surgery rotations at the VA Hospital in Seattle, took a few weeks off and am now back in Seattle for my ER rotation.

My break started by going back home. My dad, 2 dogs and I flew across Cook Inlet in his plane for opening day of duck season. We started duck hunting over there together when I was in 5th or 6th grade so it was a pretty nostalgic trip. We stayed in a luxury duck shack complete with a stove, table, porch and separate room for bunk beds. Opening day found us swatting swarms of mosquitoes in the twilight hunkered down behind a pile of driftwood fashioned into a duck blind. There had been some ducks on the pond in front of us prior to shooting time that acted as live decoys to give those we'd put out a hint of authenticity.

It's hard to describe the following hours in a way to paint the taking of birds in a majestic light but there were picturesque moments, freeze frames where every contributing factor summed to etch an indelible snapshot in my mind. After a morning of birds flaring into our decoys, birds from the far side of the pond responding in curiosity to our calls and dogs finally realizing their inborn drive fulfilled, my dad and I decided to take a walk and jump shoot before heading back to the shack for breakfast.

We had already put down 14 out of a 16 bird limit and were both wanting to prolong the day, but still felt compelled to seek out those final 2. We walked through the grass and marsh without seeing much for a while, the dogs trotting along tired from a long morning. I spotted two heads peeking up among the tall grass and signaled to my dad their location. We crouched, crept forward quietly until in a burst of sound and motion, they rose into the air. A pause. Eyes tracking, guns rising, a moment of calculation. Simultaneous shots forming one loud BOOM and both birds fell synchronized from the sky. The dogs, Chipper and Darby, alerted to the action bolted to find the fallen ducks in the grass.

It was the perfect ending to a morning unparalleled in all the duck hunts I have been on. It wasn't so much the hunting as it was the plane parked in the blowing grass with the mountains stretched skyward in the background. It was the plate of chips and onions and cheese and chili the night before. It was walking through the tall grass in silence with my dad and the dogs and the occasional hawk riding the air currents. It was the moment of anticipation, of hearing the wings overhead and briefly tensing before reacting quickly.

It's hard to describe without having been there, but it was one of the ways I felt a reawakening during my time off. It was a chance to sit quietly and experience the fullness of the life that God has given me and be thankful.

Birthday(s) 2009

It's always hard to come back after being gone for so long. The occasion this time is a 6 hour flight from Anchorage to Chicago. I didn't bring much to read and have had some time to reflect and eventually realized I could write without the distractions of the internet.

A couple days from June rise to the top when I think about blog-worthy events in my life lately. The first was my birthday. Prince of Wales Island is in Southeast Alaska, a large island home to around 5,000 people. I spent my birthday week out there with a family doc from Wrangell putting on clinics at various small towns. I awoke on my 27^th birthday in a vacation cabin overlooking a lake and spent some time in prayer preparing for the coming year and reflecting on the last. My doc wished me happy birthday and after a hearty breakfast of oatmeal, we headed to work at the Whale Pass library, which was hosting the day's clinic.

Most of the patients were of the run-of-the-mill primary care variety, but about midway through, we were informed that there was a man in the parking lot with a large laceration that would not come in for some reason. I went out and discovered that he was concerned about the cost. After looking at his injury and persuading him that he shouldn't let cost be a barrier, I found myself repairing the injury. I casually mentioned that it was quite an interesting thing to be doing on your birthday and he replied that he would be celebrating his the next day.

We closed up shop and headed out to Naukati for an afternoon clinic, finally ending up at Rosie's, a seaside restaurant in Craig, for a birthday dinner of halibut oscar. It had been an amazing day.

Except it wasn't my birthday. I was a day off. I had called my parents from the lone hill in Naukati where cell phones get reception, expecting birthday wishes, but as the conversation drifted on, I ended up asking, “Aren't you going to wish me happy birthday??” Oops. Fortunately I hadn't missed it, but would get to have my 27^th birthday... again.

I spent my actual birthday, June 4^th, in Koffman Cove and woke up on a church floor, not quite as picturesque. Clinic wasn't quite as interesting, but I had an excellent steak dinner with an older couple after paying them a house call. From their beach front, I watched whales spouting, played in the tide pools and reveled in the surrounding beauty with my God. Following dinner, we went for a hike through massive cypress trees to a waterfall and then a drive through the woods of Prince of Wales Island... a perfect end to my birthday(s).

A great weekend

A post I wrote during my last weeks in Anchorage... from a weekend on the Kenai River.

Friday: My doc has come to trust me quite a bit in the OR. I think that bodes well for my hopeful future as a surgeon, but regardless, Friday morning found me holding the scalpel over two patients: one, a young woman with questionable health, the other, an infant who had yet to see the light of day. I cannot describe the sensation of the moment, but it intertwined the weight of responsibility afforded by breaching the natural surfaces of the human body with the light-hearted elation of being the first to experience fresh, new life. Some element of self-preservation resonated as well, akin to the feeling of clinging to a rock wall high above the ground with only my fingers and toes as purchase, although my life was not the one at stake. Upon throwing the last stitch, the tension resolved and I was left with a great sense of satisfaction and, admittedly, relief.

Later in the day found me working with laparoscopic instruments in the recesses of another patient, shaky, yet excited to be operating. Surgeries I may never perform even as a general surgeon, but within my grasp thanks to a trusting, confident and gracious physician.

Later still in the day found me at a charity walk and let me highlight to you the joy afforded by finding that your delicious chili has STEAK PIECES in it. And that your entry ticket also buys you unlimited chocolate-covered strawberries, cotton candy, sno cones, corn fritters and fabulous prizes. Top that off with downtown statue-climbing utilizing the jump-lock-pull method to ascend said statue and hanging out on the sun, watching the sunset followed by a top-floor oceanside deck hangout to watch the sunset AGAIN and you have the right combination for a fantastic Friday.

Saturday: 70 degrees. Drift boats floating down the upper Kenai River with my dad and a buddy. Moose roast sandwiches for lunch on a gravel bar and a long nap reclined on a log in the sunshine. A puppy finding satisfaction in a prize fishhead. A brown bear frolicking on the shore not 30 feet away. Revisiting a place of youthful memories and sitting on a mountainside with the Lord. A welcome reception at home with food only a mother could make. Walking on the beach and then finally resting peacefully.

Sunday: You can't beat waking up to homemade blueberry muffins made with berries you picked on a venture into the wild in search of a bull moose. Unless maybe you count spending time with your sister and nephews and parents and worshipping with numerous friends and church family. Then again, there's a lot to be said for a relaxing afternoon catching up on school work on a comfortable couch. The drive home was beautiful.

The weekend was beautiful.