Sunday, July 24, 2011

intricacy.

I had a cup of coffee at 8:00 tonight. The power was out all day today, and I wasn’t going to attempt to make coffee by heating water on the stove and…I don’t even know how I would’ve accomplished that. So I took the opportunity to rid myself of my caffeine headache as soon as the power came back on, which means my sleep schedule just went out the window. These ideas have been stewing in my brain for a few weeks now. Two Sundays ago Janet and I were driving out to Valley of the Angels. It was sunny and clear, allowing for beautiful, unadulterated views of the mountains. There is a vastness to the mountains here that seems different from any other “wilderness” I’ve experienced, probably due to the limited road access and overall lack of development that makes them seem so untouched. By humans, at least. I like to pick a little spot on the side of a mountain, indistinguishable from anything around it, and wonder if a single person has ever been there, in that exact spot, touching that one tree. God’s intricate design radiates from the landscape here, and some days I can only gaze in wonder at the way the sun illuminates a part of the mountainside, how the rain comes across the valley, and how a freshly-fallen Manzanita tastes like roses. I would like to think that I can fully appreciate this intricacy God has bestowed in His creation, but I feel like it is too profound, no matter how devoted I am to observing and understanding it.

The intricacy of this beauty has been so clear to me this summer, but so has the intricacy of evil. The pain of this world is specific, detailed, calculated, and unfair. One of my favorite views this summer was the glimpse out of the newly-cut window of Jessica’s house in Cataluña. The blues, greens, and greys combining into a hazy and unique sprawl of mountains and sky. Yet in the same village, in a different wooden shack with the same view, a 2 year old girl is being sexually abused, contracting the telling urinary tract infection we would diagnose during a mobile clinic two weeks later. It will never make sense, but it is delicate, disgusting, and real. I can never say that these situations, these tiny specks of the world and humanity are untouched by God. I know that’s false. He is omniscient and omnipresent. So how do I come to terms with the sharp, relentless focus of evil? Like the beauty of God’s creation, it is too profound for my full understanding. I want to reconcile it, with God, with the victims. We have at least five crying patients every day in the clinic. Most of the time it’s the toddlers who are angry at me for gagging them in order to diagnose their swollen tonsils. The other cases are women who present with insomnia, headaches, and gastritis. As per our usual consultation, Dr. Olga asks them about stress in their life, explaining how it manifests in their physical condition. Then the tears start as these women explain their husband’s drinking problem, the multiple deaths occurring among their friends, or the poor health of their pregnant teenage daughter. Like I said, relentless. Some days I space out, convincing myself I don’t understand what they’re saying, when really I just can’t understand why they have to be hurting. I don’t ever want to be ignorant of any of this, either. There have been problems in my life that are delicate, intricately positioned as to cause the most pain, and they still can’t seem to compare to the stories I hear or the pain I see in someone’s eyes.

The tiny details of this pain are powerful and can eclipse the intricate beauty of life sometimes. There’s a balance, or war, I’m pretty sure it’s both, that exists between the two. I have poignant memories of both in my life, and each has its own ability to strengthen or further define my relationship with God. I remember the desperation I felt in March and April, when I was consumed with self-doubt and terribly isolated as I poured every ounce of energy into studying for the MCAT. Then I remember being home at the end of May and looking at the peaceful, curled frame of my sleeping 3-year-old cousin just before I woke him up from his nap. These events are separate and non-reciprocating, yet provide a delicate, warring balance in my life. Good and evil are never going to one-up each other or be comparable. Relationships in my experience seem to work similarly – so much strength can be built on little moments and details of devotion, and other little aspects seemingly insignificant can cause intense pain and decay. A pro/con comparison does little to alleviate this conflict and save a relationship; a decision to work towards the good in spite of the war is necessary to do so. We are left with resolve. This war causes weariness, confusion, and doubt, yet every day when I get out of bed, I must resolve to continue towards the ultimate good that God represents without denying the strength of each opponent. And how much I have to learn about this. I can theorize and philosophize much more readily than I can employ this idea in my life.

There is an image of despair so sharp and repulsive that I witnessed a few weeks ago. I have yet to verbalize it to anyone. What is seen in Honduras affects everyone in varying degrees, and what I describe may seem mild to you. I, however, will never be rid of it. I was with Tim in his truck one day after a clinic. We were going to meet the bus at the dump and hand out pizza and water. The situation was out of hand from the start, so we had to alter our original plan. Because of the mob-like atmosphere, I stayed in the truck. While I was sitting there, a garbage truck drove past after its passengers had received the pizza and water. Standing on the back of the truck with one arm looped through the handle was a girl, 7-months pregnant. She was probably 17. Three other guys were also on the back of the garbage truck, one of them trying to grab the two pieces of pizza from the girl. She clutched the plastic bag tightly, laughing and refusing to give it to the man as the garbage truck drove away from the dump. I can’t measure the desperation present in that situation, and no beautiful facet of God’s glory on Earth can reconcile that in my mind. Yet the good will thrive and exist alongside the evil, with some of us in our insignificance working to unveil more of the good found in God’s creation.

Tuesday, July 12, 2011

learning.

i'm at home today. i have a lovely sinus infection and respiratory congestion. it's like they say about druggies, hang around them long enough and you become one. i've been hanging out with patients all the time and now look at me. this at least gives me time to update here and upload photos. i've been here 4 weeks to the day, and have 4 weeks left. the first 3 weeks were absolute craziness. being part of a group here is always an adventure, and i've definitely been all over the place, doing all sorts of different things, with three different groups! one of the best parts about the first 3 weeks was the medical clinics. we pack up plastic bins full of donated medicine, bandages, vitamins, etc and set up usually in a church building in one of the villages we're working in. we divide the room into triage, doctor station, and pharmacy. we have translators set up at each station...they're pretty important. the first clinic we did was in los pinos. we were going to start by handing out 40 numbers to the anxious people outside the building. unfortunately an errant blank notepad and a well-meaning church member caused that number to rise to 70. THEN families were taking their number after being seen and handing it to another outside the gate. i'm not sure how many repeats we saw before we finally started collecting the numbers. we saw TONS of patients (approx. 350) and i learned so much. i was at gayle's side the whole time, listening to lungs and hearts, looking in ears and down throats. experiential learning is such a huge part of medicine, and i am so, SO blessed to get so much of it before i even start med school. a good teacher is invaluable, and gayle was amazing. we had some pretty crazy cases come through. there is so much more to being a doctor than diagnosing and treating. more about that in another post. it takes a lot of strength to sit across from a 7 year old boy who we suspect has a dissected abdominal aorta and calmly explain that he needs to go to the hospital. In the states, he would have immediate surgery. when you're in a little church building on the side of a mountain, there's not much you can do except hand a piece of paper with the name of his illness to his mother and strongly encourage them to proceed to the hospital. luckily gayle had this strength....i sat there stunned, fighting back tears. this past semester i was in honors physiology lab, where we were assigned hypothetical cases to research and diagnose. during our cardiovascular unit i was assigned a patient with a dissected aorta. she was in critical condition, but she was sent to surgery immediately and recovered quickly. this surgery is very serious, and knowing the aptitude of the local hospitals, i don't even know if they could successfully perform this surgery. what was going through my head at this point? CRAP. WHAT...I...HOW...CAN WE...CRAP. yeah i know, not very poetic. you really shouldn't lie to patients. more importantly...you shouldn't freak them out. we didn't lie, but we didn't divulge the full gravity of the situation. now, keeping someone else calm while having a silent panic attack is a skill i have yet to acquire. working on it though :)the years that lie ahead in my medical education seem so daunting, and actually practicing medicine even more so. books i can learn, memorize if i have to. but knowing how to trust and be trusted by, calm, comfort, and chastise patients will take so much more concentrated effort. now for those of you who are already drafting emails telling me to reconsider my career choice because i actually have to work on the way i behave around patients, chill. some of it comes naturally. when i'm talking to a patient about their symptoms or explaining how to take their medicine, i am relaxed, using simple terms and joking around a bit. i am starting to activate different skills, aspects of my personality that i've just never had the opportunity to use before. and i love it. what an amazing life challenge God has set before me. yeah i know, He's been pretty absent from this post so far, but definitely not from everything i've been doing.so, to be honest, i like the feel of a stethoscope around my neck. i like being introduced to patients, listening to them, speaking their language, explaining their illness, and hearing "gracias, doctora" when i give them their meds and send them on their way. it's a really good feeling. it could easily go to my head. it doesn't because of the loving, all-powerful and gracious God i choose to follow every day. every day i spend in the clinic or in another village i am humbled, almost beat to the ground because almost every day i use the words "No puedo..." in conversation. "I can't..." Even if i were the best cardiothoracic surgeon in the world I couldn't fix a 7 year old boy in the church at los pinos. at the clinic we can't give blood or urine tests or do ultrasounds or x-rays. we rely on medicines donated from the states, and we definitely don't have every type of medicine our patients need. i'm learning medicine by leaps and bounds, yet there will never be a day when I can fix everything. especially here. i'm not sure how doctors who don't believe in the ultimate Physician go to a third world country and practice medicine. because in these helpless moments, when a solution exists in other parts of the world but not here, I pray. I can't fix it, but I can pray to the God who can. it's almost forced, like i literally have no other option...which is probably good for me, seeing as prayer is a reflex for me only in extreme situations. so as I am confronted with my limits on a daily basis, God is teaching me to push them and accept them at the same time, relying on Him more completely than I ever have in my life. here i am but a humble student...being led toward God every day, because sometimes its hard for me to do the walking on my own.I'm thankful I have the motivation to keep blogging. it's been difficult to find the words lately. enjoy the pics!!!! love, annie














check out annie's green stethoscope :)














listening. writing prescriptions. soaking it all up!!!


















accosting the poor man's eye ball. this guy was pretty sick.
















los pinos church where we were set up















got a little crowded sometimes....



















this is as difficult and awkward as it looks...




















5 year old with a goiter (enlarged thyroid)...don't see that every day.



















candy is important. we're not dentists.

Monday, June 27, 2011

catch up time....

so we haven't had internet for a few days, and before that i was running around with the group doing awesome things, making it nearly impossible to blog. so i'll be posting A LOT over the next few days...even though i'm still running around like crazy :) i'm noticing that it's much harder for me to blog this time around. I've barely taken any pictures, and feel like i have little to say when i sit down at my computer. but i will try, because i know i will regret it. so....here goes major-rough-day-#1.

I never liked building houses. I’m not coordinated, tall, nor strong enough to feel like I’m useful. It STINKS feeling like you’re in the way. My first house build 3 years ago was with a very experienced crew, and I felt completely useless, especially compared to my monkey of a brother. I was not too thrilled about building a house yesterday, but I was itching for some hard work (wonder where that came from, MOM!) And boy did I get it. We had two houses being built in the same community. We divided our group and proceeded to our site. In a community like this, you start on a large dirt road, big enough for the bus. When the bus can go no further, the road turns into a rocky path. After a few twists and turns and usually a considerable increase in elevation, it becomes a barely visible grassy foot path…and ten minutes later, you’re on the side of a cliff, with a 20 x 20 flat square of dirt laid out for the house. Walking there is a job in itself, let alone hauling tools, posts, and wood for the house. The wood truck can get farther along than the bus, but not much. My cousin, Maggie, and I ended up in charge of the wood-hauling crew. IT TOOK FOREVER. The sun was blazing as the temperature rose throughout the day. We came home sunburned and heavily bruised. My right arm was splotched green for a week. We were all exhausted, with a layer of sunscreen, dirt, and sawdust covering every inch of exposed skin. Once we FINALLY got all of the wood to the site, I expected it to be halfway done. While we were having incredible difficulty hauling wood, the other part of our team had to dig the four main postholes several times because of the precarious position of the house and the composition of the dirt, so the first wall wasn’t even started. We kept at it for most of the day, finally finishing around 3:30. The other team (who walked maybe 15 feet to their build site) finished much earlier than us, so we had some help towards the end.

Throughout the whole day the woman whose house we were building, Jessica, helped with every single step. She hauled wood, held boards, handed out nails, and then even bought the entire team gatorades and chips with her own money. She was amazing. She has five children, ages 14 to 1 ½. As we finished the house, I got to talk to her a lot. One of the best things about this trip so far is how much more effective I am at communicating. I get to listen to peoples’ life stories, as well as encourage them and make them laugh. Jessica was incredibly sweet and so thankful. Since I was one of the few she could talk to, she thanked me over and over again, getting more tearful each time. We finished the house and brought the team and the family inside to pray and present the house. As we prayed, the tears came. Jessica and her mother were balling, going around the circle of 20 people, hugging each of us. Jessica prayed as well, thanking God for the amazing blessing of a new house, barely getting through each word. I started crying during the prayer and LOST IT when I hugged Jessica and her mom. We spoke Spanish through our tears, talking about the beauty of God’s blessings and how He provides for us in any situation. As we were leaving, I gave them one last hug, telling them to sleep well in their new house that night. Jessica asked me if I would come back to visit. It is so difficult to say yes, because I have NO control over my schedule, and I can’t just jump in the car and drive into the village by myself. I told her that if our group returned to Cataluña, I would definitely come see her. Beyond our initial meeting, I knew nothing about Jessica’s life. The simple explanation for why a family needs a house is usually that they’re poor, they need it. And honestly, that is good enough. But then there are the people who have lived an unimaginable life. That’s Jessica. We didn’t know her story until Tim told us that night at devo. We spent the day building a house for her and her family, having little idea why she really needed the house. As I mentioned, Jessica’s oldest child is 14. Jessica is 25. Simple math says she was ELEVEN when she had her first child, and she was married before that. Why? Out of necessity. Her family was so poor they could no longer provide for her, and she had to become the dependent of someone else, a husband. She was with this husband until the age of 20. I think she had her last two children with her second husband. About two months ago, her husband was working at his job at a communication company when some men broke in and robbed the business. He was shot three times, suffering life threatening injuries. At the hospital, they determined he needed a series of tests that needed to be performed at a different facility in the city. He was to be transported by ambulance. Jessica rode with him in the ambulance to the testing center. On the way, the ambulance was stopped by armed men. The ambulance driver ran away, leaving Jessica and her severely wounded husband alone. The men forced Jessica out of the ambulance, telling her they were taking her husband along with the ambulance. His body was found in a ditch by the side of the road three days later. She told Tim that leaving her husband in the ambulance was one of the hardest things she has ever done, but she knew she had to stay alive for her children. She never received any answers, any closure about her husband’s death. About 3% of the crimes committed in Honduras are ever solved. The only income for the family is Jessica’s 14 year old son, who has a job in the city. And while there’s a minimum wage, the vast majority of child workers make less than 50% of that, meaning Jessica’s family of 7 are living off of about $20 a week. Her life has been rife with anguish and hardship so unimaginable to me. We built her a house. In comparison to all of the problems in her life, it seems insufficient. More important than the four walls, roof, and floor is the hope, the blessing of just one problem being taken care of by God. It’s a start, a new beginning, the turning point for Jessica’s family. I will probably never be able to conceive what that moment meant to her when she stood in the doorway of her new house (left) but I do know that as I struggle to find the same peace and hope that Jessica sees in her situation, this verse applies to both of us: “We are hard pressed on every side, but not crushed; perplexed, but not in despair; persecuted, but not abandoned; struck down, but not destroyed. We always carry around in our body the death of Jesus, so that the life of Jesus may also be revealed in our body.” 2 Corinthians 4:8-10.

P.S. The group that built Jessica’s house got a huge box of clothes, books, and food together and visited her about a week after her house was built. In the pouring rain in the village of Cataluña, I got to hug a crying Jessica once again, realizing my return meant more than the stuff in the box. I now have Jessica’s number in my phone and plan on calling her soon.

Sunday, June 12, 2011

swarm.

It is a beautiful Sunday morning here in Santa Ana, Honduras! The mountain climate is behaving, which means we have a nice breeze and sunshine. Today should be a relatively easy day, but we never know what's going to materialize by the end of the day.

I can already tell that this summer in Honduras is going to be different from the last. I am in a totally different place in my life, my relationship with God has changed considerably, and I've already gotten used to the crazy everyday happenings that define Honduras life. And yet, God has proven to me already that it is silly to think I won't be affected or learn as much this time around. Case in point....

We spent the day in Nuevo Oriental yesterday. A group from Tupelo, MS and Little Rock, AR have been here all week and took on quite the project for this village. A few days ago they measured the feet of 450 people in the village. yes, 450. They then went to the market in the city and bought 450 pairs of shoes. The project took about 3 days to set up and plan. They were definitely meticulous, with lists of each person they had measured and their shoe size. It is rare that a group attempts such order and precision in a giveaway of this magnitude. Even rarer is successful execution. We gave out the shoes at the school in the village, with rooms for VBS crafts, feet washing (cool, huh?), and the actual shoe handout.

Imagine with me for a minute the stories we hear (or experience, if you're crazy) about the stampedes for a cheap DVD player at walmart on black Friday. Those people quickly become a mob, pushing and shoving so that they can snag and pay for a DVD player. Now imagine 450 people with torn flip flops, toe-pinching loafers from 3 years ago, or bare feet waiting to receive a free pair of brand new shoes. Add to that an uncomfortable cultural lack of personal space, and you have the overwhelming situation that occurred yesterday. I was pulled in immediately to help translate for the registration people. As soon as I sat down, the swarm happened. Showing you pictures of me at the little school desk in the middle of the schoolyard would do nothing, as you couldn't SEE us. We were buried by anxious people wanting their name checked off the list so that they could get their shoes. The names were misspelled, others didn't have the last name, and some just weren't on the list. The chaos was overwhelming, and I actually was afraid that I was going to run out of oxygen. The sun was beating down on us, hundreds of people crammed into a few square feet of space. The words MAS ESPACIO came to my lips quickly, and the volume with it. I was hot, stressed, and in actual contact with fifteen equally sweaty hondurans at any given moment. My words were urgent, desperate, even angry as I tried to convey the need for order. I was heard, but definitely not obeyed. No one had a handle on any of it - before long I was stomping around spitting spanish out of my mouth, trying to stay true to the system.

In order to rescue me and those around me, God intervened. Somehow I ended up with a list in my hand and an instant crowd around me. God lifted the panic and the anger from my heart, even though the situation remained the same. I was able to laugh and joke with the crowd surrounding me, calmly checking names off of the list until the group ditched the whole system entirely and just started handing out the shoes. I know everyone learned a lot yesterday, and almost an entire village received clean feet, socks, and a brand new pair of shoes. Simplicity seems to be key in these projects, but big ideas are ALWAYS worth a shot.

It's difficult to look back on my behavior during the first part of the day. I still see the startled, defensive eyes in response to my questions and my orders. I was fighting, trying to stay afloat amidst the chaos. But the people were fighting too. They were fighting for their toddlers, their mothers, their sisters. Here stood an opportunity for them to have a need fulfilled, and they were NOT going to miss it. I was fighting for the rules. There was a system, an order that in my mind had to be followed, despite everything around me. Thankfully, others were not so bent on the rules so that some "unlisted" children, unable to fight for a pair of shoes, got them anyways. I don't want to fight again. I want to give and love and serve without my shortcomings getting in the way of God's work. Maybe somewhere between days 3 and 56 I'll be a few steps closer than I am now.

Friday, June 10, 2011

I'M BAAAAAAACKKKKKKK!!!!!!!

Three years too late, I am back in honduras!! So begins a two month journey of discovery- of language, God, myself, and the amazing people He is going to put in my path. I will hopefully be updating the blog consistently, as time allows. In the first twenty four hours I have begun to wipe the dust off of my spanish, met a few new amazing people, and reconnected with other acquaintances from three years ago. So here we go! A summer long awaited is here at my feet, and I can't wait to experience all God has prepared for me. Please check back soon - and be patient if it takes awhile to post :)