Sunday, May 27, 2012

Your Face is Just an Airbag for Your Brain

When my mom has health problems, she has a few options to chose from:

1) Call her GP for an appointment
2) Discuss it with her neurosurgeon daughter
3) Discuss it with her gynaecologist daughter
4) Actually get practical advice from her daughter who is a social worker

In this particular scenario, as it was something she associated with her head, she called my older sister (the aspiring neurosurgeon) and explained that she was feeling a little bit off-balance and felt like she was going to trip and fall on her face.  My sister's immediate response:

Oh mom, don't worry about your face! Your face is just an airbag for your brain.

Perhaps the most hilarious part of this advice was the fact that she was serious (just don't tell the plastic surgeons, ENT surgeons, dentists or opthamologists!)  I on the other hand, argued that one's brain is in fact purely an airbag for one's vagina.  Its amazing how often that airbag fails to deploy however...oh well, I suspect I'd be out of a job if it worked all the time.

Friday, March 23, 2012

In Search of Hope

My friend Kate is in Uganda right now, part of an eight-month long pilgrimage around the world looking for good things that are happening in the world 'to fight hopelessness with inspiration' and sharing them in videos on the web. Quite the undertaking! In our adolescent years we were quite close, our relationship based on summer camp, running, and God.  Since then geography and busy lives have come become between us and I can’t say I know what motivates her any longer.

Hearing updates from her remind me of my tired, jaded approach to international development.  Uganda is a country that has both filled me with hope and broken my heart.  I find myself easily criticizing what she’s doing as at best short-sighted and naive, at worst voyeuristic perhaps. Taking stories and giving nothing back. But where does that leave my work?  What’s wrong with focusing on good things?  It is after all something that people want to hear and may even have more impact than stories of poverty and hunger that create a discomfort so profound people tune out and distance themselves.

Back to the shared God that we spent endless hours as teenagers pontificating and theorizing about as we perched on wooden benches by the calm, lapping waters of Pine Lake or alternately discussed as we jogged along the gravel road, past the picture-perfect chapel on the hill nearby in the early mornings.  My theology is centered on Jesus’ solidarity with the poor, crying out for justice in a world of growing inequity and suffering. I’ll admit, sometimes the hope that I claim motivates me gets buried in a witnessed suffering. Maybe Kate is looking more towards Paul’s words: whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is commendable, if there is anything excellent, if there is anything worthy of praise, think about these things. (Phil 4:8)

As I head back to Uganda in just over a week, perhpas I need some renewed hope in all that is good and beautiful and hopeful about engaging with humanity in an unjust world.

Sunday, March 4, 2012

On Being

There we sat, the room lined with orange and beige fiberglass chairs, all nervous, making awkward conversation with those sitting next to us. Most people were in suits, of course, I didn’t own a suit and had certainly never worn one in my life. (Not to mention my mother informed me years later that my acne was terrible…) A young, boisterous guy with blond spiky hair across the room wanted to let the whole room know he was different, he had a fine arts degree you know. Sitting next to me, a skinny Asian kid who appeared to be about 13 turned to me and asked me what I was studying and where I was from. I had just flown thousands of miles from Tanzania for this interview, my head was fuzzy and my guts were churning with nausea and apprehension.

Oh, I’m working in Tanzania right now. I live in a village and mostly work with maternal-child nutrition and HIV education programs. How about you?

He paused…

Um…wow…I just finished my second year of biology at U of A…I’m really good at piano though… 

It seemed his slight frame in its stiff black suit sank ever further into his chair. I felt bad, I’m sure he was a good kid and I sometimes wonder what kind of doctor he turned out to be. Presumably he was a brilliant genius and I’m sure he ended up going to medical school somewhere. The large part of the process of becoming a doctor is about portraying yourself in a certain way, focusing on all the ego-boosting accomplishments you have and saving face at all costs.

The entirety of my interview started with: “Well…this one time in my African village…” Afterwards I felt the pangs of regret of having completely blown the only chance I would ever have at becoming a doctor by boring the interviewers to death with African village stories that had nothing to do with real-life. The truth is that having just spent months and months in Tanzania with no running water, no electricity and surrounded by an overwhelming amount of human need that I was powerless to do anything about gives you an incredibly accurate idea of what real-life actually is. I had done a lot of soul-searching and although I had no suit and bad acne, I knew who I was, what my core values were and what I passionately believed in. The process had made me redefine who I was.  Everything that I had used as a crutch to define who I was had been stripped away and I was laid bare (with a lot of time on my hands) to figure out how to start anew.

Now, over ten years later this year spent in Uganda and Ecuador rings with some of the same truths of redefinition. I nostalgically think back on a time when I was self-aware and so deeply convinced of what my role in the world should be, 'doing' medicine can so easily let us forget those aspects of our vocation.  Although my roles are now very different and I feel I have more to offer on many levels it reminds me that all of life is about who you are, not what you do. In Canada, I am defined as a doctor, a baby-catcher, a joker, a runner, a snowboarder, a hiker, a biker, a church-goer, a wife, a friend, a sister, a daughter. While these continue to be true for the most part, this year I am mostly defined as a foreigner, as different than those around me, wherever I am. After a while this can be somewhat un-grounding, yet it provides a unique opportunity to question what about me is ego and pride and what is really who I am and who I strive to be. It is all too easy to define ourselves by all that we do, instead of just being. Needless to say, a shift in mindset that is easier said than done.  Who cares what you do?  Who ARE you?

Wednesday, February 29, 2012

Spanish Lessons and Pregnancy Culture

Here I am in Machala, Ecuador. What I'm supposed to be doing is MPH courses, designing a grant and writing a publication for my most recent work in Uganda. What I mostly do is go to spinning class, sit around and sweat while I listen to lectures, go running in the early morning, swim on occasional evenings, sweat some more, do dishes, hand wash clothes, sweat, and create fabulous dishes to cook without the use of an oven. Did I mention the sweating?

Trying to make the most of this unique opportunity of living in a rather idyllic mosquito infested swamp I'm taking some Spanish lessons to brush up on vocabulary and grammer. My teacher, Marcelo, used to be a high school chemistry teacher. Before that he studied medicine but had to stop because his wife left him with his two young daughters to take care of and well...studying medicine is expensive. Now he works in mosquito control, spraying for Dengue mosquitoes. He's a nice guy. Mostly we talk about how to describe vaginal discharge, religion, birth control, pregnancy complications and Ecuadorian culture. Its good he's not squeamish about these things.

Today was a contraceptive day and I listed off types birth control which he translated and made cultural comments on. My favourite: "Yeah, mostly its just the pill, the injection and the Copper-T that people use...well, there's also vaginal douches, but only prostitutes use those."

Good to know...

Before my Spanish class I was at one of the local health centers doing what they call 'psycho-prophylaxis' with pregnant women. It appears to be generic women's health education, so I don't know if the 'psycho' is related to the teacher or the patients, anyway... I was told to talk about nutrition in pregnancy, which I did with flare of course (with no preparation...I hadn't gone over that topic with Marcelo yet!) The health center is packed with patients and family members lining up with a garden variety of complaints. A cute, scruffy haired, ripe-smelling 2-year old screamed for most of my talk, and then happily played with my cell phone as he sat his ripe little diapered bottom on my foot. At one point the nurse wanted to emphasize a point I made about the complications of diabetes in pregnancy and having a baby that is larger than normal, she said "See what the doctor is saying? If you eat too much sugar you are condemning your baby to a life of obesity, diabetes, high cholesterol, heart attacks and early death!"

Perhaps not exactly how I would have worded it to a Canadian population...ah, I have much to learn, both language and culture.

Wednesday, February 1, 2012

A Hint of an Existential Crisis

The final hint of tropical moisture was removed from the air with a fine chemical mist as the flight attendants emptied their aerosol cans into the air to sterilize any hitchhiking mosquitoes. As the air-conditioned plane lifted off from the Entebbe airport I felt a mixture of relief, nostalgia and regret. I couldn’t help but feel just a hint of an existential crisis in the residual mixture of emotions left behind after spending August to December in Kampala. Although my expectations may have been unrealistic, on many levels, both personal and professional I question if there was any point to the exercise and whether the balance of good and bad, frustration and hope leveled out to a positive balance. The truth as, looking at the history of ASPIRE, a huge amount of progress has been made this year despite my questions as to the sustainability and local investment. Perhaps my goals for my time in Kisenyi were somewhat unrealistic.

After a few weeks in Europe for some much needed rumination and healing I found myself back at Hopkins, trying to drink in some knowledge from the Public Health fire hydrant. Its always an intense and exhausting experience but I found myself searching for mentors and perspective on how to direct my vocation in a way that will both be personally rewarding but actually contribute in a way other that just catching individual babies. Don’t get me wrong, I don’t need to save live ‘a million at a time’ like Hopkins claims to. As my wise spouse often quotes, “its not important to be important, its important to be useful.”

Sunday, December 25, 2011

Christmas Around the World

Christmas Day finds my family on three different continents, what's new? We're in Barcelona, the sun is shining and the sky bright blue over the Mediterranean Sea. Our Christmas dinner will likely consist of tapas instead of turkey. My older sister is in the midst of an Australian summer while the younger one is on a local boat somewhere on the Amazon between Pucalpa and Iquitos in Peru, a few cows are penned on the boat deck and apparently there was potential for one of the chickens to turn into Christmas Eve dinner! Mom and dad are staying in Calgary this Christmas, celebrating with old friends while my in-laws are having a feast in a brown and snowless Manitoba...what a family it is!

Of course, Christmas in much of the world is very different than the shimmering lights, Christmas markets and designer boots we find ourselves surrounded by here in Spain. I love the public health messaging campaign below about the 'festive season'. The gift of health for Christmas is priceless but as 'cheap' as two doses of antimalarials for some!

Wishing you all the best of Christmases, may you know hope and peace, and share some of it around.

Tuesday, November 8, 2011

Tanzanian Nostalgia

I recently went on a rather nostalgic trip to Tanzania to climb Kilimanjaro (an epic tale told elsewhere). Let me be clear, it wasn’t nostalgic because I’d climbed the mountain so many times before! The truth is, I really like Uganda. It’s a country with a dark and violent past where (for the most part) people have chosen reconciliation over judgment and much about the nation and its people fascinate me. But I LOVE Tanzania, perhaps because I speak the language, I can interact on a different level, joking and teasing. Undoubtedly it is because I spend a very formative year of my life there. Immersed in Tanzanian food, culture, language and families. I will forever think their elephants are larger, their hearts are bigger and their language more beautiful. There’s no questions I’ve left a chunk of my heart there. The nuances of Ugandan work culture and language are to some extent wasted on me. Tanzania was my first African love, I can’t help it!

I miss Tz.