We’re here in Palm Coast, a resort community about an hour from Jax, just north of Daytona, where we arrived to a sundrenched condo and a placid sea about 50m away. Over the next day through today we have been enjoying Tropical Storm Fay with torrential rain, 50mph winds, and high water. Click here for T.S. Fay track. This being my second tropical storm, the first was Dolly in Texas, I’m starting to get the hang of it. This one was birthed in the Caribbean and has travelled the length of Florida only to stall over top of us. The upside is that we are all here and inside having a hoot, eating, drinking and laughing way too much.
We, being the screwball Pendletons that we are, went into the water this morning and promptly got ourselves maytagged. It was fun but the women-wives-inlaws-outlaws on the beach were a little less than enthusiastic about it. I was the last out and must admit between the incoming tide, shore break, big waves and rip tides life was a touch more immediate.
Since the last post we have enjoyed a bona fide vacation with the offspring and “onspring”. It has been special that we have all been together. Our first grandchild, Judah, keeps us all in stitches and we look forward to more in the next several years. The time has been punctuated by loads of laughter and good natured ribbing. It’s been hilarious to hear from the in-laws about the seldom seen sides of the offspring Pendletons
I’ve gained about 10 lbs. and so what. I remember the last 200fr I did in Houston and probably that will have to do for awhile. We have been given a house to live in Gabs so the transition will be much easier than if we lived in and out of several flats for a month.
For now, Lynne and I will enjoy the company, both human and meteorological, and then head for the next chapter in our lives, as ready as we can be, in three days.
Thursday, August 21, 2008
Friday, August 15, 2008
So whats been happenin' the last li'l while?
Been in Texas, takin’ a course, learnin’ to talk Texan.
Lynne and I bade farewell to our beloved Columbia Gorge and drove through central Oregon to Burns, then on back roads (way back!) to Twin Falls, ID then through Utah onto Dillon, CO where we saw my sister Jan and her husband Bob. Then to Denver where we stayed with our daughter Bethany for a couple of days. Then drove down the eastern Colorado border to the Texas panhandle and ultimately to Houston. Most of our travel was on "blue highways" through stressed rural towns many of which had strip malls at the outskirts and a decaying central core.
In Houston Lynne flew to visit family and I began a month long class with Baylor International Pediatric Aids Initiative. They are in several places in Africa, including the same medical campus in Botswana where I'll be based. The class was "Tropical Medicine and HIV, Lite" (my name for it). The information came at this aged learner at a pace that required much studying and time in front of my laptop, and was invaluable.
All the Baylor folks, indeed all the Texans I met, were genuine and welcoming. The medical campus in Houston is the largest in the country comprising innumerable hospitals, schools, and clinics of various specialties, all of which are able to make a financial go of it.
The class attendants were all BIPAI docs save three of us auditors. We were welcomed at any and all activities and received the same material as if we were enrolled. The BIPAU program is extraordinary and the physicians (almost all of them newly minted from residency in Peds) were all very bright.
To clear my head I volunteered with Habitat for Humanity and pounded nails for a couple of Saturdays. There is a measure of extreme satisfaction that is rare in medicine when you show up for work at 7:30am and frame an entire house by quitting time at 12 noon. I would drive home drenched in sweat with a novel sense of fulfillment.
Forrest flew to Houston on the last day of class and we drove together to Jacksonville, FL where he and his family are currently stationed. We stoppped in Mobile and gorged ourselves on barbeque (in the South barbeque is a noun as well as a verb).
Now for an all too brief family reunion at the beach and then on to Botswana on the 24th.
Lynne and I bade farewell to our beloved Columbia Gorge and drove through central Oregon to Burns, then on back roads (way back!) to Twin Falls, ID then through Utah onto Dillon, CO where we saw my sister Jan and her husband Bob. Then to Denver where we stayed with our daughter Bethany for a couple of days. Then drove down the eastern Colorado border to the Texas panhandle and ultimately to Houston. Most of our travel was on "blue highways" through stressed rural towns many of which had strip malls at the outskirts and a decaying central core.
In Houston Lynne flew to visit family and I began a month long class with Baylor International Pediatric Aids Initiative. They are in several places in Africa, including the same medical campus in Botswana where I'll be based. The class was "Tropical Medicine and HIV, Lite" (my name for it). The information came at this aged learner at a pace that required much studying and time in front of my laptop, and was invaluable.
All the Baylor folks, indeed all the Texans I met, were genuine and welcoming. The medical campus in Houston is the largest in the country comprising innumerable hospitals, schools, and clinics of various specialties, all of which are able to make a financial go of it.
The class attendants were all BIPAI docs save three of us auditors. We were welcomed at any and all activities and received the same material as if we were enrolled. The BIPAU program is extraordinary and the physicians (almost all of them newly minted from residency in Peds) were all very bright.
To clear my head I volunteered with Habitat for Humanity and pounded nails for a couple of Saturdays. There is a measure of extreme satisfaction that is rare in medicine when you show up for work at 7:30am and frame an entire house by quitting time at 12 noon. I would drive home drenched in sweat with a novel sense of fulfillment.
Forrest flew to Houston on the last day of class and we drove together to Jacksonville, FL where he and his family are currently stationed. We stoppped in Mobile and gorged ourselves on barbeque (in the South barbeque is a noun as well as a verb).
Now for an all too brief family reunion at the beach and then on to Botswana on the 24th.
Career in medicine, 2.0
Greetings,
This amounts to my maiden voyage in blogging and as such is probably best viewed as a work in progress at several levels. As I am determined to become a faster and more accurate keyboarder, these postings should improve with time and of course with adventure!
Many of you have heard what follows before. As it puts things into perspective for me, and hopefully you, I'll repeat it so as to give credence to the notion that I'm neither totally off my rocker or suffering from premature dementia.
In the Spring of 2006 I went to South Sudan with Doctors Without Borders, known as "MSF" everywhere else in the universe. I was posted in a heavily stressed part of the African sub-Sahara. During a particularly difficult week when I had lost 9 kids in two days I found myself on the airstrip cussing at God and anyone else who would listen. It was there that I had a life changing moment. I was struck by how little our presence made a true difference. Sure, the people that we treated might have died in our absence but any legacy that we had there would vanish with our departure. MSF was teaching nurses in a formal course setting, and the head nurse of the area was teaching as well. But I, the physician, was sprinting through rounds to prepare for that day's onslaught of new patients and wasn't teaching and thus demonstrating any confidence in the capability of my Sudanese colleagues.
Rounds then went from 2 hours of pressured, superficial evaluating and ordering to all day. The staff, the best of whom had had two years of post secondary education, were highly variable in capability, dedication, and training. As difficult as it was for this white, middle class, male physician to even appear to cede control of "his" patients, the staus quo was of little long term benefit to the Sudanese. On the departure of MSF the mortality rate would rise to baseline, morbidity would rise as the MSF initiated immunization programs would cease. The only true measure of the presence of any western NGO would be the deep water wells in the area courtesy of OXFAM and the agricultural projects being taught by another NGO across the airstrip from MSF's compound.
All the nursing staff was male as women did all the domestic work including the raising of crops, building and maintaining the homes (tukuls), livestock husbandry and the like. Rounds became full of jocular humor, teaching, re-teaching, re-re-teaching, and constant searching for the most appropriate way to inform, cajole, lead, shove....And it worked.
Four months later, as I was preparing to leave, I was informed by MSF that my replacement wasn't coming until two weeks after my departure. Thankfully we had a great expat nurse who could coordinate things but I and MSF were definitely leaving the staff in a bind. On my last day, as the plane was literally circling the strip, I was out at the hospital (a series of three tents located 2.4 km from the living compound and the air strip) and entered the ICU only to find it on its ear. Many of the cots were sideways and there was detritus everywhere. I erupted. Once I took a breath the nurses explained to me how they had admitted two patients with malaria and anemia, had found donors and typed their blood for transfusion (which is where I would have become involved at any time of day or night) and then transfused it. They had also admitted two other kids with pneumonia and started appropriate treatment and compassionately supported a neighborhood child (my dear Nybol) and her family as she died from sepsis. I was stunned and moved beyond anything I had experienced in my career.
On my return to Oregon I decided to look into spending the latter third of my medical career in a developing nation teaching and treating. As I was decompressing and adjusting to medical life at home a letter came in the Spring of 2007 that invited me to consider teaching medicine in Botswana, not exactly a "developing" nation but one on the cusp of entering the first world. The program was sponsored and funded through the University of Pennsylvania, my med school alma mater. As Lynne had made it clear that we weren't going to be separated for six months again and since she hadn't been out of the country (well, Puerto Rico for two weeks) this sounded like a fantastic idea. I visited there in the Fall and was sold. And here we are, on our way.
This amounts to my maiden voyage in blogging and as such is probably best viewed as a work in progress at several levels. As I am determined to become a faster and more accurate keyboarder, these postings should improve with time and of course with adventure!
Many of you have heard what follows before. As it puts things into perspective for me, and hopefully you, I'll repeat it so as to give credence to the notion that I'm neither totally off my rocker or suffering from premature dementia.
In the Spring of 2006 I went to South Sudan with Doctors Without Borders, known as "MSF" everywhere else in the universe. I was posted in a heavily stressed part of the African sub-Sahara. During a particularly difficult week when I had lost 9 kids in two days I found myself on the airstrip cussing at God and anyone else who would listen. It was there that I had a life changing moment. I was struck by how little our presence made a true difference. Sure, the people that we treated might have died in our absence but any legacy that we had there would vanish with our departure. MSF was teaching nurses in a formal course setting, and the head nurse of the area was teaching as well. But I, the physician, was sprinting through rounds to prepare for that day's onslaught of new patients and wasn't teaching and thus demonstrating any confidence in the capability of my Sudanese colleagues.
Rounds then went from 2 hours of pressured, superficial evaluating and ordering to all day. The staff, the best of whom had had two years of post secondary education, were highly variable in capability, dedication, and training. As difficult as it was for this white, middle class, male physician to even appear to cede control of "his" patients, the staus quo was of little long term benefit to the Sudanese. On the departure of MSF the mortality rate would rise to baseline, morbidity would rise as the MSF initiated immunization programs would cease. The only true measure of the presence of any western NGO would be the deep water wells in the area courtesy of OXFAM and the agricultural projects being taught by another NGO across the airstrip from MSF's compound.
All the nursing staff was male as women did all the domestic work including the raising of crops, building and maintaining the homes (tukuls), livestock husbandry and the like. Rounds became full of jocular humor, teaching, re-teaching, re-re-teaching, and constant searching for the most appropriate way to inform, cajole, lead, shove....And it worked.
Four months later, as I was preparing to leave, I was informed by MSF that my replacement wasn't coming until two weeks after my departure. Thankfully we had a great expat nurse who could coordinate things but I and MSF were definitely leaving the staff in a bind. On my last day, as the plane was literally circling the strip, I was out at the hospital (a series of three tents located 2.4 km from the living compound and the air strip) and entered the ICU only to find it on its ear. Many of the cots were sideways and there was detritus everywhere. I erupted. Once I took a breath the nurses explained to me how they had admitted two patients with malaria and anemia, had found donors and typed their blood for transfusion (which is where I would have become involved at any time of day or night) and then transfused it. They had also admitted two other kids with pneumonia and started appropriate treatment and compassionately supported a neighborhood child (my dear Nybol) and her family as she died from sepsis. I was stunned and moved beyond anything I had experienced in my career.
On my return to Oregon I decided to look into spending the latter third of my medical career in a developing nation teaching and treating. As I was decompressing and adjusting to medical life at home a letter came in the Spring of 2007 that invited me to consider teaching medicine in Botswana, not exactly a "developing" nation but one on the cusp of entering the first world. The program was sponsored and funded through the University of Pennsylvania, my med school alma mater. As Lynne had made it clear that we weren't going to be separated for six months again and since she hadn't been out of the country (well, Puerto Rico for two weeks) this sounded like a fantastic idea. I visited there in the Fall and was sold. And here we are, on our way.
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