Thoughts on the Journey & Settling In

As most of you know by now, after 36 hours of traveling, I made it safely to Eldoret on Friday morning. Thankfully, my apprehensions and worst “what if” scenarios never came to pass (I was more than a little anxious about traveling alone this time around), and the journey was blessedly uneventful. The only glitch (not even that, really) was that the hotel originally booked in Nairobi had to be changed last minute, as Friday also happened to be a national holiday to celebrate Kenya passing its new constitutional referendum. What that meant on Thursday night when I got in was that most major roads were closed; and not just closed, but with mega-police barricades and guards. Of course this also meant the roads around the hotel I was originally to stay in. But, the new hotel was fine, and my driver got me back to the airport in plenty of time Friday morning to make my flight to Eldoret.

Since arrival, I’ve found myself settling into the rhythms of Kenyan life quite easily. Granted, it’s convenient that I arrived on the first morning of what turned out to be a three-day holiday weekend. As I’m now a resident, I’ll be staying at IU house for the full two months while I’m here instead of the student hostel. Part of me is glad to be closer to the more modern conveniences (internet, warm showers), but part of me also will miss that very rich experience I had of living as Kenyan medical student for two months, not to mention the wonderful friends that I made. A large group of IU students and residents went to Kakamega Rainforest this weekend, so IU house has been very quiet, relaxed, and peaceful, which is precisely what I wanted.

I’ve already met a new cast of characters who will feature prominently in my tales of Kenya this time around; a few oldies but goodies; mostly new faces though, as I realize I’ve been gone for a full three years. They will all be introduced in due time, but I will say that after only two days here, I am already amazed at who you may meet halfway around the world, and how much you might find you have in common with them.

I’ve also recently been contemplating what exactly I expect from this second (and not last, I am sure of that) visit to Kenya, and the simple answer is that I’m not quite sure. Well, at least I do have a general idea, but I know that as clear as my memories seem after three years, I have selectively blocked out a portion of things that were not so great the first time. Not to mention that it has been three years; years that have seen significant violence & tribal tensions as well as the recent passing of the constitutional referendum. I’m sure there have been physical changes to the city, hospital, and even IU house (some of which I have already seen), not to mention the innumerable ebb & flow of people that have since come and gone from IU house & MTRH.

The discussion of this experience as similar yet also different would not be complete without mentioning that I, too, have changed a great deal in the past three years. Anyone who has ever known a resident even a little bit could tell you that the three-to-five year process changes a person enormously. Acute on chronic sleep deprivation & seeing some of the worst that our society has to offer has made me more cynical, bitter, impatient, and skeptical (this coming from someone already with “glass half empty” tendencies at baseline.) On the other hand, all those hours of lost sleep, split second decisions, heart-rending 2AM conversations with families, and seeing the best of what our society has to offer has also made me more assertive, confident , compassionate, and a better leader. It is the latter qualities I hope to bring with me my second time through MTRH.

If the reasons for coming to Kenya in the first place were complex, the reasons to return a second time are even more so. Every person is different, but for me it’s a mixture of curiosity, adventure, and love; and largely a true sense of calling that I haven’t felt since first applying to take the MCAT & go to med school. While I always hope to give more than I get, I can’t help but hope that the next two months will be extremely restorative to me; a chance to get back to the basics of patient care as caring FOR patients, not simply taking care of THINGS for patients. As physicians, and residents especially, we are daily overwhelmed with an inexorable line (a tidal wave, really) of admissions, daily notes, medication reconciliations, discharge paperwork, faxing, phone calls, dictations, prescriptions…. And the list goes on. (As my dear friend Mandy recently told me: “I usually try to think of my ‘to do’ list as more of a wish list.”) While some would argue this is actually all a part of patient care, I would return that for the last six months or so, I have spent 60-70% of my days at work doing the former, while only 20-30% of my actual physical time in a hospital is spent in my patients’ rooms. While I will leave the current state of our healthcare system for a future discussion, I do sincerely hope that the next two months will re-remind me of why I wanted to be a pediatrician in the first place. You don’t have to talk to me for very long to know that I am simply… tired. Intern year was a harsh introduction into residency life, sleep deprivation, and missing my family, 2^nd year had its utterly disheartening moments, and the last six months have held truly some of the most difficult moments of my life. Part of the reason for coming to Kenya so early in 3^rd year was because I knew I would need a break, a refresher of sorts. It is my sincere hope that Eldoret once again will refresh me, recharge me, and remind me of that deep inner calling to medicine I felt those many years ago, as it did the first time I was here.

And of course, the most important and exciting reason that this time will be different is that Mike will be joining me in 3 short weeks. The expectations we have of this time together in Kenya truly cannot be put into words. All I can say is that I’m sure we will both grow a great deal individually (and together) in a short period of time. His job very graciously gave him a month of leave to make the trip, so he will be working on a variety of projects, mostly with S, the PharmD from Purdue who lives in Eldoret full time & manages the pharmacy exchange side of things, not to mention about 50,000 other projects. (Some of you will remember him from Blog v. 1, he definitely falls into the “oldie but goodie” category). Speaking of blogs, I would be remiss if I didn’t mention that aforementioned Husband will also be keeping a blog. If you’ve made it this far and actually want to keep reading, check it out here: http://the-world-is-calling.blogspot.com

Until next time, Faithful Readers.