Jenna Beth Marie Estrada?

Well, I’ve been officially adopted by a Guatemalan family. Just like the Ereaux’s in Montana and the Gomez’s in Chile, now I’ve got the Estrada’s in Guatemala.

In a recent post I mentioned that Dra. Estrada (Wendi) had invited me to spend the Day of the Dead weekend with her family in Xela. We arrived at her house late Friday afternoon and spent the evening just generally lazing around and getting acquainted. Her father works as an engineer for Gallo, Guatemala’s national beer company, and her mom’s a school teacher. She’s got two younger brothers: Manuel, who’s my age and a medical student at the San Carlos University in Quetzaltenango, and Elimas, who’s 14. From the very beginning I could tell that they’re all just genuinely good people, and the dynamic reminds me exactly my real family.

The Estradas are very outdoors-y, so their idea of showing me around Guatemala’s second biggest city was escaping into the surrounding mountains, which is fine with me. We got up early Saturday morning and went on a rather vertical hike up a volcano, then straight down into the crater at the bottom. After erupting several thousand years ago the crater filled with a beautiful, crystal-clear lake, which is a sacred Mayan site. Visitors are welcome to come and enjoy its beauty, but no one’s allowed to enter the water. Mayan priests perform religious ceremonies along the water’s edge, where we saw burnt and wilted carnations lying along the bank; remnants of a recent ritual.

It was a somewhat vigorous trip, but wussing out wasn’t an option. Wendi’s dad, (also named) Elimas, assured me time and again that this was nothing compared to the Santa Maria volcano, which they’d be taking me up next. For most people the trek up Santa Maria is an all-day affair, requiring an overnight stay before coming back down. For Elimas, who’s closing in on 50 trips up, it’s to the top and back before noon. Just trying to keep up with these guys will get me back in shape!

After our morning hike, we went back to the house to eat heaping plates of the traditional Day of the Dead meal, fiambre. The dish is essentially a giant platter of meats, sausages, cheese, flavored hot dogs, meat, cow tongue, intestine, sliced meat, a (very) few vegetables and a bit of meat on the side. Any of those readers familiar with my dietary habits will appreciate how I felt about this. I don’t specifically object to meat, but it’s far from my favorite choice of foods. Unfortunately, since I have a general rule of always participating to the fullest when given new cultural opportunities, I didn’t have much choice beyond digging in with the fam. It didn’t help that their overflowing hospitality ensured that the honored guest (ahem, me, of course) was served the largest and most lavish plate. Gag. Actually, it was kind of funny – in order to ensure that I got a full fiambre experience, Wendi’s mother Isabel had me arrange one of the platters. Thinking that I was preparing my own dish, I was very careful to artfully arrange my plate in order to appear as if it was heaping with meat when, in fact, it was mostly vegetables. Much to my dismay, this crafty trick was foiled by Isabel’s superior hostess skills. As we sat down to eat, she made a great show of presenting me with a dish twice the size and with at least three times the meat as my own humble assortment. Curses!

Of course, I had no choice but to act completely and totally delighted with the distinctively Guatemalan meal. Sadly, that means that the entire Estrada family is now convinced that I’m an absolute meat fanatic, and will probably never believe that I’d much prefer not to eat dead animal.

After the fiambre we headed out to the Xela general cemetery, where festivities were in full swing. We wandered through the street fair which was set up outside the entrance, buying treats like Guatemalan-style marzipan and drinking warm sweet corn atol. We visited all of the family’s difuntos, admiring the graveside decorations and watching kids flying their kites over family plots– a symbolic way of communicating with the heavens.

Xela’s much colder than the lowlands of Mazate or even the mountainous Santo Tomas. The weather was exactly what you’d expect of Oregon in November – cold, with a drizzly rain gently dampening the atmosphere. I felt right at home. Night falls early in Guate, around 6 pm. As the evening turned dark we went to the city’s old plaza, where the remains of a colonial cathedral form an elegant façade for the newer building, rebuilt after an earthquake destroyed the original. We had Mayan-style hot chocolate – rich, almost spicy, and with a thick creamy foam on top – on a terrace overlooking the city’s historic center. That night, since we’d all filled our little bellies on cow intestine and blood sausage (again, gag.), we dined on the distinctive Quetzalteca parches. Although similar to the tamales served in other parts of the country, cooks in Quetzaltenango make their tamales with a masa (dough) of either potato puree or coarse ground rice flour. Everywhere else it’s tortilla dough – pure ground corn. Saturday was a very typical Guatemalan day, in every possible way.

Sunday, then, was themed a bit differently. On the road between Xela and Mazate is a giant theme park, the IRTA complex. Half of the park, Xocomil, is just like a Six Flags. The other half, Xetulul, is an elaborate water park with all of the slides, pools and artificial rivers which you’d expect to find in any American water park. Indeed, I saw in the newspaper the other day that Xetulul recently received an international honor from and American theme-park evaluation organization (such things exist?) for its general awesomeness. I’ll vouch for their designation: it was a blast. We spent the entire day climbing stairs and shooting down slides, getting slightly sun burnt and generally have a fantastic time. Isabel was a riot – she was ahead of us “kids” every time, literally running up the stairs to secure her spot at the front of the line.

Sunday evening Wendi, her husband Carlos (who’d met us at Xetulul after working an overnight shift at the hospital) and I went back to Mazate, where I stayed the night in their home. Before we left, the entire family emphatically expressed the fact that I was now an Estrada, and I needed to plan on coming to visit them again soon. I’d had a great weekend, so it was no chore assuring them I’d be back.

I didn’t realize at the time how soon they intended to see me again.

Saturday, I did a 24 hour shift with Wendi at the hospital. It was pretty slow –one cesarean, and I delivered a baby, but other than that it was a lot of sitting around. However, while we were at the hospital Isabel called, inviting me to join along on their upcoming family excursion. The next day, Sunday, they were planning on visiting her parents and sisters in Coatepeque (Co-ah-teh-peh-k). Since I didn’t have any better ideas for spending my Sunday, I agreed to tag along. I thought we’d just swing by, say hi, and come back to Mazate. Instead, we hung out for several hours, eating a delicious caldo de mariscos (seafood stew) prepared by Isabel’s sister and visiting the city’s expansive Sunday market in a fruitless, albeit exhaustive, search for curtain material.

I fell asleep in the car on the way back, and was somewhat surprised to awake in Xela once again. I’d been kidnapped! Turns out they’d decided that Wendi and I would spend the night in Xela, and head back to Mazate early in the morning. Once again I spent the night with the Estradas, feeling even more at home than the first time.

The funniest part of it all was when I mentioned the fact that I need to leave the country this month, in order to renew my tourist visa. I’d sort of assumed that I’d take a solo trip somewhere for a few days, probably to El Salvador or Honduras. The Estradas, however, were totally opposed to the idea. In order to avoid me spending a few days traveling alone, they actually offered to take a weekend trip to Mexico with me – the whole family! To be honest, I’m not sure what to do about it. I feel like there’s no greater definition of being imposing as a houseguest than prompting the entire family to leave the country for a weekend. It doesn’t help that I have no doubt they’d insist on paying for everything. I’d really feel quite uncomfortable accepting such a generous offer. However, they did come up with the idea, with out any sort of suggestion or anticipation from me at all, so they must not feel like it’d be a huge inconvenience. On the down side, I think that the weekend they’d want to go is the same weekend as a big medical conference here in Suchi. We’d probably take of Friday night, which is the closing ceremony, and it’s supposed to be a great big party with dancing, live music, an open bar, oh, and, er, lots of medical knowledge flying around. I’m thinking I may just run off to El Salvador or Honduras this weekend, but if I don’t get around to it I’ll consider their offer.

Other than that, things are pretty routine. I’m continuing to go to the hospital, plugging away on my med school essays and drinking lots of fresh fruit licuados. Nispero’s in season, and anyone who’s a long-term reader of this blog (reach waay back, to my Easter Island trip…) will understand how ecstatic that makes me. There are also plenty of jocote, a strange little fruit with a giant pit and a juicy bitter -sweet meat, strawberries, bananas, blackberries, pineapples, watermelon, grenadines, papaya (yuck) and apples galore. The only thing missing for total fruit paradise is an abundance of mangos, but we had that when I got here so I can hardly complain. Theoretically cherimoya (called anona here) should be coming into season any time now, so that should more than make up for anything lacking.

So. That’s my vida of late…sorry my descriptive journalism skills are somewhat sliding by the wayside, but I assure you that the lack of creative free time is good for my mental well-being. Once school starts up again, I wouldn’t be surprised to find a few more elaborate descriptions finding their way onto this blog…

Dia de los Muertos

This Just In

Kurt Vonnegut = Fantastic

Obligatory Foreign Country Market Shots

Mercado de Santo Tomas

(This is a slideshow, btw. Click on the picture for more...)

It's about time for some of these, right?

This weekend are two big Guatemalan holidays -- Dia de los Muertos y Dia de Todos los Santos. We don't usually have market on Fridays, but in preparation for the holidays there was one today, and I decided to take advantage of the unusual abundance of flowers. Tomorrow and Sunday these will be blooming all over the Santo Tomas Cemetary. I, however, will be in Xela (aka Quetzaltenango) with Dra. Estrada, who invited me to come meet her family and celebrate the holiday with them.

Takalik Abaj

Photos!

Takilik Abaj

More Hospital Adventures

Sunday, October 26, 2008

Well, bummer. This was going to be a really happy blog post about how nice of a day I just had. However, as I was moving my laptop from one room to another, so I could settle down and type all about my adventures, a power cord got caught in the doorway and my poor old dinosaur contraption of a computer went tumbling to the floor. It appears to be mostly functioning, although a wide blank band down the middle of the screen makes viewing a challenge at best. I’ve been struggling with this antique model, nursing it along like an adult child refusing to let their poor, sick old parent just get on with it and die, for some time now. I’m pretty certain that this is going to be the last straw – the pneumonia infection that’ll do in my bedridden PC. I’d kind of like to cry right now.

The purpose of that preface is twofold: primarily, I’d like to generate some outside sympathy. I feel pretty darn sorry for myself right now, and I’d like to feel as if someone else was sharing in my misery. Secondarily, it’s to apologize for the damper which has now been placed on what otherwise promised to be an upbeat entry.

To begin with, I’d like to explain what I’ve been up to lately. I haven’t been writing about my activities for a few reasons. I’ve finally found something to do that actually fills up my time and is fulfilling, two very important things which I’d quite honestly been missing previously. I’m continuing to go to the hospital in Mazate very regularly, and have been helping out around the clinic where I can. At the hospital, I’m making friends with new doctors all of the time (there seems to be a never ending supply of them, each one introducing themselves with all four names of their names – “Silvana Margarita Hurtado Garcia”, which makes remembering who in the world they all are an anti-Alzheimers brain exercise. I’ve developed a cheat-sheet with descriptions like “the bald guy with lots of nose hair,” “the fat sweaty really nice lady” and “Mr. Big Bushy mustache” to help me keep them all straight.)

On the 17th I very briefly met a very nice young lady doctor who invited me to do a “turno” – an overnight shift -with her the coming week. Even though I barely knew her at all – by chance, I ended up helping her do a hysterectomy on a woman with endometriosis, but that was all the contact we’d had – I agreed to come. By the time Tuesday rolled around I was somewhat regretting my decision. I was afraid it would be terribly awkward, sitting around the hospital trying to make conversation all night long with a woman I didn’t even know.

I went anyways, since I’d said I would, and couldn’t be happier that I talked myself into it. Doctora (Wendi) Estrada is a wonderfully sweet lady, just a few years older than I am, and not long out of medical school. She’s actually invited me to spend Día de los Muertos with her family in Xela this weekend, and I’m planning on going. I felt pretty much instantly comfortable working with her, and I was at the hospital for barely an hour before the surgeries started. We entered the operating room around 6 that evening and I didn’t leave until long after midnight. I started doing two cesareans with Dra. Estrada, then she switched out and one of the other on-call doctors, Dr. Delgado, came in and together we did two more. After that Dr. Javalois (yet another on-call surgeon) and I did an appendectomy. Finally, around 1 am, we got around to setting a broken bone on a boy who’d been waiting since we started pulling babies out of bellies.

One of the cesareans I did with Dr. Delgado really was a case study for me in what’s most lacking in heath care here. The doctors seem to be wonderful, well-educated and incredibly innovative. They are (at times) terribly limited in terms or supplies and diagnostic tools, yet they very clearly know exactly what they’re doing. Two weeks ago, for example, I watched a Whipple Procedure, one of the top most “major” surgeries a person can have. Technically, it’s called a pancreatoduodenectomy, and it consists of the removal of major parts of the stomach, the pancreas (total or partial) and the entire duodenum. It’s a curative response to a specific gastrointestinal adenocarcinoma (stomach cancer.) This surgery is such a big deal because it requires an enastomosis (simply put, reattaching the plumbing) of the stomach, bile duct and pancreas. Every time you have to totally sever a set of biological pipes and then totally reattach them, in hopes that they work well the next time you flush the toilet – er, eat some food, in this case – you’re taking a major risk. Unfortunately, plumber’s tape and that nasty stinky neon blue PVC pipe glue don’t do the trick here, and all sorts of outside organisms are given a chance to enter what should be a totally closed system. Fistulas, or, in non-doctor speak, giant gaping hole infections, are enemy number one in these cases. As one of the surgeons explained to me while we were in the operating room, the top of the list of riskiest surgeries is as follows:

1. Liver transplant
2. Whipple procedure
3. Heart transplant

That should give you an idea of how big of a deal it is. And yet, here we were in the dilapidated little Mazatenango National Hospital, elbows deep in intestine, sweating up a storm (since we’re only allowed to use the A/C every once in a while, to save on energy bills) and b.s. ing about everything from American politics to my boyfriend (everyone’s favorite topic of conversation, it seems). The doctors explained to me quite frankly that most American doctors would think it was crazy to do this surgery in these settings, but that they were quite confident that good surgical technique was the number one most important factor in making it a success, and they could supply that much. Sure enough, the woman is recovering just fine.

On the other hand, take the example of what happened during one of the C-sections with Dr. Delgado. This particular patient had been pushed ahead of several other waiting procedures when the fetal heart rate dropped dangerously low. We wrestled the little cabezon (they’ve got some great ways of modifying words in this language. “Cabeza” is head; the “-on” suffix means “very large,” so when you call a baby a “Cabezon” it means they’ve got a giant head. Spanish lesson of the day.) out of her mommy’s belly and could see right away that she had some problems. There were certain physical features which were not quite right, like the placement of her ears abnormally low on her head, and very large wide-set eyes. She didn’t cry out immediately, nor for the first several minutes of her life. The doctor told the waiting nurse to get her out of the surgery room and into the incubator, with oxygen and a fast-running IV, and to be quick about it. Not fully understanding what was going on, the nurse ambled out of the room with her charge, and the baby didn’t get much of the attention it needed until several minutes later when one of the other docs came in and took over.

It was evident very quickly that this little neonat needed to be admitted to the peds ICU, but that created a major inconvenience. The people responsible for getting her ready for admission, filling out the requisite paperwork, taking her over to the other ward, putting her on a respirator (which didn’t end up happening, actually, since there weren’t any available), and handing the case off to the on-call pediatrician were all the exact same people in charge of keeping the operating room functioning. This meant that admitting the patient would require a halt in the evening’s surgeries, which were already stacking up.

We closed up the mother and went to see how things were going with her daughter. Eventually mom was wheeled out and left in the middle of the operating room staging area, uncovered and shivering as she recovered from anesthesia, confused and uninformed about the status of her child. Meanwhile, the doctors worked to establish an umbilical IV and made phone calls around town attempting to locate a working respirator.

Generally speaking, I think that the place most in need of growth here is in nursing. A well-trained nurse would have understood that this baby needed special care, would have explained to the mother what was going on while the doctors ran around frantically, would have covered the patient following anesthesia. Clearly, too, we needed more than the people who were on hand, since the same nurses (not anesthesiologists) who are running the anesthesia machine all night have to also act as a neonate ICU team.

I’ve always thought that nurses have an important job, but now, working in an environment where good, knowledgeable and dedicated nurses are the minority that’s even more clear. Sadly, in Guatemala there’s no uniform training program, nurses are terribly underpaid and those who do take it on are horribly overworked. Most of the people providing direct patient care are “enfermeras auxiliares” or “paramedicos,” people who’ve completed a 10-month training program at a “nursing school.” However, there’s not a set accreditation program for these schools, and the amount of training varies wildly. Even then, there are not nearly enough of them to cover all of the jobs which need to be done.

Don’t get me wrong; there are certainly very good nurses who have years and years of experiences and are very dedicated to their job. However, there are also plenty of people who just don’t have the background to know what they’re doing or how to do it right. That’s not to imply that I do, either, but I have noticed serious deficiencies. I have a much greater appreciation now than I did before for the indispensible nature of our nurses at home.


Tuesday, October 28, 2008
As I write this I’m coming off of my insomniac’s hangover resulting from another night shift with Dra. Estrada. This time we got significantly less sleep than on my first turno. I started out doing a D&C, then a cesarean with Dra. Estrada, followed by an appendectomy with Dr. Javalois; warm-ups for what was to come. Around 9 pm we entered into surgery on a woman who’d been shot while selling ice cream in the park in Cuyotenango. Not a place I’ve ever been, and now a place I don’t have much desire to conocer. The bullet had entered on her left side mid-way down the ribcage, and angled sharply up to a final resting place below her right breast. Luckily it was pretty superficial by the time it reached her right side, and didn’t enter the thoracic cavity. Not that this little advantage mattered much; the bullet had managed to wreak havoc through her abdominal cavity. Dr. Javalois, Dra. Estrada and I spent nearly five hours digging through tripa (guts), tediously trying to first localize the major problems and then repair them. Lying on the table, before Javalois sliced in, her belly looked distended and tight. Sure enough, upon opening her up bloody fluid and coagulated blood gushed down her sides, soaking the drapes and our surgical gowns alike. (If you’re cringing right now, perhaps you understand why I haven’t been writing regular blogs about my experiences at the hospital. They’d all include similar descriptions – “…as I pulled my gauze pad away from the man’s gunshot wound, I was startled to see brain matter clumping to the bandage, looking like the offspring of old cottage cheese and a death certificate…”)

That dramatic beginning was indicative of the mess we’d jumped into. Lead had ripped through her liver, prompting a constant leak of blood which was nearly impossible to address. The liver has a texture similar to a waterlogged sponge, and putting hemostatic sutures (stitches designed to create pressure and stimulate clotting, to stop blood flow) is a tough proposition, since the tissue isn’t designed to hold tension like that. After we at least slowed the flow of blood from the liver we moved our way across the upper half of her abdomen, discovering a semi-vaporized pancreas which was removed after numerous unsuccessful attempts to cease its hemorrhaging. Zigzagging back across, we next encountered a leaky, multiply-perforated duodenum which needed mending. Going down a bit farther we learned that her left kidney hadn’t been spared from destruction, and also needed removing. (Which I found particularly disappointing, since the kidneys are my favorite organ, in case you were wondering.) Through all of this a mounting stench was permeating the OR, festering in the heat and causing us all to feel slightly nauseated. Sure enough, our next discovery was a perforated bowel, leaking fecal-esque material everywhere, and requiring a colostomy. Somewhere in there we removed her spleen, too, although I don’t honestly remember when.

We finally finished around two a.m. All of us were beat, and thanks be to God the cesarean that followed was quick and easy.

I made it to bed around 3:30, and didn’t waste much time dozing off. We got up around 7 for another cesarean, a breach baby with a huge head which we nearly popped off while trying to wrench it out of the uterus. (Don’t worry, that’s a joke, not a medical evaluation of the situation.)

Our gunshot wound patient died a few hours after we finished surgery, a fact which surprised absolutely no one. I feel terrible for her family, but also fortunate to have had such a fascinating and comprehensive surgical experience. I hope that doesn’t seem like a cold-hearted statement, because I certainly don’t intend it as such. However, the truth is that I barely even noticed the five hours flying by. I was totally engrossed in what we were doing, fascinated by Dr. Javalois’ skill and expertise (he worked for the military during the civil war, so he’s done this a time or two) and, as always while at the hospital, growing steadily in my excitement for being a doctor myself one day. Seriously, guys, it’s going to rock.

On another note, this weekend the sisters had a meeting in Retalheulu (just say Reu; no one actually knows how to pronounce that other crazy compilation of letters). On a coffee finca near(-ish) to the city they discovered a ruins site 20 years ago. The site, Takilik Abaj, is particularly cool because it’s a mix of Mayan and Olmec work, the only one of its kind known. It’s over 2,000 years old and still relatively un-discovered; archeologists are very actively researching and excavating. I rode with the sisters to Reu and then took a series of buses and pick-up trucks to the ruins while they were off discussing ecclesiastical matters. The weather was absolutely beautiful – it reminded me of one of those rare gems of an Oregon coast summer day in July, where all you want to do is grab a tractor inner tube and head for the Nestucca. I’ll put up pictures as soon as I get a chance to get them off of my camera.

Alive still, I promise!

Just in case you were wondering…

I am still alive, and not bed-ridden by some interesting infirmity. Instead, I’m blissfully busy, which is a nice feeling to have again.

I’ve been continuing to spend lots of time at the National Hospital in Mazate, where the doctors and nurses are giving me wonderful learning opportunities every time I turn around.

Example?

1) Yesterday, a man who’d been shot in the head was wheeled into the ER. “Maria, (that’s my name these days) would you do me the favor of sewing that up, please?” inquired the on-call doc. With pleasure!

2) Today, I spent eight straight hours watching (and assisting somewhat) in hernia repair surgeries. Two doctors from Guatemala City came to Mazate to teach the surgeons here how to use a new prosthetic tissue implant, so they did a “jornada” of eleven repairs this morning and afternoon. I’d heard about it, so I approached one of the doctors yesterday to ask if he’d let me observe. He was more than willing, and I made sure to arrive bright and early as procedures were starting this morning. It was my first time in the operating room here, so I was a bit unsure of what to expect. I slid in the door as they weew beginning with the first patient, thinking I’d stand back and peer over shoulders from a safe distance. To my dismay, the two surgeons, scalpels in hand, looked up at me with perplexed expressions.

“Aren’t you going to scrub in?” they asked me.

I don’t know if my subsequent jump in heart rate was the result of excitement or fear (at what level of expertise they were expecting of me – I keep explaining that I’ve only got a bachelor’s degree in Biology, but no one seems to get it.). Nonetheless, I quickly scurried out and began to scrub, and spent the rest of the day cutting sutures, retracting tissues and passing instruments.

They seemed pretty ok with my performance (it’s impossible to fake your way through with this stuff), inviting me out for dinner and insisting I come visit them at work in the city. Their private hospital is in Zona 15, the same place that Janet, Stephanie, Kammie and the rest of the International School teachers live, so it will be far too convenient to not take advantage of the invite. Although I think one of them maybe might have fallen a bit in love with me, and that’s weird. He spent a good part of the afternoon sharing colloquial expressions regarding the fallibility of long-distance relationships, and acting surprised by my firm disagreement. If nothing else, you’ve got to give these guys credit for their confidence. Just like the staff neurologist who seems to be claiming me as both protégé and future wife, today’s gastroenterologist would-be suitor has kids my age. Really, guys? I think I may need to come back from Christmas break “engaged,” or “pregnant” (if I gain weight naturally, I can just pretend, right?) in order to get some respite.

All of this time at the hospital has been, until this week, happening in the mornings before class at the school. Now, school’s over, and I’m going to begin spending more time in the Clinica Maxena. I don’t think I’ll miss school much, in all honesty – there’s no use hiding that being a middle-school teacher isn’t really my thing. Then again, I think that there are a limited number of people in the world who can say that it is, so I don’t feel terrible about it. Stay tuned for how working at the clinic shapes up…

In the meantime, I’ve been neglecting my blog-writing because the med school secondary apps have begun a steady avalanche into my inbox. Since each one requires at least two (often three or four) additional, unique essays, and must be returned on a timeline, my writing efforts have been diverted. Honestly, it may be a while before I get caught up on them, which is both a blessing and a curse.

Also, I spent last weekend in Guatemala City hanging out with the wonderful girls I went to Montericco with, and just enjoying a bit of American cultural immersion. It was a great break, and I’m so glad that I’ve got some people I can identify with when I need a mental-health weekend. Oh, and Stephanie let me borrow a really awesome book – The Spirit Catches You and You Fall Down – which I devoured in two days. I highly recommend it.

So, that’s what I’m up to these days. Life is good; I’m loving the time I’m spending at the hospital, I’m getting incredibly excited about being a doctor (even if it may be pretty far down the road still) and I’m meeting very friendly and interesting people.

El Hospital Nacional en Mazate

Remember my friend Ruth? The one who I got so lost trying to find at church several weeks ago? Well, after passing a long period without contact, I was lucky enough to bump into her in Santo Tomas the other day. I’d tried calling several times, but got strange messages about the line not working, and then lost track of the idea of touching bases with her. When we first met, I’d been very excited to be friends with her for a couple of reasons. First of all, it was just nice to have a Guatemalan friend – meeting and connecting with people is one of the reasons I’m here, after all, and I’d been having a hard time doing that. However, we are clearly compatible as amigas, which is a relief after feeling a bit out of place in a school environment. As I believe I’ve made pretty clear, being a teacher just isn’t my thing. Medicine, however, is, and Ruth works as a registered nurse at the national hospital in Mazatenango.

When I saw here by chance on Monday, she told me that she’d been transferred temporarily to emergency room duty. She invited me to accompany her on shift, which luckily happens to be early mornings. That fits great with me, and so on both Wednesday and Thursday of this week I went with her to Mazate. So far, it has been an incredible, enjoyable and eye-opening experience. I’ve taken to introducing myself as a medical student, because our education system is significantly different from those of the rest of the world, and anywhere else my background would be equivalent to the first three years of medical school. With that, everyone’s been more than eager to give me full access to everything that’s going on. I even had a long, jovial conversation with the hospital director, who I think may now consider me a fast friend.

My first day, a man came in who’d been working on a construction site. He’d fallen and impaled himself on a rebar pole, essentially in a sitting position. An HIV+ man who’d been in a car accident was wheeled in shortly after I arrived. I watched with horror – before knowing that he was HIV+ - as he was catheterized and examined by half a dozen un-gloved hands. When a nurse from another department walked by and recognized him as an HIV patient, I felt sick realizing that I’d been thinking about protective equipment all along and hadn’t said a thing. Having just gotten there, not even yet introduced to most of the staff, I felt out of place correcting them. Lesson learned. I spent much of the morning with an internist who enjoyed the novelty of a) a student to teach and b) its being a gringa. I did rounds in the internal ICU with him, examining patients with everything from pancreatitis to hernias.

The next day, I spent much more time in the emergency room, and was given above and beyond unlimited access. Doctors love to teach, and they were more than happy to give me opportunities which are appropriate for a medical student. That means I was doing a lot more than giving shots. I stitched up the head of a 17 year old car accident victim, pulling his ear back together and closing up a variety of slices across his scalp. I extracted a leatherworking awl which a 15 year old boy had accidentally jammed it into his hand, and took over the ambu bag for an anesthesiologist when he got tired of providing respirations for an unconscious victim of severe cranial trauma.

The national hospital is fascinating because it’s exhaustively overworked and undersupplied. No one knew what to do with our cranial trauma victim once he’d been stabilized, since the hospital’s only ventilator was currently occupied. The doctor had to use suture material which was several sizes too small when re-attach the heel meat of a girl whose foot had slipped into the engine when the motorcycle she’d been riding on crashed. The supply of urinary catheter bags dwindled to nonexistence early on Thursday, so plastic bags taped to the catheter’s end are being employed for now. Lincoln City Animal Clinic has a far nicer x-ray machine than this hospital, and the generally stark and decrepit appearance of the facilities is initially shocking.

That being said, the doctors and nurses are fantastic. They were incredibly nice, and everyone was clearly very focused on their work and in-tune with whatever the current emergency happened to be.

Because it’s a national facility, all of the poor patients who can’t afford a better, private hospital arrive there. Since Guatemala’s a pretty impoverished country (aside from the upper echelons of society tucked behind bodyguards and razor-wire topped fences in the city) that means pretty much everyone with a problem. Among other interesting cases, I saw a 7 month pregnant woman whose uterus had ruptured through a previous cesarean scar. The baby was stillborn, but apparently the mom’s doing alright. A few minutes before, I’d watched a lady with a breach birth being rushed to the operating room, only to have her bed taken over by a tiny bright yellow baby. With fluorescent eyes and skin the color of a Golden Delicious apple, it didn’t take a rocket scientist to figure out she had hepatitis. Um. Not that a rocket scientist should know anything about that anyways, but you get the idea. Ruth’s brother actually came in, too, after having an air compressor explode somehow while he was working on it. Despite a cut across his thumb and blunt trauma severe enough to swell one hand to twice the normal size, he was lucky enough to have relatively little damage.

I think that the most shocking moment for me happened not long after we’d gotten there. I was standing next to the doctor over a patient complaining of abdominal pain, when I glanced up to see the door swinging open. In sauntered an EMT whose expression I couldn’t distinguish between bored and dazed. “Buenos dias..” he drawled while surveying the room, evidently looking for direction. In his arms, limp, wild-haired and covered in blood, was the tiny body of a young girl. The moment was remarkably reminiscent of the famous Oklahoma City bombing photo of a firefighter carrying a bloodied preschooler out of the debris. This child’s face had been slashed open at the upper lip, forming a gory sort of grin which exposed her bright red mouth and unnaturally jutting teeth. This artificial facial expression stood out perversely, drawing attention from her listless empty eyes and dangling limbs.

Estefanie, as I later learned to be her name, had been in a car accident. She was actually just in shock, and after a thorough exam it was determined that the cut on her face was pretty much the worst of her problems. However, the initial shock of seeing her distorted and unresponsive face being brought into the emergency room is an image that will stick with me for a while. Why on earth the EMTs hadn’t put her on a backboard I have no idea, but I feel like a more conventional presentation would have softened the impact of first seeing her.

Sadly, Ruth will be rotating out of emergency pretty soon. First she’ll head to a turn in Women’s Surgery, which will be neat, and then it’s on to her usual post in geriatrics. Luckily, I’ve already had several doctors offer (unprompted!) to let me work with them once she moves on. I’ve been more happy the past two mornings than I’ve been in the whole combined time that I’ve spent at the school – you can be sure I’ll take them up on the offer!

Monterrico...a weekend at the beach!

Last Friday (September 12th), I returned to Guate, recovering my passport from its hostage status in the immigration office. Sheila was already planning a trip in to pick up Dr. Strode, a Carroll chemistry professor who will be down here working on a sabbatical project for the next few weeks. The timing worked out perfectly, because it also happened to be a three day weekend. September 15th is Guatemalan Independence Day, and the whole country shuts down. The last time we’d gone into the city, Mary and I stayed with her friend Judy, a Montanan who teaches in Guate at an international school for rich kids. The night we stayed at her house, Judy invited a young woman she’d just met to come over for dinner.

The woman, Janet, is a fellow doing HIV/AIDs research for the CDC. She clearly took pity on my isolated, friend-less state, and we exchanged phone numbers and email addresses that night. To be honest, I wasn’t all that disappointed to learn that my passport wouldn’t be returned the same day I dropped it off. After meeting Janet, I was hoping that a return trip could potentially be turned into a weekend retreat with my friendly, interesting new acquaintance. Lo and behold, it turned out far better than I myself could have planned, since the whole country had a three day weekend. Janet emailed me shortly after we met, inviting me to join her and some friends on a mini vacation during those days.

So that’s how I ended up wandering around Zona Quince (the number in Spanish, not the fruit), one of Guatemala City’s upscale neighborhoods, on a beautiful Friday afternoon. After picking up Dr. Strode at the airport I was dropped off at Janet’s apartment complex. She’d left a key for me at the front desk, so I was able to take a real, hot shower and drop my things off. I continue to find the city to be a somewhat unreal experience. I was struck by how very normal Janet’s apartment is. It’s very nice – spacious, with large windows and several balconies. Aside from one very typical Guatemala painting of women in traje, there seemed to be absolutely nothing distinguishing this particular place as being in Guatemala. That seems like such a contrast to my life in Xejuyup and Santo Tomas, where it seems like almost nothing we have or do would be considered normal at home. To put it simply, Janet’s apartment made me feel as if it would be possible to live an American life in a foreign country, should one so choose.

I spent Friday night with Janet and her roommate, and then Saturday morning we loaded up the car for a trip to Montericco, a Pacific coast beach resort. Before leaving town, we picked up two of Janet’s friends, Kammie and Stephanie, who are both teachers at the same ritzy international school as Judy. Apparently, and I was totally unaware of this, there exists somewhat of a circuit of international schools all around the world. They are very expensive, multi-lingual schools which generally conduct classes in English for half of the day. There are teachers who jump all around the globe, working on one- or two-year contracts in sundry large cities all around the world – Social Studies for a year in Hong Kong, 7th Grade Math for two in Rio de Janiero, 4th Grade in Paris, World History in Cape Horn, and now a year or two of Biology for middle schoolers in Guatemala City. It seems like a great way to be a professional nomad – they get paid on an American salary scale, which is enough to live like a king in a good ¾ of the world’s countries.

The entire school had a three-day weekend, thanks to the Independence Day holiday. There were several other teachers who’d also chosen to spend their days off at Montericco, and we ended up spending most of our time as a large, very fun group. It was fantastic relaxing with other Americans for awhile, where it was easy to crack jokes that made sense, we could have analytical conversations about world politics, and all anyone really wanted to do was drink beer by the pool. I figured out rather quickly that I’m much younger than any of them – I’d guess their average age to be a decade greater than my own. However, that only was really evident when I was the only on who didn’t know the words to a Salt n’ Pepa song which was part of our hotel’s eclectic soundtrack.

The weather in Montericco is almost debilitating hot, and the ocean has a frighteningly strong undertow. In response to these two conditions, nearly every establishment boasts a swimming pool (or several.) We spent much of our time drifting between restaurants, the beach and pools. Both nights we sat lounging on the beachside for hours, playing games like Mafia until it was late enough to go dancing. In the on-the-beach clubs, we quickly learned that Montericco is more of a Guatemalan destination than a gringo hot spot. The only other Americans we met were some Peace Corps volunteers, but the place was packed with very upper class rich Guatemalans. I concocted some elaborate tales about being happily engaged or a mother or married or pregnant in order to ward off the latino machismo, although you’d be surprised how persistent they can be. They always asked why my husband/boyfriend/fiancé/baby’s daddy wasn’t there, and pointedly inquire where my ring was to prove my taken status. I only recount all of this so that I can share the level of absolute absurdity to which these schmucks took it. After very deliberately explaining to me all about his Corvette, one guy asked how much my ring cost. “However much it was,” he told me “I’ll buy one for you that’s twice as expensive.” He just looked confused when I replied “But I don’t love you,” and walked away.

In addition to dancing and drinking and swimming and eating, we were able to squeeze in a little, well, I guess you’d call it culture. Endangered Loggerhead and Leatherback turtles lay their eggs on the beach in Monterrico, and the town has a preservation center. Even though they’re endangered, the eggs are sold in large volumes in the local markets. Despite my confusion with regards to international acts protecting endangered and threatened species, locals are legally allowed to sell 80% of the eggs from a given nest. Apparently their supposed aphrodisiac qualities are more important than, oh, I don’t know, the preservation of the oceanic biosphere. Because that’s what this country full of seven-child families and little acceptance of contraceptives needs - more babies.

Luckily, this preservation center buys eggs at the going rate from locals, then incubates them and releases the hatched babies. For a price (of less than $1.50) tourists can buy a baby for the nightly “turtle race,” where everyone lines up, lets them go, and sees who reaches the sea first. Not that that’s really winning, since that’s probably the first cute little bugger to be gobbled up by a seal, but that’s beside the point. We all found the process to be somewhat morally confounding. Babies who hatch during the week spend several days swimming around in a pool, waiting for the weekend’s tourist crowd. They surely use up a fair amount of their finite energy stores, and undoubtedly spread amongst themselves whatever diseases happen to plague turtles. Additionally, “buying” a turtle sort of promotes the currently legal system of selling 80% of the eggs. If the current system is acceptable to both conservationists and turtle egg snatchers, the laws will never get changed to protect the turtles more.

On the flip side, tourists pay about 3 times more for an egg than the conservatory buys them for. All of that money goes to help further their cause, promoting conservation efforts and hopefully educating the public. Basically, it’s still supporting a good organization.

Eventually, we concluded that morally, it’s a wash. But, if we paid 10Q, we’d get to hold an adorable baby turtle for a few minutes. With that decision made, I got to spend at least fifteen precious minutes with my newly adopted Camilla before having to understand the pain of that cruel adage “If you love something, you’ve got to set it free.” She was among the last turtles to enter the sea, losing the race by several minutes. I interpreted this as a sign of intelligence: she was waiting for her siblings to satisfy the appetites of waiting predators before risking her own retractable neck. That a girl!

I feel like this post would be somewhat dishonest if I didn’t mention the fact that en route to Montericco we were in a pretty serious car accident. I don’t think I’ll go into details, since it still terrifies me to think about and I don’t want to pass on the nightmares to whoever may read this. There is no doubt whatsoever that our driver was not at fault, the other driver fled the scene without leaving so much as the glow of a brake light, and Janet’s car was totaled. Some exceptionally kind Guatemalans who’d seen the accident (fearing that the semi would trash them as badly as it had us) stopped to help. They were truly a God-send, as I was the only one of the four of us who speaks conversational Spanish and I had no idea what to do after making sure everyone was ok. Which, by the way, we all were, thanks be to God. The cops did show up, although all they did was take pictures of the gringas while waving their semiautomatic assault rifles around and shrugging their shoulders. As if there wouldn’t be significant and noticeable damage on the truck. Thanks guys – I’m glad it’s not my tax dollars paying your salary!

We did a pretty great job of taking it all in stride, and once we figured out we were stranded near Montericco the decision to stay for the weekend was unanimous. We all need to wash the glass out of our hair, and a little beach time seemed like just the right thing for our rattled minds. It all turned out alright, and we were able to disperse ourselves among the cars of the other international school teachers, so we didn’t even have to ride the chicken bus back. One more adventure for the memoirs, I guess. All in all, a great weekend, despite the rough start.

La Jornada de Ojos

It’s been a while since I’ve written anything; I was unprecedentedly busy last week. It was very nice to finally remember what it feels like to be running from place to place, barely finishing with one task before moving on to the next. In the three months I’ve been here, that lifestyle has been totally nonexistent for me. As much as I’ve try to get used to living a laid-back, slow-paced life, too much free time is still consistently driving me nuts.

The last week provided a much appreciated departure from that routine. Three American ophthalmologists and their three nurses arrived on August 31st for the bi-annual “Jornada de Ojos.” Every September and February their medical brigade takes over the clinic for a week. A surgical suite established mainly for cataract surgeries was built here over a decade ago, and Guatemalans come from far and wide for exams and operations. The doctors and nurses bring Christmas to the clinic, in the form of glaucoma drops for the patients, surgical tools for Guatemalan ophthalmology residents and copious amounts of trail mix, books and wonderful company for Sheila, Mary, Anna and I.

I spent most of the week down at the clinic, translating for patients during their exams and watching cataract surgeries. I spent all of my mornings in the clinic with the doctors, ran up to the school to teach in the afternoons, and then returned to Santo Tomas in the evenings for dinner.

Working with the doctors was a much needed refresher, reminding me why I’m working so hard applying to medical school right now. I spent most of June and July writing, re-writing, revising, erasing and writing over again the essays and job descriptions for my first round of applications. Then, as soon as that was turned in, I began receiving secondary applications. Most of them require an entirely new set of essays unique to the school, often requiring research into the university’s specific programs.

It’s hard – really hard – to spend so much time trying to articulate why I want to be a doctor, how I know I’ll be a good one, why you, Medical School No. 43, want me as badly as I want you….blah blah blah. It all begins to feel very empty and one-dimensional. I’ve wanted to be a doctor for as long as I can remember having career goals; how am I supposed to convey my passion and desire in a medium as bland as black ink on white paper? I find medicine fascinating; the idea of dedicating my life to studying every minute detail of what makes us work is exhilarating. Honestly, I just get a kick out of it. However, through the process of writing “when I grow up I want to be a doctor” a million different creative ways, I’d somewhat lost track of the truth in the statement. It was beginning to feel like an idea which I’d been told to sell, regardless of whether or not I believed in it. “You’ve set a goal, now achieve it” is a different mindset than “pursue your goal because you love what it stands for,” and I’d begun to undergo the unfortunate transition from the latter to the former.

Then, right on time, cue the ophthalmologists. Before they arrived, I was excited about the change of pace which a half-dozen visitors would bring. I was looking forward to spending some focused time in the clinic, and I was eager for a chance to be useful and busy. However, the truth is, I wasn’t exactly expecting to care much about the actual work they’d be doing. “Eyes? Eh. Take’em or leave’em” would probably be an accurate representation of my medical interest in the subject. I’ve seen some enucleation (removal) surgeries on dogs before, and they were interesting enough I suppose. I’ve always taken advantage of the opportunity to dissect the surgery’s end product, but I can claim to have ever found myself particularly captivated by it. Truthfully, I couldn’t have explained the difference between a cataract and glaucoma before this last week, although I had at least heard of them.

Fantastically, the doctors and nurses were more than accommodating, allowing me all sorts of front-row and back-stage access to the goings on of the operation. For the first time in ages, I was reminded of my total fascination with biology, anatomy, physiology, pharmacology…all of the sciences which come into play with medicine. The week felt like a flashback to my entire childhood and adolescence, which can be blended quite conveniently into a single image of Jenna asking her father “Why?” That question, and the subsequent search for an answer or explanation, seems to have occupied the majority of my lifetime brain activity:

“Why do cows get milk fever? Why do dogs get salmon poisoning? Why do we have to test animals for TB before shipping them across state lines? Why do cats get diabetes? Why do you put neon dye in an animal’s eye when you want to examine it? Why do you treat kidney failure with subcutaneous fluids? Why are you using Baytril this time, and not Keflex? Why did you pull this tooth and not that one? Why does the spleen look like that? Why are taking out the meniscus on this ACL dog, but you didn’t on the other one? Why do you get more prolapsed uteruses during a full moon? Why do you have special diets for cats with chronic urinary tract infections? Why can’t we (pretty please!) do a cesarean on this dog? Why don’t you do major surgeries on horses? Why are people worried that their horse will be a crypt orchid? Why can you live without your pancreas? I mean, it seems pretty important....”

Asking a million question, varying from the trivial (why are most calico cats females?) to the downright unanswerable (why would anyone ever own a dog that’s not a golden retriever?), and getting solid thoughtful answers is easily my favorite pastime. School’s alright in that respect; the only problem is that as a student you don’t usually get to craft your own questions. Instead, it starts to feel like you’re simply presented with answers, and told to do something with them. Write a paper. Do an experiment which proves these facts true. Not much time, or energy, is left over for the much more enjoyable process of learning by simply watching and asking.

The return to a truly intellectually stimulating environment, where I was once again encouraged to ask, ask, ask and ask some more, was like a throwback to working with my dad. Most importantly, it reminded me of how much I really do care about the answers to all of my questions – I want to know how everything biological works for the simply purpose of enjoying the knowledge. I have no idea why that’s true for me with anything scientific, yet I could care less how the internets intertwine. Nonetheless, that’s just me, and it’s what’s driven me to pursue the study of science (however informally; think coyote dissections in the driveway while in grade school) since day one.

What’s more, once I become a doctor, I’ll be able to take it one step farther. More than just understanding the background of “why,” I’ll be in a position to apply that information. Ahh! I can’t imagine what would possibly be more fun!

What’s more, I find the process of explaining medical conditions incredibly fulfilling. More than just pestering the docs with questions and glancing over shoulders, I got to help. One of the doctors employed me as his full-time translator while he examined patients. I loved the whole process of watching, helping, and translating throughout the entire exam. Providing a good, honest explanation of someone’s medical condition and how it’s going to be address has a feeling reminiscent of public service. Summarizing the important aspects of a complicated medical scenario, in a way which gives the patient a clear picture of what they’re dealing with and how they need to react essentially de-mystifies the magical machine of the human body. After all, could you draw an anatomically correct picture of an eye? If you were told tomorrow that you had glaucoma, would you know what that really means? Probably not, but you would notice if you went blind. We take the normal functioning of our bodies so much for granted, and it can be terrifying to hear that something’s gone awry. But I’ve always found that really understanding a problem makes it so much less scary. That’s why I it’s so rewarding to put the body’s functions into plain words. It takes away a fear of the unknown and replaces it with a sense of prerogative.

Despite my occasional disillusionment with the process of applying to medical school, I know that all of this essay-crafting-application-fee-paying-letter-of-recommendation-requesting-circus-show’s-worth-of-hoop-jumping will be worth it in the end. I’ll be a good doctor, because it’s what I really want to do. Spending a week working alongside wonderful, kind and encouraging doctors and nurses only served to reinforce what I’ve known all along, even if it had been buried under a mountain of transcripts and application forms.

So, dear readers (“readers” is plural because I know that I’ve at least got Mom and Dad still checking this every once in a while), this particular blog entry may not be as interesting or entertaining as you’re used to. No silly situations which required a tricky escape, no cultural mishaps, days of bedridden near-death or elaborate descriptions of My Guatemalan Life. However, it’s what’s been going through my mind, so it’s what you’re stuck with. Lo siento. If you find this rather introspective diatribe to be boring, I’ll leave you with something to laugh about: Jenna, in her infinite wisdom, thought that teaching sex ed to classrooms packed full of 55 unruly, boisterous, impudent, disobedient, irreverent, energetic, disrespectful, bilingual (and I’m not referring to English) teenagers was a good idea. That’s what’s been keeping my on my toes since the doctors left. Imagine the mayhem. Ay…mi vida chapin…

Now I know why Ms. Daisy needed a driver...

“I don’t like this going from one lane to another business” Sister Mary muttered in a gravely voice. “Because. I just don’t know how to do it.”

We were driving through Guatemala City early Tuesday morning, trying to find our way to the immigration office. Rather than going through the expensive, extensive process of procuring a working visa for my stay here, we’re skirting the system a bit. I’ve got a tourist visa, which is valid for 90 days at a time. It can be renewed once at the immigration office in the city, and after that requires an overnight stay out of the country. Sadly, since I’ve missed so much school thanks to my little tryst with Pseudamonas, we decided I should do the quick in-and-out trip to Guatemala City this time.

Sister Mary, one of the two nuns living at the mission, agreed to drive me in. For some reason a policy exist which forbids volunteers to drive Diocesan vehicles. While that may seem like a rational idea, further reflection soon proves it to be without logic. You see, Mary and Anna (the other nun) are both in their 70’s. I can remember with clarity at least a baker’s dozen worth of newspaper articles about senior citizen drivers plowing into crowds of people, bakery windows and bodies of water through the past year. Following 16-year-olds and drunken people, I think they’re one of the most dangerous populations on the road. For example, how many of my SoCo readers remember when a motor home inexplicably fell off of the straight-stretch in front of the elementary school a few years ago? It ended its open-road wanderings flopped on its side, unceremoniously dumped into the blackberry patch down the bank. How is that even possible? Old people. Harrumph.

It wasn’t long into our trip before I learned that Sister Mary is no exception to this old-age = bad driver rule. Initially, I’ll admit to appreciating our speed. Loch Ness Monster-sized potholes and speed bumps which Sheila (literally) flies over were regarded with caution. We puttered along the rough mountain roads, easing over obstacles with an appropriate level of care. However, upon reaching much smoother highways, our velocity failed to adjust accordingly.

This is not a problem in and of itself. However, it was indicative of a larger concern in driving prowess. Upon reaching the bustle and congestion of the Guatemala’s only real city, I was quickly made aware of the danger posed by septuagenarian chauffeurs.

Had I found Mary’s opening statement regarding lane changes difficult to believe, she soon proved the point. We drifted through the congestion, our monolith Isuzu Trooper oblivious to the spatial constraints created by neighboring autos.

“Can I get over?” she’d ask, peering over a shoulder and simultaneously pulling the wheel, causing us to gently drift in the direction of her gaze.

“No.” I’d firmly reply, as she continued to merge us into the next lane. We generally only avoided the seemingly certain kissing of front quarter panels thanks to the dexterity of the unlucky Peugot drivers in adjacent lanes. When I did see an opening, I’d spit out – “Yes – but go quickly!” only to cringe as Mary e a s e d into the next lane, slowly cutting off the angry businessmen behind us.
Our antics elicited the expected cacophony of honks, all of which was utterly lost on Sister Mary. We breezed blissfully through the city streets, scraping our wheels on the curbs as we turned and disregarding the emphatic wavings of traffic policemen.

My heart found a comfortable place in my throat a few minutes into our excursion, and stayed there much of the morning. Every turn had me praying that this new street not be an opposite-flowing one-way. Luckily, that fear was only realized, at most, a half-dozen times. I eventually decided to stop providing my consult in merging and lane changes. I appeared to be obsolete anyways, and I didn’t want to risk blame for any collisions.

All of this terror did, at least, serve to stimulate my tired brain. As usual, I’d gone to sleep around midnight. However, I’d been awoken this particular day around 5:30. Geez – what’s with Guatemala and early mornings? My foggy mind cleared as we circled the city; Mary-stimulated adrenaline fired neurons with an abandon as reckless as my chauffer. We passed the same street-performer children and Pollo Camperos (the Guate equivalent of Micky D’s) nearly a dozen times. Mary’s mutterings narrated through it all, of course, explaining that the immigration office was maybe down that street we’d just passed, and that we’d now need to circle the block several times before having another shot at reaching our destination.

And then, unexpectedly, we were there. After having passed the building’s front side several times, I was surprised and disoriented when Mary stopped to let me out. Somehow, we’d pulled into a quiet side street along the office. No at all sad to be de-boarding, I hopped out of the Trooper and made my way to the office. There, after a half an hour’s worth of waiting for a person who never showed up to work, another thirty minutes of line waiting, and paying the requisite fees, I learned that my passport would need to be held hostage several days. Renewing a tourist visa, formerly a same-day task, now requires a minimum of three days. What does this mean for me, and for my blood pressure? Another trip to the city, and another opportunity to reach dangerous levels of cardiac stress. I wonder if I can find some Valium before my next ride in with the sister…

Pictures!

GuaTeam 08

A few photos from my travels with Caleb, Brady and Celia...

Making Tortillas

Tortilleando

Update on the Health Tally

Well, in case have wondered where I’ve been recently, the answer is simple: in bed. Much of that time, heavily medicated and on IV fluids.

This brings the official tally to:
Tropical diseases: 4
Jenna: still a big fat goose egg

Profile of the latest culprit? A particularly tenacious, aggressive little bacterial buddy commonly known as Pseudomonas sp., who found a comfortable habitat within the environment of my digestive tract. You may be interested in the general manifestation of this condition. While I could certainly provide the reader with detailed descriptions of fecal viscosity and the color palette of my vomitus, I’ll refrain.

Instead, perhaps I’ll give you a few of the more palatable features of my malady, and leave the rest to your imagination. Let’s start at the very beginning, “a very good place to start…”

Last Wednesday (August 13th) was the 25th anniversary of our Sololá bishop’s priesthood. In accordance with custom, a large celebratory mass was held in his honor. Since our bishop is a Jesuit, and the Jesuits are a particularly close-knit community with a heavy presence in Central America, the event was attended by somewhere around ninety priests. Thanks especially to their heavy involvement with the people during civil wars across the continent, many of these men are quite well known.

One of these Jesuits, a man named Ricardo Falla, is a friend of Sheila’s. He spent several years living with the Communities of Population in Resistance (actually, “Comunidades de la Populación en Resistencia, aka CPRs) during the 1980’s. These were non-violent groups of refugees who spent years hiding in the jungles. They suffered regular military attacks, bombing raids and massacres by the military. The government claimed that the CPRs were helping the guerillas, while they maintain that their only desire was to remain markedly Swiss in political involvement. I just finished one of Falla’s many books, “The Story of a Great Love,” which details his own personal experience with the “CPR’s” and how it affected him spiritually. It’s a great book, and I’m eager to read some of his other works. He’s mostly renowned as a sociologist, and has done a lot of research into how the war impacted the people of the country.

Falla is just one example of the fascinating, inspiring Jesuits who was at the Mass. In the world of liberation theology and Central American politics, many of these people are somewhat like spiritual celebrities. Knowing I’d be interested, Sheila invited me along. Wednesday morning, at the (ironically) ungodly hour of 4 am, we set out for Sololá, about three and a half hours away. (Why on earth it was a good idea to leave so early I have no idea, but it wasn’t up to me.)

I’d had an upset stomach the whole night before, enough that I wasn’t able to sleep, and the whole morning I felt pretty sick. However, I decided to blame it on the ridiculously early hour at which we’d began our day, and planned on feeling better once I woke up a bit more.

Sadly, my “plan” to feel better never materialized. By the time the Mass was starting at 10, I could barely stand to watch the impressively long, exaggeratedly slow procession of priests entering the cathedral. The crowded hot building, banging marimba music and thick copal incense had my head spinning, with my stomach following not far behind. Thoroughly embarrassed, I ran from the cathedral, barely finding a public restroom quickly enough to, as Nanc would say, “toss my cookies.”

Now, as you read this, you may be thinking “Boy, that doesn’t sound like any fun at all.” But unless you have first-hand experience with Latin American public toilets, I don’t think you have any idea how not fun it was. After paying my 1 Quetzal (15 cents) at the door (and, of course, receiving a receipt along with my several squares of tp), I hurried into the stall. As I shuffled into the baño green-faced and grimacing I was gawked at by three or four young men who apparently had little concern for the “Ladies Room” sign over the door. Wonderful. A captive audience.

They had no need to worry that the sounds of my efforts would be muffled; the tiny tin booth which housed my toilet provided excellent echo-chamber acoustics. The curious yet common phenomenon of an absent toilet seat applied to this bathroom, as did the equally ubiquitous overflowing toilet-tissue bucket. Flushing paper is, after all, unheard of in these parts.

You can hardly expect to have a can full of used t.p. to not house a burgeoning population of eager flies. So, of course, there was a multi-species element to my spectators. Sticky, filthy liquid of unknown composition coated the floor, papered with discarded bathroom receipts, and my door utterly refused to latch shut. All in all, I guess you could say it was a location conducive to feeling quite ill.

I spent the rest of the Mass prone, in the back seat of our jeep, developing fever aches and chills. The long drive home over impossibly pot-holed roads was nearly the end of me. I drifted in and out of awareness, no doubt moaning with every bump and bounce. By the time we arrived at the mission that night I felt like I’d survived war, or at least a demolition derby. I tried to go to bed early, only to find that lying down invariably incited angry abdominal spasms. I was quite sure, in my fevered delirium, that a young kangaroo was determined to escape from my pancreas, through my bellybutton.

Take a second. Reflect on that.

You’re probably not going to be surprised, then, when I tell you that the vomiting which ensued was more a reaction to pain than to nausea.

I spent the entire night suffering through periodical (in the trigonometric sense) bouts of pain, followed by trips to el baño, where my body spared no expense in ensuring my discomfort. I wondered, as I rose from my sweat-drenched bed every twenty minutes, what grave sin I was currently being punished for. Perhaps the bishop had called down God’s fury in response to my fleeing like a pagan from his celebratory Mass? I probably made a mental note to write him a letter of apology. The specifics of that pledge were lost in my haze of febrile hallucination.

In the early hours of the morning, my salvation arrived in the form of Anabella, a sweet Guatemalan doctor who happened to be sleeping in the dormitory next to my room. She’d heard my moaning, groaning and constant lavatory usage and came to investigate. Anabella was immediately concerned by the state which she found me in, and set into motion a battery of tests and treatments. Sheila came immediately, and has consistently played the role of concerned nurse-mother from that moment to the present.

Blood was drawn, fecal samples were taken, injections and pills and intravenous tubing and all-natural teas smelling of illicit drugs and tasting of pond scum were administered. I was visited by a dizzying rotation of doctors, nurses, cooks, pharmacy technicians and medicinal plants experts, each presenting treatments, advice and general concern. I was considered a candidate for hepatitis, Dengue Fever, kidney failure, gastric ulcers, and E. coli or Salmonella infections. Unable to force poo colonies to grow faster than their own volition, we had no choice but to wait several days until the fecal culture provided us with concrete evidence regarding the enemy.

I spent most of the next few days in a listless miasma (thanks, Microsoft Word synonym finder!). I’d begin to feel better until I ate, or moved, or thought about eating, or thought about moving, and then everything would spiral back downhill. As abdominal palpations continued to elicit tears into my fourth day of convalescence, an ultrasound was ordered.

This meant a forty minute drive over the bumpy roads to Mazatenango, where Sheila and I sat several hours in an overcrowded waiting room. To pass the time, we had more blood drawn, and found that my white count had actually risen after three days of steady intravenous antibiotics.

As the radiologist squirted ultrasound goo onto my bloated belly, I couldn’t help but think “Well, I suppose this could be worse…” Apparently thinking along the same lines, she peered at me over her glasses and stated in a quite matter-of-fact fashion:

“Pregnancy. You don’t have that problem, do you?”

It didn’t take her long to decide, however, that the offending article was not a baby, but my appendix. The first time I’d heard this possible diagnosis, images of emergency abdominal surgery in a third world country began dancing through my head. It wasn’t a pretty sight.

This little diagnostic imaging adventure, my first ultrasound to date, set in motion a somewhat scary cascade of reactionary events. The grayscale picture of my right lower abdomen crowded with inflamed tissues sparked several hours of intensive scrutiny regarding my condition. Was it appendicitis? We drove back to Santo Tomas, wondering, and by the time we’d arrived Sheila decided she’d better consult with a surgeon friend in Mazatenango. Describing the whole scenario to this doctor, he immediately drove all the way to Santo Tomas to examine me, concerned I may be somewhere near an emergency state.

By now, I was feeling much better than I’d been the past few days, and was pretty certain it was probably just a severe intestinal infection. The somewhat aggressive reaction on the part of Sheila and the doctors, however, did have me a little shaken.

It didn’t take Dr. Fidel from Mazate long to decide that I looked much too good to warrant a diagnosis of appendicitis, and my pain was probably a result of severe dehydration. At one point, after all, my blood pressure had dipped to 80/40. He prescribed several more bags of IV fluids, these ones enriched with potassium, and continued antibiotic treatment.

The fecal culture which had been returned earlier that day finally revealed the face of our enemy: villainous Mr. Pseudomonas aeruginosa. Everyone has been somewhat mystified regarding my contraction of this particular bug – it’s an opportunistic colonizer who usually shows up in hospital patients who’ve been on heavy doses of antibiotics, and is known for being remarkably drug resistant. How or why it’s in my belly is a mystery. The only thing we know for sure is that it must have come from food I ate at the school, which means I’m probably not safe to dine with the girls. I’d been carefully avoiding anything which wouldn’t have been boiled for extended periods of time, but apparently that’s not enough.

Now, nearly a week later, I’m mostly recovered. I don’t have much energy still, but I can hold down a full meal and drink enough tea to keep myself hydrated. I’ll probably be back at the school soon, and there will be some changes in my eating habits. The Tuesday before I got sick, I passed my bowl to the cook at lunch time. She returned it, a cow-hoof planted firmly in the middle of my soup. It won’t be so hard to say goodbye to her cooking, really.

Montana Catholic Article

This is the long version of the article I sent for publication in the Montana Catholic...although I'm sure what actually appeared is much shorter...


Vernor Muñoz, a United Nations education official, visited Guatemala this July. He toured the country, met with top officials and studied facts and figures pertaining to education. On July 29th, Muñoz issued a report of his findings, sharing the state of Guatemalan public education with the world.

His conclusions were dismal, and embarrassing. Nationally, Guatemala invests between 1.9 and 2% of its GDP on education, a number Muñoz unapologetically labeled “unacceptable.” He’s got cause for concern; that’s the lowest level of education investment in all of Latin America. The importance of this figure wasn’t lost on me as I read through a summary of the report, but it certainly didn’t reach at least 24% of the population. Nearly a quarter of all Guatemalans, after all, are illiterate. The percentage soars to 39% in the rural areas, where as many as half of all women have never been taught to read or write. This isn’t to say that they wouldn’t like to. However, when 54% of the country suffers from chronic malnutrition, I’d wager that they’re more occupied searching for food than studying school books.

Muñoz lamented the obvious structural racism which exists in the public schools, where native Mayans suffer from exclusion and discrimination on an impressive scale. He highlighted the utter lack of support for the rich, ancient Mayan culture, the dearth of bilingual teachers and a complete disregard for teaching the unique Mayan cosmovision. Of particular concern is the slow death of Mayan languages. In Guatemala, 23 indigenous idioms are spoken, but with unilingual Spanish education taking place in most schools, their preservation is seriously endangered.

Of course, when 1.5 million children are employed in child labor instead of sitting in classrooms, there is some hope that the “old ways” of poverty and subsistence living will survive a bit longer.

My reactions to Muñoz’ findings were mixed. I’ve been teaching at Asunción for two months now, and I’ve started to get a feel for the school, students and surroundings. Working in a tiny, isolated mountain village, I’m living among the poverty which plagues 82% of rural Guatemala. Only 123 of our students board; the rest live in surrounding villages. Many of these kids return from school to homes empty of food, and wake in the morning with stomachs still growling. Xejuyup, the town where Asunción is located, is the incarnation of state statistics describing an impoverished population.

And yet, Asunción clearly exists outside of the Muñoz report. As a private institution unassociated with the national education system, we weren’t included in the tour or statistics. Had he visited this pretty little school, I think the reaction would have been delight. Here, tucked neatly between waterfalls and mountains, a truly quality education is changing lives.

Despite having only 558 students, Asunción boasts the best library in the entire Suchitepéquez state. Our students sang the national anthem in Ki’che’, accompanied by a band of flutes, at the regional “Teacher’s Day” conference this June. A Congressman from the state of Sololá who happened to be present was so impressed that he invited our choir to sing for Congress; we sent sixty students on August 8th..

Enthusiastic and dedicated teachers interact with their pupils both inside and outside of the classroom. They’re supported by fantastic administration whose approachability and interest have them constantly in contact with students and staff alike. On Father’s Day, for example, the boarding students insisted on putting on a variety show to honor the school’s male administrators and professors. Touched, they stayed for several hours before going home to their “real” families.

Most importantly, Muñoz’ observations about cultural suppression are the antithesis of Asunción. I’m one of the very few teachers who doesn’t speak Ki’che’, although I do occasionally surprise my students by asking “la utz awatch ut?” (“How are you?”) or responding to “Good afternoon teacher!” with “xeq’ij!” (“Good afternoon!”). Nearly all of our students are Ki’che’ Indians, wearing their native dress, eating traditional foods and nearly always speaking their indigenous language. Required classes of Mayan Mathematics, Ki’che’ Language and Guatemalan Cultures ensure that all of our students stay in touch with their native roots. Being Indian is seen as cause for pride and celebration. Miss Asunción, elected annually, must give a speech in Ki’che, wear and explain the significance of her region’s formal dress and perform a native dance or ceremony.

In short, I’ve been impressed by Asunción, and judging by the shortcomings which Muñoz found in Guatemalan education, he would have been too.

Of course, my experiences here haven’t exactly been a bed of roses. It’s been something more along the lines of a bed of pineapples, I’d say: sweet, but not always comfortable. Tackling classes of fifty-five teenagers, all eager to coax an outburst from the new teacher, is not an easy task. I had absolutely no formal training in education before stepping into my first classroom, and the learning curve has been steep. Our resources could most optimistically be described as “limited,” while my huge classes are, in a euphemistic sense, well beyond exuberant. The daily tropical downpour which beats on my tin-roofed classroom means I end most days exhausted and with a raspy voice.

However, frustration quickly dissolves when my students offer to guide me to a hidden waterfall tomorrow, or bring me fresh jalapeños from home. The kids adore teaching me Ki’che’, with its impossibly difficult words, and invest an impressive amount of time into trying to coach distinctive clicks, clacks and clucks out of my throat. The language sounds like a mixture of Arabic, German, and the African clicking bush language. Basically, there are lots of lilting, pretty sounding words, like “iliawakan” (toes: iyll-e-a-wal-kan), which are started, finished, or interrupted by guttural clicks and gurgles. Luckily, the kids are so animated in their teaching endeavors that I’ve yet to tire of making an effort. They assure me I’m a quick learner, although I have to wonder how much of that is genuine truth and how much of it is encouraging teachers talking.

Meal times can be especially fun, since I frequently turn into the focal point for my table as they collectively contribute to my vocabulary. Adding to the festive mood is their distinctive fashion of flamboyant oral jewelry. Most of the girls, and many adults, too, have several pieces of gold accent on their teeth. Sometimes it’s a whole golden tooth (I inquired; they’re actually just glued foil covers), other times it’s initials, stars or hearts. It’s quite a sight when a whole table of girls sparkles their metallic glee after I mispronounce “Ixquiactap” (it’s a last name.)

Speaking of mealtimes, perhaps I’ll take a few minutes to describe the general menu. Food at the school is consistent if nothing else; nearly every meal is beans. Occasionally they mix things up, adding rice, soft cheese or eggs, but generally it’s rotating varieties of legume, always accompanied by tortillas. Occasionally, the cooks really outdo themselves, whipping up delicacies unlike anything you’ll find at home. Today’s lunch is a fine example: I was served a watery pool of whole pinto beans garnished with a cow hoof. I turned down the hoof.

Most importantly, every meal is begun and ended with both an Our Father and a sung prayer asking for the blessing of our food. When we start and close a simple, two-ingredient meal with a prayer thanking God for abundance, it’s impossible to ignore the fact that this is actually abundance. Here, at La Asunción, we get three meals a day. At home, many of these girls would never have such plentiful food.

Living and working here is an opportunity for constant personal growth. My occasional frustration with giant, boisterous classes is well complemented by Monday night group Rosary. When I feel like I’m not making progress with my students, I’m able to devote some time to working on much-needed fundraising efforts. When I begin to miss my family and friends at home, I swing wide the door to my bedroom and am quickly visited by the cheerful talkative girls who want to know all about me. What I’m doing certainly isn’t easy, but there’s no doubt that it’s wonderful.

Generous donations from student sponsors, imperative to the continued success of our school, are giving Guatemala a chance. Our school and students rely on the support of our donors, especially through the sponsorship program. The beloved Padre Santiago (you probably know him as Father Hazelton; “Santiago” is one Spanish translation of James) will be traveling back to the states for a well-deserved break this month. However, characteristic to his hard-working spirit, it will be a working vacation. The padre’s annual Hazy Days celebration is one of our largest fundraisers, providing students with much-needed scholarships to continue their education at Asunción. At only $30 a month, it’s incredible the impact such a small contribution can have on the lives of these students and on the future of their country. If you don’t feel capable of supporting a student individually, I suggest sharing a sponsorship at work, Bible study, in your book club or simply with a few friends.

The education system which Muñoz criticized so heavily is a world apart from what we’ve got at Asunción. He’s right: there are major problems in Guatemala. While international organizations and a corrupt internal government try to sort it all out, institutions like our own will continue quietly educating future leaders. Only by creating a generation of educated, involved individuals will there ever be hope of overcoming the problems uncovered by Muñoz.

Statistics:
La Prensa Libre, Guatemala City, Guatemala. July 29, 2008.
Presentation by Dr. Hugo Icu, ASECSA Director (Guatemalan Association of Community Health Services). July 5, 2008.

Tortillear

As part of my employment by the Diocese of Helena, I’ve been given the assignment of writing a few articles for the Montana Catholic newspaper. Officially, I’m “sharing my personal experiences in mission work” and “providing our parishioners with an intimate perspective of what life is like at the mission.” Translation: remind the readership that the Diocese has a mission in a foreign country, so they’ll feel compelled to donate. I knew that I was expected to submit an article this August, with the 15th sticking in my head as a deadline. I’d begun contemplating potential article subjects over the last weekend, although I was yet to start anything. More than a week is plenty of time to whip up something, I thought.

That attitude changed on Monday, when, for no reason in particular, I decided to double-check the article due-date. Surprise! My article was due in 2 days – the paper is printed on the 15th.

The Diocese had specifically requested that I include pictures of myself doing very Guatemalan things; proof that someone sitting in an office isn’t surfing the internet for research and making it all up. Unfortunately, although I’ve taken plenty of pictures, I don’t tend to appear in them. I’m not particularly fond of saying “take a picture of me doing this! Now this! OK, another one, but this time standing over here!” It’s just a bit too outwardly self-centered for my tastes. This attitude, however, now presented a problem. Needing a quick fix, I decided that perhaps it was high time I learned to make tortillas, and photo document the event.

Monday night, I asked the cooks if I could come the next morning for lessons – would they teach me to tortillear? I inquired. The verb tortillear literally means to “to make tortillas.” This food staple is so engrained in their culture it warrants its own verb.

Every morning a different group of girls takes a shift waking at the crack of dawn to prepare the day’s batch of tortillas. With about 150 mouths to feed thrice daily, each probably averaging 4 tortillas, that’s a hefty load of 1800 tiny corn hot cakes. I hadn’t done the math before deciding to contribute my own unskilled hands. Had I thought thing through, I wouldn’t have been surprised when the cooks said “Sure thing! See you a 4:30!”

Crap. That’s no fun.

Luckily, one of the cooks was observant enough to notice the quick flash of terror across my face, and wise enough to realize that my inexperience would probably be more of a hindrance than a help.

“Uh, you can go ahead and come down at 5:30” she reassured me.

Hmm. Somewhat like a stay of execution: should be good news, but you’re still on death row.

I pulled my sleep-heavy body out of bed as my alarm went off the next morning, already hating myself for thinking this was a good idea. Progress was well underway when I arrived downstairs. I stepped into the crowd circling the wood stove, and, taking a cue from those around me, pulled a ball of masa (dough made from just ground corn and a touch of water) off of the heap on the counter. I began forming it into a ball. The next step appeared to be simply clapping it back and forth, until it reached a suitable thinness. Certainly not rocket science. I began briskly slapping my hands together, watching the girls around me to make sure I wasn’t missing something.

Much to my dismay, the ball of dough wasted no time in sticking to my hands and tearing apart. Hmm. That’s not right. I re-rolled, and tried again. Two claps later, I was once again staring at chunks of torn dough smashed into either hand. Well, maybe I need to take it a bit slower. I started over, this time slowly and carefully patting my dough down. It patted right into my hand, and stayed there, smashing into indistinguishable chunks when I tried to remove it. I began to get annoyed. I watched the girls around me more closely, but their actions seemed genuinely straightforward. Roll the dough, pat the dough. Voila, perfect tortilla in seconds. Throw it on the stove for cooking and move on. I tried again, convinced I’d get it this time. I was wrong. My annoyance increased.

Frustration at that early hour quickly turned into irritation, then, unsurprisingly, anger. I continued to attempt various techniques of flattening my poor overworked lump of masa, to no avail. A necessity to maintain some level of professional decorum in front of my students was the only thing which kept me from exploding (in a manner which my parents and siblings would have surely found familiar), throwing the sticky ground corn dough against the wall and storming out. The girls, trained in the art of tortilleando from a young age, chuckled good naturedly at my failed attempts. At 5:45 am, good natured chuckles are indistinguishable from malice. My mood soured further.

I think I need to take up yoga. Or Buddhist meditation. Perhaps the breathing and concentration techniques taught in Lamaze classes would even be beneficial. Cooling myself down from a stewing temper tantrum can be a Herculean feat, although I think I can claim to have improved (since my toddler days.) I took a deep breath, rolled my dough into a new beginning ball, and concentrated.

I tried to be positive. “This is for fun, Jenna, remember that. They’ve been doing this for years. Do you think they could make pretty, fluffy buttermilk biscuits on their first try? Chill out.”

I never did succeed at making a truly good tortilla, although I did keep myself from freaking out in an embarrassing fashion. As the girls around me busily churned out dozens of perfectly round, even disks, I struggled with my little well-handled goo ball. In all, I think I produced three tortillas worth cooking. I am somewhat suspicious that they were mercifully discarded of when I wasn’t looking, sparing some unlucky diner the disappointment of a sub-par tortilla. My little contribution was hardly a drop in the literal bucket on the kitchen floor. It overflowed with hundreds of steaming little cakes by 6:15.

Relieved to finally be done with this Tortilleando Torture (it ranks up there with water boarding), I happily accepted the cooks’ offer to an early breakfast. Apparently skipping the long meal line is a well-deserved perk for the early-riser tortilla makers. I was delighted to see that this morning’s red beans had been cooked with shrimp (camarones) – what a treat! “Le gusta los camarones?” the cook asked me as she filled my bowl. I responded with enthusiastic affirmation, eager to taste what was shaping up to be a Cajun-style morning meal. The cooks regard me with a sort of doting affection, always being sure to offer me oversized portions, spare chicken feet and heaping piles of (cooked-caterpillar garnished) leafy greens. This morning, I watched as she enthusiastically fished through the vat of beans and shellfish, making sure to dish me up a greater-than-average quantity of shrimp.

My glee was premature, and short-lived. In the markets I’ve seen giant, fly-swarmed buckets of odiferous whole dried shrimp, fish, and tiny crabs. I’ve often wondered who in their right mind would purchase such an unappealing and clearly unsanitary form of seafood. Taking the musing one step further, I’ve also been perplexed as to how they could possibly be prepared. It seems improbable that they could ever be appetizing.

Already in a somewhat grumpy mood, I quickly learned that our own cooks, in fact, purchase these desiccated crustaceans. Sadly, my suspicions regarding potential edibility were correct. This form of seafood is far beyond culinary salvation, and even went so far as to ruin the rest of dish they were thrown into. Every bite of my beans had a distinctive oceanic taste. I would guess the best approximation to be the smell which emanates from tide pools at low tide. On a hot day. A very, very hot day. The pungent, alkaline bite of decaying vegetation and sea life permeated every spoonful. If I thought I’d exercised restraint earlier in the morning, I was doing so tenfold now. I couldn’t possibly push the dish away and refuse to eat it; the cook had made a special effort to give me the cream of the shrimpy crop, and would have been offended and perhaps angry had I done so.

The bright pink creatures swimming in my beans seemed to wave there antenna at me in mockery; they knew I didn’t want to eat them, and they clearly found joy in tormenting me from my bowl. The fully-shelled bodies crunched with each bite, spewing beany, rotten-ocean flavored shrimp juice into my mouth. Their legs and tails stuck in my teeth, provoking a gag reflex which manners forced me to suppress.

I choked the concoction down, drowning the flavor in twice my normal consumption of tortillas. Their bland palate-cleansing starch was a welcome reprieve from salty brine, and I was sure to save one to eat plain after finishing my beans.

Early-morning ordeal survived, I returned to my room, overwhelmed. I climbed back into bed, unsure of what else to do with myself, and fell into a fitful half sleep, dreaming of failure, salt and the smells of watery decaying death.

Progress progress

I’ve decided that perhaps rainy Latin American nights are good breakthrough nights for me. “Breakthrough” is a bit sensationalistic, really, but I’m currently unable to generate a suitable synonym, so we’ll go with breakthrough for now.

I’ll probably never forget the first time that I decided to venture out into Santiago (Chile – flash back two years) without a sufficiently adept guide. It was within the first month of my arrival, just days after meeting KellyAnne. The two of us, so far just barely acquaintances, decided we’d meet somewhere and find an adventure together. We began our city walkabout speaking to one another only in Spanish, and the two of us were equally unfamiliar with the metropolis which we were exploring. Places such as Bellavista, La Plaza de las Armas, Calle Huerfanos, and La Plaza Nuñoa, areas which are now forever emblazoned in a map of memories on my heart and mind, were totally foreign that afternoon. Having just come from the western hemisphere summer, the two of us were still surprised by a nightfall which came at 6 pm. We ambled aimlessly through the city, generally clueless of our location, being gently rained upon, and somehow adhering strictly to non-English communication.

Eventually, we recognized our own hunger and frustration at lack of entertainment, and decided to search for a restaurant. It took at least an hour before we found a Chilean diner which catered to her vegetarian whims and our price range. Only after we sat down in a restaurant, tired, cold, damp and generally overwhelmed, did we begin speaking in English. Considering how recently we’d arrived, and the language skills we had yet to develop, the fact that we maintained Spanish conversation for so long indicates two things: one, we were working pretty hard at just communicating, and two, we didn’t exactly have much casual conversation.

Our close friendship, I would attest, didn’t develop until after we broke down and began speaking in English. At the time, it felt a bit like defeat. Now I understand that it was foolish to expect myself to convey a personality with such little communicative ability. Jeez, it’s still tough sometimes, after all of the work I’ve done since to improve!

That night, the two of us tackled Santiago together, getting lost and found on the busy downtown streets numerous times. We used the terribly complicated and unpredictable city bus system, turned our maps upside down and inside out, and eventually formed a bond which still exists. When I got home that night, I sat upstairs explaining our adventures to Felipe while rainwater continued to drip from my hair. His response, when I finished telling all about what we’d done, was simply “This has been a good night for you. You went out by yourself, you were even the guide instead of the guided at times, and you had a chance to do something independent of help from one of us.”

He was right; it was my first chance venturing out without an assigned shepherd, and it turned out well. Finally, I was getting a chance to be my normal independent self, instead of being treated as the incapacitated, mute gringa.

Recently, I had a similar night in Guatemala. Last week, while trying to give my midterm test to 150 first-year students all at the same time (who in the hell thought this was a good idea? REALLY?) one of the other teachers came over to help me. I’d crammed two classes into one tiny, unbearably hot room, and lined the rest out in their desks in the hallway. My impossible task was to monitor everyone for cheating. I honestly have no idea why anyone ever thought this would work, but they were wrong. When I asked the other teachers what they do, they insisted it’s not a problem at all for them. I don’t think I’m capable of believing that.

Pablo, the shop teacher, could see I was struggling with maintaining any semblance of control, and came over to help patrol the students. Since this was my second test to administer that day, and the first had been equally painful, I was exhausted, frustrated, angry and desperate. I gladly accepted his help, but was incredibly irritated when he hung around afterwards and tried to make small talk. Honestly, all I wanted to do was go to my room and cry out some of my frustration. I don’t care what they say, that really can make things better.

Instead, I was stuck talking to this schmuck who kept correcting my Spanish grammar and giving me advice on classroom management. He really hit a nerve, though, when he said I seemed more distant than the other gringas who’ve been here. The truth is, I do spend a lot of time entertaining myself in my room, but more than anything it’s because I don’t know how to incorporate better with the school atmosphere. Rather than dealing with the discomfort of new, awkward social situations, I’ve taken on learning to play the guitar, reading a lot, and going to Santo Tomas to hang out at the clinic every weekend. Clearly not the best way to assimilate, but undoubtedly the path of least resistance for myself. He was right, I knew it, and it bothered me that I’ve become a notable recluse.

So, when he suggested we go have a drink after classes earlier this week, I felt compelled to accept. What better way to meet people than accept a direct invitation, right? I rode on the back of his motorcycle down to Santo Tomas, where we ate dinner and had a drink. As a side note, I’ve noticed that drinking in moderation is not a concept which exists here.

I’m sure that last line raised a few eyebrows. Allow me to explain. That statement does not exactly imply that drinking in excess is the only thing which occurs. Instead, it’s one extreme or the other. Pablo explained to me that we hadn’t stayed in Xejuyup because he didn’t want anyone to see him drinking, and then ordered juice instead of beer when we sat down. Only after being told they were all out of juice did he order, and very slowly savor, one single beer throughout the course of our entire, rather long meal. As a general rule of etiquette, I usually try to eat and drink at the same pace as the people or person I’m with. Sadly, this resulted in sipping a lukewarm beer for two hours that night. Hardly worth the effort. There are, apparently, major problems with alcoholism in the poverty-stricken areas. Either people here are life-ruining drunks, or they act as if they’re afraid of the stuff. It’s interesting.

Anyhow, although there was nothing particularly notable about what we did that night, it was a good experience for me to simply converse with a Guatemalan adult for awhile. In the same way that I’d enjoyed passing time with Ruth, spending a few hours with Pablo turned out to be a good chance to finally have a personality in Spanish. In the classroom, I have to adopt a character which doesn’t really correspond with who I am. Firstly, I’m a teacher, which is about as unfamiliar of a concept as Ki’che’. Additionally, I have to be firm, even mean. It’s just not who I like to be. Finally, I’m getting some opportunities to behave like myself with peers, instead of only taking charge of a classroom of kids.
Beyond that, it was nice to see that not only did Pablo recognize that I hadn’t exactly been socializing with the other teachers, but he made a point to keep it from staying that way. Already later this week I was invited for a snack at recess with several of the other staff members. That first step in socializing is usually the hardest for me, and now I’ve both made it with one person and have started with the rest. Definitely good for me.

Kristin, the previous English teacher, also a young American volunteer, had left me some notes about what to expect. Among other things, she’d said that Pablo was always a good partner in crime whenever she’d come up with ideas for projects or activities. Already he and I are planning on doing some coffee roasting, as tons of coffee is produced here and the school has an unused wood-burning roaster. He also has planted and manages the school’s garden, and offered to plant jalapeños for pickling and salsa making after he saw me pouring hot pepper salsa on my beans.

As we rode back up to the school on his motorcycle that night, rain soaking through my jeans and slicing into my eyes, I couldn’t help but remember that night in Chile. Although the weather may not be ideal, I’d had a good night. A night of progress, I guess.

If only I didn’t still have to finish correcting my 300 tests, I’d have been able to stay in a good mood. Bummer.