(Note: I wrote this letter last night but could not send it out because the phone connection constantly failed due to bad weather the day before.)
Hello again from Xocempich, Yucatan, Mexico... for the last time. I am scheduled to fly back to the good ol' US of A on Thursday morning (tomorrow), July 13th, almost exactly one month early. I have asked so many questions and yet been in stunned silence for hours at a time. One and a half months is such a short period of time! I do not understand why God would see fit to bring me home so early from such a short trip. Am I not accomplishing what he wants me to accomplish? Is there some as-of-yet unknown reason why I should be at home? Would I better serve him at home at this time? Is this a test of my faith and obedience to His plan even when I do not understand it? Some combination of the above? I have been upset at the whole situation, the sickness, the tiredness, going home early, having no job or plans for 2 months at home, the headaches of getting plane tickets changed (once again, I don't know how mom does it!), leaving my ministry area earlier than planned allowing apparent gaping holes in my ministry with the girls... etc. The complaints could go on until the Second Coming should I let them.
Last night I continued to review Beth Moore's Bible study on Jesus titled "Jesus, the One and Only" as part of my ongoing desire to get to know my Lord better and part of the session discussed assignments versus callings. I was convicted that I have been focusing on my temporary assignment (Xocempich) rather than my permanent calling (being totally surrendered to Him). After a little confession time and heart-to-heart with my loving Lord I began thinking about the bigger picture.
Hmm... the bigger picture.
Because we cannot see all the pieces to the bigger picture the key is always obedience to the One who can. I was clearly called to Mexico and I obeyed. I was called to nursing school and I obeyed. I was called to Northwest University and I obeyed. I was called to surrender my life, my being, my all to Him and I obeyed; all with results I never cwould have dreamed of. Now I am called home early from a short-term missions/work experience trip and I must obey. I cannot see the pieces to the bigger picture as of yet but how amazing it is to praise my Lord for his sovereignty and faithfulness in all situations, not to mention his grace and gentleness in quietly correcting my crummy attitude! Isn't it wonderful, children of the Heavenly Father, that even in times of doubt and uncertainty we have reason to praise! In all occasions even in hardship, temptation, trial, torture, and yes, even death, we have reason to praise our Almighty God! For he who possesses, embodies, and is the epitome of every good thing has the right to be praised in all situations and at all times!! What other god has that right? Not any god of any other religion for they either are made by human hands without the ability to see, hear, taste, feel, or smell; they are dead, or they are a figment of the imagination used solely to further the purposes of a group of people. The god of self does not have that right, neither does the god of money, the god of fame or popularity, the god of health, or any other thing on this earth for they are temporal. Only the "One and Only" Jehovah, the great I AM, the all-powerful, ever-present, all-knowing creator!! What a God we serve!
O Lord, forgive me for my unbelief, my lack of faith, and my bad attitude. Align my vision, desires, actions, and words with your own. Search me, O God, and know my heart; test me and know my anxious thoughts. See if there is any offensive way in me and lead me in the way everlasting. May all that I say and do ever bring glory to you.
I want to say a heartfelt THANK YOU to anyone and everyone who has supported me in any way during this trip. Thank you for donating money so that I could have this amazing experience. Thank you for praying for my spiritual, mental and physical well-being. Thank you for the words of encouragement throughout my time here. Depending on what happens I may send one more journal before signing off... perhaps with a bit about Chichen Itza because I do not have the mental capacity to share that day-long trip with you at this time. Vamos a ver (we shall see).
Prayer:
For good health in the morning and a safe trip home tomorrow.
For God's continued blessing on this clinic as well as each and every nursing student, doctor, and patient I had contact with.
Friday, September 15, 2006
Skin, wonderful skin! ~Journal 13~
I feel as if it is time to write another newsletter but I am at a loss for words. Perhaps that is due to my low energy level. I guess I will mix it up and start out with a prayer request this time! For those of you who do not know I have been dealing with a health condition for nearly a year now. Before coming to Mexico I was nearly healed but since arriving here I have gotten worse very quickly. I do not think that is due to any one factor but a combination of factors. I have discussed the issue with both my parents and my doctor and we are currently on “watch and wait” orders. As it is, I believe it would quite literally take divine intervention to prevent me from being required to return home early to give myself more time to recuperate before the start of school at the end of August. Yes, I miss my family. Yes, I am looking forward to coming home, but I do not want to go home early especially due to these circumstances. The possibility of having to go through a similar experience to last year at this time is not encouraging. Boy, the command to “count it all joy whenever you face trials of many kinds” must be one of the most difficult to obey in all of Scripture!
Working at the hospital in Valladolid has been exciting and rewarding. On Wednesday I woke up at 5:30, left at 6:30, and arrived at the hospital at 8:00. There were no complications in travel until I arrived at Valladolid at 7:30 and asked directions to the hospital. Apparently the hospital is known by two names. I only knew one name, and everyone else only knew the other. What a sight we must have been arguing whether they are the same hospital or not! I finally decided to follow their instructions (“go straight”) and find out whether it is or not. After walking for 15 minutes and the required amount of blocks I found myself in a residential district with no obvious signs of a hospital in the vicinity. I asked some women working outside their house whether they knew where the hospital was. They then called a young woman from the house because they apparently did not know enough Spanish to give me directions. I was told to take a right and walk five blocks. Exactly five blocks later I arrived at the front entrance of the hospital in Valladolid (on the way I walked around the smashed carcasses of two very large tarantulas, the first I have spotted on my trip). Interestingly enough, I was also told to “go straight” from the hospital to get back to the bus stop. On the way back I discovered a funny shaped intersection where I should have taken the street just off to the right to arrive in front of the hospital.
I found Dr. Solis just inside the hospital and was directed to the director of nurses. I spent the first several hours in the maternity ward observing a lot and asking questions. I soon discovered that the maternity ward is where all the stable mothers and infants are held I decided to change locations after lunch. I watched a caesarean section and then spent a little time in the labor department. Because there was not much I was allowed to do in that area (and there was not much to do) I asked whether I could go to the emergency department. There I met some really nice nurses and a couple really funny doctors and interns. Once they found out that I am fascinated by wound care they promised that I would be responsible for every wound that came into the department from that point on! Wow! I guarantee you I would not be allowed to do that in any of the hospitals around where I live.
I grin as I imagine that some of you reading this journal are rolling your eyes or gawking at this point. For your continuing information, I am considering specializing in wound care. Even more than tissues in general I am fascinated by our skin; its defensive and protective qualities, its ability and inability to heal, and its incredible variability. One cannot appreciate the both delicate and resilient nature of skin and other tissues until you watch multiple surgeries. Did you know that scar tissue cannot sweat? Did you know that scar tissue from a burn can completely immobilize a limb if not cared for correctly? Did you know that healthy skin is one of the most difficult tissues to penetrate in the human body? I would tell you a bit about the protective nature of skin as evidenced by burn victims but I will refrain for the more delicate stomachs of non-medical personnel reading this journal. ;-)
Since coming to Mexico my desire to work in an emergency department has only grown. Beyond caring for individual wounds I really enjoy dealing with emergent patients; doing rapid assessments and employing immediate interventions. I am sure that my squeamishness (yes, I may have just made up a word) when confronted with a patients’ pain will continue to diminish with time and experience to leave in its wake a confident but sympathetic nurse. I am also sure that is why I have had such a struggle with the fear of needles. I cannot remember the reference, but there is a verse either in Corinthians or Colossians about how God allows us to go through certain hardships so that he can give us grace and we can minister with that same grace to others in the same situation. I cringe to call a fear of needles a hardship but I believe it applies. I have literally had to learn relaxation techniques so that I could control the anxiety before an injection. Perhaps I will be able to teach the same techniques to someone in the same situation.
Ok, back to Valladolid.
That afternoon I had the opportunity to take care of one major wound, that of a man dealing with a venous ulcer for the last several years. Amazingly, I watched Dr. Federico care for a similar wound just two days before that and I had even researched the condition to help solidify what I observed! Apparently, the information had been absorbed well enough that I was never corrected on my techniques and was told I did a good job when finished. :-D I spent another couple of hours in the consultation area of the emergency department before leaving at about 7:30 pm. I arrived back to the clinic at 9:30 and hit the hammock at 10:00.
The next day I did not return to Valladolid to give myself a day to rest up but I did return on Friday (my walking time from the bus stop was 10 minutes instead of 20 now that I knew where I was going). That day I spent half the day in labor and delivery because it was very busy. I saw another caesarean, a multiple mammary node removal, and a cyst removal. The second half of the day I spent in the emergency department. The department was not as busy as Wednesday but I did care for the man’s venous ulcer again and saw my first case of Dengue fever with hemorrhagic characteristics (the poor little baby boy!). I left the hospital at 7 pm with Dr. Osorio and Dr. Pech as they were scheduled to help out with a surgery in Xocempich.
Graduation last night was… interesting. It was a great service but the attendance was the lowest Femia had ever seen and none of the doctors who often work with the girls arrived for the ceremony either. Two girls, Lina and Clauda, graduated last night which was two months after three of their colleagues were expelled. That created a rather sombre mood and the absence of the doctors was felt strongly by the girls as the two other Americans and I were asked to fill in for their usual positions during the ceremony.
The clinic is a bit quieter with only four nurses now. I may have more to say about that in a later edition but for now, I must again hit the hammock!
Prayer:
My health. Please pray that my condition will continue to improve so that I will not have to come home early.
The baby boy with Dengue. He is in serious condition as he could possibly go into shock if he continues bleeding internally.
Working at the hospital in Valladolid has been exciting and rewarding. On Wednesday I woke up at 5:30, left at 6:30, and arrived at the hospital at 8:00. There were no complications in travel until I arrived at Valladolid at 7:30 and asked directions to the hospital. Apparently the hospital is known by two names. I only knew one name, and everyone else only knew the other. What a sight we must have been arguing whether they are the same hospital or not! I finally decided to follow their instructions (“go straight”) and find out whether it is or not. After walking for 15 minutes and the required amount of blocks I found myself in a residential district with no obvious signs of a hospital in the vicinity. I asked some women working outside their house whether they knew where the hospital was. They then called a young woman from the house because they apparently did not know enough Spanish to give me directions. I was told to take a right and walk five blocks. Exactly five blocks later I arrived at the front entrance of the hospital in Valladolid (on the way I walked around the smashed carcasses of two very large tarantulas, the first I have spotted on my trip). Interestingly enough, I was also told to “go straight” from the hospital to get back to the bus stop. On the way back I discovered a funny shaped intersection where I should have taken the street just off to the right to arrive in front of the hospital.
I found Dr. Solis just inside the hospital and was directed to the director of nurses. I spent the first several hours in the maternity ward observing a lot and asking questions. I soon discovered that the maternity ward is where all the stable mothers and infants are held I decided to change locations after lunch. I watched a caesarean section and then spent a little time in the labor department. Because there was not much I was allowed to do in that area (and there was not much to do) I asked whether I could go to the emergency department. There I met some really nice nurses and a couple really funny doctors and interns. Once they found out that I am fascinated by wound care they promised that I would be responsible for every wound that came into the department from that point on! Wow! I guarantee you I would not be allowed to do that in any of the hospitals around where I live.
I grin as I imagine that some of you reading this journal are rolling your eyes or gawking at this point. For your continuing information, I am considering specializing in wound care. Even more than tissues in general I am fascinated by our skin; its defensive and protective qualities, its ability and inability to heal, and its incredible variability. One cannot appreciate the both delicate and resilient nature of skin and other tissues until you watch multiple surgeries. Did you know that scar tissue cannot sweat? Did you know that scar tissue from a burn can completely immobilize a limb if not cared for correctly? Did you know that healthy skin is one of the most difficult tissues to penetrate in the human body? I would tell you a bit about the protective nature of skin as evidenced by burn victims but I will refrain for the more delicate stomachs of non-medical personnel reading this journal. ;-)
Since coming to Mexico my desire to work in an emergency department has only grown. Beyond caring for individual wounds I really enjoy dealing with emergent patients; doing rapid assessments and employing immediate interventions. I am sure that my squeamishness (yes, I may have just made up a word) when confronted with a patients’ pain will continue to diminish with time and experience to leave in its wake a confident but sympathetic nurse. I am also sure that is why I have had such a struggle with the fear of needles. I cannot remember the reference, but there is a verse either in Corinthians or Colossians about how God allows us to go through certain hardships so that he can give us grace and we can minister with that same grace to others in the same situation. I cringe to call a fear of needles a hardship but I believe it applies. I have literally had to learn relaxation techniques so that I could control the anxiety before an injection. Perhaps I will be able to teach the same techniques to someone in the same situation.
Ok, back to Valladolid.
That afternoon I had the opportunity to take care of one major wound, that of a man dealing with a venous ulcer for the last several years. Amazingly, I watched Dr. Federico care for a similar wound just two days before that and I had even researched the condition to help solidify what I observed! Apparently, the information had been absorbed well enough that I was never corrected on my techniques and was told I did a good job when finished. :-D I spent another couple of hours in the consultation area of the emergency department before leaving at about 7:30 pm. I arrived back to the clinic at 9:30 and hit the hammock at 10:00.
The next day I did not return to Valladolid to give myself a day to rest up but I did return on Friday (my walking time from the bus stop was 10 minutes instead of 20 now that I knew where I was going). That day I spent half the day in labor and delivery because it was very busy. I saw another caesarean, a multiple mammary node removal, and a cyst removal. The second half of the day I spent in the emergency department. The department was not as busy as Wednesday but I did care for the man’s venous ulcer again and saw my first case of Dengue fever with hemorrhagic characteristics (the poor little baby boy!). I left the hospital at 7 pm with Dr. Osorio and Dr. Pech as they were scheduled to help out with a surgery in Xocempich.
Graduation last night was… interesting. It was a great service but the attendance was the lowest Femia had ever seen and none of the doctors who often work with the girls arrived for the ceremony either. Two girls, Lina and Clauda, graduated last night which was two months after three of their colleagues were expelled. That created a rather sombre mood and the absence of the doctors was felt strongly by the girls as the two other Americans and I were asked to fill in for their usual positions during the ceremony.
The clinic is a bit quieter with only four nurses now. I may have more to say about that in a later edition but for now, I must again hit the hammock!
Prayer:
My health. Please pray that my condition will continue to improve so that I will not have to come home early.
The baby boy with Dengue. He is in serious condition as he could possibly go into shock if he continues bleeding internally.
Surprises ~Journal 12~
Surprise! I woke up from a nap Thursday afternoon to the sound of suitcases being unloaded onto my front porch! Boy, I am glad I keep the house relatively clean at all times. I just needed to sweep the room they planned to stay in and we began chatting. Apparently three different people forgot to inform me I would have visitors this week. I cannot say I am exactly “hosting” them considering they have been here about ten times each! Their names are Inge and Leslie and they are from Ohio. They made the trip at this time specifically to be here for the girls’ graduation on Friday. During the week they plan on following up with some work they have done with the local kids and continuing to build foundations for future ministries with the various groups sent from their church. They tell me that they have not yet seen a tarantula in the area (though the girls killed one in their kitchen only a few days ago) but they have killed a scorpion in our house. They also tell me that the giant millipede that I have a picture of on my Yahoo album is poisonous. Hmm… I wish I knew that before I played with it (just kidding!).
I had the opportunity to instrumentar (be the "scrub nurse", the person handing the instruments to the surgeons) for a laparoscopic cholysystectomy (gallbladder removal) on Friday morning. A lap choly has very few instruments and low risk compared to other procedures and it is so common that I have seen several by now. It was a great experience! It was a lot of fun rehearsing the names of each of the instruments before and during surgery and trying to anticipate the doctors’ every move at the same time. Claudia, who has had a lot of experience in that role, scrubbed with me, prepared the tables, and helped me at every step. Knowing the exact order of which sterile packages to open and how to set up the tables definitely seems more difficult. Less stressful than working with the doctors, but more difficult. I do not think I will get the opportunity again unless we are short-staffed because now the first year students are supposed to learning that role.
This weekend has been very quiet though it could have proven quite hectic. Dr. Federico had several responsibilities outside the clinic this weekend leaving me as the primary medical personnel! Yikes! Should any emergency arrive while he was out of town it was my job to stabilize the patient before sending them to the hospital in Valladolid. Fortunately (and unfortunately) that was never needed.
Speaking of the hospital in Valladolid… I will be working there tomorrow! I leave here at 6:30 am. to arrive at the hospital before 8:30. I will be given a grand tour and hopefully Dr. Solis or the general director will have some suggestions or plans on what I can do for the day. Dr. Federico says that I could ask to shadow or work in just about any area of the hospital. If that is true, emergency department here I come!! He also tells me that if I wish to work there other days I can even make plans to stay in Valladolid overnight to continue working in the hospital on consecutive days.
There are still a lot of uncertainties about tomorrow such as what exactly they mean by “working” in the hospital. I have not yet graduated and I have no credentials in Mexico. An obvious “no-no” in the US but who knows what is permissible here! The most important thing is the general director has approved my visit and whatever it is they have planned for me at the hospital. Traveling to and from Valladolid seems easy enough but I really do not know what I will be doing in the hospital.
Yay for adventures!
Prayer:
My safe and productive trip to the hospital in Valladolid. It is a touristy town so I should feel a bit more comfortable (less staring!) but that also increases the risk of thieves.
For my ministry with the girls. A major issue just came up tonight with one of the girls that will require a LOT of wisdom to handle both as an authority and as an advocate between the girls and my authorities. I have not spoken with her about it yet so that I have a day or two to formulate what I need to say and how to handle it.
I had the opportunity to instrumentar (be the "scrub nurse", the person handing the instruments to the surgeons) for a laparoscopic cholysystectomy (gallbladder removal) on Friday morning. A lap choly has very few instruments and low risk compared to other procedures and it is so common that I have seen several by now. It was a great experience! It was a lot of fun rehearsing the names of each of the instruments before and during surgery and trying to anticipate the doctors’ every move at the same time. Claudia, who has had a lot of experience in that role, scrubbed with me, prepared the tables, and helped me at every step. Knowing the exact order of which sterile packages to open and how to set up the tables definitely seems more difficult. Less stressful than working with the doctors, but more difficult. I do not think I will get the opportunity again unless we are short-staffed because now the first year students are supposed to learning that role.
This weekend has been very quiet though it could have proven quite hectic. Dr. Federico had several responsibilities outside the clinic this weekend leaving me as the primary medical personnel! Yikes! Should any emergency arrive while he was out of town it was my job to stabilize the patient before sending them to the hospital in Valladolid. Fortunately (and unfortunately) that was never needed.
Speaking of the hospital in Valladolid… I will be working there tomorrow! I leave here at 6:30 am. to arrive at the hospital before 8:30. I will be given a grand tour and hopefully Dr. Solis or the general director will have some suggestions or plans on what I can do for the day. Dr. Federico says that I could ask to shadow or work in just about any area of the hospital. If that is true, emergency department here I come!! He also tells me that if I wish to work there other days I can even make plans to stay in Valladolid overnight to continue working in the hospital on consecutive days.
There are still a lot of uncertainties about tomorrow such as what exactly they mean by “working” in the hospital. I have not yet graduated and I have no credentials in Mexico. An obvious “no-no” in the US but who knows what is permissible here! The most important thing is the general director has approved my visit and whatever it is they have planned for me at the hospital. Traveling to and from Valladolid seems easy enough but I really do not know what I will be doing in the hospital.
Yay for adventures!
Prayer:
My safe and productive trip to the hospital in Valladolid. It is a touristy town so I should feel a bit more comfortable (less staring!) but that also increases the risk of thieves.
For my ministry with the girls. A major issue just came up tonight with one of the girls that will require a LOT of wisdom to handle both as an authority and as an advocate between the girls and my authorities. I have not spoken with her about it yet so that I have a day or two to formulate what I need to say and how to handle it.
"Busyness" ~Journal 11~
(Note: The majority of this e-mail was written last night but I could not finish it before my brain neurons ceased to fire. I finished it today still in the perspective of last night.)
Whew! What a last couple of days! Since Friday I have participated in five surgeries (another c-section is scheduled for early tomorrow morning) and cared for a patient with a bleeding ulcer and anemia, another who required a blood transfusion, and a little boy last night with epilepsy, among others. In total I have slept 14 hours in the last three nights including only 4 hours last night due to the boy with epilepsy. Again, please excuse any disjointedness.
It has really been a rewarding, exciting, and stressful experience working here as the nurses aid students simply do not have the training to care for people beyond the typical post-op. Whenever there is a more complicated patient I take part of the care and do incessant instruction with whichever students I am working with. Inevitably the more serious patients, the emergency ones, come later at night which always cuts out a large chunk of my sleep time. I have so much respect for the two doctors who work here. They are on-call at any time of the day or night.
Last night (Sunday) when passing through the clinic to go to my house after dinner I noticed a lot of activity in the nurses station and one of the nurses jogging back from Dr. Federico’s house. I poked my head in to see what was the matter and immediately went into “nurse mode.” I found a four year old boy named Isidro in the arms of his parents within the throes of a seizure. Knowing the doctor was on his way I asked for the boy’s temperature and began assessing his respiratory and cardiac status. Within a couple of seconds the doctor arrived and ordered for an IV to be started and began asking the parents questions. While we were working to cannulize the boy the doctor got some medications ready. As soon as we had the IV open and stabilized he added antispasmodic medication to the tube which inexplicably crystallized. We changed the tubing and he tried again, this time retracting some of the IV solution into the syringe to be sure the issue was fluid incompatibility. It was. As that medication is the only type of antispasmodic they carry in the clinic we only had to hope that other techniques would help to alleviate the spasms. The seizures caused the boy to breathe only sporadically which in turn caused his blood oxygen saturation level to drop as low as 60% (it should stay between 93%-100%). We placed an oxygen mask and suctioned extra mucus in his mouth. The seizure lasted about 10-15 minutes and even then it did not completely resolve. Once that seizure ended we still had to work diligently to stabilize the boy’s vital signs.
The whole process was very scary for the doctor and myself because we knew the seriousness of the situation. Not only was I witnessing the result of brain damage, I was witnessing continuing brain damage as every second the seizure lasts more damage is done to the brain and peripheral nervous system. In addition to that, most seizures last 15 to 30 seconds. These lasted from 10 to 15 minutes. Of course, the family was heartbroken to see their boy’s body ravaged by a faulty nervous system but they did not know about the continuing damage and we did not have the heart to tell them. One of the most difficult aspects of that night was that we did not have the medications to treat the immediate symptoms and minimize the damage nor the labs to determine how to stabilize him for a longer period of time but we could not transport him to a better equipped facility in an unstable condition. The best place to take him would be the hospital in Merida but that is two hours away. The next best place is Valladolid, 40 minutes away. The doctor and I talked at length about the possibilities and impossibilities of transporting him. Finally Dr. Federico determined that he wanted the boy to stabilize before we called the municipal police (the closest medical transport system available) and sent him to Valladolid.
That being determined I pulled out my nursing books and researched the etiology and treatment options for his condition as well as continued to monitor his status and vital signs. Through my research and application of specific assessments I determined that Isidro had increasing edema (inflammation) of the brain which would only put him in a more unstable state. I reported my findings to the doctor and suggested giving him an anti-inflammatory medication and transporting him as soon as possible. Dr. Federico concurred and he gave him the medication and called the municipal police, 45 minutes away (oohh... what a rush to make a suggestion to the doctor and be correct!). Right after he ended the call another seizure happened (the third one of the night but I cannot remember exactly when the second one happened), I believe because of increased body temperature (unstable vitals is another sign of brain edema). This seizure lasted another ten minutes.
After this seizure both the doctor and I were rather despondent because there was nothing more we could do. I had been praying off and on for Isidro and his family the whole night but at that point I got on my knees, put my hand on his forehead and prayed. I prayed for healing for his brain, his entire nervous system, his damaged and exhausted muscles, and his tired heart, among others. I prayed for God’s will and his glory through the situation and for salvation for him and his family members. After several minutes my vocabulary was dry. I was at a loss. How many times can you pray for the same thing? Does God consider repetition nagging? Does He listen any more or less when you repeat your requests? After I had no words I just asked that the Holy Spirit would pray for me. After all, he knows the desires of my heart. He knows better what the boy needs. How amazing it is that we have the Holy Spirit praying for us in ways we do not know! Praise the Lord we have an advocate living within us so that we can approach the throne of Grace and petition the One who is all-powerful on behalf of specific people and situations!
Isidro finally left the clinic at 1:30 in the morning and all in all, the episode lasted about five hours. I still do not know what has happened with him but I continue to pray for him.
Learning about the girls and participating in the culture has helped me realize what a tiny level of experience they have. Daily activities such as cooking, cleaning, and doing laundry take up so much time that there is little opportunity left to study or pursue hobbies. The girls come from uneducated families so they have no love for reading, a limited vocabulary, a very low reading comprehension level, and a generally low comprehension level for new information. They have virtually no critical thinking skills or patient assessment skills. When I am working with a patient and ask one of the nurses for materials I have to be very explicit on how quickly I need it because they cannot assess for themselves how serious a situation is. This has created some frustrating issues while working with these emergent patients. Twice in the last couple of days I have asked for an endotracheal tube to be brought to the room just in case the worst happened and they did not even know what it was! I tried explaining that the anaesthesiologist uses it when starting surgery and even explained that it is a tube you put down someone’s throat when they cannot breathe and yet they do not know what it is to at least let me know whether they have one in the clinic or not! I have slowly discovered how the girls do not have the training or the comprehension level to think about possibilities and alternatives. If they are not told exactly what to do, they have no clue!
Slowly developing the role of primary instructor and corrector I am also discovering how prideful they are. When I am their happy-go-lucky friend everything is fine but as soon as I or anyone else corrects them they shut down and become very defensive. I believe part of the reason they are very sensitive to correction is because this culture is very passive. Their child training techniques are very passive, their consideration for time is passive, even their sentence structures and verb choices are CONSTANTLY passive and nondescript! For example, “to be weighed, please” actually means “please step over to the scale so I can weigh you.” I have also found that they have no concept of perseverance. During the first week or two of devotions I felt they were going rather well. It has developed to the point that it is unusual for more than two of the six girls to have read the one chapter assigned for that morning and twice they have eaten breakfast and left before I got there! We had two music lessons and no more, three volleyball practices, and I have had one English tutoring lesson with one of the students. Maintaining the lessons is also increasingly difficult for me as I often need the afternoons to take a siesta due to working late at night and the girls do their chores in the morning. Ahh… perseverance, what a word!
Prayer:
For Isidro and his family, his health and speedy recovery, that God would do a miracle in his life and reverse any and all brain and nervous system damage and he would have no more seizures (a medical miracle). Salvation for the family. Ultimately, that God would have his hand on the boy and his family and His name would be glorified in this situation.
For my relationship with the girls. That I would be able to continue to teach and train them, that the Lord would open their hearts and minds to the new information, and I would continue to develop deeper relationships with them. Their names are Claudia, Lina, Reyna, Gladys, Marta, and Maritza.
Whew! What a last couple of days! Since Friday I have participated in five surgeries (another c-section is scheduled for early tomorrow morning) and cared for a patient with a bleeding ulcer and anemia, another who required a blood transfusion, and a little boy last night with epilepsy, among others. In total I have slept 14 hours in the last three nights including only 4 hours last night due to the boy with epilepsy. Again, please excuse any disjointedness.
It has really been a rewarding, exciting, and stressful experience working here as the nurses aid students simply do not have the training to care for people beyond the typical post-op. Whenever there is a more complicated patient I take part of the care and do incessant instruction with whichever students I am working with. Inevitably the more serious patients, the emergency ones, come later at night which always cuts out a large chunk of my sleep time. I have so much respect for the two doctors who work here. They are on-call at any time of the day or night.
Last night (Sunday) when passing through the clinic to go to my house after dinner I noticed a lot of activity in the nurses station and one of the nurses jogging back from Dr. Federico’s house. I poked my head in to see what was the matter and immediately went into “nurse mode.” I found a four year old boy named Isidro in the arms of his parents within the throes of a seizure. Knowing the doctor was on his way I asked for the boy’s temperature and began assessing his respiratory and cardiac status. Within a couple of seconds the doctor arrived and ordered for an IV to be started and began asking the parents questions. While we were working to cannulize the boy the doctor got some medications ready. As soon as we had the IV open and stabilized he added antispasmodic medication to the tube which inexplicably crystallized. We changed the tubing and he tried again, this time retracting some of the IV solution into the syringe to be sure the issue was fluid incompatibility. It was. As that medication is the only type of antispasmodic they carry in the clinic we only had to hope that other techniques would help to alleviate the spasms. The seizures caused the boy to breathe only sporadically which in turn caused his blood oxygen saturation level to drop as low as 60% (it should stay between 93%-100%). We placed an oxygen mask and suctioned extra mucus in his mouth. The seizure lasted about 10-15 minutes and even then it did not completely resolve. Once that seizure ended we still had to work diligently to stabilize the boy’s vital signs.
The whole process was very scary for the doctor and myself because we knew the seriousness of the situation. Not only was I witnessing the result of brain damage, I was witnessing continuing brain damage as every second the seizure lasts more damage is done to the brain and peripheral nervous system. In addition to that, most seizures last 15 to 30 seconds. These lasted from 10 to 15 minutes. Of course, the family was heartbroken to see their boy’s body ravaged by a faulty nervous system but they did not know about the continuing damage and we did not have the heart to tell them. One of the most difficult aspects of that night was that we did not have the medications to treat the immediate symptoms and minimize the damage nor the labs to determine how to stabilize him for a longer period of time but we could not transport him to a better equipped facility in an unstable condition. The best place to take him would be the hospital in Merida but that is two hours away. The next best place is Valladolid, 40 minutes away. The doctor and I talked at length about the possibilities and impossibilities of transporting him. Finally Dr. Federico determined that he wanted the boy to stabilize before we called the municipal police (the closest medical transport system available) and sent him to Valladolid.
That being determined I pulled out my nursing books and researched the etiology and treatment options for his condition as well as continued to monitor his status and vital signs. Through my research and application of specific assessments I determined that Isidro had increasing edema (inflammation) of the brain which would only put him in a more unstable state. I reported my findings to the doctor and suggested giving him an anti-inflammatory medication and transporting him as soon as possible. Dr. Federico concurred and he gave him the medication and called the municipal police, 45 minutes away (oohh... what a rush to make a suggestion to the doctor and be correct!). Right after he ended the call another seizure happened (the third one of the night but I cannot remember exactly when the second one happened), I believe because of increased body temperature (unstable vitals is another sign of brain edema). This seizure lasted another ten minutes.
After this seizure both the doctor and I were rather despondent because there was nothing more we could do. I had been praying off and on for Isidro and his family the whole night but at that point I got on my knees, put my hand on his forehead and prayed. I prayed for healing for his brain, his entire nervous system, his damaged and exhausted muscles, and his tired heart, among others. I prayed for God’s will and his glory through the situation and for salvation for him and his family members. After several minutes my vocabulary was dry. I was at a loss. How many times can you pray for the same thing? Does God consider repetition nagging? Does He listen any more or less when you repeat your requests? After I had no words I just asked that the Holy Spirit would pray for me. After all, he knows the desires of my heart. He knows better what the boy needs. How amazing it is that we have the Holy Spirit praying for us in ways we do not know! Praise the Lord we have an advocate living within us so that we can approach the throne of Grace and petition the One who is all-powerful on behalf of specific people and situations!
Isidro finally left the clinic at 1:30 in the morning and all in all, the episode lasted about five hours. I still do not know what has happened with him but I continue to pray for him.
Learning about the girls and participating in the culture has helped me realize what a tiny level of experience they have. Daily activities such as cooking, cleaning, and doing laundry take up so much time that there is little opportunity left to study or pursue hobbies. The girls come from uneducated families so they have no love for reading, a limited vocabulary, a very low reading comprehension level, and a generally low comprehension level for new information. They have virtually no critical thinking skills or patient assessment skills. When I am working with a patient and ask one of the nurses for materials I have to be very explicit on how quickly I need it because they cannot assess for themselves how serious a situation is. This has created some frustrating issues while working with these emergent patients. Twice in the last couple of days I have asked for an endotracheal tube to be brought to the room just in case the worst happened and they did not even know what it was! I tried explaining that the anaesthesiologist uses it when starting surgery and even explained that it is a tube you put down someone’s throat when they cannot breathe and yet they do not know what it is to at least let me know whether they have one in the clinic or not! I have slowly discovered how the girls do not have the training or the comprehension level to think about possibilities and alternatives. If they are not told exactly what to do, they have no clue!
Slowly developing the role of primary instructor and corrector I am also discovering how prideful they are. When I am their happy-go-lucky friend everything is fine but as soon as I or anyone else corrects them they shut down and become very defensive. I believe part of the reason they are very sensitive to correction is because this culture is very passive. Their child training techniques are very passive, their consideration for time is passive, even their sentence structures and verb choices are CONSTANTLY passive and nondescript! For example, “to be weighed, please” actually means “please step over to the scale so I can weigh you.” I have also found that they have no concept of perseverance. During the first week or two of devotions I felt they were going rather well. It has developed to the point that it is unusual for more than two of the six girls to have read the one chapter assigned for that morning and twice they have eaten breakfast and left before I got there! We had two music lessons and no more, three volleyball practices, and I have had one English tutoring lesson with one of the students. Maintaining the lessons is also increasingly difficult for me as I often need the afternoons to take a siesta due to working late at night and the girls do their chores in the morning. Ahh… perseverance, what a word!
Prayer:
For Isidro and his family, his health and speedy recovery, that God would do a miracle in his life and reverse any and all brain and nervous system damage and he would have no more seizures (a medical miracle). Salvation for the family. Ultimately, that God would have his hand on the boy and his family and His name would be glorified in this situation.
For my relationship with the girls. That I would be able to continue to teach and train them, that the Lord would open their hearts and minds to the new information, and I would continue to develop deeper relationships with them. Their names are Claudia, Lina, Reyna, Gladys, Marta, and Maritza.
The Longest Day ~Journal 10~
Apparently, one of the hazards of living and working in the Yucatan peninsula are the thunderstorms. We had quite the lightning show the evening after writing my last letter which then caused the phone lines to fail. No phone, no internet. No communication with the outside world aside from traveling to a neighboring town or using the two private phones with satellite service. According to the girls, it is not uncommon for the phone lines to be unavailable for over a week after such a powerful storm. Once, they were not available for nearly a month! I guess we can call this a quick turn-around.
Since my last letter I have also discovered three new insects in my house and had my first “long day” medical experience. I am currently running on three hours of sleep after a 22 hour day. I am weak in the knees and constantly have to fight off drowsiness to avoid going to sleep in the middle of the day and ruining my internal clock (therefore, if this letter seems a bit more disjointed than usual, please excuse said disjointedness). All those who were involved in the surgeries yesterday are going about their tasks today with a composure that reminds you of the walking dead. Of course, medical personnel never plan for such a long work day but sometimes they occur.
Rule number 1: Don’t schedule four surgeries in one day. Jam scheduling surgeries in small clinics with travel time in between leaves no room for complications. The following is a summary of my day.
0600 – Wake up, prepare for the day, do some household cleaning.
0700 – Breakfast
0830 – We prepare the surgery room and set out proper equipment
0900 – Total laparoscopic hysterectomy scheduled to begin. Delayed by special laparoscopy team’s late arrival.
1030 – Surgery begins
1300 – Surgery scheduled to end. I step out of the surgery room to warm up and eat. (In case you did not know surgery rooms are kept very cold to keep the surgeons, who wear several layers of sterilized equipment to prevent infection, comfortable. Nurses who do nothing during the surgery are not so comfortable.) I do not return to the surgery room for sake of not using another set of clothes which must be washed by hand. I occasionally return to watch the screen through the surgery room door between times of chatting with the family.
1400 – Laparoscopic cholysystectomy [lap choly] (gallbladder removal) scheduled to begin in Valladolid, a neighboring town 40 minutes away. The neighboring clinic is notified and put on standby notice.
1630 – Surgery finally ends. I help with post-op patient care and down a couple of spoonfuls of soup before being called to leave for Valladolid.
1930 – We arrive at the clinic in Valladolid.
2030 – Surgery begins. Delay due to anaesthesiologist being in another surgery at the time.
2330 – We arrive back at the clinic in Xocempich.
2415 – Second lap choly begins.
0200 – Second lap choly ends. We eat “dinner.”
0245 – Third lap choly begins.
0430 – Third lap choly ends. I help with basic clean-up.
0450 – I hit the sack and set my alarm to wake me up at 0600 for breakfast, devotionals, and another surgery at 0900.
The first surgery was a hysterectomy. The surgery was complicated by the fact that she had multiple large non-cancerous growths on her uterus and ovaries, her uterus was unusually large and hard from growths inside, and the team had only performed this cutting-edge type of laparoscopic surgery three times before. By the end, everyone involved was worried about her well being because the longer someone is under general anaesthesia, the greater risk there is of various complications. I was increasingly concerned with hypothermia, one of the common complications of surgery and anaesthesia. I quizzed the girls on duty on heat therapy which was the topic of my lecture to them a couple of weeks ago because they would help take care of her afterward. Dr. Estrella was increasingly worried and kept going in and out of the surgery area to watch the progress on the screen. After surgery was over we nurses got to work. Directly after surgery Femia, Louisa (wife of Dr. Federico), and I were the primary nurses taking care of the patient. Goal number one was to raise her core temperature. We covered her in blankets, shined a lamp on her, and put hot water bottles around her. Femia reported to me after returning from Valladolid that she continued shivering for three and a half hours. Dr. Federico told me later that part of the reason the surgery was so delayed is the technicality of the new procedures.
She and the other lap choly surgery patients went home today. Yay for no complications!
There is really a lot more to say about yesterday and today, not to mention the couple of days before that including the consistent mention of bugs at the beginning of this report, but I am sorry to say that my brain has completed functioning. All I can think of right now is a shower and bed. Perhaps I will go to the little store a block away first and see if the report of ice cream is true.
Prayer:
For a quick recovery for Dr. Estrella. He had surgery this morning (which I missed witnessing because I woke up at 8:30 right when it began and I do not remember turning off my alarm at 6:30)
Other than that… continuing prayer for general health… safety… especially from the spiders of unknown lethality (shall I call them the S-U-L-esses [think Princess Bride] from now on?) in my house (wow, what a thought pattern… I hope you understood that). Two of them in the last couple of days were I kind I have never seen before. They are bigger than my hand and run REALLY fast (yes, I did kill them with Raid… beautiful Raid!). The girls do not recognize the descriptions so they cannot tell me how dangerous they are.
Since my last letter I have also discovered three new insects in my house and had my first “long day” medical experience. I am currently running on three hours of sleep after a 22 hour day. I am weak in the knees and constantly have to fight off drowsiness to avoid going to sleep in the middle of the day and ruining my internal clock (therefore, if this letter seems a bit more disjointed than usual, please excuse said disjointedness). All those who were involved in the surgeries yesterday are going about their tasks today with a composure that reminds you of the walking dead. Of course, medical personnel never plan for such a long work day but sometimes they occur.
Rule number 1: Don’t schedule four surgeries in one day. Jam scheduling surgeries in small clinics with travel time in between leaves no room for complications. The following is a summary of my day.
0600 – Wake up, prepare for the day, do some household cleaning.
0700 – Breakfast
0830 – We prepare the surgery room and set out proper equipment
0900 – Total laparoscopic hysterectomy scheduled to begin. Delayed by special laparoscopy team’s late arrival.
1030 – Surgery begins
1300 – Surgery scheduled to end. I step out of the surgery room to warm up and eat. (In case you did not know surgery rooms are kept very cold to keep the surgeons, who wear several layers of sterilized equipment to prevent infection, comfortable. Nurses who do nothing during the surgery are not so comfortable.) I do not return to the surgery room for sake of not using another set of clothes which must be washed by hand. I occasionally return to watch the screen through the surgery room door between times of chatting with the family.
1400 – Laparoscopic cholysystectomy [lap choly] (gallbladder removal) scheduled to begin in Valladolid, a neighboring town 40 minutes away. The neighboring clinic is notified and put on standby notice.
1630 – Surgery finally ends. I help with post-op patient care and down a couple of spoonfuls of soup before being called to leave for Valladolid.
1930 – We arrive at the clinic in Valladolid.
2030 – Surgery begins. Delay due to anaesthesiologist being in another surgery at the time.
2330 – We arrive back at the clinic in Xocempich.
2415 – Second lap choly begins.
0200 – Second lap choly ends. We eat “dinner.”
0245 – Third lap choly begins.
0430 – Third lap choly ends. I help with basic clean-up.
0450 – I hit the sack and set my alarm to wake me up at 0600 for breakfast, devotionals, and another surgery at 0900.
The first surgery was a hysterectomy. The surgery was complicated by the fact that she had multiple large non-cancerous growths on her uterus and ovaries, her uterus was unusually large and hard from growths inside, and the team had only performed this cutting-edge type of laparoscopic surgery three times before. By the end, everyone involved was worried about her well being because the longer someone is under general anaesthesia, the greater risk there is of various complications. I was increasingly concerned with hypothermia, one of the common complications of surgery and anaesthesia. I quizzed the girls on duty on heat therapy which was the topic of my lecture to them a couple of weeks ago because they would help take care of her afterward. Dr. Estrella was increasingly worried and kept going in and out of the surgery area to watch the progress on the screen. After surgery was over we nurses got to work. Directly after surgery Femia, Louisa (wife of Dr. Federico), and I were the primary nurses taking care of the patient. Goal number one was to raise her core temperature. We covered her in blankets, shined a lamp on her, and put hot water bottles around her. Femia reported to me after returning from Valladolid that she continued shivering for three and a half hours. Dr. Federico told me later that part of the reason the surgery was so delayed is the technicality of the new procedures.
She and the other lap choly surgery patients went home today. Yay for no complications!
There is really a lot more to say about yesterday and today, not to mention the couple of days before that including the consistent mention of bugs at the beginning of this report, but I am sorry to say that my brain has completed functioning. All I can think of right now is a shower and bed. Perhaps I will go to the little store a block away first and see if the report of ice cream is true.
Prayer:
For a quick recovery for Dr. Estrella. He had surgery this morning (which I missed witnessing because I woke up at 8:30 right when it began and I do not remember turning off my alarm at 6:30)
Other than that… continuing prayer for general health… safety… especially from the spiders of unknown lethality (shall I call them the S-U-L-esses [think Princess Bride] from now on?) in my house (wow, what a thought pattern… I hope you understood that). Two of them in the last couple of days were I kind I have never seen before. They are bigger than my hand and run REALLY fast (yes, I did kill them with Raid… beautiful Raid!). The girls do not recognize the descriptions so they cannot tell me how dangerous they are.
Warning! Health Hazard ~Journal 9~
Warning: living and working in the Yucatan peninsula can be hazardous to your health as well as your comfort zone!
Here are some helpful tips to take into consideration before traveling to the area or working in a local clinic:
#1
Be sure to always wear shoes or sandals, even while indoors. Passive examination of the floor before stepping may not prevent the eliciting of a startling crunch from underneath your foot. Always inspect the walls, floor, ceiling and any surfaces for things such as ants, beetles, crickets, june bugs, fireflies, moths, bees, millipedes ranging from one inch to five inches in length, spiders of all sizes including tarantulas, baby toting spiders, and spiders bigger than your hand not to mention scorpions before entering the room or touching any surface. Keep a can of Raid within close range at all times! This bug poison is indispensable and useful for annihilating, asphyxiating, destroying, dispatching, executing, exterminating, and effectively sending any creepy crawly creature to its prospective genus and species afterlife.
#2
Become acclimated to sleeping in a hammock as soon as possible. It may be helpful to ask for instruction on sleeping positions and tying techniques for storage from the local natives as trial-and-error can be very time consuming. Sleeping in a hammock is much cooler than a flat bed. Though non-native sleepers find the first several nights uncomfortable becoming acclimated serves its purpose on especially hot nights when one would otherwise lie awake creating their own pool of sweat on a mattress. A rolled hand towel under the neck can help to alleviate morning stiffness.
#3
Be prepared for heat and humidity. The best preparation is mental preparation. Expect to be hot and sweaty at all times. Bring extra shower gel as it is common to bathe more than once a day. Bring lightweight pants, shoes, socks, and shirts with sleeves to avoid being eaten alive by mosquitoes and the threat of mosquito borne illnesses as they seem to prefer foreign blood over native blood.
#4
Do not expect the same materials, precautions, or treatments as in your hometown hospital. Clinics run on a very small budget so sacrifices in highly used materials must be made. Gloves are a precious commodity and are only used when absolutely necessary. They are then saved, cleaned, dried, dusted with talc, and sterilized for future use. Cotton balls are made by hand. Gauze is cut and folded by hand. Basic patient data taken by the nurses before each visit are hand written on tiny slips of recycled paper from the clinic printer. Everything is hand wrapped and sterilized in the clinic. Soiled linens are soaked and cleaned before going through the washing machine. They are then line dried and folded by hand. Learning certain key words and phrases in the local dialect proves to be very helpful for the nurse/patient relationship even though at least one family member accompanies the patient to serve as translator if needed.
#5
Expect to be pushed past your spiritual comfort zone. The window of opportunity for communication and verbal witnessing is extremely short for the vast majority of patients. Because this is a very family oriented culture, your words and actions are also heard and viewed by several of the patient’s family members. If you are asked to perform any kind of leadership role the common stereotypes of an American including a strong personality, ethnocentrism, and forward-thinking are accentuated. Care must be taken so as to not take advantage of such expectations for personal aggrandizement. Whenever a Christian works primarily in the field of ministry they set themselves up for myriads of spiritual attacks by the forces of darkness. Prayer and careful Bible study are a necessity to keep your thoughts, emotions, actions, and words within the will of God. Prepare and protect your mind from flaming arrows of doubt, fear, timidity, grandiosity, entitlement, pride, quarrelling, and any other unforeseen ungodly trait.
Prayer:
Continued prayer for Margarita. Her body refused to respond to the medication and expulse the fetus. She went home to continue waiting it out as the doctors do not want to do surgery until her body at least tries to release the baby.
For boldness in witnessing. Verbal witnessing has never been my forte and I feel that is a point of attack for the enemy.
Here are some helpful tips to take into consideration before traveling to the area or working in a local clinic:
#1
Be sure to always wear shoes or sandals, even while indoors. Passive examination of the floor before stepping may not prevent the eliciting of a startling crunch from underneath your foot. Always inspect the walls, floor, ceiling and any surfaces for things such as ants, beetles, crickets, june bugs, fireflies, moths, bees, millipedes ranging from one inch to five inches in length, spiders of all sizes including tarantulas, baby toting spiders, and spiders bigger than your hand not to mention scorpions before entering the room or touching any surface. Keep a can of Raid within close range at all times! This bug poison is indispensable and useful for annihilating, asphyxiating, destroying, dispatching, executing, exterminating, and effectively sending any creepy crawly creature to its prospective genus and species afterlife.
#2
Become acclimated to sleeping in a hammock as soon as possible. It may be helpful to ask for instruction on sleeping positions and tying techniques for storage from the local natives as trial-and-error can be very time consuming. Sleeping in a hammock is much cooler than a flat bed. Though non-native sleepers find the first several nights uncomfortable becoming acclimated serves its purpose on especially hot nights when one would otherwise lie awake creating their own pool of sweat on a mattress. A rolled hand towel under the neck can help to alleviate morning stiffness.
#3
Be prepared for heat and humidity. The best preparation is mental preparation. Expect to be hot and sweaty at all times. Bring extra shower gel as it is common to bathe more than once a day. Bring lightweight pants, shoes, socks, and shirts with sleeves to avoid being eaten alive by mosquitoes and the threat of mosquito borne illnesses as they seem to prefer foreign blood over native blood.
#4
Do not expect the same materials, precautions, or treatments as in your hometown hospital. Clinics run on a very small budget so sacrifices in highly used materials must be made. Gloves are a precious commodity and are only used when absolutely necessary. They are then saved, cleaned, dried, dusted with talc, and sterilized for future use. Cotton balls are made by hand. Gauze is cut and folded by hand. Basic patient data taken by the nurses before each visit are hand written on tiny slips of recycled paper from the clinic printer. Everything is hand wrapped and sterilized in the clinic. Soiled linens are soaked and cleaned before going through the washing machine. They are then line dried and folded by hand. Learning certain key words and phrases in the local dialect proves to be very helpful for the nurse/patient relationship even though at least one family member accompanies the patient to serve as translator if needed.
#5
Expect to be pushed past your spiritual comfort zone. The window of opportunity for communication and verbal witnessing is extremely short for the vast majority of patients. Because this is a very family oriented culture, your words and actions are also heard and viewed by several of the patient’s family members. If you are asked to perform any kind of leadership role the common stereotypes of an American including a strong personality, ethnocentrism, and forward-thinking are accentuated. Care must be taken so as to not take advantage of such expectations for personal aggrandizement. Whenever a Christian works primarily in the field of ministry they set themselves up for myriads of spiritual attacks by the forces of darkness. Prayer and careful Bible study are a necessity to keep your thoughts, emotions, actions, and words within the will of God. Prepare and protect your mind from flaming arrows of doubt, fear, timidity, grandiosity, entitlement, pride, quarrelling, and any other unforeseen ungodly trait.
Prayer:
Continued prayer for Margarita. Her body refused to respond to the medication and expulse the fetus. She went home to continue waiting it out as the doctors do not want to do surgery until her body at least tries to release the baby.
For boldness in witnessing. Verbal witnessing has never been my forte and I feel that is a point of attack for the enemy.
Tuesday, September 12, 2006
PRAISE THE LORD!! ~Journal 8~
Praise!
Thank you so much for praying! The young couple I asked you to pray for about a week ago with the partially miscarried fetus came in for a check-up just a few minutes ago. Most of the coagulated blood has been absorbed and we saw the fetus and it's beating heart!!! It was so tiny! Like a twinkling star! The doctor took her (Victoria) off complete bedrest and updated it to partial bedrest. She is still at risk for a miscarriage but overall it looks a lot better. She is feeling better and even looks better than last week. They are due back in a month to check up on the fetus. What a great God we serve! He who hears our prayers has acted to absorb the clotted blood and continue to knit this baby together within a sick woman!
O Lord, our Rock and Great Physician, how wonderful you are for answering our prayers! You who sit on the throne surrounded by the cherubim and the 24 elders, at whose voice heaven shakes and the temple fills with smoke, who put the stars into place and set the earth in its orbit, you yet listen to the prayers of your people on behalf of this little one! May you continue to knit this baby together and do a great work in this young woman and allow us the chance to minister to her and her husband in whatever way they need.
Prayer:
For a woman named Margarita. She is scheduled for a D&C tomorrow morning because her body has not responded to the medications and released her dead fetus and a lot of coagulated blood. Though this operation is relatively common, it is a very delicate operation involving high risk for the mother. The doctor fears to find additional complications which would explain why her body did not release the aborted fetus on its own, besides the strong medications we gave her.
Thank you so much for praying! The young couple I asked you to pray for about a week ago with the partially miscarried fetus came in for a check-up just a few minutes ago. Most of the coagulated blood has been absorbed and we saw the fetus and it's beating heart!!! It was so tiny! Like a twinkling star! The doctor took her (Victoria) off complete bedrest and updated it to partial bedrest. She is still at risk for a miscarriage but overall it looks a lot better. She is feeling better and even looks better than last week. They are due back in a month to check up on the fetus. What a great God we serve! He who hears our prayers has acted to absorb the clotted blood and continue to knit this baby together within a sick woman!
O Lord, our Rock and Great Physician, how wonderful you are for answering our prayers! You who sit on the throne surrounded by the cherubim and the 24 elders, at whose voice heaven shakes and the temple fills with smoke, who put the stars into place and set the earth in its orbit, you yet listen to the prayers of your people on behalf of this little one! May you continue to knit this baby together and do a great work in this young woman and allow us the chance to minister to her and her husband in whatever way they need.
Prayer:
For a woman named Margarita. She is scheduled for a D&C tomorrow morning because her body has not responded to the medications and released her dead fetus and a lot of coagulated blood. Though this operation is relatively common, it is a very delicate operation involving high risk for the mother. The doctor fears to find additional complications which would explain why her body did not release the aborted fetus on its own, besides the strong medications we gave her.
Nurse Elizabeth, at your service! ~Journal 7~
I updated the pictures on my Yahoo album. You should check them out.
Here I sit writing my latest journal in the doctor’s office of the Bethesda Clinic in Xocempich, Mexico. I pull up my sleeves to allow more of the breeze from the perfectly directed fan to cool off my ever-sweaty skin and rest my left foot on the worn and rickety leather chair so as to support my elbow with my knee. A fly buzzes close to my face and is knocked to the wall nearby. I run my upper teeth over my bottom lip, thinking, pondering, processing the activities of the last couple of days. I prepare to type and idly scratch one of many red and swollen mosquito bites on my ankle from the last week. All of this occurred in the same chair in which I sat not a half hour ago writing and signing medication orders. Are you surprised? After all, I have only one year left of nursing school before taking the NCLEX and (hopefully) receiving my RN certification. What could possibly prevent me from writing medication orders??
Perhaps I should explain myself…
Every Thursday at noon Dr. Frederico Estrella (the son) returns to Merida with his family for the weekend and Dr. Jose Estrella (the father and founder of the clinic) returns from his ranchero and takes over. Today, things did not quite go as planned. There was a lot of miscommunication and Dr. Jose Estrella went to Cancun and told his son but his son failed to inform us of the schedule change. Two patients arrived in the early afternoon and we told them to wait. We again told them to wait an hour later, and an hour later, and an hour later, until we decided we should call the doctor and find out where he is. We called his cell phone and could not get through because he was out of a service area. In this area, that can mean many things including he is on his way back and between towns or having dinner with a family friend. We then called Dr. Frederico who directed us to either ask the patients to return tomorrow or allow the nurses, meaning Lina and I, to do an assessment and call him with the results he would give us medication orders over the phone. They elected to stay because of how far they travelled to reach the clinic in the first place.
Lina asked the first question of why the patient came to see the doctor. The patient responded that she was having difficulty eating and drinking due to a paralysis on the left side of her face. A lightbulb immediately lit up in my brain illuminating the medical diagnosis “Bell’s Palsy” and I looked at Lina. She clearly had no idea what the paralysis meant and did not recognize my attempt to “Spanishize” the term so I began asking the patient questions as per my nursing training. I also did a neurological, kidney, and liver assessment in response to specific patient complaints. We then called the doctor back who had me ask the patient a couple more questions. He confirmed my suspicion of Bell’s Palsy and then instructed me in what medications she needed and even described three facial exercises to teach the patient. How exhilarating! I am technically not allowed to make medical diagnosis but what an amazing experience to have my first attempt correct!! I took the orders over the phone, instructed the patient on her diagnosis, the proper use and rationale for each medication, and the three different facial exercises. Demonstrating the faces the patient was supposed to practice three times a day for 10-15 minutes had everyone in the room doubling over with laughter. It was a nice stress breaker after the assessments and occasional confusion requiring translation of Spanish into Nahuatl by Lina.
After the visit was over and the patient went to fill her prescription Lina and I burst into fits of giggles from all the tension. We merrily made our way to eat dinner nearly an hour late telling the story to another student who was passing by. After I had finished eating Lina suddenly looked at me and asked if I had signed the medication receipt. My jaw dropped and I jumped out of my chair hurrying to catch the patient before she left. It had never occurred to me at the time. After all, since when does a nursing student sign a medication receipt!! It was definitely a strange sensation signing my name and title of NNS (Northwest [University] Nursing Student) on such a valuable and inquiry ridden document.
Other than my first experience with a medical diagnosis I have seen another birth and two C-sections. I have also taken a larger role in patient care and done some hands-on teaching with the girls. I have been reading the textbooks the girls use but they have only left me feeling empty and hungry for more so I began searching for a RN maternity textbook hoping that Femia had bought one to keep herself appraised of new information. Lo and behold I found a maternity/infant textbook for RN nurses and it is even in English! Just to clarify, I do not have a problem understanding Spanish textbooks, they are much easier to understand than the spoken form, but it still makes for slower reading. I am now learning a bit more about the anatomy, physiology, and medications surrounding birth and infancy. Beyond the immediate value as I continually work with new mothers I hope to make my next year of nursing school easier by studying as much as I can over the summer.
In other news, we had our first volleyball practice yesterday! The doctor bought us a new net and ball to practice with and ordered that every student not working in the clinic in the afternoons was required to attend practice. I think they will catch on quickly. Hopefully, some donated materials from my old volleyball coach will arrive without delay so our practices will be more efficient. I have found one of the most difficult issues to deal with in a clinic is the unpredictability. If there was nothing to distract us I would be teaching English in the mornings, music theory, voice, and volleyball in the afternoons. Unfortunately, there is yet to be two days in a row where more than one of them are accomplished.
Upon further contemplation and prayer about the issues brought up in the last journal I was reminded of the rules to which I am subject at my own school. Some of the many rules seem unnecessary and overbearing on a group of young adults but, unfortunately, every one of those seemingly “authoritarian” rules has a specific rationale. Many rules have been created over time which now plague the many honest and God-fearing Christians on my campus all due to a few students’ inappropriate behaviour at some point. The rationales at this nursing school are virtually identical. One of the reasons for such innate and detailed requirements revolves around the fact that this group of young adults will be living here for two years and certain standards must be met.
As far as the authority issues, I have decided to talk with Femia, the nurse in charge and my immediate authority, and verify with her my roles and responsibilities. I intend to bring up my situation as both friend and authority to the girls in an attempt to inform her that I see certain rules are being broken and that I feel stuck in a conundrum. This approach will hopefully help her realize that I do not want to be authoritarian with the girls but a Christian example of love and proper obedience to authority so they can observe the numerous benefits of such decisions rather than only experiencing rules as authoritarian pressure to dictate every part of life. This, when taken to the extreme, only fosters resentment and a backlash of inappropriate behaviour when the person is free from the regime. I view my relationship with the girls as one of guidance, not discipline. That is the responsibility of Femia and Dr. Estrella. I only hope and pray they feel the same way.
Prayer:
For a 19 year old girl who may lose her second ovary to a very large cyst and awaits her results regarding a cancer diagnosis. She will be having laparoscopic surgery here early next week to remove the cyst. Again, the thought of never having children is a great concern to her.
For my impending conversation with Femia about my role and responsibilities.
For the girls’ understanding of the Old Testament laws and narratives. We will be doing some history review to better understand what Jesus meant when he talked to the Pharisees and why he spoke to them in the manner he did.
Praise:
The girls, though still not completely reliable about bringing their Bibles, are actively participating in devotionals, bringing up sections they think are important and asking questions which is why we are doing a history review!
Here I sit writing my latest journal in the doctor’s office of the Bethesda Clinic in Xocempich, Mexico. I pull up my sleeves to allow more of the breeze from the perfectly directed fan to cool off my ever-sweaty skin and rest my left foot on the worn and rickety leather chair so as to support my elbow with my knee. A fly buzzes close to my face and is knocked to the wall nearby. I run my upper teeth over my bottom lip, thinking, pondering, processing the activities of the last couple of days. I prepare to type and idly scratch one of many red and swollen mosquito bites on my ankle from the last week. All of this occurred in the same chair in which I sat not a half hour ago writing and signing medication orders. Are you surprised? After all, I have only one year left of nursing school before taking the NCLEX and (hopefully) receiving my RN certification. What could possibly prevent me from writing medication orders??
Perhaps I should explain myself…
Every Thursday at noon Dr. Frederico Estrella (the son) returns to Merida with his family for the weekend and Dr. Jose Estrella (the father and founder of the clinic) returns from his ranchero and takes over. Today, things did not quite go as planned. There was a lot of miscommunication and Dr. Jose Estrella went to Cancun and told his son but his son failed to inform us of the schedule change. Two patients arrived in the early afternoon and we told them to wait. We again told them to wait an hour later, and an hour later, and an hour later, until we decided we should call the doctor and find out where he is. We called his cell phone and could not get through because he was out of a service area. In this area, that can mean many things including he is on his way back and between towns or having dinner with a family friend. We then called Dr. Frederico who directed us to either ask the patients to return tomorrow or allow the nurses, meaning Lina and I, to do an assessment and call him with the results he would give us medication orders over the phone. They elected to stay because of how far they travelled to reach the clinic in the first place.
Lina asked the first question of why the patient came to see the doctor. The patient responded that she was having difficulty eating and drinking due to a paralysis on the left side of her face. A lightbulb immediately lit up in my brain illuminating the medical diagnosis “Bell’s Palsy” and I looked at Lina. She clearly had no idea what the paralysis meant and did not recognize my attempt to “Spanishize” the term so I began asking the patient questions as per my nursing training. I also did a neurological, kidney, and liver assessment in response to specific patient complaints. We then called the doctor back who had me ask the patient a couple more questions. He confirmed my suspicion of Bell’s Palsy and then instructed me in what medications she needed and even described three facial exercises to teach the patient. How exhilarating! I am technically not allowed to make medical diagnosis but what an amazing experience to have my first attempt correct!! I took the orders over the phone, instructed the patient on her diagnosis, the proper use and rationale for each medication, and the three different facial exercises. Demonstrating the faces the patient was supposed to practice three times a day for 10-15 minutes had everyone in the room doubling over with laughter. It was a nice stress breaker after the assessments and occasional confusion requiring translation of Spanish into Nahuatl by Lina.
After the visit was over and the patient went to fill her prescription Lina and I burst into fits of giggles from all the tension. We merrily made our way to eat dinner nearly an hour late telling the story to another student who was passing by. After I had finished eating Lina suddenly looked at me and asked if I had signed the medication receipt. My jaw dropped and I jumped out of my chair hurrying to catch the patient before she left. It had never occurred to me at the time. After all, since when does a nursing student sign a medication receipt!! It was definitely a strange sensation signing my name and title of NNS (Northwest [University] Nursing Student) on such a valuable and inquiry ridden document.
Other than my first experience with a medical diagnosis I have seen another birth and two C-sections. I have also taken a larger role in patient care and done some hands-on teaching with the girls. I have been reading the textbooks the girls use but they have only left me feeling empty and hungry for more so I began searching for a RN maternity textbook hoping that Femia had bought one to keep herself appraised of new information. Lo and behold I found a maternity/infant textbook for RN nurses and it is even in English! Just to clarify, I do not have a problem understanding Spanish textbooks, they are much easier to understand than the spoken form, but it still makes for slower reading. I am now learning a bit more about the anatomy, physiology, and medications surrounding birth and infancy. Beyond the immediate value as I continually work with new mothers I hope to make my next year of nursing school easier by studying as much as I can over the summer.
In other news, we had our first volleyball practice yesterday! The doctor bought us a new net and ball to practice with and ordered that every student not working in the clinic in the afternoons was required to attend practice. I think they will catch on quickly. Hopefully, some donated materials from my old volleyball coach will arrive without delay so our practices will be more efficient. I have found one of the most difficult issues to deal with in a clinic is the unpredictability. If there was nothing to distract us I would be teaching English in the mornings, music theory, voice, and volleyball in the afternoons. Unfortunately, there is yet to be two days in a row where more than one of them are accomplished.
Upon further contemplation and prayer about the issues brought up in the last journal I was reminded of the rules to which I am subject at my own school. Some of the many rules seem unnecessary and overbearing on a group of young adults but, unfortunately, every one of those seemingly “authoritarian” rules has a specific rationale. Many rules have been created over time which now plague the many honest and God-fearing Christians on my campus all due to a few students’ inappropriate behaviour at some point. The rationales at this nursing school are virtually identical. One of the reasons for such innate and detailed requirements revolves around the fact that this group of young adults will be living here for two years and certain standards must be met.
As far as the authority issues, I have decided to talk with Femia, the nurse in charge and my immediate authority, and verify with her my roles and responsibilities. I intend to bring up my situation as both friend and authority to the girls in an attempt to inform her that I see certain rules are being broken and that I feel stuck in a conundrum. This approach will hopefully help her realize that I do not want to be authoritarian with the girls but a Christian example of love and proper obedience to authority so they can observe the numerous benefits of such decisions rather than only experiencing rules as authoritarian pressure to dictate every part of life. This, when taken to the extreme, only fosters resentment and a backlash of inappropriate behaviour when the person is free from the regime. I view my relationship with the girls as one of guidance, not discipline. That is the responsibility of Femia and Dr. Estrella. I only hope and pray they feel the same way.
Prayer:
For a 19 year old girl who may lose her second ovary to a very large cyst and awaits her results regarding a cancer diagnosis. She will be having laparoscopic surgery here early next week to remove the cyst. Again, the thought of never having children is a great concern to her.
For my impending conversation with Femia about my role and responsibilities.
For the girls’ understanding of the Old Testament laws and narratives. We will be doing some history review to better understand what Jesus meant when he talked to the Pharisees and why he spoke to them in the manner he did.
Praise:
The girls, though still not completely reliable about bringing their Bibles, are actively participating in devotionals, bringing up sections they think are important and asking questions which is why we are doing a history review!
Contemplation ~Journal 6~
Over the last couple of days I have found myself with more time on my hands than I expected, thus, the lack of journaling. Apparently, the workload in the clinic has been close to nothing compared to the usual. Dr. Frederico attributes this to the graduation season coming up. People do not wish to have extra expenses like doctor visits or operations around the end of the school year because of the traditional fiestas and gifts for the graduates. In addition to that, the girls have finals this week so our teaching sessions have all been postponed until afterward. Therefore, I am left with abundant study time and observing whatever consults happen throughout the day. The only part of my schedule that contains any markings is Wednesday morning at 0600. Dr. Frederico has a C-section scheduled for that time unless the woman comes in earlier due to complications.
In other words, I do not have much news to give you. Whether that is positive or negative, I am not sure.
One thing in particular that has been occupying a lot of my prayer and meditation time in the last couple of days is the issue of my responsibilities with the girls. As I have mentioned previously (I think), five of eleven girls were expelled last month due to various reasons including entertaining boys in the middle of the night. Part of my responsibilities with the girls is to keep an eye on them and keep them accountable. This leaves me in somewhat of a pickle. Suppose I find out during my abundant time with the girls any issues about them which are grounds for expulsion. Do I immediately bring it to Dr. Estrella and or nurse Femia as my authorities and lose all trust with the girls? Do I try and bring it up one-on-one and try to work it out with the girl in question and risk losing trust with my authorities? Something in between? On the other extreme, how do I deal with the constant breaking of certain minor rules which the girls argue, and I agree, are overbearing and unnecessary? As one more prone to gentle training than authoritarianism, especially in regards to young women my age, where is the balance in exhortation and staying under my own authorities who believe in ruling with a strong fist (notice I did not use the expression “iron fist”) and demonstrating proper obedience?
(WARNING: Theological contemplation ahead!) Throughout the book of John the emphasis is on God’s love for us and his desire to reconcile us to himself. Numerous times Jesus uses the illustration of the New Covenant versus the Old Covenant whereby we are judged by grace and not by law. I have always felt the Holy Spirit leading me to impress upon the girls obedience in response to His love that we see so effectively narrated by the apostle John. Determining how, exactly, to do the same with our human and fallible authorities seems to prove more difficult. Perhaps that is where Romans 13 comes into play.
(Note: the following is not an exegetical essay. It is not an exhaustive study. It is not a recommendation. It is not even my final determination for application with this immediate issue. It is simply the chronicling and organizing of my thoughts into something sensible for future reflection.)
Some may argue that the commands of submission to the authorities in Romans chapter 13 only relates to evil authorities, as in the time of the Caesars when Paul wrote the letter to the Romans. Quite obviously, Paul makes a blanket statement which must also include Christian authorities: “…there is no authority except that which God has established. The authorities that exist have been established by God (v. 1).” Not only does he make a blanket statement, he states it twice to make sure we get the point! So, why does God put someone in authority? “For he is God’s servant to do you good. But if you do wrong, be afraid, for he does not bear the sword for nothing. He is God’s servant, an agent of wrath to bring punishment on the wrongdoer (v. 4).” What is more, we are to submit to our authorities not just because of possible punishment, but because of conscience (v. 5). Therefore, if our authority is God’s servant, then by obeying our authority, we are obeying God and keeping our conscience clean.
Another section that deals with authority is 1 Peter 2:13-3:7. Again, we find a blanket statement about obeying all levels of authority. Why? Because “…it is God’s will that by doing good you should silence the ignorant talk of foolish men. Live as free men, but do not use your freedom as a cover-up for evil; live as servants of God (v. 15-16).” Continuing on in the chapter we find the application to servants and masters. (I think this section will make a good point should the girls argue that they don’t have to obey the small and overbearing rules ;) ) We are to submit to all types of masters, even the harsh (and overbearing) ones. Why? “For it is commendable if a man bears up under the pain of unjust suffering because he is conscious of God…but if you suffer for doing good and you endure it, this is commendable before God (v. 19, 20b).” I must clarify that I do not believe these girls are experiencing the “pain of unjust suffering.” There is authoritarianism and overbearing rules at times, but not always, and all of them have an appropriate rationale. Some of the rules simply are abundantly strict. The master and servant application can be useful in demonstrating to the girls that even under worse conditions we are commanded to submit to our authorities and do good in the eyes of our authorities for the sake of our conscience.
Now that I have organized on paper some of the rationale for bringing this issue up with the girls I must determine how (and when) to implement it while staying under my authorities and showing a good example. Ahhhhh… sounds like there is to be more theological contemplation ahead!
Prayer:
For wisdom regarding this and future related issues.
For God to prepare the hearts of the girls for confrontation.
In other words, I do not have much news to give you. Whether that is positive or negative, I am not sure.
One thing in particular that has been occupying a lot of my prayer and meditation time in the last couple of days is the issue of my responsibilities with the girls. As I have mentioned previously (I think), five of eleven girls were expelled last month due to various reasons including entertaining boys in the middle of the night. Part of my responsibilities with the girls is to keep an eye on them and keep them accountable. This leaves me in somewhat of a pickle. Suppose I find out during my abundant time with the girls any issues about them which are grounds for expulsion. Do I immediately bring it to Dr. Estrella and or nurse Femia as my authorities and lose all trust with the girls? Do I try and bring it up one-on-one and try to work it out with the girl in question and risk losing trust with my authorities? Something in between? On the other extreme, how do I deal with the constant breaking of certain minor rules which the girls argue, and I agree, are overbearing and unnecessary? As one more prone to gentle training than authoritarianism, especially in regards to young women my age, where is the balance in exhortation and staying under my own authorities who believe in ruling with a strong fist (notice I did not use the expression “iron fist”) and demonstrating proper obedience?
(WARNING: Theological contemplation ahead!) Throughout the book of John the emphasis is on God’s love for us and his desire to reconcile us to himself. Numerous times Jesus uses the illustration of the New Covenant versus the Old Covenant whereby we are judged by grace and not by law. I have always felt the Holy Spirit leading me to impress upon the girls obedience in response to His love that we see so effectively narrated by the apostle John. Determining how, exactly, to do the same with our human and fallible authorities seems to prove more difficult. Perhaps that is where Romans 13 comes into play.
(Note: the following is not an exegetical essay. It is not an exhaustive study. It is not a recommendation. It is not even my final determination for application with this immediate issue. It is simply the chronicling and organizing of my thoughts into something sensible for future reflection.)
Some may argue that the commands of submission to the authorities in Romans chapter 13 only relates to evil authorities, as in the time of the Caesars when Paul wrote the letter to the Romans. Quite obviously, Paul makes a blanket statement which must also include Christian authorities: “…there is no authority except that which God has established. The authorities that exist have been established by God (v. 1).” Not only does he make a blanket statement, he states it twice to make sure we get the point! So, why does God put someone in authority? “For he is God’s servant to do you good. But if you do wrong, be afraid, for he does not bear the sword for nothing. He is God’s servant, an agent of wrath to bring punishment on the wrongdoer (v. 4).” What is more, we are to submit to our authorities not just because of possible punishment, but because of conscience (v. 5). Therefore, if our authority is God’s servant, then by obeying our authority, we are obeying God and keeping our conscience clean.
Another section that deals with authority is 1 Peter 2:13-3:7. Again, we find a blanket statement about obeying all levels of authority. Why? Because “…it is God’s will that by doing good you should silence the ignorant talk of foolish men. Live as free men, but do not use your freedom as a cover-up for evil; live as servants of God (v. 15-16).” Continuing on in the chapter we find the application to servants and masters. (I think this section will make a good point should the girls argue that they don’t have to obey the small and overbearing rules ;) ) We are to submit to all types of masters, even the harsh (and overbearing) ones. Why? “For it is commendable if a man bears up under the pain of unjust suffering because he is conscious of God…but if you suffer for doing good and you endure it, this is commendable before God (v. 19, 20b).” I must clarify that I do not believe these girls are experiencing the “pain of unjust suffering.” There is authoritarianism and overbearing rules at times, but not always, and all of them have an appropriate rationale. Some of the rules simply are abundantly strict. The master and servant application can be useful in demonstrating to the girls that even under worse conditions we are commanded to submit to our authorities and do good in the eyes of our authorities for the sake of our conscience.
Now that I have organized on paper some of the rationale for bringing this issue up with the girls I must determine how (and when) to implement it while staying under my authorities and showing a good example. Ahhhhh… sounds like there is to be more theological contemplation ahead!
Prayer:
For wisdom regarding this and future related issues.
For God to prepare the hearts of the girls for confrontation.
Monday, September 11, 2006
Romans 5:6-11 ~Journal 5~
What a beautiful sunset tonight! It lit up the sky with streaks of fire and cast a pink hue over everything. Nature often makes me want to break out in praises to the one who paints the heavens, sets the stars in place, assures cyclic rising and setting of the sun, and knits us together in our mothers´ womb!
The weather here is quite nice other than the heat and humidity between noon and 4:00. Even that is not unbearable. Sometimes torrential downpours alleviate the heat during the day. They also send us girls shrieking and scampering outdoors to grab the clothes off the clotheslines before they are re-soaked! Today several loads of linens from the clinic were hanging to dry when a tropical downpour appeared nearly without warning. Five of us girls scurried to grab whatever we could and hide them under our hunched shoulders for less than a minute before the rest were too wet to save. I believe we saved about ¾ of what was hanging on the lines. We hung what we could under a small awning and the girls began to laugh at me because my scrubs were soaked all except for a bit around my hips! We all had a good laugh at our collective hysteria.
Yesterday, two of the girls and I trekked through Xocempich asking at each tiny store whether they had certain baking ingredients for banana bread. Interesting enough, bananas were the most difficult ingredient to find! We returned about a half hour later triumphant and ready to bake. We had a proper party laughing at the oddest things while I explained to them what I was doing. I only wish I had more experience with old gas ovens. Apparently, you must hand light them and let it warm up a bit as you s-l-o-w-l-y turn the knob up to the proper temperature (if only the oven heated past 300 degrees! At least it makes for softer bread!). The first time I lit the oven I assured it was functioning correctly and raised it to 300, 50 degrees below the desired temperature. As soon as I turned away a small *BOOM* sounded from the oven, causing the door to open enough to as to make quite noise when it slammed back into proper position. All three of us squeaked and jumped back a couple of feet. The immediate danger passed, I dove to turn the oven off and the kitchen soon resounded with nervous laughter. Fortunately, the second time´s the charm. The banana bread turned out beautifully and the girls are asking for more! Tomorrow we bake brownies and muffins, as per gifts given to the girls by previous American groups.
I am pleased to finally have had one-on-one conversations with each of the girls, adding to the camaraderie and ease in the group. We seem to be meshing quite nicely though I often feel out of place simply because I do not know where the vast majority of equipment is in the clinic.
I have found my role in the clinic is not one of hands-on experience like I had expected, rather, as an educated observer, teacher, and mentor. As students they are required to staff the clinic on rotating shifts and have very specific rules and responsibilities both on duty and off. Like me, they also look forward to hands-on experience as many of the clinic visits do not require any treatment from the students. Those who do nearly always require gluteal injections of either pain medicine or antibiotics. I try to help out with their more mundane tasks like cutting and folding gauze and making cotton balls as those are the kinds of things required in any underpaid small-town clinic that hospitals in America provide pre-packaged and ready for use. I also hope to learn how to pack and sterilize instruments sometime soon.
I have taken a bit more time these last couple of day for prayer and devotions. Some of that is due to being familiar with the girls´ schedule and some is for preparing my heart and my relationship with the Lord so I can better witness to the girls and others who come to the clinic.
I have definitely been blessed to have as much time as I do for prayer and meditation. The opportunity to have a house to myself where I can one moment shout my praises and sing at the top of my lungs and the next moment to just be silent is so freeing. I savour the lack of time crunches from which I could never escape at school. As much as the trials at school aided my relationship with the Lord it also strained it as far too often my attention was stripped from my personal time with Him to instead type furiously in front of a lifeless lit screen or cram all semblance of critical information from a textbook into my ever tiring brain. I want to make the most of this opportunity to lay aside the hindrances to my relationship with the Lord, making the most of my time with Him for these days (and time itself!) are evil.
Through my studies in John and Luke I have been impressed with how our devotion and obedience to the Lord is truly in response to his love for us (Romans 5:6-11). I believe this is the theme God wants me to use to minister to the girls. The book of John wholeheartedly focuses on the agape love of God demonstrated through his son, Jesus Christ and those are the kinds of verses the girls are picking out to read and discuss each morning. I feel the Holy Spirit telling me that once someone honestly conoce (Spanish for 'knows in their heart') the love He has for us, the obedience will naturally follow.
As we are all familiarize ourselves with a new schedule (devotions in the morning, music theory and voice at 2:00 and perhaps English in the evenings sometime soon) things are slowly running more smoothly (HA! Slowly? I have only been here a week!). Unfortunately, not everything can possibly happen on time as everything revolves around the workload in the clinic. For the last two days we have not had music class because of the patient load (the primary in each case had to do with a broken finger!).
Prayer:
For a couple that came to the clinic today. The 20 year old wife is one month pregnant and came in because of bleeding. Via ultrasound the doctor found the beginnings of a spontaneous miscarriage. The issue is complicated by the fact the girl is rather thin due to an active E-coli infection. The miscarriage is most likely due to that and the subsequent nutritional deficits. Family is priority one in this area and this is their first child. They were both clearly crushed. The doctor put her on absolute bed rest though he made it clear she will most likely lose the baby soon. I am praying for God to knit the baby together and she would miraculously carry it to term, and that his perfect will be done, among many other things.
For continued spiritual growth in both myself and the girls.
The weather here is quite nice other than the heat and humidity between noon and 4:00. Even that is not unbearable. Sometimes torrential downpours alleviate the heat during the day. They also send us girls shrieking and scampering outdoors to grab the clothes off the clotheslines before they are re-soaked! Today several loads of linens from the clinic were hanging to dry when a tropical downpour appeared nearly without warning. Five of us girls scurried to grab whatever we could and hide them under our hunched shoulders for less than a minute before the rest were too wet to save. I believe we saved about ¾ of what was hanging on the lines. We hung what we could under a small awning and the girls began to laugh at me because my scrubs were soaked all except for a bit around my hips! We all had a good laugh at our collective hysteria.
Yesterday, two of the girls and I trekked through Xocempich asking at each tiny store whether they had certain baking ingredients for banana bread. Interesting enough, bananas were the most difficult ingredient to find! We returned about a half hour later triumphant and ready to bake. We had a proper party laughing at the oddest things while I explained to them what I was doing. I only wish I had more experience with old gas ovens. Apparently, you must hand light them and let it warm up a bit as you s-l-o-w-l-y turn the knob up to the proper temperature (if only the oven heated past 300 degrees! At least it makes for softer bread!). The first time I lit the oven I assured it was functioning correctly and raised it to 300, 50 degrees below the desired temperature. As soon as I turned away a small *BOOM* sounded from the oven, causing the door to open enough to as to make quite noise when it slammed back into proper position. All three of us squeaked and jumped back a couple of feet. The immediate danger passed, I dove to turn the oven off and the kitchen soon resounded with nervous laughter. Fortunately, the second time´s the charm. The banana bread turned out beautifully and the girls are asking for more! Tomorrow we bake brownies and muffins, as per gifts given to the girls by previous American groups.
I am pleased to finally have had one-on-one conversations with each of the girls, adding to the camaraderie and ease in the group. We seem to be meshing quite nicely though I often feel out of place simply because I do not know where the vast majority of equipment is in the clinic.
I have found my role in the clinic is not one of hands-on experience like I had expected, rather, as an educated observer, teacher, and mentor. As students they are required to staff the clinic on rotating shifts and have very specific rules and responsibilities both on duty and off. Like me, they also look forward to hands-on experience as many of the clinic visits do not require any treatment from the students. Those who do nearly always require gluteal injections of either pain medicine or antibiotics. I try to help out with their more mundane tasks like cutting and folding gauze and making cotton balls as those are the kinds of things required in any underpaid small-town clinic that hospitals in America provide pre-packaged and ready for use. I also hope to learn how to pack and sterilize instruments sometime soon.
I have taken a bit more time these last couple of day for prayer and devotions. Some of that is due to being familiar with the girls´ schedule and some is for preparing my heart and my relationship with the Lord so I can better witness to the girls and others who come to the clinic.
I have definitely been blessed to have as much time as I do for prayer and meditation. The opportunity to have a house to myself where I can one moment shout my praises and sing at the top of my lungs and the next moment to just be silent is so freeing. I savour the lack of time crunches from which I could never escape at school. As much as the trials at school aided my relationship with the Lord it also strained it as far too often my attention was stripped from my personal time with Him to instead type furiously in front of a lifeless lit screen or cram all semblance of critical information from a textbook into my ever tiring brain. I want to make the most of this opportunity to lay aside the hindrances to my relationship with the Lord, making the most of my time with Him for these days (and time itself!) are evil.
Through my studies in John and Luke I have been impressed with how our devotion and obedience to the Lord is truly in response to his love for us (Romans 5:6-11). I believe this is the theme God wants me to use to minister to the girls. The book of John wholeheartedly focuses on the agape love of God demonstrated through his son, Jesus Christ and those are the kinds of verses the girls are picking out to read and discuss each morning. I feel the Holy Spirit telling me that once someone honestly conoce (Spanish for 'knows in their heart') the love He has for us, the obedience will naturally follow.
As we are all familiarize ourselves with a new schedule (devotions in the morning, music theory and voice at 2:00 and perhaps English in the evenings sometime soon) things are slowly running more smoothly (HA! Slowly? I have only been here a week!). Unfortunately, not everything can possibly happen on time as everything revolves around the workload in the clinic. For the last two days we have not had music class because of the patient load (the primary in each case had to do with a broken finger!).
Prayer:
For a couple that came to the clinic today. The 20 year old wife is one month pregnant and came in because of bleeding. Via ultrasound the doctor found the beginnings of a spontaneous miscarriage. The issue is complicated by the fact the girl is rather thin due to an active E-coli infection. The miscarriage is most likely due to that and the subsequent nutritional deficits. Family is priority one in this area and this is their first child. They were both clearly crushed. The doctor put her on absolute bed rest though he made it clear she will most likely lose the baby soon. I am praying for God to knit the baby together and she would miraculously carry it to term, and that his perfect will be done, among many other things.
For continued spiritual growth in both myself and the girls.
USE RAID!!! ~Journal 4~
Yay!! Combining the helpful tips from two friends I finally managed to get my pictures online! Follow the hyperlink and enjoy!
[hyperlink rerouted to my Facebook page. Look for my albums from Xocempich and Chichen Itza]
I will leave the explanation of the e-mail title until the end. Those who like bug stories are welcome to skip to the bottom.
Those who do not like injury or blood stories should skip the next section.
************
The clinic was much more busy this morning than it has been since my arrival in this town of about 500 people. At about 08:00 the groundskeeper for the clinic, Don Cozumel, approached the nurse´s station and calmly stated he had cut his hand. Naturally, no one asked him which hand he referred to since everyone knows he lost his left arm in a car accident several years ago. Skipping that assessment question my next thought was "how badly?" We quickly invited him through the half door and blinked at the small pool of blood accumulated on the floor. A handkerchief wrapped around his fist was soaked and dripping at a regular rate. With the doctor in an adjacent room near the end of a consult with a patient we did not call him right away and instead began assessing the patient. I immediately washed my hands in case I should be needed and supervised the two students. Upon discarding the handkerchief I told one of the students to get the doctor right away and told the other to prepare the patient for stitches. Between the fingernail and the knuckle his middle finger appeared as if it had been momentarily put in a blender. Apparently, nearly that had happened. He was doing some kind of yardwork, left his machine running (I did not recognize the name of the machine but I think it was a weedwhacker) while he did something close to the blades. He slipped... and... well. Flesh vs. Machine. Not good. The doctor did a little bit of tugging and discovered the lacerations went through the bone. He reprimanded Don Cozumel several times for not being careful with his one good hand. He would have lost the end of his finger if the lacerations went much farther. The doctor had to clean Don Cozumel´s hand before giving him anesthesia to decrease the chance of infection. This caused him so much pain that I could not watch any more. I have discovered in the surgery room that as long as the person does not react to the pain or does not feel pain due to anesthesia I am purely fascinated by the whole process. If the person is obviously in a lot of pain and reacts to the treatments then I am left with a sick feeling in my stomach, vision that threatens to tunnel, and blue lips. I took a quick siesta outside and returned to watch the doctor anesthetize the finger, clean the wound carefully, and stitch it up. During this time two obviously pregnant women and their families walked in.
************
After taking care of Don Cozumel the doctor went to consult with a 20 year old pregnant women and invited me to come along. She is 38 weeks pregnant and the doctor discovered the baby is not positioned correctly for birth. He scheduled her cesarean for next Wednesday at 6 am. He also told her that if there were any signs of labor she should come in right away and we would do surgery. The other woman is 8 months pregnant and both she and the baby appear to be in good health. That means I am "on call" for observing a C-section at any time of the day or night! Other than introducing the girls to proper singing technique, some warm-up exercises, and the concept of singing the same note as everyone else most of the day has been filled with studying and putting my pictures online. I bet that this computer is less than a 56K because it took much longer than the estimated time to upload the pictures. (I sure hope you all enjoy them!) That makes doing anything online quite a chore. Even trying to access and load my hotmail account takes a couple of minutes.
USE RAID!! A short story:
Note the picture in my photo album of the large spider on my kitchen floor. I found it last night, took a picture, and went after it with a plastic can right away to kill it. Would you like the thought of a very large spider with unknown lethality skittering around your house unsupervised?!? I decided to use the plastic can because the thought of cleaning a huge spider carcass and entrails off the bottom of my shoe was not appealing. Unfortunately, I forgot I had a can of Raid not five feet from the spider. When I positioned the plastic can above to hit the intimidating thing it dashed and hopped (yes, hopped) in search of safety. As a matter of bad luck for the spider I am quite willing to kill something even when it is intimidating! The fact it had the capability to hop made me all the more anxious to see it curled into a (relatively) small twitching ball. As a matter of bad luck for me upon hitting the spider it virtually *EXPLODED* with hundreds of spider babies!! The explosion caused me to pull back and the strike was hardly damaging to the mother. This also caused me to shout quite loudly...I must say, it is the closest I have come to screaming since I was 7 years old. Now I had hundreds of skittering babies and a skittering and hopping monster mom on my kitchen floor!! My heart suddenly pounded with adrenaline. I immediately discarded the flimsy plastic can and grabbed the sandal off my foot. Forget the guts, I wanted it dead!! I killed the mother with one swift blow and began tapping the sandal all over the floor. In several minutes it seemed all tiny black dots were either dead or within the safety of the cabinets. I got a quick drink of water and returned to examine the carnage once again overlooking the can of Raid on the counter. I noticed a couple more dots moving and killed those. This began a chain reaction. The motion of tapping on the floor disturbed others who were playing dead and the tapping continued. All in all, the whole episode lasted about 20-30 minutes. Only after I had prepared for bed did I suddenly realize that all the trepidation and desperation could have been bypassed by a simple can of bug poison. Not to mention, I would have had a better night sleep.
Prayer:
That the girls would participate more in daily devotionals. I cancelled them this morning because no one brought their Bibles. If anyone does not bring a Bible tomorrow I will tell them to go get it.
That the girls would do well in their exams this week and next week.
Thank you all for praying so diligently! I am encouraged by the number of people who send me e-mails to say they are praying for me. I am sure they are not unheard!
[hyperlink rerouted to my Facebook page. Look for my albums from Xocempich and Chichen Itza]
I will leave the explanation of the e-mail title until the end. Those who like bug stories are welcome to skip to the bottom.
Those who do not like injury or blood stories should skip the next section.
************
The clinic was much more busy this morning than it has been since my arrival in this town of about 500 people. At about 08:00 the groundskeeper for the clinic, Don Cozumel, approached the nurse´s station and calmly stated he had cut his hand. Naturally, no one asked him which hand he referred to since everyone knows he lost his left arm in a car accident several years ago. Skipping that assessment question my next thought was "how badly?" We quickly invited him through the half door and blinked at the small pool of blood accumulated on the floor. A handkerchief wrapped around his fist was soaked and dripping at a regular rate. With the doctor in an adjacent room near the end of a consult with a patient we did not call him right away and instead began assessing the patient. I immediately washed my hands in case I should be needed and supervised the two students. Upon discarding the handkerchief I told one of the students to get the doctor right away and told the other to prepare the patient for stitches. Between the fingernail and the knuckle his middle finger appeared as if it had been momentarily put in a blender. Apparently, nearly that had happened. He was doing some kind of yardwork, left his machine running (I did not recognize the name of the machine but I think it was a weedwhacker) while he did something close to the blades. He slipped... and... well. Flesh vs. Machine. Not good. The doctor did a little bit of tugging and discovered the lacerations went through the bone. He reprimanded Don Cozumel several times for not being careful with his one good hand. He would have lost the end of his finger if the lacerations went much farther. The doctor had to clean Don Cozumel´s hand before giving him anesthesia to decrease the chance of infection. This caused him so much pain that I could not watch any more. I have discovered in the surgery room that as long as the person does not react to the pain or does not feel pain due to anesthesia I am purely fascinated by the whole process. If the person is obviously in a lot of pain and reacts to the treatments then I am left with a sick feeling in my stomach, vision that threatens to tunnel, and blue lips. I took a quick siesta outside and returned to watch the doctor anesthetize the finger, clean the wound carefully, and stitch it up. During this time two obviously pregnant women and their families walked in.
************
After taking care of Don Cozumel the doctor went to consult with a 20 year old pregnant women and invited me to come along. She is 38 weeks pregnant and the doctor discovered the baby is not positioned correctly for birth. He scheduled her cesarean for next Wednesday at 6 am. He also told her that if there were any signs of labor she should come in right away and we would do surgery. The other woman is 8 months pregnant and both she and the baby appear to be in good health. That means I am "on call" for observing a C-section at any time of the day or night! Other than introducing the girls to proper singing technique, some warm-up exercises, and the concept of singing the same note as everyone else most of the day has been filled with studying and putting my pictures online. I bet that this computer is less than a 56K because it took much longer than the estimated time to upload the pictures. (I sure hope you all enjoy them!) That makes doing anything online quite a chore. Even trying to access and load my hotmail account takes a couple of minutes.
USE RAID!! A short story:
Note the picture in my photo album of the large spider on my kitchen floor. I found it last night, took a picture, and went after it with a plastic can right away to kill it. Would you like the thought of a very large spider with unknown lethality skittering around your house unsupervised?!? I decided to use the plastic can because the thought of cleaning a huge spider carcass and entrails off the bottom of my shoe was not appealing. Unfortunately, I forgot I had a can of Raid not five feet from the spider. When I positioned the plastic can above to hit the intimidating thing it dashed and hopped (yes, hopped) in search of safety. As a matter of bad luck for the spider I am quite willing to kill something even when it is intimidating! The fact it had the capability to hop made me all the more anxious to see it curled into a (relatively) small twitching ball. As a matter of bad luck for me upon hitting the spider it virtually *EXPLODED* with hundreds of spider babies!! The explosion caused me to pull back and the strike was hardly damaging to the mother. This also caused me to shout quite loudly...I must say, it is the closest I have come to screaming since I was 7 years old. Now I had hundreds of skittering babies and a skittering and hopping monster mom on my kitchen floor!! My heart suddenly pounded with adrenaline. I immediately discarded the flimsy plastic can and grabbed the sandal off my foot. Forget the guts, I wanted it dead!! I killed the mother with one swift blow and began tapping the sandal all over the floor. In several minutes it seemed all tiny black dots were either dead or within the safety of the cabinets. I got a quick drink of water and returned to examine the carnage once again overlooking the can of Raid on the counter. I noticed a couple more dots moving and killed those. This began a chain reaction. The motion of tapping on the floor disturbed others who were playing dead and the tapping continued. All in all, the whole episode lasted about 20-30 minutes. Only after I had prepared for bed did I suddenly realize that all the trepidation and desperation could have been bypassed by a simple can of bug poison. Not to mention, I would have had a better night sleep.
Prayer:
That the girls would participate more in daily devotionals. I cancelled them this morning because no one brought their Bibles. If anyone does not bring a Bible tomorrow I will tell them to go get it.
That the girls would do well in their exams this week and next week.
Thank you all for praying so diligently! I am encouraged by the number of people who send me e-mails to say they are praying for me. I am sure they are not unheard!
~Journal 3~
The weather here is beautiful and not quite as hot as last week, I am falling in love with the sounds of the animals, the girls are very friendly and welcoming, my fridge is now working so I can have ice and iced tea (!!), and I cannot wait until the oranges ripen! I plan on making batches of fresh orange juice and freezing them like popsicles. Fresh squeezed orange juice popsicles! It sounds soooo good! Until then, I am quite content with iced tea. Speaking of food, the girls and I were talking and they decided I should make them a batch of cookies because they want to try some popular American food :). So, if any of you have some simple cookie recipies I would be greatly obliged if you would send me some of your favorites! We have at our disposal Mexican cocoa, peanut butter, and oats. I am sure I can buy some chocolate to use for chocolate chips. I would also appreciate a gooey brownie recipie. The one I have at my disposal is not anything to write home about.
Because of schedule confusion yesterday I did not lecture either on hot and cold therapy or music theory. Instead, I lectured today! Both classes went fairly well though the girls looked rather confused when I walked them through the most basics of music theory. Only one of the girls has experience with a choir and she cannot even read music. Imagine hearing about staves, measures, the signs for and length of notes and rests for the first time! I hope to practice in the church tomorrow where we can utilize the piano and make an introduction to putting sound to the black dots with lines. What fun! I will probably not lecture on nursing theory again until after the girls´ exam on Friday. Femia has yet to inform me of our next topic. Until then, I am their personal tutor!
Life in the clinic has been very slow lately. I have only helped out with one patient because there was confusion about the IV system they were using. The absence of patients has given me time to study the Spanish textbooks, do some recreational reading (I have already started and finished "Through Gates of Splendor!"), and plenty of time for devotionals. I have also enjoyed to sit in on the classes for the students. Last night the topic was "rescue breathing" and today Dr. Frederico gave the girls an overview of the surgery room. It was a great introduction for me because some of the equipment here is a bit different than in the US. I hope to sit in on a surgery sometime. There is not one currently scheduled as of yet. The experience also allowed me to discover that scrubs are very cool in the tropical climate, even though that means wearing pants rather than a skirt! I will probably make a habit of wearing them. One perk is I also look more like a nurse than a tourist. That is always a plus!
As for sending pictures, I have tried uploading them onto my album on MSN but I need to download ActiveX and this computer is so slow it won´t pass the intro phase. I then tried posting them on MySpace but the photos are too big and there is no photo modification software on this computer... then I tried attaching one to this e-mail and Hotmail gives me an unnamed error message *sigh*. Oh well. If any of you have bright ideas for either sending or posting photos, let me know! I can´t imagine taking photos for two and a half months and not sharing them with anyone until I return home and can once again utilize my beautiful computer!
During my devotional times I have been impressed with using this summer to fall in love with Jesus again. I will be taking the girls through the book of John in the mornings with an emphasis on the character of Jesus in an attempt to give them a good foundation before graduating in a month. I will also review and rework the Beth Moore bible study of Jesus I did a couple of years ago during my personal study times.
Prayer requests
The only prayers I would add to the last e-mail is that traffic in the clinic would pick up and I would be able to help out and gain some clinic experience and that I would remain faithful in my personal study time and keeping the girls accountable in being ready for morning devotionals.
Because of schedule confusion yesterday I did not lecture either on hot and cold therapy or music theory. Instead, I lectured today! Both classes went fairly well though the girls looked rather confused when I walked them through the most basics of music theory. Only one of the girls has experience with a choir and she cannot even read music. Imagine hearing about staves, measures, the signs for and length of notes and rests for the first time! I hope to practice in the church tomorrow where we can utilize the piano and make an introduction to putting sound to the black dots with lines. What fun! I will probably not lecture on nursing theory again until after the girls´ exam on Friday. Femia has yet to inform me of our next topic. Until then, I am their personal tutor!
Life in the clinic has been very slow lately. I have only helped out with one patient because there was confusion about the IV system they were using. The absence of patients has given me time to study the Spanish textbooks, do some recreational reading (I have already started and finished "Through Gates of Splendor!"), and plenty of time for devotionals. I have also enjoyed to sit in on the classes for the students. Last night the topic was "rescue breathing" and today Dr. Frederico gave the girls an overview of the surgery room. It was a great introduction for me because some of the equipment here is a bit different than in the US. I hope to sit in on a surgery sometime. There is not one currently scheduled as of yet. The experience also allowed me to discover that scrubs are very cool in the tropical climate, even though that means wearing pants rather than a skirt! I will probably make a habit of wearing them. One perk is I also look more like a nurse than a tourist. That is always a plus!
As for sending pictures, I have tried uploading them onto my album on MSN but I need to download ActiveX and this computer is so slow it won´t pass the intro phase. I then tried posting them on MySpace but the photos are too big and there is no photo modification software on this computer... then I tried attaching one to this e-mail and Hotmail gives me an unnamed error message *sigh*. Oh well. If any of you have bright ideas for either sending or posting photos, let me know! I can´t imagine taking photos for two and a half months and not sharing them with anyone until I return home and can once again utilize my beautiful computer!
During my devotional times I have been impressed with using this summer to fall in love with Jesus again. I will be taking the girls through the book of John in the mornings with an emphasis on the character of Jesus in an attempt to give them a good foundation before graduating in a month. I will also review and rework the Beth Moore bible study of Jesus I did a couple of years ago during my personal study times.
Prayer requests
The only prayers I would add to the last e-mail is that traffic in the clinic would pick up and I would be able to help out and gain some clinic experience and that I would remain faithful in my personal study time and keeping the girls accountable in being ready for morning devotionals.
Thursday, September 07, 2006
Hello from Xocempich!! ~Journal 2~
Preface: I am sorry this is so long. I will try to write more often so I do not inundate you with a chapter of a book each time! I plan on organizing my prayer requests at the end of each e-mail so if you find you do not have the time to read the details, you can skip to the bottom and say a quick prayer before you click the delete button! ;)
**********************************
I cannot express the joy and the blessing I have already received during my time at the clinic (trust me, I have tried)! I have experienced so much in the first couple of days and been given so much responsibility that all I can do is praise God for his love and generosity to allow me this opportunity! My personal journal is filled with phrases of being "in awe" of the Lord and what he has done in my life!
I am staying in a cement and plaster house which has been well furnished and equipped by a church in Indiana. They have been coming regularly to Xocempich for 15 years and have built several of the structures on the compound. For as wonderful as the building is, some of the screens have broken and the seams are not as tight as they once were. The first night after I arrived and unpacked I discovered hundreds of ants crawling on the wall by my toilet. They weren´t there the first time I checked... fortunately, I found some raid in the kitchen and KILLED THEM ALL!!! MWAHAHA!! *cough* ahem... just in case you did not know, each time I have come to Mexico, I (personally, not the other people in my team) have had problems with ants. At least these ones do not appear to bite and only a couple of scouts have returned after the massacre. I hope the sight and smell of piles of their dead comrades on the floor will deter them from making a second attempt at infesting my wonderful WC! Other than that I have found in my house one cricket, one grasshopper, on moderately sized spider, one dead tick, several beetles, and a couple of flying bugs I do not recognize.
Compared to Merida, Xocempich is not as hot, nor as humid, nor as mosquito infested (praise the Lord!!). The mosquitoes in Merida are vicious. They are quick little things that do not hum like ours in the Northwest. Even using my magic Oil of Oregano (again, shameless plug) immediately after the bite I am left with an occasionally itchy red mark that can only be due to liquidation of the tissue around the bite, not just your common allergic reaction welt. Fortunately, I have not been bitten by them since leaving Merida. I have discovered a couple of welts or bite marks in Xocempich that I cannot attribute to any obvious perpetrator. All in all, the insect issue is not bad at all! Since I sent the last journal I have seen real, honest-to-God palm frond huts(!), helped deliver a baby(!!), fallen asleep to the sound of LOTS of strange creatures, seen avocado, lime, orange, mango, and mandarin trees including some other tiny fruit I could not recognize nor remember the name of; washed clothes by hand, slept in a hammock, learned a couple of Mayan words, drank fresh limeade (which they call lemonade here), taught two of the girls how to sing the Spanish version of "Majesty", and accompanied hymns in a Spanish church service.
Due to transportation issues I arrived in Xocempich on Friday morning, one day earlier than originally planned. I was informed on my role in the clinic and the school the night before and the morning I arrived. I am basically the equivalent of a headmistress for the Nurse´s Aid students when Femia, the head nurse is not here. She showed me around on Friday morning and left soon after not to return until Monday sometime! She also made sure to let me know that I am to give the girls a lecture on the proper use of hot and cold therapy on Monday! They sure have a lot of confidence in the leadership skills of an unknown American!
Apparently, there was some misconduct among the girls here at the school and 5 of the 11 students were expelled one month ago. In addition to being headmistress (and disciplinarian, which is not my forte among girls of my age) I am also to be their spiritual leader, demonstrating the attitude and actions of a Christian, leading them in daily devotionals, and discipling them so they can graduate with a Christian foundation in one month. Above all, this issue occupies much of my prayer and meditation time. It is a lot of responsibility with girls of my same age. Both Femia and the doctor are very strict and I tend to be more lenient, especially with 18-22 year old girls. Femia counseled me that this class of girls, more than any other class, has had little household discipline and the school must take up the slack so they can graduate as competent nurses.
She also told me that I will be allowed to do most everything in the clinic once I learn the protocol. Apparently, another nursing student who visited a couple of months ago took the night shift every night so the girls could sleep and not take a swing shift every four days. I am seriously considering doing the same.
Prayer requests:
That the Lord would grant me wisdom in how to juggle relating to the girls, being their leader, and discipling them.
That he would grant me an added measure of grace to learn a whole area of new vocabulary and, hopefully, a tonal language called Nahuatl (na-WHA-tl).
That I would use this time to draw closer to God and he would bless me with a deeper relationship with him.
**********************************
I cannot express the joy and the blessing I have already received during my time at the clinic (trust me, I have tried)! I have experienced so much in the first couple of days and been given so much responsibility that all I can do is praise God for his love and generosity to allow me this opportunity! My personal journal is filled with phrases of being "in awe" of the Lord and what he has done in my life!
I am staying in a cement and plaster house which has been well furnished and equipped by a church in Indiana. They have been coming regularly to Xocempich for 15 years and have built several of the structures on the compound. For as wonderful as the building is, some of the screens have broken and the seams are not as tight as they once were. The first night after I arrived and unpacked I discovered hundreds of ants crawling on the wall by my toilet. They weren´t there the first time I checked... fortunately, I found some raid in the kitchen and KILLED THEM ALL!!! MWAHAHA!! *cough* ahem... just in case you did not know, each time I have come to Mexico, I (personally, not the other people in my team) have had problems with ants. At least these ones do not appear to bite and only a couple of scouts have returned after the massacre. I hope the sight and smell of piles of their dead comrades on the floor will deter them from making a second attempt at infesting my wonderful WC! Other than that I have found in my house one cricket, one grasshopper, on moderately sized spider, one dead tick, several beetles, and a couple of flying bugs I do not recognize.
Compared to Merida, Xocempich is not as hot, nor as humid, nor as mosquito infested (praise the Lord!!). The mosquitoes in Merida are vicious. They are quick little things that do not hum like ours in the Northwest. Even using my magic Oil of Oregano (again, shameless plug) immediately after the bite I am left with an occasionally itchy red mark that can only be due to liquidation of the tissue around the bite, not just your common allergic reaction welt. Fortunately, I have not been bitten by them since leaving Merida. I have discovered a couple of welts or bite marks in Xocempich that I cannot attribute to any obvious perpetrator. All in all, the insect issue is not bad at all! Since I sent the last journal I have seen real, honest-to-God palm frond huts(!), helped deliver a baby(!!), fallen asleep to the sound of LOTS of strange creatures, seen avocado, lime, orange, mango, and mandarin trees including some other tiny fruit I could not recognize nor remember the name of; washed clothes by hand, slept in a hammock, learned a couple of Mayan words, drank fresh limeade (which they call lemonade here), taught two of the girls how to sing the Spanish version of "Majesty", and accompanied hymns in a Spanish church service.
Due to transportation issues I arrived in Xocempich on Friday morning, one day earlier than originally planned. I was informed on my role in the clinic and the school the night before and the morning I arrived. I am basically the equivalent of a headmistress for the Nurse´s Aid students when Femia, the head nurse is not here. She showed me around on Friday morning and left soon after not to return until Monday sometime! She also made sure to let me know that I am to give the girls a lecture on the proper use of hot and cold therapy on Monday! They sure have a lot of confidence in the leadership skills of an unknown American!
Apparently, there was some misconduct among the girls here at the school and 5 of the 11 students were expelled one month ago. In addition to being headmistress (and disciplinarian, which is not my forte among girls of my age) I am also to be their spiritual leader, demonstrating the attitude and actions of a Christian, leading them in daily devotionals, and discipling them so they can graduate with a Christian foundation in one month. Above all, this issue occupies much of my prayer and meditation time. It is a lot of responsibility with girls of my same age. Both Femia and the doctor are very strict and I tend to be more lenient, especially with 18-22 year old girls. Femia counseled me that this class of girls, more than any other class, has had little household discipline and the school must take up the slack so they can graduate as competent nurses.
She also told me that I will be allowed to do most everything in the clinic once I learn the protocol. Apparently, another nursing student who visited a couple of months ago took the night shift every night so the girls could sleep and not take a swing shift every four days. I am seriously considering doing the same.
Prayer requests:
That the Lord would grant me wisdom in how to juggle relating to the girls, being their leader, and discipling them.
That he would grant me an added measure of grace to learn a whole area of new vocabulary and, hopefully, a tonal language called Nahuatl (na-WHA-tl).
That I would use this time to draw closer to God and he would bless me with a deeper relationship with him.
Hello from Merida! ~Journal 1~
Buenos dias!
The trip went very well, all things considered. I arrived in Merida last night at 10:30 pm and had no trouble finding my hosts. I am staying at the house of pastor Pablo Estrella in downtown Merida. He is son of the doctor who runs the clinic in Xocempich. Today his wife is giving me a tour of Merida and we will keep doing tourist type things for the next couple of days before going to Xocempich (hopefully the ruins and the impact craters, too!). I believe they planned that for two reasons: to prevent culture shock, and also to give me a general overview of the location and culture before working one-on-one with the people in the clinic. They are so considerate and understanding!
According to a comment made by pastor Pablo my role in the clinic will mostly revolve around working with the nurse´s aid students and doing one-on-one evangelism with those who come to the clinic. Other than that, I still don´t have many specifics.
I am told that the clinic has internet access that is relatively reliable, so I am sure I will be sending messages rather regularly. Right now I am using a paid internet service in Merida. That seems to be the norm in large cities outside the US.
The weather here is HUMID!! I do not consider it extremely hot, but the humidity makes you feel like a sauna, even when you are sleeping. Last night was the first night I have slept the entire night without any covers.
I´m so glad I brought my Oil of Oregano! (shameless plug ;-) ) The mosquitos here are very small and they make only small welts, but my skin turns very red and very itchy... that is, until I put on some of the oil. I would definitely have a hard time acclimating if I didn´t have my trusty mosquito medicine.
Well, off to see more buildings and paintings!
Dios les bendiga! (God bless you)
Senorita Elizabeth
The trip went very well, all things considered. I arrived in Merida last night at 10:30 pm and had no trouble finding my hosts. I am staying at the house of pastor Pablo Estrella in downtown Merida. He is son of the doctor who runs the clinic in Xocempich. Today his wife is giving me a tour of Merida and we will keep doing tourist type things for the next couple of days before going to Xocempich (hopefully the ruins and the impact craters, too!). I believe they planned that for two reasons: to prevent culture shock, and also to give me a general overview of the location and culture before working one-on-one with the people in the clinic. They are so considerate and understanding!
According to a comment made by pastor Pablo my role in the clinic will mostly revolve around working with the nurse´s aid students and doing one-on-one evangelism with those who come to the clinic. Other than that, I still don´t have many specifics.
I am told that the clinic has internet access that is relatively reliable, so I am sure I will be sending messages rather regularly. Right now I am using a paid internet service in Merida. That seems to be the norm in large cities outside the US.
The weather here is HUMID!! I do not consider it extremely hot, but the humidity makes you feel like a sauna, even when you are sleeping. Last night was the first night I have slept the entire night without any covers.
I´m so glad I brought my Oil of Oregano! (shameless plug ;-) ) The mosquitos here are very small and they make only small welts, but my skin turns very red and very itchy... that is, until I put on some of the oil. I would definitely have a hard time acclimating if I didn´t have my trusty mosquito medicine.
Well, off to see more buildings and paintings!
Dios les bendiga! (God bless you)
Senorita Elizabeth
The beginning of the story...
The following is the letter I sent out to about two hundred friends and family announcing my plans to spend the summer working in a clinic in Mexico. Considering the internet connection there was a predictable 28.8 Mb/sec. it was difficult to post any updates on the internet. Instead, I regularly e-mailed "journals" to chronicle my experiences in Mexico. The journals were intended for all those who asked to be on my mailing list. Due to popular demand I am posting them here for all to see and access at the same time. I hope you enjoy them and are encouraged to continue making your relationship with God more personal as I have.
Matt. 28:18-20 "Then Jesus came to them and said, 'All authority in heaven and on earth has been given to me. Therefore go and make disciples of all nations, baptizing them in the name of the Father and of the Son and of the Holy Spirit, and teaching them to obey everything I have commanded you. And surely I am with you always, to the end of the age."
~~~~~~~~~~~~~~~~~
To my lovely friends and family, I know that I haven't communicated to some of you for quite a while, so I am going to give a short wrap up of the last couple of years: Since graduating Highline Community College in 2004 I have been attending Northwest University and have gained entrance into their 4-year nursing program. I have thoroughly enjoyed my time at NU, completing my last year of prerequisites with excellent grades and making several life-long friends. There is now about two months left to complete my Junior year, a feat I questioned several times last semester when I had some very involving health issues. Now for the news: In October of 2005 God orchestrated a meeting between a Mexican evangelist named Magdiel and myself through my church’s missionaries to Ecuador. Due to discussion about my current status as a nursing student and my desire to work in a rural setting he informed me of a rural clinic in his hometown that would be willing and welcoming to a nursing student. The town is called Xocempich in the state of Yucatan in Mexico. It is located on the Yucatan peninsula about 60 miles Southwest of Merida. After communicating with Pastor Magdiel, his brother Pablo, and an American graduate student who has lived in Xocempich for a total of about a year, I plan to minister there as a volunteer student nurse from the beginning of June to the middle of August. The clinic also runs a nursing school and I will be staying in the "hotelito" adjacent to the clinic with the Mexican nursing students. The town of Xocempich itself is only a couple of hundred inhabitants but the clinic serves people in a 150 km. radius. Many of the people that come to the clinic for services are of native Mayan descent and a large percent only speak Yucatec, a dialect of Mayan. The weather there is hot and humid and May is reportedly the hottest month. Most of the churches in the area were founded by Presbyterian missionaries in the 1920s who also did the first translations of the Bible into Mayan. Above all, I covet your prayers during all phases of this trip especially because it will be my first time traveling alone and by far the longest missions trip I will have attended. My goal in Mexico is not only to learn about the culture, their methods of communication and rural methods for health care, but to show God’s love through word and deed to my hosts, the other nursing students, the inhabitants of Xocempich and all of whom I come into contact. I am excited and very blessed to have such an opportunity virtually "fall into my lap" and come to be a reality after much prayer and investigation.
Matt. 28:18-20 "Then Jesus came to them and said, 'All authority in heaven and on earth has been given to me. Therefore go and make disciples of all nations, baptizing them in the name of the Father and of the Son and of the Holy Spirit, and teaching them to obey everything I have commanded you. And surely I am with you always, to the end of the age."
~~~~~~~~~~~~~~~~~
To my lovely friends and family, I know that I haven't communicated to some of you for quite a while, so I am going to give a short wrap up of the last couple of years: Since graduating Highline Community College in 2004 I have been attending Northwest University and have gained entrance into their 4-year nursing program. I have thoroughly enjoyed my time at NU, completing my last year of prerequisites with excellent grades and making several life-long friends. There is now about two months left to complete my Junior year, a feat I questioned several times last semester when I had some very involving health issues. Now for the news: In October of 2005 God orchestrated a meeting between a Mexican evangelist named Magdiel and myself through my church’s missionaries to Ecuador. Due to discussion about my current status as a nursing student and my desire to work in a rural setting he informed me of a rural clinic in his hometown that would be willing and welcoming to a nursing student. The town is called Xocempich in the state of Yucatan in Mexico. It is located on the Yucatan peninsula about 60 miles Southwest of Merida. After communicating with Pastor Magdiel, his brother Pablo, and an American graduate student who has lived in Xocempich for a total of about a year, I plan to minister there as a volunteer student nurse from the beginning of June to the middle of August. The clinic also runs a nursing school and I will be staying in the "hotelito" adjacent to the clinic with the Mexican nursing students. The town of Xocempich itself is only a couple of hundred inhabitants but the clinic serves people in a 150 km. radius. Many of the people that come to the clinic for services are of native Mayan descent and a large percent only speak Yucatec, a dialect of Mayan. The weather there is hot and humid and May is reportedly the hottest month. Most of the churches in the area were founded by Presbyterian missionaries in the 1920s who also did the first translations of the Bible into Mayan. Above all, I covet your prayers during all phases of this trip especially because it will be my first time traveling alone and by far the longest missions trip I will have attended. My goal in Mexico is not only to learn about the culture, their methods of communication and rural methods for health care, but to show God’s love through word and deed to my hosts, the other nursing students, the inhabitants of Xocempich and all of whom I come into contact. I am excited and very blessed to have such an opportunity virtually "fall into my lap" and come to be a reality after much prayer and investigation.
Subscribe to:
Posts (Atom)