Wednesday, July 9, 2008

At the airport, still shaking with excitement.

Welcome to my blog of the Tanzania trip: July 9-31.  I've never done a blog before, and I promise to keep it clean.  Unless you guys want it dirty--and I will do requests.  Any and all comments are encouraged.  Please post!

A couple months ago, my roommate Julie's boyfriend Nick said I should do a blog, like of my daily life.  While me and my ego would love the idea that people not only care about my daily rants but would take the time to read about it, that is clearly too much attention.  This, on the other hand, should be a good way to give updates to everybody, as well as being a good little journal for myself.

Speaking of Julie, as I sit here in the Minneapolis airport, I'm chatting with her online.  Frequent shoutouts on the blog.  Thanks go out to 
#1 Roommate Audrey for dropping me off and then getting the power cord/meds to Solomon.
#2 2nd Year Resident David Solomon for covering me and a good couple weeks of nights
#3 Retired Resident Jack Song for driving me to the BART in the morning.
#4 My Primary Care Doctor, Thomas McCoy, for the Xanax.  Excited to see why benzos are addictive!

Anyways.  I'm here at the airport, at the beginning of 36 hours of traveling, running on no sleep in 24 hours.  Yes, I scheduled a flight after working a night shift.  And while I should be (and in many senses am) exhausted, I'm so excited.

For years, I've been wanting to do this.  Bigtime international service.  I've done things in El Salvador, Ecuador and most recently Paraguay.  While I attended patients by myself in Paraguay over 2 years ago as a 4th year medical student, I didn't have a clue.  After 2 years of residency at the prestigious, world renowned (some things may be a little exaggerated in my blog, but too bad.  It's MY BLOG!) Contra Costa Family Medicine Residency Program, I'm much less clueless.  Not that I really do have a clue, just less clueless.

I remember in Paraguay, a guy came in with a hand laceration, and they other docs had to teach me to sew.  I had to get help to put a cast on.  And I couldn't distinguish infected from milk-engorged breasts.  I don't know how much I really contributed.  Blaire (CCRMC intern, KU grad, also went to Paraguay) did more than I did, I think.  Anyways, great experience, great learning--but how much did I really do and help?  After 2 years of training in Adult Medicine, Peds, OBGYN, ER and Surgery during residency, I'm actually worth something.  In many ways, I can really help people.

Shit, that's exciting.  It's exciting even in the imperfect US system.  But much more so in the places where there are no doctors, you're needed, people are sick.  You can do more good.  I feel like I've been chasing these ideals buried in books in 4 years of medical school and 2 years of intense residency training.  Now, it's finally time to get out there and get my hands dirty.

Not to imply that we aren't doing it everyday at the county during residency, because we really are.  Most of our county patients are poor.  And I'm proud of our system, docs and the care we give them.

But I've been passionate about international service for years.  It was the end in mind when I first went to medical school.  Life changing experience mainly in El Salvador during college realigned my medical aspirations: Instead of being some rich schmuck doctor, I saw medicine could be a real agent for social justice, in amazing service of the poor.  The ideal of serving the poorest of the poor inevitably leads, I think, to the third world.

These ideas motivate me to drop 2500 on a plane ticket and run halfway around the world.  It led me to specialize in Family Medicine--the last standing true generalist, who is most valuable in the resource poor world.  It brought me to California, to a program I thought would make me the best true generalist I could be.  It's why I still don't have a girlfriend, wife or kids.  Or mistress.  Being gone for months or years on international projects isn't how I want to start a family.

So, I'm excited.  And a bit nervous.  What if it sucks?  What if I don't like it?  Midlife crisis time.  Then I turn 30 in December and I'm in really big trouble.  Maybe I'll rethink that whole "No Mistress" policy at that point.  Or I could just do Locums with Jack.

I am a little scared.  I'm still quite limited--in knowledge, skills.  And how good am I without a CT scanner?  Nishant Shaw, recent residency grad, who went to the same Tanzanian hospital this past April, scared me a bit.  The first day, he decided to see the sick kids in the peds ward.  And the doctor there was like, "Ok, call me if you have any questions."  And that guy took off.  He left.
Wonderful.  Great. There will be a little more consulting and calling for ol' Lorenz (that's how I refer to myself, btw.)

Let's talk Tanzania.  I should say I know nothing about this country.  This will all soon change.  Located in East Africa below Kenya, The Republic of Tanzania is home to 40 million, the Serengeti and Mount Kilimanjaro--which some consider the tallest mountain in the world.  They speak English, Swahili and numerous indiginous tongues; are rather poor--median income under $800/year (about $2-3/day).  The average life expectancy is 50, and the top 3 killers are 1) AIDS (30%)
2) Pneumonia (non TB)
3) Malaria.
All preventable/treatable diseases.

That's it.  That's everything  I know about Tanzania.  And half of the above I just pulled off the internet.  Cheater!  Wait, wasn't the Disney move The Lion King about Tanzania?  It has some swahili in it.  Ok, enough of me displaying my ignorance about Africa and Tanzania.  So BACK OFF!  Residency keeps me busy.

This is funny.  Ambitious, I bought like $150 of Swahili tapes and books.  Out of the hours of CDs, I probably put in about 4 hours.   And now I can say, hello, how are you and fine.  I can't even say my name.  Good thing I bought 4 different courses, though.  Because clearly one wasn't enough.

I'm excited.  But now I'm getting tired.  No sleep catches up with you eventually, as refreshing as neck-straining plane naps can be.  I did purchase the "Comfort Neck Pillow" here in the airport for an exorbitant amount, and am looking for big things from that guy, along with his buddy, the "Nap Gel Eyemask."  There will be no pictures from this part of the trip, btw.

Was this too long?  I'm so no looking forward to the next 24-36 hours of travel.  I can read only so much of Barak O'Bama's autobiography before my brain craves crap.  Like TV or trashy magazines.

I miss everyone.  Well, not yet.  But I will.  I hope this blog will keep Roy ("father," "the old man") from thinking I'm dead, will give Grandma some tea-time bragging material, and enable Aunt Cath to re-live vicariously her own African adventures.  Hi Sister, how's the baby in your belly?  Allright.  I see McDonald's in my future, and am going to pound a couple cheeseburgers for Kirk.


Sanity Scout said...

This is really awesome, Larry! I'm really excited for you :) I actually have a very good friend in Tanzania right now, doing 2 years with the Peace Corps. She also does a blog, and she loves it there. I'm sure this will be a completely earth-shaking experience, and it's great of you to share!

Sanity Scout said...

This is Angela V., by the way...

Tom said...

Remember the deal, two xanax for you, 18 for me. You better come through too or it is a long walk home from the airport when you get back!
Looking forward to the next post.

Jen said...

Hey Larry- I love the blog! Good luck with the long plane flight and have fun with the xanax. I'm looking forward to the next post.

Pediatrician said...

Rock on for finally getting a chance to dig deep. Take care of yourself!

Berta Lázaro Corcuera said...

you should remember "Hakuna Matata!" too, for the weak moments.

Have fun!

barryllium said...

This is flat out awesome Larry. I couldn't be more proud of you, bud - you are doing something truly amazing.

Anonymous said...

Hey, Larry,

I hope you got my e-mail with the contact phone # for Pete & Charlotte. Thanks for the shout out. You'll be passing through places where I have been. I look forward to your pix - Tanzania is always calling to me to return.

Pediatrician said...

The pediatrician is me. you know me. you can check out my so-not-updated blog:

GW said...


Been keeping up with your travels- I think there's a screenplay in there.