Ale La (Go There)

I sit in an alleyway of sillar stone. The white walls collect the heat and shine it back at me. I have just ordered a pizza a la leña from a tourist trap restaurant behind the cathedral. When it comes a man walking by comments, "Asu, que rico! Provecho!" Only he's not looking at my pizza when he says that. I have forgotten that to wear a tank top here often invites a full body glance up and down, a lingering stare at the blondish streaks in my hair, or some incarnation of a whistle. I have tentative plans for today including eating tres leches cake at least once, drinking a cappuccino with some friends, and perhaps drinking a cusqueña negra in the airport. I have to catch up on my caloric intake after the colossal effort that my metabolism made in the high altitudes. And my Peruvian mom's voice echoes in my head, "Amandita! Porque tan flaquita, mi reina?" I love the sound of my name here, Amandita. Teresa managed to fuss over me all morning, even while...

The high places break me every time. My hands crack open and bleed from the dry air and from the wind. My breath comes in gasps. When we sing hymns in the morning it comes in an unsteady line of rich notes, full yet breathless. The meaning is full. Eyes around the circle of faces are full. There is a pressure in my chest and I don't know if it is from the thin air or the emotion. Somehow the severity of the landscape breaks off my hardness. Is it the people walking out of the empty painted hills, the way they call me Tia or doctorita, or is it the way that Venus actually shines like the star of Bethlehem illustrations from years of Christmas cards? Is it the intensity on Cathy's face as she stands in the main square in Choco reading the Bible to people who cannot read themselves? Or maybe it is the baby girl, born two months premature at home, because the hospital is 2 days away, who is now cooing at me from within the brightly colored blanket that wraps her to her mothers ...

What is it like to arrive somewhere after walking kilometers through the dust, dirt and thin air? Maybe the altitude is sucking your breath away, maybe you have blisters or an ingrown toenail, maybe you are feeling good, or terrible, and maybe you are thinking What did I get myself into? as you realize that the only way out is more of the same mule trails stretching on in a seemingly perpetual pattern of ascents and descents. Here is a brief description of each of our arrivals: Llanca. We saw Llanca first from across the canyon. We were going down a slippery gravel road in the back of the cattle truck and looking up at the crisscross of the line that was to be the next 4 hours of a nice little hike/climb. It's always discouraging to go down before you have to go back up. After climbing up in the dust and wind for a few hours, we started to pass the fields and a few of the towns people came running down the path to do the afternoon chores and shouted encouragements to...

A reprise: The repetition of a piece- played again at the end or repeated throughout a score. A reprise stirs again the thoughts and emotions of before, reshaping them and calling to a deeper place, perhaps, perhaps not. It is an invitation to feel. The joy may be rekindled, the flames may rise a little higher. This reprise is a rest from the weight. It is a burden of a different kind. It is a return to the dusty trail where I felt the heft of surrender digging into my palm. It is a reflection on a year that was surprising, challenging, heartbreaking and life giving. I’m going back to Peru… Going back to the Canyon… Going back to the windswept highlands that are barren and empty, lonely and full. I’m going back to Peru. The music plays through my head. The first time I remember feeling alone and feeling uncertain. That underlying melody is the same, but the bridge is different. Because last time I was given a family and last time I surrendered my certainty. Thi...

This morning I looked at my journal and realized that I've been neglecting all the stuff that is swirling around in my heart. It's cheesy, and I know a lot of people don't journal any more, but for me my journal is a place where I realize what I'm feeling in my day to day life. It's like talking to a close friend. It's the most honest place of my prayer life. It is full of mistakes, bad spelling, terrible handwriting and sometimes bad words, but I know that God can take it. He already knows all of that anyways. The problem is that for the past week, I haven't been journaling very much. It's more like I have been bullet pointing the things that happen in my day to day life, and avoiding how I feel about them. I arrived in Lima on Thursday afternoon and got settled in to my guest house in San Miguel. This guest house was a surprise plan. Which means, I thought I had a plan and then SURPRISE, this happened. I had originally planned on staying with some ...

"How do we understand God in this?" This was a question that really struck home with me over the past two weeks, as I was translating for our MMI trip to Puno/Juliaca. How do we understand God in this, when a woman grabs your hand with tears in her eyes and says "Help me," when you have to tell a woman with no insurance that she may have cancer of the spleen, when a mother of two deaf/mute girls tells you that she will sell her organs so that they can have cochlear implants? How do we understand God in this? When a patient comes in with a fungal growth the size of a cabbage on his foot. He says he has been cleaning it with urine and that it's "getting better." The team manages to convince him that he needs to be hospitalized, it is a potential emergency, and that he could contract sepsis. But, when he finally agrees to go to the hospital they tell him that all his paperwork has been transferred to Arequipa, where the health care workers are on ...

I have a confession to make: I brush my teeth with the water here. I also carry a rock with me whenever I run in a strange city. Thank you Steph for that advice. It´s crazy how quickly you get used to things you never thought you could. For example, I used to hate the fact that I had to speak Spanish to do everything. Now I love it. I used to feel claustrophobic when it took a long time to make things happen. Now it´s a part of the adventure. I don´t have to shower everyday to sleep well at night. And whenever we drive anywhere I just fall asleep rather than freaking out. One time I made this face and someone took a picture. I know. It´s a little embarrassing. They call this face "the eye," and when we play cards I try to intimidate people so that I can win. Note to self: Sportsmanship = a good thing to learn. There is dog poop on the street, there are taxi drivers honking so close that your left eardrum ruptures, and there are bus driv...

Where do stories start? Do they start on a dusty path in the silence of the wind? Or do they start with a 5 year old girl who hears the story of Dr. Livingstone for the first time and says, "I want to do that someday."? Either way, the stories inside of our hearts start somewhere. This past week I found myself at a crossroad type feeling, even though, in the moment, there was only one way ahead. We were walking through the Colca Canyon, on an MMI trip that traveled from one rural pueblo to another, doing health clinics, and giving away toothbrushes. During those two weeks something deep was stirring in my heart, the opportunity "the call" (if you like) to surrender myself. That morning my friend Vicente shared a devotional and I translated. He talked about how he, when he was a young Christian, had said "God I give you my life." And then proceeded to live his life exactly as he wanted. Five years later, on bed rest for a work related back injury, he ...

I have, at last met the Real Baddest Ass on the planet. Some of you may know that I am, admittedly, a little obsessed with being a bad-ass. Well, I have found him, or her, the boldest Baddest Ass on the planet lives in the Colca Canyon and looks like this . Do you see him? That tiny speck in front of the mountains. That is the mule that was standing in the middle of our path on the longest day of hiking in all of my life. Do you also see the amazing backdrop of the mountains behind the Bad-Ass? Yes, you see the mountains? Oh good. Does anyone else think that those mountains are epic enough to be featured in the upcoming hobbit movie? Peter Jackson, bring your dragons, trolls and elves to Peru, you won't regret it. I felt like I was walking through the mountains of New Zealand with all of my friends; Aragorn, Merry, Pippin, Frodo, and company, which meant that I was thinking a lot about Lord of the Rings while we were hiking through the Colca Canyon. Here ...

Travel pants. Some of us need them, and some of us don't. Even amongst those of us who need travel pants (because I am one of them) there are varying degrees of extremity. There are those who consider leggings to be excellent travel pants, possibly because they have no insecurities or maybe they have just transcended their insecurities with lots of cellulite-drop-kicking yoga. Others go with the baggy camo capris that have all those nifty little toggles and ties. Or, perhaps, you prefer the classic zip off pants, like myself. But never have I heard someone say, "Why yes, these brilliantly white pants are in fact my favorite travel pants." I spotted her on my way home from the hospital today. After walking through the ever tempting array of street food around the hospital I came to the touristy, old town center. I stopped at a stop light. The guy selling holographic pictures of horses running through fields of green was yelling across the street to his fellow street v...

Please forgive me. I had to type the title in Spanish. I'm not trying to be a poser or anything, you know that person who goes all "native" and speaks rubbish Spanish all the time. It's just that right now, I only have three months left and I'm trying to say EVERYTHING in Spanish. And, yes, I know those two sentences contradict each other. Irony. Anyways. The type of medicine we did in the jungle was not too different from the medicine we do in other places in Peru. We still saw (what felt like) millions of patients with low back pain, lots of gastritis, and moms who were convinced that their children had parasites. Quick, an excerpt from a real live conversation: Me - "Entonces, su hijo tiene la grippe. Algo mas?" Anxious Momma - "Seguramente tiene bichos tambien." Me (with eyebrows raised)- "Hmmm, bichos. Porque piensas que el tiene bichos?" Anxios Momma- "No come bien, y solo quiere comer carmelos." Me- "Ah...

Sometimes life is really full. It’s full of great moments, uncomfortable moments, and people, hundreds of people. We just got back from a two week clinic in the Amazon area of Peru . Imagine going from the bald heights of the Andes , to the humid heat of a rainforest in a few hours. System shock! The first time I went for a run in Inapari I was sweating from the backs of my knees. Seriously? I didn’t even know there were sweat glands back there. Ewww. I have this tendency to paint everything I experience with a beauty brush, even the bad things. So, quickly, before I rhapsodize about how much I love the jungle, let me tell you… There are BUGS there. Everywhere. And they are huge. They are not the teeny, tiny, tame bugs that we have back in CA. No, they are gigantic termites, multicolored (probably poison carrying) centipedes. They are cockroaches that fly, and spiders that are the size off your hand. If you hate bugs, the jungle is not the place for you. No amount of repe...

Have you ever wondered what it would be like to practice nursing 50 years ago? You know, back when they calculated IV drop rates using a wrist watch, and back when all the nurses still wore white caps. Come to Peru, and work with me at Goyeneche Hospital and you can experience all of those things for yourself. I remember in nursing school when Dr. Otten used to say things like, "In the olden days we did this..." and we all would roll our eyes. But here, today is a day of old. What is an alaris pump? How does a computerized charting system work? Imagine trying to explain these things to nurses who have never used them. That is what happens every time one of the nurses asks me how nursing is different in the States. Don't even get me started on the patient to nurse ratio (in some places it's one nurse to an entire floor). And yes, I did learn how to calculate drip rates using a wrist watch. But no, I will never wear one of those white caps. Aside from technol...

In this post, I'm testing the philosophy that less is more, simply because it is pretty hard to describe how amazing it is to hike around here, even when that means you have to wake up at some un-godly hour of the middle of the night and hike by the light of a headlamp. Picture it. It is 3 in the morning, you are clambering over volcanic rocks, breathless because the air is thin, farther up the mountain you can see the lights of a group that is further ahead. You are wearing three layers of pants (which makes high stepping up onto all these rocks a little more challenging), two pairs of socks, a shirt, a fleece, a jacket, gloves, a hat, etc, but you are still cold. You have to stop to breath, but you can't stop for too long because it is COLD (did I already mention that it is cold? Whooops!). You can see all kinds of constellations, shooting stars, and the weird refracted light off of the snow from the peak that looms closer and closer. If you succeed you will arrive at th...

Over the last couple of weeks, I have had the great privilege of working with a team of volunteers and surgeons here in hospital Goyeneche. I was the RN in charge of the Pre-op area. Which meant that a team of nursing students and I got the patients from their beds in the hospital wards, placed their IVs, took baseline vitals, double checked for drug allergies and time NPO, and then sat with them while they waited to be cut open. We also got to duck in and out of the operating rooms and see a lot of surgeries like septoplasties, laparoscopic gallbladder removal, hernia repairs and hysterectomies. It was a huge honor to work with this team of proficient and compassionate people, and to work with the Peruvians from the hospital who were translating and helping us problem solve. It's pretty amazing how these things come together. By the end of the two weeks, we had the routine of patient in, patient on the table, patient in recovery, down to an art form. It was almost effortless,...

This week we have a huge team here in Arequipa doing a surgical outreach at hospital Goyeneche where I work. It's weird because I'm working with Americans and Canadians, but sometimes I feel most comfortable siting down and chatting with my Peruvian friends in Spanish. It's very exciting to be a part of this project and see people come in for surgeries that they wouldn't be able to afford unless these surgeons volunteered their time. Here is some snazzy fun for those of you who are linguistically inclined. Can you match the Quechua word with it's English equivalent? There are tons of words in Quechua that start with the "ch" sound. See if you can mix and match them correctly. 1. Chancho                                                  ...

Two physical therapist and a nurse on a home visit, in a field. Feli our Quechua translator, Tajel and Stephanie (PTs) and our patient. He was paralyzed at the age of 14 and is wheelchair bound. We evaluated him under a tin roof while it was raining. Then his aunt brought us hand made cheese and toasted corn. The family farm, chakra (in Quechua) The cute donkey After our home visit we walked through Quinua Pampa a city up at 10,000 ft.