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Tuesday, January 11, 2011

settling, continued

What takes up one's days as a doctor who is not really seeing patients?  I was pondering that last night as I tried to get out the door at 8 p.m. for a Bible study one of the volunteer pathologist couples invited us to in their home, and it kept getting later and later.  So, week 2 begins.  Early mornings, trying to be back in our routines of Africa, the pre-light quiet for Bible reading and prayer, the edge of dawn for a short jog (gasping, altitude, dim light and uneven roads, reluctant to venture far) and shower, kids getting up for school, breakfast laid out.  Only it gets light so much earlier here.  (We're a 23 hour drive east in the same time zone).  By 7 am we try to intersect at the table for a Bible reading and prayer then the kids head up the hill with their loaded backpacks.  Yesterday we had "senior staff prayer meeting" at 8, tomorrow "all-staff chapel".  Today we each put in a couple hours of Swahili study with our books and tape, interrupted by calls to the maintenance person to check and see if our house repair/painting could start today.  He asked us to meet him at the house which we did, and that seemed so promising, but when we checked back in the late afternoon nothing had happened.  Mid-morning we both tried to tag along on hospital rounds, to begin to get the feel for the mechanics and culture of medical care here.  There are not that many more pediatric beds in this hospital than Nyahuka, double?, but about a hundred times more staff.  Patients we saw this morning had notes in their records already done by the Kenyan medical interns, had lab results, were being sent for CT scans and echocardiograms in Nairobi, were receiving hospital-cooked food five times a day.  Patients were on oxygen, which came out of tubing from the WALL.  Nebulizers even.  Electricity.  Charts. Vital signs. No one on the floor.  

Noon, back to our duplex apartment, for another hour of intensive Swahili with a language helper.  Being used to this in our old days in Bundi, I started to tell him what we wanted to learn . . but this man is experienced.  He said, that's fine, but let's get the basics first, and then proceeded to launch into his lesson.  Lubwisi is a double-edged sword--so many of the words are close, but not the same.  Lina lianje nissioni Jennifer (my name is . .) becomes Jina langu ni Jennifer.  And all twenty times I said it, Lina threatened to beat out Jina on my tongue.  

1 pm, back to the hospital for the weekly pediatric case conference, the intern and clinical officer presenting.  This is a teaching time for the 9 Kenyan recent medical school grads serving an internship here, the handful of clinical officers in training, family practice residents, surgery fellows.  As the medical director reminded us, this hospital is 96 years old.  It is like stepping forward in time from Bundibugyo, a complicated steady institution directed by Kenyans for Kenyans, with missionaries in a supporting role.  A massive institution caring for the most complicated patients in the area, but also a teaching hospital, with conferences and lectures and research.

Late afternoons, errands.  Making rounds of the few families we know for advice or borrowing.  Running paperwork up to Bob C who switched missions and countries but is still his cheerful can-do competent self and has graciously included us in some of his administrative errands for RVA.  Walking to the dukas for flour and toilet paper and pumpkins and strawberries, carrying back an assortment of fresh foods to cook.  Taking down clothes from the line which blow dry in the breeze within hours.  Sweeping, baking, cooking, washing dishes, the basics of survival.  Homework help, emotional support.  Emails, holding my computer up at various voodoo angles on the front porch trying to catch a signal, or calls and sms's with the rest of our life outside Kijabe.  Discussing our WHM Africa fields together, thinking and dreaming, upholding.  Knocks at the door as various ladies try to sell their tortillas and muffins, flowers and crafts.  Ten days on the ground and only one direct begging ask from a stranger at the door. 

Sometimes another crack at the Swahili tapes in the evening after dinner and cleaning up.  Hearing about everyone's days.  We edge our dinner time back to 6:30 even though the entire missionary world around us sits down at 5:30 sharp, so we can enjoy candlelight at sunset.  But every few days we have to juggle the times because one kid or another has to be somewhere for something.  Reading about a patient's problem we just saw.  Following up on finances.  Advising Luke on his schedule woes.  The wind picks up as darkness deepens, and we're glad to be inside our little apartment.

Not a lot to show for these days, but the exhaustion tells me we're working hard.  I think it is the attention, the edginess of newness, the strain of listening to a new language and constantly meeting new people, the remembering of all the ways this is NOT home yet, the intimidation of stepping up a hundred notches in the quality of medical care we must offer, he dread of the even more unsettled days to come when we build up a habitable home from scratch.  

So the settling continues, and I'm wishing we could justify at least a whole month this way, but every time we're in the hospital we're told how great it is that we're finally here . . . nice to feel welcome, but a lot to live up to.  

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