Panama: Four days, four new experiences, and four new outlooks

Bocas del Toro, Panama

I arrived in Panama this past Sunday, and so far it has been incredible. I’m here with Floating Doctors, a non-profit dedicated to serving Caribbean communities that need medical aid. We reach many of the communities by boat, hence the name “Floating Doctors”.

On Tuesday, we left our main location on Isla Colón (a small island off the coast of Panama) to take a water taxi to another small island called Almirante. From there we took a shuttle to reach the base of the Talamanca mountains.

Here are the four things I’ve experienced these past four days that I’ve never experienced before:

On our way to the Ngäbe-Buglé Comarca

1. Hiking for 8 miles. Once we reached the base of the mountain, we began to follow a trail for 8 miles to reach the Indigenous Ngöbe (NO-BAY) community. Our team consisted of 24 volunteers (pre-meds, med students, physicians, nurses, translators, photographers, etc). We were a big group, and we made it in record time: 3.5 hours. The weather and nature were beautiful. We surely reeked and were dripping with sweat by the time we reached the community. My scrub pants (don’t ask why I would wear that on a hike -_-) were covered in mud and dirt, and my hands were dirty from grabbing onto things to keep my balance during the rough, deep muddy parts of the trail. It was very strenuous but gratifying once we reached our destination! 

 2. Sleeping in a hammock. We all slept in a hammock with a mosquito net over us for three nights. I slept very badly the first night because my hammock slipped and my back ended up touching the ground. My back was also cramped; I wasn’t able to lay out flat like I'm used to on a bed. The next night was a bit better once one of the other volunteers came and tightened my hammock for me. The last night was the best night. By then I was a hammock sleeping "pro".

   3. Bathing in the river. I’ve gone swimming in a river, but never bathing. The rules were shorts for men, and shorts and a T-shirt for women (we couldn’t bare our shoulders). Have you ever tried to bathe yourself with clothes on and people all around you? It was really something. The trick was being discrete about washing certain areas without too many people looking in your direction. The water was also freezing cold, so the next trick I had to learn was bathing myself quickly as well as thoroughly.

4. Using a latrine. A latrine is basically a toilet with a huge hole in the ground. Needless to say, it reeks because of the waste buildup in the earth. One of my biggest challenges with the latrine wasn’t the smell, the lack of toilet paper (we had to bring our own), or the lack of running water to wash our hands. It was the location. I’d needed to go to the bathroom many times at night, but I didn’t get out of my hammock because our place of sleep was a little far. It was also pitch dark outside, and even if I had a flashlight to use, I didn’t feel comfortable leaving my hammock at 2AM in the mountains to use a latrine. Again, like bathing in the river and sleeping in a hammock, this is something that you grow used to if you have nothing else.

Here are my four new outlooks:

1. You have to be a certain type of person to do this type of international volunteer work. You’re not just working in a general hospital abroad; you are working as part of a team that brings its medical services in various communities. Floating Doctors is, essentially, a moving hospital. We carry our supplies with us wherever we go.

To do this type of volunteering, you have to be adventurous, caring, curious, teachable, patient, free-spirited, motivated, and willing to make mistakes and learn from them. If you also don’t mind taking risks, jumping into strenuous activities like hiking for 8 miles, encountering weird bugs, making yourself more vulnerable to certain sicknesses (that are treatable), or going for several days without a hot shower, plumbing, or a soft bed, then this kind of work is for you. It’s refreshing to encounter other individuals who are so willing to sacrifice comfort in order to give back to others. That is exactly what we did this past week by setting up a clinic for the Ngöbe, who are geographically cut off from any medical aid.

2. It’s important to be proactive, especially in a context such as this: busy, Spanish speaking environment that isn’t highly funded and is happy to use whatever help it is able to get. At certain times throughout my volunteering, I felt as though it wasn’t clear what my responsibilities were. I may have started off one morning on the admin shift (where I checked people into the clinic) but later was sent to Intake (where we took people’s vital signs). Your responsibilities at each station almost entirely depend on your willingness to step up, take charge, and just go for it, even if you’re not 100% sure how to do something. That’s when admitting lack of knowledge about something comes in and you learn from those who are more experienced. However, you would have never learned if you hadn’t decided to jump into the work or offer help.

3. If you do get the chance to experience anything like this, experience it again! These are circumstances that forge you into a more humble, understanding individual.

4. Gratitude (not new, but I needed a fourth thing to fulfill the title of this entry). Living for a few days without a bed, plumbing, or hot shower inevitably makes you grateful for what you have back at home. I am always grateful for my life in the U.S. whenever I travel to developing nations. It’s easy for us to complain about what we don’t have, but it’s important to realize that many, many others who don't have half of what we do have, so we need to be grateful.

12-hour trip to Canada

US-Canada border

We went from New Jersey --> Ithaca, NY --> Niagara Falls --> Toronto. If you subtract the breaks and rest stops though, it was about 9 hours to get there. We stayed with my mother’s uncle in Toronto, Ontario in their beautiful three-story home. I met a few cousins that I've never met before, relaxed and hung out a lot with my parents and younger brother, and learned a few new things about the nation of Canada.



At the US-Canada Border
As we drove through customs to be checked before entering the country, I jumped to the back of the van to grab my passport from my suitcase. My parents and brother already had theirs out, including their NJ licenses in case an alternative form of ID was requested.

“Deborah, you found it?” my Dad asked me as he drove up to the customs window.

The back of the van was a mess. I’d pulled out all of my clothes and toiletries in a frantic attempt to find my big brown wallet that I put my passport in. When I found it, I breathed a sigh of relief, “Thank you G…” I froze when I opened the wallet. There was no passport inside.

“Deborah, honey, did you find it?!” my mom was sitting up front in the passenger’s seat, and she was turned around, her left hand holding the back of my dad’s seat. She was looking at me with concern.

I didn’t respond. I just buried my head in my hands. I completely forgot that I recently applied for a passport renewal and had to submit my old one with the application. Now I had no passport, and I didn’t think I was going to be let into Canada. I couldn’t even look at my parents. I was embarrassed. Before we left for the drive up, my Dad asked me a couple of times if I had my passport, and assuming it was in my big brown wallet, I said I did.

The man at the window asked my Dad, “How many people are in the vehicle?”

"Four."

“I need a form of ID for the fourth person please.”

I grabbed  my NJ license and Cornell student ID from another wallet and handed it over.

Long story short, the man ended up letting us through. Our names on all IDs matched (which proved that we were family) and thankfully, he believed that we were indeed going to visit extended family in Toronto for the week.

Never let this happen to you. There are plenty of scary stories out there where people forget their passports for international flights and don’t realize it until it’s too late (once they reach the airport). Always check to make sure you have your passport on you before you leave for the airport, or in this case, before you cross the border into Canada (unless you have an enhanced driver's license or some other "approved secure document").

Our first stop was Niagara Falls, and we spent the rest of our time in Toronto with family :)

A week volunteering with Jamaica Difference

Jamaica Difference Spring Break 2014 Volunteer Group

This past week has been pretty amazing. Jamaica Difference, a relatively new student organization on Cornell's campus, took a trip down to Jamaica to carry out an educational service activity at Ensom City Primary School with the students. Our trip leader, Onella, a native-born Jamaican and one of my good friends, did an incredible job of organizing everything. And I mean everything - the homestays, our service activities at the school, in-country transportation, trips to well-known touristy spots, and much more.


We went into this experience with two goals: to have a positive impact on the students at Ensom City Primary School and to get a taste of Jamaican culture.  I'd gotten a taste a few times before, but I'd never gone with a group of young people before. It was very different from the rural Jamaica I'd experienced in Mandeville with my older relatives.

Me, Tony, and Emily with our fourth graders.

We're hard to find!

We were split into teams of 3; Team 1 aimed to teach fourth grade students the importance of literacy, writing, and presentation, Team 2 worked with sixth grade students to arm them with skills to transition smoothly to high school (high school begins with 7th grade in Jamaica), and Team 3 strove to find the gaps and problems students face academically through analysis of recent test scores.

On the weekends and in the weekday evenings, we did our excursions to places like the Bob Marley museum, a few restaurants, and two beaches.

This was such a fulfilling trip. I would love to return to my homeland for a longer period of time to have a bigger impact on communities, particularly within Mandeville, where my mother was raised.

My week with a gynecologic oncologist

Taken prior to observing a hysterectomy

A gynecologic oncologist specializes in a field of medicine that deals with cancers of the female reproductive system. The gynecologic oncologist I shadowed at Weill Cornell Medical Center – New York Presbyterian Hospital (#7 in the nation and #1 in the state) is an African American, middle-aged genius who is incredibly knowledgeable and personable with his patients and colleagues. He’s also one of the top physicians in his field.

I had the opportunity to shadow him as he examined, consulted with, and operated on patients. I learned more about procedures like a hysterectomy (removal of the uterus) and conditions like peripheral neuropathy (damage or disease affecting the peripheral nerves; can cause tingling in the extremities). Dr. Holcomb sees quite a number of women with medical conditions such as cervical cancer, ovarian cysts, and endometriosis.

Pelvic exams: a dreaded part of the routine check-up at the gynecologist

I’ve noticed that the women Dr. Holcomb sees are generally comfortable with pelvic exams. Very few were uncomfortable, and rightfully so. Having a stranger, even if it is your physician, stick his fingers and speculum inside you to examine your hoo-ha isn’t exactly something you'd get excited about. Some women winced or openly showed their nervousness by shaking or covering their mouths, while most just sat there and stared into space. The doctor carried on conversations during this uncomfortable time. I was surprised that no one was opposed to having an unknowledgeable pre-medical student in the room during this private, personal examination.

In the OR

During my days in the OR. I tried my best not to get in anyone's way (including Dr. Holcomb himself, the residents, a couple of nurses, and the medical student) and just to watch the procedure from a distance. A couple of times Dr. Holcomb was very kind to let me move a bit closer to take a look at what he and the residents were doing over the patient.
On my first day in the OR, the first thing I saw as soon as I entered the room was a vagina on the operating table. The woman was covered with sterilized sheets, and only the portion of her body that was showing and would be operated on was her vagina. Actually, she was getting a vaginal hysterectomy, so her uterus was actually the site of operation. I wasn’t disturbed by the sight… I admit, I was a little startled. I'd never seen anything like this before, let alone observe any type of surgery. But it was an incredible experience, and during the few hours I spent in the OR just staring at the professionals do their job, I began to reflect on how privileged physicians are to heal and treat the illnesses of our patients.

Here are a few interesting encounters I had during my shadowing:

• Earlier this week I met an older woman who chose to delay chemotherapy treatment for her ovarian cancer (she had valid reasons). She looked like she was reaching the end of her lifespan. She sat and talked with Dr. Holcomb to discuss her treatment options, then after her pelvic exam, she left. I pegged her as a bitter old woman because of her comportment toward the doctor and the reality of her imminent demise, but on her way down the hallway out of the office, she turned around momentarily, caught me watching her walk away, and waved and smiled warmly at me, saying, “Take care, and good luck!” I was immediately stung by my previous impetuous dismissal of her. I was unfair to not have given her the benefit of the doubt, and to not have tried harder to be empathetic and understanding of her.

• On Thursday, right before Dr. Holcomb made his way into the exam room to see another patient, a loud voice came over the loudspeaker and boomed urgently, “Attention! Code red, code red!” I froze, thinking we were about to die. Then I looked around anxiously to see how the rest of the hospital staff was responding. “Uggghhh, it’s so loud!” one of the PAs (Physician Assistant) cried, covering her ears as the person on the other end of the loudspeaker kept calling out “Code Red!" Thankfully, it was meant for another part of the huge hospital, and I calmed down. Code Red in a hospital typically means that there’s a fire. (Code Blue, another common code, means that a patient is in need of immediate medical attention). Everything ended up being alright, I later learned.

• Yesterday, the doctor was speaking with an Asian couple. The woman couldn’t speak English, so the husband translated everything for her. The doctor then told them that she did not have that much time left to live… I didn’t realize until a few moments later that I’d been holding my breath. The woman’s reaction to this news was, “Oh my goodness!” and the man simply said, “Oh!” but there were no tears from either of them. I couldn’t move until the consultation was over because I felt that if I did, someone would turn to me and yell at me to leave the room. I felt as though I didn't belong there anyway. The conversation left me feeling heavy and deeply saddened. I don't think I can ever become an oncologist. My heart went out to the sweet woman whose life would be ending soon because of a horrific disease we are still striving indefatigably to find a cure for.

• The New York-Presbyterian University Hospital of Columbia and Cornell is flooded with wealthy patients. Dr. Holcomb has treated a number of well-to-do women, including a movie producer who was recently interviewed by CNN, a family member of the CEO of Hearst Corporation, both the daughter and sister of a Russian billionaire who publishes many well-known U.S. magazines (such as Golf Digest, Forbes, etc.), and many Arabs from places like Kuwait and Saudi Arabia whose care is paid for by the kingdoms. Can you believe this? I had no idea this hospital was filled with such affluent patients, or that people come from faraway places to be treated here.

I had a great shadowing experience with Dr. Holcomb. I'm blessed to have been able to complete this as part of Cornell's Pre-Professional Programs. My resolve to pursue a medical career has grown.

Winter break 2013 in Maryland: ebullient times & significant life lessons

Managua, Nicaragua

Early in the semester I started making plans to go abroad over this winter break to Nicaragua but that fell through for a few reasons. I think my mother told me to take a break from traveling and to stay home for the holidays with the family. It also didn’t work out because I couldn’t pinpoint an organization (an inexpensive one) that would take on college volunteers for four to five weeks during the holiday season. The funding from sources on campus would also take forever to come through. I missed Christmas & New Years last year with the family and went to Guatemala instead because I was hungry for more international and medical experience.

With my sister at a mall in DC

I’ve been crashing at my sister’s apartment in MD for the past couple of weeks, and it’s been pretty awesome. She graduated from Cornell in 2012 and is now working at the National Institutes of Health (NIH) while at the same time studying to get her Master's in Human Resources from Georgetown University. I'm so proud of her. So so proud. The time we’ve spent together has been laid back and convivial at the same time. We watched a few movies (including “Best Man Holiday” and “The Switch”), laughed our heads off while reminiscing on the past, went out shopping, and talked up a storm about any and everything.
I’m leaving tomorrow to go to NYC for a week to complete a shadowing program at the NY Presbyterian Hospital. I’ll be shadowing a gynecologic oncologist and, yes, I am super excited. After next week, I’m going back home to NJ, and after that week classes start again.

I made a list of goals I hope to accomplish over this break (which is a measly five weeks).

Three main goals:

1. Read 7 books. I picked these books below (most dealing with health and medicine) because they received very good ratings. I finished the first three so far. Here’s the list:


· "Everything I Learned in Medical School: Besides All the Book Stuff" by Dr. Sanjay Kansagra

· "The Devil Wears Scrubs" by Freida McFadden

· "From a Name to a Number: A Holocaust Survivor’s Autobiography" by Alter Weiner

· "Gifted Hands: The Ben Carson Story"

· "The Fault in Our Stars" by John Green

· "The Immortal Life of Henrietta Lacks" by Rebecca Skloot

· "How Doctors Think" by Dr. Jerome Groopman

2. Learn the songs for my acapella group’s (Baraka Kwa Wimbo, Swahili for "Blessing through Song") spring concert at the end of next semester. In reality, we’ll be learning them together at rehearsals, but the more we learn and know on our own, the more productive the practices will be. Our concert is going to be great. Feel free to check out our group on YouTube.


3. Start preparing for the MCAT. I don’t plan on taking it until 2015, but because I’m an excessive planner and I really want to do well on this exam, I want to start as early as possible. One afternoon, as I was going over some practice Organic Chemistry problems on my sister’s dining room table, she came up to me and said, “This is ludicrous! Stop studying. Your exam is over a year away!” True. But what's wrong with giving myself ample time to prepare?

~*~*~

A couple of nights ago I finished the third book on my list, “From a Name to a Number: A Holocaust Survivor’s Autobiography” by Alter Weiner. I have never before been so touched by a book as I have by this one. I won’t think the same way about life again. Everyone needs to read this book. Several themes from his story resonated with me, and I’m going to share them with you:

· Gratitude. I’m extremely grateful for my life in the United States as an African American female in this day and age. Yes, I face challenges now and again, but they come nowhere near to equating with the adversities the Jews experienced during Hitler’s reign. Hitler was an unstable megalomaniac. Al Weiner, the author, was forced into starvation, suffered from emaciation, lost every member of his immediate family, witnessed the murders of thousands of his counterparts, and was beaten mercilessly for asinine, groundless reasons embodied by German society. This also made me consider other pogroms, mass genocides, and events in history where people have experienced the inconceivable.

I never had to go through any of this, and if you’re reading this, you likely didn’t have to either. We certainly face challenges and hardships in our lifetime but they pale in comparison to what others endure(d), so we should be grateful for what we do have and are blessed with.

· Forgiveness. This was another salient theme for me. The fact that Al Weiner was put through so much suffering, heinous treatment, and wanton cruelty and still had no retaliating bone in his body after WWII is unbelievable.

We hold so much bitterness in our hearts over dramatic situations (like he said/she said nonsense, getting hurt by a boyfriend/girlfriend/person you like, etc.) that seem huge to us but totally pale in comparison to the nefarious circumstances Weiner and other victims of the Holocaust suffered. Some people are even intent on killing or seriously hurting someone else over petty things (Sharkeisha is one prime example, a young man in NJ was shot by his neighbor over a parking spot – seriously?? - and more sad, sad situations). Let’s learn to forgive and forget. We'll end up feeling like a load’s been taken off our shoulders anyway.

· Indomitable character. Al Weiner preserved his faith and values even after the Holocaust. He saw the bloody corpse of his father as a child and was torn away from his family by demented Nazis…regardless, he continued practicing his Jewish faith and maintaining the values that his parents imbued him with even after his egregious experiences in the camps. Amazing.

If someone can go through so much and still have tenets of forgiveness, gratitude, respect, and other values that many Holocaust survivors may have lost, then this should inspire people to stay strong in their own beliefs and principles.