Learning To Live At Home… Again.

I’ve sat at my computer several times in an attempt to “wrap up” my blog, to somehow sum up my experience in a few paragraphs of text. And every time I have done so, I have stared at a blank screen with a blinking cursor while no words come. But at the gentle prodding – actually, she’s asked me at least ten times – of my grandmother, I will do my best now.

I’ve been home for three weeks now and it feels like forever. It’s fascinating how quickly you can adapt back into the old routine. So much has happened in those three weeks, though, that it has made the adjustment easier and more exciting. There are a few things that have stood out in my mind since returning home that I think are worthy of sharing…

It’s interesting when you come home and everything is entirely the same, but everything about your life is entirely changed. It was my first night home and I stood in the kitchen listening to my dad, brother and step-mom go back and forth with each other about their days and different issues at work. I stood completely silent, watching them like a tennis match, moving my head back and forth. It hit me – it’s the same here. And that isn’t a bad thing at all. But I am not the same. Ecuador and my experiences there changed my life. I did things I never thought I could do, I learned things about myself that I had never known, I made plans and goals that I may not have had the courage to make with the influence of everything and everyone at home. So now I am adjusting, fitting myself back into my old life, while working toward creating my new life.

Grocery stores are big and excessive. The first time I wandered around Safeway by myself after being home, it took me far too long to find the few things I was looking for. I roamed around like I had never been there before, like I was a foreigner in the same store I’ve been shopping at for ten years. I came home to a place that has everything, from a place that has next to nothing, at least by our standards. I don’t feel guilty, as many do after an experience like I had, for having so much or from luckily being born an American. I just feel irritated. Do we need hundreds of flavors of cereal? Does the freezer section need fourteen brands of frozen lasagna? No, we don’t need much of what we have available, but we can have it so we do. This experience opened my eyes even more to the differences in our world, and more narrowly focused my passion for international health disparities. I will most likely never take my future child to the hospital for a waterborne illness or parasite, but women I met might take their children a dozen times. And that is an unnecessary and preventable truth.

I no longer care when the telephone operator asks me to “press 1 for English.” As selfish, embarrassing and horrible as I know this sounds, this used to be a gigantic pet peeve of mine. Why on earth should I have to press 1 for English? Just talk to me in English – this is America! Other languages shouldn’t even be an option! That was shallow, naïve, pre-Ecuador Cassie. Post-Ecuador Cassie now knows what it feels like to be the minority, to be treated with prejudice at times, to be poked and prodded at for being different and standing out, to not be able to communicate on the most basic of levels. As Mark Twain said, “travel is fatal to prejudice, bigotry and narrow-mindedness.” I have a new compassion for others who may be foreign to the country I call home, who may speak a language I do not understand, because I have now been that person. And there is no right or wrong in that situation. Everyone has a home, a language they use, traditions they practice – everyone has culture. Mine has just expanded.

“Travel is more than the seeing of sights; it is a change that goes on, deep and permanent, in the ideas of living.” (Miriam Beard) This quote sums up the thought I could not verbalize. I saw a lot of beautiful sights, tried a lot of delicious foods, met a lot of interesting people, witnessed a lot of depressing realities, and learned a lot about myself, my country and life. It’s a curious thought that just six weeks, such a seemingly insignificant amount of time, can change your perspective on living. Sure, I still love my variety of cereal flavors and never-ending freezer sections at Safeway. I am not so different from who I was on June 10th, but the August 14th Cassie thinks differently. The time I spent away showed me more of what I want out of my own life. And my hope for myself and everyone else who traveled with me, is that we won’t forget what we learned about ourselves, the goals we set and the plans we made. No one quite understands what we went through without doing it themselves. So that is my advice – get out, travel, experience, live. You’ll be amazed at what it can do for you.

And this trip has done a lot for me. It has allowed me to have now finished my education at Central Washington University (pending my receipt of that shiny and expensive piece of paper in the mail). It definitely helped in my interview process for my new full-time job at Seattle Children’s Hospital, starting next week. My life right now is exactly where I hoped it would be, and I’m honestly stunned and humbled just taking it all in. I am a college grad with a full-time job and dreams bigger than the sun. This trip opened the door, taught me more than I ever imagined, reinforced my confidence and abilities, showed me what I am capable of, and reminded me that if you want it, you can get it. So this blog cannot adequately wrap up how I feel or what I learned, but I have done my best. Three weeks out, this is how I’m feeling as I sit here on my couch, once again staring at my computer screen.

Thank you for sharing in this journey with me, for supporting me through this process. I know I couldn’t have done it without the help of many, many people. So until next time, adios.

Lo es loco en Cuenca!

These are observations I have made in my time here in Cuenca – things that have stood out for either just being odd or for also being a regular occurrence AND odd. Shall we?

  • Fireworks go off almost daily. It’s not a holiday.
  • People sit in their cars. At any time of day. They just sit there. WHY?
  • Sometimes they sit in their cars while their car alarm is going off. Again, WHY?!
  • Sonia makes fresh juice everyday. There is a distinct kind, fruit unknown, that tastes like what Holly and I would imagine bodywash to taste like.
  • At random times walking down the street, just about anywhere, there is a slight smell of poop (yes, poop). It’s there and then it’s gone.
  • Restaurants give out Halls menthol drops as candy with the check. Halls are sold right next to the candy at the grocery store.
  • I’ll be walking down a sidewalk (or even jogging) and a group of people will be walking toward me. Instead of stepping to the side or making room, they just keep going, shoulder-to-shoulder, as if we are not even on the same sidewalk.
  • You are not in line unless you are touching. Back up, man with the cart, I have to pay too!
  • Americans (or Starbucks) created the Grande and Venti coffee sizes. I haven’t had a coffee served to me that is more than 12 oz.
  • Iced coffee is a rare commodity. WHY?! This is the equator, people!
  • Last week, there was a display at the SuperMaxi with all the fixings for a turkey – the pan, basting kit, flavorings, etc. Is it turkey season?
  • Those Cuencanas do NOT hold out on their PDA. Anywhere. Anytime. Even if they make eye contact with you awkwardly when caught in the act.
  • All of the Sacajawea gold dollar coins are in Ecuador.

I love this city.

Bus Ride Observations

People watching has always been one of my favorite pastimes. Watching someone go about a daily activity, wondering who they are, where they are going, why they are doing what they are doing – sometimes I make up stories in my mind, and the busses in Cuenca provide an ample opportunity to do just that.

Wednesday afternoon I had some errands to run, things I wanted to do, and just wanted some time on my own. I’ve gotten much more comfortable getting around here, even by myself sometimes (but only in the daylight and in safe areas, Dad).  I walked to a store about 10 minutes away and then hopped on a bus to head to the El Nomad center. I live on the opposite side of town so it was long bus ride.

I think what I am about to say sounds entirely cliché, but I am going to say it anyway. After watching people work here, work in America can sometimes appear to be a laughable concept. A few events sparked this thought in my head. A little boy, not more than 10 years old, got on the bus with his mother. She was dressed in clothes typical of women who live in the more rural areas, also those typically with much less money. With them, they loaded onto the bus 5 very large jugs, 1 box, and 3 containers of some sort. My guess is that they sell juice or some sort of food on the street somewhere. But it was the way this little boy loaded it all, helped his mother, and then sat with their belongings on the jerky bus ride until their stop came. I would guess he has been with her all day, helping her to sell whatever it was. He looked so young, but also looked like he knew nothing else. Family is VERY important here, and he was supporting his mother and family the way I’m sure he was raised to. Also on this bus ride, I saw several children with their parents selling similar food items on the street. The other day when Holly and I were souvenir shopping at our favorite market, a girl not more than 3 years old was pointing out scarves to us at one of the booths. Yet the age here that you can work, legally anyway, is 18. Hmm.

It’s observations like this that have become almost normal to me here, and to be expected I would assume. Yet it doesn’t get old or less impactful each time. That is the beauty of an experience such as this, though. It opens your eyes, makes you appreciate life more, and allows you to evaluate your own life in new ways. This quote sums it up perfectly, better than I ever could (Thanks Rebecca!):

“I beg young people to travel. If you don’t have a passport, get one. Take a summer, get a backpack and go to Delhi, go to Saigon, go to Bangkok, go to Kenya. Have your mind blown, eat interesting food, dig some interesting people, have an adventure, be careful. Come back and you’re going to see your country differently, you’re going to see your president differently, no matter who it is. Music, culture, food, water. Your showers will become shorter. You’re going to get a sense of what globalization looks like. It’s not what Tom Friedman writes about, I’m sorry. You’re going to see that global climate change is very real. And that for some people, their day consists of walking 12 miles for four buckets of water. And so there are lessons that you can’t get out of a book that are waiting for you at the other end of that flight. A lot of people – Americans and Europeans – come back and go, “ohhhhh.” And the light bulb goes on.”

Well said, Henry Rollins, well said.

Today I lost my job.

The word I would use to best describe my experience at the hospital is challenging. Not solely because of the heartbreaking health circumstances I witnessed on a daily basis, but also because of the language barrier, the cold demeanor of many of the doctors, the daily differences in what we are allowed access to, and the general sense of discomfort in being there. At the end of the day, it was a great experience, and one I wouldn’t change for anything, but it was also the first time I ever lost a job.

Let me explain – Tuesday morning started as any other, with Katy and I following the doctors around on Pediatric rounds. An hour and a half in, we got a text from some fellow students working in the hospital saying they had been kicked out. Katy and I, in a bit of confusion, gathered our things and left the hospital to meet our friends outside and hear what had happened. Out of respect for the hospital and everyone involved, I’ll just say that the hierarchical nature of the hospital here, and the lack of adequate communication led to us essentially being kicked out of the hospital. The plus side? This turned into new placements for us the next day.

Wednesday morning, myself and two other students went to a hospital on the outskirts of Cuenca, which is not entirely public but also not entirely private. There are fees for services but they are very small. It was a world of difference; much cleaner, all the staff are much friendlier, and we generally felt accepted and wanted. The language barrier still exists to an extent but it is seem as a minor obstacle rather than a determining negative factor.

I have been placed in the nurse’s office, where patients first visit prior to their external consultation. Hospitals often double as doctor’s offices here, providing basic appointments and consultations for patients. In my office, there are two nurses and myself. Patients come in after they check in at the front desk, and then the nurses check blood pressure, height, weight, and temperature –standard information that I would have checked at a doctor’s office back home. From the moment I walked in, I knew I would love it. Though the head nurse does not speak English, she is the first person that knows exactly what Public Health is, and has explained it to several people wondering just what the gringa in the corner is doing here. I understand much more Spanish than I can speak, and she took the time to explain everything to me that she was doing, show me the vaccinations they give, etc. Maybe we can’t understand each other perfectly, but we make do. We laugh, we show each other pictures of home on Facebook, play games on our phones and take coffee breaks (I swear I’m working!). I feel a part of what is going on. They even taught me how to enter patient information into their electronic system, so I can assist as they gather that information.

Getting fired was a blessing in disguise. It has allowed me to see another aspect of the healthcare system here, to meet more people in the area, and to get a better understanding of how it all works here in Ecuador. I’ve gotten so comfortable here that I think it might even be harder to get used to life back home than here. On that note, only 12 short days until I am back in Puyallup. The time has absolutely flown by so much faster than I ever imagined. Hmmmph.

Dinner Table Talk

Some of my best moments here have been at a table full of people, often late into the night, just talking about whatever comes to mind. It has been entirely refreshing to meet people from all over the world and just share a conversation. Without the pretense of judgment or trying to impress, we are all here for different reasons with different things to say, but at least for myself, that is enough to form a pretty tight bond over – just the fact that we are HERE.

Tonight was Holly’s birthday, as well as Amir’s last night; he’s a new friend from the United Kingdom. Amir is one of the most thoughtful and intelligent people I have ever met, and he will make a great doctor in the next couple of years once he finishes school. He has a way of making more serious conversations feel light and not daunting to have. For example, in the midst of dinner he leaned over and asked me, “So, you’re about two-thirds done with your time here in Cuenca. What have you learned – about life, yourself, Ecuador, anything?” Well where do I begin? At this moment, this is what has stood out to me the most:

America is a curious place. It is the only country I have ever spent a significant amount of time living, apart from now but I have only been here for a month. It is the only way of life I know and can reflect on, the only place I feel I have a firm grasp of knowledge on in terms of politics or current events (but even then I am no expert.) It is the only healthcare system I had previously been exposed to. And despite all of this, and my 22 years there, this one-month here in Ecuador has seriously altered my perspective and worldview. Now, don’t read into this as insulting or derogatory, for I am a very patriotic person from a great country, but as I said and will say again – America is a curious place.

I think we, as a country, tend to think that our way is right, our way is best, and our way should be followed everywhere else. We, as a people, can have a sense of entitlement that we should get what we want, when we want it and exactly how we want it; because we are America, the most powerful country in the world. But why is it that way? We are not near the top for education or healthcare. Greater opportunity for a better life? Sure – but the best? No. I would say that is entirely subjective for judgment. America is just different, from almost any other country in the world. Remove the negative connotation from the word different; different doesn’t mean anything bad, it just simply means different.

My conversations with people from Europe, people from Ecuador, my own friends and family from home, have opened my eyes to what people think of the U.S., what I think, and just how big this world is. I have no concrete answers for our problems or problems abroad, but just a broader base of knowledge to now formulate my thoughts off of. Being exposed to a system of free college education and free healthcare, and discussing it with many others who enjoy a similar system, makes me wonder what that would be like in the United States, but even then it’s hard to imagine or make a solid decision on – because it is simply different. Some things work in some places that don’t work in others. This isn’t a political forum; just a 22-year-old girl opening her eyes to the world, realizing that the way I have always known is not the only one, and that often much more can be learned at a dinner table than in a classroom.

Bipolar Days and Nights

After having such unbelievably eye-opening and difficult days at the hospital, it only makes sense to have unbelievably fun and memorable evenings; hence the bipolar nature of my days here in Cuenca.

This past Monday started out as any other, early morning at the hospital, but the evening ended with guinea pig eyeball, brain and lung in my belly. Let me explain – guinea pig, known here as cuy, is a bit of an Ecuadorian delicacy. I knew this coming down here, so it was part of our group’s initial plan to try it out. Monday was the last night for our professor and one of the students in our group, as well as a friend’s birthday, so what better way to celebrate?? Roast up that guinea pig! Covered in pig fat and roasted over an open flame, after much anticipation, our cuy was delivered to the table. It is surprisingly tasty and yes, since I know you are thinking of asking it, may slightly taste like chicken. But what happened next was NOT part of the initial plan. “Hey Cassie, want an eyeball?” My response – “Sure!” It is times like these that I tend to question my mental state, but one eyeball, a bit of brain and some lung later, I have delighted in the delicacy that is cuy. The best part? Skyping my dad about it the next day, and him NOT showing me the new resident bullfrog in the backyard pond for fear that I will come home and eat him. I promise Pappy, no more small rodents or amphibians for me. But I did find out about a place that exports cuy…. ;)

Wednesday marked the always fun holiday of the 4th of July! However, the Cuencans don’t seem to care much about this day. Us Americans, though, made it a point to celebrate. I decked myself out in blue pants, a red sweater and a white t-shirt, to show my love for home, and a group of about 15 of us made our way to our new favorite sushi restaurant for dinner. Because as Kelly said, nothing celebrates the birth of America like some sushi (insert laugh track here)! After dinner, we roamed the streets of Cuenca in search of the perfect location to light off our box of fireworks that Matt and Jake so kindly risked their lives in the Cuencan black market for. We found a great place in the park for this entirely legal and safe activity and proceeded to put on a great show high up in the sky with cheers and shouts of ‘Merica until it was over. (Video forthcoming) Then we made our way back to the El Nomad center singing the National Anthem, again in the streets of Cuenca. It was probably the most memorable 4th of July I have ever had.

This week just continued to get better and better. Thursday is technically my Friday since I don’t work Friday mornings, so with it being Lisa’s (a fellow Washingtonian and independent intern down here) last night here, we all got together to celebrate with her. I’ve made some great friends here in a short amount of time, making this experience that much better. A few drinks and dance moves later, as well as a toast in the discotec (dance bar) parking lot with invisible drinks, we said goodbye to Lisa and made our way home. Sleeping in was fantastic, I was able to relax all morning and finish my current book, The Help, and have some more delicious meals with Sonia and Holly. The best part though? When finishing lunch and drinking my water, Sonia looks at me and says, “Oh, only water and no juice for your chuchaki?” Chuchaki is the Spanish word used in Ecuador for hangover. Sonia is more and more like my mom everyday, calling me out with no shame! She even offered me chocolate, para mi chuchaki. I don’t think I’ve laughed so hard in weeks. :) 

 

The Circle of Life – not just a movie theme song.

From the day we arrive on the planet

And, blinking, step into the sun

There’s more to see than can ever be seen

More to do than can ever be done

There’s far too much to take in here

More to find than can ever be found

Day 2 at the hospital (my planet for the next three weeks) for my internship was vastly different from my first. All I’ll say is first days are first days. But the second day, that’s when things start to get interesting. It started off in a whirl of confusion, random staircases, long hallways and a general bewilderment as to what it was I should really be doing. Right when I got there, we jumped in on rounds on the Pediatric floor of the hospital. And this is where my world changed.

 There’s just something about sick kids. And then there’s something about sick kids who shouldn’t be sick with things that can be prevented, that could be treated better, that just plain don’t need to happen. I knew this would be an emotional journey, and that proved to be the understatement of the century. Let me paint a picture for you: five or six beds to a room, sick kids in each of them, scared mothers crowding around, cracked walls, moldy ceilings, chipped paint, inadequate supplies, broken tools.

So that’s where we start. Working our way from bed to bed, listening in as the doctors and students check the patient’s charts, look at x-rays, check the children, speak with the family. Most of the children I saw were suffering from pneumonia, many for a second, third or fourth time. And these children were all 3 or younger. They are malnourished, fragile, helpless and beautiful. We saw one child who had traveled to the hospital in Cuenca all the way from the Amazon. When asked by the doctor why they hadn’t gone to or stayed at the hospital near them, the father replied, with a laugh and smile that seemed a bit too forced, “I don’t trust them there.” We saw another baby boy, already suffering from Down syndrome, in the hospital with another bout of pneumonia, malnourished, with clubbed feet and a host of other issues. The doctors were concerned that maybe it was more, maybe it was Cystic Fibrosis or something else, as his mother sat next to his bed with the most worried look I’ve ever seen. Another baby looked much too premature, suffering also from pneumonia, with parents who looked no older than 16. Teenage pregnancy runs rampant here in Ecuador. The same was seen with a baby with the worst diaper rash I’ve ever seen, in the hospital for I’m not sure what, as her mother looked like nothing more than a baby taking care of a baby. This was just one room.

We followed the doctors down the hall, to a room with a single bed, with a single boy laying in it and his father in a chair next to him. We were told he was a very special case. He was diagnosed with Leishmaniasis, a tropical parasite that can be transmitted from the bite of a sand fly. This boy came down with the disease when he was 1 year old. It was never treated, or not treated properly. He is now 13, but from looking at him I wouldn’t have guessed he was over 5 years old. The disease effected his entire development. Normally only causing ulcers in the intestinal tract, his have spread all over his body. He had a lesion on his head, his ears look mutilated as they were damaged as a result, and he cannot eat because his bowels have been destroyed. He is weak with very little muscle mass and severely underweight; getting him to sit up in his bed resulted in him letting out painful cries. And to top it off, he has mold in his esophagus. Everything that has affected this young boy could have been treated or prevented. But it wasn’t. Now they can just treat what they have the resources for. The Belgian pediatric resident helping us and showing us around made a powerful statement – “He needs such-and-such medicine to treat the mold in his esophagus, but we just don’t have it. The government says it’s free, but if it’s not there, it’s not there.”

After a morning like that, I didn’t know what else I would see or do. We were taken down to the pediatric emergency area of the emergency room. Here they have a “rehydration station” for all the kids who come in dehydrated after struggling with diarrhea due to dirty drinking water; yet another preventable sickness. They follow a plan laid out by the World Health Organization for rehydration. First, the child is given ORS, an Oral Rehydration Solution that can come in many fruity flavors to appeal to a child’s taste buds. If they cannot get this down, they are given an IV to rehydrate intravenously. After this, they are again given the ORS, and if this works they are sent home with more to use in case of more bouts of diarrhea and/or dehydration. Or we could just get them clean water. What a novel concept.

Last but certainly not least, we made our way to the Obstetrics/Gynecology wing of the hospital. A woman was in labor, about to give birth, so what did we do? Tied on our gowns, covered our hair, put on masks and booties, and WATCHED! Talk about the circle of life. I witnessed a baby coming into the world, and it was sure something; a beautiful, shocking, emotional, interesting event to witness. A BABY BEING BORN! I’d call that a pretty good Monday morning, as far as Mondays go. Interesting in terms of health too, as I asked about epidurals and C-sections. Epidurals are just not commonplace at the public hospital because the resources are not there. Many opt for C-sections, not knowing the incredible amount of possible complications, as well as rehab time. There is a bit of a lack of education here. For example, a 4-month-old baby was admitted, malnourished, as they all seem to be, with a young mother who has only been feeding her soup for the first four months of her life, not breast milk or even formula. They do have healthcare though in an improving system, available to them if they can get to it, and that is more than many can say.

I am getting to do things here in Ecuador that would simply never be possible in the United States, learning more than I thought I would – and it is entirely changing my life. It’s making me reevaluate whatever life plan I was currently working from, and sparking passions in my heart that I didn’t know were there, as well as igniting new flames.

It’s the Circle of Life

And it moves us all

Through despair and hope

Through faith and love

Till we find our place

On the path unwinding

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