pensive?

Nothing much has been happening here. It's cool to hear about Nolan's life-changing experiences over the phone or via email or IM, and then realize that I too, have a duty to do something meaningful with my life. Of course, I still have to figure out what that is...but I guess that is what life is all about, right? The pursuit of God, love, and happiness (consequently, I think the first brings about the latter two), and that feeling at the end of the day of being able to go to bed knowing that you LIVED life. Ahhh. Here's to the adventure...

Nolan comes home in exactly 2 weeks from today, so, readers, hopefully we can start giving "family" updates then instead of continent-to-continent updates on where we each are individually...though that is important too (though not necessarily what this blog is about). Nolan was right to start his own, since this one is mostly, as the name implies, about "The Caldwells". I hope you are still reading it, though, because it truly is amazing to see a window into another world that I think we lose touch with, more than is healthy or beneficial.

News-wise: we are planning on moving into a new apartment (same area, though) before September 1. So keep your eyes peeled for a new address soon-ish.

~A

Nolan - Location Change

Greetings to all who desire to peel back my sheltered thoughts

I am not one to divulge personal thoughts, accounts of emotional situations, or anything that might cheapen the genuiness of those true moments in life. However I have found my recent journal writing to be both cathartic and enlightening in my review of life and self assessment of my role in it. I write for myself, not for the reading pleasure of others, so please do not expect a cursory or superficial description of daily activities nor the homie shout out you and your posse might be so accustomed to. If however you would like to continue in my life's narrative I invite you to join me at http://nolancaldwell.blogspot.com I will no longer be posting on this blog (http://acoupleofcaldwells.blogspot.com) as it seems to serve a different purpose then the ones in which I write for. I encourage you to still check this blog as it will be update with various minutia and issues concerning Anneliese and I, however my personal blog will contain the entry type you have grown accustomed to reading of me.

Sincerely,

Nolan J Caldwell

1 year and counting!

Today is our one-year anniversary! Hooray! It was nice to talk to Nolan on the phone for a few minutes this afternoon (!) and verbally celebrate, heh. We'll do the official traditions and celebrating when he returns, but until then: Happy Anniversary to us!!!
~A

Nolan - 7/17-18/08

7/17/08 5:39 PM

It is hard to believe my time in Uganda in nearly ½ way done. My time here so far has been consumed with data crunching, training days, and analyzing pieces of information. It is not glamorous all the time, but will lend itself to big outcomes in the end., I hope. The moments of interacting and seeing real patients, (instead of a public health equivalent such as DALY’s ) is both depressing and motivating. Depressining because these people have illnesses that would be easily fixed and attended to in a country overflowing with money, such as the US. Motivating because maybe someday I can change their outcome…

In my time free from the “lab with the pen and the pad” (Thank you Dr. Dre)… I have been trying to make the most of genuine moments. To capitalize on those irreplaceable moments, conversations, and smiles that will forever be remembered. What I expected as those genuine moments are not what I thought of when I thought of Africa. When one thinks of the red soil of this great continent one is reminded of tribes, dances, hunters, cultural rituals and the obligatory safari. However from my time here that is not apart of life. The dances, safaris, and “tribal walks” are filled with tourists with 10” zoom lenses. I imagine this is like the toursists that visit the USA and look for cowboys, or who go to New York and visit the Statue of Liberty. If one goes to the US looking for such things then to leave without being apart of the them, they are left with a “dis-genuine” experince of the USA. Yet, a real experince of the US varies by City and by neighborhood. For instance each area of San Franciso has its own culture, people and atmosphere. Yet all of that has nothing to do with the GG Bridge nor Alcatraz. Those big touraist attractions are there for the tourists not the people that reside in the area. The same is true to the typical “African things here”. The most genuine moments we have had have been the unexpected African Club or Bar, getting lost on a stray matatu, or getting consistently cheated on receiving change on our purchases. Outside of the designated safari, I do not feel like a tourist here nor do I believe I am treated as such.

7/18/ 2008 12:16 PM


This morning Justin and I began our rotations with the Trauma Causality Surgery Department. We both want to work with the Casualty to get a feeling for how the presentation for traumas arrives at the hospital and how they are dealt with. This will give us a comprehensive understanding of the problem on the ground.

Upon arriving into 2A the smell of urine, puss and death was continually evident. Our first patient an elderly gentleman had an axillary lymphoma comparable in size to a large cantaloupe arising from his shoulder. This cancer is slow growing, but malignat… This hyper growing lipid filled carcinoma felt like a waterballon I used to fill as a child. He seemed to be in no pain, but sat there with his shirt off just looking at me. The head doctor asked if I would like to take a picture of it. I had an immediate juxtaposition of thoughts. On one end this is an amazing specimen. To feel the flowing fluid just below his skin made me want to catalog it in my medical records. However, on the other end the mans eyes reminded me of something so much different. Why had he waited so long to reach care? He had been hospitalized now because his condition had deteriorated. Why not come for care when the disease had not spread so far. Was it because he lacked any money to be helped? Did he not have transportation or the family to help him? Was taking pictures of patients from foreign doctors routine? Are the poor and disenfranchised even in the 3rd world put on display for the amusement of others, all to similar to the safari ride I had taken the week before… These questions flooded my mind as I asked the gentlemen to place his shirt back on.

The next patient was an advanced AIDS patient who with his sunken flesh, bleached palor, and frail body reminded me more of something from TV then reality. He lacked any palpable pulse, and could not have weighed more then 95 lbs. A Hb count was ordered and we just moved on. Seeing death gripping a man was normal there, was an everyday occurrence, we just moved on….

We saw gang green, empyema that made me sick to my stomach. We witnessed profuse bleeding from lacerations and burns that gauze was suppose to cure. So much death, so much mutilation, yet the world seemed to carry on as if life were no different. And yet to Justin and I the world seemed to move a little slower. The cries of the babies in the halls searching for their mothers, the boy who had necrotic burns on his back,… life just seemed somehow changed for us.

In the hospital it amazed me how close a family must be. If the family is not there to feed, wash, help the patient then the patient receives no food, cleansing, or bed changing. There is a lack of medical care and the family is integral in the care of the patient. Colorful outfits of women at the bedside filled the wards as men in white coats talked about them as if they could not hear. Discussed there life as if they could not understand. Yet, they understood. Their silent voices upon us arriving did not constitute incomprehension but rather a deep reverence for the medical treatment, something unlike anything I have experience in the States. At the bedside of one patient was a mother, brother, sons, wife, and daughters. He had been badly damaged in a recent RTA. The mother of possible 70+ in age, immideitly rose from her chair and sat on the cold, hard, unsanitary floor. In her words, that I could not put meaning to them, I saw respect for the white coat I was wearing. I did not know precisely how to feel, but I knew this woman was older, wiser, and more deserving of any chair before I.

In the Causality ward in the late afternoon Justin and I had been waiting for nearly 2 hours for a surgical team to scrub in with. During that time I felt the most useless as an individual as I think I might ever have. Imagine a filled waiting room with injuries that would in the USA be rushed off to immediate care. Here patients wait until a doctor can arrive in the ER (Casualty Ward) to take care of them. Head Trauma, Snake Bites, RTA’s… Patients were desprate for care, and there we were in our white coats waiting…. People continually gazed in our direction believing us to be doctors wondering why weren’t doing anything for them or their family. Continually looks of sadness which rose to disdain were shot at us. I tried to justify it in my mind: I have only been in medical school for one year, I don’t know how to remove the skull cap on my own… I don’t know how to fix a lacerated liver. At this moment most of my knowledge is theroretical, un practiced, un refined. Also I am at a hospital with permission to learn and heal under the supervision of a local doctor. I can not just jump the the front of the lines and start sowing flesh together and cutting disease apart….. Yet, none of these self-justifications vindicated me from the needs of the onlookers nor the confliction in my heart. Eventually I removed my white coat, and sat in an area away from the patients with care… Again I just walked away. I felt ashamed, worthless… If only I had known what to do… I know that is why I am in school, to learn…. But my learning didn’t help anyone that day. They were still waiting for a doctor…

Nolan - 7/15/08 8:34 AM

7/15/08 8:34 AM

I am unsure how I can transpose so much so fast, but I will do my best to cathartically digress my thoughts and experiences from these last few days here.

This last Friday evening we began packing for our safari adventure. After the challenge of pushing our backpacks beyond their limits, we sat down to watch Prison Break. In the corner of Erica’s eye she saw a rat run across the floor. It took us about an hour to trap it, decided who would kill it, and then clean up. It was rather hilarious to see 4 med students with facial shield and surgical gloves disposing of anything the rat touched – 3rd world rats carry some serious diseases. I have learned however through my time here that I am different in terms of the level of cleanliness I need to be content. Everyone in my apartment I feel is freaking out about the cleanliness. I understand I differ from most people, so I am the one that is off course here probably, but I find a tough time seeing the need to clean something if it will get dirty again…. Anyway, onto the weekend,

We headed North East toward Murchison falls in a small safari mutatu. As I listened to my Ipod and watched the passing landscape I started to have those deeply introspective thoughts that make me evaluate my life. I know I will be unable to do any justice to the sheer magnitude of what transpired in my mind here, but I will try my best. On the road we passed herding villages with lots of cattle, and only a small 5 year old boy and a stick to guide them. We saw massive poverty, Thatched and Mud homes, school children in uniforms running along a busy highway on their way to an education, and much more. Initially in my mind was a sense of pity. They being poor, me wearing an Abercrombie shirt. But as you watched the faces of those on the road you didn’t see despair you saw joy. I saw smiles and waving families. Women in colorful traditional dresses and men hard at work, but always with a smile on their face. I realized that these people and many people worldwide and perfectly content in their life. The only moments on this last weekend when I saw peoples faces changed is when rich tourists flashed their money… and by comparisons highlighted the lack of the locals. I am thankful for how I am traveling here… meager and in no grand entrance. We eat where the locals eat, ride with them, and spend time trying to understand their lives. I have taken zero pictures of the people here, for I do not want to make them apart of my safari.

Being in the position of growing with the people here brought back distant passions to do something meaningful with my life. I have always thought of death, and what I want to do with my life so that when I die I have created a legacy. This is one of the biggest reasons why I went into medicine. I wanted to have some knowledge, some skill that I could serve that would change the lives of those that encountered me. So far in my medical schooling I have become greatly disillusioned for several reasons. The first being the desire for comfort, that while I want to do something noble with my years I don’t want to have to live in poverty to do so. I want to be able to be compensated proficiently for my time, so that my family does not lack. I then think of all the different jobs I could have gone in to…. With less work, less schooling and using defiantly less of my brain then I use for medicine I could be making easily $500,000 a year. This amount may seem staggering, and I guess it is, but it highlights in my mind that I did not choose medicine for money, I chose it to make a change. That brings up disillusionment #2. I chose medicine so that I could usher in a better life for others, and without me it would never have happened. I therefore have been drawn to the difficult and competitive specialties: Neurosurgery, Trauma Surgery, etc. Yet just like medical school applications, there are tens of thousands of students behind me fighting for the spot I have. So even if I devote my life to a field of medicine, become the best doctor out there and save thousands of peoples lives, in the end I have effected nothing. For if I decided to instead become a janitor that neurosurgeon position would have gone to someone else and he would have effected the same thing. I do not want to be just a cog in this wheel of life. Whether it be a top important cog, or a bottom medical student cog, I don’t want to be easily replaceable. It is this desire that directed me into global medicine. There are not many who are passionate enough and willing to give up many of the luxuries of the US including their continental family to work abroad. There is not much competitiveness, there is not a long line to help the poor. There is no sizable paycheck waiting at the end of it. There is no glamour, no monetary reward, no factors that drive mass people to the field. And yet, I find myself continually drawn to forsake my culture of wealth, protection, and prosperity that puts us in a coma to the hurts of the world, so that I can effect a change somewhere. I want to go somewhere and establish something that will heal and help and without my personal sacrifice, without me going and organizing and working it would never have come to fruition. I guess I still search for that meaning in my life, that justifiable reasons as to why on an individual basis we were put here on this earth. I refuse to believe mine was to be a cog. As I see these people in Uganda who don’t have care and desperately need a doctor, it gives a reason for why I am learning physiological splitting of S2, Renal Tubule Acidosis, and Thiamin Deficiency. Back at UCSF all of this seemed just as useless trivia because, I could not foresee myself as going the path of a medical cog. But here, it seems like the information I learn will save a mans life. And If I personally don’t learn it, then he will die. No one will be competing for my position. No resume padding, no ulterior motives… Just life and Death. I see myself in a familiar woods with diverging roads… One road is the path of personal meaning and lifelong work I would be proud of…. And on the other is trying to acquire the easiest and richest life I can in the states. The question I guess is: Do I posses the strength of character to effect change in this world?

I never thought that I would be having these great apprehensions about medicine. But then again, I should be thankful for these apprehensions are what remind me of what is personally paramount. These apprehensions show me I have not yet been completely lulled into the American indifference. These apprehensions are what prick and prod, and even comfort my heart into not settling for comfort but striving for change.

This past weekend I also had an amazing late night conversation with Willie, Erica, and Justin concerning racial and cultural differences. However I will save the lessons from that for a later time. There is still so much to convey, and I must be going to work here very soon.

Saturday night we stayed in Masindi which had its own Rose and Thorn. Rose being the game of soccer played with the local children for hours. They only had a deflated 4 square ball to play with so I bought them a soccer ball, and my team along with 100 village boys all played into the night. It was an amazing time, and probably the first time many of them had ever played soccer with a white man. They were thrilled I was there, but I was thankful to be allowed apart of there game and life. Thorn being that it was the worst night sleep ever. There was a part next door with loud music, and we got up at 3:30 AM to begin our tracking.

Once we crossed the Nile we began finding elephants, giraffes, hippos, buffalos, antelope and more. It was an amazing experience to be able to see all of these beautiful creatures in their natural habitat. Absolutely stunning! We then hiked murchinson falls and saw the beauty of the nile.

Yesterday however was my favorite day of the entire trip. We got up early in the morning and left with our Chimpanzee tracker. Her name was Sauda and works with the Jane Goodall Primate Preservation Group. Seeing as how there is no fence, no cage, it is often difficult to find the chimpanzees in the jungle for they roam and go wherever they want. Sometimes weeks without people being able to see them. We tracked Chimp Nests, Dung, and broken fruit. We saw chewed leaves they self medicate with, and listened for Chimp calls. We tracked this all and got closer and closer…We saw them slowly at first and got rather excited. 1, then 2, then 3 etc… There was a moment when they surrounded us and started howling…. Our guide told us what to do if they attack: Drop to the ground lay flat and guard your hands and arms as they will break them. After we showed that we were no threat (This was a CRAZY experience…. So much adrenaline) they began to mellow out and resume their life of grooming and eating. What followed was sublime. We spent several hours with this wild chimpanzee crew of around 30+ Primates just watching this breathtaking and once in a lifetime experience. Even our guide was amazed at how many were there, and how open they were to have us there. Truly Truly outstanding. My pictures do not do justice to the magnitude of this time.

Nolan - 7/10/08 10:10 AM

7/10/08 10:10 AM

The microscopic insanity that is found in currency within Uganda is astounding. Panic, nay hysteria has overtaken this country and compelled everyone to only except pristine newly printed out side bills. Several of my Benjamin’s have a minor rip in the outside corner. No bank in the country will except them, why? NO GOOD REASON. My teammate has a Jackson with a minor pen mark on it. They were unsure if they would except even that. I say this because of budgeting. I calculated and planned and reasoned and speculated as to the exact amount of money I would need. It would have been perfect, save for the strict religious code that must be followed in money here. I am forced to borrow some money from my research partners, but in the end I feel it will all be okay.

Last night we went out to an Pub with some locals. It was a good time. There were so many international trivia questions that I didn’t know, but the atmosphere was great.

Tomorrow we leave in the morning for an exciting lion, elephant, giraffe, zebra, rhino, and chimpanzee trekking. I have never seen these animals in there natural habitat, so it will be invigorating to observe. So far in Uganda our research has not carried us to many of the older tribes in the south. Part of me would like to visit and learn from their culture, but I also do not want to be apart of the tourist culture which is destroying ancient ways of life.

Justin and I have now wrapped up 2 weeks of our project. We are planning the re-training for all the first aid trainees for late july. Next week we are planning on spending a lot of time in the hospital assisting in surgery or the ER.

Even though it is summer, it is hard for me to not think about studying. The USMLE haunts my thoughts. It is interesting to see the Brain Drain of Africa first hand. We have hired a few med students in Uganda to help us with research and most of them want to pass the USMLE and work in the states. The economy of Africa is not great enough to support the income they want to achieve so they leave for another place where the economic outlook is brighter. It is sad really, this continent will never grow and develop if the people don’t invest back into it. Instead all the best resources get shipped to the developed world.

Nolan - 7/7/08 5:39 PM

7/7/08 5:39 PM

I am sitting alone out in front of our living space right now. My teammates were not ready to leave, and I guess I just needed some reflective time. I am trying to take as much of it as I can this summer, as I do not allow myself the luxury of time back in the states. I am 10,000 miles away from my family whom I desperately wish I could be with. I don’t hear much detail from people, only that there are more health issues with my sister. Besides the hormonal growing experience that is high school I have never been in geographical location to my sister. We do not really talk much over the phone either, and so our relationship is grown by succinct and sporadic catch up conversations. I desire more, as I know she does… I wish I could be around her more, be with her through hard times, and be a brother that she can go to when she needs something. I don’t think I have been that good of friend, resource, or overall companion to my sister. I regret many things and am out of answers. So much of it seems out of my hands and the rest seems lost in the sad stolen moments of life. I remember the first journal entry I ever wrote… It was in high school, I had just had a painfully intimate moment with my sister as we both broke down talking about her fears about her health, life, and future. The world seemed so out of whack, lost on an axis, painted in one color… something of such glaring magnitude that I was shocked the rest of the world had not launched a global campaign of reform. I had been dealt pocket rockets every year of my life, and would often hide the ace up a sleeve as well. She had been dealt nothing. Nothing.

Anyway…. People are starting to stare more and more at my laptop… I need to hide this thing and move to a more public area….

Come on Over

I realize that my post is highly "skip-able", compared to Nolan's newscasts, but in case anyone is wondering what I may be up to, I thought I'd add a little note.

I'm back in the city at work again after a nice vacation up at my parents' house...I have gotten to see them, my in-laws, and others in my wonderful time off. I watched two of our good friends each get married recently, and heard the news that cousins are expecting another baby! I feel a bit like my life is at a plateau for now until the distant future when something new happens, whether it be a new location, job, school, new family, etc. I've realized that my life is pretty much set how it's going to be for the next several years at least, and so now my biggest challenge is to find some way to make it mean something. One thing I absolutely love about Nolan is that he challenges me to use my time to make a change and a difference. I am still deciding where I want to spend my free time, since I have a few volunteer opportunities available, and just need to make a decision. They are both big commitments, but a friend has advised me to just take that leap. So we'll see. Also I'm *in the process* of getting involved with the band at our church. Music is something I am super passionate about, and I picked up the guitar a couple weeks ago and realized I hadn't played or sung anywhere but the car and shower in maybe a year. Too long. So I am doing everything I can to get involved in that way, which is another reason why I am waiting a bit with the volunteering opps, since I have the feeling that the band is potentially a huge commitment. I'll have to wait and find out exactly how much time I will have to set aside for that.

Other than all that, I'm just keeping myself occupied with friends, family, and of course Milo until that day when I can drive to SFO again and pick up my long-lost husband from his adventures. Of course, I'm also spending hours on my new Wii (thanks, family!) practicing my tennis swing so that I can spank Nolan at tennis when he returns.
~A

7/7/08

presentation or our PI. The evenings of Thursday and Friday have been taken up with this TV Series called “Prison Break”. Willie brought all of Seasons 1 + 2 on DVD and we have been roaring through those. It has been fun. I am getting to know Willie, Justin and Erica a lot better and deeper then I ever would have at school. Each is such a dynamic individual with a breadth of talents and a depth personality.

On Saturday we hitched a taxi ( Which is a muni type transit of small cars) down to city center where we tried to find a taxi down to masaka. We found a taxi, but they do not leave until the entire car is full, so we waited for 90 minutes in that car baking as every man woman and child came to our windows trying to sell us trinkets and toys. We got off on our way to Masaka to visit where the northern and southern hemispheres meet. The water demonstration was cool…. It flows clockwise in the N, counter-clockwise in the S, and if you pour water in a funnel right on the equator, there is no pull of water in any direction.

After touring around a little at different villages and shops we decided to find a way home. We had no taxi, or transportation available but were finally able to flag down a large bus. Once boarding we realized the bus was PACKED with barely any seats available. The conductor (The man who handles the fairs) told me to go to the back of the bus with him. There sat a mother nursing her infant child, and in the seat next to her sat her two toddlers, both whom looked under three. The conductor proceeded to grab the children’s arms and yank them off the seat. The mother started screaming and crying and I tried to plead with the conductor that I would sit in the aisle. He would not listen. My heart was broken for these people. I did not feel I deserved these children’s seats, nor did I want them. Once I was made to sit down I grabbed the young girl and pulled her onto my lap so that she could sit down. The rest of the ride back to Kampala that little girl sat on my lap and slept…I really felt touched for some reason. Not that she was a child, but because of the hassle it caused, and the opportunity I got to make something “right”. A lot of the country men here do not look favorably upon the “Mazungus (White Skin)” because most that visit here come for the crazy African adventure, and tour around. They swing there big paychecks, act like they own the world, and view the local people as some sort of exhibit. How would you feel if anywhere you went an oily faced tourist was trying to snap a picture of you in poverty or working for his church back home, or for his buddies waiting at the airport. Anyway….. Sorry, quick heated moment.

I am loving the culture here! The rich vibrancy of life is amazing. The people are all o so friendly and I cant help but feel at peace here.


7/7/08 12:55 PM

I rounded this morning on the surgery ward. It was quite an experience to assist in the care of these patients. Gang Green, Large Tumors, Burns, Laceration.... Maybe it is the lack of primary care, or the shortage of doctors. But when people come to the hospital they REALLY have a problem, and there is not enough doctors to go around so medical students do alot of the work. I am learning alot from these experiences and I plan to use my time in the hospital valuably.

I went to the market place the other day and on the way back found an african tribal antique store..... found alot of really awesome things that I need to take back for my collection.

Introspective

7/2/08 8:04 PM

I finished one of my projects today, the baseline study so now I can begin data analysis on it tomorrow, to find out how best to adjust our study to maximize results. But all this pales in comparison to what is going on in my heart. Already I have a pattern of life after 3 days here, but there is still unrest within.

As much as I was distraught and dreading being apart from life with my loved ones, part of me was thankful for the time that I would be forced to be alone… be with God. Along the paths of my life I have chosen, so much has been accumulated. So much baggage of wrong choices, layers of doubt dragging down inward growth, not to mention the steady twenty of 20 so lbs of unwanted adipose tissue I have gather since beginning undergrad. I remember who I was went I entered in at UC Davis…. A somewhat cocky, but confident, passionate, in shape, young man breathing in the sweet aromas of life wherever the wind took me. I find myself now more cynical, more doubtful of miraculous and mystical unknowns or even just people with a hope, or a dream. I remember the excitement I had upon meeting new people. I wanted to understand mankind, engage its most dynamic creatures and learn from its wisest. I find myself now content with passiveness, and dejected with the idea of something new, something out there, and bold. I wonder if the glory of my earlier time was simply youth, or a deeper belief in something in this earth. I desire all that back… I desire the veracity of life. I desire the passion and joy I once found in God. I felt he was so near, I felt he was real in all things of life. Breath and Heartbeat, Wind and Sun, Voice and Love held the deepest beauty to both mind and soul because a God who loved me created all that was before and ahead of me. It is the only way to live life. Now I find myself more educated, but more dull… like a diamond covered with soot… longing to once again reflect back the brilliance of the sun. My belief in a God has only grown since learning about the human body and everything science, but my belief in God interacting with man has been bended greatly often to the point of near breaking at times. I did not and still do not at times see Gods hand in the great tragedies of life. In the dying deathbed of a mother, or the frail hand of starving 3 year old child…. Point being that despite my struggles I desire to be the man I once was. I am discontent with who I am as a person and I want to grow into the man I hope to become…. The last few nights have been fun, but I feel wasted simply playing cards or watching movies with my research partners. I want to spend it well.. I want to spend my time growing. How though do I shake off these clouds that follow me even to Uganda? How do I break the entrapment of something that takes no isolation in country or origin but travels with me wherever I go?

The only time I find solace from all these thoughts…. The only time I find freedom from these pressures is when I truly enter into a harmony with God. And yet what do I do when my mind questions if he is answering back, or if that communication is simply a projection of my cortex? The best memories of my life, the only ones that will test the struggles of time have some connection with God, The Christian Mission, and Fellowship with Christians…. To deviate from this by having so many questions separates me not only from myself, my God, but also my culture…. The only culture in which I have ever belonged. I find myself in a group of one, with no one really able to relate. I miss greatly Jacob Saur for we had this in common, and could converse in honesty with each other. I wish I had someone like that now… When I try and come back to Christian Culture…. I do not even get to the point of striving to improve my relationship to God because so many other things come in the way now. I am told I am a hethen and going to hell if I believe in evolution. I am told I have to be pro- “life” and anti “gay marriage”… even though I believe in women’s rights and more mercy then justice….

Anyway… I digress, but all I am trying to emesis is that Christian subculture does not give much room to worship God, without worshiping doctrine of minutia first….

If I could, I would go back to undergrad in a heart beat… My friends are scattered around the world, and I dare say the momentary glimpses of conversatin are not enough to cause satiey in my desire to grow with them. How does one deal with losing almost everyone he cares about all at once in life?

Anyone, I should let my mind rest and go back to engaging my heart.

Psalm 6 2-3

7/2/08

7/2/08 7:03 Am

Our moments of warm showers, nice meals, and easy living seem to be beind us. We had been staying at the Makerere guest house for the past few evenings. We were disgruntled because it coust around $30 a person. We laughed because by US standards this place was a dump. However we did get substancance and an easy sleep. We then moved in Bukoto flats approximetly 3 days ago. This place reminds us more of a refugee concentration then of an aparpment complex. We must be extra vigilant to lock all the bars up to ensure that no one tries to rob us.

This week will be rather slow in terms of “adventure” as we are trying to establish a baseline of data for our research so it is rather tedious and monotonous. However, once that is established things will pick up. Willie is quite the talker, and is always keeping people on their toes, I have enjoyed getting to know him. At UCSF we did not interact that much, but I can see now that he is a fun and engaging person. Justin and I have shared quite a few moments together, and I am the closest to him than anyone on my team. Although you would not know it each member of my team is incredibly deep and introspective about events in there life. It is refreshing to be allowed a glimpse of someones soul. Ericka amazes me, and I can relate to her in a variety of ways. She comes off as ditzy and air head, but that is just because of the culture in which she was raised. She is brilliant and an intellectual monster. I am always sad that my speech, I feel, makes me appear less cerebral then I feel I am. The culture in which I was raised was in a town not too educationally driven nor advanced. Therefore my speech lacks the pop and sting of a private school academic. Ericka and I relate in this manner.

Yesterday we saw big military trucks drive by us on the streets. Loaded on the back was armed men with automatic rifles. The crowds around us were cheering and yelling as they drove by. We did not think about it too much until later on in the evening we saw on a TV about a drug dealing insurgency in Kampala. Several people had been shot, many wounded, police cars and buildings lit on fire. I am not sure if the populace supports the rebels or the national police. When I asked a Ugandan co-worker she said people dont trust the police here, there is alot of corruption.

I have been able to talk to Anneliese on the phone recently, which has been really nice. It is enjoyable to be caught up with life in the states, but at the same time saddens me because I can not come home to her. After being gone for a week now, I am beginning to realize just how long 2 months is…

Hopefully my e-mail will work here soon, so I can stay in contact via that. But for now, this blog is my source of voice.

Day _ : No Malaria

New Posts from Nolan. Quick Uploaded Journal

6/27/08 3:34 PM

When you step beyond the comfort of the known and understood there is the thrill of adventure, the exhaustion of adjustment and the agony of feeling down right retarded.

I left San Francisco two days ago in what has been the hardest parting of my life. I walked away from my tearful wife as I waved goodbye for what seemed an hour, only to want to run through customs to give her one last hug. I wish I had known this passion, this desire, this love for her earlier. I have wasted some much time being content with surface understandings and cursory approaches to our relationship. She is deeper then plato and more eloquent then Shakespeare, yet she converses with me in beautiful compassion of my ignorance. I can not wait to see her again.

So where did I leave off? Oh yes, the airport. My flight to seattle was pretty un eventful except this quirky construction worker who sat next to me telling me about how to make the most of my life. I arrived in seattle met up with Sarah and rode over to Amsterdam. She slept the entire way by downing some Z drugs and was left to my incapacity to manage my adenosine regulatory drive to sleep and its circadian clock of a step child mudding up the whole process. Needless to say when I arrived in Amsterdam people might have well thought I was stoned… but no it was do to getting no sleep and watching 6 movies on the flight over including Pocahontas (which of course I sung along to) and a variety of other post starlight flicks. On the 8 hour flight to Kenya I gave in, popped some BDZ’s and passed out only to awaken with cottonmouth and a lady named Julie next to me saying I was snoring. Thank you Julie. For the layover in Nairobi, I played chess with Ericka. I must say I was impressed by this girl for the game went on into the flight to Kampala, but yes I finished victorious with only a king and a bishop left.

Although we were tired, everything would be alright as long as we could get some sleep… right? WRONG! Turns out Kenyan air pinned me as a sucker from the get go and just decided to leave my luggage in the Nairobi airport. Now youd think to yourself, well that cant be too bad, right because they will send it the next day? WRONG AGAIN. They didn’t just leave it at Nairobi airport they put it on the luggage carasel and cant find it anymore, they think someone picked it up and walked home with it. So here I am with a large wad of Ugandan money, a pair of shorts, shirt, shoes and a watch seeing how little I can conquer east Africa with. But the Ugandan people seem to be in good spirits, so I will just go with the flow and see how things play out. Good thing I packed my malaria medication in my backback with me on the plane…. But nothing else.

We arrived in our place of lodging, the makere guest house at 2:30 AM after getting into nearly 4 road traffic accidents. Driving here is the worst I have seen in the world. We passed out only to be awoken at 6:00 am by a roosting, two fighting villagers and then the Islamic call to prayer. We ate what appeared to be mushy cereal and began work on settling into Uganda. So with all chaos behind us we set forth for our first full day in Uganda. We saw beauty in the mountains, simplicity in a worker watering the basketball course and a man picking up leaves with his hands on his lawn. We went to Mulago Hospital and got introduced to several doctors including the chief of surgery. After talking for quite awhile he attempted to set up a living space for us in his house, and have several of the Ugandan doctors carry our luggage for us. What an experience of hospitality, amazing. It is quite an experince here because doctors in training are calld Dr. after there first 4 years of eduation (Which amounts to my undergrad degree). So here I would be known as Dr. Nolan, but back home I get nothing, lol. Anyway, I am having a wonderful time so far, and am in the process of trying to internet with my laptop at our office.

-Nolan-
Day 2: No Malaria

6/28/08 5:03 Am

I have been lying awake in bed for the last two hours, despertly wishing to fall asleep. But I find myself with a slight twinge of happiness because it has given me a moment with the Lord I may not have had otherwise. In the hectic moments of my life, even here in Uganda, I do not allow time for God to speak to me. He has become so distant, so faint that it take miracle after miracle to bring me back. I have time here now in Uganda, for the first time in my life I have time, but do I have time for God? Father, please work in me, do something amazing with me so that I might cling to you in the most busy or silent moments.

Day 3: No Malaria

6/29/05 7:25 AM

The lines between dreams and reality are beginning to become blurred as I press on with lack of sleep. I keep dosing off with narcoleptic syndromes throughout the day entering into lucid dreams. Every dream involves my family and loved ones in the USA missing me and wishing me home. I then awake and am sad, because it is still very early and I will be gone for a much, much longer time. Where will I find strength in these times of missing those I cherish?

Yesterday was quite the day of adventure as my teammates and I learned about life in Kampala. We began our trek leaving our apartment walking toward the city central. I had hoped that traffic would improve if we were not walking on the main roads during rush hour, but was immediately shown that at every hour of every day the roads here resemble a coastal fog as you wade through the car exhaust and boda-boda fumes. The vehicles they have here are mostly antique almost, and yet what be some of the best mechanics in the world are squeezing 400-500 k miles from these hunks of junk. The traffic and heat at the end of the day would lead to a dark film that would cover my body, leaving behind the residue of poverty found throughout life in Kampala.

In Kampala, the pedestrian has no right of way, and to make it worse there is often none or very little “sidewalk” on the streets. People are hit by cars, feet run over by motorcycles, and if you want to cross the road you must dodge traffic like frogger. Walking around is quite the experience. I began taking pictures of the city, people, builds etc. But when we passed this side street on side Kampala road I put my camera away for good. I consider myself, not immune per say, but dulled to poverty and depravity around the world because of my experience with it both home and abroad. What I was to witness would top the saddest thing I have ever seen. In Kampala there is open sewers everywhere, so no matter where you go the distinctive smell of feces and urine is abundant. However in this area of the land the open sewers join to create what is like a culvert of human excrement. It is here where I saw families, elders, children living in this culvert. Children as young as 3 would be sifting through this sludge in hopes of finding bottles or something of value they could sell to acquire food. Here people begged not for money, but water…. Bodies, barely alive, lined the streets hoping for a handout that could provide substance for another day. I could have easily heaved whatever remnants of food were in my stomach at this horrible sight, but instead I emptied my wallet of whatever money I could find. I only had 80,000 shillings or so, I wish I had more. Seeing this life, this depravity was heart wrenching. People here do not have the luxury to think of others. They can only concentrate on self-preservation. My place of privilege and blessing in the United States is often forgotten midst my studies but is evident in every degree here. I have the privilege of being able to help someone, the privilege of worrying about a job or school, and the privilege of self reflection. When true poverty descends life is concerned with only one thing, making it to the next day.

The preceding statement is what mounted a reflection upon effectiveness in the third world. I met this Christian missions group on the flight that was ecstatic about brining 1000 pair of shoes to children in Rwanda. They were excited because of the grand impact they would make with there shoes. I then crunched the numbers… 10 flights and 2k eash + 1k living expeses each + 5$ per pair of shoe they are bringing = 35,000 to bring these shoes to the kids. If they had just given $35,000 to these people they could not only have had a pair of shoes, but food enough to feed them and there families for a year. I began to get disgruntled at Christian Missions trips and the ineffectiveness of them all. If I had my initial choice I would rather have given all the money for my trip to these people, but I know that my work here will save thousands of lives a year. I need to be diligent in my work, and invest our research and program, because it will pay off. My work here allows me effect change on a great level then I could as just a doctor. I often get disgruntled with my work back in the USA because the health system we have intact often places doctors in the role of placing a bandage over the health crisis instead of solving it upstream more. That problem is exemplified here in the lack of budgeting to put a ground well for clean water here but instead investing money in treating cholera that arises from lack of clean water. In the US there is so much bureaucracy and resistance to change, that is seems impossible for me enact change. But here I am a 23 year old medical student, working on developing the health care system for Uganda! When I write this I find both absurdity and solace in that statement. Solace because I have been greatly blessed in my life and my upbringing and with great power comes great responsibility. Here in Uganda I am able to invest my time and change a country. I find absurdity because where are governments priorities when iit takes 2 medical students and 2 surgeons from UCSF and Uganda to enact this countrywide change?

After we toured a gorgeous mosque near Makerere Hill we began to walk back to our place of lodging. When we were walking we saw a public gathering watching a scene that had unfolded after a recent accident. A boda-boda had been T-boned by a taxi while turning onto a side street. He had been injured pretty bad with massive losses in blood. The police arrived approximately 10 minutes later to take care of the individual. The Police Officer new exactly what to do, ABC’s, recovery position, splint etc causing Justin and I to be quite amazed. It was then we realized the badge and equipment this police officer had. This David Okoua was one of the trainees from OUR program. He was using the material I created, he filled out the information that I am using for my research, and my PI had even directly trained him. I was amazed we only accepted 300 people in this initial pilot program due to budget limitations and scalability issues, but this Police Man helping to save this mans life had been directly trained in my program. I was awestruck, I as stunned. I have not been through the prospective data yet, but already from 10,000 miles away I had been able to work on a program that was currently saving lives…. Whoa, humbling. They proceeded to load this man in a taxi and take him to Mulago Hospital.

Later in the evening we left for a local Ugandan Club where I was only 1 of 2 white people in the room. It was quite an interesting experience. There style of dance, and youths culture is much different then my own. Not only did my style of dance seem foreign, but most Ugandans are also very small. I would say the average Ugandan in height was 5’7. I stuck out. In any regard it was much fun, and an exciting cultural learning moment.