Surely enough the digestion began and continued into the weekend, or should I say indigestion, because over the follow three days I developed diarrhea and stomach pains. This usually happens to me when I travel, right around three weeks for some reason. It happened to me when I first went backpacking in Europe, when I went to Nepal with my family in tenth grade, and just about any other time I stepped off a plane. The time I was in Nepal I learned a valuable lesson, story time: I had developed the runs, big time. Montezuma’s revenge as some would call it. Although probably more accurately Songsten Gampo’s revenge (founder of the Tibetan empire, had to google that one). When I developed this ailment I considered what to do. My mom, an incredible doctor, is also a mother, and when it came to her little chickens, the neuroticism of motherhood always trumped the collected intellect of a top quality clinician. Thus, when diarrhea struck I did the sensible thing, and turned to my father instead, old school type, a man’s man some might say. His advice was crystal clear, take some pepto bismol my son. Lo and behold what does his 16 year old son do? He goes into his bathroom and drinks some pepto bismol, a glass to be exact. Yes, I drank a full glass of pepto bismol. Needless to say nothing moved through my channels for the better part of a week. Solution found, problem solved. I mention this story because contrary to popular belief, health related anxiety is not exclusive to non-medics, and even though I was certainly suffering from travel related diarrhea, I became terrified with covid paranoia. Much like anxiety in general that magnifies with age, the 16 year old version of myself would have surely been more sensible and just waited it out. Not me however, I took my pre-packed pepto, as well as my temperature around the clock, informed the boss and waited for instructions. In the end everything was okay, but I lost a ton of sleep and ruined any chance of a proper rest after my first mission.
The day after we got back from the field, I was positively knackered. I was baffled at the notion that Friday was still a real work day, and when the team arrived I dragged myself around the base doing what was needed to be done like an empty shell. My legs were on fire from the sancudos, and the exposed patches of skin from my friction-burnt off leg hair were getting further battered by the rays of sun. I had a lot of patients to follow up on with Sam, and in the morning we spent a good while trying to get thing sorted. That’s another thing I have learned about here, how much tedious legwork makes up the skeleton of healthcare. In Ireland you could just write a referral letter and bingo bongo onto the next. The secretary will ensure the letter gets to where it needs to, that physician’s secretary or triage nurse will book them an appointment. Someone else will send them a letter, or call them to let them know. The patient turns up, the clinical nurse takes the patient’s blood before their appointment, and if they need imaging a porter comes down and takes them down to xray. Once they walk into your office there have been hours and hours of costly work spent on this patient already. The doctor gets his ten minutes, the glory and the credit, and then the cycle begins anew. Here at FD we were the secretaries, the nurses, the doctors, the clinical workers, the porters, and everything in between. The bits and bobs are endless, and they really put a damper on your fun. I guess that’s kind of the whole point though isn’t it. It’s like the guy who sweeps the floors, people only notice the job when it doesn’t get done, because if he doesn’t do it no-one will. After a morning spent going back and forth trying to arrange some way for our woman to get the mammogram for her breast mass, which would involve sending up a letter with instructions and money for travel because she had no chance to be reached by phone, the team had a de-briefing session. We started by going around and saying something we were all thankful for. I was last to go, and I thanked the team, their support got me through some tight spots, and I felt truly lucky. There was something that I wanted to discuss with them that had been on my mind, and it revolved around the most precious commodity of all: time.
See, I was happy to be here. All I was getting was a month, despite how much more I wanted, and if it were up to me, we’d stay in clinic till 11 at night if that’s what it took. A conversation with my mother just that week had gotten me thinking. ‘Imagine being one of the other members’ she said. ‘You are here for fun, on a part-time gig. This isn’t real life for you. These people are here all through the year, and this is their job. It’s not fair to them that every time a new member comes in the rules of engagement change. You think you are doing everyone a favour by staying late, and some people will be thankful, but sometimes it isn’t fair to the rest. Just be mindful’. I had mulled her words over during the day, and I realised she was right. I had to know where things stood, so when the moment came during de-brief I said it out-right. What are our limits? I asked. I need to know how long we actually mean to stay. The reaction I got from them was heartwarming. ‘We’ve been off for long enough’ they said ‘We stay until the job is done’.
Isn’t it so nice to work with people who are on the same page as you?
To be honest the rest of the day was hazy, I felt about three steps behind the rest of the world. The first moment of free time I had was used to draft an email to Muck boot company asking them to sponsor us with some decent mud boots, the vendetta of my battered feet having become personal. I met with the big man via zoom to discuss every patient I saw to make sure I didn’t make any huge errors. He was much obliged and we spent close to three hours going over the charts and my notes. I made some good calls and some not as good calls, but that’s learning. I tried to take it all in stride. That night I was exhausted still, and in that way we do I convinced myself I was just harbouring fatigue from the week. Poor sleep in the hammock, lots of moving around, decimated legs and feet, I just need rest I thought. Twas the beginning of something more though as I would soon find out.
The Saturday began alright for a Saturday. I woke up earlier than I wanted to, which is always frustrating. I spent a lot of the day trying to set up this damn blog, which was further frustrating at every turn, from the web design to the media, to my inability to ever be satisfied with any piece of writing. Jack asked me to show him how to do a few things, things that could be of service to us in the field, taking blood pressure and blood glucose. He picked it up right away, and despite my desire to teach him I felt real sour the whole time. I was trying to understand why. Was it because it was Saturday and I wanted my day off? I knew I was more than happy to teach him, as a matter of fact there was more I wanted to show him. I was just feeling rotten, cheesed at every lingering moment of conversation, every task that continued taking up my time. I hoped I wasn’t being rude but I probably was. That’s one thing I have always struggled with, pretending to be interested in something that doesn’t interest me. I decided a nap was what I needed and so I did, waking up after 40 minutes in that type of grog after a nap that’s gone too long. I went to the bathroom and it wasn’t pretty. Well there’s the answer I thought; definitely not calling my mom tonight, she’ll smell it on me right away and get worried. What is about mom’s that gives them that power? Imagine we could harvest it into a bottle and feed it to doctors…
The evening rolled around and the team members on base were celebrating Jack’s birthday. There was BBQ prepared by Chrys and beers in the fridge. I went up there for a while, doing my best to show face when all I wanted to do was go to bed, and yet slowly our conversation got interesting. We talked a lot about the Latin world. I asked Jack, Chrys and Anselmo where they felt the Panamaniam identity laid, Caribbean or Latin American, or perhaps indigenous for them? Identity is a big thing for me. When I was a kid, growing up an immigrant in Canada, I never really felt Canadian. For that matter I didn’t really want to be. People say that immigration is tough on kids and I think that is utter bollocks. Kids can adapt in a pinch, they cry but they get over things, they make friends, they are sponges. I think it’s much harder on the parents. I watched for years my parents miss their home, never having really wanted to leave but feeling forced to by a system that made it impossible to climb without stepping on those around you. Imagine a circumstance so aggravating, that you’d be willing to say goodbye to all the things you grew up with and love because you saw a better future somewhere else? I saw how our migration broke their hearts in many ways. I sat down with my father once not long ago, I was back home from Ireland in medical school and he told me something that I won’t forget.
‘Hijo’ he said ‘You know when I sit down to eat somewhere. In a restaurant. All the voices I hear around me speaking English… I still notice it. That is, I still notice that this isn’t home. I still feel out of place here. These aren’t my people.’ He’s lived in Canada for twenty years. Likewise he’s raised three positively gringo children – I wonder how that makes him feel.
When I was a kid, I wanted to be Argentino. I held that part of my identity on my chest. Argentino first, gringo second. Always. Yet when I returned to Argentina people made fun of my accent, I had a twang, subtle enough but still there. It really bothered me. In Argentina I would clam up. I’d go with my cousins into shops, people would speak to me and I’d get embarrassed, mute with shame about my accent. In Canada I didn’t feel Canadian, nor did I want to be, I was Juan Manuel Lopez Tiboni, yet in Argentina I clearly wasn’t one of them either. I struggled with identity for a while, and in time of course I grew to rescue the positives of both my homes. It probably wasn’t something that conquered until I was in my early twenties, when I went backpacking in South America and finally put it all to rest before I started medical school. I was embarrassed to be a gringo for a while, and sometimes I still am. I met an Argentinien guy in Europe once, getting off an overnight bus at 330 AM in Budapest. He was from Buenos Aires. We shared probably two sentences until he asked me where I was from.
‘Capital’ I said, meaning Capital Federal, Buenos Aires. ‘But I grew up in the exterior for many years’
‘Ah’ He said, then proceeding to look me up and down, like a pervert sizing up a 19 year old girl. ‘I can tell’. It made me want to punch him in the mouth.
When I asked the Panamanian’s where their identity laid, Latin American or Caribbean, they perhaps didn’t realise how much history there was behind it. They told me Caribbean, which I never would have guessed. Just goes to show. We talked a lot about our different uses of Spanish, different words meaning different things. I grew up speaking informal Spanish in the home, often not realising that a lot of my vernacular is actually crude and colloquial. Imagine growing up in Germany to Irish parents and thinking that craic was a regular term used everywhere, or a Canadian thinking that dart was the actual word for cigarette. This happened to me all the time. Jack and Anselmo talked about their native identity, and what it meant to them. I told them about our Canadian history of abusing our natives, a nasty stain on our self-proclaimed nicest nation in the world reputation. We talked about other things not fit for this blog. For a moment I forgot I was feeling sick, I was even able to put back some wine.
After I retired I took my temperature, I had a slight fever, tiny, at 37.6. I’l give it untill tomorrow I thought, I’ll worry then.
I worried all night.
Sunday I felt positively rotten most of the day, and I spent nearly all of it running back and forth to the toilet until Mr Pepto kicked in. Good old Mr Pepto. Thankfully that evening I was feeling well enough to call home. I barely had to say a word and mom could tell I had been sick, but that I was getting better. Still blows my mind.
