Archive | October 2011

Travel Journaling

Vacation is time set aside, in a socially accepted manner, solely for our enjoyment of life however we decide. So makes sense that we’d want to savor it, enjoy it, re-live it and keep it fresh in our memories for as long as possible. And there are many techniques to choose from.

For centuries journals or diaries were very common – in fact much of history is discovered in these as well as letters written and sent from travelers of many kinds- dignitaries, soldiers, missionaries, clergy, settlers & explorers – both nomads & rooted individuals of “all walks”.  Prior to 1913, the invention of the 35 mm camera, & 1925, first mass-produced by the Leitz company in Germany, these journals rarely ever contained photographs.  Which brings us to two other forms of vacation capture: Sketching & Photography.  Photography of course encompassing still-frame & video

My family travelled a lot  when I was a kid and we owned many different cameras over the years.  I suppose I come from a family of people who, like me didn’t like to write. I say this because our main, dare-say only, capturing-technique was photography.  Unfortunately all those lovely pictures, with so much time, money and energy spent in creating them, would end up in photo albums in a dusty box if they were lucky & many of them instead in shoeboxes in that same corner. These memories were only ever revisited when someone stumbled upon them while looking for decorations for one or another holiday or when they were moved to a new corner of a different house.  My father recognized this lapse during his last year with us and in an effort to reclaim these moments, & perhaps to extend the memory of himself beyond is impending death as well, he took up an effort to create “collages”.  Essentially we went through boxes upon boxes of photos from various times, condensed them onto poster boards that were encased in plastic and hung along the hallways.  Producing them was enjoyable enough but they quickly fell apart and repairing them became less and less feasible as time went on shortly there after – I’m not even sure where they are anymore or what happened to them in the end.

Isn’t it interesting though?  Travel & school are like markers on our mental time-keeper.  Every day in clinic, I listen patiently as people rack their memories for years or dates saying: “Oh it was right after we went to Hawaii that time…” or “the year we went to Disney with —, he was in kindergarten then so…”

Since the internet has become central to life as we know it now Blogging is the new version of the Journal.  It combines text, video, photos and sketches too if you scan them in.  I wonder how Blogging will impact history and whether posts & blogs will preserve people’s memories compared photo albums and journals of the past.

In ‘This Time for Africa‘, I told you about my impending trip to Africa and some about the significance of this trip for me.  So naturally I’d like to capture this experience as best I can. However, these previous posts have also cited that I ‘hate’ writing. Despite this aversion, I’ve tried journaling many times before and while believing that writing it down is important enough that I can always be seen in my daily life with a pocket-notebook jotting down medical pearls, lists, etc (a task or skill that I would recommend to EVERY medical student and most people in general), I have never been successful beyond that.

So my motivation to create this blog and my journal was kick-started by:

  • requirements for these electives,
  • self-actualization (being honest with myself of strengths and short-comings) of my tendency to fail in the maintenance of regular journal
  • As a solution to general lack of easy & regular communication with my family & friends (both in country and abroad).

While a journal allows for documentation*, expression & reflection, a blog also allows me to share my experiences, thoughts and photographs with you and potentially my future self.  The fact that I need to continue my blog/journal for course-work presents me with a unique opportunity of enforcement, and hopefully when the month-long endeavor is finished I will have developed a new and beneficial habit of journaling.

*“Remember,” every clinical professor says, “documentation is everything in modern medicine. If you didn’t document it, you didn’t do it!”

Aware of the fate of previous journaling efforts before this one, I did a little research, some soul-searching/prioritizing & in the end some shopping.

The most helpful article I read about travel journaling was “How to Write a Travel Journal That’s Worth Reading” by Amand Kendle.  The annotated/improved cliff-notes version looks something like this:

  • Use an Attractive Book (aesthetically pleasing, practical and useful)
  • Alternating Pen Colors per day, entry or major thought process
  • Write the important/’weighted’ stuff – not everything 
  • Format:  Put Facts in Bullets  &  Head pages/entries with day, date, location.
  • Paste stuff in (tickets, photos, etc)   –  To Do: Carry scissors & glue-stick
  • Doodle!
  • Index your book.   First number all of your pages.  Then create an index on last several pages per destination, event, person, etc.

With this research, previous travel experience and my own priorities and goals in mind,  this is what I did for my travel journal.

1.  Established a gestalt of what I need and wanted in and from my travel journal.

2.  Glanced through shops to find a book that met my needs.  For this particular journal I wanted a book whose appearance seemed congruent with the trip itself – in other words I wanted a book that aesthetically looked like “an Africa book”.

I chose a red leather-like bound journal with ~80 pgs from Staples.  I chose it because it’s sturdy, small enough to easily carry around, ribbon marker & particularly the red one because I knew that the Masai incorporate a lot of red into their clothing, art, etc.

3. I numbered every page in the corner.

Since I plan on carrying it with me:

4. Wrote many of the details on my “Critical Travel page” over the inside of the front and back cover.

  • Personal & important names, addresses & emails.
  • emergency contacts in the US.
  • Embassy & emergency contacts in the countries I plan to travel through.

5. Wrote in the broad strokes/critical dates of my itinerary esp transportation information & confirmation codes.

6. Packed List (by bag if applicable).

  • able to track what I brought with me & annotate the usefulness of these items for repeat/similar trips
  • improves efficiency and reduces frustration in the inevitable scramble for supply assembly once in country.
  • finding items after arrival is easier – especially if you’re travelling via back-pack &/or loading duffel.  (This is more a problem for items you might normally carry in your daypack that you have to check & especially if you’re going through customs with medical equipment/supplies or on a medical mission – a whole other topic for another post.)

Night-Shift in a Daytime world.

What a crazy week! Night shifts are strange and they completely mess up all rhythm.  You get home exactly as everyone else is leaving or getting up to leave.

Sunrise occurs as you drive over the bridge and brings that comfortable, strangely hopeful and happy feeling. Its buoyed by a attention starved kitty who welcomes you home and the cool sea-seasoned air through windows you open to enjoy it.  Your tired, hopefully in a pleasant manner, but after the ER you still need maybe 30-60 minutes of calm before sleep is going to be a fruitful endeavor rather than an exercise in frustration and attempt at Not staring at the ceiling. Sleep comes interrupted off and on by the noisy nature of day-time, this week it’s motorcycle galore!  When you wake up it’s the afternoon and part of you can’t help but chastise yourself as if you’ve slept in – even though you’ve probably gotten less than the optimal 8hrs and most of it interrupted so a cruddy less than 8 hrs. And its starts again.

Time becomes a meaningless number without context and basics like eating, etc are all random.

ER at night becomes strange-er.

Small things that people live with all day become ’emergencies’ at night, things that happened two days ago come in now because they want to ‘avoid the lines’ as well as big things that they’ve put off &/or true ‘events’.

Time becomes totally relative – a watch with the date and the day is ESSENTIAL! and if you’re familiar enough with military time then that’s probably helpful as well. Dictating charts and histories alone turns into a complex word problem like out of your math book from 7th grade but worse, where you must untangle something like: Pt retired to bed last night at 9pm without symptoms but had experienced epigastric pain similar to heart burn with possibly some shortness of breath starting four hours before that and ending about an hour before bed in a waxing and waning nature; she then awoke 2 hrs later with pain epigastrically, across left chest and in left shoulder which went away as she walked around her house for a half-hour and then re-occurred with chest tightness a few hours after the resolution of first incident at which point 2 dosing trials of nitroglycerin reduced the pain temporarily but recurred and then maybe EVAC was initiated or they tried to get her into the car…. …. what the hell time did this incident start and how long has she been in pain now ? – are going to be the first among many questions to me from an attending & is it true or atypical chest pain? in other words which system is really the problem? And the pt & family think I’m completely incompetent & not listening now because I need to know what time did you start having THIS pain after that story has been recounted to me and I feel like screaming No YOU are Not Listening. (For those who don’t know – when this happens during the day it often comes with times and relative times are in terms of lunch hour and ‘a little after 3’ much more tangible times.

When you don’t “live” on the night shift – in other words when it’s not your usual for long periods of time – your life is on 2 opposite time tables and the balls you juggle require you to be present for both. Especially in professional school where you’re working hard and things take longer than practitioners do them and then OH Yeah! School stuff too!  Since this is an impossibility you end up just doing poorly with both. All of the balls you juggle all the time and the expectations of your peers/family/colleagues/professors for you to continue or maintain those juggling manuevers of course fail. Your basic needs aren’t even being satisfied so you’re always running sub-par and wondering if you’ve done X yet or not, what day it is and when was this or that event.

Imagine if I was the type of person who doesn’t like the night-shift?! Lol.

This time for Africa

November of this year I am fulfilling a dream that my late father and I shared – I’m going to AFRICA!  -Que Shakira.

The night that I confirmed with my school and the accepting program in Africa was absolutely nuts. My soul surged. I spontaneously was hooting and hollering, crying and laughing and jumping around like a crazy person.  – Good thing I was living in a small cabin “in the middle of nowhere’sville” as one colleague puts it in Marianna, FL or I would have woken a whole apartment building up I’m certain and no amount of restraint or embarrassment could have held it in.   There were many bumps in the road since then that tried to and were almost successful in shattering the dream but it’s still going and now I’m less than a month from departure.

I am so excited.

The fact that I’m planning to do this seems to have a surprising effect on people. I’m really not sure why – perhaps because they probably felt they knew me as this highly mature, practical, buisness oriented person – at least while I’m working 🙂 . But of course I am like hopefully all human beings – dynamic, multidimensional, both consistent and conflicting, in other words a being that is absolutely impossible to completely capture in totality in any one medium and at any one time. (Yet another reason that computers will never be capable of replacing physicians ( – a story for another day).)   Many of my attendings have heard this news and literally appear to undergo a startle reflex. Nevermind that I’ve been to South & Central America numerous times on medical or research mission work.  I think that some of it is the fear that Africa brings with it especially to the medical community.

Paul Theroux in his book Dark Star Safari – Overland from Cairo to Cape Town, discusses how overarching statements, mostly of the negative kind, are common about Africa relating this back to the continent’s unknown nature, especially in the time of european discoverers – it being drawn as blank, represented as white or black, on maps. ‘Terra Incognita’. He concludes that despite knowledge of the lands it has faded in and out of blankness on the map due to all of the things that the word Africa brings to mind in the realm of current events and recent history even.  Perhaps this explains the surprise and I admit that it does inspire a certain baseline of fear. With little effort, even people like me who have been minimally in touch with current events for some time, can bring to mind a list of associations: starvation, poverty, HIV, plague, droughts, refugee camps, political uprising, warfare, child soldiers, genocide, kidnappings, bombing, etc and even names we’d never heard before for ever associated with horrible images or emotions: Darfur, Rwanda, the Congo and even recently in Tanzania. And for the medically minded: HIV (and all of the various new or rare conditions it brought with it), Ebola, Anthrax, TB, Malaria, Yellow Fever, Dengue, Tsetse/sleeping sickness, leshmaniasis, hemorrhagic fever, Plague, and especially the dreaded Unknown that so many of these diseases were when first discovered. (If you have the stomach for it, whether medical or non-medical in background, I’d recommend just about anything by Richard Preston beginning with The Hot Zone &  The Coming Plague by Lauri Garrett, .)

The baseline of fear is higher for Africa than it is for Central & South America somehow. Curiously enough, many of the travel-loving Americans I’ve interacted with agree with that statement, while the Europeans I interact with (likely fewer due to my polling location no doubt) seem to have more of an opposite view.  Rationally though, there shouldn’t really be much of a difference. You can just as easily get killed, kidnapped, fatally or non-fatally ill in both regions. There may be more current civil unrest in Africa than Central & South America currently but I would venture to hypothesize that press-coverage largely dictates what we perceive of threats to human life and unrest more than their actual status internationally. However, that argument is one that would (and no-doubt has) launch a very long, very heated and highly circular debate in every college & graduate school-associated environment across the globe.  Despite my generation of that hypothesis, I still remain relatively uninterested in that debate though – mostly because I don’t really care about the perception of the problem but rather the identification, understanding and solution to the problem.  Yup – there’s that practical bit peaking it’s head out 😉 .

But I digress…

I’m going to Kenya & Tanzania with a friend of mine (we’ll call him BC) who has gone with his family to various regions of Africa just about every year of his life, mostly on medical missions as well. So with experienced company, the baseline of fear reduced to a managable level and the hurdle of my mother’s comfort level was likewise appeased though neither of which ever becomes completely resolved.

We are using Elective Africa for much of our working and living arrangements and they have also arranged a 3 day 2 night safari for us as well.  They do this for many students internationally, including the “Senior Medical Student” – the MS4 or OS4 in the US, and have a good reputation for it.  This was especially important for the requirements of our medical school – this way we can get credit for the experience. BC found this company from an astute use of Google and following perusal of their site, a mess of pestering questions from both our advisers and the two of us, we applied and everyone on both sides (school & program) agreed that we could fork over our money and participate. Thus leading to the day I started by describing to you.

If you have questions on how to find international student opportunities in medical/health-related fields, please leave your comments expressing interest & I can post on this topic some in the future at somepoint.

Hello World!

Let’s jump right into it then shall we?

Hi! This is the first ‘post’ in my new ‘blog’ … see I’m picking up the lingo already (with a glance of “I am using that right, right?).

>So why am I doing this?

Part of me answers: “Beats me, sorry for interrupting your life – just go back about your business, I’ll clean it up. (lol)

But in truth I think it revolves around this: Lots of different people keep saying that I should write a book.  Typically this comes after I’ve told them one or more of MANY fantastic stories in my repertoire. Often it is accompanied with “you’ve done so many neat things and in a short lifetime” and then some phrase implying guilt or waste if I should not directly adhere to their advise forthwith.

While this reason, and the comments that spur it, make me feel terribly self-concious when I hear them, writing them here makes me feel like a self-promoting “donkey” which is probably worse. (No offense to all you loud donkeys in the audience. You’re great! I just don’t have the vocal chords or the complexion for that.)

However, back to the original question, I’m writing a blog here  in-leau of a ‘book’ because I hate writing (ironic I know) so I guess this is a way to do it without actually doing it. Plus this seems more potentially interactive and I’m really into that!

>You’re practically a kid M, what could you possibly have to talk about or even actually say?!

Well I agree with most of that. I still require the figurative pulling by the ear, kicking and screaming into parts of ‘growing-up’, though on a very rare occasion.

You know what I mean right? You’re there facing something you really don’t want to do and you parent calls, after some discussion it’s “This is part of growing up Mr or Miss   insert FULL_Legal_Name here .”.  In other words, a nice version of when your parent had to grab your hysterical kid-self by some painful or embarrassing means and drag you back into the doctor’s office to get your “shots”.  (No wonder they save the ten-at-a-time for 7th grade.)

Despite this, I have done quite a bit and seen even more through circumstances and opportunity.

I’ve travelled a lot:


49 of 50 states & lots of foreign countries. Medical Missions combines many of my passions so I enjoy and participate in that when I can.



I have been in Construction, Education, Medicine & the Navy.  So I’ve observed, intervened, listened, created, done, assisted, witnessed, delivered, pronounced,written, informed, ‘coded’ and many many other verbs. And am still ambitious to take on even more verbs such as: fly, evacuate, marathon (kind of a non-verb verb), climb (more stuff), prescribe (on my own some day), etc.

I have marked this blog as PG because while I don’t intend on bringing up things that are terribly graphic – much of my daily life is, so it may spill over.  Plus children under 12 probably don’t want to be reading this anyway.

Summary: Good things to look forward to.