And so it ends

It's off to the US of A tomorrow. I'll be returning to a place that is very different from the one I left. Saturday will be what would have been my med school graduation (four years, already?), and I'll be sitting in the bleachers. I am going to pick up my things from my old home, and will have to find a new one. Still, I look forward to seeing friends and family and to paying tribute the best of the northwest (microbrews, cheese, and camping). As I get ready to go back to a life that will be both familiar and strange, I worry that Africa's going to slip out of my system faster than I want it to. It's easy to forget how people live here, being constantly on your toes, seeing things in more vibrant shades, your good friends, the adventures and stories you shared. I hope I really have learned something, and that what I have seen and done leaves its mark on me.

So, to say goodbye, this is my homage to Africa...

Sunset on the lower Zambezi river

Zambian kids makin' some tunes

Namibian sand dunes

Elephant crossing

Little girl

Trees in bloom in Lusaka

The Kafue river

And of course... my favorite people in Zambia

Coming full circle: Five things I learned

My time in Africa is coming to an end. I will carry away so much from this year. It’s been a long journey, and I am indebted to this program, to Zambia, and the people I’ve met along the way for the lessons I was able to learn.

The greatest thing I have learned is that life is very, very short. That we don’t have much time, and whatever we think lies ahead could change quickly. Do what you love, keep your eyes wide open, and let yourself experience fully whatever comes your way.

Secondly, I have learned to have greater patience. There is a time to let things sit, and there is a time to act.

Third, I have learned to be thankful. To not waste opportunities, nor to minimize the things I have and the people who are in my life.

Fourth, I have learned more about respecting others. That doing things differently doesn’t mean doing them wrong, and to observe first and judge second. 

Lastly, I have learned to love Africa in a way I never expected. To appreciate a place that dances with its feet while packing a punch in its hand. It’s not an easy or simple place, and things are rarely as they seem, but it has a spice that can be addicting.

Value of a dollar

     When does a dollar not equal a dollar? When you live in a place where the majority of the population lives on a dollar a day. Think about that - we spend, what, $600 a month on rent, $150 on food, $50 on gas, maybe a $30 haircut every now and then? That's about $30 a day, just living like a normal 20-something American. Now think about a place where 97% of the rural population doesn't have electricity, 85% have dirt floors and palm thatch roofs, and almost half use a bike as their main transport? You ever think your apartment seems barren? Half of the rural population have a bed, and less than half have a chair. I looked around my house recently, thinking of all the things I would be leaving behind when I left Africa. My dirty, ripped-up, five-year-old tennis shoes, with two holes in the toes and duct tape holding together the heels? Those would be gold to somebody. My stained tee-shirt? Years of wear left. That extra bottle of vitamins? Okay, I bet those have no value as they're probably too weird to a Zambian to even be of use.
     You get the point. I'll be heading back to a place where I can get peaches year-round, coffee imported from Jamaica, designer shoes, and the newest electronics at the touch of a button. I will never go hungry, my feet will never get calloused from years without shoes, and I won't ever have to choose between educating my children or paying rent. I'll be the first to admit I'm absolutely salivating at the thought of the sushi and good beer that awaits me, and I may or may not have already ordered a pair of jeans on JCrew, but I doubt I'll ever look at dollar bill again without seeing the inequalities that are hidden behind Georgie's little smile. Yes, it's a mad, mad world we live in.

By the way, all the stats are from the Zambian Demographic Health Survey, 2007, available online. The numbers paint a fascinating portrait. For instance, 34% of teens 15-17 years old are orphaned or vulnerable, 21% of women who work report their husbands make the all the decisions about their earnings, and 47% of women have have ever experienced physical violence as adults. Interesting.

Reading Anna Karenina in Lusaka

Tolstoy probably wasn’t expecting his work to be read in an African town of dusty roads and tooting minibuses, but here I am, halfway through the tome. The main story line of Anna K. revolves around her extramarital affair with another man. It’s hard to draw many parallels between late 19^th century Russians and modern-day Zambians, but both seem to be places that are outwardly obsessed with protocol and propriety, where wearing an improper skirt can create a stir or where telling someone you don’t attend church is like telling them you eat babies for breakfast. However, despite these formal exterior, marrying and keeping a dish or two on the side (for both sexes) is par for the course, though the attitudes around it are very different. One of my Zambian colleagues just laughed when we were talking about it, “ah, yes, it’s normal! Maybe 80% of us do that!” And here we are, in a country where there was a letter in the newspaper the Post about how cohabitation before marriage is going to be the downfall of modern society. Anna is driven slowly crazy by her guilt, but her sense of shame would have been totally out of place in this region in Africa.  What is so strange about all of this is the HIV rate, that turns what could simply a different definition of fidelity into a very real threat to an unsuspecting partner. If commercial sex workers have an HIV rate of over 60% here in Lusaka, and the general populace has a rate of around 20%, then sleeping around becomes… well, like Russian roulette.  The fictional Russians at least didn’t have to deal with that. I guess the meaning of "forever" takes on a little bit of a different meaning when the life expectancy is only a few decades or when you're hardly more than a child yourself when you say those words. It's just an interesting phenomenon to me, the contradiction that so many people seem content with here. Maybe it has to be that way - we don't have any functioning train tracks here to throw ourselves upon if it all gets too much. 

Dissolving into one

The proximity of death pushes on our view of life, warping it like a prism suddenly held over our eyes. Today, I watched a patient falter on the boundary between worlds, every breath a struggle. He was suffering from advanced pulmonary disease – probably tuberculosis, and was in acute renal failure. His breathing sounded like a man gasping through shallow water, his eyes open and unseeing as his body raged to keep alive. He survived the morning, but I don’t know if his illness will claim him soon. All through the day, his face came back to me. Sometimes, especially when I am exceptionally tired, after a call night or an extra long day, I feel the boundaries between myself and the world dissolve. As if a hard push on my skin would simply pass through, to touch what lies underneath. At these times, I feel more connected, but more disconnected at the same time. I feel depersonalized, like my individual experience is meaningless. Instead of death casting my life into sharp relief, or making me more aware of the strength and youth in my bones, I feel that we are all part of a wave of humanity. Images of my patients – the body of a small child a few months ago, the face of my patient, a baby newly born, rise up and seem to be part of a tapestry. The threads, our selves, lose their meaning on their own, but together form a flowing, endless creation. Death seems to clarify that for each of us, it is the same: as I am, so shall you be, and as you are, so was I, for we are one.  

Translation

I spent a few minutes today putting together a facebook album for my nephews, who live in Alaska. They are growing up on the other side of the world, and I had received a (very cute) plea for some "fotos of Afruka" from them. As I started compiling, I started stumbling over what I thought would be a 5-minute project. Things like HIV/AIDS are well known to almost everyone in America, but how do you write about this for children? There are no simple terms to explain a poster like the ones shown here, which I saw up in a local community center:

How do you translate what AIDS orphan means? Explain vertical transmission of a disease that affects children because of their parents' infections? Or write a simple caption for an epidemic that creates caregivers out of 6-year olds? Children in Sub-Saharan Africa are not strangers to the concept of early responsibility; it's nothing at all to see little girls, some barely large enough to carry the weight, with their younger sibling strapped on their backs. Four, five, and six-year olds are well into the age of being able to ride the bus by themselves, be left alone, or take on household chores like caring for the livestock or cooking. AIDS is another part of life here, and seeing a child care for a sick adult is par for the course.

How does this shape the consciousness of a continent? What ideas do resource-rich American  youth grow up with? Barbie and Ken-doll families? Sesame Street? Hello Kitty? Plasticized, cuddly, and sheltered versions of the world... Here in Africa, the realities of life are not going to wait for adolescence, so why wait to introduce them? What is most telling, is that kids here in Africa can be just as young at heart as children in the USA. They are resistant and amazing small beings, and while they may grow up fast here, they carry still the threads of their youth in their smiles.

I hope I didn't scare the bejezus out of my nephews. Hundreds of thousands of children grow up too quickly, and we have decide what we translate from the adult world, to their world.

Giving it up

Things are changing here. Old friends are going, new faces arriving, habits dissolving, work evolving, weather shifting from rain to dry. Like a loose tooth finally letting go, I feel that whatever state of permanence that I was pretending existed here is eroding.  It seems that this state of flux, learning to accept change, is much more natural than the static life we can create in the States. Here in Africa, I find that trying to hold on to something is impossible. We are all in a state of motion in life – but the motion is more controllable in the US. You can speed it up to mach-5 in a city like New York, or you can carve out a suburban crawl at a pace so slow that it seems frozen in time. In Africa, it seems that not only do the changes happen more rapidly, but they are far, far less within your realm of influence. When I ride my bike, what seems like a perfectly calm (muddy, bumpy, but calm) stretch of path can suddenly turn into a yawning ditch poised to trap unwary cyclists. At work, a project meticulously planned out may be thwarted by a provider’s lack of part X or Y, or a staff member’s unexpected departure for an emergency. Even things we take for granted in the US, like our family, shift quickly here as people go from a state of health to the grave in days. In life here, you accept change as a natural state of being. Parents die, working parts break suddenly, political will reverses a law overnight. It makes sense why every Zambian or long-term ex-pat shrugs and says, Ah, oh well. In Zambia, a typical reaction to new events is just to sit back, watch the dust settle, and try to pick up the pieces after. No use interfering, when the river is going to take you where it may. I was under the del/illusion that I could maintain that same sense of control here, but with the ending of the rain season, I find that this fantasy too is washing away.

(Not) Practicing in Africa

I never expected that I would miss medicine the way I do here. I am not yet a doctor, but I feel that with every day of medical training, I become closer to something I was born to be. The reasons I first gave to the admissions committee about why I wanted to be a physician have evolved and become so ingrained, that now I couldn’t separate out these reasons from my own life story.  Here in Zambia, I float around medicine like a bee around a particularly scrumptious flower. I help design clinical tools, I perform chart reviews on patients, I occasionally am lucky enough to observe in the clinic. But the hands-on, nitty-gritty of patient care is neither my right nor my expectation while I am here. A big part of the reason I was so attracted to global health was the incredible health disparity between the first and third worlds, and I dove into the global health opportunities that were available to me. Yet, the more I experience, the more I begin to realize that what have always been advantages in the past are obstacles to providing care here; my skin color, my strange accent, my gender are disadvantages despite the prestige of my education. It hardly helps to know the intimacies of anatomy of a human heart, or to have six antibiotics for pneumonia on the tip of the tongue, when you are at a clinic where cardiac echoes are unavailable, or the only drug in the pharmacy is penicillin.  After a few months here, I know now that while some could adapt, I will never be able to learn the blend of fatalism and practicality that is so necessary. A few weeks ago, I was helping a clinical officer in one of our most rural clinics. A patient came in for fatigue, heart palpitations, episodic chest pain, and headache. She had been having these symptoms for months. Diagnoses flitted through my head incessantly; valve prolapse, cardiomegaly, variant angina, panic attacks, hyperthyroidism. For each, though, I only knew how to reach an answer through tests or medications. The clinical officer, pressured by the long queue of patients, finally provided her with analgesics, recommended light activity for a few days, and asked her to come back if the episodes continued. I was frustrated that we didn’t have the luxury of time for an adequate patient history, that we had no tools at our disposal (without significant effort to refer the patient or costs for lab tests that were prohibitive) other than our stethoscopes and our hands, and that my clinical knowledge was insufficient to help her. I was disconcerted that I offered so little, but at the end of the visit, she looked both of us in the eyes and warmly thanked us for hearing her story and said she felt much better already. In a few months, I will return to the States, to a cornucopia of designer drugs and 3D images, and I will once again be able to immerse myself in medicine full time. However, I hope that I remember that medicine comes in many forms, including the ability to listen. 

Fresh paint, old story

Ellie and the kids

This past weekend, I volunteered with some friends to help paint a youth center in a small town outside Lusaka. My friends Gaz and Ellie started the center a few years ago, and continue to maintain it through the generosity of donations (visit the Gazelle Trust website). This weekend, Gaz brought down some of his 6th grade class from the American International School to help paint. The day passed in a blur of paint splattered faces and turpentine fumes (we did make a good faith effort not to kill too many brain cells!), but several things made a lasting impression. I was struck most of all by the contrast between the group of kids who arrived with us, and the local children who filled the youth center.  

Though most of the AIS kids were African by birth, they were of a far, far more privileged socioeconomic group. They had grown up in a world of nannies and drivers, where high walls and electric fences separated them from the majority of the population. They had ipods and cell phones, packed lunches in personal coolers, and clean white converse sneakers. In sharp contrast, their counterparts at the center came with bare feet and balls made of plastic bags bundled together, dirty shorts and shirts missing buttons. As we ate our lunch in the shelter of the school bus, curious faces pressed against the glass. We organized games of basketball and futbol to distract both groups of kids while we finished painting inside. The locals played with a ferocity that surprised the AIS kids – elbows thrown, balls kicked with a vengeance. It had nothing to do with the team composition, for I had been watching an equally fierce game between the locals only minutes before. 

 What happens to your concept of the world when you are raised in such an environment ? As they told us in medical school on our first day – this is the most empathetic you will ever be to your patients. The same seems true of the new arrival in Africa. We slowly learn to curb our emotions, to swaddle our feelings in thick blankets of jaded experience.  So, what kind of person do you become if you are brought up with these images? I think you must begin to accept life as status quo – to believe the dynamic between you and the face on the other side of the glass as how things should be. How can there be an urge to fix what you do not see as broken? As I watched the kids from one country, but two very different worlds meet, I hoped that I would be proved wrong.

Learning to Stay (or, why I have had 18 addresses in 9 years)

Pema Chodron is an American woman and an ordained Buddhist leader known for her teachings. Last night, I was listening to a part of a speech she gave about what she calls the ability to stay. Her words seemed profound before, but listening to her dry chuckle as she spoke, I immediately felt personally connected to the lesson.  She spoke of the fear and insecurity we all carry, and described the efforts that people go to in order to avoid these feelings. As I thought about this, I considered how much of a driving influence this can be. For some of us, that insecurity takes the form of feeling left out from social activities. For others maybe it wells up as a feeling of lack of accomplishment or unworthiness. She talked about the primordial restlessness we experience, how we feel this compulsion to move forward, and the distractions we use (she calls it “scratching the itch”) to avoid the feelings of discomfort in our lives- numbness, pleasure-seeking, and anger or hostility.

I am certainly guilty of seeking to quell this insecurity. I have experienced plenty of moments of feeling socially unaccepted, doubt about my abilities, and that I just haven’t done enough with my life. I pause and reflect on this, and I am surprised to find that my efforts to avoid this insecurity, whether by heading out to a Friday night party or pushing myself to do just a little more work on a project, doesn’t really make me feel fulfilled. This is what Pema speaks about – how all our efforts to not go to that place lead instead to suffering. It is only through learning to pass through this that we can be fearless. When I think about the big picture of my life, really, of all of our lives here in Lusaka, I wonder how many of us are just running from that place? Do we seek adventure and grand ambitions because we are actually succumbing to the itch? Would we in fact be happier if we just learned to stay? 

Thinking of what moments have led to fulfillment in my life, I start to suspect all this is true. Yes, I am genuinely happy when I’m headed off on a new adventure, but it can be addicting. The joy of departure is always followed by the withdrawal felt for days after return. There are moments of true calm, but I often find them in not very exciting places. Sitting with my nephews, reading a book. Walking in the woods. Holding someone’s hand. A good workout. Drinking coffee with my parents at the breakfast table. They don’t give me a high like rock climbing, or delivering a baby, or avoiding elephants in the bush, but I am left feeling relaxed and sustained. Like all things, I suspect there is a balance to be had, so I can learn to chase lions and somehow be able to stay.

A changing view of global health

By the time of graduation, 27% of medical students will have had international medical experience. That number probably doubles when you consider those who have informal medical experiences during or around medical school. Global health is a hot topic – for my school the number of students who participate in the global health pathway and certification program has been rising astronomically every year, and now represents about 25% of the class. For me personally, global health was one of the primary reasons I went to UW, as they have a fantastic global health department and are a member of a number of international programs. My first experience as a medical student in Madagascar left me reeling - the contrast between the environment of the University hospital and the small hospital in Antsirabe was beyond comprehension. We had one little boy who was in house for the entire 3 months I worked – he had been burned in a bush taxi accident from thigh to ankle, and also had a broken femur. Every day, we would hold him down and remove and replace the bandages stuck to his leg, helping the wound to stay clean of infection, but causing immense pain. The first time I participated in his care, I couldn’t understand why we weren’t providing pain medication. The reply? We have it, but if we give it to him every day we have to do this, we will run out. I walked away from my summer shaken to my core about what the right to health really means. A few years later, as I find myself again spending time in clinics in Africa, my understanding of these issues has again changed. Stories I used to tell about Madagascar, of the sharps containers made of soda bottles, or washing with only hand soap prior to surgery, now seem incredibly benign. Having now spent time in clinics where a sharps container of any kind seems like an alien concept, or where there is no hand soap to wash at all, you begin to wonder what you can even offer. When you have nothing to work with, what is the use of your fancy education or your ideals about improving a care system? You have to have the drugs in order to improve prescribing practices. You have to have the patients come to the clinic, rather than stay at home until they are too ill to walk and die of treatable, preventable diseases. You have to have providers who are motivated to improve the system and who want to learn, rather than disappearing the moment a potential extra pair of hands appears on the scene. I realize, through all of this, that these experiences will make me a better doctor. I am probably (no, certainly) benefiting more from my time in the clinic than the patients are. They say that medical students who return from global health experiences are more likely to work with underserved populations, have less reliance on expensive imaging, and have better physical exam skills. My original goal in medicine was to allow others to reach their potential, without the burden of disease. I know I will return to the First World more dedicated than ever to the concept of health, having seen vividly what this “burden of disease” can really mean. Still I can’t help but think about what effect I am having on these areas. As a student in Madagascar, I felt more like I was in the way and a drain on the valuable human resources than like I was contributing. Here, though the majority of the time I am not in the clinic, when I am, the best I hope for is to not to be a negative influence on the situation. My knowledge of vascular physiology is far less valuable than the ability to palpate a spleen. Because of this, I suspect I will leave Africa with my enthusiasm for global health intact, but my beliefs about how and where to apply that interest will be drastically changed.

Hallways that are usually teeming with patients in the morning clear out by mid-afternoon as patients are either seen, or told to come back tomorrow to wait again to see the provider.

An admission ward at a rural clinic

The clinic pharmacy

Cholera tents with a latrine trench, in preparation for the epidemics that start annually in the compounds of Lusaka

Luangwa, Visit Number Two

“That Baobab outside your hotel, that’s where they rounded up the slaves before going to the Indian Ocean. The weak ones they threw in the river.” These sentences are casually tossed out before dropping me off at the hotel in Luangwa. We are in the most remote of our three districts for work, and the distance from Lusaka spans more than geography. Here, the clinic is run by the maid (actually, technically she’s on leave until April, so it’s really run by a volunteer with even less clinical skill), there are annual floods that cut the small population off from the rest of the world, and the sand toilets for the village have collapsed so everyone has reverted to the river for all their needs (including water, bathing, laundry, and relieving themselves). If Lusaka feels like the African offspring of the American Midwest, Luangwa feels like… well, Africa-Africa. Thankfully, there is electricity during our visit (the last time I was here, not so much), but I am told that this is to curry favor for the upcoming election. The tap water in the sink is muddy brown (but again, this is an improvement over the last time).

Yep, tap water was really, really brown.

There are usually some farm animals involved in our car rides – squawking emanating from a cardboard box quickly was revealed to be co-worker’s new chickens as we drove along. I’m just thankful that no one has strapped part or all of a goat to our Land Rover, but we still have a day to go before we head home.  What amazes me, more than the fowl stow-a-ways or stories of the past, are the people. One patient I saw this morning had been to the clinic five times in the past five months. Each for the same complaint – chest and back pain. What was different about the five months, I asked her.  Ah, she replied, with a fond gaze at her young son. My son is going to a new school. We parents have to build it, though, to contribute, so I have been making and stacking the bricks for the past five months.

What else would you bring on a work trip?!

As cliché as it may seem, there is nothing that reaffirms my love for Africa more than these moments – the grateful dzekomo from a patient, play-racing with children during my afternoon run, the extra few minutes that a kindly stranger takes to walk me to the right place, the laughter and a few extra mangos from the woman at the market. The sweetness and grace of these times balances out the frustrations that threaten to drown us in our work and our lives here. As usual, trading the posh civilization of Lusaka for a few days in the rural village of Luangwa reminds me what is really of value.

Whiskey and Shake-shake

I spent last evening at a Caledonian society ball. It was an evening of tartans, dances with names like Strip the Willow, and a whiskey bar. And no, I didn’t just move to Scotland. Evidently there is enough of a Scottish community here to throw these types of balls several times a year. Bagpipes, piper, and two kinds of haggis flown direct from the motherland (fatherland? What gender is Scotland, anyways?). Besides tripping over my feet trying to do the Military Two Step, I spent a good portion of the night wondering about culture.
The contrast between Zambia and Scotland is pretty stark. I heard some “amusing anecdotes” of trying to teach a Zambian chef to make cock-a-leekie soup, or what a bungle the staff made of the chocolate mousse. The toasts to the Lassies involved the same worn laughs - man’s inability to understand women, communicate worth a damn, and apparently function without the support of a good female. The riffs and compliments were familiar to me – apparently American humor about the sexes really hasn’t been influenced by two hundred years away from the British isles.

A few days before, I had spent another evening at a play put on by a Zambian acting group. Essentially, the play made a farce of the infidelity that is rife throughout Zambia, by illustrating the battle between married women and the single girls who poach their husbands. There were such winning jokes as, “the wife is better than the girlfriend, because you can beat her and she won’t leave you,” or the father of a character advising his distraught daughter to go back to her husband because “even I had girlfriends! Go back or I’ll kill you!” There were jokes about Indians, rural traditions, alcoholism, murder, and materialistic women. The Zambians were in stitches. I alternated between being appalled and laughing from sheer disbelief. Women are apparently equally guilty as a bad wife for the inability to keep their husbands “on a leash,” and for being the “sluts” that tempt away the men. 

Yep, Toto, we’re not in Kansas anymore. You can bring your culture, your oatcakes, and your kilts to Lusaka, but it just reinforces how many miles away your countries really are.

Zanzibari Christmas

Zanzibar. The very name sounds exotic. The streets are narrow, jetting off at odd angles, strung with tattered flags. Men wear the robes and caps of the Muslim faith. Women wear full burkas, with only their kohl rimmed eyes showing. We are in Stone Town for 3 days, over Christmas Eve. The mosques are far more abundant than churches, and the call to prayer reverberates throughout sunlit alleys far more often than occasional carols heard from open shop windows. Everywhere is the smell of cloves, sweet and spicy and blending with the stink of meat left in the sun and the underlying odor of fish. The market itself is a riot of items, far more variety than we see in Zambia. There is dorean, a spiny fruit which smells of sulfur, has flesh the texture of (as one woman put it, unfortunately) “fat on meat,” and tastes like nothing so much as garlic bananas. Jackfruits piled high, as large as watermelon, drip sticky white sap. There are bags of vanilla beans, cumin, and chili powder next to tables with dried octopus (octopi?), stacked like pancakes. 

 The food is delicious; curries thick with coconut milk and fresh spices, prawns, grilled octopus, fish of all kinds, ice tea flavored with limes and honey, coffee brewed Arabic-style with real milk, coconut rice, spicy ginger gelato, Tusker and Sarangeti beer. Bellies full and bags heavy with scarves and spice packets, we head to Jambiani, on the east of the island. Our van blows a tire halfway there, and we wait by the side of the road for an hour or two while cars stop and men pile out to help our beleaguered driver. Finally, we arrive in the village, which consists of a number of houses (all, it seems, have crumbled on at least one side; apparently repairs become less urgent when the climate is balmy), around 5 restaurants, and a collection of beach bungalows for the mzungus. 

We have rented out the entire bottom floor of a large guesthouse, run by a cheerful, small Zanzibari man named Dude (doo-day) who sports Hawaiian print board shorts and Von Dutch tees, and pads around like a helpful house gnome delivering fresh bread and instant coffee. He takes us sailing after a few days in his mango tree boat (apparently, the wood lasts longer). It’s a catamaran with a sail sown of hand stitched tarps and rice sacks, and is constructed by deceptively simple engineering – lines and twine and random sticks all serve in place of the usual pulleys and cables.  He takes us toward the reef, and we weigh anchor long enough to snorkel. There are giant starfish and sea urchins the size of softballs, and hundreds of multicolored fish. In the evenings, we eat religiously at Coco Beach, a restaurant with amazing food and a sharp-tongued manager who at least once a meal manages to offend us. 

I spend most of our three days at the beach lying on the bench outside the house, with a fever and cough. It’s the most beautiful place to be sick, ever. By New Year’s, I’m back up, though I go to bed at a shameful 9 PM after eating dinner by candlelight on the beach. The next day, we catch a ferry to Dar es Salaam. The line to the ferry reminds me of a cattle drive, with everyone pushing to board the boat and secure a seat. Kate (who is about 5’ tall) says her feet didn’t touch the ground as she was borne along. The ferry makes us all slightly nauseous with the rolling, but they show Jackie Chan movies, which helps somewhat. When we arrive in Dar, we are amazed at the amenities. Chamomile tea! Gummy bears! Tabasco sauce! We stock our suitcases. Annie, Kate and I share a hostel room with Hank, an older man who works in the mining industry and comes to Dar monthly on business. He makes sweet, but awkward attempts at jokes, though clearly has lost the knack of talking to twenty-something females. He keeps a bow in a pair of cowboy boots in the corner, a plate of fresh chilies on the nightstand, and has four cell phones. After a blissfully air conditioned night, we head back to Lusaka. It’s been a good trip.

 

Getting in touch with your inner Neanderthal

Alright, digression to my undergrad years as a psych major... There’s a pretty well-known phenomenon in psychology about our ability to consciously express preferences. That is, people are capable of coming up with an explanation about why they like something, but that very act alters their preference. For instance, if you ask someone to pick their favorite book, they really love Harry Potter. But if you ask them to pick their favorite book and tell you WHY, they will probably realize that Harry doesn’t make them sound sophisticated or cool (unless, like me, you think Harry Potter transcends such paltry things as coolness), so they say that their favorite book is actually Zen and the Art of Motorcycle Maintenance. Then they can give a nice, clean explanation about why they love it. But they’re deluding themselves AND you, because admit it, they really, really love Hogwarts, and they’d be way happier reading Harry Potter over and over if stuck on a desert island. So, pretty much, if you want to get in touch with who you really are, you can’t think through your opinions too much, because then the rationalizing of just why you get all googly-eyed at Daniel Radcliffe ruins it. 

Interesting.

Now, for me, I’ll admit I’m a naval-gazer. Hence, the blog. Unfortunately, the above phenomenon guarantees somewhat that all my carefully thought-out opinions about what I think about the world, including thoughts on medicine, social justice, hobbies, relationships, and the like, are probably an attempt to make me into a person that sounds good to myself.  And that means that I could (and not even be consciously aware that I was) actually be someone who would prefer to watch Jersey Shore reruns and eat marshmallow peeps all day. Scary, no? So maybe I should go with my gut more, and stop thinking about all this life stuff, and I’d be way, way happier. Hmmmm.  Well, if you need me, I’ll be in my room listening to the Postal Service and reading the Chamber of Secrets.