Como ATRAVESistes?

My first day in Nicaragua, Audra told me that here in Nicaragua, instead of "good morning," you say ¿Como amanesistes? I forgot the next morning, and instead said ¿Como ATRAVESistes? ATRAVES is the organization I am volunteering with this summer. Audra, Nathan, and I are doing public health initiatives in Camilo Ortega, a bario or neighborhood on the outskirts of Nicaragua. So now after work, we ask eachother, ¿Como ATRAVESistes?

Nicaragua is an amazing country. I am learning so much every day - about the language, culture, traditions, history, oh, and of course FOOD!

This past week played out somewhat like an orientation to my life for the next nine weeks. I met my amazing host family, got to train and do home visits with a community health worker (every global / public health workers' dream - see photo below!), and  spent a lot of time trying to understand what people are telling me in Spanish...

Volunteers teaching the promotoras how to use a glucometer

During our time here in Nicaragua, we will be doing a lot of projects, but most focus on health education. General health for fifth graders, sex ed for sixth graders (oy veigh!), and nutrition and exercise for the general community. We will also be working with the community health workers (here, we call them "promotoras") and will be volunteering in the open clinic once a week. We have a lot to do, and are so happy to be able to use the skills we learned in our public health courses to make some positive behavior changes!

So back to the food. Sadly, there is little interest in spicy food here. However, the gallos pintos (rice & beans) are to die for, and everything else is fried in tons of oil. So to combat the new diet, I found a gym! My host brother Jean Pierre is a pilates instructor, so we go with him to Aerobicos a few times a week. Also, sweating all day in the heat of Camilo Ortega is a workout in itself - we get so little work done compared to in the States just because we are so hot and tired all the time!

My host sister, Maria Fernanda del Rosario, or "Ma-Fer," is an amazing and spunky 16 year old with a heart of gold. She and Jean Pierre speak English, but their mom, Doña Rosario, banned English because I told her I was trying to learn Spanish... Oops. In the mornings they start chatting to me and it takes me about a half an hour to understand anything. Trying to learn Spanish is a challenge - I literally feel like I am thinking and focusing so hard all day. I can understand most conversations but miss out on things like tenses. So I will know that at any point in time, someone was, will be, has, may, or kind of did an activity. I understand a lot, but I need to learn more, and need to be able to conjugate verbs when I speak... Also, I sound like "I NEED GO KITCHEN NOW" when I speak - we like to translate what I said in hindsight. Also, a few embarrassing speaking errors: sopa means soup, not soap (jamon), and boda means wedding, not body (cuerpo). Awkward...

This post is getting rambly, I think I'll blame the heat for that. But to wrap up, here are some highlights:

Noni fruit

-went dancing with Audra's host mom at Chaman a club shaped like a pyramid that looks like it came out of Las Vegas
-saw (and smelled) a noni fruit - it supposedly can cure cancer and diabetes, but it smells and apparently tastes like barf...
-tried making a clay pot on a wheel spun by foot in San Juan de Oriente, an artisan town
-a visit to San Juan del Sur, a touristy surfing town where my MD/MPH buddies are staying for the summer, where they have iced home roasted coffee and beautiful private beaches.
-tried surfing in San Juan thanks to some super nice tourists who lent us their boards and gave us some quick lessons. I didn't stand, but I was knee surfing!
-took the chicken bus - a jam packed school bus that travels between different towns in Nicaragua. If you get on too late, you have to stand packed between vendors who hop on and off and different people and their belongings

My Donor

I started this post a month ago, but was too afraid to post it and got lost in the throws of finishing first year. However, before I discuss anything else, I wanted to be sure to discuss the most meaningful experience I have had in medical school so far. 

Throughout my Anatomy course, my donor, James would suddenly seem alive to me. A scar, the stubble on his chin, his thick head of hair - I would see something and it would snap me out of the current dissection and spin me into thoughts about what his life was like.  The first week that I met James, one of my lab partners pointed out a ghost-like divet of a wedding ring around his ring finger, and we all stood in silence reflecting on what that meant. James had a family. People were missing him as we spent hours getting to know him in such an intimate way. As the course went on, I learned everything there was to know about James's body - the curves of his brain, the tiny bones that allowed him to hear, the arteries of his heart, and even the pancreatic cancer that ultimately took his life. However, I was unable to discover how he lived, who he was, what he meant to the family he left behind.

At the end of our gross anatomy course, Tufts held a memorial service for the students and family of the donors to meet and reflect on the people that started us off towards our careers. On the day of the memorial I was extremely nervous. I mean, what do you say to the family? How can you truly explain how much the experience meant to you? I tried to come up with what to say before the memorial, but nothing felt right and I just hoped that if James's family showed up, I would be able to understand more about James's life and maybe bring his family some form of comfort in return.

The memorial was beautiful, thanks to the many talented students at Tufts. They wrote poems and reflections, sang songs, played instruments, and I felt that everyone in the audience was able to understand the gift that the donors gave us. At the end of the service, our professor asked if any family members would like to speak. One lone hand shot up, and a young woman was directed to the stage. She mentioned her husband James, or Jim, and pancreatic cancer and I knew she was talking about my donor. My stomach heaved and my eyes filled with tears. I was amazed at her bravery as she told us about Jim's decision to become a donor, his experiences as a medical student in gross anatomy, and how much it meant to her to meet us. As soon as the ceremony ended I sprinted down to meet her. And the first thing I saw was the ring on a necklace around her neck. The ring that left the divet.

James gave us many gifts as our donor -  knowledge, appreciation for the human body, an ability to understand the many terms we hear in our courses. However, Jim's wife filled in the empty spaces that the gross anatomy course left behind. I was able to comprehend the importance of compassion, empathy, and human experience. I was able to understand concepts that you can't find in Netters Atlas of Anatomy. His wife gave us a copy of the pamphlet from his memorial. We saw pictures of Jim and learned about what he was like in life. We learned about his family, his children, his passions, his interests. I will never forget the experience, and will never forget Jim or his family. I am so thankful for the experience that Jim and his wife gave me. As a team, they introduced me to the most important foundations of medicine. As I continue through my journey I can look back and remember the gifts that they gave me so that in return I can help my patients with both knowledge and compassion.