Life back in the US

I've been home for nine days and am mostly adjusted to life back in the US. Last week was mostly working, and taking a nap after work to allow me to stay awake until 8 or 9 pm. Transition back to life here is a multi-faceted thing. There is the time zone transition which takes many days. I read somewhere once that it takes our bodies one day for every hour of time change. So the seven hours difference between East Coast and Ethiopia takes at least a week. Going from east to west is easier, at least for a morning person like me. I wake up early and am energetic in the morning; it is the late afternoons and evenings that are tough. Naps are wonderful things! I am still waking up early, but I can usually manage to stay in bed until my normal wake up time.

The transition to "normal" US things happens at a different pace. Some things are like riding a bike: My house, my work, friends all seem normal because they have been part of my life for a long long time. It is usually several days before I start thinking of how different things are here. Maybe the first few days of time zone change overshadows some of the many other jarring transitions.

In Ethiopia, as in many developing countries, one needs to be careful of everything you eat and drink. We only drink bottled water. We try to be very careful about only eating cooked food served in reliable places. E coli is lurking everywhere, and you can't see it or smell it. Almost all of us were sick at least one day, some for several. Even with the precautions, you just can't always tell where you went wrong. Was the food not cooked well enough? Was it mixed with uncooked food? Were the dishes and utensils washed in unclean water? Westerners I know who live in Ethiopia have large water filters and soak all vegetables in a dilute bleach solution before eating them. They still get sick sometimes.

Since I have been home, I have had lots of salads, fruits and veggies, and have been out to eat several times. I don't think twice about the water I drink from any source. It is a true luxury to be able to do this. I will most likely forget how much of a luxury this is in a week or two. We take all of these things so much for granted, but most of the world does not enjoy this luxury.

I noticed on our OR schedules in Ethiopia that more than half of the children had a birthday listed as January 1st. The first few that I saw I thought it was unusual. I then began to see more of them and assume that since so many babies are born at home and birth records are unusual, that many people don't know their actual birthday. They know about how old there are, so for the hospital paperwork, they just list January 1st as the birthday with what they think is the appropriate year. How strange that seems to me. We make such a big deal of birthdays. Hospitals often use it as an "additional identifier" to make sure that the right patient is being treated.

I have given anesthesia to many patients since I have been home. Most have been children, and most have been elective procedures. Because I work several days a week at a pediatric dental surgicenter, many of my patients are children who need extensive dental work. They can't or won't sit still to have it done in a dental chair, so they receive general anesthesia for dental work. Most have behavioral issues or family situations in which teeth-brushing is a battle that the parents just can't or won't fight or win. I was struck one day with what a tribute this is to modern anesthesia. No longer is there such fear of surgery and anesthesia that people go to great lengths to avoid surgery. It is in stark contrast to developing countries in which everyone knows someone who has gone into an OR for a procedure and didn't come back out. No wonder they are frightened. No wonder parents are so overjoyed after a successful surgery. What a privilege to be working in an environment where for the vast majority of patients, this is just not an issue. I can understand why the parents of the patients I care for here are fine with general anesthesia for dental work: it is safe, and the children are unaware of what is happening. But let me tell you, this is not routine in Ethiopia.

We are starting to try to plan our next trip for the fall. The needs are great, the obstacles ever present. I only have to remind myself of the amazing wealth we have here to be motivated to return. It is hard to know for sure how much difference we are making, but smiles on the patients and parents face really put things into perspective.