Sunday, November 29, 2009


Man, I love research. Not the kind in a lab (that stuff I can't stand actually), but the anthropology/sociology kind. For our final in our IHM (International Health and Medicine) class we're having to put together a group presentation about one of the many topics that we've covered in the past 4 months. My group is doing Poverty, Equity and Human Rights and how that relates to health. Broad topic and somewhat intuitive, but even with that, I'm absolutely loving doing the research for it. The really frustrating thing is that we had less than a week to throw all of it together, which is why I've been up all night doing my part of it. I'm on literature review, which really is my cup of tea. The thing is, I spent a whole semester last year doing literature reviews for my own research about medical treatment seeking behavior in sub-Saharan Africa, and now it's so hard for me to cut it down to less than a week's worth of work. After all, as a group we only have 10 minutes to present, so that's just a little over 2 minutes a person, and with no paper required, it's something that could be done in just a couple of days with no problem. But it's so hard to limit myself to so little.
We're looking at the Kibera slums in Nairobi, Kenya and the Jamii Bora project there that provides micro-loans to many of the impoverished people there. There's a little bit of literature out there about Jamii Bora, but the issue of micro-loans as a whole in relation to health, and particularly HIV/AIDS in Kenya has been covered quite a bit. It's like this huge internal battle to make myself stop looking for and reading new articles and sit down and just write out what I've found so far. Looking for articles is like a huge treasure hunt for me. Remind me again why I'm going into medicine where I have to study biochemistry and cell biology and all of that, which I have a hard time enjoying. Ugh, I keep having to tell myself that this will all pay off someday. At least I get my research fix every now and then :)

Tuesday, November 24, 2009

Terrible, Horrible, No Good, Very Bad Day (excuse me while I rant)

Man, it was one of "those" days today. Woke up this morning, got ready to take a shower, only to realize that our water had been shut off for the 3rd time in the past 4 days. I sighed and decided that I would just wear a knit headband thing to school to cover my dirty hair and take a shower later in the afternoon when the water would hopefully be turned back on again. (A water line broke a few weeks back, and they've been repairing it for quite a while now to no real avail). Frustrating, but not entirely surprising. Then, I go to turn on my light to find that knit headband only to realize that my light wasn't working. Ok, I thought, no big deal, the light bulb might have burnt out, so I go to turn on the lights in the living room and kitchen, only to learn that they aren't working either. Yep, no electricity. Even at that point I wasn't that frustrated--more amused. It seems like Keiko and I have kinda taken on the attitude of "well, what else can go wrong?" after all of the other drama that we've had with our apartment, so this was just another thing to add to that bag of special experiences that we probably wouldn't have gotten if we were going to school in the States.
Well, luckily I was able to get ahold of the girls across the street to use their shower right before I had to leave for class (for whatever reason, they had both water and electricity), so I was nice and clean for class. The day's looking up right? Well, on my way to school, running just a little bit late because of the shower, another bicyclist runs into me. No real damage done other than twisting my seat around off to the side, making for a very awkward ride for the rest of the way to school. Anyway, I made it to school just about on time, and headed up to the 6th floor where we usually have our classes only to find out that classes weren't being held there today. Of course, our schedule wasn't posted on the bulletin board like it's supposed to be (and was supposed to be posted there on THURSDAY) and which we hadn't received a paper copy of in our mailboxes (like we were supposed to receive on Thursday as well), so I had no way of finding out where I needed to head off to in order to get to Microbiology. Also, not really surprising, the computers in our break room weren't working, so I couldn't check my email, and the wireless internet on the 6th floor (which I don't even think is set up by our school...rather we're tapping into someone else's) was once again too weak to stay connected long enough to check my email for the schedule and classroom locations.
So, I head back down and over to the "real" medical school campus as opposed to our few classes on the 6th floor of the hospital. To get onto the campus without having to go all the way around to the main entrances, there's a rotating gate thing that unlocks when you swipe your student card through it. This thing is notorious for not working, and of course, it wasn't going to work for me today. I stand there like an idiot swiping my card again and again and again, until it finally lets me in. Now, there's a lot of classrooms on the medical campus, so I try calling Susan (one of the girls who lives across the street from me) again to see if she can look up what classroom we're supposed to be in. At first no answer. I know that Keiko is sleeping still, so that wouldn't work...Christal is out an about somewhere, most likely not near internet, and other people who would know are probably in I try Susan again. This time she picks up (she'd gone back to sleep after I had left after my shower) and she finds out that it's in the Pathology building--back on the hospital grounds. So, I turn around and retrace my steps over toward Pathology.
Microbiology was rather uneventful...that is until I tried to get the updated powerpoint during the break. A guy in my class had copied it from the computer the teacher was using, and gave it to me on his disk-on-key. As I'm getting it off of his zip drive, my antivirus stuff pops up saying that there's a virus. I couldn't eject the zip drive and I couldn't perform any of the recommended actions for the virus, so I ended up just pulling out the disk and telling him that he had a virus on the drive that he should try to get off. He found it without too much trouble (and being a Mac person, without much concern) and said that it hadn't been there before, so it must have come from my computer. I started running all of my antivirus stuff, which ended up taking most of the rest of the day only to find that none of them found anything about a virus once the disk-on-key had been taken out. So now I don't know if I have a virus or not, but am going to just pretend that I don't and see what happens.
Well, class lets out and I head to the main university campus across the street to get lunch because I wasn't able to make anything in the morning because of the lack of water (no way to wash veggies). I ended up getting jipped 10 shekles when I was paying, but didn't realize it until it was too late, so yeah, there went some of my money that could have been used to buy like 15 pitas.
Back to class, now biochemistry. We have 2 teachers for biochem, one is great and the other is ok--if you can get past the thick accent and monotone voice, which was not working for me at all. Class ended up running late, so I wasn't able to go down to the travel agent to try to work out cashing in on my return ticket so I can hopefully fly home for Christmas...meaning I have to get up early and do it tomorrow.
After class let out, I went to get my bike and was luckily able to beat the seat back into place and ride home without any trouble. At home, I find out that the water is back on, but definitely not clean. First it came out all red and rusty, even with a little plastic cut out of a rocking horse coming out of the faucet, and then finally clear. But clear and clean are two very very different things. This water SMELLS! I'm not sure how to describe the smell, other than chemical-ie, or metal-ie--so much that I had open the window out of concern of poisoning myself on noxious gas. Even after letting it run for a good 20 minutes, the smell was still going strong. So yeah, still no clean water.
Thankfully, we do have electricity now. I ran a few errands after trying the water out, and when I got home I tried flipping the breaker (which Keiko had done earlier to no avail) and LIGHT! So, praise the Lord, something ended up working!

Ok, that's my rant. I have another much less complaining post about some of the stuff that I learned about the Bedouin that will be up shortly--hopefully within the next few days.

Let's hope for a better day tomorrow.

Love you all--and miss you so much!

Carolyn (or Anna if you ask any restaurant where they take your name. I don't care where you are, if English is not the main language, "Carolyn" is pretty much impossible to say)


Friday, November 20, 2009

Days and Nights

As most people who know me at all know all too well, I'm a night owl to the max. Every time I start a new school year, I get all excited about a chance to have a clean start and make myself into a morning person, but that's never worked out. So, now I have a new plan: switch my day and night. My flatmate, Keiko, helped me come up with it and I think it has the potential for genius. Here's how it goes.

The facts:
I have class from 8-5 or 6 pretty much every day, so I have to be awake then
I get my best studying done around 1-3 or 4 in the morning...I've tried to change that, but I can't
I usually will only get about 3-4 hours of sleep because of the previous 2 facts
I generally don't have set plans after school

The plan:
Sleep directly after school (5:30 or 6:30 until 12:30 or 1:30 or thereabouts). Then get up,have "breakfast" and go to the Caroline House (the new student center on the medical school campus that's open 24/7 and a GREAT study place aside from being kinda cold) and study until 7:30 or so, have "lunch" and then go to class. What is lunch for everyone else will become my dinner time, and then off to the afternoon classes, after which I will go home to sleep and repeat the cycle. Sounds promising right? After all, I'll be much more awake during my morning classes than I usually am and I can study when my mind actually wants to.

Guess I was born for the night shift...

On another note: I've realized that one of the best studying techniques for me is to have something going on in the background. So last night I watched Jane Eyre and the Stranger (each from the 1940s), 3 documentaries (one on women in Afghanistan, one on homeless health care in LA, and the other on the war in Darfur) and listened to the Doctors Without Borders updates about meningitis in several places in Africa, and caught up on world events by listening to the BBC news podcast, and listened to a few old time radio shows (the Shadow and Jack Benny). The surprising thing is that I actually feel like I took in a lot more information about bacteria, viruses, fungi, and their role in respiratory tract illnesses than I would have just sitting there in silence or with music on. And it gives me a motivation to sit down and study because I want to listen/watch those other things too.

So yeah, that's all that I have for now. Gotta hop in the shower and then get some sleep because we're hosting a dinner at our place tonight witch already has the potential to throw off my new schedule haha.

Love you and miss you all!!!

Wednesday, November 11, 2009

The Requirements/Responsibilites of an International Health Care Worker

Tomorrow is our "IHM" (International health and medicine--or something along those lines) day. That means that we have clinical rotations (this week in the Peds ER) and then lectures about international health issues. This week we are discussing war, catastrophes, displaced persons, refugees, terrorism, and disaster management. This is the stuff I've been waiting for, the kind of work that I really want to be involved in.

Reading one of the first paragraphs in our text though is rather daunting. Here's what it says...

"Whether or not the aims of the work are narrowly or broadly defined, practitioners need excellent technical skills in evidence-based medicine and public health to avoid doing more harm than good. They must become rapidly familiar with the particular health problems threatening the population in question, and the available resources (structural, human, and organizational) and strategies that exist to cope with them. The most effective aid workers elicit and prioritized the health concerns of those being served; respect, support, learn from, and , when appropriate, guide colleagues; coordinate efforts; maintain flexibility; and strive for equity and efficiency while ensuring that assistance also reaches the most vulnerable populations. These aid workers also dedicate themselves to serving others while taking care to maintain personal health and equanimity in the midst of unfamiliar and stressful situations.
"Experienced aid workers realize that their work may put them in danger, and they contribute to individual and group security by respecting sound security protocols, maintaining positive interpersonal relationships (with officials, community members, and colleagues), and collecting and sharing relevant information. In sum, the consummate humanitarian health worker combines compassion, commitment, and integrity with technical proficiency in promoting the delivery of the most appropriate, evidence-based, and up-to-date preventative and curative health services--a tall order in what are often very challenging environments."

WOW, that's a tall order in deed. I keep telling myself that it'll get easier in some sense in a little while, once I'm out on the field doing what I want to be doing. But, really, I'm not so sure. The logistics that I hate are always going to be there, and perhaps even more so in "humanitarian aid" work.

My only hope in being able to be that kind of doctor, with all of those responsibilities and stresses on a daily basis, is the Lord. It's an interesting thing to have these seemingly insurmountable dreams. Looking at it from my own understanding, it's impossible to achieve any of them. What makes it even harder is that when I share my passions for this kind of stuff with other people (even believers), I'm only reminded that they're impossible. Why? I mean, I don't expect people who have a human understanding of "possible" and "impossible" to look at all of the requirements for a "good" international health care worker and think that, yeah, ain baiahya, zeh efshar (no problem, it's possible). But, what about believers? Why don't be believe God's words, His promises that "anyone who has faith in me will do what I have been doing. He will do even greater things that these because I go to my Father" (John 14:12) or "commit your way to the Lord and your plans will succeed" or "with God all things are possible" or any of the hundreds or thousand promises that we read and quote and feel good about but seldom act on or live by?

When will we give up operating by the world's understanding and actually live out what we say we believe? What evidence is there that we actually believe God and trust in His promises when we never step outside of what we think is possible, face the giants in the land and fight "impossible" battles? Yalla, bo'ee le'amim (Come on, let's believe--I think that's how it would be translated at least). Col efshar im Adonai Yeshua (all is possible with the Lord Jesus).

Monday, November 9, 2009

Gotta love analogies

Immunology is a really complicated subject (not to mention that our teachers for immuno aren't the best). Just glancing over a page from the book in front of me, I see paragraphs talking about cytokine secretion influencing the type-commitment of T helper cells. If they have a TH1 profile, they will secrete Interferon-gamma, Interleukin-2, and Tumor Necrosis Factor, which fight bacteria and viruses. If they are TH2, they will secrete Interleukin 4, 5, or 10, which fight against parasitic infection or infections in mucosal areas. The T helper cells receive signals from their surroundings in order to decide which cytokine profile to secrete. These signals are generally cytokines released from other immune cells such as macrophages. The interesting thing is that T helper cells that are already committed to a certain profile can influence others to commit to their profile as well...Now here's the analogy put forth in "How the Immune System Works" (a great book that, as you will see, makes things much easier to relate to on a "normal person" level.

"Committed Th (T helper) cells can also influence the cytokine profile produced by other Th cells in the neighborhood. In this sense, helper T cells are like 'evangelists' who try to 'convert' other Th cells to their 'religion.'"

Oh, man...but, it makes it make SO much more sense...

Ok, off to play volleyball. Have a great day everyone!

Sunday, November 1, 2009

A little reflection...

Two things you should know: (1)There's a gate to the university labeled the "Gate of Peace." Ironically, this gate is never open, but instead padlocked. (2) Everywhere you walk in Beer Sheva, and most other places in Israel for that matter, the sidewalks are littered with broken glass.

Gate of Peace

Broken glass shards litter Israeli streets

Reflecting the faces of those walking above.

Ordinary sand destined to be great

Tested and tried, put into the furnace

Shaped by a Master’s hands into something useful yet delicate—


But pressure and carelessness undoes this exquisite work

Shards with sharp edges and hazy memories of what had been—

These are all that remain

Trampled by my foreign feet, rushing about my business

Caught up in my own “completeness” from the same Master’s touch

And forgetting the incredible beauty of mosaics—

diverse pieces of brokenness

united to reflect something bigger than themselves.

Will I risk the my own pain from their sharp edges

In order to pick up these pieces

To lay them before the Master Artist and maybe join in His work?

Or am I more content in the rubble

In front of the padlocked Gate of Peace.