yyy la vuelta

Heeyyyy. We’ve been over my Dengue, my revolutions and revelations. I know.. BOOORING! Fret not. I’m going to steer this Blob back to where we started.

Feeling well blood-plateletted, I returned to the jungle grind this week. As all Wednesday mornings go, I rallied the troops at 7 am to start the next –from city to campo (countryside)- medical adventure. In one SUV enter 8 people and their overnight bags, tons of meds, groceries, hartos litros of potable water and my VIP guitar. The important task of careful cd or Ipod playlist choosing transposes and… we’re off! Driving here is a trip. My favorite is the constant back seat commentary from the newbie Americans. “Heyyy Raquel…digamos (do we say) that here in the Bolivs the red lights do not apply?. Just like everything else, I learn as I go and YEP I’d get in a lot of accidents if I didn’t learn quickly which red lights do and do not apply.

It’s always fun to get back to the clinic. Life is way more than tranquilo out in the jungle. Wait I fantasize. On the way to the clinic and deep inside the jungle… life is prob pretty tranquil. But in the spot that they cleared out for clinic, docs, impatient patients, emergencies, trauma and drama, alter the ambient just a bit. Have I explained yet about my dual existence? Jungle (Wed morn thru Sat afternoon) - tranquil surroundings, people who have never seen doctors in their life, silly bursting at the seams clinic. City (Sun thru Tues) – carbon-copy contrast to jungle life. Santa Cruz is the plastic-surgery fancy car shiny mall new money Miami of Bolivia. In the private city clinic (the pride of my Bolivian doc and boss—and where I meet campo patients every Mon and Tues for further care) my joke is that when I finish with this job my bono bonus will be the same as everybody else’s… new breasts, new nose and why not? sure, throw in a new tummy. My joke in the Campo is ha ha, uhhhhhhhh you have cancer and need chemotherapy and we would have to close our clinic to pay for it. Uhhh your gonna die kinda soon. Luckily you don’t know what cancer is and you think there was a strong wind, a stronger rain, and that your bones hurt as a result. The doc gave you some aspirina and now we’re all smiling as a result. ~? Not all patients’ interactions are like that. Cancer and chemo of course are worst case scenario. We also help save people in a moments notice… without them ever knowing what would have happened had in that moment we hadn’t been there.

Each week clinic arrival is kinda just like the movies. Up pulls the white man in the modern SUV to save the day. No kidding, it’s only half like that. The travel is as follows: 1 hr of traffic and road construction autonomia, 40 min of amazing scenery, 20 min of Palacios’ bumpy/muddy/often flooded road. Getting there is always a happy moment. 1. I can breath a sigh of relief that we arrived safely. 2. It’s the jungle for goodness sake. It’s cool to roll up and see the awaiting Micros, taxis, a horse or two (the mixed transport by which the patients come). And the welcome back greetings with our clinic buddies are always warm and loving. My post-dengue return made it all that much sweeter.

Ok readers here’s the agenda for next Blob.

n Character profile of “clinica buddies.” Character profile of life actors in general

n Realization of how my life is akin to a taxi driver. But not at all in the chauffer or even transport sense.

n Realization of what my deal is about context. In language, jokes and how I live my life

n How I am getting really excited about the movie I’m gonna make one day. How when I walk down the street all I can think about are fascinating slow contextually without context movie scenes. And how I feel that I might be living inside the movie right now.

n This weeks’ story about how the clinic’s horse has disappeared/was stolen (we had two), the casero clinic caretaker/security/fix it man announced his resignation, how Dona Maria is a nut job and her words can’t be trusted for anything, how the Nuns did an unexplained emergency appendix operation on one of our patients (and did 4 more that night on not our patients), how the lab tech we have just “doesn’t show up” for three days, how the Portacheulo doctors we work with are also problematic no shows, how the Founders just announced construction plans to build a $110,000 new dormitory to “accommodate the gringos”, how I don’t get how a non-profit in financial and personal crisis can be SOOOO disconnected from the real-world……..how little Jefa Boss Rach has lots of important conversation about work, ethics, life, feelings, passion, shame, respect.

And I love you all.

ps.

scripted post: when my grandmother was in the hospital with breast cancer, laying in her hospital bed hooked to an IV, the first thing she told my visiting mother was "lucy, i've been trying to tell them, they just don't listen. my arm is not hungry anymore! "

moral of the story: it's in my blood.

"Raquelita, despierta!!!

What is a wakeup to me, you probably already know. No one wants to hear “Dengue has been good for me.” It’s trite for me to say my fall helped me to feel the ground. Nonetheless, I want to let everybody I do know what could, could have and is happening to me. I know how it feels when I write to you. I also know how it feels to live my life (especially now after being knocked over the head long enough to be forced to process). I still don’t know, although I’ve got a few good incites, on how it might feel to receive my scattered, stoic, flippant smatterings of updates.

I’m sorry to have worried you. (Not about the worry that was in-order but more the build up worry my stories create). I’m sorry to convey really important things flip and on the flip side. I’m sorry that something about me comes across as dangerous and too accommodating to unacceptable life measures. I feel the love and the reality-check. However I have to say that what I write is not crrrrazy different from how I am living. I am as aware enough about my situations to deal with them as they come, and YES to tell the details LATER. Don’t worry, I l haven’t changed. I will always be hyper-aware. Yes I take worry and risk and envelop it in adventure, jokes, uniqueness and possibly a semi-sick fascination with the struggle of survival. I am only as disconnected to make it through to the next day, knowing all the way through exactly how much my connections are worth.

The Dengue allowed me, made me and everything around me STOP. Instead of 1 besito (little kiss goodbye, I got 8 from one person.. por si caso just to make sure. All of a sudden a really fast, really stressed, really productive world went quiet. Planted in my bed my accomplishments went from trying to micromanage a non-profit poor people’s HMO to trying really hard to animate the stricken eyes and pulse of my number one patient.

Dengue or not, we all are existing in drastically different worlds. I try to convey where and how I inhabit foreign spaces and places while recognizing the gravity of existences and at the same time sharing the not-so-different (roll with, bounce back, entertain the ride) Rachel approach. Dengue wasn’t a joke but you better believe I was joking the whole way through. Yeah there were times to worry. I worried, I cried, twice I think. But yeah I feel proud for the most part that I was the one making sure my doctors (and frightened onlookers) didn’t get too stressed out and learned and felt the experience (on many levels) as much as I did. I was told “Man you’re Dengue sucks… but jeez are you entertaining and enjoyable through it.”

So this is the deal.. I’m not some crazed egotistic comedian/tale teller who ignores reality and feeds off the hilarious disconnection. As I struggle through the Dengue, or get harassed by cops, or understand realities I would wish didn’t exist to understand, my jokes, my suppressed worry, fright and meta-commentary ARE my experience. They aren’t to dupe, divert, dismay. I told jokes in my Dengue cama bed to keep me (and later us) going. I’m never existing in this world alone, so the reverberated smiles and energy of those around me got me to the re energized smiling and energetic state I’m in now.

I’m all better, platelets are up, the Dengue got the beat down. Dengue can strike again (there are 4 types), and worse on the repeat, this I know. Thank you for your support, and how u give when I don’t know I need it. Thanks that this life is kickin… and yes I taunt it, and yes I think I have it all under control, and yes I’ll keep telling you to try not to worry. Understand me as much as I don’t understand myself. Disconnected from you or myself I am not. I am gonna try to think more and have quiet without the Dengue and have balance and circular strength unity cuz that’s what it’s all about.

Ps. I really like memoirs.. i always have. So, I'm practicing. It's ok that I'm as fascinated by the writing as fascinated/mystified as you all are by the result.

A lil song to the tune of the Dengue

hello dearly beloved,
here's a little song i rewrote. based on the diddy "both hands" by Ani Difranco.

my version "Dos Medicos" tells of my last lil adventure (Sat night to the ongoing recovery of today) no worries about the details. i was sick. pretty sick. we were worried. yep a lil worried. but now i am on the blissful and carefully monitored road to recovery. in post-acute stable condition Dengue Fever i am: 1. amazed at the security of my medical care (with the bolivian connections and the american volunteers i am as taken care of as i will ever be) 2. incredibly educated on one more lovely detail of life 3. wiser beyond my years once once again 4.humbled and rooted by the reality of it all 5. thankful to be alive

Dos Medicos

I am walking
out in the jungle
and I am visited by the aedes aegypto
mosquito again
and I am getting the Dengue fever
and it can't let it go
but I will get through...
a tourniquet test behind the dark curtains
and the open door
on the second floor
he’s looking for many petechiae
to see how long our coordinator can last
and dos medicos
I need dos medicos
oh, I can't open my eyes

I am counting
platelets in your body
I am reading about Dengue
And how few have died
How few have died

I am watching your pulse rise and fall
like the cells of my life,
and the pain of it all .
and your bones have been my breakpoint
and your flesh has been my fall
I am waiting for DEET
to offer up my keep
ohh dos medicos
*I need dos medicos
oh I can't open my eyes

but in eachother's hearts we grew less and less small
and eventually the laboratorio couldn't explain it all
and I'm recording our history now on the clinica wall
and eventually Dr. Douglas will come
and solucionar it all

I am walking
out in the jungle
and I am visited by the aedes aegypto
mosquito again
and I am NOT getting the Dengue fever
and I can't let it know
that I will get through...
So now use dos medicos
please use dos medicos
so you can open your eyes
I am counting
platelets in your body
I am singing about Dengue
and how we survived
I am singing about Dengue and how we survived

paso a paso

heyyyyahh,
here's to letting you all know that all is a-ok. sorry for the lil' lapse. i haven't been in town, had enough time, nor felt grounded enough to write a real blog. my current "grounded" state shifts between planted and floating at all times. my equilibrium hasn't balanced quite yet.

everything is going well but i've been feeling stressed lately with the incredible weight of it all. my shoulders are creeping dangerously above ear level, so yes, i'm a little tense at best. the job is amazing and at the end of the day if i can focus on the small successes, that warm cozy feeling should envelope me inside. unfortunately i don't work like that. when you present me with a task, i see the task in 3-D plus an unlimited montage of invisible sides (first simplicity then history, social context, future, bureaucracy, heir achy, challenge). this makes for a long day (a given) and my mind and go-getterness makes it even longer.

Scenario: 1 lil jungle clinic. cute. friendly. open. lots of poor jungle people. cute. friendly. open. a service that asks for nothing and gives everything. a clientel that asks for everything and gives nothing. lots of docs...smart. little to no staff, social work, accounting, standards, policies... really stupid.

Centro Medico Humberto Parra is a cool place, and an even cooler idea. As far as I observed, we give the shirts off our backs. We're they're for the people in moments of need--- the gravity of need scale is completely open. We do this and it makes some people feel good about themselves. It makes some sick people actually better. We also do this and it makes some people, who need to replace the shirts, re-energize the backs, and make sure this process happens over and over again, feel really proud but really exhausted. It makes some strong, visionary people say to themselves pretty much everyday "Op. I do think I've gone cross-eyed." Oh yeah, the some people is Staff Member Me.

So that's about where I'm at. It's hard to explain. There be--- 100 patients half in great need status, half in "I take advantage of anything given for free" status. 4 American docs who know a lot and complete immediate tasks. 1 Bolivian doc who knows a little but attends to a lot. 1 nurse who is non-licensed but passionate, giving, and culturally knowledgeable. and then there is me.. for, no joke, EVERYTHING else. Meds, resources, logistics, patient follow up, patient politics, patient need, emergencies, hospitalization, exam transfer... (list length undetermined).

last week I chatted with Don Julio (president of all the Centro Med health groups serves). he told me two interesting things. 1. when researching how to socially classify the people we help he offered this standard: Bueno. Normal. Malo. Good, Normal, Bad.. those three words soon will determine who can pay, who can help, and who needs us the foundation to cover it all. 2. Don Julio ( an amazing wordsmith by my standards) also told me: "You people are like cows. You share a really giant organ." Cows have big hearts. According to Don Julio (despite the struggle and the confusion I feel everyday) apparently I do too.

The Americans are cute. They call me La Jefa (the boss lady) or La Jefa Spice (the boss lady Sporty Spice) and support me in a lot that I do. They can't really help most of the time but they seem to respect their time is but a glimpse into this reality. The Bolivians are also cool. They do their part and do it well. The exhaustion is that no one else but me is there to experience it all. I feel like I'm always working. I basically always am. The good news is that I've had some distraction (half Boliv half American), I really like Regaeeton, I've been playing a lot of guitar and sharing my voice and finger pickings with others. I'm working on balancing Gringo and more permanent life here. Cambas (Santa Cruz people) are funny.

Carnival is coming. It starts tomorrow. American Founders One (and hopefully Two..Dr. Molitch was not let on the plane from Miami because his yellow fever card was not written in Spanish) arrive in a half hour. 5 more Gringos arrive tomorrow (there are already 5 here). Again this all sounds fine but the more people, the more questions and planning and 24/7 WORK for me. Ps. we don't have enough beds, enough work spaces, enough car seats for this many people. The founders will be here. I haven't done much to solucionize (word in Spanish) cuz I want them to face the facts.

I wrote a really serious agenda to discuss with Founders (Number 1, Number 2 and Bolivian). It covers everything from "this is great to this is totally unsustainable to I am willing to work and give to you but your gotta make some changes to make my work and giving supportable." I plan to call a meeting for an organization that in 7 years has never paused the helping to make efficient and and standardize the help that we give.

I'll let you know if I'm successfully in getting them to pause to discuss such things. They tell me step by step and cool it Gringita Coordinator girl. I agree. But if my legacy here can be to make 1 or two tiny changes that makes the next person's job (and the Bolivians I work closest with) a little less head-splitting at the end of the day, I'm gonna try.

Ok I'm gonna go relax. And play guitar. Or get a call and have to go pick up the founder. But either way music (my own or de Reggaeton) will lead the way. Well one way travel... until the Founder (really prestigious American Med Head) is sitting next to me.

Love biggg hugs.