We are the third world

Disclaimer: all statements in this post are observational they should not be taken as fact. They should not be read as to malign the Norton Sound region, its people, or its health care providers.

The title of this post is an exact quote from an undisclosed person working in healthcare in rural Alaska. After our week in St. Michaels and Stebbins I can’t argue with that view.

While “third world” is a passé term – and ethnocentric (there is only one world) – the idea that rural Alaska is not on par from an economic, social welfare, or healthcare standpoint, compared to the majority of the US, is true.

What we see in Rural Alaska is replicated in community after community, country after country around the world. Our time in St. Michaels and Stebbins served as a reminder that we live in a broken world.

We haven’t been tracking our blog visitors as much as before so we’re not sure who is reading what we’re writing – or, if you will, feeling what we’re throwing down.

For those that don’t know I consider myself a Christian. Simply one who believes that “religion that God our Father accepts as pure and faultless is this, to look after the orphans and widows in their distress and to keep oneself from being polluted by the world.” Avoiding this pollution by the world – sin – is impossible so we need the sacrifice of Christ – for the forgiveness of our sins – to have a relationship with God.

The preceding paragraphs will tie into our experiences in St. Michaels and Stebbins by the end of this post if you make it that far.

We left Nome for St. Michaels on Monday morning.

St. Michaels and Stebbins are two communities that are actually quite close together (separated by more than 10 miles but less than 15 depending on the “road” traveled). St. Michaels is the smaller of the two and we arrived in time to set up and start seeing patients by just after noon.

St. Michaels has plumbing.

Stebbins does not; however, both clinics where we were working were equipped with running water. We were not able to have a shower in St. Michaels because of a broken shower. We had the opportunity to request to go to people’s homes to have showers but decided to go stinky.

We.

Decided.

To.

Go.

Stinky.

How many people in the world don’t have the choice of whether or not they go stinky? Over 1 Billion people in the world don’t have access to clean drinking water let alone extra water for hygiene.

The people in Stebbins don’t count toward that number because they do have access to clean water it’s just not pumped into their homes.

Swell’s Grandparents are not included in that number because they have a well nearby their home the water is just not pumped into their home.

Can you believe that there are entire communities in the US who do not have plumbing? There are and only some of them live in rural Alaska.

Can you believe that there are a billion people in the world who don’t have clean water nearby? No drinking water. No cleaning water.

We worked pretty hard in the old clinic in St. Michaels.

It was hard work as usual but it was fun work for the most part. The people were very nice.

Although many were sick. Some type of virus was sweeping through the town and when native people are sick apparently it becomes "ok" to snort and sniffle and spit into garbage cans no matter who is sitting two feet from you.

By the end of the week we would all be sick.

They have a big store in St. Michaels so we would walk way over there every day for some treats.

Some very, very expensive treats.

It amazes me that people don’t starve to death in these rural villages. Food is expensive.

Beyond expensive.

Many, like in much of the inner city throughout the US, are forced to live off of prepared foods.

Canned “pasta”, frozen pizza, TV “dinners”, and ground beef. You get the drift.

Fresh fruits and vegetables and lean meats are just too expensive.

So like in much of the inner city throughout the US obesity is becoming a problem. With obesity comes diabetes, high blood pressure, heart disease, etc.

Alcohol is also a problem. We saw many children with fetal alcohol syndrome (many is an undefined term but it was more than one and less than all).

We also made the dramatically unscientific note that many girls seem to get pregnant at a relatively young age. 17, 18, 19. I’m not sure if that is a “problem” or a cultural fact. It does seem (again observationally) that many children are raised by single women and many of the single women are the children’s grandmas.

While on these trips one can’t help but think. The overwhelming back pain and fatigue that comes from doing 50 eye exams over a 14 hour day begets thinking.

Swell and I have no desire to live in rural Alaska for any length of time. We doubt that the clinic here will need us anymore come July, as they have hired a full-time/permanent person to begin then.

I doubt we’ll end up in Africa, or rural Asia.

I fully suspect that we’ll soon become dreaded suburbanites. Something that I’ve never, ever desired.

Something that I’ve long despised.

What will our role in the world be if we’re living in Seattle, or Edmonton, or Portland, or Auckland?

A good bit ago I read The Irresistible Revolution by Shane Claiborne. He seems to agree with a lot of my thoughts but rather than just think them he has put them into practice by living in community in the inner city and having nothing that isn’t shared. (All money from the sale of his book was given away.)

While reading his book I noted a few paragraphs.

Going back through the book some of them address the questions Swell and I have re: our future.

We worked hard in St. Michaels and when we were done working hard we hopped in an Ambulance for the short drive to Stebbins.

It’s funny that they have an ambulance. They don’t have a hospital. They have a well equipped health clinic staffed by a physician’s assistant and some health aides. I’m guessing that the ambulance was to transport people from their homes to the clinic or to the airstrip to be med-evaced to Nome or Anchorage.

Many of the things that are done in rural Alaska are straight from the pages of a global health public health text book. Some of them are in the good ideas pages:

Health aides (well respected local people trained to care for the community and refer up the chain if necessary)

A central tertiary center to which people can come if needed.

And many of them are from the “do not do” pages.

An ambulance is one of those things that should not have been done.

In a global context transportation to a tertiary care center (or for that fact a primary care center in a lot of places) is a challenge and a burden for folks. A solution attempted by some was the purchase of vehicles to either transport a medical worker to a patient or transport the patient to a medical worker.

Problem – roads are often impassable. St. Micheals to Stebbins – road is impassable at times during the winter.

Problem – maintenance of the vehicle is often an issue. Ambulance in St. Micheals/Stebbins runs but no one knows how to maintain all the sophisticated ambulance parts.

This is but one example of why I’ve found it interesting to work in Rural Alaska. Rural Alaska is as it was bluntly put “the third world’ with the same problems and the same attempts at solutions as many countries have attempted/are attempting.

We worked harder in Stebbins than we did at St. Michaels – more people means harder work.

At least we had some happenin’ digs to sleep in.

As we were working hard late one night (probably 9 pm) a health aide accompanied a woman who was in obvious distress into the clinic. I knew immediately what was happening as I saw the health aide carrying two bags full of a bloody liquid.

The woman was having a miscarriage. Soon after they health aide and the woman arrived the physicians assistant who lives in St. Michaels arrived.

The health aides are amazing people. Lay people but trained very well. They can and do almost anything health related. From well baby exams to emergency care.

When they call in the PA trouble is brewing.

It was very difficult to be in the clinic that night. Swell and I had finished our – what often seems meaningless - work and were watching Heroes on the computer. Every now and again we would hear some sobbing coming from the clinic room down the hall.

At one point long after we had gone to bed we were both awakened by wailing. We both felt so bad but there was nothing we could do.

When morning rolled around the clinic was empty and it was back to work. As we worked we knew out there in this small village was a woman hurting. But as this thought crossed our minds we also realized that out there in this village there were many, many people hurting.

Alcoholism .

Suicide.

Neglect.

Abuse.

Problems around the world but more prevalent in some areas than others.

We hope that the underlying truth that people are hurting everywhere be it from a social disease, inequality, health crisis, injustice, spiritual battle, or some other cause will direct our future.

As we try to determine our future a passage that Shane wrote is of particular interest:

“As we consider economics, some of us will give people fish. Others will teach people to fish. But still others must be looking at who owns the pond and who polluted it, for these are also essential questions for our survival. We must storm the fence that has been built around the pond and make sure everyone can get to it, for there are enough fish for all of us.” Page 151

I had always hoped to be one who “teaches people to fish” but as an optometrist the opportunity to teach in a global context is rather limited. I’m guessing Swell and I will be relegated to the “giving of fish” and the important task of questioning our politicians and leaders as to why injustice exists in the world. The whole idea of living in suburbia and owning a practice scares us. It scares us because we don’t want to become those people. We don’t want to have a kid and say: my goodness our 950 sq foot home is no longer big enough. Bring on the 4000 square foot homes! (Have you ever watched HGTV? Those people are nuts. Three people family? You NEED a five bedroom house!)

Shane is able to verbalize concerns I’ve had for years much better than I can:

“Layers of insulation separate the rich and the poor from truly encountering one another. There are the obvious layers like picket fences and SUVs, and there are the more subtle ones like charity, Tithes, tax-exempt donations, and short-term mission[s]…, while they accomplish some good, can also function as outlets that allow us to appease our consciences and still remain a safe distance from the poor.”Page 157

How true this often is. The poor become an idea rather than people. Yes we recognize that poverty exists in this world but we do our part by giving to our church, by flying to Mexico once every couple of years to build a house. We go to the local soup kitchens annual fundraiser but we never meet the poor. We never interact with them. We never question why they are poor.

“As we consider what it means to be ‘born again,’ as the evangelical jargon goes, we must ask what it means to be born again into a family in which our sisters and brothers are starving to death. Then we begin to see why rebirth and redistribution are inextricably bound up in one another, as a growing number of evangelicals have come to proclaim. It also becomes scandalous for the church to spend money on windows and buildings when some family members don’t even have water.” Page 163

How do we redistribute? Ingrained in me as a Christian is the idea of being a steward of my money but I consistently hear from Christian leaders the idea of building wealth so that we can give more. Swell and I did our best to attend a Dave Ramsey study at our church (who are now disappointingly undertaking a multimillion dollar building campaign). Dave Ramsey is a Christian but the gist of his message is to live like no one else so that you can live like no one else. Translation? Spend less (GOOD!), so that you don’t go in debt (GOOD), so that you can save more (OK?), so that you can build wealth through investments (OK?), and then you can live like a king once your money starts making money. If you do it just perfectly you’ll be wealthy AND you’ll leave a legacy for your kids.

I don’t want to leave a legacy for my (completely fictional) kids. There is so much need in the world now. What good is my money doing in investments and savings when like Shane writes “our sisters and brothers are starving to death”?

(For those who have read things I’ve written over the years its like he stole the words out of my head, eh?)

“One of the fathers of the church, Basil the Great, writing in the fourth century, put it this way: “When someone strips a man of his clothes, we call him a thief. And one who might clothe the naked and does not – should not he be given the same name? The bread in your cupboard belongs to the hungry; the coat in your wardrobe belongs to the naked; the shoes you let rot belong to the barefoot; the money in your vaults belongs to the destitute.’” Page 165

Ouch.

So what do we do? Do we move to the suburbs? Open a practice? Make money? Give money away?

Or do we move to the inner city? Open a practice? Make less money? Give everything away?

Or do we end up in Asia or Africa living with the world’s poor. Making nothing but truly living?

Or do we end up traveling more. Seeing what plagues this world.

Alcohol.

Drugs.

Sex.

Poverty.

Inequality.

Injustice.

And while we see these things can we bring ourselves to make a difference.

How do we make a difference?

It’s the end of another year (Our years begin and end on May 25^th) and we are probably further away from answering these questions than we were 6 years ago but now we need to come up with an answer. Our house is for sale (its been shown once!), we have no jobs when we come back from our Eastern European tour of poverty and by now we’re probably unemployable in Atlanta (that’s what happens when you keep quitting jobs).

So we continue to struggle with life and the meaning of our lives. We continue to struggle with the choices we’ve made and are making. We continue to move about directionless hoping to stumble upon our life’s calling.

Where will this year take us?

Well this time last year we were just leaving Palestine. This year we’re in Nome. So who knows but we are going to try to have a different year this year. A year that accomplishes something.

Stay tuned for that.

I guess.

Eventually our time in St. Mikes and Stebbins was up.

We hopped on the plane for our flight back to Nome.

Exhausted.



But on the way home we flew over a bunch of Walrus. The pilot was kind enough to break from his flight pattern circle around and descend so that we could get a good look at them.

It.

Was.

Awesome.

Although the pictures didn't turn out you could see hundreds of Walrus just sitting around.



A neat way to end the week.

We ended up at home. Sick as dogs and spent the next two days sleeping.

And looking miserable.

Sick and Tired

Literally.

But not figuratively.

I hope that I never, ever hear a woman wailing the way I did last night.

Not fun sleeping in a hospital while a woman is having a miscarriage with complications.

Learned a lot.

Had some fun.

Had some not so fun.

Ice is gone here in Nome.

More when not tired although I fully expect we'll still be sick.

Gone

Gone to St. Michaels and Stebbins.

Back on Friday (?).

Later

Nome in May

Well most of you realize now that I've only really been in Nome for three days this time around. When I was in Little Diomede it was COLD.

It was so cold that I could barely stand to take my glove off to take pictures. Most of that cold was from the wind chill though. I don't think the air temperature was that bad - probably around 20-30 F (-12 to -1) - but with wind chill it was much, much colder.

When I got back to Nome I was shocked by the warmth. It is a veritable heat wave here. Sunrise occurs around 6:15 am with the sun setting at 11:45 pm. Daily highs are around 40 F (4 C) and lows around 25 (-4 C).

The snow is melting rapidly uncovering muddy dirt roads. Its not as pretty now as it was when we were here a couple of months ago but once the snow melts and the rain washes the dirt away it will be very nice again.

We'll put some pictures up in a the next couple of days.

Back to work tomorrow.

Anyone out there?

Little Diomede

So I thought all y'all might want to hear about my big trip to Little Diomede.

There really isn't much to tell when one goes on a village trip to work so much of this post will be pictures.

I went into work on Tuesday morning with Swell and worked for three hours or so. Worked because I only ended up seeing one patient. At lunch time I caught a ride to the airport in the patient transfer truck. I checked my stuff in and was soon on the way to Little Diomede.

Little Diomede is only about an hour flight away from Nome. We flew over the Bering Strait for much of the flight and proceeded to land on an ice runway. It is quite a sight to land in a plane noticing that there are small rowboats between the land and the runway - meaning that in the summer the runway doesn't exist.

Little Diomede is a remote village that depends on airplanes in the winter and Helicopters in the summer for supplies.

Weather often cancels these supply flights so they still live off the land - seal, crab, etc.

Little Diomede is three miles across the water from Big Diomede.

Little Diomede = USA
Big Diomede = Russia

Little Diomede = population 120ish
Big Diomede = population 0 (the former USSR moved everyone off the island years ago)

Picture of Big Diomede from the plane


Picture of Little Diomede from the airport


Upon arrival we (the optician and I) walked to the village and determined that we would set up in the Rec-Hall (bingo hall/after school hall/dance hall). Little Diomede is built on what is basically a cliff. There are about four rows of buildings. The rec-hall is on the second row and is accessed by walking up snow stairs. Unfortunately when the snow fell throughout the week the stairs became a slide. I would take a step and just slide the rest of the way down when going to the store or where I was sleeping. Not a place you want to live if you're frail or elderly or clumsy (JDL).



We set up and started to see patients at 4 o'clock.




We worked seeing 3 patients an hour until 7 when we broke for dinner. It went quite well except for the fact that some of my equipment was broken and I had a tonne of kids to start with who all came simultaneously. It was a zoo. Three kids standing over my shoulder while I examined their sibling. We broke from 7 until 8 and then came back from 8 until 10.

A busyish day seeing 14 people in Little Diomede.

We then stumbled down the hill to bed.





The next morning started at 8:00 with lunch at noon. And then from 1 to 7 we worked some more and then back from 8 until 10. Very busy day with my seeing 34 people.

We were supposed to work a few hours the next morning and then leave Little Diomede for Nome. The weather wasn't cooperating with wind and snow so our flight was canceled.



Big Diomede from Little Diomede compared with following picture (first day taken from rec-hall) to get idea of weather





We worked a couple of extra hours and then found that we had seen all who wanted to be seen. Thus started our boring, boring 30 hour delay. I watched some Office. Watched a movie I found in the clinic (not a clinic movie, a real movie)

We awoke the next morning to a nice day but the runway needed to be cleared. I basically sat around all day Friday waiting for the plane. It finally arrived to take us home at 5ish and my time in Little Diomede was over.

The people were great there. Very kind and grateful. It was a neat experience.

Like I said not much to talk about when you're working 14 hour days and trapped by the wind and snow. Hope you enjoy the pictures.

The Store


Boats


The kids








Going Home

I'm Back Nome

Yippee! I made it home from Little Diomede only 30 hours late or so.

More soon.

Another one!

Wow, that post I wrote yesterday barely made any sense.

I was so tired, I went to bed at 9:30! Right after watching Sixteen Candles for the first time.

I met a neighbor this am. I was just about to leave when she knocked on my door. She asked if I had a key that opens "these doors" and pointed to my door. I said yes. She apparently somehow left her jacket inside her apartment and is locked out and wanted to try my key on her door. I was hoping that it was not going to work and it did not. I offered her my fleece jacket and she happily accepted. She was just wearing a tank top! When I walked outside I felt bad I didn't offer her a sweater and a jacket both...and a hat and mitts.. But she can probably handle the cold way better than me.

It seemed extra cold this am, but maybe it's cuz I'm still tired. There's a full book of patients today, but I hope that some will not show so I can have a little break now and again.

Here's hoping for good news when sheepie calls at noon...

Stuck. Flight canceled.

Rogue internet signal (from a space ship?) comes and goes. Mostly goes.

Running low on food.

Cold out.

Running low on entertainment.

Leave tomorrow if weather breaks.

Weather doesn't look breakable.

Send help or I walk to Russia.

From Swell!

Wow, I don't think I've posted something in a year! This won't be long since I really want to get home and relax (I'm using the internet at work). And I am exhausted. This is the hardest I've had to work since...well, since last time I was here. Today was such a busy day, even though I saw as many patients as yesterday it just felt way busier. It's harder here since the patients are more challenging. You have a head trauma patient followed by a screaming 2 year old coming for his first eye exam. It's also harder working without Sheepie since he usually is faster than me and can pick up my slack!

Sheepie was supposed to get back today, but the flight not allowed to leave due to wind. Hopefully there will be good weather (and by good I mean cold - the runway is on ice) and no wind tomorrow....I miss Sheepie :(

I've been pretty much just working, eating, watching tv and sleeping. I'm happy we gots cable. I went through more price shockers at the stores here...and this time we actually had to buy more stuff since it was not in the apartment. The kitchen was really lacking stuff. No useful pots or pans, we went and bought just a frying pan...so I can just cook stuff you can use a frying pan for, oh so healthy! And a microwave! The utensils are maybe 20 years old (as is the rest of the apartment). I went to try to buy new ones, but it cost $6 for 2 forks or 2 spoons! My mom is supposed to send us a package with kitchen necessities before they leave for Romania. Until then, we'll have to keep our meals simple.

Oh, and it's still light out even at 11:15, that's when I went to bed last night!

Just a quick update on our condo: I'm upset w/ the realtor's thoughts on the price we should list for and completly disagree with her...I want to contact someone else for another opinion. She wants to list it about 40,000 less than the exact one that is on the 5th floor! She thinks the whole building is overpriced. She probably doesn't realize we are not desperate to sell...But I haven't had a chance to tell her yet. Hopefully I'll have some time tomorrow morning to call her. So far, it is not listed at all. We haven't signed a contract or set the price. (partly her fault, she never got back to use when she was supposed to)

One last thing: It snowed yesterday and the day before! Pretty huge flakes of snow! Now it's sunny and cold... Everyone here keep saying that it is normally a lot warmer by now. I was the only person here excited by the snow I think!

Bright Lights of Nome

Well after 18 hours of travel we made it to Nome safe and sound.

We're working today.

I leave tomorrow.

I get to go the bustling metropolis of Diomede. I hope beyond hope that the horror stories don't come true. It seems that people often get stuck on Diomede due to weather. I don't wanna be stuck. In and out. Thats what I want.

We aren't both going because the population isn't big enough to keep two of us busy. So its just me. Swell elected to stay in Nome.

One of the first things we're asked when we meet people who are interested in Nome is how long the days were.

Well they weren't that short when we were here last time. And they are LONG now. We got in at 8:30 last night and I swore it was mid-day.

Remember I'm from Edmonton and I'm used to long days.

But dang it was bright.

We're quite excited that we'll be here for the midnight sun party/celebration thing.

Well a short update. If you're lucky Swell will keep all y'all up to date over the next 3 or 4 days. If you know her number you should give her a call starting tomorrow. She is gonna be lonely.

You can't call me 'cause where I'm going cell phones don't work.

Woe is me.

Buh Bye

So Swell had the bright idea - a number of days ago now - to phone Alaska Airlines to find out our flight information.

What they had to say was confirmed the next day by the folks we're working for.

Our flight is on Sunday - Tomorrow - at 6:20 am. We arrive in Nome at 8:30 pm and start work on Monday at 9 am.

We're packed and ready to go.

So until next time.

Buy bye.

Miserable

So its been somewhat of a miserable week.

Between some happenings (which I'll delve into in a moment) and the stress of getting our place ready for showing as well as packing for Alaska its been a tough, tough week.

We were told that our tickets to Alaska were purchased two weeks ago.

We still haven't been given our itinerary. We may be leaving as early as tomorrow morning yet we haven't a clue.
And no one seems keen to tell us.

Now I fully understand cultural differences exist between here and there. I understand that time is not a priority in the Alaskan culture. They are very laid back and what happens happens. That said I'd still really like to know if I leave tomorrow or the next day. I'd also like to know how long my flights are and where we're flying and if we have a huge layover that we need to plan for.

I'd also like to know when I should start forwarding my mail.

When should I cancel my cable for? When should I cancel my car insurance for? Do we really start work on Monday? If so, do we land and go immediately to work or do we have a day or two to settle?

In the continued battle for health insurance Swell decided that she would, indeed, need to go the expensive route and activate her COBRA. Now for those of you who are foreign to the greatness that is the US health care system a relatively recent law was passed that made it illegal to deny someone who PREVIOUSLY had coverage through a job from extending their coverage after leaving said job. This is not permanent coverage but it is to act as interim insurance while said person finds a new job with benefits (remember that most jobs require a few months of work before you can get insurance).

When Swell quit her job she was asked by the lady who is in charge of insurance, etc whether she would need COBRA or not. Swell said No, as she hoped to get something cheaper.

Swell was unable to get something cheaper.

She phoned the insurance agency to find out if she could still activate her COBRA.

They said, "Yes, but your employer needs to fill out some paperwork and then we'll send you an application and you'll owe us back payments from the time you ended your job until the day your coverage starts."

Swell said: "OK." and emailed her previous job saying that she does, now, need COBRA and would like them to fill out the paper work.

She received an email back indicating, and I quote, "I had [insurance lady] check with [insurance company] and they said that you needed to start COBRA right away and that it is too late to add you on now."

To which Swell replied: "Thanks for checking on the insurance for me. I was not aware of that. When I called them they told me it was not too late, but that I have 60 days to apply for COBRA after the paperwork gets started from my employer. I guess I give them a call again."

She then phoned the insurance company again where the reiterated that it was not, in fact too late. They indicated that you have only 60 days to enroll once they mail out the application. If you wait more than that you are no longer eligible. They also mentioned that they did not mail out the application because they did not receive the paperwork from the previous employer.

Swell then sent another email to her employer and copied to the insurance lady telling them that she talked to the insurance agency again and that they indicated that it wasn't too late. She further wrote:

"This is the way it works: you as the employer are supposed to fill out a "Cobra Notifications Form" and fax it to them. After the Cobra Notification Form has been received by the insurance, they will mail me an enrollment package and I have 60 days to finish the process. In their system, this form has not yet been submitted, therefore it is not too late... [removed insurance company contact information]...Getting COBRA seems to by my ONLY option at having health insurance, as I was denied when I applied for Individual coverage (and it took this long to get an answer from them). We are leaving for Alaska in a few days and I would appreciate the process getting started ASAP. :)

Thanks"

To which she received this surprising and very funny email response:

"Sorry to see the Alaskan cold has effected your memory. When you were leaving I personally asked you what you wanted to do about your health insurance, since I was requesting COBRA for [another employee]. You said you would get your own policy because COBRA would be to expensive. I don't have any problem requesting COBRA for you but don't quote me chapter and verse as to how the plan works, I am fully aware of how it operates. My mistake for not having your refusal in writing, didn't think I needed it from you 'WRONG'"

Now I was shocked at the email but found it kind of funny. Swell on the other hand was devastated. Cried. And couldn't stop thinking about it... and still hasn't.

Now upon seeing said email we thought of a million things we could say back but chose to apologize and thank the insurance lady for now getting the process started. We also decided to delve a little further into the world of COBRA insurance.

Now the main thing that popped out was that BY LAW the employer MUST fill out the form the Swell is requesting is filled out EVEN IF the employee indicates that they do not expect to need or want COBRA coverage. This is to be done within 30 days of the employees "qualifying even" (i.e. leaving the job).

We chose not to impart this piece of information to the insurance lady.

Another reason to leave Atlanta as fast as possible. The meanest people live here.

We were finally able to get our place cleaned up quite well. We were expecting a phone call all last week from our realtor to set up an appointment for document signing and a decision on price.

Phone call never occurred.

I called them.

They called back and said someone would phone us yesterday to set up an appointment for today at which time the documents would be available for signing.

No phone call.

Person phoned this morning and came and took pictures.

Still no decision on price or documents signed.

Regretting choosing this realtor.

They better redeem themselves quickly or there will be no soup for them!

Wow. I think this is one of the longest stretches without a real update.

A lot of not much going on here.

Since we came back to Atlanta we’ve been preparing to leave Atlanta.

Of course we had a week with our nephew, Cami, which was a lot of fun.

Expensive, but fun.

After he left I worked three days of that next week while Swell packed boxes.

We are supposed to be listing our place before we go back to Nome so to prepare our condo to be shown we’re trying to get rid of some of the clutter. We rented a storage unit and Swell packed a bunch of boxes to put into storage. Well, we both packed boxes but she spent more time at it than I did. We put extra clothes into storage, books, CDs, DVDs, knick knacks and a bunch of stuff we’ve accumulated for Romania.

In addition to bringing many car loads of stuff to storage we also borrowed the storage units big truck into which I threw a bunch of book shelves, chairs and storage units.

I carried all of these things myself.

They were heavy.

I am now bruised from carrying said items from our unit to the elevator.

From the elevator through the parking structure.

From the parking structure down the sidewalk to where the truck is allowed to be parked.

It was hard work and our place still doesn’t look great.

There are a million units for sale in our building. This doesn’t bode well for the sale of our unit.

I’m not sure why everyone is moving. I don’t think that the mortgage crisis is applicable to most of the people who live in our building. It seems that most of the people who live in our building our professional people with some money but who knows.

We’re supposed to be back at work in Nome on Monday.

We have yet to receive our travel information.

We have yet to receive our travel information as our tickets have yet to be purchased.

We’re supposed to be back at work in Nome on Monday!

We were told to expect the tickets to be purchased today…

…hopefully.

I’m back at work today.

The four days I’ve worked since being back in Atlanta have all been at a practice in Jasper, GA. It is only about 65 miles, but seems worlds, away from home.

It is a rural community in the deep south so it has been an experience.

When I took the job I thought that it would be two or three days each week for three weeks. It turned out that they only needed me the four times I’ve been here. This left a gap of a week with nothing for us to do (other than pack and clean).

Not wanting to be responsible adults we went to Universal Studios in Orlando.

We had a week of fun, and WAY too much food.

It was completely irresponsible and we now feel guilty for doing it.

Oh well.

In the midst of the above we paid our tax bill. Ouch.

We also started a short, short way down the path of responsibility by opening an account for mutual funds. We got a tax savings out of it and were able to deposit quite a bit of money into an IRA (above the normal limit as we did it as self employed people – which we are – rather than employed folks).

Hopefully we can put more and more into these funds so that we can retire when we’re 55.

As if.

We weren’t created to work.

So we don’t.

We will be in Nome until the end of June. We then fly back to Atlanta where we’ll dump off our cold weather clothes and throw our warm weather clothes into our carry-on size backpacks. We’ll fill 3 or 4 suitcases with clothes and stuff for poor Romanians and then four days later we’ll leave to spend five weeks in and around Romania.

After our first week there my sister, JDL, and the good one will join us for their introduction to the cesspool of Bucharest. We’ll also spend time in other parts of Romania and then take the train to Prague where we’ll part ways and Swell and I will fly back to Hotlanta and ???

Denied

No insurance for Swell.

And we're not talking about good insurance. We're talking about $10,000 deductible catastrophic insurance.

Options:
1) New Zealand for a year or longer (if they need/want us)
2) One of us gets employment at a company that offers group insurance
3) Cross our fingers that she never gets sick/pregnant/injured
4) Emigrate to Canada
5) ???

As a celebration of her status as an insurance risk and our upcoming anniversary we're going to Florida for a week. We leave tomorrow.

It was supposed to be solely an anniversary trip but someone (who shall remain nameless) invited a parent.

It will still be fun.

Deleted

You may have noticed that the previous post about Swell's health insurance woes has been deleted.

Simple reason: the person (who shall remain nameless) who read us the letter from the insurance agency over the phone didn't read every word.
That said she may or may not have insurance in the near future.

Your Mouth is Not a Pocket

Where in the world are we?

Well we've left Nome.

We've left Maui.

But we're not at home in Atlanta.

No, we're back in the greater (and I use the term "greater" loosely) Portland area.

I really, really like Portland - after all what's not to like about a city that is home to Powell's Books (Think four stories of literary goodness)?

I do NOT, however, like Vancouver, WA.

Vancouver, WA is to Portland, OR what leprosy is to an intelligent beauty queen.

It detracts from the overall greatness.

Without the parasite of Vancouver, WA sucking the life out of it, Portland would be among the top cities in the world. With the greasy, grimy meth-heads of Vancouver defiling the greatness of Portland, Portland becomes that house you'd buy if you could just ignore the neighbour's dirty lawn fridge, cars on blocks and loud obnoxious parties.

I detest Vancouver.

A deep, almost primitive, hatred of the city of my wife's youth fills my very being. My soul cries when I enter Vancouver and rejoices with my departure.

I'd rather live in that God forsaken, rat trap of a so called city known as Bucuresti than Vancouver, Washington.

As you know we'll be moving from Atlanta as soon as absolutely possible and will, of course, probably end up in Vancouver.

Meh. As they say, in the instructions to that very silly game I am forced to play every freaking Christmas, "thems the berries".

We got into Portland yesterday morning after taking the red eye from Maui. Swell's Dad was kind enough to pick us up from the airport and drive us from the good side of the Colombia river to the wrong side and down past the stink that is Camas to the isolation that is Washougal, WA.

Let me tell you a thing or two about Washougal.

When Swell's folks first took us out to their new homestead the foundation for their home hadn't even been poured.

It was a desolate land.

Filled to the brim with deer and frogs.

Now five years later?

It is an overdeveloped wasteland that seems to be the epicenter for all that was wrong with mortgage lenders over the past few years.

Empty lots unable to be sold.

Homes that were built and purchased? Back up for sale.

More for sale than lived in.

The across the street neighbours from Swell's folks just up and left one day.

Bank notices are plastered on their front door.

They say something along the lines of "Ummmm.... would you pretty please drop by the bank to make arrangements to pay your missed mortgage payments. We fully realize that we shouldn't have qualified you for this overpriced home but we did and we'd really like our money."

The owners response?

Well like I said they left and took everything with them.

We wandered around Washoughal yesterday looking at all, the many, many, homes for sale.

1) Ugly
2) IN WASHOUGAL!!!
3) Poorly constructed.
4) Ugly and in Washougal.

Sorry folks-in-law not a chance.

Now that I've said all these bad things about Washougal let me assure you that Swell's parents have a very, very nice home.

With a great view.

And it suits them.

But not me.

But it is better than Vancouver.

Because its not Vancouver.

We have problems.

Big, big potentially life changing problems.

(Yes that means its new problems not my very many old problems - like living with the trauma of getting a pink bracelet when I was born, or having a grandmother who thought I was retarded for much of my childhood, or having to go to skating lessons rather than bowling lessons as an impressionable young lad.)

What problems could such fortunate people such as ourselves have?

How about we were told that we should return to Nome on April 14th?

How is that a problem?

Well we were told that before we left Nome. We were also told that we would know for how long we would return to Nome before our departure.

We were not told the length of our second trip prior to our departure.

That was over 3 weeks ago.

Since then we have heard nothing.

Zero.

Nada.

Not a thing.

At least the person we've been contracted through has finally been paid meaning we can finally get paid (as of yesterday).

Ummm... if we're supposed to go back in two weeks it would be very nice to:
A) Have a ticket
2) Know for how long we're staying and
iii) If this will be our last trip.

How is this life altering?

1) We don't have enough money to survive more than a couple of months (especially since April 15 is fast approaching and we have to write two five figure cheques)
2) We need to be able to buy our tickets to Romania this summer but don't know when we can leave making scheduling somewhat difficult.

Bastards.

In case anyone who has decision making power for our return is reading this - we are looking forward to coming back and working very, very hard. Please bring us back. I'll be nice. I'll even smile once in awhile. I'll try hard not to bite anyone again. And you get Swell if we come back. How is that not an incentive to hurry up and finalize things?

So Swell has finally clued in that I have An annoying habit. I hold things in my mouth. Driving through a toll booth or state park if I give someone money and they give me paper change I put it in my mouth and continue driving. Give me a pen - I'll hold it in my mouth. Give me a piece of paper and I need my hands, I'll use my mouth to carry the paper.

She has come up with a new slogan for me.

When she sees me do this she thinks its important and appropriate to shout: "YOUR MOUTH IS NOT A POCKET!"

Lame.

I fully intend to do a Maui post that is about how nice and fun it was rather than how nice and depressing it was.

I'll do it. Soon.

When I download my pictures.

One thing that needs to be told about Maui is that we learned a great lesson. When someone is nice and lets you stay with them, and plans things and gives you surprises and is very kind and fun to be around - DON'T TRUST THEM!

They are just doing it to take something that belongs to you.

G did the above things. She gave us a bed. She let us take over her home. She planned nice outings and surprises. She showed us all the cool things in Maui we wouldn't have done otherwise (1/2 price sushi, lavender farm, winery, swinging bridge and red-rocks-in-your-sandals hikes). She didn't even yell when Swell left the sugar out which bred millions of tiny little ants in her kitchen.

Why did she do and not do these things?

Solely to steal something.

Let it be known from this day forward that G in Maui is a thief.

Furthermore let it be known that we will not stand for this thievery.

We ask all of you to stand in solidarity with us while we fight for the return of who is rightfully ours. Do not talk, email, facebook, myspace or otherwise communicate with G until she renounces her evil and returns our property. If you are not with us you are against us and will face a similar, as yet to be determined, fate as G.

WE DEMAND THE RETURN OF THE HOSTAGE KNOWN AS SHEEPIE.



Return her safely or suffer our wrath G.


We know where Sticky lives.



We love you Sheepie we will not rest until your return.

One week

So we've been here in Maui for a week.

We have four more days to go.

We like it here.

We like the sun (although it often gives me a headache).

We like the beach (although I'm not much of a swimmer).

We like the atmosphere (although at times it is a little too laid back).

We don't much care for the guilt.

We're in a strange stage of life right now.

We're really unsure of what our next step should be. We know that we want to sell our Condo ASAP.

We know that we no longer want to live in Atlanta.

That stage of our lives is over.

It is time to move on but to where?

Seven years ago Swell was a beautiful fourth year optometry student. Being the very serious student she was she chose one of her practicum/externships in Maui.

Not because it was to be a terribly challenging externship. Not because she was dying to be an optometrist at the location she was to work at.

No she chose Maui for two reasons:
i) It is after all Maui and
b) She knew a girl.

Swell met a wonderful young woman at Pacific University who was from Maui. Her family was still there and this girl was going to return for summer break. Swell took advantage of this and soon had a free place to stay.

Optometry school has certain rules about how many hours who needed to work per week to receive academic credit for the externship.

Swell flirted heavily with the minimum.

While she was in Maui I was slaving away in the bustling metropolis of Chattanooga, Tennessee.

Now that is a long distance relationship.

We saw each other for a week that summer - at which time I proposed before leaving for another four months far, far apart.

All of that is an aside.

The important part of this story is that while apart from the love of her life Swell found two new loves.
A) Maui - it is after all Maui and
ii) The L family.

Swell lived with the L's that entire summer. K - the Dad - is a pastor at a church here on Maui. S - the Mum - owns a cleaning business. M - the daughter - was at that time an undergrad student at Pacific University and is now an optometric colleague of Swell and I. MK - the son - was then a young punk kid and is now married and in college in Oregon.

Swell was treated as a daughter. She ate with them, was included in their big family events of the summer and was loved on by this family.

It was arguably the best summer of her life.

After her departure from Maui we finished school and got married. The L's attended our graduation (despite having had a very early morning attending M's graduation from Undergrad). They also attended our wedding in which K played a role (one of three pastors at our wedding), M was a bridesmaid, and S made a beautiful flower arrangement under which we stood.

Life move on for both us and the L's.

Swell's other friend, G, was attending OT school in Tacoma, WA and happened to be renting a place from a Hawaiian Airlines pilot. She got a couple of guest passes from said Pilot and took Swell back to Maui for a week or so in the winter of 2003.

G. eventually did an externship of her own on Maui and then transitioned that into a full time job.

We visited her - and I made my first trip to the Island - after my first semester of public health school.

We had the privilege of doing a bunch of stuff while here and also spending a small amount of time with K and S at MK's wrestling tournament.

It was toward the end of that trip that I received a phone call from my Pa telling me that my Grandpa had passed away. A rotten way to end the trip but it was still a very nice trip and I began to realize just why and how much Swell loved the Island.

We continued to live life.

M was enrolled in optometry school in California and MK began undergrad in Oregon.

As a family the L's decided to take a once in a lifetime family trip following MK's first year at Undergrad and M's completion of optometry school.

They went to England, France, Italy and Greece.

We just happened to be doing our big Romania, Italy trip around the same time as there trip.

We just happened to be on the same no-name street as them at the same time as them in Florence.

A one-in-a-million happenstance.

We were able to coordinate schedules and spend an amazing few days with them in Rome and the Vatican.

It was great. They were kind to us. They were inviting. And importantly, for me - as someone who is disillusioned with the church -, they were real with us.

It was a great/beyond words time and we were blessed to have had that "coincidental meeting".

M found her way back to Maui and is now working various jobs as an optometrist here on the Island.

We came here to Maui this time to spend time with G and M and any of the other L's who had time for us.

We came expecting nothing from our trip other than time with people we care about and rest.

G made quite the schedule of activities for us.

One was a surprise.

It was a really great surprise.

On our first Saturday here we got to live as if we were rich.

G took us to the Grand Wailea - an extremely expensive resort where the rich and famous stay - where we sat in lounge chairs, swam in their cool pool and ocean, and ordered pool side food service.

It isn't that G is rich (at least in money - she is rich for knowing us) its that she knows people who can get us a day pass at the pool. It was a great time, although I came to learn that the new "spray on sunblock" sucks.

It was while on this "live like the rich" adventure that I began to read my book.

I purchased a no-brains-required novel that I finished on the flight to Maui but now I only had "The Irresistible Revolution" by Shane Claiborne to read.

Irony at its finest.

Here I was sitting in the lap of luxury with arguably some of the wealthiest people in the world reading about "living as an ordinary radical".

Shane writes about his life and his journey as a Christian. He is part of the "emerging church" - the Christian who doesn't identify with the Republican party. The Christian who doesn't find solace in large church buildings and material things.

I was reading about Shane and some friends packing their things up and heading to Calcutta to work with Mother Theresa.

The night before we had attended K's church.

We were beyond disappointed.

Huge.

New building.

Showy.

A let down.

Seeing that and then going to the Grand Wailea while both Swell and I are struggling to find our place in this world was difficult.

While we had great fun at the resort it created a little sense of guilt.

What were we doing here when we've done so little to improve the lives of others? We were again confronted with our opposition to but complete involvement in the materialism, over consumption of the Western world.

Our trip continued and as Swell and I hung out watching sunsets and seeing the beauty of the Island we began to be tempted by the idea of moving here. The oversupply of optometrists isn't as bad here as it is in the Pacific Northwest. There is a distinct lack of optometrists in certain parts of the Island.

We were also tempted because it is an easy thing to do.

Move to paradise.

Forget the troubles of the world.

We are isolated here.

Far from starvation and lack of clean water.

Far from the needy.

To ease the fears of those who want us closer to them I'll jump ahead.

Maui is not for us.

Swell still loves it here. I love that she loves it but we cannot live our lives surrounded by wealth. There is, of course, poverty here but to open a practice among the million dollar houses we would need to pursue wealth daily.

Our lives would become very limited. The Practice would become the end all and be all of our lives.

We're not ready for that.

So where does this leave us?

Back at the beginning.

Uncertain.

Confused.

Lost.

The L's invited us over for a really nice dinner. It was a delicious Bar-B-Que complete with chicken and steak.

K was feeling under the weather that day. He had been informed earlier that he was anemic and he was having some fun with his family.

"I've never been anything before! Now on those forms you have to fill out I can say Anemic? Why yes I was!"

"You better be nice to me, I'm anemic you never know how much time I have left."

Two days later he was diagnosed with an aggressive form of leukemia.

He starts 3 months of chemo on Monday.

He preached on Good Friday.

Swell and G after crying their way through the sermon (I was a rock...) came home and drank - heavily (well, put some alcohol on their ice cream - as a celebration of life).

I won't go into the sermon but it was good and meaningful.

K and the whole L family have a long road ahead of them. K will be on Oahu for the next 3 months and then in California for the 3 after that.

We have a few more days left here on our own and with the guilt we've (I've) been feeling and the witness the L's have been to us over the past 7 or 8years and K's sermon we have a lot to think about and a lot to decide.

Prayer from those who pray would be helpful both for K and for us.

Here's to bad news in Maui!

And to moving ahead with life while "sowing into other's lives".

Off again

So we're on our way.

Sitting in an airport once again.

This time we have 11 days of doing nothing to look forward to.

We're excited. In about 6 hours we'll land in Maui pick up our car and then we'll do whatever we want, whenever we want.

Not much has happened since we left Nome. We took care of some long overdue errands. We introduced Swell's parents to the Wii. I ran into my first love and gave her a hug.




We had difficulty connecting with people.

Swell got her hair did.

We slept well.

Swell ate a lot (Its interesting how everyone loves their Mum's cooking.)

A lot happened in our last week in Nome that we've neglected to write about. We'll get to it eventually. It was nothing groundbreaking it was just a week of work and hanging out.

Well we're on our way soon so I'll sign off with a Congratulations Lance Mackey! (Look it up)

Happy Happy

Happy Birthday BL The best oldest sis and sis-in-law a guy and gal could have.

Emphasis on oldest.

Shishmaref and beyond

I forgot to mention that when in Wales one can see mainland Russia off in the distance. The international date line is also very nearby.

After the long cold walk to the airport. We were soon on our way to the next village - Shishmaref.

This village was larger than Wales and we knew we were in for some busy times.

We flew on the same plane with the same pilot as took us to Wales.

The plane was still cold.

After a short flight we landed in Shishmaref and were soon on a much shorter walk to the clinic.

This time our clinic was located in the health center. It was a largish building with three exam rooms, a pharmacy, a front office and two - for lack of a better descriptor - storage rooms.

The health center is staffed solely by health aides. These are lay people trained to diagnose and treat basic conditions and refer up the chain for extra help. They basically follow algorithms to come up with diagnoses and treatment plans but have physicians, optometrists, pharmacists, dentists, audiologists, etc. available for consultation via fax, telephone, and tele-medicine.

The communities seem to love and trust their health aides.

Upon arrival we grabbed a quick bite to eat and were soon setting up.

The question was where could we set up? We had quite a bit of stuff and the clinic would still be seeing regular patients while we were there.

I asked where we could set up our main exam area and was told to set up in the room "to the left of the kitchen".

Now here is where Swell and I began to get a little angry.

Looking in the room "to the left of the kitchen" I soon realized that there was no way in the world that we could do anything in that room.

To put it bluntly I could barely fit in the room by myself let alone with equipment and a patient. This room was packed to the rafters with a combination of junk, dental equipment and supplies. (Dentists being who they are, are able to leave some of their big equipment in each village rather than lug it around - I'm talking patient chairs, exam chairs, lights, and the like). In addition to all of the stuff there were also file cabinets, a desk and a couple of book shelves.

No way, no how.

We decided forget it we'll set up wherever we like.

We set up in exam room 2, the main hall and a little hall off to the side.

It was not ideal.

Not ideal at all.

The optician set up in a little room to the right of the kitchen - and she wasn't happy about it.

We did the best we could to clear it out but she ended up using our big Tupperware boxes as tables and sitting in an office chair with a drug dispensing table as a desk. Not only was she cramped and uncomfortable she was way in the back of the building with no phone. This meant that patients we unsure of what to do and where to go and she was running back and forth between the office (where she was calling people to set up appointments) and the optical where she would help people with their glasses.

This really didn't work well so the next morning I, without asking, moved her to the front reception area of the building. It worked out much better and we didn't seem to be in the way of the clinic staff.

Swell and I had it tough. I did half of my part of the exam in a little hallway beside her room and the other half in the same room as her. She did her first bit in the main hallway and then the rest of it in the exam room.

It was crowded and unfortunate.

I was finding prescriptions in a way too short hallway with a chart that was a bit out of focus. It was not fun.

When we asked where they usually set up nobody really seemed to know or care. Eventually a patient indicated that they thought in the past that they eye exams occurred completely in the room Swell was in.

I really can't see how that worked but we made do.

And hopefully people's glasses work.

We dealt with a lot of minor disease issues and made a number of referrals both to Anchorage and to ourselves when we come back - we need to so some special testing on some kids and adults that we couldn't do while there.

Here are some pictures of our wonderful examination areas:

The Big E - for the optometrists out there, yes it was only 10 feet away. Yes it was out of focus. Yes I should be killed in my sleep.




New and improved glasses area:


We worked until 9:30 that night. We were happy that they had a TV in the clinic and we watched a little bit while having a midnight snack and unwinding then it was off to the least comfortable sleep ever.

Swell had an air mattress, the optician/assistant had a pull out bed, I had a little mat that they use for medi-vac patients. I was basically sleeping on the floor.

Ouch my back.

The next morning we were up and working by 8:30 and would end a little after 9 pm. It was on this day that we learned that the itineraries we were given were not, shall we say, accurate.

We would not be leaving Friday afternoon, rather we would be working a full day on Friday and leaving "sometime" on Saturday.

Great. Just great.

We were happy that there was a fairly big grocery store in the village although things were extremely expensive. Beyond expensive. We thought Nome was expensive this stuff was nearly twice as much as it is there. I guess thats what happens when you need to fly stuff in.



It was a neat village. Very hilly. Very snowy. Not terribly cold most days.




Beautiful sunrises.


Cute kids wearing wolverine jackets


Dogsleds




Antler Roofs


Rusty Gas Pumps (???)


We worked hard that day and all day Friday - from 8 am until 10 pm on Friday.

We were tired.


I think we did alright work. That will remain to be seen when others look at our charts though. It was hard. It was tiring. My back will never be the same both because of the sleeping arrangements and the awkward position I stood in for a week doing eye exams.

We eventually left not getting back to Nome until Saturday afternoon around 3 pm.

We flew to Nome via three other villages in the wind and ice. It was scary.

Icy Runways




Beautiful views


All in all a good trip.

What's going on?

In the last two days I've examined two patients who were wearing handcuffs and accompanied by an armed guard. I get to see one of them again today.

I just had a little 3 year old girl who I could not examine. Remember I used to teach how to examine kids. I've examined severely retarded individuals, autistic kids, I've been hit and kicked. I've sat on the floor to examine kids. I've sung, jumped up and down, whistled and made silly faces. Never before have I had a problem.

This kid from the moment she walked into the room until the moment I told her Ma that we'd have to reschedule clenched her eyes shut or covered them with her hands. She yelled and screamed. In the fleeting seconds that she wasn't doing this I was able to do about half of the exam. The other half? There was no way.

I hate kids.