home sweet oregon

i've been home for just over a week now and settling into the routine, or more accurately, the chaos that is these two weeks before pete and i leave for patagonia.

i am processing the reverse culture shock i usually experience when returning from a developing country. it involves quite a bit of guilt for having so many nice things and living in such excess, and a considerable amount of effort to live more minimally and conserve/recycle/unplug the toaster between uses.

it is wonderful to see family and friends. i have taken advantage of my free weekend by hiking angel's rest and table mountain, and spending a day skiing at meadows with my dad and pete. we are in the midst of birthday celebrations this week (yes, i turn another year older on thrusday, bah!), and last minute patagonia preparations. and as if that isn't enough to keep me busy, it is match week and yesterday i received possibly the happiest email of my life thus far, letting me know "you have matched", so now i wait to hear where.

i feel so lucky, fortunate, blessed and privileged to be where I am today.

every travel adventure i have i cannot believe that i am allowed such an incredible, unforgettable experience. i have an intense appreciation for my good fortune or luck or whatever you want to call it and i love to remind myself how important it is to savor all of the good things in life and as for the other stuff, be like a duck, let is slide off of your back if you can, because life is too short to dwell on anything less than happiness....

thanks to everyone who read about my travels, it was a trip! and so fun to know that people back home could share it with me.

xo
linds

the travel part of travel

you know how i feel about this... the travel part of travel is the worst.

saturday evening a group of us headed to the airport around 7pm. our taxi we had "reserved" for the trip didn't show, which is a bummer because, when you have all of your belongings with you, it is nice to be certain you are with a legit/safe taxi driver. instead we hopped in a tiny unmarked taxi-ish colored car with a guy who the hostel staff assured us was legit.

first thing i did once we were all crammed in the car with our bags was establish a relationship with this guy. they say that is one of the best ways to avoid being robbed/attacked/whatever - make a connection. and so i struggled with my limited (though considerably improved) spanish and he actually turned out to be very nice, correcting my grammar and laughing at my attempts at communication (though, in my defense, he really did understand everything i tried to say to him, and he did not speak english).

the only shady part was when he stopped at a dark gas station  in the middle of nowhere (which is possible when you're on a 1+ hour drive to the airport - the new airport is soooo far from quito!), got out, leaving his door wide open, and disappeared for awhile. lauren, trisa and i sat patiently in the car, our respective doors locked (which i'm sure would do a lot of good given that his was open and inviting people in), and debated if this was the part where he brings guys over to steal all of our stuff. fortunately this did not happen and eventually he returned and drove us the rest of the way to the airport - lucky? i will admit i was pretty darn worried while we waited, the epitome of sitting ducks. but all's well that ends well, right?

at the airport most of our group were lucky enough to get on a plane - slav and i (foolishly purchasing tickets home on sunday morning - because our course director was not clear that we would be done friday), tried to get on an earlier flight (fail) and attempted at least to get our bags checked and make it through security (no luck); it was all futile - fat chance accomplishing any such thing in a place like ecuador. american airlines had no established counter or designated employees and until the check-in window opened at 4am (it was about 8:30pm) we could do nothing.

we hunkered down in a corner for the night, expecting to get some decent sleep - wrong! within minutes of settling down, our bags piled in a corner and us laying in front of them, these two guys walked over. if you know me well, imagine the way i look at ice cream or cookies or good beer :) well this is how these guys were looking at us, or rather, our bags :( now i have a few thoughts to interject here. if i were going to rob tourists at the airport, i would definitely rob them when they arrive, carrying a considerable amount of $$ and all of their new travel gear. I would not rob the departing tourist, who inevitably has a bag full of dirty, disgusting clothes and a bunch of useless souvenirs, without a penny to their name. i wanted to explain this to the shady looking dudes standing over us. they were empty handed except for their cell phones, unusual for most who are traveling, especially in the international wing of the airport. yeah, it was pretty obvious these two were not here to hop a flight, and they were not being so discrete about their intentions. slav and i discussed this openly as they stood there and they soon wandered away, only minutes later replaced by an equally shady duo, who wandered over and like the first two, stood in front of us and blatantly eyed the bags we lay in front of... slav and i again discussed the situation. was their security here? would they harm us or just take our things? do you think they have weapons in their pockets? because again these two were empty handed aside from their flip phones.

when they strolled away the space before us was almost immediately occupied by two large men that mirrored the others only these guys were considerably bigger. ecuadorian men are short, and when i tower a head over them they are definitely less threatening. this was not the case with these two and with a glance at each other and no words, slav and i stood up, gathered our things, and headed over to the well-lit center of the airport right by the guy who checks boarding passes and passports to let people through to security. we stayed here the rest of the night and felt much safer - though after our earlier encounters there was no way i was sleeping, and so i spent the night reading until 4am when we were finally able to check bags and head through security to our gate. there we slept another 2 hours before boarding, which thankfully slav woke me for, because i was sleeping hard enough i was setting up to miss our flight. a two hour delay for fog or who knows what (this is the new airport, so new that when we flew into quito a month ago we flew into a different airport), and we were on our way to miami and home....

as a reminder here is the link to lo's blog she kept during the trip...
http://jardinedelosandes.blogspot.com/

adios quito...

figured i'd better finish this thing off right...

our last 2 days in quito finally felt like vacation. we had our beautiful hostel as home base and all the time in the world, with very little scheduled (a farewell dinner with the group and a final "exam" friday eve, but that was about it).

we spent our mornings in the daylight restaurant drinking coffee and enjoying bread and eggs - always a big breakfast in ecuador... after digesting, lauren, anne and I took advantage of the side yard/garden and did workouts on friday and saturday.

repacking for the trip home proved to be a puzzle. i wanted to fit all of my souvenirs in my carry-on bags and threw everything else, dirty and haphazardly, into my one suitcase for checking. a lot of clothes stayed in ecuador as donations to the school (which advertised a program that distributed donated clothes to those with the most need). the day lauren and i walked to the school to drop off my bag of clothes it was closed, which we hadn't yet seen during our time in quito. so after debating whether or not i would be able to throw it over the fence topped by barbed wire topped by three layers of what appeared to be electric fence, i looked around (guaranteed appearing very suspicious to the nearby security guards eying me curiously), and flung the bag up and over the wall, just clearing the top wire. success! we hurried away before the bomb squad got called in...

grocery store runs for plane snacks and some final time in the market kept us occupied for a day. i bargained down to my last penny and even started including stationary and other random gifts I had brought along to give to gloria's "children" (until we found out they were older than us). my best trade involved a long list of random item: apple flavored chapstick (unused, obviously), a lanyard, like 5 pair of earrings, a wallet, a notebook, a cosmetic bag, and some other things i cannot remember + $7 in exchange for the most ridiculous souvenir i purchased - a fluffy alpaca stuffed animal made with real alpaca fur. anne and lo tried to talk me out of it but i couldnt leave ecuador without one! it is impossible to look at this thing without laughing, and no one can resist touching it - how could i not want one?!

we got mani pedis one of the days with almost every girl in the group. certainly more business than the place usually gets in a day, i would imagine, but they managed the crowd well and we eventually all left with pampered hands and toes (many hours later given that they only had two foot tubs for soaking). french tipped manicures and pedicures with brilliant designs on our toes were a total of $8 - cheap!! gotta love this place. the sanitary technique may have left a little to be desired but i'm almost 2 weeks out from mine as a write this and without complication so i can't complain. the other interesting thing is that of the 4 "women" who were doing our mani pedis, I am fairly certain that half of them were actually men - the beard poorly concealed by foundation is kind of a dead giveaway... and there is only so much you can do to cover up male bone structure; i always think the hands and wrists are a dead giveaway. but regardless of gender they were skilled and we had a great spa day getting the rainforest cleaned from under our nails and scrubbed off of our feet (it is amazing what a week in rainboots will do to your toes!).

but i dont wanna go...

 sorry for the extra odd format on this one...

I think I am made for the rainforest.

being a pisces, I love
      all of the rivers and water... yes, including the humidity.
      and as an oregonian I have been acclimated to endless rain my
      whole life (see: RAINforest). and fit the female stereotype
      and always complain of being cold (reference: pete), which is
      never an issue in the amazon - amazing!! raised on the
      willamette, I love boats; the main means of amazonian
      transportation, and I don't mind walking everywhere else.
      finally, I happen to look pretty darn good in knee-high
      galloshes. and so, for all of these reasons, I think I have
      finally found my habitat - the rainforest. truly the only
      issue I see is the whole bugs deal. me and bugs, we don't get
      along so well. and bugs of all kinds and alarming sizes tend
      to be overly plentiful in the rainforest. so I suppose I'll
      hold onto the bug memories, particularly those of the large
      spiders, just long enough that I willingly get on the bus and
      don't run into the jungle to hide out until the rest of the
      group leaves... dont worry ma, I'm writing this quito, so
      they did get me on the bus, despite my reluctance.
   
      our bus ride was one of those experiences I have mixed
      feelings about. my plan was to sleep; which, not to brag
      but, I am really good at - practically a professional given
      that I can sleep almost anywhere these days (likely explained
      by the chronic sleep deprivation that has come with my last 4
      years of medical school). the problem with sleeping on this
      bus was that the view from my window was impossible to look
      away from... basically the entire drive until probably the 15
      final minutes when we were in the city was too gorgeous to
      miss for something as silly as sleep. dense jungle, with
      endless interesting plants, turned to massive cliffs, somehow
      still coated with plant life despite the vertical angles of
      the mountainsides. we crossed rivers on bridges hardly fit to
      walk across. we passed the waterfalls seen on our drive down,
      and then some (after the recent downpours). I couldn't peel
      my eyes away from the side of the road, always searching for
      cows and horses and llamas tied up and grazing. I could spend
      all day watching for the variety of mix breed stray dogs just
      doin their thang in the villages and along side the road -
      what freedom these dogs have, and for the most part they look
      surprisingly healthy (though some, not as much, and it is not
      an easy life for a dog here - if only amani realized how
      terribly spoiled she is)... the river we followed for a good
      portion of the drive was wild and angry, fueled by all of the
      runoff... apparently this is a huge destination for kayakers,
      but let me tell you, I couldnt be paid enough to get in that
      water - that's just askin to die... that river looked mean...
      but oh so beautiful.
   
      we hit a little 'situation' around our halfway point. well a
      few situations. one was that the bus ride was so insanely
      windy, and our driver was driving like such a maniac (he must not be paid by the hour), that
      half the bus was blue and on the verge of leaving their
      breakfast on the side of the road. the other situation was
      that, unluckily or not, after 3.5ish hours on the road, we
      hit a traffic jam and came to a complete stop... in the middle of nowhere. apparently the
      area is well known for landslides... lovely. we had actually
      passed a few not long before. tons of mood spewed out into
      the road, trees still standing upright, but considerably
      transplanted from their origin of growth. our driver had
      navigated these with little difficulty. he definitely
      believes in the big car rule and would drive that bus just
      about anywhere short of off the side of the cliff. his theory
      appeared to be that if you honk, they will move. which
      fortunately for us, seemed to work. but when we hit the
      traffic jam, his honking just didn't do the trick. we were at
      a standstill. he left us on the
      bus and went to investigate. turns out there was a mudslide
      ahead (what we didn't know at the time was that it was miles
      ahead and we were at the end of a very long lineup of cars,
      all impatiently waiting). our driver, upon his return,
      started up the bus, cranked us into the oncoming traffic lane
      (thankfully there was no oncoming traffic - I wouldnt put it
      past him), and we drove up several miles until we came to the
      other cars who had done the same thing. this was some serious
      cheating!! but it did get us way ahead, and when you're on a
      9 hour bus ride, you'll take what you can get.
   
they eventually opened the road and we made it through. another hour of driving and we stopped for a lunch break. this place, Gina's, was crawling with kayakers, in their broke down vans with their dreads, totally fitting the long time traveler stereotype - they were living the dream. this restaurant was known for its trout and everyone in the group seemed to order it a different way. they were all delish, despite the fact that your fish was served, head and all, which I felt a little bad about...


the rest of the bus ride was more beautiful landscapes and crazy rainbows and interesting clouds and then this section that looked exactly how I imagine new zealand looks... straight out of lord of the rings. I drained my camera battery taking so many photos out the window :)

in quito we checked into our hostel - the most amazing one in quito as far as I'm concerned. the side patio is gorgeous and the rooms are clean with comfy beds and the shower was hot! yeah I'll admit I missed hot showers. feeling finally clean and more importantly dry for the first time in a week I began to unpack. I was amazed that everything in my backpack, even clothes I never took out in the rainforest, was soaking wet!! that humidity is something else, certainly nothing I'm accustomed to having grown up in oregon.... aside from being dizzy all night (either from the bus ride or returning to such altitude, or a combination of both) I felt great and slept like a baby in my fluffy white bed feeling totally spoiled :)

vanilla filled chocolate donuts

where were we...? i remember just starting to tell you about our rafting excursion down the branch of the amazon river. it was comical to see 9 gringos and 1 ecuadorian floating on 9 black tire tubes tied together haphazardly. jenny, lo and and i were relaxing in the canoe, which drifted down the river behind the tubes, engine off. it was reminiscent of summers in oregon, when we would pile into inflatable rafts and tubes and make our way down the clackamas river, trying to stay cool in oregon's version of summer heat.

my seasons are all thrown off here. i see instagram posts of the snopocalypse that hit the east coast a while back, and hear stories from my family and pete of epic days skiing hood. but in the amazon it is always 70 something and so humid it feels like you're breathing underwater. the humidity is so intense i could easily be convinced the temp is pushing 100F. it cools slightly when it rains, but the air gets even heavier with moisture and i am not sure it is worth the trade off. overall, though, i like the weather - it is nice to be warm always and my skin never needs lotion like it does in oregon. and if you're really desperate to cool down you can always retreat to the icy showers - freezing 24/7 :)

after our "tubing" (or more accurately floating) excursion we headed back to the lodge. lo, anne, leah and i decided to hike back to the lookout in the jungle for the sunset. we set off covered in bugspray and sporting our muck boots (the only two essentials needed in this rainforest). we passed a futbal game on a cement block surrounded by swamp after the recent rains. when the ball went rolling off into a marsh near the trail we walked on, the closest player, sporting his converse futbal shoes, reluctantly stared at it, clearly contemplating if it was worth the sacrifice of his clean, dry shoes. i thought he might kiss me when i tromped over, mid calf deep in mud, picked up the ball, and tossed it to him. such is life in the rainforest.

we wandered through a small village on our way to the trail. chickens cleared the path as we passed. children gawked and some managed a tentative "hola", which we returned enthusiastically. the number of wipe out close calls was more than statistically should have been possible without someone actually falling - muck boots: great for keeping the mud off, terrible for traction.

we eventually made it to the lookout, sweating so profusely my clothes were drenched and i was dripping - this seems to be a trend of the amazon. it is so gorgeous here photos dont do it justice. we decided to head back before the actual sunset, dependent on the lingering daylight without our trusty leader, robert. we retreated back to the resort that used to be the eco lodge until it was recently sold. this place is beyond words.... let me try...  a massive deck jutting out of the jungle and overlooking the river and rainforest. bats swoop around eating up insects (which makes me very happy) in the dusky hours of sunset and the clouds glow a spectrum of pinks, oranges and reds. as we stood there taking in the beauty we were approached by a man. we instinctively "hola"-ed him, and he responded in english... an american? no, obviously a canadian after a few minutes of speaking with him....

he is one of the coordinators for the program: free the children (apparently started by a 12 year old boy), that gives high schoolers the opportunity to travel to amazing places around the world and do volunteer work and experience areas in the world they might otherwise not have the luxury to travel to. he listed a handful of amazing places in africa and se asia where they also have program bases. they are the ones who bought the lodge from this guy, douglas, who was in some debt and looking to build a different lodge across the river - which is in process now. it is all a little confusing but this is what i gather of the situation. either way this guy talked to us some about his program and asked what we were doing here and it was fun to share and learn... boy do i wish i could have gone to a "camp" like that when i was in high school!!

he did say it is a ton of work to maintain a wood eco lodge in the jungle because the place is constantly trying to digest itself. that is the job of the jungle. maybe this is a well-known fact but the rainforest soil is super nutrient poor - and if you cut down the insane number of plants that are able to grow on every square foot here, you end up with soil so awful you cant grow crops - which is one of the reasons it makes no sense to destroy the jungle for farming. the reason the rainforest grows so wild despite nutrient poor soil is because it provides it's own nutrients. the leaves and biomatter that fall from the plants decomposes rapidly into detritus and that is the nutrient matter that the plants use to grow like they're on steroids. hence, the jungle's job is to digest, rapidly, even the eco lodge, and anything else built here. this poor guy said it feels like he is replacing boards and planks daily - a lot of work to keep up with the rainforest.

we said our goodbyes and continued home. the chickens we had passed on our way out where now half dead and laying in their own blood on the deck of a small shack, where a woman stood, blood-stained hands, ready to prepare dinner. the line between pets and dinner here is very foggy... the futbol game was still going on. the sunset kept getting better as we walked and i couldnt help but keep stopping to take photos. there are these nests here that are like 5 feet long and the shape of a baseball in a tube stock (?) so that the opening is at the very top and the nest with the eggs is at the very bottom - this serves great protection from animals. the tucan is really only animal with a beak long enough to get down in there but they are so narrow that the tucan's beak often will get stuck. robert says if we see one of these nests on the ground often you will find tucan bones stuck in the opening... i just thought of that because there were many of these nests on our walk home and they are so interesting.

after dinner we were entertained by the high school students with a show and dance. they were in traditional clothing and showed us how they prepared meals and then did this awesome dance where they create their music and beat with the beads dangling from everything they wear, just by swaying their bodies back and fourth. it was super cool. once they finished they went to change, the spanish r&b music came on, and the real dance party began. it was total chaos. a bunch of high school students and us. lo and i could only watch and clap along, we were exhausted and soon retreated to our room to fall asleep to the sound of that gangnam song - what must the jungle animals think about all of this?! :)

ok, gotta run, but i will blog about our trip back to quito and our last few days in the city when i can...

i head back to portland tomo!! wish me safe travels and give me a call sunday if you're bored, i'll have lots of layover time...

xo

day 4 in the amazon

   dr. W headed back to quito for some ambiguous "business" and
      left us to our own devices these next couple of days (which
      is actually nice because 1. we are in very competent hands
      with Robert around, and 2. though he does a lot to make this
      trip work, overall everything is more difficult and less
      efficient with dr. W around)... our brigade was a close was
      walk today after a particularly short boat ride, just
      downstream and across the river. it went really smoothly,
      everyone has figured out their place and we powered through
      60 something patients by noon (only about a dozen less than
      our day prior, and in a couple hours' less time). it really
      does feel like we make a difference here too, which is great.
      everyone is so appreciative. arguably my favorite part is
      handing out all of the goodies to the kiddos. I wish airlines
      were less strict about baggage prices for checking donated
      supplies... with our brigade successfully complete we headed
      back to home base for an afternoon of eye exams for the high
      schoolers living with us at the lodge, followed by tubing in
      the river!! of all things :)
   
      we took the canoe upstream a while, and thankfully with the
      weather cooperating, 9 of our group members hopped in 9 tire
      tubes all tied together, and began the float downriver, with
      robert (naturally) as their ever-competent river guide. lo,
      jenny and I chillaxed in the canoe, the designated
      photographers.





ok this is wayyy too much for one evening, i need to stop and get some sleep, but there is more to come from amazonian adventures so keep a look out! and i havent proofed anything so i really apologize - feel free to make corrections if you´d like ;)

miss you all, cant believe i´m home in 3 days!!



   

grubs: they taste like bacon

  lunch was at 4 pm and we were starving. after, I dropped into
      a post-prandial coma, barely making it from the hammock to my
      bed, lulled to sleep by my full belly and the rain on the tin
      roof... anne thankfully woke me up in time for our evening
      activity - some traditional cooking! I volunteered to help
      with the first part and was brought up with julie and liz to
      prepare the chicken. just a slab of meat that I can guarantee
      was running around earlier that day, a little salt, and a
      leaf they call 'stone leaf' which is fire resistant and
      sounds like plastic when you bend it then snap it straight.
      we wrapped the chicken up in the traditional way and tied the
      end tight. Robert put these in the small fire burning under
      the shelter where we eat all of our meals - it was still
      pouring rain.
   
      next a surprise - rachel offered to open the leaf that
      contained something "kind of like chocolate" according to
      Robert, when I told him that would be my favorite surprise.
      everyone gave Rachel space as she unfolded the leaf because
      given what we've seen here we were assuming it was going to
      be a tarantula or worse (tho at the moment I couldn't tell
      you what would be worse than a tarantula)... but rather than
      something leaping out at us, when she splayed open the
      massive leaf, all we saw was wiggly, slimy, fat... grubs!!
      weevel larvae. I am talking exactly like the grubs that
      tamone and pumba munch on in the lion king. they are like two
      inches long and half as fat and paristalsing just like bowel,
      their bodies rippling them forward as they make their slow
      escape off of the leaf - no luck. Robert picks one up to
      demonstrate... "you have to grab it behind the head at the
      'neck' so it can't turn around and bite you". bite me?!! sure
      enough these guys have big pincher jaws!! Robert says "to eat
      them, you have to bite them first". eat them how?! alive?!!
      what do you mean bite them first...? robert takes the porky
      little guy, sticks the dark head far back between his molars
      and bites down - we all hear the crunch of the hard
      exoskeleton of the head between robert's teeth and the
      squirming pale body goes sort of limp... sort of... it is
      like the chicken with the head cut off scenario, the grub
      still has a little squirm left in him. Robert sticks the
      whole thing in his mouth as shocked and dismayed sounds of
      disgust erupt from those of us watching. this is a delicacy
      here, a special treat, and Robert is not training for fear
      factor, he likes it!! he'd eat the whole pile if he didn't
      have to share with us.
   
      "it is like oysters" I hear him say. no it is not, I think to
      myself, wishing oysters really were tonight's treat and
      missing the east coast oysters pete and I had in mystic...
      who wants to try one alive? three of the girls in the group
      were intrigued and daring enough to give it a go... I was not
      among them, my stomach is still turning just writing this.
      they selected their victims, picked them up as instructed and
      in a moment of courage, clamped down on the head like they
      had been shown. they all stood there for a moment with the
      'what have I gotten myself into' look on their faces, and
      then, with even more bravery, put the whole slimy gooey thing
      in their mouths and attempted to chew. now this part was more
      funny than gross because there was a lot of hopping and arm
      flapping and squealing to assist the chewing process, and if
      you saw the pus-oid (resembling pus) white cream that came
      out of these guys, you would jump and arm flap too... one of
      the girls had spontaneous chocking fits 4 times between chews
      and we were certain she was gonna spew - but with the help of
      their chaser (a salt covered lemon, of all things), she got
      it down. even with pressure from the group, no one else, not
      even the boys, would dare eat one alive. so we moved onto the
      cooked option. I helped skewer the grubs, because clearly I
      was not brave enough to eat them. one skewer through the
      neck, the other through the tail, you just need to crush
      their heads first so they stop squirming and the skewering is
      easier. a little salt and lemon, and we set them over the
      fire, assured that once cooked they would taste just like
      bacon :)
   
      in the meantime our chicken was done and I was endlessly
      impressed by my meat cooking abilities given that I've been a
      vegetarian for the 12 years antes de recently. that was the
      best chicken I have ever had; get me some stone leaf back in
      the states and I will cook you some chicken!! our final food
      was heart of palm, which robert had gotten for us and cut
      down to the leaf, which doesn't look like a leaf at, but
      tastes delicious - very tender and a flavor I cannot compare
      to anything I have eaten before.
   
      at this point the grubs were ready and most of us were
      mentally prepared to give them a try... I thought about
      passing. in the skewering process we had left a puddle of
      black goo on the table that was anything but appetizing.
      ultimately I gave in and munched a grub in true lion king
      fashion... and.... and... oh wow that really does taste like
      bacon!!! who wouldve thought!!?
   
      now the thing about the grubs is that getting them isn't
      easy. not only is there a grub season, but there is a
      designated grub guy. you want grubs, you call grub guy, who
      supposedly keeps track of the fallen or downed palm trees,
      which is where the weevil lays her eggs. the grubs gotta grow
      for about 3 months to get to the size they were this eve.
      sounds like a lot of work to eat larvae. what is less work,
      is this thing everyone does here that is apparently an
      ecuadorian deal. I think I've mentioned we have soup with
      almost every meal, even in the hot and humid rainforest. well
      sometimes with the sopa they have popcorn to put in it, and
      it is so delish!! how did I not think of this before?! def
      bringing that back to the u.s. :)
   

why it's called a rainforest

day 3 in the amazon:
   
      woke up extra early this morn for an hour long bird walk in
      the jungle. at 6am the sun is just rising here, so we set out
      with headlamps and waited for the silhouettes of trees to
      turn to color. with daylight we could, with some difficulty,
      spot the birds so easy to hear in the dim dawn. thankfully we
      had robert along, and birding is definitely one of his super
      powers. he can identify the birds from so far away and when I
      would be skeptical of his accuracy he would set up his fancy
      binocular tripod and open his bird book and sure enough, what
      we would see through his lense would match the exotic bird he
      pointed to in his book. super power.
   
      we did not have a ton of luck with finding tucans and parrots
      like we were hoping, but we did some very colorful and
      beautiful birds. and either way I love any excuse to run
      around the jungle, so I was content with the morning walk
      despite the illusive birds.
   
      quick tooth brushing story. I've been walking to the end of
      the deck to brush my teeth because we are one of the farthest
      rooms from the "bathroom" (except I don't know if you can
      call open air toilets, showers and sinks a bathROOM...?)
      ...this morning, juggling toothbrush and waterbottle and lid,
      I made an unfortunate fumble and dropped my waterbottle lid -
      rookie move. it fell the two stories below and upon hitting
      the ground, rolled out of sight. this wouldn't be so tragic
      had I brought other bottles, but no, I am holding onto this
      one for dear life because it takes a lot of effort to stay
      hydrated here and my solo waterbottle is the only thing
      standing between me and hypovolemia every day. so, toothbrush
      in mouth, I head down to retrieve the lid. I soon discover
      that it has rolled into what appears to be a large animal
      hole in the ground. I could easily be convinced a large
      snake, spider, or biting mammal made this hold - in any case
      I did not want to stick my hand down there. after much
      contemplation and personal turmoil, I opted for the
      faster-than-lightening grab, which, when fueled by
      adrenaline, is surprisingly close to that speed ;) I took
      inventory: lid rescued, hand/arm intact - victory!!
   
      the health brigade today was notable for the weather. you
      know how I have discussed rain here before? after today I
      realize that nothing before qualified as rain - it was
      arguably fog in comparison to the downpour we experienced
      today. we took the canoe up the river and started our hour
      long walk in a light rain. decked out in ponchos and
      rainboots we were unphased... we arrived damp and ready to
      work, but in true ecuadorian fashion, hardly a patient was in
      sight and the school rooms weren't prepared for us. so the
      next 30 minutes we spent setting up the little desks and
      spreading the word that the doctors were here... by that I
      mean this old man walked into the field with a large (snail?)
      shell and used it to call everyone in the area. you could
      hear other shells call back in response, echoing across
      jungle from nearby villages. how cool?! ahh life before cell
      phones :)
   
      ...which is exactly what we've been experiencing this week,
      by the way. no cell service, no wifi, no media of any sort -
      we are out of touch with the world... a meteor could hit
      russia and we would be none the wiser (did this really
      happen? pete and one of the guys in our group - who is
      russian - tell me it did, but anne and lo tried to look it up
      online when we were back in quito and couldn't find
      anything)...
   
      back to the health bridge: Rachel and I were responsible for
      the eye station. for those of you who donated eye glasses,
      they're a huge help here!! we've done hundreds of eye exams
      and given away nearly all of the glasses we brought - thanks
      everyone!! we had this one woman who was juggling this
      adorable little baby and her medications from her clinic
      appt, and do her eye exam, so I offered to take her baby - as
      soon as I did... well, see earlier excerpt on diapers, or
      rather the lack thereof, here. this cute little niña didn't
      pee on me, but she was not wearing a diaper and she really
      smelled like pee, which transferred to my damp scrubs for the
      rest of the day... Jon wasn't as lucky, he actually got peed
      on the next day - and get this, because it is so humid and
      warm here he didn't even notice until the mom took the baby
      back... ha!
   
      we test vision in less-than-ideal situations. it is noisy and
      impossible to keep the family members away - the moms whisper
      the answers into the ears of their kids! cheaters!! and the
      room we are in, which appears to be a kindergarten classroom,
      is overly decoded and distracting, not to mention poorly lit
      and without the luxury of electricity.
   
      we were assured all of the kids knew their alphabet, so we
      used the letter eye chart - our first little one was 8ish
      years old and getting everything wrong!! poor kid, having to
      deal with such terrible vision his whole life. his mom told
      us he doesn't see as well as the other kids :( it was bad
      enough we questioned if we were all on the same page, and
      brought over a few blocks with letters on them to assure
      ourselves the barrier wasn't confusion with the alphabet. he
      seemed to identity the letters we showed him ok, so we moved
      on to trying to find him glasses. since they are all donated
      and our eye exams are a little rough around the edges, we
      usually have patients try on pairs until something makes
      their vision mejor (better). this little guy insisted
      everything made it worse, which confused us, since our exam
      showed him with 20/70 vision in both eyes. frustrated and
      confused we brought him up to the chart and repeated the eye
      exam from a foot away - same result!! it allmade
      sense... when he called everything that looked like a
      "d" just that, and everything that looked like an "f" that,
      it was actually because he didn't know his letters, and had
      nothing to do with vision. now we get it... swapping charts
      to the E directions chart we repeated his exam at 20 feet -
      perfect 20/20 vision. how exhausting!! we sent him away,
      lesson learned, and were careful to use the directions chart
      for the rest of the day if there was any question about
      alphabet competency.
   
      our exams ran smoothly after this, until the rainforest storm
      hit. we went from melting in our tin roof box heated by the
      sun, abruptly to 20 degrees cooler with gusting wind and
      bucket of rain. the tin roof now made for the noisiest
      rainstorm I have ever been in - far too loud it continue the
      eye exams, and so dark that we had to get out a flashlight
      once the rain eventually died down, so that our patients
      could see the chart. the sky was black and angry looking, and
      if I hadn't been assured that our location on the equator
      deters hurricanes, I would have worried that was exactly what
      was building outside. inside the open air school rooms we
      found little protection from the rain. it blew in from all
      sides and leaked through holes in the roof, which, in the
      sun, decorate the floor of the school house with speckles of
      light.
   
      rachel and I agreed our favorite part of the day was when we
      would do eye exams on the really little ones - the 6ish year
      old niños would need a good 5 minutes of instruction before
      they understood that they were to turn their hand in the
      direction of the E I was pointing at on the wall. rachel
      would hold a paper over their eye (because if you ask them to
      cover their eye they press it so hard that when we switch
      eyes, their exam is much worse from smashing the first
      covered eye - the adults do this too, so we resorted to
      holding paper over the eyes for all of them)... these little
      guys would be pulling away from the paper covering half their
      face, which looked awkward and comical as they contorted
      their necks and turned their heads while still trying to see
      the chart. and they would point up and down and one direction
      with ease, but turning their hand in the opposite direction
      was complicated and extremely awkward, and only one little
      guy figured out that switching hands for that direction
      remedied this. I tried not to laugh as the display 20 feet
      from me got more and more absurd as the exam went on. what
      cuties!! and all with great vision considering their exam
      were in the dark and with plenty of distractions.
   
      our 1 hour walk home was at the end of the rainstorm - and it
      didn't matter that I had a poncho covering me from head to
      toe, I was soaked under it. when it rains that hard I think
      their is nothing you can do to stay dry. especially when you
      have to trudge through rivers and there's wind. our
      rainboots, which clearly are not made for walking, were
      filled, as the ponchos just funneled the water down to our
      scrub pants and directly into the boots. there was not an
      inch of dry anything on any of us by the time we made it back
      to the lodge. I felt right at home being native to a rainy
      habitat myself, it was awesome :)
   

blow dart skillzzz

we were scheduled to visit the local healer here, and a group
      of us were up for an afternoon adventure, so we set off in
      the canoe again (which I do not think I have mentioned
      doubles as the school boat around here. yes, you heard me,
      school buses are impractical in the rainforest - thank you
      captain obvious - a school boat makes far more sense... and
      yes, there are designated school boat stops. duh). a short
      hike and we were at the healer's home on stilts (because
      flooding is so common here, and to keep snakes out of the
      house).
   

      we learned about the traditional healing medicine, similar to
      what we have seen before in ecuador. a few of our members sat
      through healing sessions, which involved the shaking leaves
      and blowing tobacco smoke on them and then whistling to bring
      the good energies to fill where the bad had left. we were
      offered the tobacco to smoke but Robert warned even one good
      inhale can put you on your ass, so I passed.
   
      once we were through with cute little medicine man, we moved
      onto bigger things - namingly, blow dart hunting. robert
      joked we were starting out with chickens but instead took a
      naranja (orange) and put it on a stick he stuck into the
      ground, our target. he first showed us the ropes -
      demonstrating how to hold and fire the 8 foot hollow stick
      that we would blow the dart through. he said we would each
      get 3 tries. he drew a line in the dirt and went first. miss,
      miss... and miss. embarrassed he handed off the weapon to
      misha, who on her third try, nailed the fruit target. I was
      blown away! (no pun intended :) and robert was clearly
      impressed. lo went next and despite good form, didn't have
      the accuracy (or luck) to hit the target.

I was third in line
      and stepped up feeling totally incompetent and doubtful I
      would even get the dart out the other end of this 8 foot
      tube, which was so long it was difficult to hold straight at
      the target. so while questioning form and logistics, I step
      up to the line and I guess my inner warrior took over because
      I blow darted (can that be a verb?) 2 of my 3 blow darts
      directly into the unsuspecting naranja!!.... annnddd I could
      not stop laughing after each hit. I was so surprised at my
      obscure hidden talent with the blow dart - and here I thought
      chicken catching was my strange skill. give me a blow dart
      and watch out!! Robert was laughing too, more because a
      second gringa had just shown him up than anything. we
      continued down the bench, and at the end me and the two
      gringos in the group had both gotten 2 in the naranja, so
      naturally we had a blow dart shoot out, which I did not win
      :( (but Robert thankfully decided there would just be 3 blow
      dart winners regardless)...
   
      after this the only thing that made sense was to paint war
      paint all over our faces. there is this special plant with
      these spiky pods that look like lychee but when you break
      them open they're filled with these red seeds and the red is
      just like paint and you can widle green stems into paint
      brushes and create warrior designs in red, which is what I
      asked for - boy did I look fierce!! as Robert was painting on
      my face someone asked how long it lasts, and straight-faced
      in perfect english he says "only 2 months" - even someone a
      fraction as gullible as me would have raised an eyebrow.
      thankfully (though I will admit there was a moment I was
      mildly disappointed), he was joking...
   
      we headed home after that, just in time for a workout then
      dinner. quick aside about the walk back to the boat. on the
      way there we had walked across this old, frail bamboo bridge.
      it looked unsturdy enough that Robert had us wait to begin
      crossing until the person in front of us had crossed.
      wonderful. well apparently his perception wasn't too far
      off... on our way back we came up to the bridge and... it
      was... gone? yup, a couple hours later and the bridge had
      vanished! fortunately we were prepared in our boots and
      crossed the stream below with ease.
   
      by 8 I was so exhausted I could hardly stay awake for my
      shower, despite how chilly it was. also, the tarantula on the
      stairs made it somewhat difficult to coordinate bathroom
      trips, but he hasn't attacked me yet and now I'm starting to
      think he's kind of cute.
   
      what is not cute is that every bathroom stall had some
      surprise creature bigger than my hand ready to pounce when
      I'm most vulnerable!! and what is also not cute (but more
      awesome than being ambushed by a frog when you flush the
      toilet), is the army ants that run around this forest in a
      swarm, 10m x 3m, destroying everything in their path. robert
      picked one up on our way home from medicine dude... he wanted
      to show us that they can be used as sutures (or more
      accurately a staple gun), if you have a big cut that needs
      closing. you simply lower the massive jaws over the wound,
      spanning to either side, and let the little guy chomp down.
      these ants won't let go, even when you cut off their bodies,
      which you can do, leaving a neat row of ant heads clamping
      your wound shut. robert accidentally got himself chomped on
      when he picked up one of the ants and I had to pry to jaw
      open to get it off of him - they are strong little
      dudes!!
   

blue-footed boobies!!

day 2 in the amazon:
   
      do your remember in camp when you were younger how the group
      would do the rain activity, where you all sit together, but
      are divided into smaller subgroups, and one group starts
      rubbing their hands, then snapping, then patting their legs,
      and finally stomping their feet, and the next groups follow
      so that the sound builds and then dies like a big
      rain/thunderstorm... I always loved that. well this is what I
      woke up to this morning, only it was massive rainforest
      raindrops on the tin roof overhead and the sound built up
      then died away within minutes and the animals and insects,
      normally so loud, quieted at the peak of it, then picked back
      up to fill the silence once the rain had passed. I guess
      there's a reason they call it a rainforest. the air is so
      thick with moisture it reminds me of the tamascal hut, or the
      rainforest exhibit at the zoo, so true to the extreme
      humidity - (and I love it because I never feel the need to
      put on chapstick here, which is my daily addiction in the
      u.s.)...
   
      I realize I titled this blue-footed boobies (if you don't
      know this bird, you need to watch more animal planet,
      discovery channel, and/or planet earth - you can find them
      here in ecuador, but only along the coastline, where we have
      not traveled), more accurately it should have been titled
      blue booted... footies? (blue footed boobies... blue booted
      medical students!). we are a pack of blue-clad gringos all in
      matching knee high galloshes and we look ridiculous!! but the
      muck boots are practical for mucking through the extremely
      mucky rainforest - especially given this morning's rain
      (creating endless muck), and I have been so happy to have
      them, especially when tromping through swarms of ants (the
      boots offer some level of protection from the ants in your
      pants scenario you heard so much about in elementary
      school)...
   
      after breakfast our group trekked down to the river, caught a
      boat upstream a ways, and then walked down a gravel road for
      20 or so minutes, until we came upon a grassy opening in the
      jungle that appeared to be a school yard. we would hold our
      brigade here, in an open air, half constructed building with
      a raised tin roof and a dirt floor. the familiarly tiny desks
      and chairs were brought over from another part of the school
      and our health brigade began. in sets of two we worked our
      way through dozens and dozens of patients. these people are
      particularly remote and we had some gnarly medical problems
      we weren't quite sure how to handle given our limited
      resources.
   
      patient 1) an almost 3 year old niño who had been in a car
      accident a couple months ago and for 2 weeks after had gross
      blood in his urine. apparently this has now resolved but he
      has, since the accident, had issues with bladder control and
      it sounds like there is some question of nerve damage... he
      needs a pediatric urologist, but good luck finding that in
      the middle of the jungle. to complicate matters, he does not
      speak and his mother believes he can't hear as well as her
      other children - no kidding... and to top it off, he has a
      pretty bad cold, like every single other patient we saw that
      day.
   
      it was wild - like the ecuadorian flu/cold had hit this
      little jungle village and spread like wildfire. all of our
      patients complained of their gripe symptoms: cough, fever,
      green mucous, congestion, some with diarrhea... everyone had
      it. hope we're not infected now and bringing this bug back to
      the u.s...
   
      we had a young niña, maybe 4 years old, who had hit her head
      on something in the home about a week ago and not had what
      appeared to be an abscess on her scalp under the scab. we
      didn't have the sterile tools to lance and drain it so we
      sent her away on antibiotics and with instruction to return
      to a clinic if she didn't improve in a couple of days.
   
      we treated almost all of the kiddos with parasite meds, which
      was ironic only in that we had them swallow these pills with
      untreated agua from the faucet - which is what they drink
      since it is their only option, but seriously, how futile is
      it to treat parasites with a pill that requires swallowing
      with the aid of unclean water...?!
   
      here's an aside. diapers are super expensive, difficult to
      access, & create waste you can't get rid of -
      alternatives for those babies who don't have diapers? well
      you could do the cloth deal like my parents did for me... but
      what if even the cloth is too expensive & not accessible?
      well let me ask you this, who really needs a diaper?... the
      mothers here carry around diaperless babies, and at the hint
      of a wetting they just adjust their hold so that the urine
      gets on them as little as possible and on the ground as much
      as possible... when the mom that slav and jon were seeing as
      a patient spread her legs apart and the baby she held in her
      lap peed, urine splattering on the dirt floor at her feet,
      the only awkward thing about the situation was amy and I
      attempting to act like that was normal... so a word to the
      wise here, when you hold a baby here, if you feel like you're
      being peed on, you probably are :)
   
      we made it back for a late (and totally worth the wait)
      lunch. it is so funny to get everywhere here by boat and
      trekking through the mud... I love it!! and it really makes
      you feel like you earn your meals. post lunch I was hoping
      for a bite of the taffy candy treat I had kept from baños,
      but when I found it in the top of my backpack, I was highly
      disappointed to realize it was covered in stupid sugar ants!!
      few things, however, come between me and sweets (especially
      when good desserts are so few and far between this trip), so
      I did what any kid would do - I washed/picked off as many
      ants as I could, and ate my taffy, residual protein topping
      and all :)
   

the amazon

day 1 in the amazon:
      paradise
   
      I'm in heaven.
 
      despite a stressful morning (our taxi driver, a friend of
      mami gloria's, was late picking us up to drive us to the
      meeting place for our bus ride to the amazon... gloria
      insisted he is never late and rightly assumed he was still
      sleeping, but rather than drive us herself she just called
      him til he answered, and he picked us up 4 minutes before we
      were meant to meet the group across town. fortunately he
      drove like a maniac - and more fortunately didn't crash us;
      blowing through red lights and stop signs in the early morn!!
      - and we made it just in time, which I am guessing
      disappointed dr. W, who I think would smile an opportunity to
      leave the portland trio behind... we're such an
      inconvenience, us three ;) ...), the rest of the day just got
      better and better.
   
      the 8 hour bus ride ticked by slowly. I was kept sane by
      exhaustion, (which helped me sleep despite the wild ride that
      was the back of the bus), and the view - the longer we drove
      the better it got, as we took a road that lead us deep into
      the rainforest, the last 14 or so km unpaved and very slow
      going for our city bus. the steep cliffs out windows on
      either side juted upward until they disappeared into the
      clouds - the reason areas like the one we drove through are
      referred to as cloud forests. massive waterfalls that would
      dwarf multnomah emerged from the cliffs every so often and,
      as before, the plants grew larger the farther from the city
      we drove, until we looked comparably smaller, as though we
      had been shrunk down like alice when she was in wonderland :)
   
      our stop was at a waterfall you could walk to, for a small
      fee charged by the family who owns the land. we wandered down
      a long set of stairs and the falls came into view. it was
      beautiful. now off the bus and able to appreciate the change
      in climate, I wiped the beads of sweat from my temple once
      before acknowledging that this muggy heat would be my entire
      week, and there was no use in resisting it.
   
      we passed trails of leaf cutter ants, marching their green
      goods back to their nest, where it would be chewed and made
      into media on which the ants grow their actual food... at the
      waterfall there were more butterflies than I have ever seen
      in one place. yellow and blue and zebra stripped, they
      flitted about our group, following each other in trails that
      would dip and rise and twirl one after another as though a
      string connected them all... it seemed like a fairytale
      world, made more convincing by the larger than life plants
      that surrounded us.
   
      upon our long-anticipated arrival to a branch of the amazon
      river, we piled out of our bus, which had attempted to drive
      onto the sandy riverside shore and was now stuck (remedied by
      a little extra horsepower and thankfully without us having to
      push). the group piled into a long motorized canoe with all
      of our belongings, and we were motored upstream to another
      branch of the river, where we unloaded and began the trek to
      the school-turned-rainforest-eco-lodge.
   
      a 15 minute walk through the jungle brought us to the wooden
      structure that resembles a two story horse stable. the rooms
      are wooden boxes, windows on either side, unenclosed by
      screens... that's right, so all the bugs who want to come
      hang out are more than welcome to, including the cluster of
      massive spiders nesting just outside our room. gulp!! I would
      consider this a less-than-ideal arrangement with the local
      insects, which grow to sizes unnatural for even your average
      bird. but here they supersize everything, unfortunately
      including the spiders. the room is so bare there are no
      tables or shelves, only 3 miniature bed, two stacked as bunk
      beds, and all thankfully covered with mosquito nets. we
      'unpacked' or at least set out a few things, already damp
      from the humidity, to dry.
   
      after lunch we set out on a sunset nature walk through the
      jungle, with Robert, a highly educated 22 year old local, who
      we will soon decide, after spending some time with him, has
      several superpowers. among this include spider spotting and
      poisonous frog wrestling. he found us one of the frogs with
      venom it secrets from pores on its back strong enough to kill
      200 people - and the thing is hardly a half an inch long!
      Robert held it, but only briefly, because you can even get
      sick from absorbing the toxin through your skin!! fierce
      little unsuspecting dude, all blue and red and cute looking.
      Robert found us a couple other more benign but equally cute
      frogs as well as a terrifying yellow and black spider that
      ranks among my least favorite rainforest finds. our sunset
      overlooking this branch of the amazon river was gorgeous, and
      we made our way quickly back before it got too dark. they say
      it can get so dark here without light pollution from the
      cities that in the forest you won't be able to see your hand
      in front of your face. the full moon rescued us tonight,
      lighting our way back to dinner - which was delicious as all
      meals look like they're setting up to be, prepared by the
      chef, who we were (jokingly?) told is 15.
   
      pre-bed showers are in outdoor, open-air stalls lit dimly by
      a generator-powered bulb. we have electricity from 6-10pm
      here only; a luxury they offer us so that we can charge our
      cameras and our headlamps don't run out of battery (and
      because we're american and obviously need electricity when it
      is dark ;) ). hot water is, however, a luxury we must do
      without, which is less of a concern given the muggy heat
      here. and I'll happily endure an outdoor shower in cold water
      for the view when you look up - so many stars! from the 3rd
      stall down orion's belt is framed perfectly between the
      gigantic leaves of the trees towering above; this is where I
      shower. they say from here on ecuador, on the equator, we get
      the big dipper (a northern constellation) and the southern
      cross (bet you can figure out which hemisphere this one's
      seen from), simultaneously!! how cool is that?!
   
      I fell asleep to the music of insects and frogs,
      appropriately louder than back home given their
      proportionally larger size. the forest is almost deafening,
      which is nice for drowning out the noise of your neighbors;
      there is no privacy here (many of the windows, include out
      back ones, lack curtains and screens).
   

mitad del mundo

today we journeyed to the center of the earth... how cool is
      that?! turns out we are only a little over an hour's bus
      ride(s) away from the mitad del mundo. I guess way back when,
      some smart dudes figured out where the equator is - pretty
      impressive before they had the tools available to us today
      (which determined the actual location to be 250m from where
      the original smart dudes had built their monument)... so
      today, we first went to the original monument and walked
      around - nothing too impressive - and then strolled down the
      street til we found the museum with the actual center of the
      earth coordinates - really cool! latitude 00*00'00" (note:
      asterisk = degree symbol, my phone isn't that
      competent)...
   
      I guess in terms of longitude, the reason the "official"
      center of the earth is in ecuador has to do with other even
      longitudinal coordinates (like 0 degree, 90 degrees, etc)
      being in the middle of the ocean. and the fact that ecuador's
      elevation at this point makes it the farthest away from the
      center of the earth, even farther away than the top of
      everest - crazy, right? and as a result we all weigh 1kg
      (2.2lbs) less here due to less magnetic forces from the earth
      since we're farther from the center. does this make sense or
      were we eating out of the palm of their hands, believing
      everything they were saying...?
   
      it got better. we were taken to this line that marked the
      equator. our tour guide took a small sink full of water, set
      perfectly on the line, pulled the plug, and we watched the
      water drain without swirling clockwise or counter-clockwise.
      how?!! wha...?! is this real?! so then she picks up this
      little sink and moves it 5 feet south - drain is pulled,
      water assumes a whirlpool spinning clockwise (I think, but
      that's the opposite of what the toilet just did when I
      flushed it to confirm, and now I'm questioning my memory).
      either way, then she moves her sink 5 feet north, pulls
      the plug, and the water clearly spins in the opposite
      direction. magic!! it was really cool...
   
      they had other demonstrations too, like balancing a raw egg
      on the head of a nail - which I did myself after a lot of
      focus. other parts of the tour taught us about the species
      and indigenous populations of the amazon. we learned how to
      shrink heads for goodness sake!! seriously, we saw a shrunken
      head, a real one, over 150 years old. and we learned the step
      by step process by which you too could shrink a head, if you
      had one in need or shrinking. what a wild cultural ritual...
      we saw anacondas and spiders, thankfully preserved and no
      longer alive, given that were all about 300 times larger than
      any snake or arachnid should be, as far as I'm
      concerned.
   
      after hours of living 2.2lb lighter than I am everywhere else
      on this planet, we finally set off for home. 2 packed bus
      rides later and we were back home, eating our final dinner
      with mami Gloria. tomo morn at 6am we take an 8 hour bus ride
      followed by a boat ride, deep into the rainforest. we're
      supposedly extremely isolated, so I am guessing I wont be
      posting blogs until friday, when we're back and I can bombard
      you with stories... wish us luck!!
   
      xo
      linds

surgery!! :)

need surgery? on a budget? look no further than ecuador!

$250-$275 for a tubal ligation (compared to thousands in the u.s., especially expensive if you want it done laparoscopically, which many would argue - and I agree - is a waste of money as the surgery can be done "open" with a single tiny incision and minimal post-op pain, but that is an entirely different story)...

too expensive and still in need of contraception?
IUD - $35 (compared to $500 something in the U.S.)
Implanon - $145 (compared to $400-800 for insertion in the U.S.)

this morning I escaped 4 hour spanish class for a much better alternative. I went with Leah and Emma to observe minor surgeries at a local medical center - lucky me!! we are the only 3 who have gotten to see surgery this rotation, and though we were merely observing, and the morning consisted of just 4 tubal ligations (all 4 completed in less than an hour!), it was very interesting. 

 we changed into our loaner scrubs. Leah was in a massive pair of green scrubs and had a marked resemblance to a lettuce leaf. Emma and I both wore pale pink scrubs reminiscent of the mother baby unit, or maybe an easter bunny costume? what I'm getting at is that we looked good ;) especially when you added the scrub caps we wore as shoe covers because they were out of the shoe covers... make due with what you have; and boy do they ever take that to heart here, it is impressive!!

we entered the tiny OR and tried to stay out of the way while they prepped. the patient walked in and climbed onto the table - in contrast to the u.s. where patients are wheeled in on their designated beds and shifted to the OR bed... she lay wide awake and completely exposed (apparently respectful drapping of your patient is not a priority here), while the physician scrubbed in a far less than sterile manner. I had to hide my cringe and bite my tongue - this is his OR, his sterile technique, and his patient outcomes (which I would be very interested to learn about - rates of infection, tubal ligation failure, etc)...

the surgery began with the patient wide awake and the anaesthesia tech struggling to get prepped. the surgeon had already pulled the fallopian tubes into view when the first bit of sedative was given. the poor patient had been wincing and crying and sweating from the pain of the surgery thus far only with a little bit of local analgesic. we watched her heart rate and bp pick up on the monitor as he dug deeper into her pelvis. we were all relieved with the white sleepy milk was finally injected into her veins and she drifted off. 7 minutes later she was sterile, closed, and with the dressing in place, she was wheeled out of the room... 

the three of us gringas made to leave the room to allow for the turnover (cleaning). not necessary. we watched in dismay as one tray of surgical tools was dragged off the "sterile field" and another was set down in its place... the surgeon, wearing the same gown, simply replaced his own sterile gloves and his assistant did the same. no. way. the bed was not wiped down, the face mask for oxygen unchanged. is this allowed?!

the second patient was in the room moments after the first was wheeled away. 7 minutes later and they were asking for the 3rd patient... I was troubled by more than what I've already mentioned. importantly, when the medications were injected and the patients drifted off, their breathing was always compromised for a few minutes before anesthesia got the oxygen mask on and the O2 sats back up to normal... it stressed me out watching the saturation dropping from the high 90s to to the 70s...even 60s! it made me equally anxious the way they would recap needles, just asking for an accidental stick! I didn't like when the patients were clearly still awake and suffering, struggling against the arm restraints in reaction to the pain. I didn't agree when he explained to us, with the patient still awake, that because she was so fat he had to make a bigger incision. 

 it smelled familiar, like the ORs I love back home - oh how I welcome the smell of the cautery :) associated with the happiness of what I am excited to do for the rest of my life!! It sounded familiar enough, the bleep of the vitals monitor, the quiet conversation, the focus. but it looked so wrong. the sterile field hardly existing and the drapes tattered and faded. I glanced at the clock on the OR wall, it was stuck at 1 minute before 4 pm, the second hand twitching in time but moving nowhere... 

this is the 4th country where I have observed surgery and I thought it wonderful despite the many apparent shortcomings to eyes from a place so different. the thing is that my education has taught me to value evidence-based medicine, and as a result I couldnt help but correct each step of the surgery in my mind, making improvements in skill and efficiency as I have been taught at OHSU.

interestingly, the surgeon did the cutting and the identifying of vital structures, but nothing more. his female assistant, not a doctor or trainee, did all of the sewing. compared to my experiences in africa, this was impressive surgery. compared to the artists I observe and have the honor of assisting in the u.s., this was barbaric. oh the contrast, it is all relative I suppose.

what an interesting experience... and wow do I miss the inside of the OR.

just another day in paradise...

after my suerte (lucky...?) manana and once my sapataos (shoes) and the rest of my body was clean of pajaro poo, we continued on to the medical museum. there we were split into two groups for a tour. unfortunately it seems our group drew the short straw and ended up with a tour guide who spent the first 20 minutes talking about a religious painting outside the museum. once we got past that, he spoke in great detail about a few minute objects at the entrance of the museum. at the rate we were going our tour could easily have lasted for 9 hours, but dr. w has us on a strict schedule and as a result we learned a lot about a little and very little about the interesting lot in the back 40 of the museum. i do know that we saw ecuador´s first ekg machine, which was pretty awesome. there was a lot of old medical equipment - amazing how far we´ve come!! the other group said they learned a bunch about the history of the objects there. for example, a ton of medications in antique bottles of all colors that apparently havent been opened for 150 years. these were on display, for our group, solo a photo op. despite the shortcomings of our tour it was still very interesting... to us, at least :) i wont bore you with the details (you´re welcome)...

we spent our afternoon at the market picking up some last minute gifts to bring home. i could decorate my entire house with the beautiful blankets, table cloths, artwork, and other decorative things here. and the alpaca everything is amazing!! incredibly soft and accordingly expensive. we leave for the rainforest this coming sunday and are there through thursday. when we return to quito, on friday we basically have a farewell dinner and then people begin to disperse home. this trip is flying by!! it feels like just yesterday we were noting our halfway point and now we´re almost down to one week!

our plan yesterday evening was to attend a cocktail making class held at the school where our spanish classes are. unfortunately there was some miscommunication about the timing and our spanish class overlapped with drink making class (bummer) and as a result we missed it :( despite my attempts to suggest we just combine the two ;) so instead we spent our evening hunting down a grocery store. note to self: 6pm is the wrong time to go to the grocery store in quito - the place was packed!! and though there were endless lanes that could be opened, only a handful were actually open, and as a result the checkout area was a series of meandering lanes of carts extending into the isles of the store and all piled to the brim with rice, oil, strange plants, and other ecuadorian diet essentials. if i didnt know better i would say either one of the volcanoes was about to blow and people were stocking up accordingly! that, or the zombie apocalypse was about to hit and we were out of the know... which is a definite possibility here in ecuador where lo, anne and i are still struggling to communicate - though we have made vast improvements in the past 3 weeks.

we made it home for dinner, delish as always, and spent the rest of our evening watching part 2 of the 4th twilight (yes, our second attempt at bootleg video purchasing was a total success!). crazy night for us :) oh, and cant forget spanish homework, which definitely reminds me (as if dr. w doesnt already say this enough) that this is a rotation, and not vacation.

no sh*t?!

this morning, no 4 hour spanish class - thank goodness, my brain hurts!

instead we walked from home to the hospital/medical museum/medical school in quito. on the way we stopped at a park near our house to take some photos of these beautiful tile horse statues. we were wrapping up and as I swung my backpack around to put away my camera I felt a massive impact on my right shoulder/arm and right shoe... I was confused... something... warm? wet...? I looked down and realized what I already knew, I had been pooed on by a... wow that is a lot of poo!! it must have been a... condor? ;) likely, judging by the quantity of the feces.

lo and anne saw the expression on my face and went from puzzled to cracking up as they realized what had prompted my reaction. 'let me take a photo, then you can have some tissue' I heard lo say. I was trying to evaluate the mess. somehow, in addition to the poo all down my right arm, there was also poo on my left arm - splatter? and my right shoe was clearly covered, a direct shot! this bird was definitely aiming. but somehow, given the volume of the poo, when the rest hit the ground around my feet it splattered up onto both of my legs. yes, you are reading this correctly. one bird (or it could have been a flock for all we know), managed to poo on all 4 of my limbs... simultaneously.

now if that isn't lucky I don't know what is! :) fortunately we were so near our casa it was easy to run home, change my poo covered outfit - yes, it also got on my shirt and jacket too, and wash all of my limbs... thank goodness the backpack and my head were miraculously spared!!

maybe I shouldn't have mentioned so often how much I like poo... what a way to start the morning!

mascota

foreword: mascotas = pet in spanish, not so much a school
      mascot (like a person from the u.s. might image)... so in
      spanish class today when I was asked about my mascota when I
      was younger, I insisted to the teacher that my mascot was a
      lion... she was quite alarmed, and I didn't understand until
      she asked if I also had I had a pet cat or dog in addition to
      my pet lion, at which point I caught on that maybe mascot did
      not mean what I thought it meant... oh the joys of learning a
      foreign language.
   

      so to be honest, I don't have a whole lot more to say about
      today. we are in our routine and learning a lot!! 4 hours of
      spanish in the morning without a word of english; regain our
      strength in the early afternoon (nothing too exciting today);
      then two hours of spanish with the occasional english to
      clarify such confusing things as the meaning of the word
      mascot. we walk home and enjoy whatever amazing dinner is
      waiting: always sopa (soup, not to be confused with soap) of
      some sort followed by rice and a veggie/meat dish - tuna with
      tomatoes and a delish dressing today. no dessert in this
      household so we have our post-dinner tea, manzanilla with
      honey, incredible!! (we're going to try to find some to bring
      home)...
   

      one thing before I end this notably dull blog (my apologies,
      at least it is short)... I have to mention something I'm
      fondly (or maybe not so much) going to refer to as the ecua
      stroll. you see, as is the case in many of the other
      countries I've visited, the people here meander slowly down
      the street or sidewalk. a stark contrast to the ever-hurried
      american trot; always rushing somewhere!! here it is as
      though people put a great deal of effort into slowing their
      pace to that speed just abutting reverse, and believe me when
      we get caught behind these people on the sidewalk it takes
      everything in me not to plow them over. and when I manage to
      slow my pace to match theirs, while I wait for an opening to
      pass, I feel as though I am moving in slow motion and I
      cannot comprehend how it doesn't exhaust them to maintain
      such an excruciatingly sluggish pace. I think it is worse for
      me and lo, used to chasing surgeons around the hospital - if
      you're unfamiliar with the group, they're a speedy bunch,
      which is great for me! and all the more reason why I find the
      ecua stroll physically painful. who needs to stop and smell
      the roses when the air is filled with their aroma?! the
      faster you walk, the more hits your olfactory bulbs, am I
      right? from their point of view I always imagine them judging
      us right back when we whisk past them, our pace unnecessarily
      frantic from their perspective - silly americans rushing for
      what? often nothing at all... it is a cultural difference
      that I find amusing more than anything, unless I am in that
      moment when I am forced to ecua stroll, and then lo and I
      give each othe the eye roll and wait impatiently for a place
      to pass. I've got places to be!! :)