Boy, I did NOT want to get up Thursday morning. The three days of clinics had finally caught up to me and despite getting a good 8 hours of sleep I was quite unwilling to stir at 6 a.m. I made it til 6:15 before the chorus of unanswered travel alarms that get louder and more irritating the longer they go unanswered just wouldn’t let me slumber any more. (Did everyone get together and agree to buy the same maddening travel alarm?)
Not even coffee at breakfast had much effect at waking me up. While at breakfast, I also discovered that the shirt I had worn—the allegedly fresh clean, though still slightly damp shirt from my wash the night before—was not in fact fresh nor was it clean. It was down right sour-smelling. Turns out only the first t-shirt I washed really got clean, while the other shirts, shorts, socks and undies I’d washed afterwards were contaminated by the stinky water from the clothes before them and had not been rinsed properly. I couldn’t face being stanky all day, so I had to run change shirts before we left.
We drove back to Pasaco for the week’s final day of clinic. There was already a huge crowd gathered outside the Palacio and we could barely get through the doors. Evidently, the mayor of the neighboring town had been true to his word that he was sending everyone he could.
I’m sorry to say that my mood didn’t really improve once we were in the pharmacy and the clinic got underway. I wasn’t so much cranky as just very lethargic. After a bit, I realized that I was probably dehydrated. I usually slept with a bottle of water at my side in case I needed a drink during the night. Unfortunately, at some point the previous night, I’d rolled over and knocked it over the side of my bunk and possibly down onto Andrew’s head. I’d not had much to drink since, save for the coffee at breakfast, which doesn’t count because it’s a diuretic. After that discovery, I start chugging water and within 10 minutes I felt back up to speed.
Instead of David or Whitney as our pharmacy assistants, we had Jenna. She’s from New Jersey and is enrolled at Word of Life’s New York Bible Institute for a year-long program designed to help prepare her for the mission field. About the only thing I knew about Jenna was from her testimony at our evening meeting the night before and from Dr. Allen, who told me that she speaks fluent Hebrew. We were all terribly impressed that a young lady like herself would have gone through the amount of work necessary to learn Hebrew, a phenomenally hard language to master. Then we found out that while she had done all the work to learn it, she had done so over the course of her entire life, as one of her parents is Jewish and Jenna had spent a lot of time at Hebrew School. She was still a smart cookie and a quick study in the pharmacy. We were glad to have her along.
For most of the week’s clinics, Jenna had been helping the missionary staff with witnessing. I think there may have been some trade-off on Thursday, though, because one our team members from West Virginia, Larnie, went to help with the missions. One of the gospel sharing techniques was to use a beaded bracelet that worked to tell of Jesus’s sacrifice exactly the way the wordless book does. By the end of the day Larnie had heard the gospel explained this way in Spanish so much that she’d memorized it and was able to start reciting it from memory to the people she witnessed to. And with great results.
As for the pharmacy, we were far busier than on any other day that week. There was very little down time at all throughout the day and the three of us and Esdras were kept hopping. Unfortunately, Esdras had caught a cold somewhere along the way, no doubt from germs on the patient histories he’s been handling for three days now. The rest of us have been hand-sanitizing like fiends, (particularly after coming out of the mayor’s bano), but I don’t think Esdras had very much. The cold was also slowly making his voice go hoarse. I’d been feeling pretty invulnerable to contagious illnesses, because I’d just gotten over a nasty cold a couple of weeks before we left and figured my immune system was pretty strong. I feel bad that we didn’t take more precautions with Esdras and the other vital support staff.
In the morning, we got a prescription from Dr. Lally that called for a medication to be cut into a dosage of 1/8 of a pill. We could see from the patient’s history that it was for a baby of only a few months age. It would be important to give such a tiny dose, but I didn’t think we were capable of cutting pills that small. Mary Ann’s pocket knife was no longer very sharp and had been smashing pills up as we just tried to cut them in half. And our pill cutter was no good either, since it only worked on round pills and these were long pills.
I’m sorry to say that my reaction to this problem was to become intensely frustrated. I was mad that yet another doc was asking us to do something that was beyond our means, expecting us to react like real pharmacists would. Mary Ann suggested I go ask Dr. Lally what we should do, since we weren’t able to fill the prescription as written. Dr. Lally said that she couldn’t give the child any more than 1/8 of a pill. She asked me what I thought we could do about it.
Let me make sure you read this correctly: The doctor was asking me my opinion as to a medical matter. I, of course, had no idea, but the fact that she was asking me, in all seriousness and as though she believed I did have a clue, just floored me. To paraphrase Jack Nicholson in As Good As It Gets, it made me want to be a better fake-Shemp-pharmacist.
I admitted to Dr. Lally that I was stumped. The only solution she saw other than cutting them was to crush them up and make a suspension liquid with them. However, not being even a fake chemist, I had no idea how to do that either. I figured Mary Ann probably could, but it didn’t seem like a very appealing solution. My mind suddenly felt convicted that I hadn’t even attempted to do what had been asked of me before coming up to whine about it. So I told Dr. Lally that I would go and make the attempt to cut the pills into 8ths and if I failed I could always smash up all the bits and find someone to help me make a suspension with them. And the thing was, when I went back to try it, I was entirely successful in my pill-cutting! I just cut the pills in half, then that half in half, then each fourth in half. It was actually quite easy and the knife didn’t smash any of them up at all.
It was just one more sign that I hadn’t quite learned the lesson of what medical mission work is all about. We weren’t all there to do jobs we already knew how to do. Only a few of us were in that position, and even they were called above and beyond their training on occasion. What we were really there for was to do the best job we could at the task assigned us and to seek help when we couldn’t. I had just reacted to the problem as though it was something not in my job description. I forgot that on a trip like this, there are no solid job descriptions.
Ashley and I got to go to lunch together again. She said she was starting to feel tired of hearing the same complaint from nearly every patient, which was, “I have a headache, I feel bad and it hurts when I pee.”
Through her translator, Ashley would ask, “Are you drinking enough water?”
“How much water do you drink per day?”
“Five big glasses?”
“Oh, no. Five little glasses,” they, to a person, would say, indicating something the size of an orange juice glass. These are people, mind you, who walk nearly everywhere they go, in the hot sun, and often stand all day long, in the hot sun, selling fruit.
“You have to drink more water!”
“More water?” they would ask, as if such a thing were impossible.
“Si! Mas Agua! Two liters a day!”
At lunch Ashley told me, “No wonder it hurts when they pee. They’re peeing solid crystals!”
Our lunch was much more in line with what we were looking for on Thursday. Once again we were served tortillas and refried beans, but we also were given fried chicken, fruit and salad. There was also more of the local soft cheese and sour cream, which I smeared on tortillas with beans and a firey green chili sauce, which I hoped would kill off anything unpleasant in the food.
I’m not sure that it did.
That afternoon my stomach began feeling a bit odd and upset. Nothing I could really take offense about at first, but I could tell it was the sort of thing that was slowly building toward a climax and I just hoped that climax would occur some time well after we got back to camp. Coincidentally, the mayor’s bano chose that moment to stop working altogether. The water in the sink refused to run, the toilet wouldn’t flush and in fact seemed to have been clogged with toilet paper! Now you KNOW the locals hadn’t clogged the toilet with paper, so it had to have been one or more Gringos. And even though we all knew better, I imagine someone had simply forgotten the rule about dumping your soiled paper in the little bin by the commode and then been too squeamish to reach in and fish it out. Either that or they noticed that the little bin by the commode hadn’t been changed in a couple of days and was now quite full and quite foul and had no more room for ANY soiled paper. The interior of the toilet bowl itself was a sight I shall spare you all the details of, except to say that horrific is a word that came immediately to mind. Eventually, the attention of someone in power at the Palacia was called to this problem. They came and had a look and seemed pretty horrified themselves. Then they went away (some say fled), declaring the mayor’s restroom to be inoperable.
These were omens that did not bode well for the tempest that continued to rage in my gut for much of the afternoon. I hoped and prayed I could make it.
Alyssa was back on the job, but had begun feeling ill again as well. Ashley told me later that Alyssa had come to her station at one point to ask if there was anything Ash could do to help her. Ashley talked with her about her symptoms and decided to try some more manipulation techniques. The trouble was, everything Ashley did made Alyssa aggressively more ill to the point that the girl turned green and threw up.
Around 3:30, I realized I wasn’t going to make it. The gut-tempest wanted out and not through the front door. I also knew there was no way I was going to use the Mayor’s bano if I could possibly avoid it. The only other option I knew about was the bano across the main hall, in the heart of the dental team’s territory. Only the sign on the door was flipped around to read OCCUPIED. And it stayed occupied for ten grueling minutes. My stomach ached terribly and I finally decided that I would go and knock on the door on the off chance that someone had actually vacated the bano and just forgot to turn the “Occupied” sign back around to “Vacant”. I went across the main hallway and to the bano’s door. I then realized that even if I knocked I would never hear a response because the dental team had chosen to store their air-compressor in that bano and it was currently making loud farty sounds of its own at a very high volume. I knocked anyway and waited. No response but the compressor’s roar. Then, preparing to avert my eyes at the first sign of an occupant, I opened the door. It was blissfully vacant.
Once inside the bano, I saw why there was a need for an Occupied/Vacant sign. This bano also had no handle on the inside of the door other than a piece of vinyl twine. Did no bano in this building have a lock? I wrapped the twine around a nail and hoped it would hold should someone attempt what I just had. I then proceeded to sit down to, er… “release the tempest,” as it were. Let me just add that I was eternally thankful that the near deafening compressor was in there, for it was drowning out any unpleasant noises I was making.
After that I felt much better.
Thursday afternoon, I returned to giving out pen-lights to kids. I saw one little boy who didn’t have any toys at all and flashed the light in his direction. He jumped back, as though it were a laser. I blinked the light at him a couple of more times and passed it to him, then showed him how to flash it himself. He dashed away and soon returned with his little sister. The sister was too shy to ask for a light, but I gave one to the brother to give to her and she grinned at me. Soon they had another friend and I gave him a light too. A little while later, the first little boy came over and gestured to me to lean over and whispered something to me in Spanish. I tried to tell him my standard reply in such situations, “Hablo mui piquito Espanol” (I speak very little Spanish). He said it again. This time I heard him say something about “caro.” I gestured for him to say it to Esdras, who listened and then told me, “He wants to know if you have a little car.”
Did I have a car? Oh, boy did I ever. I had only brought my own personal collection of Hotwheels cars, which amounted to four or five toy cars that I’d had since me and my friends used to use them to play the Car Wars card game like big nerds back in college. I’d brought them for just this purpose. I told the little boy “Un momento,” then dashed into the pharmacy for my backpack. Unfortunately, I’d neglected to transfer the cars from the pocket of my carry on bag into the backpack, so I didn’t have any with me after all. Surely someone in one of the other clinics had a toy car somewhere. I gestured for the boy to wait there again, then zipped from clinic station to clinic station looking for toy cars. I found toys of every shape except that of a car. ARGH! I hated to do it, but I had to return to the little boy and say, “Lo siento. No caro.” I expected the little boy to be crushed by the news, but he just grinned and went back to his friends. I would have loved to have given him one of my cars. Unfortunately, I would be giving no children cars on this journey because of an inconvenient rip in one of the vinyl side pockets of my carryon duffle bag. I had tried to duct-tape it shut before we left the United States, but the tape had not held. All of my cars had evidently been in that pocket and had fallen out during their journey from America. I imagined that at that moment, the child of a baggage handler somewhere was probably playing with the really wicked-sweet toy car daddy found on the tarmac. (And his infant brother was probably drinking our Enfamil!) That was fine. As long as someone’s kid was enjoying them, it was okay by me.
That afternoon, not long after my adventures in the bano, we were paid a visit by a former patient from the day before. I had gone to ask Dr. Allen a question in his clinic room that he shared with Ashley and Andrew. I hadn’t yet asked my question when one of our translators, Astrid, came in accompanied by a local woman who was carrying a plate of tamales. The tamales looked exactly like tamales should: little warm packages of dough and meat and spices wrapped in honest to God corn husks. And she’d then put each corn husk-tamale in a sandwich baggie; a whole plate of them, piled high, piping hot and smelling wonderful.
Astrid got everyone’s attention and then said, “This is one of our patients from yesterday. She was so happy that we helped her that she baked this plate of tamales to say thank you to us.”
We all stood there, staring at the tamales that we really wanted to, but didn’t dare, eat. They had almost certainly been prepared with local water and were possibly microbe ridden. I was especially wary, being as how I’d already had one potential run in with microbial results less than an hour earlier. No one moved. The lady continued to stand there, holding her plate of hot tamales and smiling at us. She didn’t speak a word of English. Astrid continued to smile widely at us, through slightly clenched teeth, and reiterated, “She brought them for us to have to say thank you for helping her.” Her smile then became tighter and teeth more clenched and she began nodding at us as she spoke. “So we should ALL. TAKE. ONE. Since she spent time making them for us.”
It then occurred to us how extremely rude it would be not to take one and that we didn’t necessarily have to eat them even if we took them.
“Gracias! Gracias!” we all said, lining up for a tamale.
Ashley ate hers right away. I was far more hesitant, considering my stomach, but I held onto it.
Despite the fact that we saw far more patients than the day before, we actually finished up clinic earlier than expected. Our last patient was out by 6:15 or so and then we were able to pack up the pharmacy. This was a little frustrating, because my brain had, as usual, stopped working so well a couple of hours before and so I couldn’t really focus on telling all the people that kept asking how they could help what to do. This didn’t make them stop asking me, though, so I began getting grumpier and grumpier until I just shoved a bag at them and told them to start stuffing it with supplies. To their credit, they were all very patient with me and didn’t seem to take offense at my less than polite behavior. None of them were any less tired than I was. Before we’d gotten everything packed up, the chief of police returned to reclaim his office. He surveyed the rearranged furniture and occasional stray pills, as we did our best to clean up our trash and haul away our things.
All that we needed to do now was wait for the dental team to finish up. Since they had long since run out of local patients, they had offered to do dental checkups for any of the Guatemalan staff who wanted one.
Outside, I sat with Esdras on the Palacio’s sidewalk. I’d been dreading this moment for a while now. See, it’s a mission tradition to bring thank-you gifts to give to your translators. However, I had not brought anything with me that I thought was particularly suitable. Oh, sure, I’d brought a WV University t-shirt and had even considered giving away my watch. However, I’d managed to get Deet bug-repellent on the watch, which had eaten away the its lettering and permanently scoured the surface of its face. (It was a pretty cheap watch to begin with, too.) And the WV t-shirt was about three sizes too big for Esdras’s slight build. I just felt awful that I didn’t have anything approaching adequate to say how thankful I was at having had him there to translate for us. He’d been superb at the job and deserved more than a crappy watch or a tent of a t-shirt. In the end, I decided that I would get his addresss and send him something nicer. I still wanted to give him something then, though. I decided I would instead give Esdras my own stainless steel penlight. I explained that it too was inadequate to express my thanks, but it had served me well while I’d owned it and would hopefully serve him well too.
Esdras and some of the other translators soon ran off to play basketball. They invited me, but after my gut-wrenching afternoon I didn’t know if I could stand it.
After learning that Ashley had eaten her tamale from earlier to no ill effects, I opened mine and ate it. It was cold, but it was very very good. We then stood there talking to some of the other mission team as we watched the full moon rise above the square. We had just been in a long discussion of how it’s a proven phenomenon that strange cases always arrive in Emergency Rooms during a full moon, when I happened to glance over and saw that there was a man standing close to Mary Ann and Dr. Allen who was the creepiest dude I’ve seen in a long time. He was wearing what appeared to be dress-pants and a white button up shirt, but his face screamed Asylum Escapee. He looked menacing and angry and curious all at the same time and just stood there staring at us as we continued to chat. I was a little afraid he might go for Mary Ann’s neck and was wondering what I would do if he did. He didn’t. Instead, he wandered off toward the Palacia where Dr. Lally was giving out candy. Soon after, he wandered INTO the Palacia itself. Evidently this creepy guy either had an in with the police or he was just too crazy to care.
The Dental Team was still hard at work when Marcello told the rest of us to load up and head out cause he was taking us back to camp. On the way, he announced that the camp had purchased a new transformer to accompany the new water pump and it had been installed. This meant that that night we could have all the A/C we wanted. We were nearly moved to tears at this news. Even better was when we reached camp and I walked into our cabin to find that someone had already turned both air-conditioners on full blast and the whole building was little chunk of sub-arctic heaven. Whenever anyone walked through the door, their immediate reaction was to stop in their tracks, grin and say, “Ahhhhhhhhhhhhh!”
We were back a good hour before supper was to be served so I figured it would be a fine time to revisit my laundry needs. Since I’d only done a small fraction of my laundry the night before, and poorly, I figured it was time I did it up right.
I went down to the kitchen and borrowed a bucket, then went back to the cabin and dumped all my filthy clothes into it. My Woolite was still lying atop my bed in its former water-bottle home, so I grabbed it and the bucket, then headed for the bano. In one of our shower stalls, I poured water into the bucket, then added a little Woolite. Ashley had told me to use only a little Woolite when washing as a little of it was supposed to go a long way. However, this Woolite wasn’t producing many suds. I added the rest of the bottle and it still wasn’t making any suds at all. Stupid dud Woolite. I figured, though, that I probably just had too many clothes in the bucket or something.
So I’m washing and washing and no suds are happening and therefore, in my mind, my clothes are getting no cleaner. I finally went and got my bar of soap and chunked it into the bucket too. That got me a few suds. I sloshed and washed the rest of the clothes and then rinsed them out under the shower nozzle. I then took them outside and hung them on the warm concrete steps to dry during the night. I was feeling pretty good about the whole process and was safe in the knowledge that my laundry was now all done. That’s when I went back to the cabin and found that my REAL water-bottle full of Woolite was still resting atop my bed. That’s right, I’d grabbed the wrong water bottle and had actually washed my clothes using only WATER instead of Woolite.
At camp that night, we ate very well. We’d had a full four days of clinics and we were now finished with it and had two days of more leisurely activity ahead of us. We were ready to relax–or as our fearless leader Rick Brooks put it, “unlax.” Our food was authentic local cuisine as prepared by the fantastic kitchen staff. It was laid out buffet style and we all got in line quick.
Ashley and I sat down to consume our grub. Emilio and two other members of the local missionary staff joined us. No one talked much, but this was mostly due to the fact that we were too busy stuffing our faces and not so much that we didn’t speak the same language. Through a complex series of sign-language moves, Emilio indicated to me that the food we were eating that night was the real deal, unlike what we thought had been good food back at the cocina in Pasaco. I was hard pressed to argue. Though Emilio didn’t speak much English, I’m pretty sure he understood a lot more of it than I’d given him credit for earlier. As we wound up our meal, he listened to Ashley as she retold to some of our tablemates her earlier complaints about her patients not drinking enough water he and nodded and laughed along with us. The other two guys at the table spoke even less English than Emilio, but they seemed to want to share in the fun too. At one point, I think they heard us speaking about the fact that none of us had thought to grab any water on our way from the buffet line and now it was all gone from the beverages table. Our two tablemates got up and went to the camp’s cooler and returned with water bottles for all of us. Once again, I’d misjudged the skills of the locals. We thanked them with a round of graciases (probably the most used Spanish word of the week). While none of us spoke very much of the other’s language, it was a good time to just hang out together.
Rick and Butch and Marcello took the floor and congratulated us on the clinics we’d accomplished and began telling us what they had planned for us for the next two days. On Friday we would be sleeping in and breakfast would not be served until 9:30a. This received a cheer from all sides. Then, many of our translators and missionary staff would be leaving for Guatemala City to spend Good Friday with their families for Holy Week celebrations. This received sounds of disappointment from the Gringos. We didn’t want them to leave. However, it was explained that Holy Week celebrations were similar in nature to Thanksgiving for us, and it was a time for families to gather and celebrate together. The fact that so many of our team would be leaving made me feel even more guilty that I had not sat with Esdras for dinner that evening. This would be one of the last times we’d get to see each other, barring future mission trips. I think a lot of the American side of the team came to a similar realization at that point and the mood of the group darkened a little.
Marcello continued with our itinerary, saying that after breakfast we would drive to Antigua, where we would see some of the elaborate and internationally reknowned Holy Week festivities. A trip to Antigua had been discussed earlier in the week, but it had been felt at the time that the city would be too busy to be able to get very close to the heart of it, so it might not be ideal. Now it seemed thoughts had changed on the matter. I think the trip itself was good enws for everyone, just not as good news as it would have been if everyone were going.
It seemed like things were turning into a downer of an evening, so I decided to try and liven things up. We’d reached a portion of the evening when many of the team-members were speaking to the group about their experiences during the week, so I signaled Marcello and Butch that I had one to share too. Soon they brought me up and, with Marcello translating, I told the tale of my misadventures with the Woolite. It was not something I’d planned or rehearsed, but I’m a good speaker and know the basics for timing such a story. It was a much more condensed version than my account here, because I could only tell little bits of it before those bits had to be translated. However, it was kind of fun to get to the punchline of the story, (“And there… on my bed… was my real water bottle full of Woolite…”) and get two sets of laughs, once when the Americans heard my version and again when the locals heard Marcello’s translation.
After this, Marcello explained to us that the Guatemalan team wished to give us a each a small gift to remember our time there and thank us for the work we had done. They brought out hand-carved wooden clocks with the word “Guatemala” carved into on them.
We heard a number of the Guatemalan staff speak that night, telling us how much the mission had meant to them and how happy they were to have been a part of it. It made me proud all over again that we were able to join with the national team and accomplish something bigger than ourselves.
After the meeting had adjourned, one of the two mission-staffers who had brought us the water earlier came up and handed me some money. It was a bill worth twenty cordobas, which is the currency in Nicaragua. He began speaking to me in Spanish, but had gone far beyond my limited translation abilities so I asked Astrid to come over and translate. She said his name was Fernando and he was from Nicaragua. He wanted to give me the money as a souvenir from his country. I thanked him and accepted it. Only after we’d spoken a bit more and said good night did it occur to me that I could have given him a souvenir bill in return. Granted, I didn’t think that 20 cordobas came anywhere close to equaling 20 dollars, but perhaps I had something equivalent. I tracked down Marcello, who was speaking to Rick, and explained that a staffer had given me 20 cordobas as a souvenir and asked them how much the bill was worth. I should have phrased my question better, I think, because they seemed to take what I’d asked as though I wanted to know how much it was worth so I could go trade it in for that amount of dollars. They, in turn, had to “break the news to me” that the bill was probably only worth 20 cents and that I wasn’t getting rich off that.
“No, you don’t understand,” I said, a bit peeved that I’d not been clear. “I don’t care how much it’s worth. I was just asking so I could trade an equivalent amount of dollars back as a souvenir.”
They gave me the perplexed look again and shrugged, so I figured it was just best to walk away. I didn’t have any small bills and I didn’t think handing Fernando a quarter was very nice.
There were plenty of activities going on that night: Butch had set up his laptop’s DVD player to show movies and there was talk of a Gringo Vs. Locals (locos) basketball game. I didn’t want to stay up for any of it, though. I wanted to head back up, get a shower and crawl into my semi-dusty bunk for some shut-eye in our hopefully freezing cabin. And this I did.
GUATEMALA CLINIC DAY 4 STATS
Patients Seen: 498
Prescriptions Filled: 451
TOTALS FOR THE WEEK
Patients Seen: 1983
Prescriptions Filled: 1752