a week in America's unhappiest city

Business week ranked Portland OR the unhappiest city in America.

http://images.businessweek.com/ss/09/02/0226_miserable_cities/2.htm

Who could be depressed when there is all of this do to in the city and state

 Thanksgiving day Turkey trot

Jake playing spiderman

Riley and Wilco.  Do you see that mischevious look on Riley's face.  Yep, she woke up Wilco and this was the only photo she was willing to pose for. 

the beautiful Oregon coast

jump roping with seaweed on the beach

indoor football for the boys

It may have rained almost everyday I was in Oregon, but that didn't stop us from shopping, playing in the yard, exercising, watching movies, eating, and playing games. 

According to this link

http://www.neatorama.com/2010/02/16/the-happiest-and-unhappiest-cities-in-america/

 I'm headed back to the 4th happiest city in the America.  With finals looming 2 weeks down the road, I'm not sure that I'm going to feel the happiness bug for a few weeks....

seeing Mick made my day a little bit happier....

 In April, I saw this article in a news pop-up on my computer. 

http://www.walletpop.com/blog/2010/03/30/in-unhappiest-u-s-city-one-man-spreads-joy/?icid=main%7Chp-laptop%7Cdl3%7Clink3%7Chttp%3A%2F%2Fwww.walletpop.com%2Fblog%2F2010%2F03%2F30%2Fin-unhappiest-u-s-city-one-man-spreads-joy%2F

Prior to clicking on the link, there was no idication that the article would be featuring Beaverton Oregon, my hometown and a street less than a 1/2 mile from my house that I travelled daily while growing up. 

I don't travel to Portland very often but I came home for the holidays and saw Mick in action standing on the corner in rainy 30 degree weather. 

(ps-it is illegal to talk on your phone while driving in Portland, OR but I have not heard that it is against the law to snap photos with your phone while driving)

Forecasting Winter...

SALT LAKE CITY -- The KSL weather team has been warning us for several days now: "Say goodbye to fall. Winter is on the way."

Based on this most recent news update--here is my tribute to FALL, because I for one am not looking forward to winter. 

FALL highlights up PROVO CANYON. 

1. Learning to fly fish...okay, being taught to fly fish.  I cast a line that did not have a hook on it and then took photos while my friend cast with a fly.  I would not say I really learned how, though I had an excellent teacher.  I didn't catch any fish.  You need a hook and a permit to do that, of which I had neither. 

2. Biking up past Southfork on a crisp autum morning. 

 

 3. Hiking Stewart Falls with a few other girls from the nurse practitioning program.  A much needed distraction between class and studying. 

I'm not ready to say good bye yet, but at least I've enjoyed it while it lasted.

Your future health care....

Is in our hands.

Don't worry--we still have 22 1/2 month to go before they let us loose. 

it RUNS in the genes

Growing up, Julie was always the athletic twin.  She played basketball, soccer, ultimate Frisbee, etc and I happily stood on the sidelines and cheered her on. 

When we got to college, we started running together.  Together meaning, we started together.  She would quickly pick up the pace, run a few blocks ahead of me and then circle back around to meet me only to get a few blocks ahead again and circle back around.

Since then, I've overcome my fears of running = bulky legs and can actually keep a decent pace with Julie.

In June we ran the wasatch back relay together...

This was our 4th year running it.  3rd time running it on the same team. 

In july, I ran the Hobbler 1/2 marathon down Hobble Creek Canyon in Springville Utah.

 

I surprised myself and ran a personal best at 137:19.

That's 7:26 min splits! For 13.1 MILES! I had no idea I had that kind of speed in me. 

And to top it all off, I came in first for my age division.  

 

Last week, Julie ran the St. George Marathon. 

She qualified for the Boston Marathon running a 3:38. 

And I happily stood on the sidelines cheering her on just like in the good 'ole high school days :)

Fall Only Comes Once a Year

I love Fall, but with school I have not had a chance to enjoy it as much as I would like.  Last year I was a "leaf peeper."  I ran off off to DC and Boston with the sole desire of being out there in the Fall to see all the beautiful colors.  So when Ryan called me late Monday night about hiking first thing Tuesday morning it was hard to resist. 

But when the trail head started like this:

I should have know that I might be getting myself into a hike that was harder-or more rugged--than I anticipated.   According to the hike guide printed off the Internet, we needed to cross the river at a bridge.  That pipe was the only "bridge" we could find. 

But who can say no to this:

OR this???

Me either.  But in case you were worried, Ryan did pack along a helmet for me.  I'm not sure why.  Maybe because last time we went rappelling in June down in Zion I managed to flip upside.  Thankfully, the backpack I was wearing took the brunt of the hit from the rock wall and not my head.  But it was probably the weight of the backpack that caused me to flip backwards.  Go figure.  My head was definitely safe from any danger on this hike, but my body temperature dropped a few degrees as the sun decided to stay hidden behind clouds most of the day while we descended through a beautiful, yet frigid waterfall. 

And maybe I did pray once or twice that I would a) not slip as I descended down the waterfall with rocks covered in moss that offered very little in the way of traction, and b) not freeze before making it down because for a while there I couldn't feel my feet and that doesn't help with getting your footing on uneven ground. 

And since I'm writing this, you know that I made it.  And despite everything listed above, it was a great hike on a beautiful Fall day with fun friends.  I always love finishing something that is hard-something that I doubt in my capabilities but am somehow able to accomplish with the help of others. 

And in case anyone was wondering-this was better than doing homework.  I still managed to do well on my test 2 days later.  I think I needed the break :)  Justification and Procrastination at its highest!

2 is usually better than 1

Julie and I, we do a lot of things together.  We're twins and it comes with the territory. 

Last week we canned peaches together.  It's a really big chore if you have to do it all yourself and was much better doing it together. 

Last night our combined efforts included making peach cobbler with the left over peaches.  I was putting some ingredients into the cobbler.  She was putting other ingredients in.  She was also pulling other ingredients out of cupboards while I read down the list of ingredients needed.  I figured she had pulled everything out that we had put everything in from the list.  We mixed it up and Julie kept saying it didn't look right.  I had never made the recipe before so I had no idea what it was supposed to look like.  Julie was telling me that I didn't measure things properly, while her husband chimed in and said, Julie you never measure things.  He was not surprised in the least that it didn't "look right."

We baked it and started eating it.  Then she realized...

we forgot to add the eggs.

HA-I guess our combine efforts failed this time around.  So what happens when you forget to add the eggs to cobbler-a floury (wheat flour, I might add) and sugary topping...less like cobbler and more like a coffee cake top. 

Can I get you a bowl of SOAP?

My Spanish vocabulary is VERY limited.  It is always a challenge when I have a spanish speaking patient.  Often I resort to gestures or noises to get my message across. 

Friday night:

Me to my spanish speaking patient: Are you nauseated?
Patient: (blank stare)
Me to my spanish speaking pt's daughter: Is she nauseated?
Pt's daughter: (blank stare)
Me: making dry heave/vomitting noises and actions to daughter and patient.
Patient: complete recognition of what I was asking. 
The answer was No

Later Friday night-same patient.

Pt's daughter walks up to the nursing desk.  She speaks enligsh but it is very limited. 

Pt's daughter: do you have soap?
Me: Soap?
Pt's daughter: Yes, soap.  (She then proceeds to hold her hand in a cupping position and hold a pretend spoon with her other hand while pretending to feed herself.) Soap, she repeats. 
Me: Soup? Do you mean Soup? (Me acting out soup) or Soap? (Me acting out washing my body with a bar of soap.) 

The daughter and I had a very good laugh about soap vs soup.  I doubt she will be making the same mistake again soon :)

"How Will You Measure Your Life"

I'm not sure if there is anyone out there really following my blog, especially since my travels have come to halt. I am now officially in to the learning phase of life, although currently procrastinating my studies. School will probably be slightly less exciting but hopefully equally as enriching as travelling.

There really wasn't much of a break between travelling ending and schooling beginning (is that grammatically correct? am I allowed to say it like that? Well, it's my blog and I guess anything goes). I arrived home Tuesday morning from Guam. School started Wednesday morning. I was scheduled to work a night shift Thursday night at the hospital. Definitely back in the swing of life.

To kick start my re-entry back into school, I found an article that helped me consider a few aspects of life: how I spend my time, my interactions with other people, and HOW I do things rather than WHAT I do. A little back ground first...

In 2003, while serving a mission in South Korea, I heard a talk given by Clayton Christensen. At the time all I knew was that he had also served a mission among the Korean people and that he was currently teaching at Harvard Business School. This latter point was huge in the eyes of the Korean people, who strongly value education and are very familiar with Harvard. I still know very little about this man, but I have always remembered the message he shared that night. Maybe not the details of the entire message, but the spirit of the message and a few key points that I needed for that particular phase of my life.

A few months ago, while browsing on the Internet, I came across his name tied to an article from Harvard Business School, a talk he recently gave to graduates. The link for the article is no longer available through HBS, but I found a link through another website. It is a little long, BUT well worth the read regardless of your career or phase in life.

http://arikjohnson.posterous.com/how-will-you-measure-your-life-by-clayton-m-c

Homeward Bound

Here are a few more photos summing up my time on the Mercy. The last several days we have been travelling between Timor Leste and Guam. The time was well spent taking photos, reading books, cleaning the ship, throwing eggs over board with a few of the mariners, watching the mariners fish from the back of the ship (they caught one!), playing games, making friends etc, etc, etc.

Today was a perfect day to end a perfect adventure. We ported in Guam this morning and got to spend the afternoon on liberty. Brinton, Susanne, Debbie and I rented bikes. Little did we know the weather would be rainy. Um, rainy is an understatement. It poured. Pretty much the whole day it poured--and we LOVED it. Everything I brought with me was soaking wet-passport, change of clothes, book and all.

We road our bikes out to Spanish Steps for a short but beautiful hike down to the a secluded beach for some snorkeling. (see picture #2 for a group photo).

Stay tuned for future highlights of life....but no more crazy trips for a long, long time. Grad school starts again on Wednesday. Hopefully I recover quickly from jet lag and don't sleep through advanced pathophysiology.

sorry if some of these photos are uploaded multiple times...I'm not sure what is going on with the internet at the moment.

MACRODYSTROPHIC LIPOMATOSIS

Finally I remembered to get and post the name of the foot anomaly seen here in Timor in two of our pediatric patients.

MACRODYSTROPHIC LIPOMATOSIS: or focal giantism.

Dr. Provenchar, the orthopedic surgeon, said that only 20 cases are reported around the world at this time....and we just found two more in the same village on one tiny island. (Don't quote me on the statistic...I haven't looked it up to verify that it is accurate. In any case, it is rare.)

Vocabulary Lesson

Did you know that part of the USNS Mercy experience includes lessons in vocabulary?

With sailors, soldiers and volunteers from Australia, Canada and Great Britain there has been a lot to learn.

Australian phrases:

fair dinkem: truth, or "seriously?!?" or "Are you for real?"
example: I just travelled to Timor Leste. Fair dinkem?

Tah: Thank you

Choccers: full

Hoorooy: bye

up the duff: pregnant

dag: uncool

Don't be a mug, mate: Don't do something stupid

Navy phrases

Muster: show up at 6:30 AM to report for duty

Volun-told: no one volunteers, you're assigned as a volunteer

flight quarters: No one allowed on the deck while the helicopters are out flying, no flash photography, no smoking near the helo pad

Stand by to stand by: we have no clue what is going on but be prepared. Something will be soon

Mess Deck: cafeteria

State Room: officer rooming, as opposed to enlisted berthing

Berthing: pronounced birthing but not to be confused. This is the placed where you sleep.

Secured: has multiple definitions. I have obtained something, I have tied something down, you are free to go (secured for liberty), no allowed to go somewhere (secured for flight quarters)

Sweepers: as heard twice daily. "Sweepers, sweepers. Man your brooms." Clean the whole ship now.

BZ: short for bravo zulu or translated means good job.

Rack: bed or bunk

British Vocab

fringe: bangs

chips: french fries

crisps: potato chips

Nappy: diaper for a baby

Plaster: band aid

rubber: pencil eraser

As I was getting on a "band aid" boat the other morning, one of the Australians already on the boat turned and said to the people already sitting down, "if you all shuffle over, we can make room." I realized--it's not their accents that makes me smile. It is the unexpected phrases they use. In my mind I was getting ready to ask one of them to scoot over, but the sweet aussie said it way better, way funnier and way more memorably (if that is a proper english word).
I have a British roommate. I can't help but smile as she throws in terms like heaps, rubbish, bloke, fancy, and "brilliant!" The other day she was reporting on a patient and reported the child had a "nappy rash." It took me a few minutes to determine if she was refering to the type of rash (a diaper rash) or describing the ugliness of the rash.

Photobucket

The internet is much faster this morning loading photos than I had anticipated. So, I will try to upload a few more photos for you to enjoy. These are loaded in no particular order and no particular story behind them.

The LDS charties pediatric day nurses (minus Kristen who had the day off). We are required to be in uniform at all times while away from our berthing areas just like the Navy and other military people. Our baby blue shirts (which you can't see the color by this photo) make us very easy to spot. I was walking down beach street in Dili toward the embassy to drop off a few items for the Crawfords and all of suddent someone is honking at us. Kelly Crawford was driving by and remarked that it is so easy to spot us in our shirts. We ended up getting a ride down the street and able to get out of the humid Dili air.




A few of these photos were taken on Monday when I visited a community health site that USAID is assisting with.





I took this photo thursday at sunset while on Liberty. Katie, MaryAnn and I spent the day with Kelly Crawford seeing some of the sites in Dili--Dili Rock, an Uma Luma (sp?), and hiking the Jesus statue. Sammy, Kelly's 4 year old, joined Mary Ann and I in our hike to the top...he got a pleasant ride on my back and I got an extra good work out while climbing 250 of the 500 plus stairs to the top with him on my back. This photo was taken right after that. The clouds have come in, but I think the only rain we got while in timor Leste was Monday afternoon and it didn't last very long.





This is an after photo of one of the kids who received a cleft lip repair while on the ship. I posted a before photo a few days ago. You canlook and compare the difference. He had a cleft lip and palate repair with dental restoration and tubes placed in his ear. Wow--quite a lot for one little guy to deal with AND for his father to assist with care post surgery. He had one of the worst cleft lips/palate that I saw while here in Timor Leste. He is still pretty young and was such an energetic little guy. He didn't seem ashamed or aware of his deformity prior to surgery as he interacted with all the other children. I can't help but think what a blessing this surgery will be for him. Operation Smile was also doing surgeries on the ship and had some of their pre-op patients in our unit. There were a number of adults who were on board to repair thier lips. Cleft lips/palates seem to be more common in South east Asia than in other parts of the world, according to one of the doctors I spoke with, though they are unable to determine the reason.




Another photo from the USAID trip to a community center. The average age in Timor Leste is under 20 years of age. As I have written in a previous blog, this is because so many were killed during their fight for independence a little over 10 years ago. We didn't see people in the older generation very often and I loved seeing these 3 little ladies. I'm not sure if they were there seeking health education or if this is the place to hang out and get a little shade for the day. Seemed like most of the town had shown up for the event.




Me playing in the pediatrics unit. As a side note--as you can see, the garbages are all labeled. We are required to separate food, paper, plastic, and metal garbage into different bags. The capcity of these bags is obviously huge.





If the baby can cry, why can't I? Gotta love that hat

Final Day in Dili

We have finished our work in Timor Leste and the Mercy ship is now sailing toward Guam. We spent all morning yesterday cleaning up the unit and securing the pediatrics department for sea. We are headed towards a tropical storm and told that the seas have the potential to be very rough. This makes it more important than ever to secure everything in place and tie it down. So far, the waters have been calm. I was able to watch the sun set last evening from the deck, but the winds were definitely blowing. Blowing strong enough that my folder with homework blew open and papers started flying across the deck. Oops, so much for securing my personal belongings. Lesson learned!



My last day in Timor Leste (Monday) was a day off from the pediatric unit. I was forunate to hear about a small group of preventative health representatives meeting up with a USAID employee to visit a district about an hour away from Dili. We visited a community health center with actual buildings/rooms for visits with doctors and pharmacy pick ups. There is also a birthing center. This is a 3 room building for women to come for delivery. I learned that less than 30% of women go to facilities for births and the mortality rate is very high at the time for women and babies during child birth. There are also no Timorese doctors at this time. There was a Cuban doctor at this clinic, otherwise it was run by nurses and midwives. Many of the women who deliver have a neighbor come to assist with the delivery. We met a woman who delivered her 4th child the previous night.

I love the photo below of this sweet elderly gentleman. He saw the photo taken of him on my camera and got such a kick out. Katie snapped this photo of him with a smile on his face. The other pictures I have of him, he has a very serious face. You can't see his teeth, but if you could they would be stained red. Many of the adults chew on a red root called beetle root (not sure if that is how you spell it, but is how it sounds). The first time I saw it, I thought someone mouth/gums/lips were bleeding all over the place. I quickly learned that was not the case.

This is one of our translators. I gave him one of our LDS Charities shirts. He gave me his awesome hat in return. We were grateful for the translators that assisted us. Though there was some misinterpretation that took place, it was impressive to see these young high school age kids assisting us. In 2 years I can only imagine that the language abilities for translation will improve and more of these kids who were introduced to English on this ship will continue to study and get university degrees. There is a huge need in Timor for medical providers and people with innovative business ideas to help get the economy of this new country up and rolling. These kids are well on thier way to being the future leaders of this country.

This Little Piggy Went Wee Wee all the Way.....

This is little Jebanio. Cute little guy, huh? But as my British flat mate/co-worker says in her proper english accent, he's very naughty. Maybe you can see some of the mischeviousness in his eyes. He frequently throws tantrums, doesn't mind his mom, hits her, and wants whatever toy the other kids are playing with. And he will cry and flail his arms until he gets it.




Poor little guy had a surgery that required him to have a catheter for a week. I guess I might cry too if I had to endure that for so long. For the first few days he refused to get out of bed. I was the lucky nurse that took care of him the day the doctor said he must ambulate. Shown below attempt #1 of getting him to walk. My solution: I carried him upstairs to the flight deck to entice him to walk. Instead of using a ball like you would to get a baby to take his first steps, I had something even better--boats and helicopters. It worked. He took about 20 steps up on the flight deck toward the "helo" but every step was a fight. As you can see from the picture, he had a pretty good melt down back on the unit because I tried to make him walk back to bed. He slid across the linoleum floor while mom and I pulled.

I took care of little mr. stubborn for 3 long, consecutive days. On the third day, Dr. Auge took out Jebanio's catheter! Glorious day for the kid. He was out of bed, running circles around the nursing station, kicking a big blue exercise ball, having the time of his life. All until he needed to go PEE (excuse my improper medical terminology for urinate). Once the little guy peed, he could take a bandaid boat back to shore and go home after spending 8 or 9 days on the ship. I thought it would be SO easy. I gave him water to drink, tried giving him bubbles to blow to bear down, etc. No, No, NO. It didn't work. He started screaming around lunch time and doing the potty dance. I put him in a warm shower-3 different times, tried putting him in a bucket of warm water, tried placing a warm rag over his bladder, and pushed on his bladder. The screaming only got worse. I called a different department of nurses-ones who have actually been moms to see if they had other suggestions. It was an international survey as we had suggestions from Americans, Canadaians, Britians, and a nurse born in Trinadad. I had run out of ideas. After 3 hours and attempting to place another catheter in the child while he was screaming/kicking (no luck there), Dr. Auge decided to take him back to sugery.

Pre-op called me 30 mins after I dropped him off.

He peed'd all of their floor and was still standing in the puddle when I came up to get him. Back on the pediatric unit, he continued to go pantless the rest of the shift while he wet the bed, piddled all over the flood and pretty much went wee, wee everywhere.

Sleep tight little Jebanio. Maybe on another day you can go to the market or eat roast beef.....