Layers of chaos

Today was a day off, sort of. We met with the midwives for a few hours this morning so Frank could teach them more about our potential role in the birthing clinic. After a good night's sleep and some down time I have decided that working here is just a matter of sorting through the layers of chaos. There is always a baseline, even when there are no patients there is activity everywhere, scooters idling just outside the clinic, dog running through the treatment room, somebody looking for someone or something. Then you add the patients, who have seemingly endless patience and wait hours for their turn. Add to that the fact that there are very few places to refer patients in need of different care--that they can afford. (The guy with the bone infection sold all his land and his scooter for initial treatment, and has nothing left.) There is a doctor on the staff but he's been out with kidney stones since we've been here. The first I saw of him was yesterday when he came to the acupuncture clinic for treatment. The next layer is my own, being a greenhorn and trying to adapt in all directions.

The communication is also a wildcard. I'm so used to checking in with my patients at home a lot, always making sure everything is ok. It's hard to do here--they wonder why you are asking. Of course they are ok and if they weren't they would tough it out. I can often only go by what I see: muscles relaxing, change in breathing, change in pulse. Maybe that's part of my lesson here. And if I find myself wondering how much good I am doing I have to tell myself that this may be the only care some of the patients ever receive, and if there is even just a small benefit to a few it is something. My teammates are doing an incredible job and teaching me a lot. I still dread pediatrics shift.

Sara, Mark and I are stealing away to the beach for a quick overnighter, 45 min outside of Ubud. Surrendering to being a tourist temporarily. I need to recharge, which doesn't happen if you are anywhere near the clinic.

Love,

K