A Year Later...

Well it's been about a year since I returned home from Nepal, armed with passion and knowledge for changing lives. I thought it was more than appropriate I take the chance to reflect on what this last year, and summer has been like, in contrast to the incredibly challenging and wonderful time I spent abroad a little over a year ago. I've always known that blessings almost always come in disguise and this summer was no different. Early into the spring semester of my junior year, I began to think about some of the possibilities for the summer of 2016, and what awesome experience I would take on next. However, those "big" dreams became very much hometown for me, when I accepted a job with Lincoln Parks and Rec, working at summer day camp. To say I was slightly disappointed that for the first summer of my undergraduate I wasn't directly working or doing something related to my future goals, was an understatement. However, when I was offered a position working at a law firm part-time, things began to look up. As the summer went on, my family suffered a terrible loss. My uncle, who had been suffering from pancreatic cancer for 6 months, passed-away. This put a whole new spin on the reality that is human life, and even mores so revealed yet another blessing; had I been in Nepal, or in an intensive program, I wouldn't have been able to come home, mourn and laugh and celebrate what an amazing gift life is with my family. In hindsight, choosing to live the hometown life for the summer was the best possible decision I could have made, given the unforeseen circumstances that life is filled with. 

Being in Nepal last summer, allowed me to expand my horizons as far as looking into other careers and learning what my real interests are. If I had a dollar for every time I've been asked this summer, what I'll be doing after graduation, I could probably pay off my student loans. But in all seriousness, I am undecided. I will graduate in May of 2017 with a degree in Biology, and those are my only future plans right now. Do I have some ideas? Of course, but in the 21 years I've been granted on this earth, I've learned that the hardest and most rewarding decisions take time. Will it be medical school? Not for now, maybe one day, but not in the near future. Law school? A more likely graduate school choice at this time. But in all reality I more than likely won't head to graduate school right after graduation. I want to explore and embark on this great adventure that I've been given, and as soon as I decide on a destination, I'll let everyone know. Until then, I continue to let the spirit of Nepal fill my everyday life, and the person I continue to grow into. 

Nepal: a summer for the books.

The past 8 weeks I've spent in Nepal have been a whirlwind of emotions, lessons, friendships, challenges and growth. Spending the last two months away from my friends and family forced to learn a new culture, language (which I've not even close to mastered), and make new friends has been nothing short of challenging. However, I will say that those challenges changed my life.
Nepal has captured my heart in a way that I will never be able to adequately explain to anyone that hasn't been to the country that is home to the Himalayas, and the birthplace of Buddha.
The challenges here have been in wide array; from discovering that I should've brought toilet paper from home to surviving a dangerous bus crash. But each challenge became a lesson, a memory, a piece of me that has made me a much stronger and more courageous person, as I return home.

I came to Nepal for an internship in the Kanti Children's Hospital- a government hospital that is within the Kathmandu Metropolitan City. Being pre-med, there was very little as far as procedures and assisting that I could do, but I was still able to observe and learn an extreme amount. My first week was spent in the physio-therapy ward, where I saw various physio-therapy patients, as well as neurological OPD patients. Then I moved to the immunizations ward, where I was able to do a bit of clerical work- signing the patients in, differentiating which shots needed to be given, etc. The next four weeks (and most rewarding weeks), I spent with a resident unit. I followed them to various wards in the hospital, as they went on rounds, conferred with their consultants and did various procedures- mostly bone marrow aspirations, and lung punctures (LPs, spinal taps). For many of these procedures I was needed to help hold down a patient, or keep them calm as the doctors performed the procedure. Although somewhat challenging emotionally, this was one of my fondest memories of my internship. Even though I wasn't the lead doctor- I was a crucial part of the procedure. Keeping the child calm. It all goes back to how important the medical team is as a whole, and not just one piece, which is what draws me to medicine. It comes down to more than just one person, it comes down to more than just science. Medicine is a team effort, that also requires compassion, empathy, enthusiasm. and a spirit for helping people and making a difference.
My final week was spent in the Radiology department, which proved to be extremely interesting, even leading me to check out radiology programs, as another possible medical avenue.
Overall, my experience at the Kanti Children's Hospital was unforgettable. The doctors and medical staff taught me so much, and the children captured my heart. Exactly what I was hoping for in a medical internship.

Outside of my internship, I spent time with other volunteers who were staying in my "home-stay/apartment" exploring the city. For the first few weeks, I spent a lot of time alone- which was pretty hard for me, to be completely honest, but forced me to face my fears, and accept the daily challenges that weren't as hard as I was making them. Several times I found myself lost, and several times I found my way home. But as more volunteers came and I began to find myself in this foreign country, I formed friendships- ones which I hope will last a lifetime. I now began venturing father from my home base, this time with friends by my side. Making the adventures much more meaningful and enjoyable.

I am so blessed to have had the amazing opportunities and adventures that came with being in Nepal. Thanks for taking the journey with me, everyone, and following along via my blog. Your support and prayers were essential and I will never be able to thank you all enough for that.
Nepal, I'll see you soon. But for now I take on my "real" life with a new perspective on life, love and myself.
Thanks for the memories.

8 weeks have come and gone.

I just completed my last week in Nepal.
As today, I have officially been in Nepal for 8 weeks. Crazy!
This week in the hospital I spent time in the Radiology Department. It's been extremely interesting thus far. Two days I've spent in the ultrasound room, watching numerous ultrasounds on different parts of the body, even the BRAIN! Wednesday, we spent time in the office looking at CTs and X-Rays while the radiologist wrote the reports for each individual case. I went into this week thinking that radiology would be somewhat boring, but I've actually enjoyed it a lot, and learned so much already! Radiology is a part of medicine that I never thought about perusing, but after this week it might be something I have to look into.
Wednesday afternoon I made the decision to go with two of the volunteers (Sindhu and Suku) to the villages to do a day of volunteering. We hopped on a bus bound for Devghat around 3pm. Since it was afternoon, and it being monsoon season and all, it was pouring rain extremely heavily. About 30km outside of Kathmandu, our driver was going way too fast, passed a car on the wrong side, struggled to gain control due to the ruts in the road, hit a rock our tire blew out and the bus tipped and slid along the road, into a ditch. No one was injured, PRAISE GOD, and other than a few bruises and a little bit of shock I'm okay. Frankly, that was one of the scariest moments of my life. It was all a blur when it was happening and I can't even remember the moment I realized we were crashing. I fell out of my seat onto the floor and grabbed on to another seat to prevent falling down onto the window that was sliding onto the road. I was in the back row, and the windshield behind me was completely shattered. As soon as the bus stopped moving I remember standing up, making sure my friends were okay, and then calmly asking the mother that was sitting in front of me if she and her baby were okay. Then I proceeded to climb out of the bus, and was assisted by two men to jump down from the side of the bus that was now facing upwards. Once I stepped back and took a look at the bus, I was overcome with emotion- and began uncontrollably crying. Partially out of fear, partially out of pure joy and amazement that we weren't dead. Since we were all quite shaken up, we were able to catch another bus, and we came back to the city. 
Just another experience in Nepal that has taught me how truly blessed I am. 

Our bus in the ditch

Our bus in the ditch, another view

I've spent the last view days doing some last minute shopping, and just relaxing with my friends here in Nepal. In my opinion it's an excellent way to end such an amazing journey here in Nepal. 

I head home for the states tomorrow morning (Nepal time), and arrive to Chicago Saturday evening (Chicago time). Once I'm settled back in Nebraska, I'll write a follow-up post, to the amazing 8 weeks I've spent here in Nepal.

It's the final countdown...

It's been awhile since my last post, so sorry about that! 

I just returned from a little "retreat" in Pokhara, Nepal (about 200km from Kathmandu). I spent a few calming days there, a much needed break. It lies in the more mountainous region of Nepal. I was even able to see the Himalayas early one morning and as I was leaving on the bus, beautiful!

Himalayas

I was able to go and see Devi's Falls, a beautiful waterfall in Pokhara as well as the Gupteshwor Mahadev Gupha Cave. 

Devi's Falls

Staircase down to the Gupteshwor Mahadev Cave

Not only that but I took a beautiful boat ride across the Fewa River, to the base of the "hill" that leads up to the World Peace Pagoda/Stupa. After steep, rocky 1.25 km trek up the hill I arrived at the Peace Pagoda, which was truly beautiful and a very calming and moving experience.

                                          Fewa Lake                                      

World Peace Pagoda

Overall, Pokhara was an amazing retreat from the noise and pollution of Kathmandu, and an excellent way to kick off the last two weeks of my time here in Nepal. 

Fewa River

Friday I completed the four weeks that I spent shadowing and assisting the resident unit at Kanti. It was a bittersweet goodbye, because although I'm excited to be in a new part of the hospital for the last two weeks, I learned so much from them and formed relationships with the group, that I will definitely miss them.

I can't believe I have less than two weeks left here in Nepal. In just 10 days I will be boarding a plane and headed back to the United States. I'm so excited to be back home! A big part of my experience here in Nepal has been learning to be okay with the choices I make. This journey and time here in Nepal is my own, and I don't have to worrying about pleasing others, I just have to do what's best for me and what makes me happy. Because even if I've spent afternoons in my room reading or journaling or watching the world go by out my window, it's still an experience because I'm in Nepal. Every moment is an experience, one that I won't have anywhere else, and being able to remember and hold on to that has been a life-saver here in Nepal, especially as I cling for comfort. Whenever you travel, you open yourself up to something new- a new place, a new culture, a new opportunity. And of course, having traveled to many places in the United States, I already knew this (to a certain extent). But let me tell you- going 8,000 miles away from home, crossing the ocean, and taking on my first abroad experience alone, has definitely been a challenge. Especially the first week, when I had it all planned out to change my plane ticket and fly home a month early. And now, that seems crazy, because I would of been gone by now. I wouldn't of had the chance to have some of the hospital experiences I have, I wouldn't have been able to see some new parts of Kathmandu and Nepal, and I wouldn't have these last moments to soak in everything about Nepal- the culture, the people, the hospital and most of all the lessons.
The countdown is officially on. See you in 11 days, America. 

Whoa, we're halfway there! Whoa, livin' on a prayer!

It's official. I'm halfway through this crazy adventure in Nepal. In some ways it seems like just yesterday I hopped off a plane- tired, confused and a tad grumpy to start my journey here. In other ways it feels like I've been here for months! I have learned so much about Nepal, myself and life and I thought the halfway point would be an excellent time to share some of my wisdom. 

** Keep in mind, some of these are more serious than others. :) 

1. Always pack toilet paper when traveling to a foreign country.
2. And Kleenex. 
3. I have an extremely blessed life. And it's nice to be reminded of that. 
4. Children have hearts of gold, and imaginations as big as the sky- let them explore and be themselves, unapologetically. 
5. Patience is something that is best learned in times of hardship. 
6. Always bring your rain jacket, you never know when you'll get caught in a rain storm. 
7. However, make sure you dance in rain... It makes life more fun!
8. Don't forget to breathe. 
9. Live your life day-by-day, that's all one can do. You can't predict or control the future. 
10. Don't apologize for your emotions, but don't let them dictate your life. 
11. God will challenge you, let him, it only strengthens you spiritually. 
12. Eat more rice- it helps the digestive system and makes you feel fuller than other foods. (Plus you don't have much of a choice when you're in Nepal, ha!)
13. Don't take the little things for granted, you'll miss them more than you think. 
14. You're never too old to call your mommy. 
15. It will become clear who your true friends are, when they still make the effort to talk to you even when you're 10 hours and 45 minutes ahead of their time zone. 
16. Pray often and honestly. 
17. I have the best support system ever. Thanks for the prayers guys! 
18. There's no place like home. 
19. But try to make a home wherever the wind takes you. 
20. Dare to make a difference. Dare to see the good in people. Dare to see the good in you. 

This is just a snippet of all I've learned, but definitely some of the more important lessons that have become clear to me. I'm sure this next month will fly by, and sooner than I know it I'll be back in the United States, and headed off to my junior year of college (wow that sounds weird). But for now I'm living day-by-day, praying often and having the time of my life here in Nepal. 

It's paying off in more ways than one that's for sure. 

Heart of the Jungle

Chitwan National Park. Chitwan means "Heart of the Jungle", from the two Nepali words "chit"- heart and "wan"-jungle. 

I just got back yesterday from a wonderful trip to the Chitwan National Park. I left early Friday morning (7am) on a bus, and arrived to Chitwan about 6 hours later. After having some lunch, and a couple hours of rest, the weekend events began. A member of the hotel staff, would be my guide for the weekend, Hari. He was an incredible guide, and did an excellent job at making sure my experience at Chitwan was nothing less than amazing.

Friday afternoon/evening we went on a jungle/nature walk. Starting in the small village of Sauhara and then through a bit of the jungle and prairie land, near the river. There was quite overcast, as it had been raining (Monsoon season) so we weren't able to see the sunset, but we did sit for a while at a riverside bar- and just take in the beautiful surroundings. The rest of my Friday was pretty relaxing, I just had dinner and settled into the hotel, and then went to sleep. The wake-up call came early Saturday morning at 5:30am, then breakfast, then a canoe ride down the river. 

After our morning canoe ride, we had another walk through the jungle. This time we went much deeper into the jungle, and even saw a fresh Bengal Tiger print. 

We hiked our way through the jungle to the Elephant Breeding Center. This is where the elephants in captivity are bred, for tourist and other work. I saw several baby elephants, one who looked like he had just recently been born, and some older elephants as well. 

Mother and baby elephant

After that we headed back to the hotel for some lunch and a little rest, before the main event that would come in the afternoon. The ELEPHANT SAFARI. For the elephant safari, I rode an elephant through the jungle for about 2 hours. It was such an incredible experience to be atop my favorite animal. It was also cool to get a different arial perspective of what the jungle looked like! 

During the elephant safari we crossed the river, twice, via elephant. It was a little bit frightening but awesome to trek through the water on an elephant's back, without even getting a little wet. One of the highlights of the safari, was getting to see the Rhino. We hadn't been able to see the Rhino at this point in our trip because of the on and off rain- meaning the Rhino's didn't have to seek water as much. But during our jungle safari, we saw one! And not only that, but it was a mother with her new baby- which the elephant keeper said he thought was about 19 days old!  

Mother and baby Rhino

All in all the Elephant Safari was probably my favorite part of my trip to Chitwan, just because I was able to ride the elephant, and see so much of the jungle and the beautiful nature of Chitwan. 

That evening I headed back into Sauraha and to the Tharu Culture House to see the stick dance. Tharu are the indegenious people of Nepal- who were (and still are today) thought to be immune to Malaria. At the Tharu Culture House they perform the native dances of Nepal, including the stick dance- which is the dance that teaches boys how to fight. It was so cool to watch the native people's dance- especially as a dancer, which made it even more enjoyable for me!

My weekend in Chitwan was nothing short of fantastic, and I'm so glad I took a break from the noise and pollution of the city to spend some time in nature. 

This week at the hospital I am with the same resident unit as I was shadowing last week. I finally figured out more about how the hospital works- the wards, patient care, financial side of things. So each resident unit has a day/night that they are on duty. The resident unit that I am with are on duty on Sundays, meaning all the patients that are admitted throughout the day and night on Sunday (or a particular day) are patients of that resident unit. There are many wards in the hospital- some specific wards: NICU, PICU, Oncology- that only have one type of patient, but also some more general wards. The Special Cabin ward is for patients who have more money, it's a quieter and more private wards. The Paying Ward is for those patients who would be thought to be more middle/basic class, they pay to have a bed, but it's a more crowded area. Finally the Medical Ward, is for patients who are much poorer. The beds in the Medical Ward are free, but patients/families do have to pay for some medications. It's great to be with the residents, because I see so many types of patients, so I've been able to get a better grasp on medicine and all the types there are- even within pediatrics. I've also been able to see a couple procedures- Bone Marrow Extraction and Lumbar Puncture- up close and personal, which has also been an amazing, and eye-opening experience. Today I got to see another Bone Marrow procedure (making that number 3), and was able to get a photo. 

This needle is inserted into the back (typically) and then bone marrow is suctioned out to be used as a sample for testing. Bone Marrow tests are usually done to determine if a patient has cancer, leukemia. 

Tomorrow will be a similar day with the residents, then Wednesday we will spend in the Medical OPD, seeing loads of patients who are returning for a follow-up after seeing doctors a previous Sunday. Then Thursday and Friday will also be similar days as today. I haven't decided what my weekend plans will be, but I'm sure I will think of something fantastic. 

I've officially completed 3 weeks in Nepal (as of Friday), and each day I'm feeling more fulfilled with my decision to come here. I'm learning so much (about medicine,life,myself) , and growing as a person every day. The next 4 and a half weeks hold so many new lessons, experiences and opportunities for me and I couldn't be more excited. 

You have two hands. One to help yourself, one to help others.

For this week, and more than likely next week I be will shadowing a group of residents. Meaning they've completed medical school are doing rotations in all of the wards of the hospital, to better improve their knowledge and also work towards choosing a specialty. Residents are assigned to an attending, which is a more seasoned and experienced doctor. This group's attending is Dr. Bina, the pediatric neurologist I referred to in an earlier post- who reminded me of my Aunt Betty. That makes shadowing the residents all the more interesting and enjoyable, because Dr. Bina is an AMAZING doctor. Yesterday, we attended the morning session where the group of resident's, who had been on duty the previous night, reviewed the new cases with all of the doctors in the hospital. Then they went on rounds, going more in depth with the charts and treatment plans with the another attending/head honcho guy, of whom I still need to get a name. Meaning it was a very busy and fast-paced day for them, so we didn't do much, but listen and walk quickly from ward to ward. However, one of the residents did have us go examine a patient, and try to infer what we thought the problem was. The patient had severe edema/swelling on the right side of the body, that had been there since birth. We ruled out allergy and injury and predicted that it was something genetic. Once the resident made his way over to the patient he told us that it was something genetic, probably a syndrome of some kind, that he would have to do more reading and research on to find out exactly what it was, since it was rare. Today however, was a more "typical" day for the residents. We went the morning session again, where a new group of doctors/residents reviewed the cases from the previous night, when they had been on duty. Then the residents we're shadowing reviewed cases that had already been admitted for a few days with Dr. Bina. They went patient to patient, ward to ward, going over charts and treatment plans, while Dr. Bina approved and did some teaching along the way. At one point she went on a bit of a rant, which she did in English surprisingly, and her words were incredible. She reminded the doctors that hard work and discipline were both important parts of medicine, along with taking a humanistic approach. Additionally she added that intelligence is important but more important she thought was their attitude and enthusiasm. She also mentioned that the therapeutic part of care is extremely important in medicine, especially in Pediatrics. Finally, one of the coolest things she said was, "your eyes can't see what your mind doesn't know". Meaning you could miss a diagnosis if you haven't learned about it, which is why it's so important to make list of possible diagnoses, and then refer to the literature and start ruling things out, or adding possibilities. Basically, she wanted them to be continuously learning. Like I said, she's an incredible doctor, and teacher. 
So in addition to their follow-ups with Dr. Bina, the residents also performed two procedures today, which we got to watch and "assist" with. The first one was a lumbar puncture (spinal tap) on a boy, probably 10 or 11, who had minimal capabilities to move his body, and couldn't speak. This procedure is when a needle is inserted into the spine of lower back, lumbar region, and fluid is collected. This fluid is the cerebrospinal fluid, CSF, which is the fluid that surrounds the brain. This fluid is then evaluated in the lab, the results could help lead to a neurological diagnosis. This particular procedure can be extremely painful, and this boy was under no sedative and since his family wasn't in the room, he held my hand for the entire procedure. It was so rewarding to not only watch this procedure but to be able to hold the patients hand, and assure him (the best I could) that the pain wouldn't last long, and it was all going to be okay.
The second procedure we observed was a bone marrow aspiration. This was on a much younger patient, and since it was a much more painful procedure sedative was used. In this procedure a needle was again inserted in to the lower back, to remove bone marrow, which is the spongy tissue found inside bones (containing cells that produce red and white blood cells and platelets). The sample is then spread on to slides to be examined. In this particular case, they suspected that the patient had leukemia, so they were testing for that. This case was extremely interesting to observe, but much less rewarding emotionally for me.

That's probably my favorite part about medicine. The interaction with patients. Because you have to be there for them. They are putting their lives in your hands and you have to make them feel like even if they're scared, they're making the right decision to trust you. I've always had a passion for helping people, and medicine is where my interests led me. But today, when I gave my hands to someone else to hold, to assure them that it was going to be okay, I felt in my heart and knew in my mind, that I was right where I was supposed to be. 

Each day that I'm here in Nepal and each day I spend in the hospital, I'm reminded of how truly blessed I am. It helps to put a much more humbling perspective on things, and allows me to think and feel in a ways that I never thought possible. I guess that's what happen when you're thrown into something completely new and completely different. Something that forces you out of your comfort zone. Something that challenges you emotionally, physically and spiritually. But when you take on, and eventually survive, that something, you realize that you couldn't imagine your life without it.

Nepal, is one of those somethings.