Mt. Logonot

I climbed Mt. Logonot last weekend! This is a dormant volcano about an hours drive from Kijabe. We have a great view from Kijabe of the Rift Valley below and Mt. Logonot on the otherside.

Not an easy climb, but we were able to make it up and down in about 5 hours.

Coming down was like skiing on fine dirt and pebbles!

A view from the ridge: can you find the giraffes?

Below: We found a pack of zebras near the bottom and went after them...

Transitional lucidness

A phrase I made up to describe the period of sudden alertness before death. Its a miracle in some ways, and in others unfair. Wonderful for the family to have a moment of real connection with their loved one. However you are tricked into believing, even if only for a moment, that the person is actually getting better. Unfair.

My first AIDS patient died yesterday. He has been in a coma for days now and we were at a loss as to what to do. We had already thrown every big gun antibiotic we had at him, emperically treating any of the common, serious opportunistic infections that are seen here. He was not getting better. Then, the day before yesterday, he woke up. His wife was there attempting to feed him. He was obviously communicating and we thought, Wow- this guy might just make it. We must have done something right.

Then the next morning I was the first to see him and noted that he had again lapsed and was not communicating or responding to painful stimuli. His jaw was clamped shut and he was shivering. When the team made it around to see him, he was having agonal breathing (a tell tale sign that the end is near). We completed rounds, and I went to check on him. He had already died.

Again, an HIV patient: I admitted an 10 year old boy with HIV and a cough last Friday morning at 3:00 AM. It was my first night on call (o what a night). I just found out from a friend that he died this morning. I didn't realize on admission how sick he was.

Living in Kenya is living in the context of HIV. There is almost no family that is not in some way touched by the disease. If you don't have it, someone you love probably does. Can you imagine? In Kenya- it kills. It kills your life before you even die. If you have HIV, your community no longer wants anything to do with you. Churches have been known for kicking people out once they were even suspected of having HIV, let alone confirmed positive. So what do you do? You hide until you're so sick you finally come to the hospital...and die.

What a devasting disease.

I love the story of the good Samaritan. I believe it is truly the heart of God to reach out to the hurt and dying, those cast off by their communities and even their churches. I know I have been like the righteous man who saw the dying man on the road and walked on by. But I believe that God has forgiven me through His Son, and by His grace I am able to reach out to the hurt, the dying, the HIV positive, the poor. What a beautiful gift. Even to share that moment of transitional lucidness, to love a person as they die. My prayer, though, is that I will be able to see them live more and more...

Ever feel like you're being watched?

You know, like people are staring at you, watching your every move, curious what you will do next...Its an erie feeling, almost like they are waiting for you to mess up, ready for that one moment to discount you as unworthy or inadequate.

I am a foreign visitor to this hospital. It is a tight knit community, everyone works closely with each other and they have been together for a long time. Many of the workers have spent their whole lives in Kijabe, possibly working at the hospital for generations in their family. Who am I to waltz into this place like I belong?

But I recognize that this is a wrong interpretation of that feeling of being watched. It is true, everyone is watching me, most especially the Kenyan interns and nurses. My first reaction to this constant passive attention is that I need to preform. I need to be smart medically, act quickly and intelligently, be prepared, etc. But this is not what they are looking for. I believe, instead, what they are interested in is how I am willing to interact on a more personal level. I am truly interested in the people? Or am I merely here to be some smart doctor-wanna-be from America? So my gut reaction to challenge those stares and prove my competency is almost the complete opposite of how I should be responding. I am a visitor and a learner, my response should be first humility and compassion- toward colleague or patient.