Back in the states...

I have been back one week now, and jumped right back into things.
An emergency last minute site review the day I got back, then starting on wards, 63 hours in 5 days, barely time to think or sleep.

I am not sure how I feel. Rushed back in so fast I didn’t have time to feel. Today was my day off, and I think I feel a little displaced. I have enjoyed reconnecting with friends, taking care of patients more directly, but definitely something in me feels different. I feel like Africa changed my subconscious if nothing else. I went to target today to get some necessities. Normally I like to wander in target, spend a lot of time, and normally spend too much money. Today, no desire. It’s weird, I am not directly thinking about Africa, thinking about the things I have seen, but somehow my subconscious is different.

I have been having dreams about people in Africa. In my dreams, I am crying for them, my heart is breaking for them. I wonder if in sleep, when I am allowed to let go of the day, I am connecting more meaningfully with my emotions. Am I mourning for Africa?

I spoke with my dad today on the phone, for the first time since I have been back. As I talked about Africa and the things I had experienced, and my perspective, I realized something else that struck me about the whole thing…The country is losing it’s young. The young are fatally ill. This is so strange to see, I don’t think I was able to put words to it before. It’s this disease that starts so insidiously, so slowly, that nobody knows it is happening, it is ignored, until Boom, you are in the hospital, critically ill. Too often it is not caught in the early stages because people aren’t testing. The highest group that is getting infected is those who are in their teens and 20s. Normal development at that time states you are invincible, you take risks, you experiment. And the consequences of experimentation are ignored, because still, you believe it can’t happen to you.

How dermoralizing, during the phase of your life when you are “invincible,” to be grounded and incapacitated! And how strange to see the young generation die, while it is being ignored.

One woman comes to mind when I think of this. She was about 22, and was hospitalized for life threatening infections due to AIDS. She was thin, gorgeous, high cheekbones. If I saw her in a different context, I would believe she was a supermodel. She lay in bed, her excrement all over her gown, because she couldn’t control it anymore. Her mind was still all there. My mind struggled to adjust to this picture. A 22 year old, with bright eyes, a beautiful face, and so much potential. Incapacitated, dependent, out of control of her body. Things like that aren’t supposed to happen until you are elderly, and even then I imagine it is quite demoralizing. How can a country see it’s young people, it’s potential, it’s future, it’s work force, die off one by one, and stand idly by? I have heard the phrase “the missing generation” to describe the countries where AIDS has ravaged. Now there is a picture in my mind to give a story to that phrase.

One more person whose story I must document.
Enos was my cab driver coming back from the airport when I returned from the Port Elizabeth conference. He was very friendly, and open about his life. He was from Limpopo, which is the province north of Gauteng province (where Pretoria and Johannesberg are – it is the smallest province, but the most densely populated). His wife and 4 children were still in Limpopo, but he had had to move to Gauteng for work, as there was not enough in Limpopo. I asked where he lived in Pretoria, and then wished I hadn’t. He named one of the townships – acres of land that are essentially squatter camps. Miles and miles of corrugated tin sheds that people set up and live in. No running water, no electricity. He lives there while he works, and his 2 days off a month he goes to Limpopo to see his family. This story is not uncommon here. He spoke of his youngest daughter, how smart she was, how good in school. His eyes lit up with pride when he talked about her. He said that she was sick that day, and his wife had had to take her to the doctor. He said he knew it was probably something minor, but it was hard being away when you knew your child was sick. This story broke my heart. Here he is, a man driving foreigners in this Mercedes to and from their destination, at night he returns to his shed where he is missing the comfort of his family. This story is not uncommon, and I admired this man for his strength of character. For doing what he had to do to support his family, for his love for his family, and his desire to be with them. For the pay-by-the-minute cell phone he had so that he could call them every day.

Now that I am back, I am not worried about forgetting. I am sure I will get more used to the luxuries of my everyday life, stop feeling guilty about them, and getting back into the groove. But I have realized now that there is no way I can stop doing international work. I don’t know what this will look like in the future – if it will continue in Africa, or in Latin America, if it will be long term, or a month at a time. But I can no longer imagine never doing it again, or putting a big part of myself into it.