An Introduction to the Cast of Characters

Quirks: unique in an individual sense, ubiquitous in the universal. Part of adjusting to any new environment involves coming to terms with its quirks and nuances, much like getting to know its personality.  In beginning to describe some of the things that have made my experience in Kijabe unique thus far, I found myself creating something like a list of characters in a play. While not comprehensive, these are just a few of the (non-human) players that add a little spice to my day-to-day:

[The Bedroom Door]

            On warmer days, my bedroom door becomes something like a willful horse. If there is any hesitation or sign of weakness in your touch, it resists you with every fiber of its being. A single, firm, uncompromising motion is needed to bend it to your will, though I am afraid one of these days I’m going to break it.

[The Bandit Moth]

            When the sun sets and a cool breeze slides down the escarpment over the entire town like a soft blanket, windows beg to be opened. However, once or twice when I have opened the windows but forgotten to turn off my light, a certain moth (and yes, I’m convinced it’s the same one each time) decides I need some company. Luckily, I’ve discovered the most effective method for apprehending and removing said moth, which involves throwing one’s boxers on the target and then using them like oven mitts to pull the invader off the curtains or bed sheets (to which he desperately clings) so he can be escorted out the window from whence he came.

[The Spiders]

            When I first arrived in Kijabe, the first order of business directly after moving my things into my room was to launch a small campaign against the spiders that inhabit the bathroom. Even though most are the kinds of spiders with thin, spindly legs that probably aren’t dangerous, the number of legs something has is inversely proportional to my comfort level. We’ve actually gotten to the point where the smaller ones and I live in peace and respect one another’s territory. One day, however, I walked in to find a spider that I probably could have taken a pulse on, and, after my stomach was done visiting my throat, I was forced to take up the shoe of aggression once again.

[The Shower]

            I think we all value consistency in relationships. We all have our good and bad days, but all in all, we want to be able to count on one another and develop trust. My shower and I have issues in this regard. The issue isn’t just inconsistency in terms of heat, water pressure, or simply working; it’s inconsistency in terms of its inconsistency. It would be one thing if I knew sometimes the shower won’t have good pressure, or some days the heat won’t come on, but my shower has taken it upon itself to keep things interesting with any combination of scenarios.

Act 1, Scene 1:

            Shower: I see you’ve just put shampoo in your hair.

            Me: Sure did.

            Shower: Must be nice cleaning up after a long day, huh?

            Me: Yep.

            Shower: Mmmm. Well I have to go do something else, bye.

            Me: Wait, no!

            Shower: …….

            Me: Shower?

            Shower: ……

            Me: [stands dripping with a soapy head, feeling both helpless and ridiculous]

Act 1, Scene 2:

            Me: Okay, Shower, I really need you to come back.

            Shower: …..

            Me: You don’t want me to have to rinse my head off in the sink, do you?

            Shower (anemically dribbling): Calm down, I’m back.

            Me: Are you pouting?

            Shower (pouting): No.

            Me: Okay, it’s fine, I’m just glad you’re back.

            Shower (continuing to dribble at the rate a cool glass perspires on a

summer’s day): Whatever.

Me: Ooh, starting to get a little chilly, aren’t we?

Shower: Get over it.

Act 1, Scene 3:

            Me (trembling like a newborn child): It-it’s really pretty cold now, Shower.

            Shower: I know.

            Me: But w-why? We were fine a few minutes ago.

            Shower: STOP TELLING ME HOW TO LIVE MY LIFE!

            Me: I wasn’t; I was j-just trying to point out…

            Shower: No, I don’t want to hear it. Just stand there and freeze your

appendages off.

Me: Okay.

Shower: Hey, guess what?

Me: [unable to speak due to hypothermic shock]

Shower: Jk, lol. [unleashes glorious streams of warm water]

End Act 1

(After a brief intermission, the saga will continue)

Dramatics aside, it has been interesting to see how getting used to odd little things like these, frustrating as they can be sometimes, can make a place begin to feel like home. Yes, certain things are peculiar or slightly dysfunctional (much like one’s relatives), but they create a kind of fingerprint familiarity that makes this place here and nowhere else. I’m sure I will probably write about more of these sort of nuanced experiences while I am here, but I at least wanted to give an introduction to a few of the daily details that seemed anxious to be observed.

Thoughts (or the removal thereof) and Quietness

Quietness doesn’t seem to be that difficult of a concept. Find a place relatively free from outside noise, sit there without doing anything else, and boom, you’re done, right? By those standards, living in a small town on the side of a mountain in Kenya should be just the ticket for all-you-can-handle quietness, yet of the many things I am learning during my time here, it is that quietness requires an elusive kind of mastery and (at least for me) a high degree of intention. I’m undoubtedly getting into an area of semantics here that could be argued one way or the other, but “quietness,” as I’m meaning it here, is not the same thing as “silence.” Even if I hike to a secluded location with nothing but the sounds of nature around me, I become aware of a running commentary from the mental peanut gallery, the sole occupant of which is, of course, myself. Take for instance this past weekend when my sister, her housemate, and I hiked up and around the crater of Mt. Longonot:

“This is really beautiful, huh? Man, it’s hard to believe views like these can even be real. Whoa, that crater is HUGE! It looks like a giant fishbowl for trees. That breeze feels so nice. This is really peaceful. Look at us; walking around the rim of a volcano. People should do this more often. Look at that those ants crawling out of that acacia tree. Just think, those guys have been going about their business for weeks or months, probably, and you’re just now becoming aware of them. Think about all the other stuff that goes on without you ever knowing about it. Kinda makes you feel small, doesn’t it? There are probably a lot of life metaphors you could draw from that: recognizing one’s own smallness by observing the smallness of ants. Look at us being all meditative! This is why people should do this, so they can think about stuff away from the hustle and bustle of life. Huh, these are some really thick layers of sandstone dust. It looks like we’re walking on the moon. Ooh, look at that bird! I’ve never seen feathers that color before. Just think of the genetic specificities that had to be in place so those feathers would develop with that particular hue which would absorb just the right wavelengths of light so the receptors in your retina could send a cascade of signals to your brain so it could interpret it as that color.  We’re observing so much right now…”

These thoughts have plenty of value in their own respects, but there are many times I want to tell myself to just shut up. I don’t devalue inner commentary or thoughtful contemplation, but I can’t help but marvel at how difficult it is to accept the sensations of my immediate world without any attempt to put my own spin on each. Of course, the world will always come to us through the bias of our perceptions, but what would it look like to stop there? No assignment of opinion, no creation of connections, no attempt to make sense, no assessment of value, just acceptance of being. Words are, by the very nature of their utility, limiting, and while they are fantastic for contextualizing and sharing ideas (Exhibit A: me writing this and you reading it), I wonder if we don’t sometimes blunt the outer edges of some moments by feeling the need to capture it in words or thoughts. That’s what I’m getting at here with the idea of “quietness”: attempting to turn off the inner categorizer, at least for a little while, so an experience can happen to you instead of you happening to an experience.

One of the beauties of being human is that we can share our views of the world with one another and find ways to express our inner workings, but what I want to learn how to do is delay that particular ability in order to give myself a chance to see or hear the things I may otherwise not through the noise of my own conjectures and comments. I think this is so prominently on my mind right now because I’ve recently become aware of an assumption I brought with me to Kenya that I could essentially receive the peace of my surroundings by osmosis. And while being here has without a doubt encouraged me to want inward quietness, I am now very aware that it cannot induce it. As unfortunate as it is to realize one has to actually work for self-growth, I would contend that it is a challenge well worth accepting.

Penumbra and Plums

One of the caveats about being a college graduate but not yet a medical student is that I am not qualified to do much else in a hospital setting beyond “shadowing,” i.e. observing. Given the fact that my shadowing experiences thus far at Kijabe Hospital have been some the most interesting and compelling of my premed career, I don’t mind in the least, but I am somewhat of a unique case in this particular setting. Kijabe not only serves as a referral hospital that provides specialized and emergency care to patients from all over Kenya, but it also functions as a training ground for medical students and resident physicians looking to further their training. As such, a natural question to be asked when getting to know someone here is “So what is your specialty?” or “What rotation are you doing here?” to which I feel a little sheepish in having to admit that I haven’t even started medical school yet. While I can go on to explain that I am helping to develop some data collection tools with the hopes of providing a means to compile some useful information on patients with certain conditions, my exact title eludes precise definition. Despite this penumbral situation, my excitement over the intensely life-changing potential of medicine has only continued to grow as I have seen, if only as a shadow, some incredible things over the past week.

            Being that I am working most closely with Dr. Erik Hansen, a pediatric surgeon, most of the cases I have observed have related to the treatment of children. One of the things I love about kids is their lack of pretense, but the flip side to their innocent approach to the world is their inability to contextualize pain. During one clinical session, I had to help secure a boy while a painful but necessary examination was done, and as I felt his entire body writhe and struggle against my hands, I could only imagine what a terrible person he must think I am at that moment. I think one of the most valuable aspects of shadowing, especially in a developing world setting, is the opportunity to see pain up close, as a reality and not just an idea. Before pain can be relieved, it has to be confronted and sometimes even intensified for a bit, neither of which are comfortable things to do. Another image that stands out in my mind is that of a little girl on the operating table with a tracheotomy waiting to be sedated for a scoping procedure. Some sort of stricture in the girl’s throat had threatened to prevent her from breathing (hence, the trach), and the scoping to be done that day was meant to explore the cause of the stricture so future operations might correct the problem, allowing her the ability to breathe and talk on her own in the best case scenario. Of course, sitting on a metal table in a room full of strange people wearing scrubs and masks is intimidating for almost anyone, let alone a little girl, so, as to be expected, she was crying before the procedure began. When I say she was crying, however, what I mean is that big tears were running down her face and her mouth was open just as if she were crying out, but no sound came out of her mouth. Instead, the only noise associated with her crying was the gurgling hiss (much like sucking up the last of your drink through a straw) that came with each inhale she took through the small white tube protruding from her throat. The pain I felt watching this girl was far outweighed, however, by the hope that the work being done for her would one day allow her not only the gift of breathing the air freely but maybe even the simple luxury of living her life with the ability to speak. It’s thoughts like these that help drive home the weight of practicing medicine: a few hours in an operating room may be the difference between a person living the rest of her life with or without the ability to communicate verbally. In one sense, it’s a sobering thought, but I tend to find it incredibly exciting.

My experiences thus far have not been strictly related to the hospital, however. There was one day last week when I decided I would do a little exploring, and so I started walking up the mountain road by which I had originally entered. About a mile into the hike, a railroad passes perpendicularly over the road, creating a one-car wide tunnel, and I noticed that a small dirt trail branches off the road and runs parallel to the train tracks. Thinking this might be a good route to find a nice overlook of the Rift Valley, I decided to see where the dirt path led. About half a mile later, I saw a group of four women and a boy heading towards me, so I stepped aside to let them pass. Exchanging nods, waves, and “habari’s,” I expected to simply move on once they passed, but the last woman held her hand out to me as I was about to go on my way. Thinking it was a handshake, I reached out to take her hand, but immediately I found three plums unexpectedly dropped into my palm. Surprised, I just smiled and offered an “asante sana,” and she smiled at me and walked on without ever breaking stride. Three plums the richer, I continued my hunt for a good lookout spot.

Embankments flank certain portions of the railroad, and on top of one of these, a clearing offered a place that fit the bill perfectly. Once there, I sat down to take in the view and enjoy the afternoon sun while the breeze played different tunes through the long needle pines. Just when I was starting to give some serious consideration to taking a nap, a band of young boys bobbed into view between the bushes lining the opposite embankment. At first I thought my presence had gone unnoticed, but their reappearance a few seconds later proved me wrong. One boy raised an upturned palm in my direction, basically asking, “What the heck are you doing over there?” I shrugged at him and waved. Discontent with not knowing, the same boy started scrambling/sliding down the steep dirt incline, crossed the railroad, and climbed to where I was sitting while the other two remained on the opposite side. All smiles, the boy asked me if I was waiting for the train, and I couldn’t tell if he was more amused or confused when I explained to him that I was simply walking and had decided to sit down here. I asked him his name (which turned out to be John), his friends’ names (Stannis and Emmanuel), and other small talkish questions when I noticed one of the other boys had dared to venture over as well. When I asked him “Habari gani?” he flopped on the ground in what I assume was his coping mechanism for the bizarre occurrence of talking with a strange white person and responded, “Mzuri.” After a few minutes, the boys were about to cross back over to the other side when I stopped John and held out the plums I had been holding. “Three plums, and one, two, three of you,” I said, handing them over. John and Emmanuel smiled and thanked me, dashing back across to share the spoils with Stannis who waved a stick at me from his perch. I sat there for a little while longer after the three boys had left, continuing to enjoy the view but enjoying even more the fantastic oddity of perfectly timed plums.

Enter the Tourist

We as humans have developed the useful ability to filter out sensations that occur repeatedly or incessantly so as not to overwhelm our faculties. That’s why you were not consciously aware of the feeling your shirt has against your body (until just now) or the position your tongue is resting in your mouth (until just now, and I apologize). You can imagine, then, being introduced to a place where almost every sensation encountered is novel, and thus everything is felt, seen, heard, tasted, and smelt in the arena of consciousness. This kind of experience could be summarily referred to as “sensory overload,” and also qualifies as an accurate description of these first three weeks I have spent in Kenya. In this case, I am using the word “overload,” not with the negative connotations it may carry, but with the intention to convey the unfortunate fact that I will only be able to present the tips of several experiential icebergs at this point, though each may merit its own blog if I were to do it justice.

            One of the most immediately strange sensations I had to cope with upon arriving in Nairobi was Kenyan driving. While British influence is undoubtedly the culprit responsible for the flip-flopped drivers’ seats and driving lanes, I’m convinced an anarchist society is responsible for the driving conventions. “Conventions” here can be best defined as, “doing whatever is necessary to arrive at one’s destination while dodging bathtub-sized potholes, mountainous speed bumps, fearless herds of cows, pedestrians obviously convinced of their own immortality, and knot after knot of drivers, all trying to do the same.” However, for those of us who do not yet have our international driver’s license, the ordeal is somewhat less stressful since all we have to do is clutch the edges of our seat and marvel with petrified admiration each moment that passes without an accident. How my sister has managed to master this art is nothing short of impressive, and it makes me incredibly grateful that the person transporting me from place to place knows what she’s doing.

            Automotive situation aside, I struggle to begin an adequate description of how beautiful many of the places in Kenya are. When first considering equatorial Africa, one may be inclined to imagine an environment suitable for human liquefaction, but because Kenya rests between 6000-7500ft above sea level, the actual result is a place that maintains close to ideal temperature year round. For instance, the most frigid temperature one could expect in the depths of a winter’s night would be about 50 degrees Fahrenheit while the maximum in the summer might be around 85. For the vast majority of the time, however, we experience the gloriously moderate in between. Not only does it feel amazing most of the time, but the surroundings continually make me feel like I’ve been dropped into a National Geographic article. From the three day safari my family and I took, to visiting the elephant orphanage and giraffe center, to touring and eating lunch on a tea farm, to hiking a dormant volcanic site affectionately called Hell’s Gate, I have already captured so many moments for my mental scrapbook that I will treasure forever. Before this trip, I couldn’t have told you what the rubbery, soft back of a baby elephant’s ear feels like or how rough a giraffe’s tongue feels against your face when it kisses you. I couldn’t have told you how swimming in a hot sulfur spring feels like wading through warm cream or how the entire night air groans when lions have conversations. Each of these moments could constitute a once in a lifetime experience, and yet they have all happened in a matter of weeks. Sensory overload, people: it’s real.

            One might expect, as I did, that traveling to far away places would provide perspective on how big the world is, and while this is true to a certain extent, I find that it has really made the world feel smaller if anything. I think there is a certain convenience to distance that allows us to conceptualize distant countries or people as so far removed from our daily experience that they cannot possibly bear any meaningful resemblance to our homes or ourselves. I wouldn’t say this is a conscious thought in most of our minds, yet sometimes it’s not until we are holding the hand or looking into the eyes of someone who has lived on the other side of the world for both of our lives that we fully confront and appreciate the common experience of being human and the irrelevance of location to that simple fact. I don’t mean to minimize the differences encountered in other parts of the world. In fact, sometimes I feel like they cannot be overstated, but it’s also amazing to notice the deeper common thread that connects us as people.

            My role in Kenya up to this point has been that of a tourist: simply enjoying the newness of my surroundings and attempting to soak it all in, which I have thoroughly enjoyed. For the next three months, however, I will be living in Kijabe, which is a small town nestled on the side of a mountain along the Rift Valley and home to the surgical referral hospital that I will be working with. I have only been here two days so far, but I can already tell you that I’m not in Kansas anymore. I’ll save going into any more details at this point, but it’s safe to say I’ll have no shortage of stories to tell in my next post.