Let’s do ordinary things with extraordinary love

Current Tunes: Thunder, Imagine Dragons 

Sunrise over Brooklyn

“OMG,” she snarled aloud. Not directly at me, but with enough volume plus a little shove to my elbow to show her distaste of my presence as I squeezed my body against the other human sardines on the L train. I frustratingly shot back, well in my head of course, “Excuuuuse me,  princess. You live in NYC. It’s rush hour. Did you forget? Does someone need to remind you this is how we roll?” Ha. As if I was a local or something. Then my West Coast roots tugged at my heart and I scolded myself for being quick to judge. Maybe she had a tough morning. Or maybe she’s an agoraphobic. Or maybe she is just a natural grumpy cat. But in that moment, I realized that the NYC hustle bustle attitude had become a part of me. I get miffed when people stand on the left side of the subway escalators, which everyone knows is left open to bypass the squatters. Duh. It also drives me bonkers when people get on the subway before letting people off. And when a homeless man comes on making a loud announcement about their troubles I awkwardly (and ashamedly) shift in my seat and try not to make eye contact. Yikes bikes, lately I feel like I’m always talking about the subway. (Click here to read my obsession with subway shoes…) But the new game I play on the subway is called Spotify Psychic. Basically I try to guess what’s running though the head phones of my fellow commuters. Like this mid 30s Yankees fan to my left, I’m guessing some sort of funk rock, maybe Red Hot Chili Peppers. The lady to my right watching her screen is probably watching a dramatic telenovela with a dreamy Latin male lead. And the suit across from is definitely zoning out to some NPR. And as much as I love using public transport to bypass the trouble of parking and traffic, it’s the one thing I find slightly terrifying about this city. Let me explain.

When I moved here, a few people from back home asked if I was afraid or nervous. At first I was confused. Huh? They were inferring that NYC is such a target for mass tragedy and it may not `be a safe choice right now. Which I get, it is an iconic city. But hey, you live in California…what makes you think you’re exempt? Oh we see you, North Korea. In all seriousness, one scenario that does scare me is an incident possibly happening in the underground. Imagine hoards of scrambling scared people, trying not to get trampled, and climbing through the maze of stairwells and platforms…I know you’re probably reading this and are weirded out. Like why plant this idea in some one’s head, Miriam? But come on, I’m no genius and I’m sure I’m not the first person to dream up this nightmare. Anyways, I will say after the lower Manhattan attack this past Halloween, it did shake me a little. With the reminder that terrorism in our country is very much alive, I took a visit to the 9/11 Memorial Museum two days after the attack. Wowie. I highly recommend it. The museum does a beautiful job of recreating the day with a minute by minute timeline as well as an aftermath portion. There’s live video of the destruction, audio of plane passengers calling home and flight attendants attempting to get help, and personal stories of survivors from the buildings. There’s old wreckage of ambulances that were destroyed when the buildings crumbled to the ground. I found myself brushing away tears as I silently walked through the memories of bravery and loss. I will say it was very bizarre to be experiencing this amongst tourists though. I imagine it must be what local Germans might feel if I were to visit a Holocaust concentration camp museum. Like you understand the depravity but may not really resonate with its effects.

I also couldn’t help but reflect on my own whereabouts as an eleven year old on September 11, 2001. I arrived to school by bus and I remember lining up for class and staring at the sky with my peers, while rumors that “we are all gonna get bombed” circulated throughout the playground. We walked into class confused and my teacher had tears streaming down her face. Between being on Pacific Time and our preteen age, most of us had no idea what was going on. She pulled herself together, dried her eyes, and finally she spoke saying, “Students, something terrible has happened and I want everyone to sit quietly for a moment.” She turned on the class television to the news and that’s where I remember seeing footage of a plane crashing into one of the Towers for the first time. After awhile, she shut it off, made us all stand up, and we said the Pledge of Allegiance together before debriefing on what we just had witnessed.

And here we are sixteen years later. Still fighting terrorism. Still fighting hate. Still fighting ignorance. Every day the news reminds us how truly broken we are. Another mass shooting, another secret sexual assault, another political scam or fraudulent report. All around I constantly hear people commenting on how terrible society has become, yadda, yadda, yadda. Personally I think it’s debatable if humanity is really more “evil” than it was a thousand years ago. Our access to social media and the Internet just advertises our brokenness in a quicker manner. Regardless of the answer to that debate, I think the bigger question is how do we respond to these trials? How do we create change?

I am so thankful that we live in a country where are voices are allowed. That it is legal for men and women alike to protest, write letters to Congress, and exercise the right to vote. However, I urge everyone to remember that there is a place where you can make a direct positive effect on society in an instant. It might sound simple or silly but it’s through how you live your every day life. Like marching is all good and dandy but if you can’t hold your tongue when you want to speak ill of your co-worker or take a hot second to hold the door for your fellow neighbor, what good is fighting the large battles if we don’t start at the most basic level in every day human interaction? I am telling you, smaller scale efforts can have a large impact.  So if you get anything out of this today, I guess my message is to DO ORDINARY THINGS WITH EXTRAORDINARY LOVE.

I just want to end with recognizing that I am no where near perfect. Just how I wanted to give attitude right back that girl on the subway. But we have to try.  And I love because I was loved first and I know my Maker created me specifically for this purpose. Regardless of what you believe, I think we can all agree that humans matter. So go out there and love your neighbor. And see what happens. Because chivalry is not dead unless you choose for it to be.

Okay…so that got deeper than I intended. Woof. Lastly I just wanted to do a special shout out to my travel wife and dear dear friend, Kaitlin. Three and a half years ago we met. Six months after that we decided we would travel nurse together (but it would take another half year for us to grow a pair and actually quit our jobs together). And now after several years and assignments together, she is officially taking off her travel nurse cap as she goes to plan her new chapter of life with her fiancé. It’s been an incredible journey and she was the final push that made this dream become a reality. While we loved exploring each new city together, I cherish the many nights spent in matching onesie pajamas, watching terrible reality television with a healthy dinner of stove top popcorn and a bottle of red wine most. Cheers to you, my dear. xoxo.

FIVE MORE WEEKS IN NEW YORK CITY. YIIIIIIIIIKES. I’ll be spending Thanksgiving here as well so Macy’s Day Parade, here I come! And am going to beat you to it…where next? Well, when I know, you’ll be the first to find out. Promise.

Cheers and Happy Turkey Day,

Miriam

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Me, myself, and NYC.

Current Tunes: New York, Ed Sheeran (seeing this beautiful gem of a musician play in Brooklyn tonight!)


NYC.
Dirty. Hectic. Grungy. Fast.
I have been living here for a little over three months and while I feared the Big Apple would swallow this small farm town girl whole, I seem to have become one with it. I weirdly like the madness, the light pollution, and the straight up hustle (except for the smells…homegirl could live without the stench.) The other day, my friend asked me my favorite thing about living here. My mind quickly gravitated to the delicious eats I’ve been grubbing on. How a city can offer $20 cocktails and 99 cent pizza slices at the same time is beside me. I love that there are bodies of water on both sides of Manhattan making the skylines and rooftop views one in a million. The creative events and appreciation for art and music is also notable. But I think my favorite thing has been the subway shoes. Seriously, I have this weird addiction with staring at the feet of those around me on my morning commute. Granted I’ve always been a shoe addict but I do mean this in deeper way than my problem with dropping cash on a sweet pair of kicks. Other than their aesthetic appeal I like the idea of shoes being able to tell a person’s story. They can describe where they have been and where they think they might be going. And if they could talk what would they say?
There are so many walks of life all crammed together in these metal tubes on the daily just to be a part of this great metropolis. So climb into my world for a second and imagine this…

A few weeks ago I was commuting home after a long shift and saw this gal with impressive five inch platforms studded with spikes, which I may or may not have sneakily snapped on the left. I would bet money that she could not get those suckers past TSA at the airport. They were basically weapons. I imagined wearing them while trying to push my way through the the New York crowds during rush hour and I immediately became impressed with this lady’s ambition (…I also imagined my dad’s face if he caught me in public wearing something like that and I am certain he would have a cardiac arrest). In addition to the shoes, she had some strappy thigh garter contraption that I think would take me longer to figure out than it would to solve a Rubrik’s cube, a black velvet bustier, and short jean cutoffs exposing colorful tattoos that decorated her legs. But behind the distracting outfit, I know this girl has got a story. I’m sure of it. A few seats down there is a guy in a crisp gray suit and brown leather dress shoes that could make a girl swoon. Okay, so maybe I say that from experience. Oh goody, no sign of a ring. Score…well, not that I’d have the cojenes to actually say anything. But what’s his deal? And across from him is a young teen wearing bright red Air Jordans. His feet are flying in the air as he blasts music from a tiny boom box, doing tricks and flips on the middle subway pole. There’s an overturned baseball cap a few feet away in hopes of scoring some late night cash. And then there’s me, all sleepy like with bags under my eyes, in my black work Nikes that were purposefully chosen to hide any splashing bodily fluids that they may have crossed my path.  Anyways, I’m sitting there mesmerized, taking this scene in and thinking to myself, “I live in FREAKING NEW YORK, NEW YORK!” With all these interesting humans! How can you ever be bored when you can be within earshot of four different languages at a restaurant? Or any type of cuisine in a 10 block radius? With free yoga classes on the waterfront and random bands playing in the numerous green parks across the city that break up the concrete jungle scene. What I am getting at is the diversity and variety found here is my favorite thing. God, you are one creative master and never in a million years did I think you’d place me here with this opportunity to live in one of the most iconic cities in the world. Yet here I am, blessed beyond anything that I deserve. Living amongst the beautiful chaos that is NYC.

Sunday floats on the Hudson

So…I’m happy to announce that yes, I’m staying. California, don’t freak out yet. I just signed for another three months and will beat Santa home, pinky promise. I know I just ranted about how craze amaze it is here, but I do recognize that I think I like it more knowing it is temporary. I experience things differently when I am cognizant of their impermanence. This city is a blast but I think the razzle dazzle may fade as the need for a more convenient, inexpensive lifestyle would eventually be preferred. I actually think I prefer Boston over NYC if I decided to be an East Coaster for the long term. But overall the Pacific (and mi familia) still has my heart. In a perfect world, I’d live a stone’s throw from my sisters and get to be a nurse by day and a mermaid of Southern California by night (oh and have a lifetime supply of La Croix and Trader Joe’s Peanut Butter, of course). Now as I reflect over the fact that I have officially been out of California for almost a year and a half, I am really happy that I took the leap and came to see what all the fuss was about. And quite frankly, I’m a little proud of myself. It wasn’t easy. Or cheap for that matter. But if there’s anyone out there reading this wondering if the grass is greener some place else, I urge you to just go check. Yea you might show up and it’s all weeds or is actually fake lawn turf, but at least you can stop wondering. And guess what? Home will always be there. It really has made seeing my family that much sweeter each time I go back (click here to learn more about the house that built me in my favorite post to date). Which probably leads some of you to ask the burning question that my family has as well…after my travel nursing journey is complete, will I go back to the Central Valley of California? Well, that answer I do not have. I do have a few more international trips I’m hoping to tackle in 2018. And the goal to grab that master’s degree before age 30 is still looming over me. I really need to stop avoiding that. But for now I’m going to enjoy the rest of 2017 in my stupid expensive Lower East Side apartment and continue to eat as much pizza as possible. I also intend on enjoying the most beautiful season the East Coast has to offer. I am currently typing this in my favorite striped onesie pajamas and my #basic uggies because it’s fall, y’all!

Oh and lastly the only other news I have, other than my current addiction with continuing to chop my hair (about 15 inches down since I moved!), is my recent transition out of the Intensive Care Unit for this work extension. This was a big and kind of scary step for me because critical care is all I’ve known and I do love it dearly. Buuut I was feeling a little burnt out from inpatient care and when my recruiter gave me the opportunity to try outpatient nursing in a surgical clinic, I decided to try it out just for these three months. I still work at Memorial Sloan Kettering Cancer Center but now I am a nurse for the Hepatopancreatobiliary Surgeons in the MSKCC outpatient setting. Hepatopancreatobiliary is a mouthful, I know. It basically covers cancers and disease of the liver, gallbladder, and pancreas which again, is not my background. But I am learning a TON and have had my nose stuck in articles trying to soak it all up. Even though all the information has been overwhelming, my inner nerd has been doing a little happy dance the more knowledgable I become. My job basically consists of assisting the surgeons with post-op follow up appointments or being an integral part of the education portion for newly diagnosed patients and helping them understand the diagnostic procedures and surgeries that are a part of their cancer treatment (for my medical friends think ERCPs, Whipples, liver resections, etc…) I also have to wear professional clothing like a real lady human…whaaaa? Kind of a bummer but other than that, it is a nice change for now. Well, I promise to crank out some posts more often and break this writer’s block I have been having.

Until then, cheers and keep on wishin’!

Miriam

P.S. Here’s a quick overview with some pics of the shenanigans I have been doing the last three months…spontaneous trip to Montauk in Long Island, multiple shows on and off Broadway (Chicago, Groundhog Day, The Great Comet, Sleep No More, Shakespeare in the Park’s A Midsummer Night’s Dream), baseball games (when I’m a fake local I’m Mets>Yankees), a relay race in the Adirondack Mountains of upstate NY,  getting lost in the different boroughs with new and old friends, and of course eats on eats on eats. Also, mega shoutout to the multiple visitors I have had. It’s been a pleasure  :]

Exploring the city with new buds and visitors

Montauk


Grub Time

MZUNGU GIRL: Oh hey, concrete jungle…

Current Tunes: What Do I Know?, Ed Sheeran

MZUNGU. This is my favorite Swahili word of all time (sorta pronounced muh-zoong-oo). In Kenya I would often be called mzungu, usually in whispers from surrounding children but other times straight to my face as it is generally used for a person of European or foreign descent in Kenya (and in my experience, basically anyone with lighter skin). Kind of reminds me of the Spanish “gringo” of Kenyan culture. But I was told the word actually originates from the Swahili word zungu, which roughly translates to “spinning around from place to place” and adding the letter “m” at the beginning gives it ownership to a person who roams around aimlessly. So besides the fact that it’s just fun to pronounce out loud (I dare ya to give it a try, rolls off the tongue nicely) my wandering heart and nomadic lifestyle just resonate with the deeper meaning of this word. Even when I am physically sitting still, I often feel like my thoughts are spinning with my brain just sort silently whirring. I guess I truly am a mzungu to my very core.


And after four glorious family filled weeks in California, I’ve launched into assignment numero cinco…on Saturday I flew from California to Pennsylvania since my aunt graciously let me store my Jeep filled with my whole life in her shed while I was gone in Africa/California and from there I drove to New York. Homegirl is officially living in the BIG CITY! As in underground hot sticky subways, shoulder to shoulder shuffling, corner stand hot dog stands, and a wicked skyline that won’t quit city. To say I’m excited is an understatement but underneath that excitement lives a thin, healthy layer of anxiety and uncertainty. I keep picturing myself as a sweaty hot mess express that somehow managed to take the wrong line and end up late to work or as a lost puppy that has accidentally roamed into some questionable neighborhood that could be the setting of a Law and Order SVU episode. For someone that travels as much as I do, my sense of direction is pretty abysmal and if direction dyslexia was a thing, I’m sure I would have it. Which makes me all the more thankful to be reunited with my dear friend and old travel nurse partner, Kaitlin. We last traveled together a year ago with a six month stent on the West Coast’s version of the city in San Francisco. And on Thursday together we will start a new adventure at one of the premier cancer centers in the country in the oncology/surgical ICU of Memorial Sloan Kettering in Manhattan. It all just sort of feels surreal. Never in a million years did I imagine that I would live in New York, New York.  Well not before before I made one of the scariest and best decisions of my life when I took the leap and began travel nursing two years ago.

So what’s a girl to do in NYC in the summer? Ummm, I’m sort of hoping everything. Definitely a lot of walking. Today I used Uber twice and the subway yet still managed to rack up 15, 000 steps. While we might do a few touristy things, for the most part we plan to steer clear of tourist death traps like Times Square. I really want to see the city from a local’s eyes and seek out the hidden gems. Maybe I’ll rent a bike and go on a graffiti tour, devote a whole day on a quest for the best bagel in Brooklyn, or seek out the funky events I know NYC would have to offer like being a part of a crowd that breaks some sort of world record. I do know one activity that will be on my weekly to-do list… Eat. My. Face. Off.

If you are at all intrigued by food bloggers or Insta Food Porn, click here to check out @OneHungryJew. Just looking at her posts make my mouth water and heart skip a beat.

I also hope to catch a few outdoor concerts, eat some cracker jacks at some ballgames, and get lost in each of the boroughs. For my West Coasters, the Big Apple is broken down into five boroughs (basically five smaller cities) which include Manhattan, Brooklyn, Queens, The Bronx, and Staten Island. While my workplace is in Manhattan, Kaitlin and I landed an Airbnb Sublet in one of the up and coming neighborhoods of Brooklyn in the Williamsburg/Greenpoint area. I also learned my neighborhood is often home to many television sets like Girls, The Unbreakable Kimmy Schmidt, and Master of None. Hoping for a celeb sighting or two…Aziz, hollatyagirrrrl! And guys I am just gaga over this loft duplex apartment.

The building itself used to be an old factory that was recently renovated into furnished short term rental apartments. The real exposed brick, dreamy embroidered rug, and loft ladder to the second bed got me looking like the heart eyes emoji. Plus the AC is included in the rent which is a BFD since y’all know I sweat buckets and this East Coast summer humidity is going to come at me with no mercy.

Can’t believe this time last year I was gearing up to move to Boston. Good gravy, sometimes I am just so overwhelmed with God’s countless blessings and the opportunities I have been given to see and meet His people in all forms, across so many different locations. Speaking of which, if anyone has any church recommendations in this city, drop me a line please. 

Hope everyone is prepping for some fun summer vacay plans! Just got home from a Mets game at Citi Field in Queens and I could definitely get used to this city life :]

Cheers and keep on wishing!

Miriam

CRAFTED FOR KINDNESS: Do selfless good deeds exist?

Current tunes: Fickle Heart, Ira Wolf

Setting: April 2017, Kipkarren Village, Kenya
She came rushing and panting, a bundle of squirming blankets in her arms. She laid him down, the tremors starting to subside, but his eyes still deviated far right and my chest felt tight with panic as I surveyed the look on Michelle’s face. His little belly was puffing in and out and you could hear his crackled, labored breathing. Weary, ill adults I could handle, but a seizing baby in respiratory distress? I was out of my element, but Michelle, a former ER nurse turned family nurse practitioner and the founder of this clinic, started to delegate tasks and as a team we surrounded the toddler and got to work. While two other clinical officers worked to get an IV line in one of the oh so tiny thrashing limbs, I grabbed some vitals- heart rate in the 150s, respiratory rate of 55, SpO2 87-88%, febrile 38.9C and when I put my stethoscope to his little chest I heard wheezes and rattling. Michelle rushed to get a breathing treatment started. We don’t have oxygen tanks at the clinic but we do have a nebulizer machine. The mother sat silently in worry, her brow furrowed as she watched us swarm her child. I supported his neck up with one hand and held the treatment in place, his screams actually aiding him in getting the medicine more quickly. And eventually his breathing slowed and his oxygen levels began to improve. My hand was cramping, holding the treatment in place and trying to avoid the bundle of cloth that covered his lower half as I could smell and see was soiled, but I could finally sigh in relief as they managed to get some IV access and start antibiotics and fluids. His tests came back positive for malaria, typhoid, and it was obvious he had some sort of respiratory infection as well. And the seizure was likely a result of a sustained high fever caused by his three infections. I handed him over to his mama now that he was stable.

I went back to Michelle’s office to reflect on what I had just witnessed…I couldn’t help but think of the outcome if he had not made it to the clinic. Malaria is a common and treatable disease but the mortality rate for young children is actually quite high. And while it’s not everyday that the clinic has real emergencies, it does happen. I felt the weight of everything and as we drove home that day I looked over at Michelle and just said, “Michelle, you and your clinic, you saved a life today.” And while it’s an immense amount of work to run an NGO in a third world country, I know it’s days like today that reaffirm her efforts are not in vain.

I share this story not to flaunt our volunteer efforts or for praise. They knew what they’re doing and while it was an honor to assist, the clinicians here are skilled and they could have functioned fine without me. In fact, I was the one learning since caring for babies is not really in my scope. But it feels amazing to have purpose and be needed, doesn’t it? Usually when I share about the volunteer opportunities I have had, most people show interest in doing something similar. However, one time I shared with a co-worker about my first Africa trip in 2015 and her response was,  “Oh that’s cool. I want to do that too. But not with a church. Because I don’t believe in doing good things to get to heaven, I’d rather do it because it’s the right thing to do.”  I stared at her, taken aback, not sure how to respond. I think my silence made her realize I found it a little offensive as she just indirectly said that my efforts were for personal gain only or maybe only done out of fear of a higher power (that she probably didn’t think existed for that matter). I was actually more sad than offended. Sad that this person believed a walk of faith and service to others was solely to get spiritual brownie points, as if God keeps tabs on my good deeds and is unconcerned with the state of my heart. Salvation doesn’t work like that. If it did we’d all be screwed. 

So it got me thinking, is there such thing as a selfless good deed? Another friend of mine challenged me with this question before. He insisted it doesn’t exist and that we are always out for ourselves making us look or feel good, even if it is done subconsciously.  Of course I ended up a little defensive, trying to disprove his points but after this second trip to Kenya I think I’ve come to a new perspective  about selfless deeds. What if they don’t exist? And what if selfless deeds don’t exist on purpose?

As humans, I believe we are created differently. We have a soul. A spirit that allows us to think, feel, love, create and separates us from all other walks of life. So what if our souls were intentionally designed to hunger for serving others and the joy that comes with it? Maybe it feels good to do good for a reason. Maybe we were crafted for kindness and are called to live for more than ourselves. And I like to hope that just maybe this helps to spur humanity to pay it forward. Think of the last time you put some one’s needs before your own…okay, so it probably doesn’t always feel good in the moment, but when you feed your soul in this way, I think you build character. So you’re still gaining. And other times it does feel a little magical knowing you made a difference for just one person. Because whether you’re a theist, atheist, agnostic, or are undecided on who you serve or your purpose on earth, I think we can all agree that our world could use a little more “selfless deeds.”

Which is part of the reason I re-entered America feeling so refreshed. Like I actually believe that I needed this opportunity and time away more than that African village needed me. It was so cleansing to be unplugged and away from the distractions of my first world probs. It was as if time had stopped with little need to check my watch or phone (the village has spotty connection let alone reliable electricity…our power would go out daily). My schedule was simple, pre-arranged, and filled with many opportunities to bless others and meet people who’s stories really put my own into perspective. After a day of working at the clinic I would go catch up on some much needed Zzzz’s, stroll down by the river, actually read books without picking up my phone every few pages, and sometimes wound up asleep by 9:30pm…woah, who is this girl? Now I think over a long period of time I probably would get antsy because I tend to be a busy bee and struggle with being physically and mentally still but for those three weeks, I just felt free. Also, getting to live with Michelle and William Kiprop, the missionary family and founders of the clinic, and watching firsthand what it looks like to live so sacrificially was such a blessing to me. They definitely have changed my perspective on what it looks like to live for others and Jesus. They do more than provide healthcare to an underserved population. People would often randomly show up on their doorstep at all hours of the day and night asking for food, money, health treatment, a ride, etc and while the clinic and building a hospital in the area is their tangible mission, overall they have committed themselves to representing Christ by providing hope to a community that may feel less than or forgotten. And it was an honor and privilege to watch and take part in and I know this just the beginning of many years/trips to come of working with the Kiprops and Hope Matters International in Kenya.

Oh and just a quick PSA- you don’t have to leave your home or work in the medical field to feed your soul in this way. If there’s one thing I have found through traveling is that people are broken all over the world and struggle with the same sins, hurts, and tragedies. I truly believe that becoming more mindful of helping others and intentionally serving in your everyday life can bring you so much joy and purpose and I’m sure there are needs in your community, heck even in your immediate family, that you can impact. You just have to start looking. Because people matter. And people need people. People need you.

As far as my current whereabouts, I am back in California for a month, spending time with family and was able to swing a temporary registry contract back at my home hospital in Fresno. Not going to lie, it feels pretty darn good to be back with my Trauma ICU family and in a familiar workplace. So if you have seen my Snaps or are wondering if I stopped wandering since I’ve been in the 559 for longer than normal the answer is… nope, nope, nope. But is nice to be back on the West Coast (best coast). I counted and in the last 11 months I think was only in Central Cal for 12 days…weeeeird. But I’m going to soak up the Cali sunshine as much as I can before heading back East. I think I am currently the whitest I have been since leaving utero. Vitamin D stat please.

Cheers and keep on wishin’!
Miriam

KENYA (week 3): I am Jepkoech

Ni naitwa Miriam Jepkoech. Nina toka California. Mimi ni muuguzi.
I am called Miriam Jepkoech. I am from California. I am a nurse.

The Kenyan wedding I crashed

Current tunes: Some African radio jams and the windshield wipers battling the rain
Current Location: En route to Kipkaren from Lake Nakuru National Park

Equator Quick Pic

My broken Swahili may not be much, but I enjoy watching the kiddos giggle at my Swahi-nglish (Swahili English) and noticed it does help establish rapport with the older clients at the clinic. Interestingly enough, Swahili is derived from Arabic and I’m finding there are many words that are the same or very similar to my father’s native tongue. Shout out to my Theta, aka my immigrant Syrian grandmother, that lived with my family during my childhood…your loving shouting matches at me to clean the tornado that I called my bedroom, to help with dinner, and to change out of my inappropriate outfits by Syrian standards, have all aided me in my Swahili efforts. I also found a deck of Swahili flashcards in the Kiprops’ home and have been trying to write all that I’ve learned phonetically in what I call my Swahili Bible. And who knew Disney’s The Lion King actually has real Swahili words embedded into the film? The leading cat Simba does mean “lion,” the baboon named Rafiki means “friend,” and the classic Hakuna Matata jingle really translates to “no worries” just as the lyrics state. Between Mickey Mouse and my Theta, I should be fluent in no time…yeah, right.

Oh and I should probably address this “I am Jepkoech” (jep-koh-etch) business. Kenyans are all born with a middle name determined by the time of day/the events surrounding their birth. Because I was born in the morning, William has given me my Kenyan name of Jepkoech. But there are names relating to all sorts of events, like Jerop would be for a baby girl born while it was raining and Jepchumba literally means a baby girl born “with white people around.” In addition, there is a masculine and feminine prefix change, so if I was a boy I would be Miriam Kipkoech…and to complicate things further these names are part of the Kalenjin tribe, which is just one of 43 tribes in Kenya. Don’t even get me started on how they determine your last name. Something about females getting the father’s surname (which will later change post marriage) and males inheriting the father’s middle name as their last name…I think??? While it gets confusing, Michelle says to just be aware that families do not all have a unified last name and it is common for people to give their first and middle name only, if asked.

But other than this crazy Kenyan name game, I do feel that because I am staying here twice as long as I did in 2015 and have come solo this time around, I have been able to immerse myself in Kenyan culture in a deeper way. Living with the Kiprops (yes, William Kiprop was a rain baby) has been such a blessing. If you ever have an opportunity to live with locals while traveling, do it! It always provides for a richer experience and better understanding of a country’s people.  And through working along side them at clinic and getting to know some of the patient’s families, I really am loving the hearts of these Kenyan people. William’s family is from this area, Kipkaren Village, and is part of the Kalenjin tribe that I mentioned before. Of the 43 tribes, it is the third largest. Kalenjins are known for their farming abilities and running talents. The Kenyan Olympic distance running team is often comprised of Kalenjin runners and the largest urban city in this area, Eldoret, is sometimes called the Home of Champions because of the athletic abilities of its natives. Sadly, I have only gone on one run in the last few weeks of living the village life and while the scenery is beautiful, the rocky unpaved dirt roads, the dogs and random livestock that roam the streets, and the fear of getting lost without cell service has deterred me from getting in my usual mileage.

William, my #1 local and Swahili tutor

When I asked William to describe the parts of Kenyan culture that he feels are the most valued, he first starts by emphasizing how each tribe is unique and has their own traditions and language separate from Swahili. But something they all value is respect. This is easily seen in the way they greet each other, usually ensuring they shake hands with the every person in the room and often using two hands to do so. Michelle also explained that it is a very formal culture with celebrations often having special ceremonious traditions and speeches galore. Which I found interesting since most locals have been pretty quiet around me. I asked William if this was because of the language barrier and while he says that might be a part of their silence, he adds that in general Kenyans tend to be more reserved. As an American turned ten year resident of Kenya, Michelle gave some insight on what she feels is one of the most notable aspects of Kenyan culture. For Kenyans, the individual mindset is put on the shelf to make room for the needs of the entire community. In general, the extended family is above the nuclear family and the collective experience is always considered when making important decisions.

It is also more of a paternal society with men holding more leadership positions than women and the education gap between the genders is very prominent. In the village, it is rare to see women wearing anything other than a skirt or dress and Michelle even estimates that of all the automobile and motor bike drivers, roughly 5% are women. And it’s true, other than Michelle I have not seen one female driver on the road. Which is probably why I was getting intense stares piercing the windshield when I had to drive their Toyota 4Runner home from the clinic last week. I could just feel their eyes…“Look out! Who is this Mzungu (foreigner) girl that has stolen the Kiprops’ car?”  Or maybe they heard my heart booming in my chest as I nervously learned what it feels like to be on the left side of the road while sitting in the right sided driver’s seat for the first time. Not going to lie, even though it was a quick ten minute drive on mostly village roads, my scrubs had a thin layer of sweat soaked in when I finally parked in their driveway. And while it is very unlikely to happen on a short village drive, I later learned that people are easily thrown in the clink if caught driving without a Kenyan license…yikes bikes.

Lived through my first Kenyan driving experience

One of the biggest things I noticed is the lack of urgency when keeping a schedule. Again, this is partly related to respect as putting your next meeting on hold shows that you are committed to being present with your current company. But I also think Kenyans are just a people that are comfortable with having a relaxed view towards punctuality. Just last week I third-wheeled it with the Kiprops and crashed a Kenyan wedding. The invitation indicated a start time of ten o’clock in the morning. So when I asked William what time we should leave knowing that we lived a good hour or so away from the venue, he nonchalantly replied that 10ish would be good time to leave the house…WHAT? In America they would shame you for that. And what do you know, we pull up to the wedding around 11:30am and the bridal party is not even all present yet. #HakunaMatataLife, am I right?

Well, I’m currently on the road back home (or what has been home for the last three weeks and it really does feel that way now) from Lake Nakuru National Park. I was lucky enough to have a quick one night weekend getaway with my Kenyan familia yangu (my family) to a self drive safari park. Not lion, I literally got wild this weekend…lame dad joke FTW.

And while I was so fortunate to safari in the famous Masai Mara during my last trip to Kenya, getting up close and personal with these amazing creatures does not get old (click here to check them pics and see why you need to add an African safari to your bucket list).  Only a few days left before I say kwa hari (goodbye) to my Africa life. And I honestly don’t think I’m ready…

Cheers and keep on wishin’!
Miriam

KENYA: Catch me at the clinic

Current tunes: Tourment d’ amour, La Fine Equipe & Saneyes
Current location: Kipkaren Village, Eldoret, Kenya

***This post is more laden with health care references and might be a bit uninteresting to my non-medical peeps. But I hope you give it a go anyway :] Also, permission was granted by each client before using their photo.

In my four short years of inpatient care at large facilities I have come to find that American hospitals are more so large businesses with ill clientele rather than places of healing and refuge for the sick. Perhaps this is part of the reason why it has been an interesting transition from working in a large facility of Western medicine with patient surveys and resources galore and  to a rural village clinic. I know this is sort of like comparing apples to oranges but the hypochondriac patients are nowhere to be found, there appears to be no sense of entitlement, and I can tell many are just grateful to have access to affordable care near their home.

 

Front of the clinic

And I really just have to tell myself to turn my ICU brain off and have come to find that the motto here is “give the best care you can with what you have.” On my first day I remember finding it a bit unnerving to place an intravenous line (aka an IV) without gloves and using needles that don’t have safety mechanisms on them to protect the clinician…but when resources are limited, again I go back to the motto. Of course, this does not imply that they give insufficient care here. In fact, not being able to magically get a 12 lead EKG or get a detailed health history forces the staff here to be more in tune with relying on their clinical skills of observation. Also, the clinic recently had a visit from the Kenyan Ministry of Health and were given a pretty stellar review.! Michelle has even worked to implement an electronic form of charting, known to many in America as an Electronic Medical Record (EMR). This is probably the only rural village clinic in the country that has converted to an electronic system, so it’s been pretty exciting for the staff and Michelle to grow this ministry in a way that will help provide more efficient and organized care.

While Hope Matters International offers more than medical support to the community, their Village of Hope Medical Centre focuses mainly on providing the community with walk-in urgent care treatment, maternal child health/prenatal care, diabetic counseling, and will soon be offering dental services! The clinic also has an onsite diagnostic laboratory that provides testing for the most common ailments in this patient population. The day to day patient demographic is most often composed of people with malaria, typhoid, gastric ulcers/infections, and those needing chronic wound management. I explained to one of the clinicians that I had never treated malaria before and hoped to learn more about the course of treatment and the disease process. She stared at me for a second in disbelief and said, “Never? You’ve never seen a malaria case?” I wasn’t sure if I should feel blessed or ashamed…and not to get all Miss-Frizzle-Magic-School-Bus on you, but let me give you the quick and dirty low down.

Malaria is a common problem in Kenya, especially here in the highlands

Basically malaria starts with a parasite carried by mosquitos causing persistent fevers, gastrointestinal disturbance like vomiting/diarrhea (which then causes dehydration), and terrible body aches and pains. Most everyone in Kenya gets it at least once (and often several times) in their lifetime.  Due to it’s prevalence, it is highly recommended to take anti-malaria pills for visitors and for the general public to utilize mosquito sleeping nets.  Call me a princess but I actually have grown to love my net and I pretend it’s the canopy bed my parents never purchased for me. Unfortunately if the disease progresses to a severe stage, patients suffer from convulsions/seizures from the persistent fevers, have respiratory distress, low blood pressure, anemia, severe dehydration from the inability to eat/drink, and loss of consciousness (among other things). I haven’t been here long but every day there seems to be children presenting with rampant, gnarly fevers as high as 103-104 degrees and are crazy dehydrated. So by the time they get to us we often need to give intravenous fluids and antibiotics. The cure is in fact antibiotics but I’ll spare you and not nerd out over the pharmacologic treatment here. PS I know I didn’t properly cite each piece but click here for the published guidelines from the Kenyan Ministry of Health!

However, I will say that in general, giving medicines via intramuscular injections (for my non-medical folk think any vaccination/shot you’ve been given) seems to be the gold standard for non-emergent cases as time, space, and resources do not always allow us to admit every patient for a course of IV drugs and antibiotics. And I know back home we generally go for shots in the arm but because the glutes are a larger muscle group and much of the community is malnourished, we just go straight for the buttocks (I have never given more booty injections in my life until I volunteered in Africa). In fact, before I even attempt to sloppily mime/use broken Swahili to explain the treatment plan, most patients are already pulling down their trousers to expose the top of one cheek, knowing that gluteal injections are just the norm when receiving treatment. After an initial intramuscular injection of a drug that is needed more quickly than it would take to swallow and absorb, it is then we would send them home with oral medicine.

chronic leg wound

Twice a week we have scheduled dressing changes for specific chronic wound patients. This past Friday I had the pleasure of tending to three of our wound clients and was astounded to hear the length of time they have been afflicted with caring for their injury…from three months to over two years! Can you imagine having an infected cut for two and a half years?! Because the cleanliness of an environment and nutrition play a large role in wound healing, these acute injuries often turn chronic.  When you have a large open area of skin and go home to a mud hut with dirt floors, probably can’t afford to take time off from work to let it heal, and then do not have a protein and nutrient rich diet always available to aid your body in the healing process, well it all just makes for a complicated situation. It pained me to tend to a chronic leg wound of a child as I couldn’t help but think that back home as an inpatient we probably would have pre-medicated the child with IV pain meds and numbed the site with a numbing agent to try and combat the imminent pain before taking down the dressing. But again, here we do what we can with what we have so I tenderly redressed his wound, repeating pole, which is Swahili for “sorry,” over and over as the child grit their teeth and released a few silent tears.  This made me think about my initial desire to enter the realm of pediatric medicine but after struggling to get an IV in dehydrated screaming three year old…well, maybe I’ll stick with my adult homies for now.

I can’t believe I’ve just hit the halfway point of my trip. This past weekend I crashed a Kenyan wedding with my host family but I’ll get into the details of that later this week. Oh and I befriended this little guy, too.

Cheers and keep on wishin’!

Miriam

PS Interested in furthering HMI’s ministry and goal in providing this area with holistic care? Click here :] Want to check out all my previous posts on Kenya? Click here.

 

KENYA: Frogs, flying roaches, & termites, oh my!

Current Tunes: None…unless you count the sweet sound of winged termites pounding against my windows.

First things first- shout out to my boy Benadryl! It took about six days but I think I finally got rid of my jet-lag.

Michelle

Now let’s catch y’all up to speed. Last Thursday I flew into Eldoret via a small commuter plane and was greeted by Michelle and William Kiprop, the missionaries I am interning with and the founders of the NGO, Hope Matters International. This couple continues to amaze me and I am so grateful to be an honorary Kiprop family member for the next few weeks. Our first stop was a hotel cafe, as the wifi can be spotty in the village and Michelle needed to catch up on some serious admin work.  It’s been two years since I last volunteered with HMI or have seen Michelle so it was here that she and I played a little catch up. I expressed to her how grateful I was that they welcomed me on such short notice (did I mention I solidified my decision to come end of February?!) and I admit that I think I needed Africa more than it needed me. I could not wait to have a to-do list that involved nothing about deciding future plans or moving.  Overall my soul is just eager to practice intentional serving and could probably use a little reboot by disconnecting from own self-revolving bubble and reconnect to purposefully pursuing the simplicity of His calling- to love God and to love others. Alright, tangent complete and back to Kenya.

Our second stop at the local Nakumatt, basically a Kenyan Super Walmart, was a good reminder that I had definitely left American soil. I had forgotten that it’s entirely normal to have soldiers with rifles and metal detectors stationed at the entrance of major shopping areas in Kenya. Unfortunately, this country has a history of terrorist attacks at these types of locations and I was redirected to have my bag checked and be screened after I mistakenly tried to enter through the exit door. In addition, certain grocery staples are limited here and Michelle griped that they have yet to stock fresh butter for several weeks now.  I gasped as I saw a jar of peanut butter priced at 1,350 Kenyan shillings (roughly $13.50 USD) but also did a little happy dance knowing my Trader Joe’s jar had made it safely through customs (my PB addiction has made nut butter an important part of Miriam Bourdain’s travel essentials…) And if these weren’t reminders enough that I had hit foreign territory, the traffic here will shake anyone up. Rules are mere suggestions as cars, matatus (large public transport vans), and packed piki pikis (motorbikes) zip in and out of traffic all while pedestrians walk through the madness without fear. But the crowds grew less dense and the streets became more bumpy as we left downtown Eldoret and began passing through the local suburbs outside the city until we finally reached Kipkarren Village. Kipkarren is not only William’s hometown but the main community that Hope Matters serves.

Little Ryan and I on Easter Sunday

As we pulled up to the Kiprop home, Ryan, Michelle and William’s adorable five year old son, was running around the front yard with their four dogs. I noticed some new additions as three half built buildings surrounded by laborers stood to the right of their home and I learned these would soon be housing for a new wave of volunteer groups for the organization. Just below the construction would be my home for the next three weeks. I’ve already grown to love this little cottage and it is actually larger than most of my apartments I’ve had while travel nursing.

Michelle warned me that as rain season approaches it is not uncommon for the electricity and water to go out…and of course as unloaded my bags we found this to be the case. Welcome to rural Africa! Since my arrival, the electric power seems to disappear intermittently, leaving and coming back as it pleases. Fortunately the house is equipped with a bucket of water for washing and pre-charged lights and flashlight and after years of tent camping with my dad, this doesn’t phase me. The critters on the other hand have been throwing me for a loop. I’ve already encountered flying cockroaches several inches long, giant moths flying into my mosquito net, a frog in my toothbrush cup, hoards of winged termites brought on by the rain, and the geckos in my bedroom are now my new household pets. My morning wake up call is often a rooster, cow, or the neighboring kid (that goat sure has a way with words ;]). But I can manage these as long as the malaria infested mosquitos stay away! Which reminds me, time to go pop one of my anti-malarial pills.

The next few days were spent in the clinic just down the muddy dirt road from the Kiprops’ (think Disneyland’s Indiana Jones ride x 5) and I threw myself into learning the flow of the clinic, becoming familiar with the foreign supplies available, and getting acquainted with the staff.  It feels good to work without feeling like I’m at work…does that even make sense? I guess what I mean to say is it feels good to put on those scrubs, to work long hours, yet not feel drained. And just feel appreciated. But I am still weirded out that I am often called daktari, or doctor in Swahili. I’ve even corrected them insisting I’m a muuguzi, or nurse, but when you’re an American in scrubs that is generally the first assumption.  Although, I’d be lying if this experience hasn’t been causing my original plans to be a Nurse Practitioner to resurface. I tucked those dreams away two years ago when the thought of going back to school mixed with the lust for adventure through travel nursing overtook me.  Plus I questioned if I would excel in a higher role of authority and if I desired a position with more liability. But working with the clinical officers, the Kenyan equivalents to a Physician’s Assistant, at the clinic and watching Michelle, a Family Nurse Practitioner, work with these suffering people has got me thinking about what that could look like for me.  Over these last few days I have been so intrigued by the diagnosing process and am revisiting articles/books to review certain disease processes and it’s actually been, dare I say it…FUN. Watch out, nerd alert. Let me remind you, I mostly excelled at three things growing up: finishing up my (second) dinner without parental request, growing eyebrows, and school. So maybe it’s time to revisit this NP plan. Or least make a final decision about graduate school in general.

 But that can wait, because right now I’m going to keep enjoying the simple routine schedule, the weirdly calming torrential downpours, the books I’m actually plowing through for a change, and the cleansing restriction of spotty wifi. The clinic is where I sometimes can post a Snap I’ve previously saved to my story or an Insta if the hotspot pulls through for a second…in fact I’m hoping this post makes it up!

Cheers and keep on wishin’,

Miriam