Doctor V Goes Over The Sea

Seven quick comments scribbled down as I sit:

1. There’s nothing like a herd of cows stampeding down the hill behind you to make you pick up your running speed. My usual slow jog (comparable to a lumbering yak) became an impressive sprint this morning.
2. Rather than utilizing traditional GPS to pinpoint my location when out running behind our house in Kenya, you could utilize the sing-song chorus of “How are you?”s and shrieks of “Mzungu” (white person) that follow me across the fields and past each little dwelling.
3. Right now in the fruit market, you can find piles of tiny, delicious red plums. Their sweetness is enough to inspire crimes of plum thievery along the lines of William Carlos Williams’ “This is Just to Say.” Amazing.
4. The advantage to the last-minute nature of any organized activity here is that it seems like remarkable things can still come together when you might abandon hope in another setting. Putting together a week of employee training to start tomorrow when half of the people have not yet been given official job offers, no hotel accommodations are booked, and most of your speakers are not confirmed and may not even know they are talking? No problem. It will come together.
5. Regardless of your own organizational style, I bet one’s perspective on the last-minute, (non-)organization of activities in a place like this is an excellent test of whether you have an optimistic bent or a pessimistic bent. If you can stick with “I’m sure it will work out somehow”, you are fine here. If your tendency is to despair “this will never work”, you might go crazy.
6. Our compound is rife with laundry crimes. Not so much the money laundering sort (as far as I know), but more the rampant theft of clothes pins, drying underwear, laundry detergent, and even clothes lines. I may take to drying my clothes under the cover of darkness or utilizing my room even when not necessitated by rain.
7. I watched this charmingly illustrated interview with Maurice Sendak yesterday, and even though I am not an atheist like Sendak, his philosophy reaffirmed so much of what I want to embrace in life. I love his scratchy, ancient voice declaring, “I am in love with the world” and “live your life, live your life, live your life.” A reminder for me to embrace the privilege of these days in this beautiful world.

I love this video highlighting the work of our Orphans and Vulnerable Children program at AMPATH! It features my friend/colleague, Elizabeth Chester, who runs the OVC program with skill and grace. Plus, it shows the amazing hospice run by another friend/colleague, Juli McGowan, which is truly the place that saves some of our sickest, most malnourished children.

Jemimah from Jacqueline Buckingham on Vimeo.

Today, I’m trying to finish hiring a team to help Tony get back to playing soccer.

Tony is 12, and soccer (football) is his favorite thing in the world.  He has been infected with HIV his entire life, and he has had to take medicines for HIV over the last 4 years. The soccer sometimes causes problems with taking his medicines:

I was so bad with my meds.  I just didn’t remember.  It’s hard to remember when you are playing football like I am.  I love football.  I would miss meds because of not remembering.  I wasn’t trying to skip.  Sometimes my older sisters would try to remind me, but the way they tell me is not good.  I don’t want to do what they say.”

Because he missed too many of his medicines, the HIV started to weaken his body, and he got sick enough with a pneumonia that he had to be admitted to the hospital a few months ago.

We decided that it was time to tell Tony that he had HIV; we hoped that he might take his medicines better – and stay stronger – if he knew that he had HIV.  This was a slow process for Tony. At first, he did not want to believe that he had HIV.

When I got back from the hospital, I just wanted to say, “That never happened. I don’t have the disease.”  I was feeling better and thought it was some mistake. I think I was in some big shock. I wasn’t listening. I started to get sick again. I wasn’t playing football much and the kids were saying I was too weak for it.  They started talking about me. I didn’t like the meds but I started hating being sick. I wanted to forget I had HIV, but some of the kids were guessing and calling me names. They said I couldn’t play on their football team anymore. They make it hard for me to forget about this disease.”

As part of my research study figuring out how to disclose HIV status to children, today I’ll complete the hiring of a team that will offer counseling for families and for children like Tony. We spend all of next week beginning their specialized training. We’ll have a curriculum and special materials to guide families through this process of talking with children about HIV and helping children accept their diagnosis. We’ll have support groups of adolescents that will offer ongoing support and discussion.

Tony has benefited from counseling and from one of these groups, and we want to make the groups available for more kids like Tony:

She was saying there were other kids coming to the clinic like me.  There are times when they talk together at the clinic.  I go and listen.  It helps me to remember that I am not the only one and we learn how to accept this disease.  It is still a bit hard, but I don’t skip meds.  I don’t want to get sick again.”

Most of all, I hope we will make it possible for kids like Tony to get back to doing what they love best – playing, being with friends, going to school, and growing into confident adults who can take care of themselves.

Taking a moment to express gratitude for these things that have blessed me today:

My new car. This lovely, sturdy vehicle (which may henceforth be known as the Blue Beast) was purchased through a gift to my pediatric HIV care and research program. The intent was for this car to grow my work improving the HIV care system for the children of Kenya by connecting me and my team with our 65 clinics spread across western Kenya. I could not be happier with a car that I can rely on to carry me and my team across the bush to our farthest clinics and to patients’ homes, many of which are in places where the roads are non-existent. Plus, it’s super-fun to drive.

The Market. Even though my lack of cooking skills is the stuff of legends, I love buying a cardboard box-full of fresh fruits and vegetables at the market. The colorful piles of fruit, the hanging displays, the smell of the ripe produce, and even the haggling over the best pieces and prices all make me smile. And I’m very pleased to fill my giant fruit basket for under $20.

The fields. So thankful am I for these golden fields across which I have walked and run hundreds of times over the past 7 years. Their grasses absorb the pains of the day, the golden light softens my over-working mind, and the vast blue sky opens my heart again to the possibility of wonder and something more.

Poems. The carefully crafted words of others nudge me and my heart to new places. I don’t think I’m particularly good at prayer or meditation, but there is something in the reading of a poem that comes close for me. Here are a few lines from Mary Oliver that struck me as I read them this morning while the Equatorial sun filtered up across our gardens:

Lord God, mercy is in your hands, pour

me a little. And tenderness too. My

need is great.

(from “Six Recognitions of the Lord”)

and

“It’s not the weight  you carry

but how you carry it –

books, bricks, grief –

it’s all in the way

you embrace it, balance it, carry it

when you cannot, and would not,

put it down.”

So I went practicing.

Have you noticed?

(from “Heavy”)