January 17, 2015

It is Saturday and I am writing this from New York’s JFK airport. It is 6 pm and my flight to Brussels boards at 6:43 pm. I have not written for a few days. Here is what has happened since I last wrote.

Tuesday morning Amy and me left Phoebe to school. We went to Walmart and I bought a new strap for my watch and a new duffle bag – I found the one we had bought at Cabella’s too big. I was more satisfied with this one.

I finished packing and we drove to CWA. Amy sat with me for a few minutes outside security. She told me she was proud that I was pursuing something I believed in, that was a worthy cause (or something like that). Because we have not been getting along very well, our parting was a little cold.

My flight to Boston was relatively uneventful. I decided to be brave and take the T, rather than a cab, to save money. It went quite well and I did not get lost. I got to the Holiday Inn by about 9 pm and settled into my room for the night.

The next few days were pretty much the same.I walked down to Commonwealth street where on the 3^rd floor of building 888 were the offices of PIH. The staff were extremely polite, friendly and very young. We met every day there.

Our group – the January 12 cohort – consisted on 19 people, 6 going to Liberia and 13 to Sierra Leone. To my count, there were 5 doctors – Guy, Marcus, Jessica, Molly, Emily, Rick and Katie. Rick and Jessica were going to Liberia and the rest of us to Sierra Leone. I noted that several of us had international experience, some having spent a year or more in another country as part of the Peace Core or some other medical work.

Here we are on the last day of our training…

The office training was delivered as a mix of PowerPoints, Skype interviews and some audio. It was practical and pertinent. While most of the group socialized in the evening, I chose to spend the time in my room. I did find a nice Indian restaurant, Rani’s Bistro where I ate most of my dinners.

So here are few thoughts…

A nice young man named John gave us a talk on the mission of PIH. It was filled with heady stuff about healthcare being a basic human right, working with governments to strengthen their country’s healthcare system being the key to longterm success and such. While I agree in principle, my past experience with government corruption, the transient nature of most people in power and their promises and commitment often being overwritten by the next to assume power makes me a little cynical. Yes, healthcare is a basic human right… like food, clothing, housing, education, and the right to dignity, happiness, ability to achieve one’s potential unhindered by lack of opportunity, blah , blah. So what? How do you make this real?

Here I sit at an airport going to Africa to work in Sierra Leone with Ebola for 5 weeks. I wonder about how much good I can do, and how does this fit in the grand scheme of things. I guess I am one of an army of short term workers, taking some time out of my life to contribute manpower hours to care for those suffering from Ebola, to contribute to the process of controlling this epidemic. After this, I return to my existence as a small country doctor, treating the about 1500 people who visit me regularly for their healthcare. Is it worth it? Should it be left to the professional ‘world-changers’ – doctors who do global health as a career?

I feel like I can certainly learn protocols and read and assimilate and be ‘boots on the ground’ for 6 weeks. Hopefully, my mite, along with that of other cohorts strung in time make for some continuity that makes a difference. Meanwhile, my life is on hold – my practice, CF patients, Peds Board preparation, family, all cease for a few weeks. Am I being selfish, seeking the direct fulfillment of doing something while others share in the price of what I do? Is this the right way to do this?

I certainly want to help – to work in a third world setting with intelligence, creativity and energy. However, I am a little cynical about effecting global change. Meanwhile, how do I support my immediate and extended family financially? Am I letting my CF patients and other patients in Marshfield, WI down doing this while leaving them to the mercies of whoever can help them there? Are there lives, because they are not the focus of the world and do not have a ‘glamorous’ eye catching disease or make a photo-op moment, worth any less? Yet, am I content to serve them in obscurity, putting in decades until I am old and must retire, as many of the older docs in the community of Marshfield have done?

In the end, only God can give perspective, direction or meaning to any of this. The ‘machine’ is too large for one part to behold how and where it turns and what it produces.

January 18, 2015

It is Sunday. The day began in the plane. Because of time changes, most of the day is spent in the plane, going from New York to Brussels, Brussel to Freetown, via Dakar, Senegal, Conakry, Guinea on our Brussels airlines flight. Sitting next to me was a young man, Sam, who was from Wales. He was going over as part of the British Red Cross to work in Konama. There were a number of ex-pats in the plane, all going to Freetown as part of an Ebola response from one or the other organization.

We arrived at the airport in the evening. It was dark. From the airport, we were driven by bus to a ferry stop (here is picture taken athe ferry stop that showed us our first public sign (outside the airport) regarding Ebola; we would see numerous signs everywhere.



 and took a Sea Coach ferry for about 30 minutes in the pitch dark. On the other wide, we got into a bus and drove to King’s road, where PIH had an apartment building. I got to share an apartment on the 4^th floor with a Sierra Leonian, Edward Vandy (an RN from the UK who had been working with GOAL and was now returning to work with PIH), and two nurses, Kim and JoAnne. The apartment had 3 rooms, a hall, kitchen and 2 bathrooms. The men got one half (with 2 rooms) and the women shared a room with bunk beds. The apartment was surprisingly comfortable, with a television, air conditioning in the rooms and spotty internet. After settling in for the night and calling Amy, I went to bed at 12:30 am. Here is a view from our apartment…

DAY T-1 January 12, 2015

Today is Monday. We all got up and took Phoebe to school. I don’t think I have ever done this, since I usually work and Amy drops Phoebe off. Amy and we went to breakfast at Perkins and I left her home. I went to the Clinic to get some Peds Boards review files from Sarah. I stopped by Walmart to get my old watch battery replaced and the strap fixed. I reason that it is not wise to take the expensive Raymond Weil I got for my 50^th birthday to Africa. Instead I pulled out the abut $ 30 Lorus and tried to buy a strap and battery for it. The strap costs $ 14 and for about $ 20 I can get a new watch! Times have sure changed. I came home and began to pack.

DAY T-2 January 11, 2015

Today is Sunday. Our family got up and went to church. While Amy had originally said she would not sit in the service with me, she changed her mind and did. I kept tight-lipped about my travel plans. I reasoned that it would alarm and inspire fear in some of our congregation if they knew where I was going and that I intended to come back to them. Dave Heegeman knew however, and he prayed with me after the service.
We went to Perkins for lunch and went to see Night at the Museum Part 3. It was a fun movie and we exited the theater in a good mood. We came home. I worked on backing up my data while Amy and Phoebe practiced piano and violin. After dinner, Phoebe was put to bed and Amy and me watched ‘The Good Lie’, a movie about the lost children of Sudan. Went to bed.

DAY T-3 January 10, 2015

Amy and me are not getting along. She woke up to go to counseling with Dr. Benson.  I went to the clinic to try to back up my files. We met at home at noon to go and pick up Phoebe. After going to the Mall to try to find her remote control helicopter (Amy and me had sort of promised Phoebe she could use money she got from her grandma to buy this), I left them and home. I called my mother and brother. It felt odd not being to tell them about Africa, while I have resigned my job and am shopping and packing for this. But, how would it help them? They would be tortured thinking about the risks I am taking on the job front, traveling to Africa and working with Ebola. I reasoned, they are better off knowing when I am back, if that is possible. Phoebe and Amy stayed at home, while I went to Walmart, Office Max and Fleet Farm looking for things I needed – adaptors, shoes, etc. I came home and we ate dinner. We watched the Night at the Museum 2, as Amy and Phoebe had not seen it before and were keen to see the third part in the theater tomorrow. After Phoebe went to bed, Amy and me talked some. Her initial anger and wanting a divorce has calmed down some.

Day T-4 January 9, 2015

DAY T-4 January 9, 2015

Today I resigned from my job at the Marshfield Clinic. It felt sad taking off my badge and leaving my pager on the desk. Due to HIPPA requirements, since I am not an employee, I cannot access the Clinic’s email system or read notes, look at labs or anything. I am cut off completely.

It felt odd and scary to walk away and know that I am no an employee of the Marshfield Clinic. I am unemployed. I can no longer expect a salary. What have I done? What am I doing? I backed up all my research and files on a portable hard drive, because since I resigned, IS may wipe out all my records.

It was a harrowing day as I had still not received an itinerary or confirmed ticket. Finally, after several emails and one phone call, I received it at 8 pm at night. I am flying to Boston on Tuesday, January 13, 2015 at 2 pm.

It is going to be interesting trying to record this on an iPad.