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.