08 March 2016

"Nice Times"

It was blazing hot. The ice in my drink made the cup sweat. I looked up across the horizon. Blue salt water ahead with the pool in my periphery. This was the life.

Just then, the front my head started to pound. I looked up at the pots of dinner being served on the Maasai-cloth-covered picnic table in our hut. I was wearing all the clothes in my bag and it was only the first night of our three-day climb up Mount Kenya. It was actually near freezing. And this city boy from Texas was ill prepared, clutching the one-liter thick plastic water bottle of recently boiled water. The views were incredible and the company of our six-trekker group assembled by the doctor from New Zealand made the hikes pass quickly. But the cold nighttime weather in a setting slightly outside of my comfort zone had me daydreaming.

I have been guilty of daydreaming before. I’ve even been called out by good friends when they have caught me distracted. So in this first month away, I have been extra careful to consciously ensure I’m present. “In the moment,” some call it. But I am not convinced that is always so easy, or absolutely necessary.


The excursion to Mt. Kenya was something I had considered prior to coming to Chogoria, so when the group effort had already been coordinated, I decided to take my first trip out of town. We traveled by matatu to Tumutumu to be hosted the night before by a young Pediatrician and her husband from the UK. They fueled us up with chapati and vegetables before the climb. The following morning, we had a proper cappuccino en route to stock up on snacks at the Nakumatt supermarket in Nanyuki before entering the park. It is a beautiful but challenging climb, with the second day requiring an 8-hour, 10-mile, steadily uphill trek. That day left me feeling lousy (perhaps with a bit of the 13,000-foot altitude contributing) at base camp, so I decided against summiting the next morning. Many say Mt. Kenya is tougher than Mt. Kilimanjaro and I now know why.

Following the descent, we were delivered by our guides to a freezing cold shower at Camel Camp, where our final night’s accommodation was in pastoral huts amongst roaming (you guessed it) camels. The following 18 hours replenished the depleted calorie stores and allowed us to soak up the luxuries of the bigger Nanyuki town. Pedicures for the girls, haircut and Irish pub for the boys, a late lunch at Trout Tree, and last but surely not least, the infamous brunch feast at the Mt. Kenya Safari Club. Three thousand shillings ($30), all you can eat buffet including fresh fruit, smoked salmon, multiple cheeses, grilled tomatoes, made-to-order omelettes, sweet breads, cappuccinos, all with a view of the mountain and the colorful hotel grounds. We stocked up with provisions at Nakumatt once more on our way out of town to ensure some comforts made it back to Chogoria.



On the walk home from work the following evening, a man stopped the car on his way out of the hospital’s housing compound. I was with one of the three new physicians from Michigan, in town for a one-month residency rotation. The man stuck his hand out the driver window. “My son – I just dropped him off. He will work at the hospital.” The former camp counselor (and chief resident) came out in me: “Excellent! We’ll take good care of him,” as I shook his hand. The new interns had arrived.

Medical Officers (MO) are those who have just graduated medical school. The MO Interns are those doing their one year of government-assigned rotating training. We have 10 just starting and roughly that many moving on, overlapping for three weeks. The new ones are energetic, ready to learn and serve. The old ones are drained and quick to draw up the call schedule for the new interns, suggesting starting them the day after they arrived in Chogoria. Fortunately, the rookies got a short introduction to the electronic medical record and a tour before being thrown in.

This week we have them out for an Advanced Cardiac Life Support (ACLS) class. This has proven popular with a couple other (higher-ranking, technically) MOs already at the hospital who have sat in on some sessions. Our two residents have been active in teaching the course alongside the Michigan physicians, one of the new young American missionary physicians, and me. Dr. Ritchie, the program director, put in great effort to schedule this course, coordinate the teaching schedule, and block time away for the new interns.

Anyone who has completed or worked in a residency program can tell you: blocking time off for interns can be a surprisingly high hurdle requiring crisis-level diplomacy. If new interns are out, that means old interns, or others, have to work. This ACLS training and the call coverage debate brought back fond memories of residency. These days for the course can be lighter, less stressful, and afford rare time for the intern class to build camaraderie all together. Internship and Residency can be trying on many levels, but the support of your classmates makes it tolerable.

Socially, the interns appear to be settling in well, having perfect attendance at the regular Friday night Pizza Night and a strong presence at the Sunday brunch hosted by the Michigan crew despite some of the interns being on call. There is nothing like free food to attract young physicians, no matter where you live.

Adapting to the role of attending, or “consultant,” has been enjoyable. In morning lectures, residents and interns get called on, while consultants offer advice based on experience. On rounds or in clinic, younger physicians practice medicine and deliver direct care, consultants offer suggestions, guide discussion, and occasionally dive deeper into topics questioned. The expanded opportunities for research and teaching are a welcome shift in daily duties.  


Living in the moment, enjoying your present, can be a challenge. Slowing down and just being here in Chogoria has taken an unpredictably difficult adjustment from my life in Austin. The daydreaming and living in the future got me here. So, I find it hard to believe that it is all bad as sometimes living in the present requires context. Keeping your vision or your inspiration in focus, I have realized, holds up the backdrop. The present is the main show.

Every time my housekeeper Catherine leaves my place, she thanks me and says goodbye. “Nice times,” she’ll say as she departs. Surely the meaning of that does not perfectly translate, but I cannot stop repeating that aloud to myself. “Nice times.” Nice times, indeed.

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