Tuesday, July 31, 2007

Life in Saipan

Christmas in July

Our stuff is suppose to arrive tomorrow! After 9+ weeks of crossing the swells of the Pacific, the container has deposited our belongings on Saipan. We saw the barge coming in last Friday with positive feelings of "maybe this is our stuff". Nicholas thought he could see his bike hiding. Since that time, Customs has been authorizing the shipment and Ryan got the call today to expect delivery tomorrow morning. I am not sure if I am more excited that our stuff has arrived or that the kids and I have something to do tomorrow! Nonetheless...Christmas in July! Love to all, Kim

Tuesday, July 24, 2007

The Thursday night market in Garapan features local produce, prepared foods, and entertainment. Our kids' dancing during intermission was a supplement to this week's "Hafa Adai" dancers.


I treated a 20-year-old guy in clinic for finger pain. His index fingernail was split, and there was a lot of swelling and tenderness at the tip and at the nail cuticle.
The previous night he was lobster hunting from Lau Lau Beach by his family's house. The keys to lobster hunting, he replied to my insistence, are to go out after a light rain and to act quickly. He dives in at the reef and hopes to snatch the animals as they peer out from the rocks. If he can surprise them, the lobsters don't have time to grab onto the rocks. On the right night, he and his cousins can bring back 5-10 big lobsters. His uncle throws them into the pot and the family has a handsome boil.
That night, my patient was diving when he saw from his periphery a puffer fish angling for him. It bit his index finger.
Blood and pus can accumulate under a nail and cause problems. The nail needs to be removed to create a vent. One could argue that the split in this guy's nail acted like a vent, but I wanted to give him the VIP treatment. So I numbed the finger and pulled the nail off. With the nail removed, I saw that the split in the nail actually extended through the fleshy "nail bed" down to the bone. Three stitches approximated the edges.
Teeth--and thus bites--of different animals carry different bacteria. I have a guide that lists these and suggests appropriate antibiotics. I've used this guide before for dog, cat, human, and even horse bites. It was no help, though, for puffer fish.

Sunday, July 22, 2007

July 21

This weekend started with us getting the Internet set up in our condo. Yea! I love it and feel more in touch with the world (we don't have TV). Ryan has enjoyed this time away from email, ads, and information overload.
Ryan took the kids to an island baseball tournament on Sat. morning. Nicholas enjoyed retrieving the 'home run' balls over the fence. I was busy having my car looked over. After two weeks of running fairly well, it wouldn't start. Fortunately my friend, Lito, who sold me the car, is also a mechanic. He and his friend brought their tools over to work on the car. Mark, Lito's 4 year-old son, also came and had fun playing with Nicholas.
Church today celebrated the final Sunday of Pastor Bud. It was very emotional for the congregation. I am sorry that we won't experience his leadership. There is something about music in church that triggers my tears! After the service, we had a huge celebratory meal with the Korean Methodist congregation. It was fun to try the different foods. Nicholas has been "singing" in the children's choir.
Love to you all. Thanks so much for all of your support and comments!
Photos: Nicholas watching the baseball game, shopping at a streetside market, sunset from our porch, Nicholas singing in the children's choir, and Morgan sitting with Pastor Bud (she wanted to sit on his lap during the children's time).

Wednesday, July 18, 2007

more photos

Pics of the hospital and a night out at the 'market'. Every Thursday night there is a farmers' market/dinner market with entertainment (last week there were young kids singing and dancing to pop music - Nicholas was fascinated).

July 17

We are settling into life in Saipan. I definitely feel a world away. Last week I was pretty homesick...feeling isolated and wondering what I will possibly do to pass the days. Fortunately, this week that feeling is gone! I continue to feel strengthened by God's plan for us. The sunsets help.
I have not finalized what I will be doing here for work, but I am in preliminary talks with some private practice doctors who want me to start a sleep lab. I am also interested in doing a few neurology clinics per month. There is a great need for both neurology and sleep medicine on the island.
Below are photos of 'Rocky' (Ryan's new wheels), the beach, plus a few of the inside of our condo.
love to all,
P.S. We will hopefully be getting Internet service at our condo in the next few weeks!

Tuesday, July 17, 2007

Wednesday, July 11, 2007

Commonwealth Health

As I finish my second week at the Health Center, it seems like a great place to work and learn. I have split my time between the slower outpatient (appointment only) clinic and the busier triage (walk-in) clinic. The hours are nice, 9:00-4:00, with every-other Friday off (all government workers have these "austerity" days, to save the gov't payroll--nice for those of us on salary, hard for hourly wage earners).

I have enjoyed my co-workers and patients. The doctors are mostly Canadian, but also native Chamorran, American, German, and Indian. They are glad to have me, a warm body with whom they can spread the wealth of their work load. They are especially excited to know that Kim is here and might be able to offer Neurology and/or Sleep Medicine services/advice. The only specialists available are nephrologists and an ENT. No radiologist, no cardiologist, no orthopedic surgeon, etc, etc. We are asked to stretch ourselves professionally to meet these needs.

As I have found in my short career, nurses make or break the experience in such a setting. Fortunately, the nurses here are great. They are here from the Philippines, and they really run the show. They are smart, helpful, motivated, hardworking, and fun--and tolerant of me. It makes a big difference.

But the best part so far are the patients. I have seen mostly Chamorrans, and they have been universally sweet and gracious. They are simple, easy-going folks who are open to my assessments and patient with my proposed plans. Many chew betelnuts, a mild stimulant. There are signs posted everywhere in the hospital stating "no smoking, no betelnut chewing". This habit makes their teeth brownish red, and they excuse themselves in mid sentence to spit in a trash can in my exam room (men and women). I guess this is very common all over the region, and there is a character in the play "South Pacific" called "Bloody Mary" because of the red spit. I haven't gotten the courage to try it.

Most of the patients I have seen have diabetes and high blood pressure, and many have complications of advanced and untreated disease. I have excised a man's finger to remove a fish bone, and I have seen a man with gout so bad that it oozed from his ankles.

Monday, July 9, 2007

Sunday, July 8, 2007

We have been in our condo now for one week. Ryan continues to like his job. Most of his clinic patients have hypertension and diabetes. At the end of their visit, when asking them if they need new prescriptions, many of them replied, "no, we just came to meet the new doctor!". We both bought cars this week. Ryan purchased a "Rocky" (Diahatsu???) of unknown year, and I bought a 1998 Jeep Cherokee. Because we live on a mountain with an unpaved road, we need 4x4s. Finally, a reason to own an SUV! Although I feel a bit irritable as I adjust, we are slowly finding out where to buy things and are getting used to our new schedules. I am enjoying a Sunday night without thinking about returning to work tomorrow!
Some pics of our condo and pool. We also went to the town parade on July 4th. It was hot (90 degrees and 90 percent humidity). We looked over to find Morgan being cradled and fanned by a Chamorro native. She has been waiting her whole life for that!!!
Thanks for all your comments and loving support. We miss you very much.

Church on the Island

It was time to get grounded again. I skimmed the yellow pages under churches and found Emmanual Methodist Church, listed amongst a mostly Catholic crowd. My interest was further peaked when Nicholas's school-mate's mom (who is involved in a same-sex partnership) invited us to the only Methodist church 'on island'. We arrived just in time on Sun. morning and as per their custom, we took our shoes off before entering the small sanctuary. We certainly stood out as we entered in an unavoidable raucous manner. We took one of several empty pews. The crowd smiled and we were asked to introduce ourselves. The crowd was a mix of Filipino, Korean, and North American. After the introduction, a loud welcoming chant followed, accompanied by tambourines, drums, and moroccas. We were adorned with shell necklaces as everyone clapped in unison. This was quite a welcome and I felt a huge lump in my throat. The pastor, Bud, was American and is completing his 4 year term in Saipan after 25 years in Hong Kong. A new pastor (and apparently a new building) are forthcoming in August. We have found a church!

Tuesday, July 3, 2007

Happy 4th of July!

We moved into our condo on Sunday -- only took 2 trips up the mountain in our clunker. It is nice to be in our new "home". Unfortunately we are not set up with internet service and who knows how long it will take to get it going. I am currently in a coffee house that has free wireless while Ryan is taking his turn with the kids. We don't have any big plans for today -- looking for a car and beach swimming are likely.
Ryan started his new job on Mon. He likes it so far. It has been a mix of clinic and urgent care. I'll let him explain more later. I had my start of being a 'stay-at-home mom'. By the second day I had found a school for the kids! They will go for the morning session on Tues. and Thurs. at the 'Seventh Day Adventist' school. It seems like a typical preschool with very sweet teachers. The classes are about 8 kids and a great mix of Japanese, Fillipino, and Korean. I spent an hour with them there on Tues. and both kids fit in great. I was very relieved.
Pics of our condo, etc. will be forthcoming.
Happy 4th! Love to all, Kim