Matatus, Tuktuks, and Tenwek. (Plus unofficial commentary.)

Hello all! 

I've safely arrived at Tenwek!  It was a big blessing that traveling went exceptionally smooth; everything went according to plan. 

(I was actually rather nervous about this: I did not know who would be picking me up from the airport, I did not know where I would be staying when I got into Nairobi, I did not know what time the bus left for Bomet from Nairobi.  Everything went very smoothly...God really blessed me with traveling mercies)

My journey to Tenwek, as told by a photo essay with titles and unofficial commentary:

(More photo essays to come in the future!)

Leaving DTW.

(My phone died on the plane.  I do not have any pictures from leaving Detroit until the ride to Tenwek.  Apologies for the gaping hole in the middle of this photo essay.)

On the road from Nairobi to Tenwek!  

(I took a Matatu, one of the vans that is quite affordable and easy to find.  When I arrived in Kenya I was collected by a contact of my friend from last time in Kenya, Dr. Karambu, James, who ensured that I made my way successfully from the airport to the hotel and from the hotel to the matatu stand.  Matatus are the way that Kenyans get around Kenya: fast, cheap, and moderately safe.)

In the Matatu!

(There are 12 people who fit in a  Matatu.  I was given the front seat, which I shared with another passenger.  Needless to say, it was a cramped 6 hours.  A benefit of sitting in the front was that I had great views out the passenger window of the scenery.  A cost was the fact that my left arm got rather sunburnt as it protruded from the vehicle along the course of the drive.  Alas, the costs of being a redhead.)

The Rift Valley.

(When driving west from Nairobi one runs into the Rift Valley, which extends all the way north as far as Ethiopia.  It is one of the more beautiful sights, descending on it from Nairobi.  Within the valley it is quite flat and one can see people herding their cows and goats.)

The matatu pulling away as I was dropped off in Bomet.

(From the matatu I took a tuktuk, or small motorcycle taxi, up the hill to Tenwek.  The trip cost me a total of 1,000 KSH, or $10, compared to $200 to have someone come special from Tenwek.  As one gets to Tenwek the flatness and dryness - we could see miniature dust whirlwinds - of the Rift Valley turn into rolling green hills divided into squares of people's farms.)

Tenwek!

(The hospital here has its own power station.  I am not entirely sure of the details, but I believe it is hydroelectric power, which gives power to the compound and hospital.  I do not yet have pictures of the hospital, which I will include in a future photo essay.)

I could write individual long segments on multiple things I've experienced so far but I've yet to read for tomorrow's cases so I will keep it to a bulleted list, again with unofficial commentary.  Expect a more expanded, long-form version of the some of the following items:

• Living in the Tenwek Guest house
• (I've my own room, which is quite nice)
• Getting oriented at the hospital
• (It's an impressive place!  5 ORs, multiple different wards, an ICU with ventilators, physical therapy, casualty/ER.)
• Interesting cases and getting oriented to the surgery service
• (Debridement then washout of the abdomen due to diffuse necrosis of the omentum and peritoneum of an unknown etiology in a 30 year old female; very puzzling, and very sad.  Failure of a skin graft on a woman who fell into a fire after having a seizure; she is an epileptic who does not take her medications with regularity.  An old man not getting a gastrojejunostomy due to severe malnutrition inability to tolerate the operation; the true cause: poverty.)
• Working with the residents
• (Tenwek is home to a general surgery residency program.  Even after spending a day working with them I can tell that they are an exceptionally well-trained, caring and compassionate, intelligent group.  One of the things I am most looking forward about the next four weeks is spending time with the residents.)
• Getting to know the missionaries: meals at the Manchester's and Barbara's + friends
• (I've been overwhelmed by the hospitality I've experienced here.  For lunch and dinner I was invited to people's homes where I received a delicious home-cooked meal and enjoyed conversation after dinner.  It is life as it should be lived: with others.)
• Meeting other medical students
• (There is Rony, from UMass, and Michael, from Germany.  Rony is interested in internal medicine and is spending quite a long time here at Tenwek.  Michael is interested in either pediatrics or general surgery and also happens to be a serious classical pianist!  We are planning on giving a joint concert for the missionaries here at some point, more details to follow!)

For this blog I will be including a section at the end every week where I just write what's on my mind, jumbled and rambling though it may be.  It may be related to Kenya, it may not.

(This portion of the blog will be my favorite to write.  It will focus not just on the what happened, but on the why and how I am experiencing what happened.  I've heard it said that many times people will not remember what you said, but how you make them feel.)   

On unofficial commentary:

During surgery bootcamp, a course that I took at Michigan during the month of February preparing us to be good interns come July, we had an exceptionally interesting session on conflict management a consultant who commonly works with healthcare professionals.  During the session she talked about the "two columns" of communication:  in the right column resides what is actually said in conversation; in the left column resides what people think and feel that causes them to actually produce speech to communicate these thoughts and feelings.  Depending on the situation, the person, the subject one may choose to reveal more or less of what is actually thought. 

It has been my experience that conversations revealing more of the lefthand column are somehow better: these conversations more clearly reveal our inner world to others.   They are also the most difficult to have, and many times cannot be had due to the person with whom we are talking, time becomes a limiting factor, or one decides that it is simply not worth the effort to explain what is truly going going on.

(Many times, too, there is a component of fear: what will happen if I really let people know what is going on?  Will they like me? Will they accept me?)

Through the writing of this blog it is one of my goals to try and muster up the courage to communicate some of my inner life, so that you might not only know what is happening here at Tenwek, but also what is going on inside my lefthand column.

Until the next time:

"BWANA akubariki na kukulinda,

BWANA akuangazie nuru ya uso wake na kukufadhili,
BWANA akugeuzie uso wake na kukupa amani."

(This is one of my favorite blessings, Num. 6:24-26.  It sounds even more beautiful in Swahili - it is a beautiful, almost musical, language.)

-John