Monday, June 27, 2016

Full Circle

Life is coming full circle.

It's time to "pay back" so I decided to run for the Board of Directors of the Minnesota Chapter of the Fulbright Association - the group you join after you return from a Fulbright experience.  And I won.  So now, I go to my first meeting - the hand-off from last year's Board to all of us.  I'm excited but also a bit nervous given how busy things have gotten.

And I am working on another Fulbright application - this time for a Global Scholar grant.  I'm buried in it right now, but will share what it's about after it's submitted.  It's due August 1 but I'm hoping I can get it in early because I'm going to be so busy near that time.

Writing the application for the Fulbright in Panama was really a peak experience for me.  I reveled in the language and ideas - and, importantly, I had people around me to bounce ideas off of.  That's different this time, but I have been trying to hone the arguments - and too the writing - with David and anyone else who steps in my direction.  It's getting clearer, too, as the people I'd be working with are chiming in and offering their suggestions on how to do this work together.  I'm REALLY excited about it - but I also realize that it's a very long shot because there are many people interested in the award.  I did talk with Caitlin in the program office on Friday and she said that the project I'm proposing sounded like something that would be interesting to the reviewers. We shall see!


Full Circle

Life is coming full circle.

It's time to "pay back" so I decided to run for the Board of Directors of the Minnesota Chapter of the Fulbright Association - the group you join after you return from a Fulbright experience.  And I won.  So now, I go to my first meeting - the hand-off from last year's Board to all of us.  I'm excited but also a bit nervous given how busy things have gotten.

And I am working on another Fulbright application - this time for a Global Scholar grant.  I'm buried in it right now, but will share what it's about after it's submitted.  It's due August 1 but I'm hoping I can get it in early because I'm going to be so busy near that time.

Writing the application for the Fulbright in Panama was really a peak experience for me.  I reveled in the language and ideas - and, importantly, I had people around me to bounce ideas off of.  That's different this time, but I have been trying to hone the arguments - and too the writing - with David and anyone else who steps in my direction.  It's getting clearer, too, as the people I'd be working with are chiming in and offering their suggestions on how to do this work together.  I'm REALLY excited about it - but I also realize that it's a very long shot because there are many people interested in the award.  I did talk with Caitlin in the program office on Friday and she said that the project I'm proposing sounded like something that would be interesting to the reviewers. We shall see!


Sunday, February 8, 2015

"On Beyond Zebra" - and other excitements

I started this entry when I had been back in the States for almost a month.  Of course, there was the reverse culture shock - expected though never totally comfortable.  I'm not sure whether it was more intense or less so since David was away on a 7-week around-the-world business trip for Google when I arrived home.  Probably both actually.

But the big thing was that I was ill.  Very, very ill.  I had no energy at all.  My first weekend at home I was so exhausted that I didn't have the energy to go to the grocery store, so I ate dry cereal with water until I could garner enough energy to get to the store.  I ran intermittent fevers - up to 102 F.  Because I had no energy, I slept a lot.  And when I wasn't sleeping, I had no energy, so I watched a lot of movies and my most strenuous activity was beading. And I ached from head to foot.

This continued for a very long time.

When I was in Panama, my last few days, the doctor did a sputum sample to rule out TB.  In that culture, a very rare bacteria, Stenotrophomonas Maltophilia, showed up.  The doctor there advised me to get antibiotics from my doctor to treat this.  So I went off to the doctor - slowly and totally exhaustedly.  However, I also wrote a quick note to my doc so she would be prepared - perhaps looking this bug up to see what treatment was suggested.  But she didn't do that.  Instead, she used my email to tell her how to dress - in full-out Hazmat fashion!  (and remember - this was PRE-Ebola!)  She had a gown opening in the back, with another gown on top, opening in the front, covered by a lab coat, plus heavy duty gloves (think Playtex for the dishes!), and a respirator!  I was totally floored - and vaguely humiliated.  She immediately sent me to specialists - she simply could NOT handle having me in the office more than 5 minutes!

So I went off to the specialists - no, there's no TB (I could have told you this), etc.  It quickly became clear that I needed to be seen by an Infectious Disease doctor, so she gave me a referral to UCSF.  Who never called.  I hounded them, but always got the run-around... it was SO frustrating.

I decided to change doctors.  And I'm so glad I did, because my new doctor, Dr. Thomas Stern, is an incredible doctor.  He took things quite seriously.  And within a week, I had an appointment with an Infectious Disease doctor at Stanford!

During this time, I was on close contact with Martha Maduro and her amazing doctor daughters from Panama.  They kept asking questions, and finally suggested that the constellation of symptoms suggested to them Chagas disease.  Had I been tested for that?  I said I would mention it to the Infectious Disease doc.

So I pulled myself out of bed one morning and set off for Stanford where I saw Dr. Brian Blackburn.  Immediately when he opened the door, I could tell that he had made a snap judgement, just from seeing me - "fat, old, woman, probably hypochondriac") He asked some perfunctory questions, and said that he didn't think anything was wrong.  I mentioned the diagnoses that my Panamanian doctor friends had suggested - most specifically, Chagas disease.  He said that the Stenotrophomonas Maltophilia was a very "whimpy" bacteria - and probably played no role in my symptoms (true)  He sent me over to the lab for some blood work (a LOT of blood for it!) and then sent me home.

When it came, Dr. Blackburn's letter said that he was sure that I didn't have an infectious disease, and that I should see a rheumatologist.  He also said that the Stenotrophomonas Maltophilia was probably an artifact (and, in retrospect, it was clearly a red herring).

Meanwhile, I wasn't getting better.  I dragged myself out of bed in the morning, sat for hours doing basically nothing (and certainly nothing strenuous), running fevers, aching and feeling horrible.  For months.

As the illness dragged on, David and I became increasingly uncomfortable with Dr. Blackburn's reply, so I asked Dr. Stern point blank if there was any indication that I had been tested for Chagas disease.  He could find none, so he sent me to the lab for the test.

Some background:  Chagas disease is endemic in Latin America.  It is transmitted by the "Kissing bug" which bites and then defecates after its blood meal.  It carries the parasite that causes Chagas, which is in its feces and which gets into the bloodstream when the victim scratches the (very itchy) bites.  It has an acute stage immediately after the bite for several weeks (possibly months), and then it sequesters in heart and/or GI tissue.  Some percentage of people (ranging from 15% - 50% depending on who you read) have very serious problems years later - sudden cardiac death, megacolon, megaesophagus, etc.)  And usually die.

So when , several days later, Dr. Stern called me, saying that the test for Chagas was POSITIVE, it was horrifying!  Because, when caught early in the acute stage, Chagas is curable.  But once the parasite sequesters in heart and/or GI tissue, it is impossible to cure - only to delay.  AND the drugs to treat it are not FDA approved and are ONLY available from the CDC!  But only after they do their own serological tests.  You have to be positive for Chagas on 2 of the 3 tests to be deemed as having Chagas.  The drugs have horrible side effects - they are essentially like chemotherapy and have very similar sequelae.  And, they may or may not work depending on the person.

As you can imagine, I spent the next week reading everything I could find on Chagas. As did David.

And then began the attempts to get the additional blood tests done to see if we could get (or needed) the meds from the CDC.  Because this is a disease that is not seem much in the US (mostly only in Latin American immigrants), no one knows about it.  After MANY blind alleys, I found a team in LA that specializes in Chagas! I called them and just happened to get the director on the phone late on a Friday afternoon.  She said that, if all else failed, I could come down to LA and have them send the blood to the CDC!

As these things often happen, I made my flight reservations to go to LA and that day, my own doctor called - he would do the blood draw, and then we could get the blood to the Alameda County Department of Health who would send it on to the CDC.  I cancelled my flight as soon as I heard that - and we got the blood off to the CDC.

I was fully expecting I wouldn't hear until the end of January because the Health Department told me that it took 18 days (unclear if working days or calendar days).  So we went ahead getting ready for Christmas (with me still dragging).  Dad arrived as did Anna Rachel and we had a fine time together. They both flew home the weekend after Christmas.

And on the following Monday, I got an email from Dr. Stern with the results from the CDC - NO Chagas!  :-)  I only had 1 of 3 (not 2 of 3) positive tests - so I officially do not have it!

Which doesn't explain the symptoms but which did lift the Sword of Damocles from over my head!

And so, we began a new year with no real diagnosis, but with a sense of relief.

+++++++++++++++

And now, it is February.  Reflecting back on my time in Panama - and its sequelae - I am so grateful that I had the opportunities I did to go to a wonderful place with the most amazing people.  The experiences were different from what I had expected, but equally wonderful.  I am happy I went - and hopeful that my time there was helpful to the department and others.

Yes, I wish that I had not returned with whatever-it-is-but-not-Chagas.  Yes, I need to do my part now to write the articles, give the talks, and do the things I promised I would do in my application to help foster understanding and cross-cultural relationships.  And I will do this.

Thank you, Fulbright Commission, and all of the people who made this experience possible.  And to all of those who made the experience wonderful.  And to those of you who "came along" with me through this blog.  I am filled with gratitude to all of you.

Thanks!

Thursday, August 7, 2014

Special thanks


I want to extend a special thanks to the book donors:
  • Christopher LaRoche
  • Elisa Kaplan Miller
  • Elsevier Publishing
  • Morgan & Claypool
  • Morgan Kaufman
  • Rosenfeld Media
Their generosity has created a small library of extremely relevant and timely books for future UTP faculty and students.  On their behalf as well as on mine, THANK YOU!

Also, thanks to the Fulbright Programsponsored by the United States Department of State, Bureau of Educational and Cultural Affairs, and particularly, Jennifer Fox for her support and encouragement as I prepared to come to Panama.

Thanks to the faculty, staff and students of the Universidad Tecnol√≥gica de Panam√°, and to the staff at the US Embassy in Panama City.

Most of all, thanks to my wonderful family who supported me throughout the process of applying, preparing for, and living this adventure.  

Leavin' on a jet plane (Saturday)

The portal
Living/dining room
Kitchen/laundry


Guest room

Master bedroom

As I wandered around the apartment early on Saturday morning, the day I was destined to leave Panama, I thought again of all the wonderful experiences and opportunities I have had here in Panama.  My friends.  My students.  My visitors.  My family (both "real" and "Panamnian").  My beading.  My own version of Panama.  It will definitely be a place I will miss.  And, even more, it is the people who I will miss deeply.

Pero Perro squeezes into the luggage
 
And then, we were ready to depart.

One last time, Rogelio drove me to the airport.  


And, as always, I had too much luggage (but really, when you figure I was here for 4 months, perhaps it's excusable.)  I had to do a bit of weight shifting, but everything worked out and off into the wild blue yonder I went.  What adventures lay ahead?  What has this time brought?  How will I make sense of it in a week?  A month?  A year?  Only time will tell.

But I can tell you that Panama is an amazing place.  With incredible people.  A place you should go (if you aren't already there).  A place to which I hope to return.  

I see why some people call this Paradise.  Just don't forget your smile, your flexibility, and your warmth.  You will be rewarded beyond measure.  And Panama will be as well.

So long, farewell... (Friday)

Today began by going over to UTP one last time.  It was so bittersweet!  Indeed, it felt more bitter than sweet - I'm going to miss my friends and students here!

I had promised Geralis that I would do something to decorate the blank wall in her office, but I hadn't yet done it.  So of course I had to begin by doing this - with Post-Its of course and with every color I had!  Here's what it looked like when I was done (the purple in the middle is her name)


The department had a traditional meal in my honor, and Dean Nicolas "awarded" me with a green ribbon of graduation, as well as a UTP pen-cum-laser pointer (something I had coveted for a long time!) and a Fulbright pin from Karla, who was not able to attend.  I got to say good-bye to friends (left) and students (right)



And also, to my office.  I stared at this picture many times while thinking and brainstorming, so I wanted to be sure to capture it for the future.


 And then it was time for me to leave.  Sadly, I closed the door to my office one last time.


Friday evening, I finally got to meet my friend, Annette, face to face!  We had talked about it, strategized about it, and planned it a number of times, but had never actually been able to meet.  But Friday night, Itzel and Yasmine brought us together for a splendid dinner in Casco Viejo.


Annette
Itzel

Yasmine
What lovely people!  What a lovely last night in-country!  What a hard place to leave!

Ah, Panama!  I will miss you!

Loose ends (Wednesday - Thursday)

The rest of the week is rather a blur from my current vantage point (Oh to have written about it immediately!)

I packed.  And repacked.  And repacked.  And found the scale to weigh the luggage but couldn't read it because it was obscured by the bags themselves.

I went down to the University of Panama with Lydia to meet with a Ngobe woman and a psychologist about what projects might be interesting to the Ngobe.  We discussed a number of things, such as the need for the women to learn Spanish so they are not dependent on their men, the possibility of creating some sort of touristic situation to draw money to the Ngobe (much as the Embera and the Kuna have done), and a number of other ideas that swirled around the table.  In the end, it became obvious to me that we need to begin any project with a careful (and ethnographically focused) Needs Assessment.

On the way home, Lydia drove past several key landmarks I wanted to re-visit to photograph.  Barber shops!  Cell phone dealers! School kids! Produce vendors!  Oh my!



The best thing was the chance to have one last meal with the Maduros!  On Thursday night, I went down to their already-familar apartment to see Emita ("Mademoiselle, Missy, Emma), the ruler of the family, and her minions, Martha May, Carlos, Emily, Essie (Edward was at work).


We were all going to go out to eat.  But, as the time grew long, Emita got hungry.  NOW Mom!  And that "witching hour" that seems so universal with babies was upon us.  So Emily and Emita had to pass on dinner.  The rest of us, however, climbed into Carlos' car and went off to eat at Napoli - a wonderful "institution" that has luscious Italian food.  Yum!  It was not only delicious for the mouth, but also for the soul.  This very special family has made me feel welcome in Panama to such a degree that I feel like I am now part of the family.  I will miss them more than I can say!