Amazing poem, from a friend

A friend of mine forwarded this to me yesterday, and I can't stop thinking about it.  

Thank you, Lucienne. 

Until next time...

Love life, Find meaning, Be happy,

Craiger

_____

MORBIDITY AND MORTALITY ROUNDS 

Forgive me, body before me, for this.
Forgive me for my bumbling hands, unschooled
in how to touch: I meant to understand
what fever was, not love. 
Forgive me for
my stare, but when I look at you, I see
myself laid bare. 
Forgive me, body, for
what seems like calculation when I take
a breath before I cut you with my knife,
because the cancer has to be removed.
Forgive me for not telling you, but I’m
no poet. 
Please forgive me, please. 

Forgive my gloves, my callous greeting, my unease –
you must not realize I just met death again. 
Forgive me if I say he looked impatient. 
Please, forgive me my despair,
which once seemed more like recompense. 
Forgive my greed, forgive me for not having more
to give you than this bitter pill. 
Forgive: for this apology, too late, for those
like me whose crimes might seem innocuous
and yet whose cruelty was obvious.

Forgive us for these sins. 
Forgive me, please,
for my confusing heart that sounds so much
like yours. 
Forgive me for the night, when I
sleep too, beside you under the same moon. 
Forgive me for my dreams, for my rough knees,
for giving up too soon. 
Forgive me, please,
for losing you, unable to forgive. 

Rafael Campo, MD

First place in the 2013 Hippocrates Prize for Poetry and Medicine

 

 

Read the signs

It's funny how the older you get, you see things somehow more clearly. This sums up my current feeling about writing.

I was never a good writer growing up; just ask my parents and high school English teachers. I was an average writer. It took a progressive school like Hamilton College to hone my writing skills. It definitely improved by my Senior Year, and has continued to grow since then. Scientific and medical writing notwithstanding, my writing seems to be growing into its own. I know I have a long way to go, but I am getting more and more comfortable with my writing.

I have met two travelers thus far who have inspired me to continue my writing skills. One is Amy, a freelance journalist from Massachusetts who has been covering Africa for the past 10 months. She has spent considerable time in India prior to her stint in Africa. We were talking last night about her writing, what inspires her, and how I could hone my skills. She made some great recommendations. So also made an interesting observation: Physicians really have it made. While most are clinical, see patients, etc., they can become literally anything: a writer, a teacher, etc., and can inform the world about the human body and spirit, and can really have a voice. It is quite awesome! Made me feel proud of my accomplishments as a physician, and the possibilities in the future. 

The other is a Lithuanian named Isabelle who has taken time off from life to travel the world, and write a book. She is a journalist back in Lithuania, but wants to do something different, something more profound. She is young, idealistic, and I think will do well. Most importantly, she is open-minded. This, my friends, is the key point to writing. We get so bogged down in the mundane, we don't see so many things right in front of us. These chance encounters have taught me that.

Lesson for today: Keep an open mind, and the rest will follow. Our own anxieties will only hinder the creative process, and our own success, however we measure it. 

Until next time...

Love life, Find meaning, Be happy,

Craiger

Musanze day, with a shot of coffee!

While John and Jessica were off gorilla trekking, I was on an odyssey of my own...

My friends, I am going into the coffee shop business! A friend of mine and I are starting a coffee shop in Musanze called Ikawa Yacu (Our Coffee.) There are no coffee shops there, like, zero. There have been in the past, but they have diluted the coffee concept by offering hamburgers and fanta. Our concept is simple: Only coffee, small snacks and pastries, in an outdoor setting. Coffee will be sold and prepared in a refurbished shipping container, and we will have outdoor seating under a rain canopy. We will grow as much of our own food as possible.

We will offer deals to Gorilla trekkers, and to locals. Price points will be low, so the average Rwandan can enjoy coffee. We just got our business name registered, and are in negotiations on the house renovations.

We still have a lot of work to do, but I really do believe that this simple idea will take off in a big way. More on the particulars and progress as this blog develops. Wish me luck...

John and Jessica had a great time trekking. The were starving, so we at at La Paillotte, an American venture with awesome food, and cool, chill decor in Musanze town. We headed back to Kigali shortly after they were finished.

There are no shortage of great restaurants in Kigali, but my favorite, for ambiance, view, price, and taste, is Republika in Kimihurura. It is decorated well, and in the heart of Restaurant Row in Kimi. Solange and her staff did not disappoint that night. Sitting there with John, his gf, and our friend Meaghan reminded me of many nights in New Orleans, laughing, enjoying, and just being together.

I am still collecting photos, so a post or website will be available soon.

Until next time...

Love life, Find meaning, Be happy,

Craiger

Gisenyi to Musanze

There is something about the lake that really relaxes me. There is nothing specific, but a few things come to mind: seeing a large body of water, the views from the opposing shore, the thought that I could swim across, the possibility of building a house on the shore somewhere, where would be the best view, the sound of the water lapping on the shore, the birds and other fauna I would see...

I enjoyed an early, relaxing AM on the shore, getting things done. John was supposed to wake up early with me, but arrived a few hours later, not feeling very well. This did not bode well, as he was supposed to go Gorilla trekking in the AM. He soldiered on.

We left at a reasonable time, and got the Gorilla permits, not without the classic "the machine is not working," and "we cannot find your reservation." We went for a long lunch at Calafia Cafe near the Congo Border. Started by two girls from California who were living in Rwanda, it is a gem of a place. It is perfectly located, perfectly decorated, and has some of the best California style food around. Y'all, I am talking legitimate food here. After lunch, we headed out to Musanze, all the while John got more ill.

We arrived at the Virunga Hotel directly in the middle of town. He slept while Jessica enjoyed her first African Market. African markets are always a sight to behold; this one was rather well laid out, under a metal roof, but still had everything one could think of: from cheap plastic buckets to food stuffs to Kitenge fabric (African fabric to make clothes and other items.) Most of the sellers are trying to hack their goods to you, and it sometimes works; I have somehow grown immune to their calls. We grabbed dinner at a pizza joint, and then crashed early, as they had an early start for gorilla trekking.

Lesson for the day: Sometimes the best laid plans are stymied by sickness. And you adjust for it. Thankfully, John was better by the next day!

Until next time...

Love life, Find meaning, Be happy,

Craiger

The drive

This AM, John and Jessica went out Chimpanzee trekking in a smaller forest outside Nyungwe. From what they said, it was incredible. They only had to trek in about 30 min until they found them. Once there, the Chimanzees did not disappoint. Basically, they were very happy. But, also very tired after, as they woke up at 4 AM, and were on the road at 5 AM; this is the best time to see them, when they are feeding. Sounds like I am returning for this adventure!

Meanwhile, yours truly slept in (630 AM…) and enjoyed a chill AM. I blogged, I read, I just sat and thought.  It was exactly what I needed. You are probably wondering why I didn’t go trekking with them. It is all about logistics, as someone who was not super tired had to drive!

They arrived a little later than I anticipated, as there was a flat tire, some negotiations, and an interesting mechanic on the side of the road. In any event, we rolled out of our lodge around 1130, and started the long trek to Gisenyi.

My original idea was to drive from Nyungwe through the Forest to Butare, and then North. Turns out that was the long way. Luckily, the locals showed us the errors of our ways. We instead drove West to Lake Kivu, and then hugged the coastline for about 80 km until we reach Karongi (formerly Kibuye.) This part of the road is finished, and rivals some highways in the US. A lot of turns again, but gorgeous views. We then headed another 100 km or so East to Muhanga, a main crossing point for all points West and North of Kigali. Once there, we headed due North to Gisenyi, another 120 km or so. I drove the entire way, so they could sleep, and enjoy the country side. I was perfectly caffeinated, and actually enjoyed the drive. I got the hang of it.

The worst part was the last 30 min or so, driving in the dark. Here, though there are tarmacked roads, there are no street lights. And rush hour here is less of a car problem than a people and bicycle problem. To compound the problem, the lights on the SUV are pointed down, so I have to drive with the Brights on a lot. Needless to say, it made for a interesting drive. Once we reached our destination, though, it was worth it.

The Waterfront Resort lies on the shores of Lake Kivu. It is in Rubona, a smaller town where the other “beach resorts” are located, about 6 km South of Gisenyi town. It is idyllic in its presentation and setting. The service, on the other hand, is a different thing. We ordered dinner, and 20 min in, they told us they had no rice… the rest of the food came out an hour later. And their credit card machine was broken. And they did not have our reservation, and put us in different bungalows than I had ordered. But they have amazing rooms, and the coolest bathroom I have ever seen.

As far as above, I still get frustrated at the small things. I have gotten better at not trying to complain or fix every problem. I do get frustrated here in Rwanda when something as simple as knowing when you rice supply is running low to order more, or to communicate with your staff when a customer makes a booking online. I want to yell, and scream, but I hold it in. This time, I put in all in perspective: I am in Africa, with good friends, on vacation. I am breathing, walking, have a roof over my head, and have a belly full of food. That is the most important thing. Let it be, let it be…

As I was falling asleep, I heard the lapping of the waves on the shore, the occasional bullfrog and cricket, but mostly silence. This made for the best night sleep I have had in a while…

Until next time…

Love life, Find meaning, Be happy,

Craiger

The 90 Day Rule

This one is from Saturday...

There is an unwritten rule (as an aside, why does this expression exist? Do all rules have to be written?) that every 90 days, someone living overseas should take a break from their day to day, and take a brief break. Folks, it has been 84 days since I returned to Rwanda, and I need a break.

Don’t worry, everything is fine. Life is really good here. My extracurricular projects are going well, teaching at CHUB is going well, and I am the happiest I have ever been. But this time, I feel this need to take a break for a while. There is nothing in particular that is happening, but I am feeling antsy and tired, so this is a good time to go.

Luckily, one of my best friends from New Orleans is arriving tonite along with his girlfriend. We are going on a tour of Rwanda for a week: they will see my life in Butare, then we will go to Nyungwe Forest, then Gisenyi, then Musanze so they can go see the gorillas. I will be doing other things in Musanze while they are seeing the Gorillas in the Mist (more on what those “things” are in a few weeks once I can say more!) They leave next Saturday for Tanzania and the Serengeti; I am heading to the beaches south of Mombasa for some sun, sand, and swimming. I am pretty stoked.

I am bringing my computer with me, as it won’t be an entirely work-free vacation, so I will keep blogging daily as promised.

Until next time...

Love life, Find meaning, and Be happy,

Craiger

Nyungwe Forest musings

Day one of our travel began yesterday. We left Butare in our pimped out SUV, and headed out to Nyungwe Forest. I had only been there once to cheer on friends of mine in a marathon there. This was last February. I told myself then that I had to return, and this was the first time I had been back. I know, I know: I need to get serious. But more on why I don't spend more time there in a bit.

Nyungwe Forest is the largest montane rain forest in Africa (or so the claim goes,) and it is stunning! I now see that I have to return more often.

Even the drive there was amazing. As you may be well aware, Rwanda is know as the Land of a Thousand Hills, and this part of the country is no exception. The road is a curvy, undulating collection of switchbacks and turns that even make someone like me, who doesn't get motion sickness all that often, a little nauseated and out of sorts. The funny thing is that the road itself was better constructed than most Interstates in the US. Once you reach the entrance to the park, it is even more of a curvaceous adventure. For someone who has not driven in over 3 months, I got the hang of it, after a while... 

Once you are in the park, you go register in one of the Ranger stations. There are multiple hikes, a canopy walk, monkey and chimpanzee walks, and other offerings. It is free to enter the park, but here is the catch: every service they offer is a la carte, meaning you pay for the hikes, the animal visits, etc. And it adds up: tourists pay anywhere from $25-90 per offering. There are reduced rates for Foreign residents like me, and East African citizens and Rwandans pay even less. So, even a hike is $20.

Nevertheless, it is an amazing place to see. We had a late start, and the plan was to do the Colobos Monkey visit first, then lunch, then Canopy Walk. The Colobus Monkey walk was amazing. We lucked out, and were able to see them after only walking about 15 min into the forest, up a ravine that could be considered a possible path for humans to navigate, to a trail that lead to the place where the Colobos were resting after a long morning feeding. We saw about 20 Colobos, and even ventured down the thicket to see them from a different vantage point. According to our guide, the male leaders were making warning sounds to the family, indicating Chimpanzees were near (Chimpanzees are predators of the Colobos.) We got excited of the prospect of seeing Chimpanzees, but these Chimps were far away, and were not habituated to humans, unlike the main group that can be visited on a separate tour. We took that with a grain of salt(...), and just enjoyed our time with the Colobos.

We then headed to the Nyungwe Forest Lodge, located just outside the park. It is a high-end, European-style jewel of a Lodge in the middle of a tea plantation with a gorgeous view of the mountainous Forest. It is also not cheap: ~ $300-400 per night... A 3 course lunch or sipping tea can be had on the veranda, overlooking the tea plantation and the mountains in the background.

During lunch, it started raining, which did not bode well for our plan for the canopy walk. Instead, we milked the most out of our stay, and lounged for a bit longer near the fire place. We then set out for the RDB station so John and Jessica could buy permits for Chimpanzee trekking for the following AM, and finally to our Hotel for the night (Top View Hotel.)

The main lodge here is truly impressive: high, thatched roof ceilings, cool decorations, and a good dinner. The hotel rooms themselves are nice, each "room" is a separate builiding suite, with a living room, fireplace, and a large bedroom and bathroom. Hot water bottles in the beds to have the bed warm at night, mosquito nets, the whole deal. It is a bit pricey, though, but for this guy, I was more than glad to pay for it.

Lesson for the Day: Get out, explore nature, and love it!

Until next time...

Love life, Find meaning, Be happy,

Craiger

...in my Pimped-out Navigator

Well, it is more like a Toyota Land Cruiser Prado, Kigali Edition...

These cars are THE SUV in Africa. They have different types, and upgrades, but they are everywhere here. A favorite of the NGO set, and the government. The Africanized version is truly awesome: standard transmission, a smoke stack on the outside (to keep the engine going in swollen rivers,) spare tires, roof rack, GPS, you name it, it has it...

In my case, I had to rent a car for the week as the car that I bought (a 2002 Mazda pick-up truck) still hadn't cleared all of the necessary paperwork required, even after 6 weeks (don't get me started...) So I called a rental car agency (EuroCar,) and I thought I was getting a RAV4 for the special price my friend had received a few weeks earlier. I thought it would be an older car, and smaller. I arranged for the car to be dropped off at my friends house. Then, a driver shows up in this bad boy...

Y'all, this is the nicest car I have ever driven... It is a rental, so it doesn't have all of the bells and whistles as its cousins. But it drives very, very well. I can see the appeal of this car to the soccer Mom set (No offense to my friends who have kids and drive SUVs and whose kids play hockey or lacrosse, haha!) And when you are behind the wheel, WOW.

But I do have some misgiving about this vehicle. It is a gas-guzzling, monstrosity that is hard to park. Back home, I would scoff at the sight of these vehicles. It goes with the American mantra that bigger is better. And do we, 3 tourists, really need this much vehicle? What really scared me is that I somehow felt powerful driving around in this car. I saw my moto drivers around town, and they were cheering, saying what a powerful car I had. Even my guards were impressed. And folks, the scary thing is that I liked it? That is not me; I don't like to parade around in nice cars or in lavish hotels. I am more modest, I guess. But, I have reconciled with myself that this is the car that I was given to drive around this beautiful country with some of my best friends in life, and to just enjoy it! Believe you me, I will!

Until next time...

Love life, Find meaning, Be happy,

Craiger

Good friends, good times

From last night (no internet)...

_____

It is amazing how a visit from a good friend back home can make you feel like you are back home.

I have been friends with John since 2000 when we both worked at a research group called the Tulane/Xavier Center for Bioenvironmental Research. I was fresh out of graduate school. He was the marketing guy. And after he left a little later that year, we remained friends: LSU football, Saints games, Mardi Gras, Jazz Fest, you name it. He joined me in Mali 10 years ago for a few weeks as well. Truly, a good friend.

Even after just a few hours together, it is like old times. His girlfriend Jessica is here as well, and seems to also be loving Africa during her maiden voyage here. I am looking forward to the next 6 days, showing them my new home!

Thought for the day: Friends are key to keeping it real. Reach out to your friends, and tell them hello, arrange to meet, and catch-up.

Until next time...

Love life, Find meaning, Be happy,

Craiger

"...but my lesson is this: I don't give a s#%."

So, I peruse Facebook once a week or so. And a video of Charlie Day, one of the creators and starts of "Its Always Sunny in Philadelphia," giving a commencement speech in 2015 from his alma mater, Merrimack College. I listened to it once, then twice, then a third time. It really struck a chord.

Enjoy:

"...But my lesson is this. I don't give a shit.

You cannot let a fear of failure or a fear of comparison or a fear of judgment stop you from doing the things that will make you great. You cannot succeed without the risk of failure. You cannot have a voice without the risk of criticism. You cannot love without the risk of loss. You must take these risks.

Everything I'm truly proud of in this life has been a terrifying prospect to me. From my first play, to hosting "Saturday Night Live," getting married, being a father, speaking to you today. None of it comes easy. People will tell you to do what makes you happy, but all this has been hard work. And I'm not always happy.

I don't think you should just do what makes you happy. Do what makes you great. Do what's uncomfortable and scary and hard but pays off in the long run. Be willing to fail. Let yourself fail. Fail in the way and place where you would be proud to fail. Fail and pick yourself up and fail again. Without that struggle, what is your success anyway?

As best we know we have one life. In it, you must trust your own voice, your own ideas, your honestly and venerability and though this you will find your way. You don't have to be fearless just don't let fear stop you.

Live like this as best as you can and I guarantee you will look back at a life well lived.

You are capable of greatness in your profession and more importantly in your quality of self. Stay young at heart. Stay hungry. Take those risks.

You are going to change the world around you in small ways and in big and I greatly look forward to being a part of the future you will shape. Congratulations graduates. And good luck."

To quote another inspirational character, The Most Interesting Man in the World:

"Stay Thirsty, my Friends!"

Until next time...

Love life, Find meaning, Be happy,

Craiger

It's a dog's life...

From yesterday, again.... Sorry guys, things are gettin' busy up in here....

My dog, Magnus, has been a great addition to my life since I inherited him from Jared and Tiffany Milner (Tiffany was HRH Pediatrics here at CHUB 2014-2015.) He started out a little rough around the edges, but he has finally settled in to life here at Chez Craiger.

He is about 3 years old (I think?) His approach to life is simple: exercise as much as possible, nap a lot, try to eat flies, annoy the guards and the gardener, try to eat the monkeys, and eat absolutely anything that is put near him.

He is impulsive (just like his owner) but learns quickly that Craig does not like it when he runs away and will not listen. He has gotten better.

Perhaps the best lesson I have learned from him is: take it easy. So often here I get lost in my mind, a thousand things swimming around in my brain. And I don't take the time, even a few minutes, just to breath, to take it in, to settle down for a few minutes. He reminds me that I should do that every time!

Thanks, Magnus, for making my life awesome! You are a forever dog!

Until next time...

Love life, Find meaning, Be happy,

Craiger

Be the change you want to be

From yesterday…

Sometimes, things go the way you want them. For example, today we had a joint Pediatrics and Laboratory meeting with the Chief of the Lab, the Hematology Chief and Microbiology Chief. This meeting has not happened for a while, and it was a good idea to have a discussion about mutual concerns. I will not go into specifics about what was discussed, but both sides had good topics and suggestions.

The best thing was that the residents, the Pediatricians in Training, ran the show. They empowered themselves to ask the questions, to find solutions, to work with the Laboratory personnel to make change. My fellow Senior Pediatricians and I sat back, and let them do the talking. It was remarkable to watch. I felt proud of my residents, as they stepped up, exactly the way I have always hoped they would. Akaza keze (Good job!)

Lesson for the day: Empower yourself to be the change you want to be! (This may sound like bad English, but sit back and think about it...)

Until next time…

Love life, Find meaning, Be happy,

Craiger

Water, Cash Power, and MTN internet

It is amazing how we measure measure our day in the simple things.

Back home, we take for granted that we have fairly consistent water, electricity, and internet. Occasionally, one of them might be out for a little while, but eventually it returns to normal.

Here, it is a different story. I remember waking up yesterday, and realized that the internet was good, the electricity was on, and I had good water pressure. This was rare for all 3 to happen at the same time. Sure enough, when I came home for lunch and later when I returned from work, the triumvirate were still humming along, like nothing was amiss. I was shocked, actually.I used that time to charge everything I had, to take a hot shower after Gym Tonic (African aerobics), and to make some important phone calls. And it stayed like this until I went to bed.

This AM, water pressure was meh, power was out, and internet was mixed. But I knew that I would still have a good day. Because in the grand scheme of things, these are not necessities, rather luxuries. And as long as I kept going on this path here in Rwanda, I would be better off because of it. I am learning not to measure life in luxuries, but how I am living that life everyday.

Until next time...

Love life, Find meaning, Be happy,

Craiger

Expectations

From yesterday, but I did not get a chance to post...

_________

On Friday, I had the following post prepared about expectations, but decided to publish a discussion about Childhood aspirations instead.

I have been dealing with expectations my entire life; expectations of myself, and others of me. I grew up a hard worker, and very motivated. My parents also motivated me, and expected great things. I think my expectations of myself were much stronger than those of others. I did calm down when I reached my mid-20s, but still had that idea that I had to work hard, to be the best, to be perfect.

I never really thought about it until a few years ago, when it suddenly hit me that these very same expectations were affecting me. I am learning to manage it, but I still struggle with it.

For me, I want so much that this program, these students, these residents thrive. I want it so bad that I set my expectations high. And, honestly, I should: why shouldn’t we want this of them? But I often find myself frustrated by small things that, in all reality, do not really matter in the grand scheme of things. Everyone I have worked with has made great strides, and continues to improve. And they will not be perfect, just as I am not perfect. I have to constantly remind myself of this. Learning how to change my expectations of others and myself is a work in progress. I have to work on it every day.

As a caveat, I wonder what affect culture has on expectations. What are the expectations of people here in Rwanda? Are they tempered somehow? Are they stronger, given where they have been? Like most things, something else I have to look into. Add it to the list…

In other news, I am curious to see what the next 29 days will be like in the US, and what the outcome will be. My sincere hope is that our discourse is civil, our actions are tempered, and our votes count!

Until next time…

Love life, Find meaning, Be happy,

Craiger

Childhood aspirations

This post never got posted on Friday, 7 October...

So, I had this whole other post planned about swallowing my pride, that it is not about my own will, but that of the people that I work with and for my patients. But another interesting thought occurred to me while on the bus to Kigali.

Usually, I take the Volcano Bus Line between Kigali and Butare. When possible, I get the front seat. There is no seat belt, so if anything bad happens, well, at least I can say that I had a good run at it.  In this seat, I feel I can stretch out more, nap more comfortably, and enjoy the full beauty of this country.

It is around lunch time here, and the children are getting out of school. Primary School is split between AM and PM sessions because there are not enough teachers to teach all of the students, so they do half days. There are literally thousands of children between all of the towns I have passed walking home from school. They have their uniforms on, and act like all school children around the world: playing, laughing, taunting the bus, and waving to the mzungu in the front seat.

I had a curious thought while observing them: I wonder what they aspire to? What do they  want to be when they grow up? Do they see the hundreds of moto drivers in town, and want to do that? Do they want to be doctors? Lawyers? Firefighters? President of Rwanda? Do their parents tell them like my parents told my siblings and I that through hard work, dedication, and a little luck, that we can be and do anything we want? Ever the optimist, I think they do, but with a caveat: parents are more realistic with their children. I honestly don’t know. My poor Kinyarwanda prevents me from asking this question, but I will have to use my students as a proxy to find out. Please, tell me what you think?

Cool. Off to Kigali for a meeting, and a night of restaurant food and friends. In the past, I used to stay up until all hours of the night, but now, I am tired by 1000. In the immortal words of Roger Murtaugh from the Leathal Weapon movies: “I am too old for this shit…” haha

Until next time…

Enjoy life, Find meaning, Be happy,

Craiger

Lazy Sunday AM

All-

Sundays here rock!

Walked Magnus, made good Rwandan coffee, and made a killer breakfast. Mangoes are now back (there was a rumor that they were not allowed in from Burundi? Not sure why?) I am now sitting outside, enjoying the view. This is part of my outdoor garden. Herb garden in circular plot, raspberries and strawberries behind it. The empty plot is an experiment: quinoa. Then a bunch of lettuce as well.

Here you see the banana trees, and a small bunch of parsley that is ever-growing. More lettuce int he back. My compost hole (8 feet x 8 feet) is behind the post.

My friends and I were talking last night over dinner that for some reason, this place brings out creativity. We are able to do things here that we just don't do back home. And it is not because we have more time, its, I don't know, just different. Gardening, building furniture out of pallets, etc. My friends Stacey and Jeff Dixson built a play structure that rivals anything you have ever seen in the US, complete with roof top deck for afternoon sunset view, and a mini climbing wall.

Here is part of my kitchen, complete with my first table from pallets:

Here is to adding some creativity in your lives!

Sunday Nziza!

Until next time...

Love life, Find meaning, Be happy,

Craiger

Unshed tears

My colleague, who is a visiting neonatologist from Massachusetts and is here for the next 2 months teaching newborn resuscitation (i.e. helping babies who are having problems when they are first born) and care for premature babies wrote the following poem. I have no words to describe it.

Please read, think, and...

Unshed Tears

Silent and sad

Another petite life gone . . .

All efforts made

Once again – too late.

More will come

Sadly to succumb

To this grave fate.

Today

Almost insurmountable

But tomorrow will dawn

With hope and strength

Finding a way

To preserve young new lives

and offering

A healthy start

Prior to Conception

Must be the way . . .

To herald the promise of

a new day

Healthy new tiny lives

That will grow and prosper

Survive and

Thrive

drchez

Nyungwe Forest, Rwanda

7 October 2016
________________

Until next time,

Love life, Find meaning, Be happy,

Craiger

Determining health

Yesterday late AM, a colleague was called to the NICU for a baby that was not doing well. We had heard about this infant that morning in our staff meeting. She was admitted the night before to our NICU because of prematurity and breathing problems. Mom had malaria just prior to delivering this baby, and was started on the appropriate therapy to help the baby breath better and to stop any possible infection. But the baby was still born prematurely, which in Rwanda and the rest of Africa is a challenge in itself. The infant was doing somehow OK over the course of the AM until she suddenly stopped breathing. The team did the appropriate steps to help the baby, but in the end, the baby died.

The whole team was upset, but the Mom took it with grace. She thanked all of us for our work for her baby. This is a common theme that I have heard during my time here; that of thanks, of grace. And, honestly, every time it gets me.

What gets me most is why did this baby have to die. Why did Mom get malaria? Was she using the mosquito net every night as directed? Did she have a mosquito net? Was it working? Was it treated with insecticide as directed? Did Mom have good prenatal care? Did the other siblings at home have malaria as well, and get treatment? What was the food situation? What was their housing situation? Why? Why? Why... I am awake at night because of these questions.

These are what we call social determinants of health. They are important factors in the US and in Rwanda. They have a direct impact on how well a patient does clinically. For us, we think about these factors all of the time, on every patient, and are trying to help with this. We will continue to fight for patients like this one.

For now, we move on to help the next baby, the next child, remembering the lessons from the previous ones.

Until next time...

Love life, Find meaning, Be happy,

Craiger

Dinner conversation

One of the benefits of working for HRH is working with visiting subspecialists (Neurologist, Intensive Care, Neonatologists, etc.) from around the US. I have learned so much from them! I also benefit from the comraderie from my fellow HRHers. We are a varied lot, from all over the US. We have interesting stories and backgrounds. Our histories make for amazing discussions at Happy Hour and over dinner.

Some of my most memorable dinners ever have occurred here in Rwanda. A lot of it has to do with the level of education of my colleagues. I feel humbled to be even in the same room with them, let alone holding my own in the conversation. For example, last night, I hosted 3 people, two of whom are staying with me at my house:

- My friend Cameron, a former HRHer who is back following up on projects he started last year before he left. He went to Yale undergrad, and did the same NIH program as I did 11 years ago (that's how we know each other.)
- Lorin, a Utah Global Health Pediatrics Fellow. Originally from TN, she decided to go to Utah for Peds residency. She has a wealth of knowledge, and a cool demeanor. 
- Lucienne, a neonatologist from Massachusetts. Her first foray into Global Health. She was a former gymnast, and is now practicing at a medium sized hospital in MA. Her positive energy is infectious, and she has a lot of good insight into our programs here.

We talked for a few hours on life here, the Presidential election, Harvard sports, yoga, you name it. I felt so blessed to be hosting these amazing people. 

Anyway, just a cool side effect of living in Rwanda!

Hope all is well on your ends!

Love life, Find meaning, Be happy,

Craiger

Butare mornings

So I have alluded to my usual routine in the AM before, but a quick refresher.

Usually up at 6 AM, coffee, walk dog, quick workout and yoga, prepare for the day, breakfast, then work.

One of the best parts of my mornings (besides the amazing Rwandan coffee!!!) is walking Magnus. He is a spirited one, and calming him down can be a challenge. But once we start, it is calm and peaceful. There is one point on the walk where you can see part of the valley below, the houses in front of me, and sky. I stop here, and just take it all in for a minute. I get a lot of stares (like, what is the mzungu looking at?) But, it really helps put things in perspective. When I can find out a way to post a smaller picture size here, I will show you what I mean.

It reminds me that in our rat race to get going every AM, take the time out to just stop and look around for a bit, and you just might find that you will feel more calm, and ready to start the day. 

Please pray for my friends Luther and Lisa Ward who are living in Haiti right now. Hurricane Matthew should dump down rain, but they should be OK.

Love life, Find meaning, and Be happy,

Craiger

Just another Manic Monday

Actually Mondays at CHUB (the hospital where I work) aren’t really all that bad. It just seems like it sometimes. We had only a few admissions over the weekend, and the day has so far been tranquil. I am sure that as I write this, something will happen. There is an old saying in Medicine that if you use the word "quiet" or "slow," that is when things start to get crazy!

Weekends in Butare are very chill. Not much nightlife, no live music. There are a few clubs in town which cater to the younger crowd. I am now "over the hill," so I rarely do the club thing anymore. 

It is mostly just hanging out at home, watching TV, reading, or small projects.

My current thing is to make furniture out of pallets, you know, those wooden planks nailed together that are used in shipping and cross country freight. Here, you have to pay a small amount for it, but the wood is fairly strong, not chemically-treated, and can be used in any number of designs. I will send pics along as soon as I am able.

It is a busy week at my house, as I have 2 visitors who are teaching in Internal Medicine and one in Neonatology (newborn babies). This also means a lot of interesting discussion.

OK, back to work. Talk to y'all tomorrow.

Love life, Find meaning, Be happy,

Craig

Saturday Movie Night

Day 2 of daily posting for a month. You thought I would forget, didn't ya?

Last night I hosted some friends of mine from Butare for Movie Night. After some deliberation with the Butare Social Club, Goonies won out. Yes, that 1985 classic with young Sean Austin (of Rudy and LOTR fame) and Josh Brolin, Chunk, One-Eyed Willy, and the like. We had a good turnout, but we couldn't have it outside like I had intended. The rains have started, and it rained about an hour before movie time, so we opted for an indoor viewing. However, the power went out a few times, which delayed the movie even more.

Power is a weird phenomenon here. It could be the most perfect day every, and the power will go out for 2-5 min, then come back on. This could happen multiple times throughout the day. Sometimes it is our for 12-24 hours, sometimes just 1 min. My friends and I joke that there is a man with a switch that is making all of the shots, saying: "Ok, I will turn off here, transfer that power here for a bit; then transfer back here..." and on and on it goes. Luckily he only switched it off for 30 min last night before the movie started, and we were able to watch the whole movie, sans power cut.

It was great to have some of the friends over last night. We live in a smaller city a few hours outside Kigali, so we host events at our houses for fun. Two of my friends have built pizza ovens, so we are not lacking. Honestly, better pizza than I have had back home! In many ways, we keep each other sane! And you need that, no matter where you are in the world: a sense of home, of support, of belonging. Thanks guys!

Right now it is raining, the power is on, the water is running, and the internet was not working, but is now working, somehow. Time to get some work done!

Until next time.

Love life,  Find meaning, Be happy,

Craiger

My October Challenge

My October Challenge
by Craig J. Conard

(Imagine you are back in 5th grade, and asked to write a "theme," haha!)

My friends, I have realized that I have not been the best blog poster in the world these past few months, hell, really since I arrived here. I need to do better. With that said, I will challenge myself to post every day for the entire month of October. There will be challenges (namely MTN internet coverage.) I will date each post, and try to post up when I can. The rains bring more spotty internet, but rain for the much needed crops here; in this case, the latter is preferred over the former. I hope you continue to read, and enjoy. If you feel something grabs your attention and you want to know more, or just to talk, you can contact me in any of the following means:

email: craig.conard@gmail.com
google voice (you can call me at this number, and it will ring on my Google Hangouts app): 614-859-9123
whatsapp: 614-906-1050
skype: cconard (red skype symbol with a bandaid on it)
facebook messenger: Most of you are friends, if not, I am the Craig Conard with the bandana and sunglasses

Before I leave you to start preparing for the Butare Social Club Outdoor Movie Night (Goonies!), here is my thought for the day. Despite the challenges we all face every day here, the optimism among my foreign and Rwandan friends is the fuel that keeps me going (besides the amazing Rwadan coffee!) Many of you ask me how you can help. Your offers of material collections are helpful, and we may be able to arrange something in the luggage of someone who is coming. But, at this point, money is most helpful; we can figure out how to best use the money for patient care and other materials. PayPal is my Pal for all things donations. You can give money to me through my gmail account above (More on this in subsequent posts.)

OK, off to prepare for another awesome weekend here in Butare.

Love Life, Find Meaning, Be Happy,

Craiger

P.S. You will notice that my "sign off" above has changed a bit. I changed to "Find Meaning" as I feel it better reflects the true human condition, that of making a difference, doing good work, etc. Its intention is to make you think about your own life, and how you can Find Meaning in what you do every day.