By this Author: tyrobinson

hey friends. this chunk might be a little more functional in its aim, cause i've got a lot of ground to cover -- more than three weeks of adventures to relate! i'll get to it. (oh by the way, i'm now in leon, nicaragua.)

SO, left panajachel on the 5am bus to guatemala city. interesting, everyone who got on that bus, that early, took a moment to stand in front of all who were already on board and wish them "buenos dias" (to which all responded in mute chorus). got to the city, and luckily the only thing that hastled me was an overpriced taxi ride. continued on, unscathed...! from guatemala city, took a series of buses through the eastern countryside, soon left the paved road, soaring up and down over the hills, dust coating the arid landscape, some of the most apparent squalor that i've seen flitting by like on a discovery channel program. these people seem to subside solely on whatever they could grow from this unforgiving earth. dog-tired, and dirty, arrived in chiquimula, near the border of honduras. took a shower, and laid down on my bed at 5:30, just to rest before going to find some dinner. i regained consciousness, still on my back, spreadeagle, 14 hours later. got up, breakfast, bought some 2 dollar aviators and a bottle of water, back on the bus. cross the honduran border, and arrive in copan ruinas. check into los gemelos hotel (not then aware how well i'd come to know that place), and wandered around the city in the late afternoon. copan ruinas is a beautiful town in the hot forested west, the comparative wealth of the city evidenced by swanky hotels, clean streets, a beautiful plaza... even an alcoholics anonymous chapter! it's fueled by tourism funneling to Copan, one of the significant remaining Mayan cities. Copan rivaled Tikal, and though not as dramatically tall, is renowned for its incredible sculptures. The walk around the ruins and the museum the next day was eye-opening (into which poured the liters of stinging sweat this hot land was forcing out of my forehead). macaws squaked from the trees as triple headed mayan gods, 10 feet high and their arms entwined with plumed serpents, peered out from arched doorways. i chugged two liters of water, went back to my hotel to rest, and didn't really leave the room for the next eight days. that evening, and throughout the whole night, i was deluged with sweat, then rapt with cold, squirming on my mattress and staring at the ceiling. by the third day, in which period i had only eaten one fruit shake, my fever attracted the attention of the hotel owner. she was a charming old grandma, maternalistic to the bone, and took me under her wing. in between my hurried trips to the loo, quick runs for another gallon of water, and the endless uncomfortable hours rolling around my bed, she brought me vegetable dishes, remedial teas, refrescos, and changed the sheets whenever i wadled out the door. that sickness was miserable. i was so homesick, so isolated and bewildered. i tried two doctors five times, was given injections, skeptically downed six different drugs, then finally my worried parents called the hotel directly from the states. those first conversations were a liferaft; just hearing those familiar voices put me on the road to recovery!

finally, after a few books, many pills, gallons of water and a cartload of patience, i took off on the 7am bus to san pedro sula. got into the city, transfered to the tela bus. got off in tela and began looking for a cheap hotel. a bus meandered past, its ayudante enthusiastically enticing "la ceiba, la ceiba ceiba". on a whim, i hopped on. after eight sedentary days, i was anxious to get some ground covered. landed in la ceiba, on the northern honduran coast. went for a swim in the chocolate-milk ocean, took an evening walk. still battling the loneliness set in with my fever, i had a quiet dinner and a beer, thinking too much about myself. the next morning, headed out to the ferry station and took a boat ride to utila, the backpacker, hang-loose hangout of the three famed bay islands. if you start feeling down while traveling, the easiest thing to do is just change the scenery! got to the island, had some lunch and then went for a saunter up and down the single roadway to peruse the 12 odd dive shops that vied for travellers. stayed the night on the island proper, then hopped on board captain morgans dive center's dive boat for a transfer over to their hotel on jewel caye, a spit of land some 15m wide and 250m long. the diving for the next three days was surreal. morning dives into the beautiful blue of the caribbean, the visibility almost 100ft, turtles, rays, eels, fish darting about everywhere over the reef. every color was on parade, me blissfully floating along in the middle of it all. wrapping myself around, dodging through the pillows of champagne bubbles of the other diver's exhalations, catching the light and shivering like happy little diamonds in the endless cyan, on their quivering ascent to the surface. coming back to the hotel on that post-dive high, watch movies most of the afternoon. i admit that i saw all three lord of the rings in a three days span. meals on the island... breakfast at one woman's house, lunch at another, then barbeque dinner at the big family's house over the bridge on pigeon caye. the locals were fascinating as well, and honestly gave me my largest culture shock yet on this trip (including the highland indigenous mayans). they're diverse -- garifuna blacks, honduran latinos, descendents of white expats. and they all do... nothing. all day long. just sit, chat, maybe make a sandwich, watch other people walk around, nothing. it was bliss for three days, i might survive a week, but no way i could live my life like that. i guess i've just been cultured differently! had some great moments of self-reflection out on the caye, met some fun people, swam and kayaked all around, and to the other tiny cayes. you could almost imagine some pirate landing ashore to bury his recently looted treasure. there's at least one guy on utila who thinks robinson crusoe's tale was based on this island.

finally took the ferry back to la ceiba, at 6am the morning of may 15. did some emailing in the city, called home (best birthday present ever!), and soon got myself out into the jungle of pico bonito national park, a wilderness just outside the city. i had learned of a great place to be -- the jungle river lodge, right on the shore of the rio cangrejal. it turned out to be a paradise, a raw-wood rustic place, lit by candles at night, and squatting atop the huge white-granite boulders through which snaked the river. i opted for a rafting tour that afternoon (present to myself!), which was almost indescribably fun. we spent the first hour exploring the river, climbing up and around and jumping off of boulders. at one point, jumped off a 5m boulder INTO a waterfall, drifted downriver, climbed out of the current, and scaled right up the cliff wall (overhang at one point) to 10m, where we jumped off and floated down to the raft. great fun, the rafting was a blast, got back to the hotel just grinning. had a great dinner, met some great people from baton rouge actually on their honeymoon (and willing to share their time with the few other travellers at the lodge!). the next morning, went for a walk with them through the jungle, after swimming across the river. beautiful jungle, a couple snakes, and finished at a waterfall, which even in the dry season fell an impressive 200m. wow!

after leaving the lodge, parted with my new friends and took off for trujillo, farther east on the coast, and the jump off point for the la moskitia wilderness. this huge bit of land, a UNESCO heritage site, comprises the largest jungle north of the amazon, and is rich both ecologically and anthropologically. i wanted to try the difficult traveling -- by pickup, boat, wooden canoe, and rickety plane. in the end, it proved to be prohibitively difficult for the solo traveler, and expensive!

left trujillo, bussed six hours dirt road south to juticalpa. on the way, two gringos surprised me by climbing on board. they sat down and we had a great talk. both women were recent graduates and were working as teachers at a school in juticalpa (my destination that day). after our chat, they invited me to a party that evening. we arrived, i checked in to a hotel, and called them up, happy to have a local contact and not just read in my little hotel room till an early bedtime. went to their apartment at the school, chatted, had a great time. went to a few discos, wandered the city, and ended up at the huge white cross overlooking the town as the sun brightened the horizon. they walked me back to my hotel, i grabbed my bags (which were never unpacked), and strutted off for the bus station.

14 hours, after no sleep. that's how long it took me to get out of honduras, through nicaragua, and into leon. i don't really want to talk about it, it was difficult, dirty, hungry, exhausting. so, landed at bigfoot hostel in leon. great new place with a good vibe and tons of young gringo backpackers schmoozing around. i've spent the last few days talking with travellers, enjoying some good, cheap food, and exploring leon, a fantastic colonial city. there still remains so many vestiges of the revolution here -- dramatic political murals, lots of art, bullet holes in bell towers. interesting history, friendly people (someone's ALWAYS coming up to me here, usually looking for some handouts), humongous cathedral.

did a tour yesterday with the hostel -- volcano boarding down cerro negro, a young and active volcano (you really have to check out the pictures i just posted). the pickup'bed ride out was gorgeous, lush green fields, and all the locals greeted us so enthusiastically, really unlike any place i've yet been. kids would come running out of the houses to say hi and wave (one girl bizarrely just stood her ground and screamed as we passed). pigs were grunting around everywhere, dogs, chickens, horses (passed by one lone horse hobbling on a broken leg, and a pig dragging its paralyzed hind legs through the dirt). different life, for sure. get to the mountain, it looks big! this thing just sprouted from a farmer's corn field 157 years ago. climb up, great views and expansive ridgeline, leading down into multicolored and mineral-laden caldera. sprint down a scree slope into the crater through sulphurous gas and superheated mud, sprint back up to the rim, overlooking all of nicaragua. great fun as were gasping for air. we then donned orange safety suits, our chem-class goggles and our singular work glove granted us and sat down on our plywood boards. looking down 400m of black volcanic sand, at a 40% pitch was a dizzying site, and quite scary, way more so than any snowboard hill i've seen. i was with the canadians then, so we just had to "give her". pushed off and were soon rocketing at 45kph down the slope, a dust plume straying behind us. one guy bailed at top speed. ran out at the bottom, laughing and rolling in the dirt. as we climbed into the back of the pickup the rain started. within minutes of getting into the truck bed, the skies peeked open, and all of the rainy season slid out. it quickly turned into a deluge so encompassing that you couldn't open your eyes (we wore the goggles), and people could hear the huge drops slapping my back. the dirt roads aka rivers were almost too much for our 4x4, the pigs running out from the houses we past having a field day in the mud. descended on the hostel (instant celebrities for being soaked to the bone), and were greeted by warm sheets and a free beer. good fun!

i'm tired of writing, as you are of reading. quick points to go: 1) you may have heard it. i have booked my flight home. yes, the end of an era. flying into san francisco june 8th. it feels weird, i can tell you, to now be counting my days left. but i've realized that at this point in my travels, i'm almost seeking novelties (have seen lava, haven't flown in a tiny cessna to the middle of nowhere, have been diving, have ridden a horse), rather than simply enjoying a sense of place. these last few weeks will be lived to the fullest by all means, but getting a little worn out of the same cheap hostels and comedores. looking forward to being back in cali! 2) posted a lot of new pictures on the photo gallery, so check them out! 3) i better see you all soon! 4) from here: granada, masaya, lago de apoyo, then isla ometepe on lago nicaragua, and to spend my last week in central america surfing in san jual del sur.

love to all! tyler

I'm now back on the road once again, after a month spent living in Santiago Atitlan and working at El Hospitalito. On the cusp of a new segment of my adventuring, I sit amidst a tangle of emotions. Most superficial (and which is in current contribution to my more introspective, sit-down-at-the-nearest-internet-cafe-and-write mood) is... sad! After a final weekend hurrah spent with my housemates in Panajachel enjoying live music and each other's company, they wooshed away after hurried goodbyes and hugs on the lancha back across the mid afternoon washed lake to return to Santiago. Since the first of this month, I became quite close to them, finagling sublime meals after shopping sprees in the local markets (the British ER doc perpetually insisting on her bottle of red wine to accompany our concoctions), trying so hard to make a disheveled stand for the gringos in regular soccer matches, jumping into the lake, pancakes for breakfast before shift, and fantastic conversation at 3am on call. In many ways they were mentors to me, all older, and being so fully invested into the medical world, tirelessly advised me, encouraged me and explained to me about medical school, the life of a doctor, international medicine, and all their personal convictions. (by virtue of the age diversity, I did have opportunity to have discussions I would never have had with my friends back home -- serious talks about marriage, life partners... and kids!!) I am so grateful for my time with all of them! And I already miss the staff of the Hospitalito, all the Guatemalan nurses so kind, genuinely interesting people. I've now got so many email addresses stacked up in the back of my journal, I wonder if I'll ever see any of these friends again. Such finite and such intense relationships.

The second discernible emotion related to the "tangle" of above is relief! Work at the Hospitalito was intense and emotionally involved, by no stretch of the imagination. I'm going to tell you about the events of last Friday; I have been thinking about them over and over during the past few days, and don't yet feel.. certain, or comfortable, about the day's first encounter in the Hospital. It will take some time. From what I was able to tell, it was nothing wholly rare at this place, but quite affective for me. An opportunity, really, to see such a graphic display of humanity, and of life in almost cosmic proportions. And so informative about the world of medicine in general. Friday was my last shift, the normal day shift of 8am to 5pm. I woke up, made the family oatmeal and banana pancakes, and headed off to the Hospitalito, the ferns and flowers of my morning commute bowing and curtseying in a cool morning breeze. Changed into scrubs, I sauntered into the Emergency Department (two beds and the lack of specialized materials requiring some creativity at times). Leah, the head doctor, and more than the average number of nurses were clustered around "cama A". Not a trivial ER visit, I supposed. I went over with a 4th year NYC med student named Aileen, and pulled the curtains closed behind us. As we arrived, one of the nurses was hastily urging the family, visibly distraught, to refuge out of the ED. I began to sense the energy was weird and tense and elevated in a way I'd not really felt since arriving here. My happy high since morning pancakes was quickly dissolving. On the bed was a boy, maybe one year old, and lying in such a way, slightly abnormal but not for any readily indicatable reason, that anyone's innately human empathy would stand their neck hairs at attention. He was not well; cyanotic, not breathing, approaching rigidity. All stiffened in their respective silences as Leah connected his cool chest to the EKG monitor. After a few grotesquely loud beeps, the machine reported sporadic electrical activity flaring in this rapidly dying body, causing a groan from Leah -- we were obligated to begin resusitation on this clinically dead body. A beat, then activity began in earnest, and as the med student and I looked on shocked, Leah began to bag the boy with O2, simultaneously directing application of epinephrine, and a slew of other drugs. IVs were started, vital signs taken, all so efficient and methodical. Overcoming my stupefaction, I relieved Leah of the bagging as she prepared to intubate the boy. After successful intubation, I resumed bagging as Irene began chest compressions. Anxious, unbelieving, I thumped away at the bag valve mask as my heart beat faster and climbed higher into my throat. I noticed increased resistence through the tube, and muttered that it was getting harder to bag. No one responded, so I kept on. After minutes, the gurgling resistence that I could and did push through gave way to a direct, against-a-wall resistence. I began to get scared when blood started bubbling out of the boy's left nares. Still not coordinated, Irene and I mumbled our disease some more, I guess hoping for either direction or reassurance from Leah running the code. In that moment, I have no idea where she was, what she was doing -- I couldn't take my eyes off the boy's face, pressure in his cheeks contorting his eyelids, forcing his blue lips into a frown. PRESSURE! fuckfuckfuckfuck. His shirt was quickly torn open, letting free that chest, that ripped and broken and horrible chest. In my furious bagging, and without direction, I had distended his abdomen, forcing air out of his lungs and down his esophagus into his bowls. His umbilicus seemed to rise like a mountain above his thorax, straining against the rigidity of his ribs. Leah halted all, and quickly diagnosed a bilateral pneumothorax. After a moment, and with everyone acutely aware of everyone else and of the dead and tortured baby beneath us, Leah called a cease. I quietly asked whether it was a result of forceful bagging, and was granted a firm "yes" and no explanation. Everything started to recede from my awareness, and after hazily noticing the mother tearing through the ranks and collapsing on her son's body and shrieking, I abruptly found myself outside, sitting on the rock stairs heading off the property and towards the lake. My mind writhed for an hour.

After a while, when the shellshock emotions of guilt, of grief, of complete bewilderment and of acute anger for falling into such a position while so naive and lacking in experience slowed their rages, I looked up. I watched the lake for a while, in that mind-emptied way, looked at birds cheeping and chirping around in branches nearby. I went to get up three or four times before I set my feet beneath me and walked back to the ED. Quiet, somber, I avoided eye contact. After aimlessly lapping the familiar halls in search of some distraction, but only met by more patients, eagerly looking up to me, reverently and ingenuously calling me "doctor" -- Leah caught me. She told me what I knew I needed to hear, and explained the baby's death. The boy had been brought to the ED clinically dead, and finding some remnants of electrical activity, we were obliged to begin resucitation attempts, to Leah's chagrin. Yes, my bagging had been the impetus for the blown lungs and gastric distention, but she readily and sincerely told me she had provided me no instruction for pediatric bagging, and noted she never responded to my mumbled announcements of increased resistence. "That baby's death is in no way your fault", she said. I frowned. She continued that she should have called it earlier, and she was happy for a reason to stop, such as it was -- an albeit improbable resusitation would have resulted in a life of mental retardation and years of grief for the family. She unwaveringly took all responsibility for what happened that morning. I thanked her and went for a walk to think.

Upon my return to the hospital, I was assigned vital signs of all inpatients. I cannot explain to you how strange it was and how fearful I was to again attend to a patient, even just taking vitals. It lasted a split moment only, but that feeling of fear, that knowledge of the monstrous power in my own hands, will stay with my for long. It was a good way to work back into the shift. At 10am, one of our laboring patients began bearing down, and I stood by with two other nurses to help the OB deliver the baby. It's surreal, to see and hear that blue baby suck its first breath of air, its lungs ballooning open for the first time since its aqueous life. We cleaned, dressed, and measured the baby, administered the routine Vitamin K and antibacterial eyedrops, and turned to receive the placenta. Mom, exhausted, and baby, in wonder, and so happy the whole family was. The sheer profundity of my two opposite experiences within the space of two hours set me a deeply introspective mood for the rest of the day. (In order to finish me completely, Chac the mayan rain god threw down the hardest storm I have ever seen in my life. It started so fast that I, running about 20 feet behind my housemate Will, was soaked as I panted into the covered veranda, while he was completely dry. The sound on the roof was so thundrous that I could not hear Will's words when he sat 3 feet from me. We didn't speak for two hours.)

Wow... I don't know how you're doing, but that was exhausting to write. I'm going to take a bathroom break...

One other wild hospital story. I've also now seen an emergency cesarean section operation. I didn't scrub in this time, but I can tell you, it was absolutely wild to see! It's a fast paced operation, since the anesthesia can compromise the baby, so after about two minutes, the surgeon had sliced through the abdomen, through the bottom of the uterus, and was forcing the baby out. Anyone seen the movie "Alien"? It was fantastically bizarre to see a healthy, wriggling baby pulled from the belly of a healthy, babbling woman. The baby was full term, cleaned up well, and I turned my attention back to the surgery. By now the OBGYN had pulled the uterus out of the incision and sewed it shut, it just sitting there flopped onto the woman's stomach. Bizarre, just crazy!

As of now, I'm a little too drained, and it's still a little to early to draw any substantial conclusions about my time spent in Santiago. But you could all reason the impact it's already had on me. And not surprisingly, I'm now significantly interested in medicine and admittedly have, of late, fantasized about being a doctor. I like it -- analytical yet creative, personable yet uncompromising in its goals to sustain health. It's an expertise, an art, and the be-here-now, the impetus into the active present... I'll do some sitting with it for the next few months.

That's all I've got for now. Next time I write, I've got to tell a little about my thoughts re: returning to Vassar in the fall. This is another major area where I've been spending a lot of mental time and energy (and wouldn't mind learning your opinion!). But that's for down the road.

Speaking of road, I'm heading out again! I've got to go back to the house right now and pay penance to my guide book, but I'm fairly certain I'll be leaving the country tomorrow. My gut tells me to head to Copan ruins, just over the border into Honduras. I'll likely continue up to the Bay Islands for some diving and beach relaxation, then do the travel thing down through Nicaragua on my way to Panama!

Love to all. Grab hold of what you've got. Thinking about each and every one of you, Ty

So thinking for the last few minutes about the sheer profundity of the last few weeks of my Guatemalan adventure, I’ve been anxiously wondering (musing on my rooftop patio on a shockingly clear morning – the three volcanoes that tower over looking so close it seems as though they’re either ready to topple their monstrous weight over on top of me, or skitter away in a light breeze, flimsy cardboard cutouts that they surely are) how best to ensnare my audience’s intrigue. I know I’m already jostling for attention with so many sensationalist distractions in the burdened American daily life. And you know it’d be cheating to rely solely on the fact that my friends and family must have a perfunctory interest in my goings-on. So… what then to catch them with? Not sex, American culture is so desensitized, and there hasn’t been much to speak of as of late anyway. Not drugs, not really my bag and I haven’t much accurate experience from which to pull. Violence…? Well, not violence per se, but blood, definitely. I’ve seen a lot of blood recently. Blood, organs, pain, but also compassion, genuine care, and a lot of well-placed expertise. There, I hope that’s got you for at least a minute longer, and I think I’m not being overly theatrical – this is the intensive life of a rural hospital attending to the medical needs of 50,000 t’zutuhil mayans in Santiago Atitlan, Guatemala. And I’ve been thrust right in the center of it all.

I’ve dedicated the last 10 days and the coming three weeks to volunteering for the Hospitalito Atitlan (puebloapueblo.org), located just out of Santiago on the southern shore of Lake Atitlan. It’s a city set on a beautiful bay ringed by volcanoes and virgin forest, and the only camera-laden, sunscreen-dobbed, sun-hat-donning gringos to be found come for two hours on Sundays to peruse the spectacularly embroidered textiles that Santiago is famous for. The small enclave of resident foreigners, mostly connected with the Hospitalito, attract interested and friendly glances from the locals during late afternoon trips to the market for fruit, vegetables, tortillas, or pancake mix. I live now in The Milpas, an incredible residence that was once a backpacker’s hostel and now has been rented exclusively to Pueblo a Pueblo, and the entire property is one of the most beautiful gardens I’ve yet seen in the country, interspersed with quaint thatched roof cabanas. My room is a beautiful wooden loft, two windows to each wall, which perches atop the house, with a full view of the fields of corn, cabbage and beets running down to the tourquoise waterside before being thrown aside by the slopes of the volcano across the bay. My four housemates, all medical volunteers for the Hospitalito (Tanner, 28 and Will, 23, east coast med students, Kate, 28, ER resident from the UK, and Reenie, 32 OB nurse from New Mexico) cook all our meals together in our fantastic kitchen – the boys get sent to town for shopping, the girls inspire incredibly gourmet and healthy meals. We sit with candles out on our veranda, talking, laughing, me learning invaluable amounts about the medical profession and med school and share a bottle of wine. The living here is superb (and I pay $100 a month for this paradise).

Now, allow me to tell you about work. Many of you know I got my EMT certification last winter, mostly in hopes that I’d be able to get involved with some volunteer opportunity in a medical capacity during my travels. It’s one of the lowest medical certifications (up from CPR), but has enabled me to work with the mostly Guatemalan nursing staff at the Hospitalito. I’ve hopped right on with their schedule, day shift, night shift, then a day and a half free, and I primarily help out the doctor and med students on call in the ER (two beds) and manage care for our in-patients (up to five, plus two delivery beds, which are nearly always occupied by young mothers-to-be). I’m still getting my bearings of where supplies are located and the procedures for running a shift but it’s been shocking how involved I’ve been able to be. The first real day I was working, a man came in to the ER, drunk as they nearly always are, pants tied in front with a plastic straw, with a severe posterior septum hemorrhage (substantial nose bleed way in the back of his nose). He was bleeding out his right nares and also down his esophagus and would periodically vomit out semi-coagulated blood. Our attempts at putting a foley catheter to pack his hemorrhage were frustrated until after we had recovered 600ml of lost blood and he had soaked his clothes, the ER bed, and most of the personnel involved. We were able to stabilize him, but it was an incredible experience to start of my month here. I was right in the middle of things, holding his head steady, putting pressure on his nose, coordinating efforts with the ER resident on call, administering O2. So exciting!

I’ve since been involved with other ER traumas, and also with in patient care, which is just as rewarding, as I’m able to interact with the patients, learn a little about them, and make them feel a little more comfortable around the primarily English-speaking doctors, many of whom utilize me for translation (so glad I just had that month studying in Xela). In truth, it’s usually the doctor speaking to me in English, me speaking to one of the nurses in Spanish, and the nurse speaking to the patient in T’zutuhil. You wonder how much really gets through this game of telephone. I’ve helped out with deliveries – I’ll never forget watching this 3-minute old baby, still wet and bloody, crying and clawing the air suddenly quiet, eyes wide, and stare about the room in wonder at the new world in which she was just beginning life. It was truly magical to see, especially so at 2:30am.

It’s been such a privilege to be involved. And, quite frankly, I’ve been able to do and see things here that would take a medical school degree and three years of residency to do (and then would be fighting other residents for the privilege). Last week a surgical jornada came for three packed days of operations and consultations. I was assigned to be a circulante in the Operating Room. Our first operation of the day was the repair of a veseco vaginal fistula, essentially a passage torn between the bladder and the vagina in danger of infection. I spent the first while translating, and learning from the anesthesiologist how he sedated the patient, maintained her vitals while providing for the surgeons. After an hour, the two surgeons said they needed another pair of hands, would someone please scrub in. I volunteered (realizing that the first time I had even worn scrubs was a week ago), washed my hands and forearms and then slipped into the sterile gown and gloves. It was incredible to be right there next to this open-abdominal surgery, I was responsible for suction and holding whatever clamp or malleable the doctors needed. (Two hours into the three hour surgery, the gynecologist looks at me and confirms that I was an ENT – ear, nose and throat – resident, right? I laughed, and said no, I haven’t even finished undergraduate yet, I’m an EMT! He stops and says, what the hell are you doing in the OR? I say simply with a shrug, it’s Guatemala! We laugh, and go right on with the surgery.) she gave us a scare for a minute when she shifted her hips and bore down on her abdomen, spilling a portion of her small intestines out of her incision; the anesthesiologist jumped up and gave her a direct IV injection. I learned then: anesthesiology is 90% boredom, 10% terror, according to the stats he gave me.

Last Friday I learned how to insert an IV line (well outside of my legal scope of practice in the US), and yesterday applied three, the last one perfectly, not spilling one drop of blood. I was so proud and bragged about it to all the volunteers. It’s wild how many different medical problems I’ve already seen after my first week, probable GI ulcers, scalp lacerations, potential sepsis in a 3 week old, removal of benign foot growths, diabetic ulcers, fevers, colds, coughs. This is the medical world (though I’m constantly impressed by the other volunteers that this is nothing like medical practice in the states). Still, I’m learning so much, getting such great experience, and really starting to wonder if the medical field might be a calling for me. I’d take after my mom and dad, I guess, maybe it’s in my blood. It’s been so fun, also, to learn (from the other med students and nurses, and also from the work) and really appreciate the work that they both dedicated their lives to.

Just a couple more things to communicate, update-wise. Playing a lot of soccer, the doctors just played in a three day tournament, Hospitalito vs. the carpenters, machinists and teachers of Santiago. Such a blast! Climbed volcan san Pedro, and started off paddling the local canoes across the bay (at least 70% of the time Tanner and I couldn’t get it to go in any kind of a straight direction), followed by a 4 hour hike STRAIGHT up the mountain. I’ve also been recruited to train the local bomberos of Santiago, whose only expertise are in tossing a little bit of water on any medical victims, and then driving their ambulances really really fast to the Hospitalito. It’s been frustrating to try to teach them CPR and spinal immobilization, especially in another language, and a little intimidating, me being some punk kid standing in front of 20 attentive Guatemalan men. Hopefully Tuesday will go a little better. I’ve also been offered a job here at the Hospitalito, a paid position, to take over the volunteer coordinator who leaves in a week. I was flattered, of course, and while it would be incredibly rich to really stay and get to know this town and become a local, I seem a little adverse to accepting. Firstly, it’s an administrative position, so while I’d be able to continue working with the nurses, my priority would have to be sitting in front of a computer. It’s a needed position to be filled, and I was repeatedly told I’d be a great candidate, but it would dramatically change my plans for the rest of my trip; no more traveling. I’ve gotta come up with a decision in the next few hours.

So that’s my life right now. I live in paradise and get an adrenaline fix every day. I’m learning a ton, making great friends, and potentially working on building a future career. How perfect is that?

I have posted some pictures on my photo gallery, of my house, some friends, and even a few (of me!) in the operating room, which are really wild. Dad, it took you 13 years of postgraduate study to get into the OR, I’m doing surgery on a year break from undergraduate! Note, for some reason my most recent pictures are posting in the MIDDLE of my photo gallery, so leaf through the pages until you see shots you haven’t seen (it’ll be clear which are the medical ones, look for a lot of people in scrubs and medical supplies everywhere).

Hope you all are living life as if you’ll die next week (which you might!). Live with not a drop of fear, go after your dreams like you were born to! So much boundless and energetic love, Ty

so i figured that while i'm still sitting in front of this computer at xela internet cafe i might take the opportunity to relate the story of my arrival into guatemala, something i've been hoping to tell for quite a while.

so i arrived in livingston, guatemala on the 9th of february, coming from punta gorda, belize. i quickly found a cheap hostel, threw my backpack down, and went out for a walk to get to know the new city. i went up along the northwest coastline, a black sand beach, strolling between beach cabanas and palm trees. awed with the scenery, i turned around to take a landscape portrait of whence i'd come. as i raised my small digital camera, a small voice behind me, in a lazy, slow carribbean melody, totally belying its threatening intent, muttered "who told you you could take that picture?" bristled, but ignored this first assailment. he then said to my back again, "you fucking can't take that picture!" and i turned, and found myself looking down at a short garifuna man, with ragged baseball cap, worn leather sandals, brilliantly white teeth showing out in an ebony black face, the middle of his pursed lips bleached probably from years of toking. he was standing back on his heels, hands hanging limply at his sides, and i quickly judged myself to be well clear of physical threat. bewildered, i said "no one, is it a problem?" he said, "fuck yah, it is, this ain't your hood. you don't belong here." he paused, then interrupting my subsequent weak and unformed rebuttal, "you don't belong here. where are you staying? the latin side, right? this is garifuna, do you see any other whites around?" again, i bristled at the race card he pulled out, and lifted my sunglasses. he said "woah", like he was calming a horse, "woah, why'd you do that with your sunglasses. that's an indication of changed intention...", all in his lazy, slow carribbean droll. i said i wanted to see him clear, without anything in the way, and he said "that's fucked up", crossed his arms. he found better footing, and i impressed upon him that i did not want to start anything, just wanted to walk in peace, and look. i think he understood my nonviolent intentions, but was affronted that i hadn't spooked off yet, and we stook dumbly staring at each other for a while. i told him i just wanted to see, to look, and told him of my time at the tea guesthouse with the mayans in belize, in a pathetic attempt to demonstrated that i was a culturally sensitive, nonthreatening guy. he said, there's no way the mayans wanted a white there, "you're so fucked up." as nonconfrontationally as i could, i said i resented that. he continued that whenever the mayans, just like he, saw a white, first they thought money, and second they thought how could they get that money. if they couldn't get at it, they didn't want hell to do with any whites. he then mocked me, "did you just want to find a nice mayan girl?" this accusation, and blatant stereotype of me as being a colonializing white here to senselessly rape and pillage, repulsed me. a horrible affront, i thought, i told him i had a girlfriend back in california. he, again, laughs AT me. he thinks to himself a while, then admits he knows the bay area, played music in berkeley, knows stanford, menlo park, and lived about five minutes from my house in palo alto, both of us tempering our surprise and trying to out-cool the other. he certainly didn't allude to it at the time, but i think that was an "in" for me in hindsight. i asked him directly, would he allow me to continue my walk. and he said, "no man". fine, i said, it's your home, it dissappoints me, but it's you place. how should i leave? that way? or that? " i ain't gonna fucking tell you what to do, man. you whites are always supposed to know what to do. always gotta be fucking do-ing." i threw my hands into the air, signaling my surrender to the conversation and began to walk off up a steep road running perpendicular to the beach and continued despite his mumbled protests. he got louder -- "hey! HEY! CALIFORNIA!" i stopped and turned and said i felt he was being racist. slightly incredulous, but with a little more respect since i turned my back on him, he invited me back to explain that to him another time, which he accepted with sort of a soft grunt. he started walking off down the beach, the way i was headed, and i followed him, eagerly relishing in his admittance of me into his hood. he refused me his name, and i began to become aware of a growing admiration for this guy and his quiet tenacity, and he seemed to have a potent mind, though he assured me "you don't know fucking nothing about me, gringo," in response to my attempts to pacify the situation. we meandered in silence, and he seemed to know everyone we passed, and though some people he greeted with love and compliments and some with vulgarity and insults, he got mostly the same, half-interested responses, no one seemed to care much one way or the other. to try to continue the conversation on a positive note, i asked him how long garifuna had been here. he scoffed, cussed, and said "garifuna ain't nobody's business but garifuna. that questionç's got loads of implciations -- to say that means that garifuna ain't always been here, which means it ain't natural here and don't belong." i smiled and admitted my mistake, still slightly on edge. everyone looking at me with my guide with mild interest. over the next two hours, he told me about politics in just as astutue a manner, but much more concise and direct verbage, as my professors at vassar. he analyzed me life, insulting me (becoming quite comically as he lazily did so), stereotyping me, judging. of my stated year off away from the scarcity and smallness of vassar, "oh you think you're a real gringo rebel now, huh?" (interestingly: "if you want to be a real rebel, you should have gone to berkeley." i told him i almost had.) i asked him what most people did here. "just sit", he answered me. "sit and wait." he told me about religion, about god, repeated much of my recent interests in a buddhist-type worldview, in his own garifuna vocabulary. and told me about love. that i shouldn't be wasting any love that was blown my direction. after all, all women are the same, he said. i don't know why, and especially since i don't even have a girlfriend in cali, i said that i was bored with my girlfriend back home. "your bored with yourself. what are you down here looking for? you won't find it -- it's inside. it's peace of mind." all the while, he greeted people in spanish, in english, in creole, and i began to realize that this wasn't some drunken bum cussing me out, but a real community leader. he abruptly wondered aloud how much he could get as ransom for me. i tensed, checked my surroundings, but sensed he was testing my threshold. i said, probabably ten grand. he thought it over, then explained he could take me way up to the jungle, hide me away, kidnap me till he got the money. we passed a school he had started, and strolled slowly back through town. at the very end, he quietly said he wanted to give me a cd (which he did and then demanded 100Q, whatever, i was enraptured.) he gave me a cd-r, written on it was "poco mendez", apparently he, also apparently he was the drummer painted life-size on the wall mural of the music bar we had ended in. he suddenly held out his fist, we pounded, and he wordlessly turned and walked off, leaving me thinking about our 2.5 hour encounter. being that this was all within the first afternoon of my arrival in guatemala, preceding an anticipated two month stay in the country, i estimated that my time here in the country would be pretty rich.

hello everyone. i hope that all are REALLY REALLY well, been doing some thinking of you all lately, hope that life's leading you in a rewarding direction. i just got up from a six hour nap, feeling like i'm in a cloud of grogginess. this last week has killed me -- so much going on! i gotta say my mind is pretty shot, so i'm going to start with the perfunctory info and maybe that'll lead to some deeper insights.

in this edition, you'l hear about the hike of the tallest volcano in central america, quite a week of dancing, volunteering, scrounging around xela, and then this past weekend, a trip to a guate finca (horses!!) way the hell up north. i'll also try to give you an idea of where i'm headed from here, as well.

so two weekends ago, 18 of the students from ICA went on a trip to Volcán Tajumulco, the tallest volcano in central america, and also the highest point, i believe, at 13,926ft. We started out at 7am, after another late night exploring xela's cafes and hangouts. i hopped in the back of the pickup with mateo, a international studies grad student from florida, and we snuggled in among the backpacks to escape the early morning breeze. we had a great visit over the whipping breeze as we climbed higher and higher out of xela, and couldn't help but notice an occasional US army hummer drive past, and once saw two f15 fighter jets rocketing overhead. as i'm pretty sure that guatemala doesn't have any f15s, it seems an ominous sign for the visit of our own george bush, due the following monday in the country for less than a day. we arrived with the others, our hair plastered to the side, at our breakfast stop, more beans and eggs. the countryside was beautiful, as usual, this time more arid ranchland, with small concrete block houses plopped onto the hillsides, looking like small toy castles on endless sand dunes (all with scruffy rebar sticking out their roofs, as i understand to escape property taxes, which aren't levied on "unfinished" houses), the vista is that profound, and we haven't started climbing yet. at the end of breakfast, a descision is made, though unbeknownst to the 17 gringos traveling, to change to a four wheel drive vehicle to save a little on the hike up. sounds fine, until the steed putts up the hill to meet us, and is just a regular pickup with a colorful wooden cage built up over the bed. somewhat intimidated, many grumble aloud how all of us with our gear will make it to the trailhead. through some complex hand gestures, facial gesticulations and discouragingly incorrectly conjugated spanish (it's still just 9am on 4 hours of sleep, jeez!), myself and the driver (typical guatemalan, vicously gregarious, "no hay problema" kind of energy) figure to strap all the backpacks to the outside of the bed-cage. after the work, we people pile into the bed, cramming in like cattle, and suck in our breath as the door is shoved closed. i can attest from my experience of the next two hours, absorbing the shocks, shimmies, and swaying of a truck (in the hands of an energetic guatemalan with way too much chutzpah) that travel on the 4 wheel drive roads of guatemala is... trying, at best. but, just my kind of adventure. we climbed higher, through many villages, past kids running to catch us, farmers gawking and joking about so many gringos quietly accepting this rather difficult form of local transport. the bald tires spinning, scratching for traction through sometimes four inches of dirt, and me in the very back, made for a layer of dust all over my face, head, torso, arms and pants that legitimately negated my white caucasian heritage. more than once, i jumped out of the cage when we slipped backwards more than 8 feet, just as precaution. we finally made it to our terminus, unloaded our packs, and waited for the others who had opted to walk once the rocks REALLY started, a mile back. as we were left in the dust as the truck, and its manic driver sloshed away down the mountain road, we peered vertical -- way vertical, and strapped on our packs. a diverse group, with regards to outdoor experience and exercise tolerance, we quickly dispersed through the shrubs and pine trees, climbing higher and higher, at times with all four apendages and a scoopful of curses, in our respective native tongues. the air is thin! we get a pace going, find our position in the line, and move onwards. i'm energized by the warm sun, more and more often obscured by swirling clouds and a cool jet of mountain air. i love this kind of SPACE! i hang out with our guide, just one of the spanish teachers at the school, who came up this mountain once with his friends, a different way. how can you get lost on a volcanoe, just head up! after a 3 hour slog (long to some, short to others), we reach a saddle squatting beneath the summit, and find some well-worn, trashed campsites. after a rest, we take a late afternoon shot for the top, following directions the guide for another group we met gave to me. it gets more and more vertical, and the trail turns from a well worn path in the grass to lighter parts among the pumous and volcanic sand. we break onto the slopes of the summit, red and green goretex jackets dotting the black, lunar landscape. we summit, on the top of central america, and stand speechless, each lost deep into their own meditations, gazing into so much air a bit like watching the flames of a campfire. we have incredible vistas for 15 minutes before a nefarious cumulus slams into the mountain, obscuring our view but for 40 feet. the setting sun, however, reflects off the enveloping water droplets, and before long, we are sitting quietly in a room that turns from pale shimmering marigold to golden to fire. spectacular, and we descend under the setting moon. after a campfire, and trying to down the s'more supplies that everyone brought, the absolutely coldest night of my life ensues. i decide to sleep outside with two others, underneath the flourescence of a now moonless night sky, the lights of the cities below illuminating the cloud cover below, a lightning storm rocketing around the horizon thousands of feet below us. wearing every single warm clothing that i brought to the goddamn tropics, and compressing myself within two sleeping bags, i barely stop shivering long enough to pass out from exhaustion. surprisingly, i slept most of the night, on a bed of pineneedles, and awake to a peculiar crinkling sound -- ice being forced out of the wrinkles of my sleeping bag as i roll up. it's 5am, still dark, and we can see by their headlamps that many of our group is already a quarter way up the trail to the summit. we take off loping, part to catch up and mostly to warm up. exhilerated, and threatened by an increasingly brightening horizon, i literally scamper up the trail, leaving many of the group. so much energy in this sunrise, it seems!! an abridged group makes it to the summit, and huddles down in the stillness together. it's fucking freezing. the sunrise is slow, stately, and ensues in a subtle illumination of the clouds stretched away over the ocean. finally, the god breaks over the horizon, and the mountain top is sprinkled with rays, which seem few and far between in the chill. behind us, our shadow stretches in a perfect triangle over the haze miles below all the way to the ends of the earth. silent, chilled, everything seems electric and magnetized. soon unable to bear the chill, we get up in the morning light for a walk around the caldera's rim. it's 1 degree celsius, before wind chill, which starts up viciously. we stiffly stumble over the volcanic rocks as we start down the hill in the morning sun, descending in to grasses, shrubs, then pines, loosening our muscles as the temperature grows. we clean up camp and soon head off down the ridgeline, the views unyielding, full-frontal. me and amir, from san francisco, start a garbage collection on the way down, sticking empty bottles into each other and into our waistbelts. a beautiful walk down, and a chicken bus home (four backpacks roll of the top around a particularly sharp turn). get home, take clothes to get washed, then sleep for 14 hours.

the next week was capitalized by continued spanish instruction, work at the orphanage, and frustrations as i begin to understand a little more about the latin culture. the parenting style of the two year old on the hosue strikes me and alina, my housemate, as neglectful and damaging to the child's development, and in no way alleviates her omnipresent screaming, at all hours of the day. i think back to a talk i had with deter, an australian on a similar spiritual path as i, as we came back from pacaya volcano, outside of antigua. there seems to be a lack of personal initiative in this culture, at some hostels, i've jumped up the same broken flight of stairs day in day out. when it would take just a few nails and 10 minutes hard work, many guatemalans seem content to walk around, deal with problems rather than fix them. i guess a decentralization of the individual and also diminishment of the fiscal rewards for enterprise i'm so used to in the us. people don't necessarily jump to help you so fast here as in other places i've been.

much of the week was also taken up by my flirtations with a certain dutch girl named annemarie, who by now has just become a big headache. i totally got a crush on her early, so much so as to buy her red and white flowers (first time i'd bought a girl flowers in a very long while), which she very clearly appreciated. she's fantastically attractive, as are so many of the scandinavians here, but her timidity eventually frustrated and then bored me. in fact, this theme is one of the principle reasons i've gotta get out of this city. there are so many beautiful girls here, studying abroad from all over, and all giving me meaningful glances, smiles. my life in xela has become routine (my nemesis, as many of you would smile and nod your head knowingly), dominated as of yet by me falling in love with every pretty girl that meets my eyes. this is not why i came to latin america. i've also increasingly become a social figure in xela, a few people all too dependent on my energy and spontaneity, and this constrains me. i need a clean slate, and so am leaving xela tomorrow morning, after a month of being here.

BUT, first i need to tell you about last weekend, which was spectacular. i was invited my one of my teachers (21, very attractive guatemalan, flirty, potentially bad news for my continual carefree independence) with four of her best friends up to her family's finca, in huehuetenango. after some fleeting images substantiating fears about being the only gringo and english speaker for 3 days, i accepted. after yet another late night (now clearly becoming far too much of a habit and far too expensive), we hopped on another chicken bus at 8am, they all excited, winking eyes and belting out guatemalan music to the morning commuters, me trying to stay awake and keep up with the conversation. a rather difficult day for me, trying to be outgoing and enthusiastic when absolutely shot for energy. 11 hours travel, a few bus changes and beautiful scenery, we climb through the huehuetenango department, enduring the rants of guatemalans behind me drunkenly convincing me that yes, i am in fact the only gringo on board. we abruptly disembark, meet one of the two caretakers of cuqui's family finca, and climb into the back of a pickup truck in the late afternoon sun, for the last leg to the finca. i'm happy how easily it's been to get along with the young guatemalans i'm with! after a bumpy ride, and a few barbed wire fence crossings, we arrive at the finca, after sunset. it's a rustic, beautiful a new ranch house, but deprived of much furniture or lights, so feels slightly cold, austere. after we get the generator going and some more lights on things brighten up. we settle in, dine on sandwiches made earlier that day, and flop down on couches in front of the fire that the caretaker was kind enough to build for us, the while resting his trusty shotgun and machete against the hearth. he speaks lazily and slurred, and is very difficult for me to understand. a little more energy restored, i teach the guatemalans some card games, and eventually king's cup, which absolutely delights them. we crash. the next morning, another friend has arrived, and we breakfast, dress, and are out into the morning sun, standing in front of a gorgous view of a distant lake and the northern mexican border, merely miles away. i can barely contain my excitement as we go for the horses, waiting bridled in a grove of trees. i love horseback riding, and i'm goddamn good at it too. something about the ego about willing, energizing this huge beast to get going really fast. we explore the finca, huge, and quite obviously not of the typical guatemalan family with regards to financial assets, check out a beautiful mirador, tour two groupings of mayan ruins scattered on the finca (like it ain't no thing to have ruins on your property), galloping everywhere. i have a young horse with two speeds: anxiously paw in place, and gallop. i have a blast flirting with cuqui while astride our horses, trotting up alongside her and then gunning my mount into a full run, spooking hers in the process. she squeals happily. we come across a small lake, which i jump in, refreshing after dust from the trail. i'm beginning to get an idea of the characters of the youth i'm with -- mostly rich kids, by guatemalan standards (and two of them, by any standards), not too aware of place and more interested in messing around with each other and talking pop culture. interesting too, the machismo dynamic, even among early 20 year olds. the girls prepared all the meals (i'm not too much help in the kitchen), and were surprised when i offered to wash the plates. after finishing their food, the two other guys stood up from the table and wandered off, which seemed matter-of-course. interesting. anyway, a beautiful day, incedible fun on the horses and swimming, and more cards games that evening (photo flashes going off constantly by some of the more self-involved guatemalans).

great fun with the kids at the orphanage, they seem really invested and needy of my attention, last wednesday spent hour and a half holding a five year old boy, who eventually stopped crying in my arms. heartrenching stories, some of them. more of this week exploring xela, a couple school activities, much joking around with gato, my teacher once again, more dates and less action with this dutch girl until i called myself off it on thursday.

let me know share my excitement for getting back out on the road and out of this city! from here i'm traveling with another student from ICA, a girl who just graduated from whitman college, is really fun, has a similar mind and energy level to mine (but, i'm not completely breaking out on my own again). she'd prefer to travel with another, i guess, so jumped at my leaving as opportunity to get out of xela. we'll be heading down to the southern pacific coast tomorrow, all the way down to monterrico, frisbee on black sand beaches, nature reserves among the mangroves brimming with wildlife, archaelogical ruins and a change of scenery! after a week of exploring, i'll head back to xela, pick up some left gear, and head over to santiago atitlan, this time on the south shore of lake atitlan. a little while ago, i found out about a medical clinic, called El Hospitalito (puebloapueblo.org), which specifically solicited the volunteer work of EMTs. sounds like they could use me, and i aspire to using my medical skills, albeit rudimentary, both directly and through some education of their local bomberos. it'll be a month long commitment, so i'll get over to the lake and check them out, look around for an apartment (with kitchen!) to rent, which will be great to host new friends, and check out the semana santa celebrations, rumored to be fantastic in santiago. very excited about the potential to do some medical work, and have been studying my EMT skill sheets that my sister graciously emailed to me.

also thought i'd share this idealization. i met a guy the other night from nome, alaska, quite a character. he came all the way down to guatemala on a polish sailing boat that was stopping over in his town on a circumnavigation of north america. anyway, he instantly piqued my interest, as i've long romanced of negotaiting passage on a sail boat to somewhere in the world. anyway, he told me details and tips of how to get on a boat, and encouraged me to get down to panama city and work the local captain's bars. how romanticidealistic would it be to end my journey with a month or two on a portuguese or german or south african boat, coming in through the golden gate bridge? my eyes are wide open and my mind is spinning for the horizon. a world of possibilities!

so that's where i'm at now, think i got a bit of the adventures of late communicated. learning so much about perspective, it seems. been thinking of late how it's absurdly pointless to do anything, to live at anything less than 100%, fully committed and intentional. reading a tom robbins book right now where the protagonist cultures a healthy fear of death, which keeps him living energized and without fear of life. doing some thinking about right living as well. so many of my compatriots at vassar, myself included, are so preoccupied with how they should life, what they should do with their life that they waste many weeks and forget to live in the moment! often the aforementioned romanticize the life of the poor farmer down here in latin america as noble and pure, but he lives as he does because he has no other option. he does not consider living any other way, because that would be absurd and the chores would not get done. therefor, it seems almost unethical to not utilize the opporitunities and privileges one is given. when i was at vassar, my academic study and use of the options there was so sporadic. too much self-involved thinking is useless. don't think, just feel and do. and commit fully to whatever opportunities you have. maybe a small nugget of zen with tyler.

hope you are all well. let me know anything i should know about! love, understanding, clarity, ty