Caught in the act!

I feel like the sailor out at sea: water water everywhere, but not a drop to drink!

In this case, I am surrounded by avocado trees, with fruit out of reach both literally and metaphorically. The local tiendas selling all variety of fresh fruit are all fresh out of avocados! As was the supermarket on Monday. This has been very upsetting.

Then today, I saw these bursting bags of avocados at the dock, about to be shipped out! En route to Boston no doubt.

Addendum! I just learned something very interesting. The avocados from around here go to El Salvador, where they are processed into soaps and oils. They are not for eating! The avocados that I can buy at the supermarket in Pana ("in town") are from other regions in Guatemala. Whew.

A non-hippy in hippy land

Being a non-hippy in hippy land is a strange thing. Actually, I should have thought about it more, but I had no idea that Guatemala would be filled with hostels where Australians and Americans and Germans in their 20s treat themselves to extended vacations. What do they do all day? None of them is reading, happy hour doesn't start until 5, and they all wake up around 8 or 9. I was barely able to make it one day after a nearly-all-nighter two nights before: I had to go for a walk, I wrote a blog post, I read 50 pages.

But the thing is, hippies are so nice. I was just down at the local waterfront cafe/bar/restaurant/hostel for two hours, drinking tea and juice and filled with a wonderful sense of purpose as I entered 30 paper charts into an electronic medical record, when I found myself drawn into the conversation behind me about hiking out to waterfalls. I just wanted to hang. I too want to discuss the waste that goes into producing a gallon of gasoline. But tomorrow, tomorrow I will hang. And Saturday we will all go hiking.

The good thing is, I come from a proud line of hippies with a purpose, or non-hippies who like hanging with hippies, or hippies who managed to get their school work done. No wonder I feel so comfortable.

Tonight's dinner, because I can't stand eating out when I can cook at home: sauteed green beans and zucchini, black beans and rice with an egg, white wine. Today I gave my first injection! Piece of cake. And now watching a magnificent thunderstorm on the other side of the lake, with enormous bolts of lighting and flashes that light up the whole lake.

San Pablo la Laguna

Today we took a small private boat loaded up with suitcases and boxes of medical supplies to the town of San Pablo la Laguna. The doctor I'm working under has a large staff of about eight Guatemalan women working for him as administrators, interpreters, and medical assistants. They are locals and dress in bright traditional clothing, and are all young, so that the atmosphere on the boat (la lancha) and then the van was a jovial one.

Today I saw eight patients, working as I imagine a third-year medical student might. I took the relevant history and physical, reported to my attending, who checked or re-did my work and prescribed medications (unfortunately something I know nothing about yet), and then completed the visit and charting (using an iPad!). I watched one pelvic exam and then did one myself, using a speculum. I saw ascaris, candidiasis, ringworm, and an unknown STI (minimal lab tests here). You have no idea how exciting it was to someone who recently completed a month of microbio.

Now I am sitting on the porch watching a thunderstorm over the lake. I just finished making black bean soup with butternut squash, using cumin and paprika plus a Guatemalan spice mix (dried ancho chili, cinnamon, sesame seeds, pepitas, and bay leaf, all whole), and rice. I rehydrated the beans last night, and roasted the squash before chopping it into small pieces for the soup. Is it morally questionable to blog about food in a country with high poverty and malnutrition?

Cooking keeps me sane

Today, after a very good but relatively stressful day in a new place, it was such a relief to come home, unpack my groceries, fill three straw baskets with a variety of produce and dried goods, and chop some carrots and zucchini. Order at home and confidence in a task I know how to do well. The challenge of cooking within local constraints is one I can handle and even find exciting.

This morning I took the history and physicals of five pregnant women in for their routine check-ups. I asked three very simple questions, learned to read a urine stick and measure uterine height, and even got to learn and practice using a sonogram. The women were healthy and the history a little too simple for my taste, but overall it was more patient interaction, independence, Spanish, and technology use than I'd had to date.

Carrots and zucchini with cumin:

• 2 large carrots, peeled and sliced into 1-cm thick rounds (the carrots in Guatemala have so much flavor!)
• 2 medium zucchinis, sliced into 1-cm thick rounds (I used spherical zucchinis instead and sliced them into quarters first)
• 4 cloves garlic, peeled and sliced
• 1 tsp ground cumin
• 1 tsp canola or olive oil

Heat oil in a pan with one slice of garlic until the garlic sizzles, then add garlic and cumin. Stir for half a minute, then add carrots and zucchini. Sauté, adding 1/4 water if needed to keep from burning. Cook for just a minute or two so that the vegetables retain their crunch and flavor. I didn't even season with salt and pepper, but you could.

Day 2!

This blog will temporarily be converted to a travel journal. I may make posts private if readers get bored.

Last night I treated myself to a very tall glass of fresh squeezed orange juice in lieu of a cocktail as I read Love in the Time of Cholera. So far I have been eating well: turkey and avocado soup, chicken soup with vegetables, both served with freshly baked bread. Perfect for a weary and wary (of food poisoning) traveler. Traveling alone, I'm more aware of how comforting it feels to have someone set down a place setting in front of you. This morning I wandered around town for a couple of hours, checking out some ruined churches, peeking in at mass in three different cathedrals, and finally finding myself at a supermarket where I bought some cereal and snacks for tomorrow. What a relief!

Last night, I ate dinner seated at the bar of a restaurant with live Spanish music. I chose the place because of the music and because I heard more Spanish in the air than English. The owner sat down at the bar next to me with a few of her friends: the middle-aged women were beautiful and looked out of an Almodovar movie. The owner kept slipping behind the bar to refill her tall shot glass of tequila, which she would finish in three large sips between conversation.

The town is very pretty, with single-story buildings lining cobblestone streets. Low tree-covered hills surround the city. As I walked, I eyed the stands selling fresh tortillas and cut fruit, and the stores selling fancy cakes. Many more bakeries and pastry shops than I was expecting.

Now, I am writing this from the comfort of a hammock under a roof on the edge of an inner courtyard. It threatens to rain again!

Guatemala!

After a 1:30 bedtime and a 3:30 wake up (thanks to the dog's noisy roaming, I was aroused at 3:45 in time for my cab, despite having set my alarm for the wrong time), I made it to Guatemala this morning! I believe that I am supposed to blog about it for school, although I would be writing anyway.

With my medical goggles on, I noticed, as we sat in traffic in Guatemala City, that many of the cars here were releasing black plumes of smoke. And with the windows down instead of A/C, other drivers (and pedestrians) are breathing it in. I'd be curious to see how the air pollution rates in Guatemala City. On the plus side, traffic rules seem to be observed!

The Australians at the hostel are hoping that the rain stops, but I hope it continues! For the night, that is.

Asian cabbage slaw

Last night we had a family BBQ with homemade Korean fried chicken and pulled pork. The theme was high fats balanced by vinegar and spice. To top our pulled pork sandwiches, we made an Asian cabbage slaw, sans mayo. On my own, I would make this again with peanuts, tofu, or chicken as protein and eat it for lunch.

Asian cabbage slaw:

• 1 small-medium head of red cabbage
• 1 carrot
• sushi vinegar (or white vinegar plus sugar)
• sesame oil
• chili flakes
• black pepper
• optional: chopped cilantro, roasted peanuts, fried tofu, etc.

Slice the cabbage as thin as you can. Shred the carrot with a vegetable peeler or grater. Toss both with a few generous splashes of sushi vinegar, to taste (about 1/4 cup): the sour-sweet vinegar should balance the spicy-sharp cabbage. Toss with ~1 tsp sesame oil: enough to add a hint of flavor, but not enough to be overpowering. Add chili flakes and black pepper to taste: just a pinch of each. Toss with cilantro or peanuts, etc.

I neglected to take a photo, but the slaw was a rich purple with specks of orange: crunchy and bright!