1000 Days

When we were first married, we celebrated anniversaries often. I imagine this is a normal phenomenon. Since we were married on a Saturday, every Saturday was our week X anniversary. Always a reason to celebrate. Since we were married on December 31st, the end of every month was also an anniversary. Every month of the year commemorates some occasion or another.

We don't blog about these, because we'd like to keep at least a few people visiting. However, as of yesterday, we have crossed the 1000 day mark, and we feel that this is worth publicly noting. We initially had big plans (i.e. walking to our restaurant of the month) to celebrate, but these had to take a back seat for some other obligations. However, we have only postponed, and on the 1st of October, we will not only celebrate 1000 days of marriage, but also the final nail in the coffin of Rachel's night float experience in residency. We also calculated last night that we have spent an average of 3 minutes per day watching The Lord of The Rings. Good things are happening, and we are thankful.


30 Years

This past week, my (Eric's) parents celebrated their 30th wedding anniversary. They are currently celebrating with a trip for two up in the Canadian Rockies. We love them very much and are very thankful for the inheritance of such a committed marriage. In honor of this event, I am here posting my favorite family picture to come down the wire for a very long time. It's worth clicking on it to get the enlarged view.


Trailer Medicine

Every summer and fall, my (Eric's) residency program staffs a migrant clinic. Every Thursday night, a few people drive out ~50 minutes or so from Ann Arbor, down a dirt road on the DuRussell Potato Farm, to a couple of trailers, one of which houses the clinic. There the Latino migrant farm workers have a chance to get some convenient health care during the time they're here in Michigan instead of Texas or Florida. Some speak English, some don't. Some have insurance, some don't. Last night was my turn to make the voyage, and I loved it (again). Here's why:

1. It's in a trailer on a potato farm. Anyone who wants to open a clinic in a trailer on a potato farm, please let me know.

2. It's casual. My goal is to practice medicine in a t-shirt. I don't know if I'll accomplish this, since Africa maintains a professional decorum with its traditionalism.

3. HIPPA is... elastic. The faux-wood panel walls between the two exam rooms don't really offer any sound-proofing anyways. The casual nature of the clinic means that the conversation about birth control or your kids' ear infection may continue out into the hallway and all the way to the door of the trailer. And no one (seems to) mind. It reminds me of Africa. Confidentiality can be a boon, and at times, is essential. The flip side, seen here, is that there is a collegiality in a shared experience that is also valuable.

4. The staff is excellent, and are incredibly well-versed in the logistics of what is and is not possible to accomplish for their patients.

Viva la clinica en la trailer en la potato farm!


Road of Lost Innocence

Last month I received an invitation to review a very special book, “The Road of Lost Innocence,” by Somaly Mam. It’s a memoir from an amazing woman who was sold into the sex industry around the age of 12. I jumped at the chance to read it, for several reasons. Many of you may know I spent six weeks in Cambodia in the summer of 2002 after my first year of medical school. I stayed at a guesthouse in Phnom Penh, the capitol city, and traveled down the Mekong River every week with a group of doctors, providing medical care at different clinics by the riverside. My last few weeks in the country, I was able to work at an organization called the White Lotus, a Christian house set up for girls who had left lives of prostitution. At this home the girls were fed and clothed and taught basic skills: literacy, cooking, sewing. Ways to earn a living. I gave a series of talks on health care, topics like hygiene and nutrition and basic diseases. Working, even briefly, with those girls was an experience that I have not forgotten. Human trafficking has gained more awareness in the media in recent years, and for good reason. It is a multi-billion dollar industry second only to drug trafficking in terms of global profits. Over a million children under the age of 18 are sold into sexual slavery every year.
Somaly Mam is able to write a powerful book on this subject because she has lived it. She was abandoned by her parents and grandmother at a young age, and was eventually adopted by a man claiming to be her grandfather, who beat her, enslaved her, and eventually sold her into prostitution. The sad thing about prostitution in Southeast Asia is that it is never a choice of the woman/girl. Families will sell their daughters to a brothel or a pimp for as little as $20. Some claim they think it will provide a better life for their daughter; some just need the money. But as girls as viewed as little more than property, they have no say in their own “sale.”

In “The Road of Lost Innocence,” Somaly relates how she was chained, beaten, raped, and abused for many years. She was thrown into cellars with snakes, or tied to a bed while maggots were poured over her body and into her mouth. After several years of this she eventually met a Frenchman who bought her out of prostitution and married her. She describes her transformation into a more confident young woman, one who eventually found the courage to come back to Phnom Penh and begin buying other girls out of sexual slavery. She founded an organization called AFESIP, which over the years has set up a number of homes and centers throughout Southeast Asia for young girls to come and find healing, and to stay until they can support themselves by some means other than prostitution. The organization recently started a nonprofit foundation, the Somaly Mam Foundation, part of which the profits of this book go towards.

The book is sad and eye opening and powerful, all at the same time. I would highly recommend it as a way to learn about the depravity of humankind, but also the possibility of transformation, and difference that one person can make in changing a seemingly insurmountable problem.

One thing the book does not address…I noticed early on that the book’s title is the Road of Lost Innocence, not the Road to Lost Innocence. For me, it’s an important distinction. She chronicles how she lost her innocence, how many young girls in such a situation lose their innocence, in so many ways. But is there a way back to that innocence? Is there healing, true healing, or just an experience that causes rage and anger and a desire to change things for future generations? I want to say, however na├»ve it may seem, that there can be a return to lost innocence. There is hope for healing, for newness. “He who was seated on the throne said, ‘I am making everything new!’” (Rev 21:5) “Therefore if anyone is in Christ, he is a new creation; the old has gone, the new has come!” (2 Cor 5:17)


The Road Rally

Every year, some nurses from Rachel's hospital, St. Joe's, organize a road rally scavenger hunt. This sounds like a small deal, but trust us, it's not.

Well over 100 people participate, and rivalries persist from year to year. Our first year (3 years ago), we casually joined up with some of Rachel's friends to form "Team X", a team renowned for scavenger hunt prowess (and cheating, but that's a vicious lie). Our ability to solve word problems and answer trivia on a range of topics from the Bible to beer distinguished us, and the leader of the team now reminds us of our obligation to be on his team all the year long.

We always have a great time, and last Saturday was perhaps our last road rally. All 8 of us piled into a giant Excursion and subsequently sped all over the county performing ridiculous tasks (any time Eric has to bowl, it's always ridiculous), visiting graveyards, and making the occassional U-turn. We all ended up at this pub where we picked up a couple door prizes, and headed home, absolutely soaked to the bone. Vive Team X!

The Traditional September Kalacs

We remain faithful to our New Year's Resolution, and wandered just east of the Iron Curtain this month to make Kalacs, which is a Hungarian Cinnamon Roll. It's been quite autumny and rainy here in Michigan for the last week (after not raining at all for 6 weeks), and so we pulled out the space heater to help the bread rise.
Overall, this ranks up there with the naan as one of our most successful breadmakings. Very, very yummy. The recipe makes 2 good sized loaves, and we are still enjoying them. This will definitely be made again, likely when we are back on the same side of the Atlantic as the bread's home country. No, Eric never had bread like this when he sojourned in the land of paprika and Liszt, but if he had, he would have remembered it.


Kid Swapping Conspiracy

This past weekend, we went over to Grand Rapids to see Peter and Sarah Bast, and together we went into Holland, MI, for our med school classmate Matt Nehs' wedding to his new bride Christa. Certainly a good time was had by all.

Peter and Sarah have lived in Temple, TX, for over a year now, and we visited them in January of this year, and got to meet their baby girl Greta. She is cute, well-behaved, and has some very nice pigtails. There's only one problem: She is now not the same baby we saw in January.

I know what you're thinking, that a baby girl can change a lot from 3 months to 1 year old. Of course, they can. We learned all about developmental pediatrics in medical school (regarding the raisin, etc...). Nevertheless, the Greta Bast that we encountered (above), upon closer scrutiny is not the Greta Bast that we met in Texas last January (right). Both Gretas resemble their parents distinctively, but in different ways. Therefore, one must conclude the following: That the Basts had 2 fraternal twin girls, didn't tell anyone, and have been swapping them back and forth. Thus, an extra set of congratulations are in order.

Medical Literacy Research

Funny how some things can take large parts of your time, but you never deem them interesting enough to share with friends.

But in order to give our "real" friends a chance to "really" know what's going on in our lives, I (Eric) will mention my research planning. I'm not by nature or desire a researcher, but every resident in our program has to do a senior project of some kind, and a couple years ago I got fascinated in one particular question in the field of medical literacy. "Do patient's understand medical jargon?" Even more interestingly, "Do physicians know what medical words the general public understands?" My theory is that docs are so far within their realm of work that they don't even know what they knew before they entered medicine, and thus simply telling them "You should avoid medical jargon in talking to patients" is a lost cause, since they don't know what that is.

So I've developed a survey (i.e. quiz) that will be distributed to patients and to physicians, with a goal of then comparing the actual patient responses to physician estimates of how they would do. All of this, of course, if I can get my project approved by the IRB. I don't really feel that I'm posing much risk to my patients with this survey, but we can never be too sure...

Click here for the questions, and test your own jargon knowledge!


Mayoral News

Kwame Kilpatrick has plea bargained and agreed to step down. It even made the front page of BBC news. There's still a lot of injury to the city to answer for, but may better days come for the city of Detroit.



Both of us are back on nights. This will be Rachel's last month (!) and Eric's last extended stint. He's only on for the first half of the month, and gets to take most call from home, when possible.

What Detroit Doesn't Need

For a while now, I've thought of putting up a post regarding an ongoing story in southeast Michigan, for all those of you who are outside the state, and thus most likely blissfully unaware of this saga, though it is the front newspaper story for Detroit more days than not.

Our favorite exclamation for Detroit (recently one of Forbes' Top 10 Fastest Dying US Cities) comes from Michigander Sufjan Stevens: "O Detroit! Lift Up Your Weary Head!" The city has an incredible amount of need. It would seem that almost any willing hand would be a net asset to this city. Instead, they have Kwame Kilpatrick.

Once a rising star and apparently fairly impressive politician, he was elected at the age of 31 to be mayor of Detroit. His first term was scandalized with $210,000 worth of inappropriate charges on the city's dime, including a luxury car for his wife, very expensive champagne, and day spa visits. After this being brought to light, he has paid back $9000 of the charges. Then, he was re-elected for a second term. (Shock and awe.)

The first term now seems like the good ole' days when Kwame was just spending the money needed for schools and healthcare on Moet et Chandon. Since then, the allegations have been marital infidelity, perjury, conspiracy, and murder. The explicit text messages he sent to his staffwoman and "mistress" were the basis for the court case against him. He is the only current mayor of a major US city to be charged with a felony while in office. During this whole circus, he appeared on TV and gave Rachel's personal favorite Kwame-ism: "I won't quit on you, Detroit." Please, Kwame, quit on us.

Last month, he violated the terms of his bond and went to Canada without approval, and thus got landed in jail. Tomorrow, the governor of the state will hold a hearing regarding whether or not to remove him from office. There's more of the story here. The murder allegations are particularly and unsurprisingly disturbing. So, pray for the people of Detroit, and have a little grace for the other political circles that aren't as bad as they could be.