6 stages of transition

I think a new job is always a bumpy ride. Here are the stages I've gone through in the last week:

1. Enthusiasm:
Yay! Nicaragua - it's beautiful, it's hot (this is great! I miss Texas!), my Spanish is going to be so awesome, beaches!

2. Charlie Brown's teacher:
What language are these people speaking? I think they pronounce the first consonant, and after that, all I hear is vowels. (I thi the proou the fir coos, an afe tha, al I hea i voe =  Mwah mwah mwah mwa mwah).

3. 3rd year medical student:
That was most of last week. It was like being in 3rd year of medical school for 3 reasons:

• The words that a doctor says to other doctors always sounds like another language. It was like trying to get a Spanish speaking person to teach me German. I understood about 80% of their Spanish at best. then they started saying all of the peculiarities of medicine… 
• the pimping. Duke attendings just don't ask the level of biochemical detail that my attendings in medical school did. But don't worry, all my ex-attendings from medical school, my Nica attending has taken up the torch and asked me for the specific cell wall composition of staphylococcus and the factors that make it more likely to create an abscess. If only I could understand the questions…
• I was totally useless last week/annoying. Given that I couldn't understand half of what my attending/coworkers said, I was not trustable to take a history or write a note/discharge summary/order/find the lab/find radiology/answer questions from patients/call consults. I actually attempted a discharge summary (unsolicited) and my very sweet (intern) resident that I'm following around told me it was a great effort but I did it all wrong… in the nicest way possible. I tried not to hover, or look like I was slacking/uninterested. Yes. I've done this before. In medical school. blah. 

4. Awesome weekend:

What to do when you feel defeated at the end of your first week? tag along with some nice german/swiss people to go on a mangrove tour/to the beach!!

These lovely humans whom also live in my hotel let me tag along on a wild life tour that culminated on a deserted beach reserve where sea turtles lay their eggs (at night - I didn't get to see any). 

low tide 

some nice german friends

me and some manglares (mangroves)

these are mangrove trees (red mangroves). Their branches grow into the water of estuaries like roots and keep the salt content of the water stable so that the estuaries can be the hot bed of... marine reproduction… that they are. 

the turtle reserve. horrible view. very crowded. apparently you can rent a cabin their for $10 a night and watch the turtles at night. 

obligatory pic with the water. 

coming back to the town near the tour

Then a few of us went and found http://www.surfingturtlelodge.com , which was gorgeous, and (bonus!) there was no death grip riptide so we got to go swimming :). 

Sidebar: While out jumping in the waves, my new friends started looking at me with concern and asking if I was ok. I had a tiny bit of sand in my eye, so I blinked it away, and smiled, and said of course I was fine. It turned out that, in the process of pinching my nose to avoid a netti-pot-like nasal lavage I had stabbed my nose with my nose ring. Apparently had blood streaming down my face and chin like a bad vampire movie. I got out of the water (to avoid attracting sharks, of course) and pinched my nose like a good pediatrician until I wasn't wiping away handfuls of blood every time I let go. To be clear - it didn't hurt at all, but I guess the salt water that was also running down my face diluted it and made it look like I was hemorrhaging in front of my new (non-medical) friends' eyes. sadly, no pictures were taken of this event. 

since I had abandoned the water, we transitioned to laying on the beach and drinking. this was followed by a game of volleyball that my team ended up winning by a "rock off." Apparently this is the non-american but infinitely cooler way of saying playing rock, paper, scissors. We had 3 teams, the teams each had a match against each other, and each team won one/lost one, so we rocked off to settle the score. allegedly, the winning team got free drinks and the losing team had to dance on the bar and get iced (throw back an entire smirinoff ice while on one knee), but we had to leave before these things occurred. 

Surfing turtle lodge is on a peninsula that you have to take a boat to reach, and we left with the cooking staff, so it was a beautiful walk to the boat (on the beach with the full moon out and lighting in the distance (far distance) over the water). 

Unfortunately, at the end of the day, I learned another white girl lesson. It sounds responsible to put on your sunscreen before you leave for the day. However, if you sit for an hour with your backpack in your lap and one leg against the bus seat in front of you, this is your prize:

5. 4th year medical student! 

some how, over the weekend, the people I'm working with realized that they have to talk to me slowly and enunciate (like an elderly person whose hearing aids don't work), so I understood most of what happened today. I also learned to write notes!!!!!!!!!!!!! and I'm really excited about it. just like a 4th year medical student. I can do something useful!!! and the shine hasn't worn off from having to write 8 notes an hour like it's my job. today went better. 

Now i'm hopeful for the future: step 6: resident/fluent spanish speaker??

soccer and socializing

It's easy to forget here that I still have real life things that I need to do - apply for fellowship, a QI project... Yesterday I slept some and then went to meet Ellie's friend Meredith to watch the soccer game and play with the baby. On the way home, I noticed a bar right next to my house that had some orange-clad Dutch people amassing for the afternoon game. 

Since I've been here, my inner shy person and made a reappearance, but, as always, I would rather have a few minutes of awkwardly introducing myself than spend any amount of time lonely/awkwardly hanging out by myself (in this case, I think that would mean watching spanish dubbed movies in my hotel room for two months - unappealing).

I suppressed the social anxiety and dove into the crowd of Dutch. Within minutes if acquiring my Victoria (local beer) a Dutch woman who who turned out to be the owner of the bar had painted my cheeks with a face paint crayon in the design of the flag of holland. 

My neighbor proudly explained to me what a skilled diver Robben is, and, in typical American style, I explained why I thought Tim Howard is the best keeper in this World Cup (although the guy said the Costa Rican goalie unarguably had saved more goals in total). Psh. But did he save 16 in one game?

By the end of the game, I made a friend, and we spent Saturday night exploring the night life. Have I mentioned yet that I'm turning 30 while I'm here. We went to a hostel where some other Dutch people were staying and collected a group for going out. I would guess that the average world traveler these days, based on this hostel, is no older than 25. Subtext- I felt old. Just going to say it once. From now on let's call it feeling wise.

One of our new Dutch friends blissfully continued his 12 hour buzz in celebration of World Cup success while being that awesome drunk guy who has happily befriended everyone in a 100 yard radius within 10 minutes. Meanwhile, a kindred spirit and I drank about a gallon of water (weather than alcohol) while dancing in what I can only assume was a sauna fueled by body heat and human sweat. This kindred spirit is an American who shared my desire for personal space on the dance floor - it's always nice when you're not the only person who finds it weird that it's socially acceptable to dance all over near strangers.

When we could no longer take the heat, we wandered back to the hostel (Bigfoot hostel). On the way, we picked up some street meat and gallo pinto. It's just rice mixed with beans, but it seems to be the breakfast, lunch, and dinner of champions here. Bigfoot was playing some sweet jams that took me back to high school and everyone else back to infancy (new music!). J/k everyone knew the songs and politely agreed with me when I yelled something about flashbacks to high school.

Around 1am I resisted the urge to dance all night and some of my new friends were nice enough to walk me back to my hotel. Don't worry. It wasn't hard to wake up for mass. They ring bells before mass and shoot off fireworks after mass. Yup. Fireworks. After every mass. It's broad daylight so it's the equivalent of gunfire in beauty and sound. I'm pretty sure there was a 6:30 mass. Definitely an 8am mass. And I made it to the 10am. Really I got to the cathedral at 8:30 because the hotel people told me mass was at 9, but that just meant I got to eat breakfast and write this before the 10 am. Here's breakfast: nacatamales and coffee :). 

Otherwise known as breakfast tomales as far as I can tell. I love traveling. If being a doctor doesn't work out, I'm just going to move here and teach surf lessons. Right after I learn to surf.

Leon, Nicaragua

Long time since I've blogged. Equally long time since I have traveled like this. As I started writing this, I realized that I am in a bright yellow hotel room, exactly the color of the hotel room that I used to stay at in La Esperanza. I can't decide if that makes me feel more at home or not. Here's how it's gone so far:

The good: 

- Ellie (my chief resident) got me in contact with one of her friends who still lives here. She was wonderful enough to get coffee with me, walk the city a little, summarize the last 100 years of Nicaraguan history for me, and let me play with her baby. So that was pretty great. 

- my taxi driver from the airport was perfectly on time and I successfully had a meaningful conversation with him in Spanish on the 2 hour drive from Managua to Leon.

- this city is so walk-able.

- I found the ATMs and bought a local phone. 

- viber works well, so I can have long conversations with far away people with that app. 

- my hotel room is perfect. 

- people seem nice. 

The mild to moderately inconvenient:

- american airlines gave me a pretty annoying 12 hour journey from Austin to Managua. Such jerks. But I guess it could have been better if I hadn't chosen a flight with two layovers. That was my fault. 

- My Spanish is variably good enough depending on the topic of conversation is. I went to the hospital today to meet people and get things set up. It's like starting wards in medical school - a whole new language - except in a language that I understand 85% of at baseline. When I started on the wards in medical school, I had to ask what things meant all the time, except people were speaking English. We just use a lot of short hand and jargon in medicine. Now it's Spanish and I can't decide if I people are saying weird hospital-isms or if my Spanish just isn't good enough. I repeat back everything people say six times just to make sure I understand. It's important things, like their expectations of me and where I'm supposed to be on Monday. 

- I've forgotten how to be a good traveler: do you take the passport and leave the copy or take the copy and leave the passport? I think the former. Can I flush the toilet paper? probably not…? No using the air conditioner during the day. 

- missing 4th of july at home/ the best fireworks ever by one day. 

Over all, Ellie's friend made me really excited about the city, and I'm pretty sure my Spanish is going to be awesome by the time I'm done here. This is going to be great.