Done and done

Today is my last day on the job. Tomorrow I'm off on a week-long vacation with my family Vermont, and med school orientation starts as soon as I get back. It's a pretty exciting time. Hopefully I'll have some time to catch up on posting from VT, but I make no promises. Happy Friday.

Sim City

I'm about to go spend the rest of my morning playing with SimMan, a life-sized mannequin/patient simulator, with realistic anatomy and clinical functionality. I am really hoping to get a lesson on how to perform an intubation or, better yet, a cricothyrotomy. It's cool to know that these sophisticated educational tools are around to teach us noobs these extremely important clinical skills in a non-patient environment. Performing your first intubation on a real patient is a terrifying experience, I'm sure.

Also, because there hasn't been a post up here without some mention of health policy in a long time: here is a recent interview from the Brian Lehrer show on WNYC with analysis on Massachusetts' move towards universal healthcare. I must admit that I haven't listened to this piece myself just yet, but one of the participants is Dr. Stephanie Woolhandler -- a woman I admire tremendously, and who has incredibly persuasive and smart things to say (to Congressmen no less!) about the disastrous state of healthcare in America.

I've got to run off to play with my oversized doll. Lata', all.

30 Days

It's t-minus one month until the start of medical school. I am as excited and nervous as ever --but mostly eager to meet my new classmates and get this show on the road. There are lots of fun orientation activities planned for us the week before classes start. At the moment I plan on strategic attendance of these events to make friends without being too overly enthusiastic about the Manadory Fun. I'll leave that to the 21- and 22-year olds. Although, I must admit, I have only the fondest memories of my college orientation week (described at the time – and quite accurately in retrospect – as Camp Amherst) those 7 long years ago.

Also, I just received my new mailing address, effective August 25:
435 East 30th Street
Room# 726
New York, NY 10016

Hope you all are enjoying your respective summers so far, and keeping out of trouble as best you know how. Check back soon for new content, as I'm trying to keep my readership from flagging as has been suggested by the Google Analytics and Feedburner software. Hopefully, I can keep you interested. Holler.

Motivational Issues

Just this brief note to say that I'm worried I am having a bit of trouble getting the wheels of my brain turning again. Being out of school and without a substantive job these past few months I have fallen into bad habits about working consistently. I've done enough to get myself into medical school and a job for the summer -- no small feats, I'll concede -- but have been very lax in my habits about Getting Things Done on a regular basis and it's starting to make me nervous.

Hopefully it's nothing, and my long sought-after -- but only more-recently cultivated -- aptitude for determined productivity will reemerge on cue. With jobs and a return to school looming in the near temporal horizon, it’s very freaking important. Let this post serve as notice to my current proclivity toward Sloth: I’m coming for you, buddy, and I don’t like your odds one bit, dig?

I imagine I'll be back again soon with some more interesting news for you to contend with.

Thank you!

It was so wonderful to see so many of you guys on Saturday night. It's a shame that it will probably be a while before we get to hang out again like that - unless, of course you have a little extra cash to spend and could join me for a week or two in beautiful South Africa. (The official slogan for the South African board of tourism is 'impossible', a very smart marketing campaign with an intuitively set up website.)

Big ups to cb who graciously provided me with some excellent tunes to bump to in SA. Some early highlights are:

The Beatles - Love
Miles Davis - Tribute to Jack Johnson
Wooden Dinosaur - Down home, Far out
Cold War Kids - Robbers & Cowards

This has provided a welcome break from my usual mix of soulhiphopmotown(withahintofindierock).

I will leave you to return, once again, to the difficult choices surrounding which t-shirts I want to have with me. (Do I want to bring my favorites? Will they just get destroyed by abuse? How did I get so many t-shirts in the first place?) Another FWP that I'm just going to have to suck up and deal with.

I'm leaving tomorrow night; any last minute phone-calls, e-mails, etc. would be greatly appreciated. Talk to you guys soon.

b

Picking titles for a blog entry is absolutely impossible. By the time I finish writing, the original title never makes any sense. The end.

I really should be packing, but it is has proven difficult to pare down the collection of clothes, books, toiletries and electronics that make up my life. My life, it seems, was never meant to be packed into a bag and sent across an ocean for the better part of a year. Now, before anyone starts feeling too bad for me, please note that this is probably the single best example of what we at the 'herst referred to as a First World Problem.

First World Problems occur at the intersection of entitlement and affluence, and I feel as though I am becoming more attuned to them in myself and others as I prepare to leave for SA. As an American - and as someone who has generally inhabited a wealthy, relatively insular community for the first 23, almost 24, years of life - I worry that I am prone to these circular reaffirmations of privilege. I hold out some hope that this upcoming experience will start to loosen some of these ingrained attitudes about what should or should not be taken for granted. This is an issue that I do not take lightly, and one that will be interested to examine when I am face-to-face with the public and health policies of a country balanced between the First and Third Worlds.

Who knew that this post would turn into a serious preview of what I'm hoping to Get Out of my time in SA? Certainly not me. More à propos of my procrastination from packing, I have this sneaking suspicion that I have forgotten to invite someone to tomorrow night's party (not to be confused with Last Night's Party). If you are planning on coming, please make sure that everyone else you know who might want to say Hi is coming along as well.

Dropping Mad Science

Writing a blog has been a particularly hard thing to do thus far. I try to write about things that are going on in my life - particularly South Africa related things - and I try to write about things that might interest you guys. And I am starting to get the idea that these two criteria are not quite compatible at the moment. My life in the US isn't all that interesting for the time being; I spend my time doing things to get ready for SA, worrying about things I have yet to do for SA, or hanging out with my friends/family. These three activities: not so interesting to read about, I imagine.

Maybe some of the things I have been reading about will interest you? There was just a great article in the New York Times Magazine on Sunday about the possibility of a treatment that could cut HIV infections in Africa in half. This is an interesting use of a public health answer to provide some solution to a question that seems to be baffling the biomedical community. I have also been reading about this interesting study published in Science magazine that confirms that education and religious beliefs can be accurate predictors of your belief in evolution or creationism. The study also makes some other interesting points about how are beliefs are formed. I'd recommend checking it out if you're into that kind of thing.

I think that should be all for now; keep those RSVPs a comin'.

b

If Prince were here, at least it'd be Purple Rain

In Vermont with Ariel for the long weekend. We had a couple days of good skiing at Stratton and Okemo so far, but this morning it was raining, so we decided to take the day off and rest our sore quads, calves, and backs. (I'm very glad I got a chance to go skiing before I leave.)


Shopping ensued, and I purchased 2 pairs of pants (one pair for $3.50) and two polos at the Banana Republic outlet here in Manchester, VT. These are probably the last purchases for my trip to SA; the HIV Coordinator at the McCord Hospital said the attire is "not formal (don't need shirt & tie), and it is VERY hot in January. But don't be too casual. Perhaps smart-casual is the thing to aim for." I own very few clothing that meets the "smart-casual" bar, especially for the hot weather (it turns out that when she says VERY HOT, it really only gets up to the low-to-mid 80's. Can't be as bad as 95 in New York City, can it?).

Also, I'm really looking forward to seeing as many of you guys as possible next Saturday night. Hopefully, I'll be sending around some e-mails about the party in the next few days. I'm not exactly sure who is reading my blog at this - relatively early - stage, so I want to make sure that everyone knows what's up. My apologies if you are doubly invited. E-mail me or leave a comment on the blog if you think you can make it.

Hope you all are having amazing 3-day weekends, and I'll be back in NYC for my final week by tomorrow night.

b

Don't cross the Flickr streams

Oh, I almost forgot - here's the link to my Flickr stream where I'll be posting photos while I'm in SA:

Bad News Bearnot

The stuff up there is kind of random at the moment; just some shots from Chris' birthday and New Years Eve celebrations at the moment. More interesting material is sorely needed.

Talk to you guys soon,
b

too many ?uestions

It's very difficult to Prepare Yourself for an adventure of the sort I'm about embark on. I can take care of as many of the logistical details as I can dream up – budgeting, insurance, communication, accommodation – but these necessary arrangements are almost besides the point; there are so many other questions that keep me up at night: How will I feel when I step into the Sinikithemba Clinic and am immediately face to face with the HIV pandemic that I've only read about it in books and articles? Will I be identified on the street as being American or white South African? Will I feel safe? Will I actually BE safe? How will I meet the people that I will eventually spend time with?

Obviously, these are questions that I can't answer from the comforts of New York City; the answers will all be revealed eventually, and probably not in any explicit way. Maybe imagining these possible circumstances acts as a sort of mental preparation, but I know that there are going to be situations in SA that I am wholly unprepared for. And that's what adventure is all about.

If that sounds melodramatic, I hope you don't fault me for it too much. When I tell people – especially those I'm not particularly close with – about my moving to Africa, their expression changes. Sometimes they get excited, sometimes worried – but almost everyone tells me, in uncharacteristically hushed voices, that it will surely be a Life Changing Experience. It's hard not to get caught up in the moment, thinking about what changes. But then I'm just back where I started, asking more questions without answers.

Visa-less in BK

Hey all -

Things have been a bit slow on the SA front for the moment. I have a week left at work, and lots to do to get everything in order before then.

Most recently I have been trying to decide if I want to go to SA on a tourist visa or to obtain temporary residence visa. It looks like the documents required to apply for temporary residence are complicated and confusing - and it's not absolutely necessary, I've been told. However, do I really want to have to leave SA once every 90 days, as I would have to do if I went on a tourist visa? I would just have to cross over the border into Swaziland, Mozambique, or even Lesotho (I think) - but I worry that I would always be running the risk of not being allowed back any number of unforeseen reasons.

Here's a map for people who are as unfamiliar with African geography as I was 3 months ago (click to enlarge)


When I asked the HIV Programmes Co-ordinator (for those who might have not realised: SA uses British English spelling), she told me that she has not known of people applying for temporary resident status, and wasn't sure of delays or bureaucracy it might entail. I'll give the SA consulate in New York a call a bit later this week; maybe they'll be helpful in figuring out this quandary.

And on an unrelated note, here are the albums I've 'picked up' (Beg, Borrow, Steal is how any good music collection is assembled at this point) since I put up since that last post:

Oasis - (What's the Story) Morning Glory
Clipse - Hell Hath No Fury
Buena Vista Social Club - Rhythms del Mundo
James Brown - Live at the Apollo (1968)
Tom Petty and the Heart Breakers - Damn the Torpedoes

And now I'm off to enjoy the last few hours of daylight of this gorgeous December(!?) weekend.

b

It’s been a long time/ I shouldn’t have left you/ without a dope beat to step to.

I was thinking today about the music I want to bring with me to South Africa. Of course I'll bring what I already have on my computer and ipod, but there's also a whole slew of new music and music that I've always wanted (but have never purchased/burned) to think about.

Here's what came to mind right away:

the new Decemberists album
Rhythms del Mundo - the Buena Vista Social Club Band
i've only streamed the tracks, so i actually need a legit copy of the Clipse's Hell Hath No Fury
the Hold Steady - Boys and Girls in America
for working out: LCD Soundsystem - 45:33
the Tom Waits boxset, with something like 30 new tracks
And obviously the new Timbaland disc, which actually probably won't be released until after i leave. please don't be surprised if i ask someone to send me a copy of it, come February/March

if you didn't know how eccletic my music tastes are, well, now you know.

Does anyone have any other good suggestions about what music I should make a point of getting before I leave? (It's sort of like a Desert Island Jukebox pick - except not at all, really.) I'd love to hear what you think. Please feel free to post a comment here, or e-mail me if you'd like. Maybe we can even work out a music exchange or something. This could work out for everyone. How exciting!

Looking forward to hearing your thoughts,
b

It's only a flesh wound.

I am currently shopping around, at my father’s behest, for a travel/ex-pat insurance plan for my time abroad. As you can easily imagine, it is NO fun; the thought of spending lots of money to pay for coverage that only protects you if something awful happens to you is uniquely depressing. On all of these insurance websites, there’s some discussion of an AD&D Rider. After seeing this written in two or three separate places, I decided to look it up. It turns out that AD&D is an acronym that stands for Accidental Death and Dismemberment. Awesome, right?

I have been away from my laptop for a little while, so I haven’t had access to my camera and the iMovie software – but I promise that that a video posting is forthcoming (although, in fairness, it might be pretty lame).

I sort of assumed at the outset that everyone who was reading this knows me personally, but I am starting to doubt this for a variety of reasons. Regardless of how you might have found your way here, I hope you keep on reading.

Peace.

b

Getting down to business.

I have been spending some time thinking about how best to share the insights contained in the e-mail I received from the woman volunteering at the clinic where I will working (see my post from 12/2) in Durban. Her name is Rachel, and I actually think that I’ll let her words speak for themselves – annotating and adding my thoughts where I feel it necessary. Her letter seems to be written for her own sake as much as for mine; she uses the opportunity of my initial letter to her as a way to set some of the things that she’s been thinking about during her year in SA to paper.

On disparities in the distribution of wealth:

“Although SA is the wealthiest country in Africa and the cost of living here is relatively high (I was surprised by the price of goods in the supermarkets and shops when I arrived) there is also a huge amount of poverty, most of which goes unseen by those who have the most money. Rich South Africans seem almost oblivious to the poverty that surrounds them, seem not to notice that the R300 they spend on a meal in a restaurant is more than millions of poor South Africans have to live on for an entire month.”

I have been reading a great deal about these disparities in wealth, and this seems to be a very well documented state of affairs, but I am particularly struck by the fact that she perceives ignorance to this situation on the part of wealthy South Africans.

On life in Durban (which is in the province of KwaZulu Natal (KZN):

“But then from an HIV/AIDS perspective KZN also represents a unique opportunity or a mammoth challenge depending on how you look at it. The province has the highest HIV prevalence rates in SA and modern Zulu culture (as well as some general South African culural norms) presents a number of obstacles to reversing this trend, not least massive gender inequality which manifests itself in scary levels of domestic violence and rape, women's inability to control their own sexual and reproductive health through negotiating the use of condoms in sexual relationships, and women's dependence on transactional sex with their boyfriends to guarantee physical, financial and food security for themselves and their children...but also people here have multiple concurrent sexual partners, the incidence of teenage pregnancy is relatively high, sexual debut usually occurs at a crazily young age, and there is a general aversion to condom use with a preference for skin-on-skin and even 'dry' sex.”

All I can say in response to the gravity of this paragraph is that I am very clearly in for a crash course in public health when I arrive.

On crime and security:

“This is a big issue in SA. I have never felt so caged as I did during my first week in SA. As you get used to the fact that you cannot go where you want when you want, you also have to deal with (mainly white) South African paranoia. I hope I've learnt to strike a balance between putting myself at risk and actually being able to go out and do things during my time here. I've gone from extreme caution when I first arrived, to being quite relaxed about security issues, to becoming more aware of security issues without letting them impede my movements too much. I'm certain I do more, go more places and take more risks than most white South Africans but it is calculated risk – I try not to carry more cash than I need and certainly don’t put more than a few rand in my bag (it's safer to split cash between your pockets), park my car where there are car guards, don’t leave anything valuable in the car and try not to expect the car to be there when I get back etc. There is crime in the UK but it was really liberating to get back to the UK, even just for a couple of weeks, and not have to deal with crime and security issues on this level every day.”

In this paragraph she strikes on the issue I am most concerned about in these weeks before my departure. I have never before spent time in a place where I haven’t felt relatively in control of my surroundings. Rachel notes that she has undergone several transformations about the way she has dealt internally with this situation during the past year - but no matter how small, a calculated risk is a risk nonetheless. Will I be able to enjoy my time in SA if I am constantly fearful of what danger may or may not be around the next corner.

On race:

“Skin colour and race still impact on almost all aspects of life in SA. For the first time in my life I was told I could not do certain things or go certain places because of the colour of my skin and that took a lot of getting used to. When I arrived, white South Africans told me that it would be assumed I was a white South African woman so I would have to act accordingly, ie. not go places that white South African women do not go! I think it is possible to work around some of these constraints (I go downtown even though very few other white people do) but I’m often conscious of the reaction I get from other people around me – black South Africans just do not expect white girls to be wandering around downtown!”

Again, Rachel focuses on how different life is for her as a white woman in SA when compared to her like in the UK. While I know that some of these issues won’t impact me as greatly because I am a man, I will most certainly be treated as a white South African – not as an American – and will have to act accordingly.

Sorry for the grim post; as excited as I am about my departure, there are also some very serious issues that I would be remiss not to consider and discuss. I also don’t want you to get the impression that everything that Rachel wrote to me was about the negative aspects of SA - she also shared a great deal about the beauty and diversity of the culture and scenery. But I guess I should save that for another moment, as this post has gotten a bit unwieldy. Thanks so much for hanging in there and reading through to the end.

I hope you have been enjoying my first bunch of posts, and I’d really love to hear any feedback you may have. My e-mail address, for those who don’t have it, is in my profile.

Peace out.

b

The fourth graders who insist, "second is the best" are wrong.

Tonight, I am taking time out of my busy packing schedule to go hear Jeffrey Sachs (isn't that portrait of him on the left the most amazing thing you've ever seen?!) speak at the NYU Medical Center. And no, I’m not already packing for SA – the lease on my apartment comes up December 1st and my roommate and I are moving out of the East Village. Jeff Sachs is one of those people who I only know because my friends and family have on several occasions recommended, “You should read his stuff, it’s really interesting.” In doing a little cursory research on the interwebs, it looks like his work centers around themes of economic development, poverty alleviation, and enlightened globalization – all tremendously interesting topics, all relevant to the experiences I’ll be having in Durban. I’m hoping that he is as compelling a speaker as the publicist who updates his Columbia Earth Institute website would have us believe he is.


When I wrote that first post, I’m don’t think I highlighted how preoccupied I have been with figuring out all of the things that I have to do before I depart. Just so we’re clear: it is taking over my brain, neuron by neurotic neuron. I think it makes sense on some level (I mean, one has to finish compiling a To Do list before ticking things off) but I wish it didn’t totally sidetrack me from the other, often more pressing, things on my plate. I recently saved a Things to Do for SA e-mail in Gmail. Now, every time my subconscious stumbles across another chore, I can just add it to my running list. This, it turns out, is quite convenient because it means that I have access to this list anywhere I have internet connection. Enough with the practical tips – I’ve got to keep plugging away at the documents I’m preparing for my eventual replacement at New York Cares. Hopefully I’ll have some interesting insights to share about Jeff Sachs later tonight.

b

Get ready 'cause here I come.

Hey all. My guess is that very few people will be reading this first post, but this is where I'm planning on keeping everyone up-to-date about what's going on while I'm in South Africa. For those of you who might not know (or maybe you've *gasp* never even met me), I have been invited to be a part of a research team at an HIV/TB clinic at the McCord Hospital in Durban, South Africa right on the Indian Ocean. My departure is about eight weeks away, and I'm still figuring out all of the things I have to get in order. Dr. Bruce Walker, the director of the Partners AIDS Research Centera and a Harvard Medical School faculty member, has graciously offered me a grant to pay for my travel, and I placed the request for my departing flight this afternoon.

With the pressure of this first post out of the way, I hope I can begin to share some of the things I'm thinking about before I leave. The tenor of this blog will change dramatically, I think, once I get to Durban; I imagine that there will be many stories about my new life to share. But, until then, you'll have to put up with a much more theoretical treatment of things.

I hope you find something interesting to read/watch/listen to here - I'll do my best to keep it entertaining. It feels like I am on the doorstep of quite an adventure.

b