Wednesday, March 30, 2011

Dr. Lauri Pramuk's reflection

March 25, 2011 “Nothing is more practical than finding God, that is, than falling in a love in a quite absolute, final way. What you are in love with, what seizes your imagination will affect everything. It will decide what will get you out of bed in the mornings, what you will do with your evenings, how you spend your weekends, what you read, who you know, what breaks your heart, and what amazes you with joy and gratitude. Fall in love, stay in love, and it will decide everything.” Pedro Arrupe, SJ – Superior General of the Jesuits 1965-1983 It is a great gift to love what you do. Being a pediatrician has been that gift for me. Those feelings are affirmed in my encounters with patients in clinic, and even more so in weeks like we shared in Guatemala. We all got to see how even in a simpler life people find joy in just being alive. There is no lack of color in Guatemala. I relive those wonderful colors now as I sling the strap of my bag over my shoulder everyday. Beauty abounds as I remember the scenery, volcanoes, Lake Atitlan, the purple flower trees. But what we will remember the most are the people. Endless smiles, some toothless, but all smiling. We also got to see how hard life really can be. Living in a home with a dirt floor without access to clean water is simply wrong. To quote Paul Farmer, “Clean water and health care and school and food and tin roofs and cement floors, all of these things should constitute a set of basics that people must have as birthrights.” On our first day of visiting the homes in Patanatic I wrote in my journal, “17 houses, 9 of which no longer have their water filtration systems. No wonder the kids are still getting diarrhea. The walk to the houses was the steepest mountain I have ever climbed. This is nothing to the elderly couple – woman carrying a basket laden with something on her head. These are amazingly strong people.” Life is hard here. Each day is spent in procuring what is needed for survival. If chicken is for dinner then it has to be butchered and plucked. So far from pre-packed at Kroger’s. The medicine was fun – plenty of well children. The part of the trip that surprised me the most was how healthy the kids were in general. Having traveled in Mexico, Honduras and Haiti, I was expecting some kids with severe malnutrition, but thankfully we didn’t see it. The people have limited resources, but do an extra-ordinary job of caring for their children. The mother of the 1-month-old twins was so concerned about the little girl twin (born at 4 pounds). She was already 2 pounds above her birth weight. The mother was thinking she didn’t have enough milk to feed both twins and was considering starting the girl on formula. I’m looking at this woman with breasts the size of large cantaloupes, leaking milk as we talk. Starting formula is not necessary (expensive for the family and would need to be made with clean water – or the baby will get very sick). I am so glad to have growth curves to show the mom how well the baby is growing. Her breast milk is more than enough for both babies. It is like liquid gold. Then I marvel as she slings the boy baby on her back, attaches the girl to her front and ties them up with her colorful cloth – both babies snug next to their mom. Just incredible. You all know now how remarkable it was to see 3 cases of varicella in one week. You will NEVER see that again. My pediatric resident in clinic last week was in awe when I told her that – she has never seen one case of chicken pox. Thankfully our varicella/scarlet fever patient did great and didn’t have necrotizing fasciitis. Central America is the birthplace of liberation theology. We all witnessed in our week in Guatemala what the liberation theology concept of “preferential option for the poor” means. It means one’s words, prayers and deeds must show solidarity with, and compassion for the poor. This is what we are called to do. This is what we did in Guatemala, and what Guatemala did for us. We are all poor in our own ways; some of us in spiritual ways, some more material. We are all richer from our week in Guatemala. Mishel and Diana are two sisters we will always remember. What talent they shared with us – gifts of medical interpretation, curiosity, mad skills on the marimba. We are lucky to know them. Do you think they ever stop smiling? They are Guatemala. We will take away memories of each other as well. Xavier is a phenomenal place. Your formation into men and women for others will always be connected to this trip. We also were gifted with great leaders. Amy, with her bible, is a terrific organizer, great listener and remarkable problem-solver. Rabbi Abie, so at home leading us in Shabbat dinner, and paying respects with the family of the elder of Patanatic in their loss. You will always remember Cathy as you encounter ED nurses – she is so perfectly suited for her job. Bonnie has a heart for alleviating suffering of any kind – be it human or animal. They also are great teachers. As students you know more about accurate blood pressure measurement than most residents. Then there is Richard. He is one of those rare human beings that we are graced to encounter. He is a great gift to me – someone who I can talk medicine with who also understands the humanity that we see daily in our work. As students he is a teacher you will always remember. So, drink in these memories. Share the stories with your friends and family. Guatemala will go with you always. Peace, Lauri Pramuk, MD

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