Bali, Say What? Hey MK!

24 March 2018 – 6 April 2018

Spring Break! Or at least, what felt like a wonderful one.. read on for a pause in time as I trekked further south to Indonesia and back to Thailand for one final week with my sister.

Week 12: 24 March – 30 March

March 24: Im in Bali. What?! Having arrived quite late night on the 23rd / early morning on the 24th, I caught my first true glimpse of the island late morning, as hot and humid sunshine came through my hostel window. I had met up with a good friend I made in Thailand, Alex, who happened to be there for similar dates. We planned the first half of my time in Bali to travel around together – soaking up the sun, climbing mountains, and enjoying the beautiful landscape. Having been able to save some on my budget during the first half of the year, and finding an awesome roundtrip ticket, I started my spring break a little early. We began with a day on the beach in Canggu. Crashing, strong waves of the South Pacific kept us mostly on shore; however, a few refreshing dips were needed with the heat and humidity (and I thought Thailand was hot!). Alex and I met up with other friends she had made while here, and enjoyed a night meeting new people from all over. A second day in Canggu consisted of a failed attempt at surfing. Caught a taxi towards Badung, at the base of Mt. Batur, one of the active Volcanos on the Island. Stopping along the way for a coffee break and view of the surrounding rice terraces, we inched along winding road and arrived at our next hostel, including a natural hot spring at its center. Early to sleep, we awoke at 3:00 am to begin our climb up to the top of the Volcano for sunrise. Powering through the hundreds of others (it wasn’t quite your moment alone on top of a mountain experience) we made it to the top, bundled up due to the vast temperature change and waited on the sun. It came, in full force, dazzled in a beautiful assortment of colors that ignited the green slopes around us. After an early start, a long morning in the sun and hot spring followed. Leaving that afternoon we headed for Ubud, a city centered I the heart of the island, and surrounded by rice terraces and jungle. Alex and I parted then as she was reuniting with old friends from home. Having two final days before returning to Thailand, I rented a bike on my first day to explore the land on two wheels. A full day on the bike took me to an ancient temple built into the side of a mountain, a temple of holy water, and beautiful rice terraces at sunset. Biking along, including a chain that fell off three times, I smiled back at the hundred of smiling faces that greeted me along the road, met local farmers in the terrace and loved every minute of that day. I finished the day by giving a quick FaceTime hello to Mary Kate’s Fourth Grade class to explain what I am doing and answer a few questions! With one final day, I tried out for the second time in my life a Yoga Class – and met an instructor who had taught my sister while she was there leading a Moondance. I explore the Monkey Sanctuary in Ubud, freaked out when a Monkey jumped on my back, and made it out without any items stolen. Having found a favorite restaurant with delicious Nasi Gorung Special, I went back one last time for a meal at sunset and packed my things for an early flight the next morning. The best part of all about this flight was that my return to Bangkok included welcoming my sister, Mary Kate, to Thailand! Woohoo!! Arriving at different airports, the two of us converged to the center of the city and finally reunited – running in a full embrace practically in the middle of the street. We checked into our room that was literally a bed and enough space for our door to open, ate Pad Thai and went for a Thai Massage – a perfect thing after long flights. The highlight was Mary Kate blurting out, “Oh Baby” as her back cracked about 100 times and the two masseuses laughing out loud afterwards. Having saved the experience until MK arrived, we traveled to the 64th floor of a skyscraper in the City, spent far too much on cocktails, but most definitely enjoyed our time above the clouds. With one day left in Bangkok, we traveled into the old city, explored Wat Arun Temple, the Temple of Dawn, and Wat Pho, the Temple of the Reclining Buddha. Taking Boat Canals through the city, MK got a glimpse at the Venice of the East before loading our things and catching a plane to Krabi, Thailand, in the south.

Week 13: 31 March – 6 April

After I had incorrectly booked our hotel in Krabi, we lucked out in finding an even better spot in the center of Ao Nang, where I had previously spent my time during the beginning of my time in Thailand. Waking up early enough before the heat truly hit, we went on a run along the beach, and then cleaned up for a day out by the ocean. Taking a long boat over to Railay Beach, we trekked up a muddy and root filled cliff and back down into one of the most pristine sports we both had ever seen – Princess Lagoon. Climbing down into the lagoon revealed a beautiful emerald lagoon surrounded by likely over 200 foot cliffs all around us. It was a spot in paradise. Climbing back out, we hit the beach, ordered local food on a boat and did our best to not get sunburned. Checking out a night market, we got caught in a down pour, ran in the rain and sat soaking wet listening to groovy music at the Boogie Bar. On Day 2 in Krabi, we trekked up along the Tab Rai Hang Nak Nature Trail to soak in the sights of the south from above. Rains changing our evening plans, we enjoyed a calm afternoon at our hotel and a trip into Krabi Town to check out the Weekend Night Market. Time moves quick when you’re always on the move and sure enough we were already on a plane the next day to Chiang Mai, back north! Arriving, we were picked up by a friend of Gig’s and surprised by Gig herself who was hiding in the back seat. Since Thunderbird was full, we stayed at a place nearby owned by her friend, and it was absolutely perfect! We took bikes out to explore some of the city and the temples within the old city walls and met up in the evening with friends at Thunderbird for a few drinks and dinner out. It was special for me to not only show my sister a place that had left its mark on me, but also the people who contributed so much to my time being as good as it was. On our second day in Chiang Mia, we were picked up early and driven out to the Hug Elephant Sanctuary. We were going to spend a day with ELEPHANTS! Mary Kate saw some on the drive over and already began tearing up. As it was only four of us on the tour, we had a really good opportunity to spend time with the elephants. We fed them sugar cane, took them on a walk, covered them in mud and then splashed around in the water below – it was like a dream. That evening, Mary Kate and I played a family favorite, Spite & Malice, then met up with friends for Pizza and Jazz. On our third and final day, we took our bikes around Chiang Mai University and went on a jungle run/hike up to Doi Suthep to see the temple on the mountain. Trying to soak in all we could, Mary Kate and I tried to fill our time with some final shenanigans and an evening wandering the local Night Bazaar for some shopping, and lastly, one final goodbye to all those amazing friends. We headed back to Bangkok on the 5th, wandered a bit more through the city, and made our way over to the airport for our departures – her back home to the U.S., and me over to Europe. Mary Kate made her way across the pacific while I spent 14 hours in the New Delhi Airport and lastly arriving in Vienna to meet up with a Sewanee friend studying abroad, Cindy!

Photos Pt. 1 – Bali

Not a bad view from you doorstep! Badung, Bali.

The view at sunrise, Mt. Batur.

More Sunrise ViewsSafe to say I was pretty happy. Alex and I at the peak!Morning glow at the top.Parent and Child, looking for stray bananas.Good view for your first time doing yoga!Mary Kate’s instructor, Sheila, in Ubud, Bali!Temple in the Mountain, Gunung Kawi Sebatu TempleMore at Gunung Kawi Sebatu Holy Water Fountains at the Pura Tirta Empul TemplePhoto taken just before dipping in the water for the ritual. A friendly man who helped show me the proper way to perform the ritual.Portrait of the bike that carried me 25+ miles. Mid-bike break to run off through some rice fields, because…why not?

Selfie at the Tegallalang Rice TerracesJust your average monkey business.

One final hike to eat delicious Nasi Gorung Special

Photos Pt. 2 – MK takes on Thailand!

You just cant beat a good massage after a long flightDrinks and wind and smiles on the 64th Floor Sky BarStanding beside the Reclining Buddha at Wat PhoCheck out this Lagoon! Princess Lagoon, Phra Nang BeachWe were pretty excited about it. Making our way back to mainland after a day on Railay BeachDrinks to-go + walks at sunset are hard to beat! Pano-selfie at Hang Nak!Taking crazy photos (mainly to annoy our mother! … Sorry, Mom!)MK meets Chiang Mai friends + Delicious food by the river A day with beautiful elephants!Picture that probably most accurately describes my emotions that day!Taking a bath with the elephants at Hug Elephant SanctuaryOne final evening out after the best week you could ask forWe ordered fish! Saying your goodbyes is never easy, but you can never forget how thankful you are for having the chance to meet. Turns out the older Swedish Gentleman I had a 14 hour layover with snagged this pic of me mid-slumber…Reunited with Cindy from Sewanee in Vienna, Austria!

Chiang Mai, You Have My Heart

3 March 2018 – 23 March 2018

As this post follows my recent quarterly report, you all have already seen the story people reflecting on how all of this. is. so. good. However, I will post the photo again, because it is important to not only read it once, but to return to it as a reminder of just how good it all is. It was in these three weeks described below that the emotions expressed through these words by Brian Andreas began to read true. I got the email of this photo, titled “Crazy Life” on the 9th of March, and it all clicked. I said to myself as I read it, “THAT, is how I feel right now, and how I have been feeling. This. Is. So Good.” Enjoy an update of my final weeks in Chiang Mai, the photos, and ideas that came to me in this time about my project.

Week 9: 3 March – 9 March

I began Week 9, with new orientation with the Chiang Mai office of Friends for Asia. Much of what was covered in Bangkok was re-covered there, but it allowed me time to 1) practice the Thai words I had been trying to learn and 2) meet the new staff and fellow volunteers/interns. It was my 4th week within the Thai Hospital System and it was spent at Ratchavej Hospital, a private hospital within the Chiang Mai District. We began our time in the Emergency Room, but throughout the week rotated around through various surgeries, and the Department of Physical Therapy too. Having spent my previous weeks in public, government-run hospitals in Bangkok, it was nice to get a glimpse at the private sector and begin to understand the differences there. Our German friend, Tilman, was leaving, so we celebrated with him on his last night around the city – eating delicious food, exploring cool bridges, and a bit of dancing to top off the night. Later in the week I went with Morse, Gig, and Aor to a market near the Chiang Mai University and then to watch Red Sparrow at the nearby movie theater. Thursday night, Gig, T, Aor and I found a fun beer house with craft beers and listened to T share stories about his singing (and his performances on Thailand’s The X-Factor! I feel like I know a celebrity). We also raised a little toast towards crossing over the 8-month barrier – an accomplishment in itself, and one that felt so good and full of joy to celebrate. Throughout the week, I had been discussing with Gig and others at the Friends for Asia House about the volunteer rescue services around the city. Gig took me to one service corps and Imm, a FFA coordinator, got in touch with another on my behalf. We worked it out for me to join the Pingnakorn Rescue Team Friday night. After the hospital, a run and some dinner, I joined a group of Volunteers who suit up every weekend to provide first aid, fire, and rescue operations for the city at no cost.

Week 10: 10 March – 16 March

To begin Week 10, I hopped on a bus early Saturday morning towards Chiang Rai. I had signed up for a half marathon and needed to pick up my race gear the day before. Arriving in Chiang Rai, I wandered through the city streets briefly and over towards Wat Phra Kaew Temple, but shortly took a taxi towards my Bed and breakfast that I had reserved nearby the race course. Chiang Rai was very pretty and reminded me a lot of Chiang Mai, but smaller and less busy. To an extent, the city felt like what you may find when you drive through and older, smaller American town. Life continues as normal, but as you walk or drive through the city, you can feel its age, almost as if you too are in a different time. Arriving at the Bed and Breakfast I was blown away. Apparently being the only guest there, my single, twin-bed room was upgraded to a larger double with an awesome porch. At the back of the house was an incredible view of the Northern Thai Mountains and I could tell that looking west, I would get an amazing sunset. To top it all off, there was a big, blue pool that also looked out towards the sunset. It felt pretty close to paradise to me. I went to pick up my race gear and then spent my day having a fun time documenting my one-day vacation. Some pool time, an easy run, sunset and beer, delicious food, phone calls with my sister and good sleep in a comfy bed made out for about as good a day as you could get (all for the price of $15!!). Starting early on the 11th, to arrive at the course for the 5:30am race start, I made my way through the dark streets to begin the race. I was anxious. It had felt like a long time since I last raced and I knew I had not trained exactly like I have done so in the past. The race started fast, with a few guys getting far out in front early on. I decided to hang back – knowing I am all too tempted to start too fast and fall apart later. As the race progressed, I fell into my groove, passed others, and was cheered on by many as we had a long out-and-back section of the course. Coming across the finish line in 1:18:53, I snagged 6th place and 1st in my age group! How exciting! I had so much fun and was reminded, again, just how much I love racing. I spent the rest of that day back at my Bed and Breakfast where I quickly fell asleep in the sun, and later cooled off in the pool. All too soon it was time to head home and return to Chiang Mai. Gig and T welcomed me at the bus station and the three of us grabbed dinner together. On Monday, I switched to the Pediatrics Department at Maharaj University Hospital – one of the largest hospitals in the north of Thailand. I spent two days in the Pediatric Out-Patient clinic and three rotating around different wards in the In-Patient Department. I continued having fun evenings out with friends: we went to new restaurants, saw another movie, went back to the jazz bar and sometimes just hung out at Thunderbird since some had to work their evening shift. I went on a long-run with some friend I met previously at the race and spent my Friday evening with the Pingnakorn Rescue Team again. It was another great week in Chiang Mai, just as every one before had been. Each day fits so well: mixing time for me to explore new contexts of health and my project, time to run and do what I love, and lastly time to spend my day in good company with people I care deeply about. It’s hard to believe I get to fit all of that in one day, and I am so thankful that I do.

Week 11: 17 March – 23 March

Having worked into the wee hours Friday night/Saturday morning I began with some needed sleep, a stop at a delicious breakfast spot and later more good iced coffee – a perfect set-up for a day of blog catch-up (however, as you can see, it clearly didn’t last long enough!) I was entering what really felt like my last week in Chiang Mai, and this also meant my last week I would spend with the special friends I had made up north. As the week progressed, the realizations of this began to take hold. As it was also my last week in the Hospital, I switched gears to another department, Orthopedics. During the week, I was able to rotate around with various students, residents, and doctors to understand a little more about the educational process of medicine that occurs in Thailand. I awoke early on the 20th, (my Birthday!) To be picked up by Gig. The two of us, along with Morse, were heading to a temple to make a birthday offering, which is something done by many in Thailand on their Birthday, among other days. Arriving earlier than opening hours, we placed our offering and received a blessing on a table outside (while a very large labrador decided it would be good to stand on top of the table between us and the monk!). A half day at the hospital was followed by treating myself to another wonderful Thai Massage, a wonderful long run around the local University and an evening out with my friends. We made drinks, ate cake, went out for good food and danced ourselves far into the night. It was a special day, while the days after my birthday were a blur. I finished my final two days at the Hospital, did my best to soak up all I could while beginning my packing endeavors. I had a flight to catch…to Bali! On the 23rd, I boarded a plane to Bangkok, grabbed lunch with a friend there, and then went back towards the airport for a flight over seas towards Indonesia.

Picture Time!

I told you about these awesome people, check them out. Pictured Left to Right: Tilman, T, Morse, Gig and Aor.

We go out to eat delicious food.

We like to take far too many selfies.

Some nights you sit at the bar, and on other nights you take over.

And sometimes we have to say goodbye to good friends. See you someday, Tilman! Pictured Left to Right: Me, Morse, Koh, Aor, Tilman, Gig, and T.

On March 8, we cheers-ed to 8 months away from home, and new friendships made along the way. It was fitting to be wearing my new Watson “W” hat and my Sewanee “S,” as I wouldn’t be here without either of them.

After one week at the Hospital I made my way to Chiang Rai. First step was getting all the Race Gear ready.

Followed by some Pool Time.

After a quick shake out run, I returned for a second dip in the glassed over pool just before sunset.

Pausing as the sun faded, I couldn’t: 1) stop smiling, and 2) being so grateful for all that lies before me

I had a BLAST racing. And I was reminded I still can’t get a good photo while running.

But I sure do love repping my Sewanee Gear in each race!

Post Race, I grabbed some fun photos with new friends…

Made my way to the podium…

And got a good picture with the CRRU Mascot!

The view from the temple Gig, Morse, and I went to on my birthday.I’ve started making a habit of running long on my birthday – this year’s did not disappoint.

Happy about cake!

Friends & Fun! A wonderful birthday celebration.

Project Thoughts:

All of the time I spent in the hospitals while in Chiang Mai were great, and I was thankful to have had the opportunity to see a larger variety of hospital systems than I had been able to previously. As my previous two Thailand posts have already covered much of the work and thoughts originating out of the hospital, I want to finish this post focusing mainly on the volunteer ambulance services I got to take part in.

Sometimes it seems like plans and new opportunities fall right into your hands, literally. Getting in touch with these services began during my first week in Chiang Mai. After a late night out, a foreigner had fallen from the third floor of the hostel I was staying in to the ground below. Unbeknownst to many, this traveler made their way back into their bed and went to sleep only to be found by friends the next morning in poor shape. Waking up in a different room, I walked out that morning to see the commotion that ensued following his discovery. I went in to check out was going on and stayed with the person until medics arrived. Miraculously, this patient walked away without a single broken bone. Having seen ambulances of various forms in and around Bangkok and now Chiang Mai too, I still wasn’t sure who was who: private, public, volunteer, etc. I had walked out that morning to hear Gig say, “Don’t worry, I called the ambulance. They are the volunteers; they’re free and faster!” As she was trying to reassure this person in need.

As the chaos settled, and the week progressed, Gig and I talked a lot about the different services here and we started working on getting in touch with them. Turns out, in addition to the various hospitals (private and public) that staff their own emergency crews, there are also multiple volunteer rescue services. After receiving the equivalent of licensure by the province of Chiang Mai, these services were legally allowed to operate and respond to calls; although, none would receive any monetary compensation for their service.getting in touch with these services and communicating the options before me with the time I had left in Thailand, I managed to work out time on both of my weekends in Chiang Mai to work with a team on the Pingnakorn Rescue Civil Defense Volunteers.

A brief history of the origins of volunteers like those I worked with. If you have the time, I encourage you to go read an article found on The Guardian about the rescue services in the Country. The accompany short film is also worth the time. You can find both here. In it’s origins, volunteer response came out of the efforts to make merit, a component to the Buddhist Tradition, much like that of Karma. Do good and good will come to you. Often responding to fatal car and motorcycle crashes, these services did the hard work of transporting already deceased patients; however, in time, these services began to arrive before some patients had passed. Learning basic life saving interventions and equipping themselves with rudimentary and donated equipment, these services grew from a basic “pick-up crew” into the first responders they are today. Many, if not most, of these volunteers are self supported, devoting their time off from work to responding to calls.

The Pingnakorn Rescue Team was no exception to the above. On my first night with the team, I made my way across the river to the nearest gas station and met the crew I would be working with. Sitting and standing around the back of a pickup truck, about 4 or 5 people were there waiting for calls to go out. In the back lay a spine board and a rigid leg splint made out of sawed off plastic. In the back seat was an AED, a medical jump-bag with an assortment of gauzes, bandages, and saline wash. Also present were more serious mechanical equipment, rope, a few helmets and a plastic bag full of assorted latex gloves. Arriving, there was only one other who really spoke English, while the others had a few basic words. Waiting around the truck, the man who I would soon find to be the head of the crew would intently listen to his radio receiver for any call that came out. Knowing only my numbers and a few other Thai words I was able to make out that dispatchers were giving out calls based off of regions in the city delineated by numbers, but I had no idea which number we were. Soon enough the truck started, and I heard a quick, “get in, we’re going,” and we were off. Two in the front and three of us in the back of the truck holding on to the edges, we raced down the street as a second car followed us with their lights on as well. We arrived first on scene to a man with a gunshot wound to his foot. Within seconds of arriving, sirens from every direction descended upon our location and soon enough there were 2 other ambulances, 3 motorcycle medics and 2 police cars. The neighborhood was awash with blue lights. Having only rudimentary transport, we passed the patient to the truck that had a stretcher and closed rear. Everything in front of me had happened quite fast, but I was amazed to see the coordination of all these different rescue teams. When I was applying for the Watson, I had a professor ask me in a preliminary interview, “do you think you’ll be able to get involved? Is there some sort of fraternal/brotherhood of EMTs around the world?” I wouldn’t quite say this service was a brotherhood, but they sure did act like a well oiled machine and were happy to see their friends who had also responded. As the night continued, I would see this again and again on different calls until lastly we stopped for the night at their friend’s street food cart and sat watching Muy Thai, eating Tom Yum soup, and waiting for the next call. For me, it was an incredible way to start my time with them.

I went back the next weekend for two more nights and continue to run calls in the back of that flatbed. As I would learn, this team works only weekends because of their weekly work schedule, and everything on the truck is self supported. The husband and wife in charge shared with me through the English they knew, “we do it, because it’s the right thing to do, and we can.” In the world of EMS, people often say that if you’ve seen one EMS system, then, well, you’ve seen one EMS System; however, I suspect the mentality and mission expressed by those I worked with is shared among many of the volunteers in Thailand who devote their time to this work. The majority of our calls were in response to motor vehicle accidents, while others were non-patient related, mechanical aid that our team also knew how to work on. At times too, they would don firefighting equipment and respond to the nearby fire when more help was needed. The truck that they worked out of sort of became a jack of all trades – ready and willing to respond to whatever sounded off over the radio waves. So to were the people inside it.

Of all the ambulances and services I had communicated with thus far along my year, this was by far the most rudimentary I had seen; however, the spirit filled within those who worked for the service were on par, if not rivaling many of the other services. There was such clear devotion to their work, a desire to improve, to learn more, and be better. As I have come to find this year, when I ask about how systems of emergency care provide for and create community, I find more and more that it is really, in fact, the community themselves that play an integral part in this creation and support. The volunteer rescue workers I was with were a perfect example – the community committing themselves to service in the service of others. To those at Pingnakorn Rescue, thank you for giving me the opportunity to work along side you.

While at the Pediatric Outpatient Department, I had a great time with the Nurses who showed me around and let me work with them.

Working with the Pingnakorn Rescue Team for the first time reminded me that as long as you’ve got your hands with you, you can get involved and help.

One of the coolest parts was seeing just how many personnel arrived on scene

A large majority of the calls we respond to were motor vehicle related incidents.

On call, we wait at a nearby gas station and wait for dispatch to send us out.

Thanks again for stopping by and reading on about my time and work abroad. More coming soon.

– Mark

Winding Down and New Adventures

17 February 2018 – 2 March 2018

May 1, 2018: Welcome back! As I have been trying to catch up with all that has been happening, here is another update for you to read on. Below details my last week in Bangkok, and the incredible week I spent exploring Chiang Mai and the surrounding nature. In my last post, I detailed how good I felt, much of that feeling originated in that time of exploration and learning in Bangkok, but the feeling of confidence and wellbeing was reached a new level in this third week at the hospital and as I transitioned to Chiang Mai. I wanted to share a portion of a journal entry that comes from the thoughts and emotions I have been having. For reference, when I was in Spain for only a few short days, wandering the streets, I turned and looked at my brother, Rob, saying, “there are so many people in this world.” We both laughed a bit, as it is kind of a silly observation to make; however, I keep having these feelings where in immediacy, that is the thought I have: there are so many people in this world. But as the feelings sinks deeper, it expands as I begin to think about the lives and stories of all those people. When you really take the time to think about it all, it can be quite overbearing (in the best of ways).

“One of the greatest things I am learning this year is the magnitude of life itself. Have you ever thought about a beating heart? I am sure you have felt yours before and perhaps one of those you love – a parent, a child, a friend, a significant other. But what about the one of the person in the coffee shop beside you or in the car at the red light? I saw one two weeks ago, open, beating, and then not. Two hours later, that heart started beating again, pulsating, rhythmically. Have you ever thought about ten of those hearts beating? That entire coffee shop? 1000? The pulse of a city, a real pulse. The collective hum and drum, beating. How about an entire province’s, a state’s, a nation’s? Have you ever though about every beating heart heart in this world? 7.5 billion of them, beating 60 to 100 times every minute? Can you think of that? I can’t, but I like to try. The world is pulsating, rhythmically. The magnitude of this thought, the magnitude of life itself increases when you begin to think about which one of those just stopped? Which one of those just begun? The ones that ache in pain, and the ones that burst with joy. We all ‘march to the beat of our drum,’ but at times too, those beats align, and there is power in that synchronization. It’s quite hard to put into words, and it sometimes feels as if this expression is a bit over the top, but these are the thoughts I am filled with more and more this year as I travel, as I meet new people, as I look out into the crowd across from me. It is feeling the enormity, of this world all at once, and I absolutely love it. ”

Week 7: 17 February – 23 February

As it was the last day for other interns (I was continuing on for one more week) I trekked back with them by train to Ayutthaya. Although I had already seen much of the city, I was happily surprised to be able to see new parts of the ancient city I had not seen before. We all hopped in a Tuk-Tuk and explored the city a little more calmly than my previous bike trek! That evening, after a long day out in the sun, I went back towards my favorite Massage Studio, got an hour and a half Traditional Thai Massage and couldn’t have left more content! In my third week of interning in Bangkok, I switched to a new hospital called Sirindhorn Hospital. This time a bike taxi, BTS Skytrain, Airport Rial-Link and Car taxi would be my mode of transport (simple, right? -haha!) To say the least, the week was awesome. I was stationed mostly in Internal Medicine, rotating around with the different Interns who were working there. I began my mornings in the In-patient Ward, even getting to experience a few surgical procedures, mid-day in the out-patient ward, and afternoons in the ER. Pausing halfway through the day, all the interns, doctors, and myself from Internal Medicine ate together and it was through this time that I really was able to get to know people well. The week left me asking new questions about how I want to pursue medicine in the future and the relationships I wish to make through that time. I spent my evenings that week with new Thai friends I had made and one evening out with the interns after shift to share a traditional meal, incredible dessert, and teaching a new word to them: “Food Coma.” With all that happened that week, it was hard to believe that it was already over and that I would be flying out of the city the next day.

Week 8: 24 February – 2 March

With an evening flight to Chiang Mai, I had plenty of time to pack in the morning and say a few goodbyes to the friends I had made while in Bangkok. My departure there was a reflection of what has often occurred. This Watson Year has taught me many things, among them being that i get the opportunity to say hello to so many new and amazing people, but also that I have to at some point say goodbye, and hopefully a see you soon; however, in this practice I have also learned to better focus on the experience that WAS shared, rather than the experience that comes with the departure. To have had the opportunity even in the first place to meet these amazing people is a gift, and although I do have to say goodbye, I give thanks for having had the chance and the time to meet them.

I checked into Thunder Bird Hostel (which I give a shameless plug to it being the best hostel I have stayed in to-date). Originally planning to stay two nights, and perhaps go else where for a few days before settling down in Chiang Mai, I ended up extending my stay for the week mostly due to the amazing staff that I was able to befriend. I spent my first day solidifying a few plans for Europe and the United Arab Emirates (exciting!!) and the afternoon wandering the city to explore some of the ancient temples here. Living in Chiang Mai, you can very clearly feel both the new and the old as you walk through the streets. Ancient pieces of the city still stand on street corners next to newly built houses and apartments. There is a coffee shop, hostel, and art store on every corner. There are plenty of tourists, but interactions among locals and foreigners seem friendly and welcomed. Coming from the hustle and bustle of over 8 million people in Bangkok, its nice to downgrade to just a few hundred thousand! You really can feel the difference. One of my favorite parts of the city is the moat/old city wall that separates the technical “old city” from the “new”. Each side spans a mile, and is a perfect spot for an evening run as the heat fades away into the night. I booked a trip on my second day to Doi Inthanon National Park. Originally hoping to camp, but not really finding the right options to do so, I settled on a tour that would take me to some of the highlights. Doi Inthanon is the highest peak in Thailand and is at the very base of the Himalayan mountain change. Climbing up high, I welcomed the slight temperature from down below. The park has many great sections to it, but two of the most beautiful were the twin pagodas constructed in honor of King Rama IX and the Queen.

As the week progressed, I began to get to know the Hostel staff a bit more and enjoyed sitting in with them at night having good conversation and learning about their lives. The following day, I unexpectedly got to experience some EMT work as a foreigner needed help as we waited for an ambulance to arrive to the Hostel. In the afternoon I embarked on an adventure run to a few waterfalls I had read about. Originally miscalculating the distance to my final destination I was graced by a free ride from two guys in my hostel to the top of Doi Suthep for an awesome view of the city and a beautiful temple. The three of us spent the evening meeting fellow travelers and going to a Jazz Bar. You quickly learn how many awesome people you meet and then say goodbye to within a span of 24 hours – and in this too, you learn to give thanks for the time you did spend, not the time you didn’t. The next day, I trekked out to Bua Tong Waterfalls, otherwise known as the “Sticky Waterfalls.” The limestone formation of the falls create a sticky surface for you to walk on. As water rushes over the rocks, your feet have no problem scaling the falls upward. It was surreal to be doing such a thing! On Thursday, I travelled with T, one of the Hostel Staff who had a day off to the Grand Canyon Water Park – an old quarry now filled with beautiful clear blue water. Fairly regulated now, we were still able to have some fun in the sun with a few cliff jumps as well! I made a second attempt in running to Doi Suthep, made it to the top for sunset, and enjoyed an adventure run down the mountain in the dark. Later that night, I met with the hostel staff who were off from work and joined them at Wat Chedi Luang for a ritual as it was a special Buddhist Holiday called Wian-Tiane. It was special to get to walk beside new friends as they practiced a special part of their own religion, and to be welcomed to join them in that walk. On Friday, I moved to the new volunteer house, and spent the day at Huay Tung Tao Lake with Thai friends from the hostel. We had a bamboo bungalow to ourselves and were able to swim, relax, and eat good food.

What was so special about this week was the people I met through Thunderbird Hostel. It’s hard for me to keep calling these people the “Hostel Staff”, because very quickly they became much more than that to me. They are my friends, my very close friends. As you will see in the posts to come, most of my days end with them – on a new adventure to find good food, going to see a movie, playing games, or just sitting together and enjoying our time together. These people: Gig, T, Aor, Morse, Koh, Sander, (and Tilman who has now left) made and continue to make my time in Chiang Mai so special.

Picture Time!

Back in Ayutthaya with Jessica, Bryant, and company, I got to return to some old sites and some new, like this one at Wat Yai Jaya Mongkhon.

The five of us posed one more time at Wat Maha That.

Arriving in Chiang Mai, I took my first day to tour the old city and some of the temples within it, like this one: Wat Chedi Luang, which had partially collapsed after an earthquake.

The Tha Pae Gate, or East Gate, at the edge of the old city in Chiang Mai lights up at night, especially on Sunday, as it is the beginning of the Sunday Walking Street Market.

My trek to Doi Inthanon, Thailand’s highest point, stopped first at the Wachirathan Waterfall.

Wachirathan Pt. 2

Near the peak of Doi Inthanon are two enormous pagodas in memory of King Rama IX and the Queen.

The Pagodas overlook an incredible view.

Posing at the highest point, there wasn’t much of a view, but awesome to say I was there! This is one of the few places it ever gets cold in Thailand.

The last part of the day included a hike around the surrounding area. We were greeted with stunning views.

Stunning Views and Me, Pt. 2

My Adventure Run later that week brought me back to one of the things I love most, trail running. (Kinda looks like Sewanee!)

Finishing at refreshing waterfalls was a nice plus!

Later in the week at Bua Tong Waterfalls, or the Sticky Waterfall, Tilman and I raced to the top!

The falls were an awesome playground.

T, Tilman, and I spent one morning at Grand Canyon Waterpark, a water-filled quarry. It was a great place to relax and make a few awesome jumps!

A second Adventure Run that week brought me all the way to the top of Doi Suthep, for an incredible view of the city and mountains below at sunset.

After that run, I joined T, Morse, Tilman, and Gig at Wat Chedi Luang for a ritual around the Pagoda. We carried Lotus flowers, a candle, and three pieces of incense.

To close out an epic first week in Chiang Mai, T, Morse, Tilman and I relaxed at Huay Tong Tao Lake underneath some bungalows

I couldn’t resist a dip in the water though!

Project Thoughts:

After what now seems like ages ago, I spent my last week in Bangkok at Sirindhorn Hospital in the Internal Medicine and Emergency Departments. Having been strictly in surgery during the weeks before, I was excited for a change of pace and the opportunity to see a different hospital than the one I had previously been in. Sirindhorn hospital is situated a little more centrally within the greater Bangkok metropolitan area and differed mostly in that it is not a teaching hospital; rather, it is just a government public hospital within the city.

Some highlights and key things that stood out to me in the week are as follows. On my first day, I sat with a doctor in the Internal Medicine Outpatient Ward and saw over 30 patients in the first two hours. (I was later told that she, the doctor, was behind schedule on how many she should have seen in that time. Doctors in the various outpatient clinics sit in a room, all lined up along a wall, and hit what is essentially a “next” button on their computer that rings out the ticket number associated with a patient outside. Within a few seconds the patient walks in and sits down to discuss what is going on with them. Some come in with specific complaints, whereas others come in for a general Well Check-up. I had a hard time justifying this practice in my head. Well Check-ups included a chest x-ray, a short conversation, but nothing else. No physical exam, or anything of the sort. One could argue that the ability to see so many patients is beneficial in that they DO see the patients; however, I have to ask to what point does it benefit the patient when there is not even as much as a physical exam and routine checklist of questions to go through. Some of these wellness check-ups lasted under 90 seconds.

Seeing this on repeated accounts led me to begin asking a few questions about how it came to be that so many people come to the hospital on any given day. One response I received was the fact that there is universal coverage for anyone who visits. Sometimes a patient would walk in to the doctor’s room and state that they had a headache or symptoms of the common cold. The doctor more often than not would prescribe ibuprofen or something similar and send them out the door. This system of health care, as I previously mentioned, will cost the patient no more than one U.S Dollar. Thus, a visit to the hospital for Ibuprofen will cost less than a personnel visit to the local drug store to pick it up over the counter. Because this is the common practice, many doctors I worked with believed that it has caused there to be an increase in patients who come to the hospital.

One of the difficulties I saw firsthand with the 30-Baht system, was with a man who had come to the Emergency Room for a broken hand. Under the current health care system in Thailand, individuals are zoned to a certain hospital, and thus have to pay out-of-pocket when they go to any other hospital. A worker who had been injured while on the job in the city came to the nearest hospital for an X-ray. We learned that the patient lived about 3 hours north of the city, and was therefor not zoned for this hospital. He would have to pay out of pocket for any treatment offered, including the X-ray. The doctor I was with signed an “emergency treatment” form to overrule this, but noted that not all doctors will due so, which makes it difficult for some patients in need. Patients in rural areas are zoned within their rural area, and can only received covered care at a larger hospital if they are referred to it by their zoned facility. It was little restrictions like these that frustrated me when it came to thinking about a patient’s free right to health care.

On some days I joined a senior doctor in the Inpatient Ward of Internal Medicine. With windows open, fans blowing, and AC only flowing within the doctor and nurse fishbowl room, the ward was stifling, and it was hard to see so many people in recovery who were sitting there. Some patients needed procedures done on them, such as draining fluid from their abdominal cavity, or placing a temporary catheter for dialysis. The doctor I was with wanted to teach me these procedures, and I nervously accepted being sure to check that as long as he was okay with it then I would be willing to learn. First watching both procedures on different patients, I was guided by a confident voice and gentle hand and successfully performed both procedures. (See below for a photo of this!) I was grateful for the trust this doctor gave me, and was reminded that no matter where we are in the world, there are those who are willing to teach as long as you are willing to learn. It was moments like these during that week at Sirindhorn that made me really feel like I had a place there and was welcomed. I ate each day with the doctors, and even on some occasions joined them in the evening for dinner. They seemed to understand that I was truly there to learn from them, and because of it, were welcome to share.

A lasting thought that stood with me was when a nurse said, “I get to make people happy, and that makes me happy.”

As I was ending the week at Sirindhorn, I wrote this in transit, “The ebb and flow of an emergency room mimics to an extent that of an ambulance station on the street. Often times it is quiet. Staff talk, eat, look on their phones, touch base on the past case, or tell a story about a crazy call they worked a while back. And then at times, all alarms sound at once without a moments notice. Everyone is ready, on standby at all times. This is life for them day in and day out, but is hidden behind closed doors, not only from the rest of the hospital, but the outside world too. Ambulances are the same. We see them and we see their sirens, but we rarely know their stories. I find this to be a unique practice of medicine. In other practices, you can generally predict whats going on, where — to a degree: Heart Disease in Cardiology, pregnancies in Obstetrics, etc., but not in the ER. Too often, not even the staff knows the general subject of the next case to be wheeled in – nor do the medics who respond to a house call, a motorcycle crash, a fire – theres no telling the extent of trauma they may find, but still they stand, ready. I keep coming back to the central question of my year – how do systems of care create space for community to live? It can be hard to see how this cares for the community in an outward practice, especially given that all of it occurs behind closed doors. But I think to a large degree, it is the reassurance that lies in knowing that those doors do exist and are always staffed on the other side. I am inspired that this exists in all the places I have been. I know that I haven’t always found myself in the absolute most rural environments that you can find, but to see these practices continue, at whatever measure a place has the capacity to do so, is inspiring to see.”

The nephrologist on call at the Internal Medicine Inpatient Ward guided me as I placed a temporary dialysis catheter in the internal jugular vein. Thankful for his trust and willingness to teach.

Some of the medical Residents at Sirindhorn Hospital took me out to eat at a local spot they love.

Finishing my last day at Sirindhorn, we grabbed one more photo with the Internal Medicine Nurse Team and the Dr. Niracha, who I had worked closely with.

Dr. Patiwat (center), Dr. Niracha (right), and two other interns I worked with in that week took me out for one last meal. It was a great week at Sirindhorn.

More updates (aka catching up) are coming! Stay tuned, and happy May!

A First of Lasts; My Third and Final Quarterly Report

April 19, 2018 – Day 284 of 371. I have crossed the threshold of nine months, moved through three new countries and returned to one old in two weeks, and have officially bought my return ticket home. All throughout this time, I have been continuously riding the wave that is this year and being sure to soak up every last drop. Below you will find my last reflection sent to the Watson Foundation prior to returning home. In it I describe my ever-growing deeper understanding of what this Watson Year truly means for me and what is coming up in my final chapter abroad.

“I was happy and knew I was happy, the happiest I’d ever been. Not blissful, joyous, angels-coming-out-of-the-clouds happy, but happy as in ‘a feeling of great pleasure or contentment of mind, arising from satisfaction with one’s circumstances.” Happy from hap, as in what happens—things as they turn out to be.” – Victoria Sweet, excerpt from God’s Hotel: a Hospital, a Doctor, and a Pilgrimage to the Heart of Medicine.

Watson, if there was a way to quantify how many times I have found myself walking down a street in Thailand, a Soi (alley) for that matter, feeling a grin creep across my face, bursting into a smile I literally cannot contain – emotions overflowing to the point where I can do nothing more than to raise my hands jubilantly in praise, admiration, and most of all, thanksgiving, this letter would not end. Rather, I will leave it to your imagination the imagery of a very blonde-headed Farang (foreigner) wandering the back alleys of Bangkok and Chiang Mai doing such things. That was me. I have walked these streets, whispered to myself, “I love this life” and realized again, and again, and again that, this. This life. This year. This World. Is. So. Good. Although I leave Thailand today, the emotions which grew inside me there will undoubtably continue as I transition onwards, along this rich and full life given to me. Watson, does it have to end? I mean this, this life, all that this year holds. I do not want it to end. I have asked myself these questions on numerous occasions in the recent weeks. I think the most beautiful thing I’ve learned in this past quarter is first, the realization that I do not want this to end, and second, the subsequent answer to myself, that no, it does not have to. In fact, it is quite the opposite: it will not end, but continue, as the movements and experiences of this year weave themselves into the life that is to come for me. It will permeate all walks of my life – within myself, my relationships, my career. I will be moved, just as I am now, by what has come (and thankfully what remains to come in these last three months). During my Third Quarter, I read God’s Hotel, by Victoria Sweet, who accounts her career at Laguna Honda Hospital, the U.S’s last Almshouse, a long-term patient-care hospital. In the process of her writing, she accounts both the historical origins of medicine, as well as the journey in which she undertook during her career, both personally and with patients. Finishing this book in the midst of all the emotions described above could not have been more perfect, and thus I am choosing to share a few of her quotes – not only has her writing stuck with me, but I deeply resonate with her words, finding the descriptions and the emotions of her experiences reflections of my own.

First, a brief recount of all things Thailand. Arriving to Bangkok, I gave myself a few days to adjust to the drastic time change, while finalizing future internship plans within the city and in the north. Soon after I took a trip to Krabi, Thailand to first see the southern part of the country. I wasn’t sure whether my future plans would bring me back south, and thus I tried to see all I could in the time I had. I had just written in my last report that I had been finding the importance in separating my life from my project; however, arriving in Krabi, I came to realize what I had just written was indeed the opposite of what I was experiencing. My eyes have slowly been tuned to look towards my project – of course in the hospital and in the ambulance, but they too have attuned themselves to the streets, the passer-by’s, the clinics advertising themselves to foreigners rather than to locals, the families of four all positioned on one motorcycle: daughter in front, dad’s arms wrapped around driving, mother holding with one hand, cradling their baby in the other. “Care.” The relationship I have with to that word, that people in these communities have to it, that this country as a whole has to it is no longer separated to a project day or not, a “project activity” or not; they are both, simultaneously. Each day I am called to the opportunity to both seek out the questions I hold within my project and the questions I hold within myself. Returning from Krabi to Bangkok, I had about two weeks on my own before starting an internship with a local organization. Having hoped to set up a few contacts with emergency services in the city, I continued to face a few setbacks and had to reorient myself. These two weeks turned out to be time for much needed preparation – intermixed with sightseeing and learning about beautiful Bangkok and beyond. As I would soon find, time to do both of these things would soon come to an end.

At the very beginning of February, I started working with a local organization that provided access to, among other things, hospitals within Thailand as a form of Medical Internship. Beginning in Bangkok, I spent two weeks in the Department of Surgery at one of the larger teaching hospitals in the country, named Thammasat University Hospital. Following those two weeks, I transitioned to the Department of Internal Medicine and Emergency Medicine at Sirindhorn Hospital, where I felt I really began to come alive in my comfort in seeking out new opportunities to learn from the doctors on call. Ending all too soon, I was able to get to know the local Thai coordinators, spend good time with them and their friends. It was during this time I felt like I was not only starting to meet people from here, but building relationships with them as well. Near the end of February, I traveled north to Chiang Mai – having first a few days to explore the city and surrounding mountains (boy, did I miss them!). I stayed at the most incredible hostel and met the most incredible people, who also would soon change my Thailand experience into what it is today. Later, I spent a week in a private hospital through the same organization; I got a glimpse of the private sector of health care, and then transitioned to a fourth Hospital in Thailand for my final two weeks of interning. During that time, I spent one week with nurses in the Department of Pediatrics and one more in the Department of Orthopedics. Throughout my time in Chiang Mai, and with the help of the new friends I created, I learned more about the rescue operation services, namely the various volunteer organizations who operate in the area. On two weekends, I joined the Pingnakorn Rescue Civil Defense Volunteer Corps. Waiting at a gas station, beside a friend’s stall of street food, we relaxed by a pick-up truck and waited for calls to sound off over the radio waves. I celebrated my birthday by making an offering at a local temple with good friends, spending a day at the hospital, getting a massage, running through beautiful landscapes, and taking a pause for some fun celebrating in the evening with new, now eternal friends. It all came and went so quick; I took a surprise trip to Bali, Indonesia, getting to see the sights of the islands, and really loving the brief, yet significant interactions I had with those who lived on the island and returned for one final week to welcome my sister on her spring break. Blasting through the north and south of Thailand, we were adventuring non-stop, but most significant was the opportunity to show her those who have imprinted something special on my heart. It meant so much to be able to share a large piece of what has made Thailand the way it was, and for her to see me “in my element” was a perfect way to close.

I had mixed feelings going into my internship. I was weary of being “stuck” with one organization for too long, as has been encouraged by you all, but was comforted in knowing I had set plans in the time ahead of me. What would I learn through a surgical room about patient care? And the community? That was tough, but soon I was able to find new opportunities in the ample access I had to health care personnel. My time in the hospital not only allowed me to see new aspects of health care, but it also gave me time to communicate with those who work on the “receiving” end. Ambulances bring patients, hospitals receive. Care doesn’t end in the ambulance, nor does it when the transfer to the Emergency Room occurs; it permeates into the hospital, throughout it’s corridors, back out the door, and far too often back in again. These weeks in the hospitals have also revealed a huge, but exciting new avenue of pursuit for me. Public health, specifically, with a global focus. I cannot wait to get started on my medical degree upon returning; however, the sights and questions that have come to me along this year have caused me to also seek out a deeper understanding of our Public Health, and the relationship we have to it. It excites me to be coming out of this year, with a new piece to the puzzle that I aim to fit into the journey ahead.

“A pilgrimage is a journey for spiritual reasons, but with a material goal—a shrine, a church, a mountain. It comes from the Latin word for pilgrim, peregrinus, from per ager, meaning ‘through the territory.’ A pilgrim, therefore, is someone who leaves home to travel ‘through a territory’ that is by definition, ‘not home,’ and so has the wider meaning of alien, foreigner, stranger…The pilgrim leaves home in order to experience being a stranger—speak a different language, eat different foods, encounter different expectations—to experience otherness as the other.”

Reading this first, the only word I could find was, yes, a thousand times, yes. Each day brings a new journey. I have learned that there are days I plan to be great, but turn out the opposite, and there are days that I expect to be long and slow, yet they turn out to be absolutely wonderful. On a Pilgrim’s Journey, or on a Watson, there is no telling what the day will bring – yet I do know that the next day comes, and the one after that too. Each day brings something new. At times that newness comes in the form of direct involvement with my project, and sometimes it shows itself to me in new friendships – some of which I long to return to. Still on other days, I find that quiet solitude I have come to know and love, perhaps via biking through back alley streets of Ubud, Bali seeing every smiling face look at you while you smile back at them, or on a solo trip north to run a half marathon and high-fiving other runners as we pass each other in opposite directions. How am I growing? Well, I think I am learning to live into this year for what it is – much more for what it is than what I want it to be, and it is through this that I find myself walking down that street smiling and throwing my hands in the air. My eyes have been increasingly opened wider to the people around me. To the man on the street I always go to for delicious food – the friend who affectionately calls me More (Doctor) as a nickname, or the other who says I am Uncle Marky-Marky after her pregnancy reveal. This quarterly report feels a little different than previously; there is no long list of the things I’ve learned, or numerous new questions that have come to mind. Perhaps that is because those initial things I was learning, I know I still am, and those questions I first posed still remain, but it’s the synthesis of it all that I am finding within these three months. A Pilgrim’s Journey indeed brings new truths, and leaves you with more questions, but as one continues, I think the Pilgrimage also teaches you to at times just move “through the territory,” “to experience otherness as the other,” but most importantly to live into the idea of hap, the Latin root of happy, “as in what happens—things as they turn out to be.” As the third major leg on my Watson Year closes, the third leg of my pilgrimage closes too. I walk away having learned to live into this, this life, this world. Perhaps too that will be one of the greatest gifts of all. The future will not always include plane flights to new, unforeseen destinations, to new cultures, new food, and new people. No, this life will include long hours in the library and hard nights in the hospital, but how wonderful it is to know I can carry this mindset with me as I continue along this year. To know I do not have to leave it at the gate when I cross back over to Europe now, or Tanzania later, or home in the now not so distant future. To have had my eyes opened to this, I am grateful, to you, Watson, for the opportunity, and to Thailand, and her people, who I believe truly helped open my eyes to see these things.

So, whats up ahead? Well, it looks pretty jam-packed to me, and that is so exciting! Leaving Thailand was one of the hardest goodbyes I have had to make, but I leave knowing I also get to return to a familiar place, and a family who helped begin this year for me. I am in transit now towards Copenhagen. With Visas ended in Thailand and the conference not beginning until next week, I have a few days in Transit through Europe as I make my way North. Landing in Vienna, Austria, I will see over a few short and sure to be fast moving days Vienna, Budapest, and Berlin, ultimately arriving in Copenhagen on the 15th of April and staying until the 21st. Leaving then for the UAE, I will first stay in Dubai and later to Abu Dhabi to get to know one of the major Emergency Rooms and Ambulance system within the city. On May 5th, I will depart for Tanzania, where I have planned the remaining two months of my time as a Watson. Beginning first in Dar, I will be involved at the Emergency Department at the National Hospital, and hopefully tap into the rescue services there as well. As time grows, I will move outwards through the country and north towards Arusha. There really are a lot of great things in the works – much of which I have reflected upon and wondered how so much has come together all at once. Thinking first that I just had better “luck” than the slower paced days of Denmark and some of Chile, but realizing more now it is the experiences from both of those places that taught me to pursue what I have in Thailand and what I am soon to do so in the countries to come.

The Watson is not only a Pilgrimage, it is a Way, a clear Way of life that pulls on the things you once knew, drags you both willingly and unwillingly all the same into the thick of it all, and yet still posits you on the cusp of something truly, inexplicably great: that is, everything else – life and all that it has yet to hold. Through these nine months I have ebbed and flowed between highs and lows, and just about every emotion in between. In the last three months, I have awoken each day with an energy I once did not know I had; I have, glanced at the world and wondered what the heart beat sounds like of my neighbor across from me, I have gazed out upon beautiful landscapes and asked myself how we all got so lucky to have this Place, and I have looked inwardly to myself and discovered more about myself than I could have ever thought.

“But no matter what the interior quest, the Way was a way of life, and what he wished for us was that, with the sound of our footsteps, whatever we were seeking would fill us to overflowing.…The thing about a pilgrimage is that there is no way to experience it except to do it. In that way it is very much like life….So nothing went by us too quickly; we were not tourists but actors in a landscape made to the measure of our footsteps.”

“We were not tourists, but actors in a landscape made to the measure of our footsteps.” My experience as a Watson could almost be entirely summed up into that final sentence. On some days those steps are quite small, sometimes they do indeed look like a tourist, but on other days they are big, they bound, even leaping at times into this world with people I never thought I would meet, with sights I never thought I would see, with questions I never thought I would ask. Watson, This. Is. So. Good.

Happy Spring from Copenhagen. I wish that you may be well wherever you find yourselves. Thanks for checking in.

-Mark

A Glimpse at Structure

27 January 2018 – 16 February 2018

Seven and a half weeks have flown by; they came in one door and went right out the other. I have finished an incredible week of exploring Bangkok and beyond, three amazing weeks at two different hospitals within the city, have moved to Chiang Mai, Thailand, a small city in the north of the country sitting at the base of the mountains. I have then spent a week there exploring and now am in my third week at the hospitals here. As I am now seven weeks (and counting) behind in an update, one post would go on for far too long to even know where to begin, so I will break things up a little. Coming to you first is my time in Bangkok traveling and starting at the Department of Surgery in Thammasat University Hospital. Having reported to you last about life moving a bit more slowly in January, I cannot say the same about now. I am so thankful to have had that time then, but to also now be on the move, daily, is truly wonderful. Having just written about moments along a Watson Year that drag and clunk versus the times that fly and sail, I can now so clearly see this playing out before me. We are sailing, full speed ahead. For each moment along this year, I try and give thanks, but especially now I feel I owe an extra word of thanks: to you, Watson, and to so many others, like you, reader, who continue to support me as I go. I have been this happy before, I know, but there is hardly a moment in each day that I cannot stop smiling. Perhaps a bit of the Thai Way is rubbing off on me, but the people I have met, the experiences I have shared with them and with myself has left me so fulfilled – both personally and with where I have hoped to see my project take me. New questions continue to arise and I love to engage in conversation with others as they come. I have been able to visibly see a change in the confidence I feel when approaching new situations and I can only sit here now with excitement to see where that takes me next.

Enjoy this read, detailing pt. 2 of my Thailand Journey and stay tuned for more follow-ups to come shortly!

Week 4: 27 January – 2 February

After a week spent planning for the road ahead, blogging to you all and finalizing all that lies before me in Thailand, I took some time to really get to know the beautiful and expansive city of Bangkok. There was no way I was able to see it all, but I had so much fun exploring all the different corners the city had to offer. To begin, I spent the day exploring the Grand Palace, which holds many royal buildings, as well as the Temple of the Emerald Buddha. I had wandered in and out of some places prior that displayed traditional Thai architecture, but nothing could compare to the intricacy and grandiosity of the Palace. The attention to detail in every piece of the temple constructed a breath-taking view from every angle. I spent some time along the river on a boat to catch in some sights and enjoy the sun and later spent a fun evening out celebrataing the birthday of my AirBnB host! Moving over early to the Friends for Asia House, I was excited to have a settled spot to live in for a few weeks, I took a day to settle and explore the nearby Weekend Market, called Chatuchuk. Having enjoyed my boat ride so much before, I went back to the river and hopped on a boat where you could get on and off any time you liked. This allowed me to stop at Wat Arun (The Temple of Dawn), Wat Pho (The Temple of the Reclining Buddha), the central Flower Market, and many other beautiful parts of the Old City of Bangkok. Wat Arun is a beautiful and famous temple within the heart of the city. Its white-tiled exterior beautifully reflects the sunlight that hits it. Every piece is symmetrical and looking at it casts one’s eyes continuously upward. Just across the way is Wat Pho home to a statue of the Buddha lying 46 meters long and 15 meters high. It is one of the highest class of royal temples in Thailand. The flower market was home to endless corridors of smiling faces and beautiful colors. People weaved flower necklaces, offerings, and bouquets. Later in the week I traveled across the city to Bangkok’s “Green Lung,” called Bang Kachao. As one of the last large green places in the city, further development of the area has largely been restricted. Renting a bicycle, I was able to explore through beautiful lofted sidewalks and roads (thankfully not falling into the marsh below). The week also included some rainy days, meeting new friends at the Volunteer House, a few nights out (annnnndd…one lost/stolen wallet (sad.)). On my last day of the week I traveled by train to Ayutthaya, the ancient capital of Thailand. First getting on the wrong train…I finally made my way and was able to rent a biculce to travel between all the ancient ruins. Mixed between temples, grand palaces, and ordination halls, these 700 year-old structures largely still stand to this day and reflect a beautiful history to the origins of this Country.

Week 5: 3 February – 9 February

I was so excited to start this week because I knew that it also meant starting my time in the hospital. The week began with a two-day orientation at the Volunteer House with the other volunteers and interns who had just arrived. There were six of us in total, four who had signed up for the medical internship and two others who would be teaching English. We worked with Aom, Manong, and May, the three Thai coordinators who work for the foundation and endlessly work behind the scenes to make our time there so great. We spent the day running through some need-to-know basics, toured a new temple and got to know each other a bit more. That first evening, I met up with Sarah Wells, who I had previously met a few weeks ago, for one more night before she headed back to the states. We cooked Shabu, where all the meat and vegetables come to you raw and you cook them together over a burner. It is a delicious and fun way to share a meal with others! With one more day of orientation, we continued where we had left off the day before, learned a few new Thai words and explored the market where it is far too easy to do some serious shopping there. Monday was Day 1 at the Hospital. The three other interns, May, and I took a bus, van, and shuttle across the city and through the campus to finally arrive at the Hospital. It was quite the trek, but allowed for a nice pause in the morning to get ready for a good day of work (and a nice nap in the evening on the way home!). I’ll hold off on the details of my time there until later when I discuss some project work, but our first week was awesome. Finding our feet beneath us on the first day, we were able to see many surgeries and get to know the hospital staff well. This really helped us during the second week as we returned and got to see and meet so many more awesome staff.

Week 6: 10 February – 16 February

As the weekend rolled around, I spent my Friday night with the volunteers in Khao San Road, a fun and hectic touristy strip within the city, and then trekked out of the city on Saturday and Sunday to Kanchanaburi to camp out in a nearby park as well as explore some waterfalls. Having had the time to do so in Chile, I was so happy to get back out, away, and in the woods again. At the campsite, everyone was so friendly, there was plenty of local food to eat, and the waterfalls were great for cooling off and swimming at their base. Beginning Week 2 at Thammasat University Hospital, we continued to see incredible surgeries. Benefiting from having walked around the surgery ward the week before, most people recognized us and often offered for us to step into their surgery room to see a procedure we had not seen before, like a C-Section, which will definitely go down as one of the coolest moments I have ever experienced! Also included in the week was a celebration of my Dad’s birthday from afar, exploring the University Valentines Day Night Market with a few resident Interns at the Hospital, the best hospital food I have ever had, and good evenings out after work at nearby food markets and out door eating spaces. One night I managed to see the Black Panther Movie, and it was amazing! (So far I’m keeping a good record on the new Marvel Movies released while I’m away – Rob and I need someone to talk to about it!) That Friday I went out with new friends to celebrate the Chinese New Year in Bangkok’s Chinatown District. Full of red, gold, plenty of fireworks, and even more people; it was fun to explore and experience that celebration!

Lastly, as the second week at Thammasat came to a close, I began to really appreciate the time I has having at the Hospital. I was up at the same time everyday, off to the same place, although still with enough unknown and new experiences to be had, and back home around the same time. I got to find a routine evening run and walk towards food, followed by a relaxing end to the week. All of these things put together, reminded me, as I have said before, how much I love structure. The structure has been nice: it gives me good direction for what I am doing each day and allows me to set my sights forward to the new activities and experiences to approach open the weekends. After so many years of school, you get quite used to the structure you had. Each new year you tweak it with new things as you leave behind old things, but your structure largely remains the same. For the most part, my Watson year has been the opposite of structure, at least in the way I have been used to it – and I think that is a good thing for me. It’s taught me to think on my feet more, to make a plan at a moments notice, and be prepared (and excited) for anything that happens, but…structure is still nice when it comes.

Picture Time!

The Temple of The Emerald Buddha, or What Phra Kaew in Bangkok

Every piece of the Temple stands littered in gold, covered in exquisite detail.

Next door, the Grand Palace mixes Western European and Thai Architecture.

On the water, the Temple and Palace together stand out amongst the rest of the city landscape.

Bangkok sometimes is called the Venice of the East. The canals and many Boat Taxis that run through them sure do make you feel like it is that way. (Check out this cool video, with low sound…unless you want to listen to a loud motor!)

Wat Arat, or the Temple of Dawn is absolutely astounding when you get up close to see the extraordinary symmetry.

Wat Arat Beauty Pt. 2

Bang Krachao, or Bangkok’s Green Lung, is a large green space in the heart of the city restricted to further development. Raised bike paths weave you through homes and neighborhoods in a quiet retreat from the bustling city.

Check out this time lapse taken by bike of some of the biking paths along the route.

Although I initially got on the wrong train to Ayutthaya, I enjoyed the views along the way

The Ancient Capital of Thailand holds much history to it, including this fallen Buddha’s head at Wat Maha That, now reclaimed by the natural world.

The Fallen Buddha’s Head and Me at Wat Maha That

Ayutthaya’s ancient and most holy temple: Wat Phra Si Sanphet. After centuries, it is amazing to see these buildings withstand the test of time.

I found the symmetry at Chai Watthanaram Temple to be the most beautiful of them all.

A weekend trip away to the Huay Maekamin Waterfall, brought me out of the city and back to some much needed nature.

The falls consisted of 7 flowing tiers that

This is just one of them, Tier 2.

The water was incredibly refreshing on a hot day!

Sunday Morning, I awoke to a beautiful sunrise over the lake below.

Sunrise Pt. 2

On my way back, I stopped at Death Railway. Much of the original lines for this railroad were built by WWII Prisoners of War

My last stop on the trip was a late lunch on the Khwae Yai River. These suspended nets were enticing for a late afternoon nap!

And now, a Project Update!

Within 2 weeks time, I got to see 27 surgeries ranging from minimally invasive cardiovascular surgeries such as Arteriovenous Fistulas and Grafts up to Open Heart, Aortic Valve Replacement Surgery. We saw what seemed to be everything in between: plastic surgery for cosmetics and injury, cancer and tumor removals, laparoscopic and open, multiple child births and even total uterine removal surgery. Having previously only seen a few minor surgeries at Vanderbilt during an undergraduate internship, it was really incredible to see as much as I did. Some simple (at times funny) observations I made for myself during this time: the OR is cold and there are many hours spent standing (don’t lock your knees!), but there is some really incredible work being done behind those closed doors. Above anything else, it seems like the Operating Room is what remains most hidden to the outside world in medicine. As patient’s we at least get a glimpse of our own treatment, and that may help us understand, in general terms, what it looks like or doesn’t for others; however, even if we find ourselves on the operating table, we are either asleep or restricted in viewing what is going on. On the inside, when you get the opportunity to see doctors, nurses, and aids working together for the patient’s benefit, you begin to see what a well orchestrated machine looks like. At Thammasat, the head surgeon, a resident, intern, and scrub nurse always surrounded the patient. By the patient’s head, a nurse or two monitor vitals and anesthesia. In other parts of the room, other techs help maintain order and medical students stand in different corners observing some and studying at other times. Doctors get to work, but never give off too serious of an aura: conversations were maintained, laughter sparks every once in a while, phones ring and nurses hold them up to the doctors ears. And then there is that one automatic sliding door. It separates the in from the out. Unbeknownst to the outside world, the tireless efforts of all involved create, at least endlessly strive to create, better lives for others.

In the time between surgeries, we often had the chance to speak with the physicians, nurses, and students about their work and the larger Thai Medical System. Through this we began to learn a little bit more about who pays what, or who doesn’t for that matter. Essentially, there are four different types of coverage. The first is what is called the “30 Baht System.” The name derives from the cost it takes to pay for one visit to the doctor, no matter what it is. Whether it is for a yearly physical or major surgery, the cost is 30 Baht for the patient. This equates roughly to one U.S Dollar. This system is provided for all Thai people, but others choose to use a different service where eligible, which often includes opting for a different hospital, such as a private one. For the most part, the 30 Baht system covers all the necessary things one may need, but there are limitations. As I learned, the limitations for this often fall more on the hospitals than the people. Under the 30 Baht System, the government will pay up to a certain amount of money. If a procedure costs more than this, then the extra cost will fall on the hospital where the patient is treated. This can make it difficult for a hospital, resulting often in reliance on donations and fundraisers. A recurring theme that echoed around different surgical practices was money. It is clearly on the mind of personnel here; specifically, how they can save money while maintaining the highest level of care they can give. An example of this was during a laparoscopic removal of a gallbladder. The doctor inserted a small bag inside the patient’s abdomen, and then later pulled out a gallbladder synched inside of it. Afterwards he pointed at the nurse across from him and said, “she designed this for the hospital. We can create hundreds of them at little to no cost, but if we were to order them externally, we could never afford it.” Innovation at its finest.

If a person is employed, then they are often covered under a social welfare system provided by the employer. Although similar to the 30 Baht Rule, the patient under the social welfare system does not pay anything. It is through this system that patients may opt for coverage at a private hospital and still revive full coverage by their employer. A third form of health insurance is the Governmental System, where any employee of the government, whether they are military or a teacher at a government school is funded and covered separately. Lastly, one can opt to be on their own with payments. This will either mean paying upfront in cash or through purchasing individual, private health insurance. What I learned through this though is that as a Thai National, there are plenty of options for coverage at little to no cost. Under the 30 Baht rule, it will likely cost more for the patient to even make it to the hospital than it will for them to receive coverage. As I continue to travel, and explore new systems of health, I am amazed at how many places have a system of health care that provides for their residents at little to no cost. It causes me to also reflect on the cost of health care back in the U.S and how often individuals face the dilemma of what they can and cannot pay for.

A few ideas that stuck with me during these two weeks of surgery were these: During our day with the plastic surgeon, he said, “Thai people don’t get cosmetic surgery in order to impress others, or look more attractive to others. They do it so that they may see themselves in a better way. I do this work because I want to help people feel better for themselves, for them to view the self as beautiful.” It’s hard to think that some people go to the point of surgery in order to improve their self image, but at the same time, to hear that this is the mission and intention behind this doctor’s work is inspiring. There is reason to it.

Birth is truly a miracle. On our day rotating with an OBGYN, we saw four different C-sections, each one producing, out of what seems like nowhere, new life, full of tears and screams, but nonetheless full of life. In my next post I speak a little further about the magnitude of life itself that continues to be revealed to me along this year. This was one of those moments without a doubt. At lunch that day after seeing the first two births, I wrote, “Some things are universal. Perhaps they are operated and performed in varying ways, like birth, but new life comes and is brought into this world everywhere. Far and wide, new life comes; that is something to celebrate.”

Another doctor shared with us that he thought there needed to be more doctors who remain in Thailand to train, rather than go elsewhere. He spoke about how often people leave, learn elsewhere, and return not knowing the standard of practice in their home. This was an interesting take for me, and I have had difficulty remedying it in my head. As I am so clearly away from home with the intention to learn while I am away, it is difficult to think that one should limit themselves to their own home in the process of learning. What I am taking from it is this: it is important to train in where you will practice, but this does not mean to not engage elsewhere. Nor does it mean that one shouldn’t explore new contexts, practices, and cultures in the process of learning, especially within medicine. Western medicine and practice has permeated all forms of health care, and in many ways this is a good thing as the world strives together for greater, more universal access and coverage. Today the world collaborates around new, innovate ideas and techniques, and we are better for it as a whole, but I also question what is lost in the process. These ideas about global practices and similarities in medicine coincided with other thoughts I have had about the intersection between health and culture – about the outcome of such an intersection, for the individual, or the community as a whole. To say that one’s culture doesn’t effect your practice would be naïve, so I am left with many thought after those two weeks in the Surgery Department. Where does culture permeate the into the Operating room? What is threatened when we homogenize a practice? In each of my interactions this year, I am shown just how much we are shaped by culture. Every action we take is a result of where we have come from. I have to believe that this too exists in the operating room. It may not be in in the specific incisions or sutures performed on the operating table, but I believe it still exists. These are ideas I am still working with and I welcome any and all ideas you may too have about the intersection of culture in practices/procedures that have become standardized worldwide, such as surgery.

When I started these two weeks at the Thammasat University Department of Surgey, I was initially a little nervous about how I may explore the context of my project in the surgical room. After all, I had originally posed the question about ambulance care, not surgery, but at the same time I was excited to explore the question of care within community through a new lens. Care most definitely does not stop once a patient leaves the ambulance, or the hospital ward. It occurs in the OR, the recovery bed, the outpatient ward, the ambulance stretcher, and the bed back home. I am thankful for my time at Thammasat and for the opportunity to see the care behind the closed doors – to see where it continues, and to be shown that it is given in every corner by health professionals of all levels.

Bryant, Frank, Jessica and I snagged a selfie outside the Faculty of Medicine on our first day in Thammasat University Hospital

On Valentines Day, a few medical students took us to the University Valentines Festival/Night Market.

Alright…long, over-due update (part one) complete! Stay tuned, a few more are coming! As I hit submit on this post, most of you are likely fast asleep, but I know at least some of you are wondering what I am doing on this day! Today is my Birthday! Yippee! Leaving home, I was a little worried about what my birthday would look like while away. Where would I be? Who would I be with? All those fears have vanished here. Today has been great and will continue to be! I woke early to go to a temple with my two close friends here, we made offerings to the monks and received a blessing for this day and the year ahead. They both do the same on their birthday and wanted me to share with them in that practice today. I’m thankful they did! I spent the morning at the hospital, dipped out a little early after lunch, got a Thai Massage, and am enjoying an iced coffee as I submit this post. Later I will go on a great run and meet up with close friends for a fun night of celebrating. You create family where you go; I am thankful for the one I’ve created here and for their willingness to welcome me into it.

Morse (right), posted this in the morning after our temple visit. Gig is in the center. They’re both so great. Khob khun Krap, my dear friends.

Cheers to a pretty incredible year, and for the one coming up. It’s sure to be just as good. Until next time,

Mark

A New Start, A Restart, A Fresh Start

Friday, January 26, 2018: Sawasdee khrap! Hello! As I write, all of you stateside likely are finding yourself nearing bedtime, while morning has only just begun over here. After almost three weeks, I would have thought I would be adjusted to the difference of 12 hours, but it is very much still a process (in sleep schedules and in communication!). Thailand is wonderful. It is wonderfully hot and humid as well, but all things considered, I have really enjoyed these first three weeks. They have been a smooth transition, holding a clear focus on adjustment, sightseeing, and planning. As is typical, the first three weeks have not quite been what I was expecting them to be, but they have been good all the same. Learning to navigate the streets, communicate what I do and do not want in my food (and how spicy it should (NOT) be), exploring the awesome benefits of a Thai Massage, and learning about an entirely new culture in the land of smiles – I am trying to absorb all that I can and am excited for what lies ahead here in Thailand.

With the language barrier that I face here compared to my first two project countries, showing up on doorsteps, or receiving email responses for that matter, have been difficult, and thus have left me in a bit of a standstill in relation to how things were done during the first half of my year. Just before I left, I applied and confirmed an internship with various hospital systems within Bangkok and Chiang Mai, a city in the north. Over the course of 6 weeks I will work with doctors across different fields in four different hospitals. A week from today this program starts and essentially fills my time in Thailand to completion, save for a few short breaks and weekends in which I plan to get out and see new parts of the country. This is the first time I truly have a set schedule set up before me, rather than creating one on the spot once something has worked out. It both scares me and excites me. After having had to create and plan for what seemed like each new day, a weekly schedule with a set location sounds and feels really nice; however, after having grown accustomed to the solo scheduling, there remains some timidity about stepping into it. I think these are both good feelings to have.

Below I’ll detail exactly what these first three weeks have looked like.

Week 1: January 6 – 12, The Adjustment

Arriving in Bangkok, having nearly made it through 60 hours of travel (somehow I lived on the 5th of January for all of 8 hours). Leaving on the 3rd of January and arriving on the 6th, my body was a little shell-shocked and thus I tried my hardest to focus on an easy introduction to this place. Having a Nice AirBnB set-up I began to create a routine for my first few days. Breakfast pick-up at the 7/11 across the street, coffee next door, followed by setting out to explore a new part of the town. Experimenting with new street food, new parks, markets, and buildings, I tried my best to familiarize myself with a place that was and is becoming home. What I learned in the first few days: I have not missed the humidity, that I have really missed a good rain (I think it rained all of 3 times during the entirety of my time in Chile), that this city is HUGE, but definitely very friendly, and that street food (as everyone says it does) rocks. Near the end of the week I connected with a friend from Sewanee, who was on a brief vacation from her work in Bhutan with a foreign exchange program. (Yeah Molly Mansfield!) We celebrated a birthday of the friend she was with, and then set out towards the south of Thailand towards a town called Krabi. Arriving in a rainstorm, we essentially settled in for the night in the beach town of Ao Nang, a smaller area just a short drive from the main part of Krabi Town. Waking up to a sunny day on the 12th, we were greeted with beautiful blue waters, sandy beaches, (a lot of people), and towering cliffs. Taking a long tail boat (a long wooden boat with a large motor, long axel, and small propellor), we crossed the waters to a beach only accessible by boat: Railay Beach, and then walked through the small town of Railay to a second beach called Phra Nang. Boats washed ashore carrying kitchens with drinks, smoothies, roasted corn, and delicious Pad Thai. All was well. Afternoon thunderstorms led to good times with new friends and a fun game of cards. It was nice to have some beach time.

Week 2: January 13 – 19, The Beach

This week consisted mostly of my time in the south, while the ending contains my return to Bangkok. On the 13th, Molly and I traveled with a new friend we had made to the Tiger Cave Temple. There, we climbed 1237 steps through pesky monkeys to reach the top of the mountain. At the top we found an incredible 360º view of the land around us and a beautiful, enormous shrine to the Buddha. It was quite the climb, but every part was worth it once we saw what was at the top. Climbing back down we toured some other areas of the temple grounds, ate, and bartered our way to another site in the area, the Emerald Pool. Unsuccessfully bartering, and ultimately paying a steep entrance fee for foreigners, we discovered the Emerald Pool to be as was described – quite emerald green and tucked away in the jungle, but entirely overpopulated as one might find in a public pool in the summer. We tried our best to laugh off the experience and didn’t stay too long. We finished the evening in the night market of Krabi Town. On the 14th Molly and I signed up for an Island Sunset Tour that took us to a few beaches to swim, a spot to snorkel, a tour around a few iconic islands in the area, like Chicken Island (which seriously does look like a chicken), and a nice buffet at the end. The peak of the trip, however, was after dinner where we set back out on the water in the dark to swim with bioluminescent photoplankton. Memories of Planet Earth and biology labs sprang back to me and then I jumped into the water and experienced the real deal. Every tiny movement of my body caused hundreds of brilliant, blue lights to light up around me. The hair that I could see on my arms and head through my goggles glowed with small blue lights as it moved with the current. It was as close to magic as you could get. Having a sunny day in the forecast on the 15th, Molly and I rented kayaks and snorkeling gear. We paddled around for lunch and onwards to new islands we had not yet been to. It was so awesome to just stop and swim where we wanted, and then afterwards float out on the open waters. On the 16th we went to a trail I had read about, Hang Nak – which features a hanging ledge for an awesome photo, but also incredible vistas of the surrounding mountains. Pillar like towers of rock, dirt, and trees poke out of the ground all around you, and flow seamlessly into the waters edge. I learned that this area in geological terms is what is called a Karst Topography, a word I had often heard before…in Sewanee, which also is described as such. Knowing the two resembled each other, it was interesting to see such similarities; however, what was so cool about Krabi, was that it is one of three places in the world where this topography meets ocean waters. Hiking higher and higher we finally reached the top and were blown away at all we could see. We spent our last afternoon relaxing on the beach and soaking up the sun. Back to Bangkok on the 17th, Molly and I parted ways as she departed to Bhutan to continue work and I headed to my new AirBnB to feel like I really was begging my time in Thailand. Taking the next day to map out the rest of my time here, and the 19th at the immigration offices, I received an additional 30 days to my 60 Visa and ended the week feeling like I was all set for an amazing time.

Week 3: January 20 – 26, Planning Week

After having planned for the time ahead, I pictured this past week to be filled with meeting new people, exploring the topic of my project on my own and getting to know a little more about Bangkok, and Thailand’s larger medical system. Well, this didn’t quite occur in the way I had expected…shocker! At a bit of a standstill with hearing back from different groups, the week turned into a bit of further and prolonged planning. What it has allowed me to do is plan for new places I want to see in Thailand, races I hope to run, and beyond as I look forward to my last three months in my Watson year. Adding a return to Denmark for a conference and an additional country to explore before I end in Tanzania, the time to both settle in here and prepare more thoroughly for all that lies ahead of me feels good.

All of this of course comes with their own hesitations. Am I really being productive this week? Are you learning? This current week has both proven to be incredibly necessary, but at times slow. I found myself rereading a quote I had found early during my time as a Watson. In searching for tips from past fellows and their blogs, I came across a fellow from the 2016-2017 year. In crossing over his 8-month mark, he writes,

As a Watson Fellow, the past 8 months have flown; sailed out the window before I realized they happened. And they have dragged, clunking along like cinderblocks. And as I continue to travel, learn, and stumble, it feels like the best way to ‘make the most of my time’ is to just let it fly and clunk and do as it pleases. All the while accepting it for everything it is rather than judging it for everything it is not.”

So, Noah – Thank you for unknowingly guiding me as I travel, learn, stumble, fly, and clunk.

Coming up – Week 4: January 27 – February 2, Bangkok Touring

As I continue to allow myself to fly and clunk with the year – and as I was reminded by a friend who read my first quarterly report to “let the days carry me rather than try to carry the days” I plan to spend my last week before my internship getting to know this beautifully big city just a little bit more. There are countless temples to discover, markets to meander through, and stories and people to meet along the way. I have learned (and been affirmed) that often times much of my learning about myself and my project comes through these times. Things are surely to begin flying again soon, so I look forward to enjoy the slow ride as I learn more about what people call The City of Angels, that is, Bangkok.

As always, Picture time!

Very early on, I found my park to run!

Evening Light here almost always glows like this

Day 1 Views from Phra Nang Beach, Krabi

More Beach Views Boasting Towering Cliffs and Long Tail Boats

A Steep Look Up (towards the Tiger Cave Temple)

Buddha, 1237 steps above

Molly, Luida and Me at the Top!

These cute (but mischievous) guys were everywhere!

At the Emerald (turned public…) Pool

Island Views from our Boat Tour

Standing on Isola Tup as the sun began to fade

Selfie with the Chicken Island! (Can you see it?!)

We got some really great sunset afterglows

It happened again the next day!

Many nights we got to watch an awesome fire show

Hiking towards the top of Hang Nak

Molly and I at the top!

Hanging (on tight!) at Hang Nak!

Back in Bangkok, I hunt for delicious street food, like this pork.

And now…some Project Thoughts!

As I said above, I haven’t felt quite as productive with my project as I would have hoped, but that isn’t to say good thoughts haven’t been happening. I have stated before how I have found importance in separating my quest to learn about my project, and time to let myself “just see a new sight,” and I laugh at how I am coming to realize that seeing a new sight and learning about my project are so intricately related to each other that these days I find it much harder to distinguish much of a difference between what I am learning and what I am seeing. This makes me happy. Where I at first joked about how I was “studying” every time I saw an ambulance drive past me on the streets of Copenhagen, I now find myself with a heightened sense of awareness towards these situations and the sights around me.

What fascinates me so much about ambulance care, is that no one is external to it – that is, if you or someone you care about need help, you are going to want an ambulance, or at least someone with the training and qualifications to help you. (At least I think you would!) Thus, when I see ambulances drive by sirens blazing or idling in traffic, or when I walk past clinics or major hospitals, my mind is now constantly drawn to these questions. No, I do not stop and have a conversation with the person next to me every time an ambulance whirls by us, but every time my mind is centered back towards what I am exploring. I see an ambulance here in Bangkok, and my mind flicks back to those in Chile – to those in Denmark. What’s different? What’s similar? My mind darts across traffic, and how do you react here? In the response I received from my second quarter report, I read “One of the distinct characteristics of a Watson is that there is no end product, and in many ways this year is all about experiencing and leaving the concluding to a later date….I always say, the best Watson years are the ones where you come out with more questions than answers.” I have come to love that each day as I wake, I find myself asking new questions. Seeing new things and then asking, well, how does this relate?

What has most profoundly struck me here has been what I saw in Krabi, near the beaches. Walking around different parts of the town I found tucked in between hostels, restaurants, street food, and cheap merchandise vendors, nice, glass-filled buildings reading, “AO NANG MEDICAL” or “KRABI TOWN CLINIC,” and just below it would read, “International Insurance Accepted,” and “We Speak English.” Parked outside of these places were single ambulances. Each clinic I passed reflected the same, and there were plenty. The more I walked past, the more my heart sank a little. The ways these places advertised their services made me question who they are really there to serve? I was left with two main thoughts: perhaps the increase in tourism in the area has caused more health centers to rise up, and perhaps that too brings an increased level of access to healthcare for the local people who live in Krabi and around; however, at what cost? Do these clearly privatized clinics, who advertise a welcomeness to visitors, also care for those who live locally? Even for those who may not afford the same income levels as those who visit? It’s something still left unknown for me, and I look forward discussing these questions with the doctors I will soon be with during my internship.

Over here in Bangkok, I see ambulances as often as I did in Santiago. Similarly, they are almost always a different one than what I had previously seen. It seems like hospitals have their own ambulances for transport and transfer as well as emergencies. From what I have read, there also is a more central service as well, titled BES – Bangkok Emergency Services. At an open, public festival in the park where I like to run, I did see a medical tent with these ambulances stationed there. With the existence of both public and private sectors here in Thailand, I am interested to see how these services operate towards the greater community – who they serve, and who they perhaps do not. A new component to the overall system, which I am still in the process of searching for, is about the volunteer emergency services around the city. Originally labeled as, ‘body snatchers,’ due to their arrival on scene to transport a Dead on Arrival Patient, these services have evolved and matured. Now, they often receive calls and arrive on scene before a death has occurred, and thus are able to provide intervening treatment. Operating often in the night, these services frequently help provide for those involved in motor vehicle accidents; they operate entirely off of volunteer fundraising, and serve any who call.

Lastly, arriving in a new place also means adjusting, learning, and engaging with a new culture – a new way of life. With six months having come and gone in a flash, it still feels like I am starting over. I recognize the similar challenges that arrive, and feel like I slowly become more prepared each time. As it was in Denmark, and continued to be in Chile – I am loving the opportunity to see a new way of life, different than where I had been before, and ever more so from where I have come. As I pursue this year further, I am beginning to see this more clearly. Life happens here. There is community. People laugh; people cry. There is poverty and there is wealth, but community and communities exist and persist. It amazes me how many ways there are for people to come together, to engage. Gratitude is a big factor in your interactions here; you bow in greeting, always say thank you, and exchange a healthy round of smiles. Living in the Land of Smiles, I am beginning to feel those effects and the sense of welcome that comes when one smiles at you on the street or in a market. As I continue to pursue these questions of communities in the face of crisis and health emergencies, I am so thankful to have had the chance in these first weeks to be more observant in the Thai way of life. Knowing that I have only barely scratched the surface, I am thankful for the welcome and for having had the opportunity to begin.

ขอขอบคุณ, Khob Khun Khrap, Thank you, sincerely, and talk to you soon.

Mark

Second Quarterly Report – January 8, 2018

Two weeks in and I can’t seem to find where they went! I must say, what an amazing start it has been here in Thailand! Minus the adjustment to the humidity (still in progress), a lot of good things have happened; however, before I get into detail about Thailand, I want to share with you all my second quarterly report. I submitted this to Watson HQ on January 8, 2018 – which also officially marked my half-way point in my year away. That is a crazy thought! As I hoped before, I hope that you enjoy this, once again, rather raw account of my time in Chile: for all the good and bad, ups and downs it carried. From my long-winded and picture-filled blog posts, this one serves as a hopefully more brief (at least trying to be) synthesis of my second quarter. I hope you enjoy the read:

Hey Watson! First off, I can’t believe I am already writing to you again. How has six month come and gone this quickly?! As you know (from the many emails and phone calls – and many thanks for your patience with my stress) I have now arrived in Bangkok, Thailand. The day this report is due marks my third day here. So far they’ve looked like this – 1) accidental (but needed) sleep starting at 4:00 pm 2) wrapping up a blog post and park exploring 3) food experimentation, Tuk-Tuk (minor) rip-offs, and a Thai Massage! I must say, amidst the humidity and sweat that I was not prepared for, things have started off well. I realized that this has been my first arrival where I have not had someone meet me at the airport – and thank goodness I had the first two times! I still struggle knowing where to start, feeling pressure to make this letter, “perfect,” while knowing that whatever I write to you is just what I am supposed to write. Such is life with me, and emails from you in response to my previous report and near the holidays offer continued reassurance and confidence, that just by doing, I continue to do things, “right.”

So how about another three month update? Three months in Chile went by in a flash. As I was in Denmark, most of my time was spent in Santiago, the capital. I spent my first week adjusting, familiarizing, and planning. In my 2nd week, I faced far too many unsuccessful moves into AirBnB’s that just didn’t feel quite right. Ultimately finding a comfortable spot, I started trying to get in touch with various ambulance agencies. I walked around to hospital ER entrances, took note of the dozens of different agencies and looked into their locations. Trying my “knock on the door” technique after waiting on unanswered emails, I was met with marginal success and a day riding with one private agency. It was during my 3rd/4th Week in Chile that I found myself asking, “is this really what you want to be doing…you know, knocking on doors over and over to see what works?” I was discouraged at how often I was turned away, and I really started question what I was doing. It was during this time I emailed you about biking. I was searching, for something, anything that may change the pace of things and bring new energy into my time in Chile. Reflecting now, I more clearly see this moment as a period of avoidance – a running away of sorts. I think it took a pretty low, anxiety-filled moment, for me to realize that I was hiding and that I needed to revamp. So I did. I pushed hard with new agencies and booked a trip to the south in Patagonia – to let myself see a new place. In my 5th Week I had confirmed work opportunities with the local public ambulance service and headed south on a trek through Torres Del Paine National Park. I ended up hiking the trek with a Venezuelan, who really became a powerful and motivational voice for me (Thanks, Juan). The break continued to give me renewed motivation. Finishing, I got to observe in the ER at the local hospital in the South of Chile, followed by a return to Santiago for my first ride in the public ambulance service, SAMU. I had an incredible time, and was reminded that, yes, this IS what I want to be doing. Through my first day with the service I worked out some additional days to work with them. It soon came time to head back south (what I had planned to do by bike, I switched to bus). I headed to Concepción and checked out the hospital there. Speaking to a few physicians I found out how lucky I had been in Santiago. I was warned about lack of access because of being a foreigner without a professional degree. Again, plans changed. I turned my south-trek into a quick sight-seeing tour with a few stops only to return to Santiago for more opportunities with SAMU. I am so thankful I did. My opportunities working with them only continued to improve as people became more familiar with who I was. People began trusting me to work along side them and help out where help was needed. It was really special to feel that sense of welcome, especially after I had spent much time searching for it.

December and Christmas fast approached: I took one last trip up north to see the Atacama Desert and welcomed family for the holidays. I didn’t think this year would hold the same feeling of a winter break as I have always had with school, but I definitely ended up taking one, and know that it was good for me and my energy. Being back alone, I spent my least week in Chile focusing hard on my final reflections and preparations for Thailand. Watson, I really enjoyed what you said to us in our email about the holidays. Having had family, I most definitely felt the difficulty of parting ways, but mostly felt the strong sense of gratitude for having had the opportunity. In that final week, as you know, I was also met with the challenge of changing some major flight plans in a rather short time period. Though a difficult change, I know it was a strong moment of learning. This moment continued to teach me that no plans are certain, and that you must be okay with that. It taught me that you all at Watson HQ are there for me (us) when needed, and aren’t going to be disappointed in an honest mistake. Most importantly, it reminded me of the resiliency of friendship. I was met with grace after sharing with my friend that I would not be able to see her. Those few days both left me in a heightened sense of my solitude, yet at the same time, a strong sense of the connections I share with those I care about even though I may be distant from them. There’s always a positive, right? I think so.

Am I learning? Yes, I know I am. Have I answered that main question of mine – how do ambulances provide senses of security and well-being for the communities they support? Well, that I am still searching for. I now know this is not an answer so easily found. It takes time and is subjective. I think I originally thought I would get in the back of an ambulance and the answers would be lying right there as plainly as the patient on the stretcher. Let me just say, that is not the case. I am finding now that it takes a more attuned sense of awareness, both in my periods of work with the ambulances, and as I am out and engaging with others around me. Slowly, answers come and a more clear understanding comes into light. I now better understand that this too takes time.

But really, what have I learned? I mean, about me – the personal? Last time I told you I felt way too detail oriented and not enough people oriented. I am happy to have seen a a shift in that. Looking back at my blog posts and the way I have written about my project in comparison to how I did in Denmark, I can tell I focused much more on the conversation and experiences I had, rather than the structure of the system. Perhaps part of this comes in that I was able to speak the language of Chile…well not perfectly, but enough to maintain a conversation. It was so cool to see how my ability to communicate improved over time. From evening “intercambios” (Spanish – English exchanges) at nearby bars to navigating and communicating around the city, I found how much I wished I had focuses more in Spanish, but also how excited I am to pursue it further and improve upon my return home. That realization may be one of the most profound yet. Language used to minimally fascinate me, or catch my eye (ear); however, having engaged with so many people from so many different places, I am astounded by the way we communicate – or don’t because of a language barrier, and yet still, do in the midst of one. So, language and my desire to improve it was a major outcome from Chile. A second major outcome, came from my low moment where I found myself in that period of avoidance. I had a pretty hard moment during Week 4 that I now can more clearly attune to the likings of anxiety, self-induced stress. I have felt this before – in school and other activities. It’s a result of me trying to succeed by the means I think I am supposed to. Again, this year is eye-opening in ways I could have never imagined. These ideas of success I hold are not so easily attuned in this wild and amazing year. Watson, you are causing me to come to terms with the stress and anxiety I can cause myself, and you are teaching me to let some of that go. Writing postcards home I found myself sharing two questions from my time in Chile that I have more clearly found the answer to. They are as follows: “Have I missed something – I mean, are there things about this year and this project that I have not reached, tapped into, discovered?” And “Again, am I doing this right?” Well, Watson, what I found in Chile is that the answer to both of these things is a resounding, yes. Over and over, yes. Of course I’ve missed things. There’s simply no way catch it all, but in no way does that mean I am doing it wrong. That’s life; we miss things. Simply the fact that I am doing, reminds me that I am learning.

Where my greatest battle in Denmark was engaging with people, as noted above, my greatest battle in Chile was clearly with myself. Each place carries a new battle, right? In a sense, it excites me to discover what that will be in the next places and how I will choose to overcome. I continued to have new moments like the sunset in the Faroe Islands. Trips to Torres del Paine and the Atacama exposed me to new landscapes I didn’t know exist. Again, I continue to be affirmed in the importance in seeking out what enthralls you. Of course, for me, medicine does, and I have continued to be affirmed that this is the career I want to go into. Along this year I have thought much about what a future in medicine may hold. I know it takes time, and sacrifices are made, but I am being reminded now – it is important to seek out what else enthralls you. For me, that’s running and the landscapes of the wild. It’s fun to feel the same sense of excitement and wonder in an ambulance when I am finally getting involved as I do when I am out in the Atacama Desert looking at an extraterrestrial landscape and the clearest stars I’ve ever seen. And again, there is that intricate design you created in this year – the opportunity to explore the things you love, and discover new ones as well. My gratitude continues, Watson, thank you.

Alright, so whats up ahead? I have a few days here in Bangkok to get settled, familiarized and begin my networking. In Week 2 of Thailand, I head south to see some of the landscapes in the southern part of the country (and perhaps engage with some local health services). I will return for Weeks 3 & 4 to Bangkok on my own. I have made a good lead with one of the volunteer ambulance agencies and hope to solidify some time with this group while I am there. This third leg of my year, I have switched it up a bit. I chose to sign up for an internship in Bangkok and Chiang Mai. As I continue to ask, “what does it mean to be cared for?” And, “how do different systems of care provide that sense of security?” I am excited to explore the context of these questions in new departments and see where they overlap with what I have previously seen in an ambulance, as well as where they don’t. I’ll have three weeks in Bangkok, a week off and then three more weeks in Chiang Mai. I’m excited about the opportunity and the change of pace. I think it will be really good to have a set schedule and it sets my time in Thailand as a balanced mix between independent and organizational partnership. I will be working with the Friends for Asia Foundation, who have facilities in both Bangkok and Chiang Mai. I guess I will leave it there, Watson. I think that accurately sums up all the excitement that was the last 90 days. I said it before and I will say it again – Thank you for this opportunity and for your unwavering support as I continue to discern my project and myself in each new place I go.

And there you have it, 6 months down, two reports in, and onwards I go to the next adventure (there have already been some good ones!). New blog coming soon detailing my first few weeks here. Enjoy the end of January, and all the continued good things to come in 2018!

Take care,

Mark