Motivational learning

As I watch another hysterectomy, I can’t help but think of all the skills and facts I don’t know. Why does the surgeon cut the broad ligament first? Why did he make a vertical incision instead of a horizontal one? How does he select the #1 suture instead of the #2 suture? How can he stand on his feet for so long!?!

My motivation to study and learn grows every time I stand in the operating room or adjacent to patients’ beds during rounds. As my “trip” in East Africa winds down, a new motivation to study and academically succeed grows. Hit those books. Write those notes. Attend those lectures. Watch them again!

How do I maintain this energy in the middle of the school year when I’m filled with stress, fatigue, and junk food? My first year punched me in the face because I lost motivation to persevere. Though I did well enough, I could have done better, and I think the key to improvement involves reminding myself why I’m doing this. I need to get clinical exposure at least once a week throughout the school year.

Our hospital back in New York offers a plethora of opportunities to see patients – even if it is behind Plexiglas. I can watch surgeries. I can volunteer. I can shadow professors. I can conduct research. Also, a friend of mine from synagogue volunteers at the local HIV/AIDS non-profit and offered to get me in.

I never found the need to do this last year; I resorted to my usual undergrad habit of running several student organizations and planning events, which I enjoy. However, if I plan to stay sane during the trials of the next 10 months until my USMLE, I will need to switch my extracurricular priorities.

Bike Challenge

You can always count on two things: family and connections. A nice doctor from KCMC connected me with a bike provider. Suddenly, my bliss knows no bounds.

Isn’t she pretty? She was placed in my care for love and good keeping for my last few weeks, and on the first day, daddy felt obligated to take this baby for a test spin around the block.

However, it wasn’t easy. During our maiden voyage, I realized that we weren’t living next to a mountain for four weeks; we were already on one. The roads either sloped downward in a crazy-fun death spiral or climbed painstakingly upward. At many points I had to stop and walk until I regained my breath.

How do I overcome this? Was the seat too low? Was I that out of shape? Is Moshi, Tanzania bike un-friendly? As I rode upward, I looked over and caught a glimpse of a 19,334 foot-tall friend in the distance. It finally decided (after a week) to poke it’s head out of the clouds. I was able to capture it from the seat of my bike.

That’s when I realized that climbing this hill will require more than a seat adjustment; it will require an attitude adjustment. I plan to keep riding this path as often as I can until I can make it up the hill without having to stop.

Then, a new challenge was born.

First Year Going On Third.

Excitement. I’m preparing to present my first patient (and her newborn) during the daily morning report.

In lieu of my research failure, I’ve taken the opportunity to learn as much about Obstetrics and Gynecology as I can on the wards. I’ve watched many surgeries, seen many patients, and read many textbooks.

I’ve been reading the “First Aid for OB/GYN” – the bible for third-year students rotating in the OB/GYN department. I’m attempting to turn my “shadowing” experience into a mini third-year rotation, where I actually get involved. I can’t tell you how gratifying it is for your attending to mention the types of abnormal vaginal bleeding, which you have already studied a few days earlier.

Without formal training, I can’t do most tasks like IVs, blood draws, cleaning wounds, etc. However, two weeks ago I was allowed to scrub in and assist the surgeon with surgery. It was an abdominal hysterectomy and my first time touching a uterus. The entire experience filled me with excitement as I assisted the surgeon clamp, cut, and sew.

Yesterday, I was allowed to assist in a cesarean section for the first time. After observing a few (and years of hearing the story of my own cesarean birth), the speed of the procedure took me by surprise. The cutting didn't elapse as long as the anesthesia. After a few minutes of cutting and some blood-splattered scrubs later we were able to deliver a healthy baby boy amidst a sea of meconium, blood, and amniotic fluid.

It was both amazing and disgusting at the same time. I have joined the club of those who have placed their hands inside the uterus of a woman he or she didn’t know (though I did know her vital signs).

After the delivery, the hard part began. The surgeon delivered the placenta, and we both started the process of cleaning, patching, and sewing. After we finished and both patients were transported to the right places, I got the third-year honor of presenting this patient to the rest of the OB/GYN staff.

Simple Pleasures

When one settles in an unfamiliar culture in an unfamiliar country (especially a developing country), he or she finds refuge in simple pleasures to help with homesickness.

A popular source of refuge for me involves food – lots of food. In a sea of beans, rice, ugali, chili sauce, and mangos, I appreciate the opportunity to have a hamburger once in awhile – or even better… waffles and ice cream!

They sell this at a coffee shop down the road from our house. What I’ve really enjoyed about this particular dish is the richness of the waffle. They must put some form of cream or cool whip in their batter to make it extra thick. Yes, it is more expensive than the beans and rice we could have purchased (though still cheaper than New York prices), but tasting the comforts of home is worth the money!

Furthermore, what’s a lazy weekend afternoon without a nice, long run to remind you of home! In New York, my running paths took me either to Central Park or to the East River. Here, my running paths always take me to see Mt. Kilimanjaro among a sea of sunflowers, which makes it worth the sweat, fatigue, and panting.



The girls, on the other hand, have found their refuge in tea – for good reason. Most nights are often spent enjoying several cups of hot tea and a good novel. Par chance, I visited an attending physician’s house and spied his collection of Sex and the City DVD’s. I knew the girls in the house would enjoy a marathon of Seasons one through seven. I had only seen a few episodes, but seeing New York City again (even if its on a fake TV show) appeals to me. This is the third week of our marathon.

I don’t want to go back and start school!

A Crazy Idea

I have a fantasy; let me disclose it to you. I want to circumvent Lake Victoria and visit the surrounding cities.

This desire probably stems from my admiration of road tripping – traveling on the go. Also, as a person who grew up near the Great Lakes in Michigan, I hope to see this “other” great lake they keep talking about.

My dream trip will probably go something like this (click on the photo for a better quality):

Day 1: Take a bus from Moshi, Tanzania (Point G below) to Nairobi, Kenya (Point B), get a hotel, and experience its infamous nightlife.
Day 2: Explore Nairobi during the day and learn more about its blossoming art scene
Day 3: Take a bus to Kisamu, Kenya (Point C) and see Lake Victoria for the first time.
Day 4: Take a bus into Uganda and travel to Kampala (Point D), it’s capital city – also known as the “Pearl of Africa” (courtesy Winston Churchill).
Days 5, 6, & 7: Meet up with a two medical school friends and explore Kampala. Also, visit Entebbe (on the cost of Lake Victoria) and Jinja (where the Nile begins). We’ve discussed the possibility of white water rafting!
Day 8: Via bus, trek around the western edge of Lake Victoria into Tanzania to Bukoba (Point E).
Day 9: Travel to Mwanza, Tanzania (Point F). In lieu of a bus as indicated on the map, I intend to take a cross-Lake-Victoria ferry.
Day 10: Set off on the final branch of the trip: a 12-hour bus ride back to Moshi, exhausted and gratified.

Because transportation is often unpredictable, who knows if this plan will work or how long it will take, but I can’t give up the prospect of visiting all these cities.



However, there is a caveat. I will most likely do the traveling alone…

Part Three: Ngorongoro Crater

Formerly a volcano – now collapsed and inactive. Our campsite overlooked the crater and chilled us to the bone. The temperature at night fell to 12-15 F.

When we first arrived, we encountered a surprise: two thirsty elephants! They often visited to drink water from the campsite’s water tank (in between the two elephants in the first photo). One walked among the tents for a bit before leaving.

The following, bone-chilling morning we paid the crater a visit. Despite the chills, this place easily became my favorite of the three parks – abundant animals, endless clifts, and spectacular views – especially the sight of cloud shadows. Whenever I think of God, my mind’s eye pictures this:

Lions. Lions. Lions. They ruled the place and knew it. Though today must’ve been their day off because all they were all napping. We even found a couple lions lounging in the middle of the road. The approaching cars only succeeded at making these lions even sleepier. We had to drive around them, but again appreciated the proximity. Our guide, during lunch, described a scary moment when a lion once jumped on the hood of a truck and fell asleep – he apparently liked the warmth of the engine. The lion was so heavy that when it finally left a dent in the hood remained.

Again. Kings of the jungle!

And here are its subjects: wildebeest, zebra, ostriches – we had a fun time.

More photos:

Lion cubs!

Part Two: Serengeti National Park

Siringit = endless plains in Massaai. 14,763 square kilometers of endless plains grazed by tens of thousands of wildebeest during their annual migrations. We visited during the dry season (June to November) and easily spent two days here. Every tree, animal, cloud reminded me of the movie the Lion King. I’m not sure why they don’t sell it at the gift shops here.


Our first animal of the park: the superb starling. The metallic blue-green feathers caught my attention. However, I saw hundreds of them over the next two days, and the novelty wore off.

More elephants. We spied another grazing herd move through the plains. I adored the proximity.

More acacias. They never get old.


We arrived at our campsite for the night and caught the sunset while fighting off mosquitoes. Also, a hyena paid a visit to our campsite during the night. My classmates were worried, but I slept through the entire thing.

We arose early enough to see the sun rise and spy a few more animals. We saw lions from afar, though we saw most of them the following day at Ngorongoro Crater.