2008 in Review: Annual Letter

Merry Christmas and Happy New Year!!!
Greetings! This past year has been quite eventful for Lindsay and me, and we would love to share some brief updates with you as we enter the New Year. We have graduated from medical school, moved to Denver, Colorado where we are six months into our three-year pediatrics training program, have traveled around the globe both in a medical capacity and as tourists, and have made countless memories with dear family and friends. It is incredible to look back on the year and see how God has orchestrated our each and every move, and it gives us great hope for the coming year to know that He will once again guide and direct our steps.
In February of 2008 – about six months after returning from our Central & South American excursion – we were back at it, this time working on a public health project in Juventino Rosas, Mexico. Juventino is a wonderful city of about 70,000 people located about three hours northwest of Mexico City. The University of North Carolina has formed a bond with this small city in large part because there are many transplants from Juventino that now live in the Carrboro/Chapel Hill area. We joined up with the local Catholic church and government officials in Juventino in an effort to discover local health needs and stimulate economic development for the underserved through microenterprise projects. It was an incredible experience and we were blessed to make so many new friends. We hope to return sometime soon.
In March of 2008, we went through the much-anticipated Match – whereby all medical students discover where they will be spending the next 3-7 years of their lives. We were thrilled to match here in Denver, Colorado at The Children's Hospital that serves patients from the greater Midwest area. By June, we had managed the move by driving cross-country, twice, and we are thrilled to finally be settled in our home.
Before making the long journey from Durham to Denver, we were afforded the remarkable opportunity to vacation with two of our good friends, Chuck & Angela (who are second-year residents at Vanderbilt), in Kauai, Hawaii. It was a perfect celebration of the Match and wonderful opportunity to catch up with friends who had left the year before and started their own residency journey.
Medical school graduation finally arrived, and shortly thereafter we were blessed with the opportunity to experience the thrill of a lifetime, traveling to Kenya with Mom & Dad, and Lindsay's sister, Rory as a celebration of the long-awaited graduation (and earning of a PhD – Rory). We had planned to work in Ethiopia prior to our grand adventures in Kenya, but unfortunately that portion of the trip didn’t work out this time. Kenya was incredible, and such an amazing opportunity to see the world through a different set of eyes, to enjoy God's creation, and to fellowship with family and friends. Pristine views of Mt Kilimanjaro and a pride of lions lazily enjoying the last rays of the setting sun; visiting a Maasai tribe and seeing first-hand their proud and yet simple ways of life; a mighty leopard gracefully stretching and flaunting its fangs, and the sheer power of a white rhino as it sauntered through the brush; a mother cheetah and her two cubs, and a sunrise hot air balloon ride over the Maasai Mara.... Pictures indelibly etched into our minds, and memories that will never be forgotten.
Once we landed back in the U.S. and our hearts and minds returned to the present, we geared up for our move to Colorado, trying our best to spend time with family and friends before making the daunting trip. Lindsay moved out to Denver with a little trepidation, having never lived so far away from family. I had a slightly easier time moving away having grown up separated from my family for the majority of my adult life; but it has been difficult for us both to leave our parents and wonderful friends behind. However, frequent visits from family and friends have made the transition much easier and have allowed us to keep our hearts and minds attuned to life back home while we eagerly begin our new life here in Denver.
Life is moving at a new pace, but despite long hours at work, we have been able to spend good time together and make the most of our free moments. We have found a great church located only four blocks north of our home with a nice southern flare to it – the pastor is from South Carolina! Denver has been an incredible place to live as well, and we have thoroughly enjoyed the outdoor opportunities – overnight camping, hiking in the Rocky Mountains, and skiing at Arapahoe Basin and Breckenridge. All in all, we have been truly blessed this past year. Our move to Colorado has been a big life change, but we have felt supported and encouraged throughout it all. Thank you for your prayers, phone calls, and visits. We look forward to 2009 and what it will bring; and we hope that it brings you out to Denver to visit!
God Bless, Merry Christmas, & Happy New Year!
JR & Lindsay

Pediatrics Internship - the basics

Well, Linday and I are fully engaged in our peds internships, but have had a great time of it so far. We are now starting our 6th month and will be moving to new services on Monday (11/24/08). Here in Denver we work at two different hospitals - The Children's Hospital - a tertiary care children's hospital, and Denver Health - a county hospital. We have already rotated through various blocks including general wards, NICU, clinic, night float, etc. This coming month will be a nice change of pace for Lindsay as she moves from night float to a clinic month. I will be starting a month of general pediatric wards at TCH. Fortunately, we will both be working days this month :o)

The picture above in our intern class here in Denver.

Just to catch you up to speed: Pediatrics residency is a three-year process. As interns (first-year residents) we do most of the grunt work at the hospital and learn the basics of caring for children. The second year is a transition year where you gain more autonomy and begin to take a supervisory role in the care of your team. The third year is a unique opportunity to take full responsibility for a team, manage the patients, teach your junior residents, and work as a team leader.

CATHCING UP!

Gray's Peak - looking across to Torrey's peak, Rocky Mountain


Hello all! It has been a very long time since Lindsay and I got back to the blog to post new updates. Since the last post a lot has changed. After returning from Juventino Rosas, we returned to UNC where we eventually graduated from medical school - it only took 5 years!. During that process, we went through the much-anticipated (and sometimes dreaded) MATCH - the process whereby all medical students find out where they are being shipped for the next 3-7 years. Lindsay and I were thrilled to match in Denver, Colorado at The Children's Hospital, where we have now been for the past 6 months.

A lot has already transpired since moving out here - we have purchased a home, started our clinical internship, had visits from both sets of parents and friends (Preston, Angela, and Chuck), and thoroughly enjoyed the beauty of our new home. God has an incredible imagination, and seeing his handwork in our backyard (ie - the Rockies) is truly awe-inspiring.

We'll leave you with a few pictures of the fun we have had, and we'll do our best to post more often.

Much love,

JR & Lindsay

Mt. Ida - Chuck, Angela, Lindasy, JR

Mt. Bierstadt - Preston & JR

Pike National Forest

Garden of the Gods - Rory, Lindsay, Bob

Oh the Impact!!!

Well, when we arrived here on January 26, just two weeks ago, little did we know what all would unfold before us. The group with whom we are staying and who is helping to organize our efforts on this side of the border is a tremendous group of caring, sincere, and kind-hearted individuals. They have nothing but our best interest, and the peoples’ best interest in mind. As we mentioned before, the municipal government has been excellent as far as helping to facilitate our project as well, even giving us access to government data sheets and vehicles for our own personal use. But that is just the tip of the iceberg! In the last two weeks, the municipal government has created a new bus line and taxi service… in honor of me!!! I have now seen buses with the initials up to, JR – 0034, starting from JR – 0001. The taxis are swarming all over town, each proudly boasting my initials on their sides, and on their bumpers. There is even a brand new gas station at the corner of one of the biggest intersections boasting my name in big letters across the front windows! I was hoping that we would be able to help the people, but this has been beyond my wildest dreams… Please see attached photos below. You may have to double-click the photos and zoom in to see the glittering letters “JR.”

Well, if you haven’t guessed, my mind is running away with fanciful dreams, or I am just plain having fun. It is true, the buses and the taxis, and even the gas stations carry my name. On first arrival I thought it a pretty cool coincidence that my name was on a smattering of buildings. But the more I looked, I realized it was everywhere! Then I actually kicked my mind into gear and took a brief moment to think about why this might be the case, and realized that we are staying in the municipal state of Juventino Rosas, and therefore any and all items associated with the government, as well as any building that wants to proudly proclaim its loyalty to the state, places the initials “JR” somewhere on its exterior. So sadly, our time here has not led to a new bus line, a new taxi service, or a fantastic gas station...

We have, however, in the last two weeks visited 23 communities (out of 61 total), generally talking with anywhere from 10-40 persons, meeting often in the chapel courtyard. Part of our purpose in these group meetings is to talk with the locals, build rapport, and determine the specific needs of each individual community – including health needs, economic needs, as well as daily needs such as food, water, shelter, etc. We have also tried to get a better understanding of how the families function when spouses or children have left to the United States. There are a large number of single women in these communities (often secondary to US immigration), and unfortunately, many of the jobs that the men obtain are seasonal, so there is never a steady influx of remittances to help pay for basic life necessities back in Mexico. Because of this, we have also talked with the women about possible skills and abilities that are either unique to their communities, or could be marketed on a small scale with some financial backing and instruction from experts at UNC as well as local help from the University in Celaya. We have delved into the possibilities of starting small microenterprises (ex: tortillas, tostadas, bed linens, clothing, cheese, yoghurt, etc) that might provide a source of jobs for these women that are otherwise stranded with multiple children, waiting for money that is slow to arrive.
We have been met with great enthusiasm in almost all of the communities. These women are strong in spirit and want to work for their livelihood and for their families. Hopefully this project will take off and be able to address these financial needs (with the longer goal of helping address the problems with depression as well). Of course, we are neither experts in business nor microfinance, but we are also helping to find communities in which a new group of volunteer medical students and physicians (about 20 in total) will be able to come and work this summer, providing free medical consults for the needy and underserved.

Two weeks have flown by, and we’ve only got two more to go. We still have a lot of work to do, especially here in town as far as discovering what current services are available for both general medical health and mental health. We hope to partner with psychologists in the area or even with psychology students to lay the foundation for a collaborative effort to provide support for these impoverished women who are known to have high levels of depression. The day awaits us, so I suppose we had better get back to it! Thank you for your support and prayers. We look forward to seeing you when we return.

The Next Adventure: Juventino Rosas, Guanajuato, Mexico

Itinerary:
January 26, 2008 – depart for Juventino Rosas, Guanajuato, Mexico
Conduct community visits, visit with the municipal government, gather background data
February 23, 2008 – return to Durham, NC

Well, after only 6 months at home in North Carolina, we are once again crossing the border, this time to Juventino Rosas, Mexico. While back in Durham/Chapel Hill we happened across an opportunity to work on a public health project here in Mexico and jumped at the opportunity. However, before giving you the details, let me give you a little background information:
Catholic Church in Juventino Rosas
Background:
There are about 600,000 Hispanic people living in North Carolina. Of those, about 75% are from Mexico. Within the Carrboro/Chapel Hill community, there are close to 50 families that attend Saint Thomas More Catholic Church who are all from the same small municipio in Mexico, Juventino Rosas. When it was discovered that so many people from the same community in Mexico were congregated in Carrboro/Chapel Hill, a brotherhood of sorts between the two church parishes began to form, and within this context, over the past five years, different groups from the UNC community have visited Juventino Rosas to try and support the local people there. More specifically, groups of physicians and medical students have traveled to Juventino Rosas to offer medical services; and this past October, a delegation from Juventino Rosas came out to Chapel Hill. While in Juventino Rosas, UNC medical students worked on a depression screen and found extremely high rates of depression, especially among single women.

Given the high rate of immigration from Mexico into the United States, there is an ever increasing number of single women who are left behind, who depend on remittances from their family members in the US. Many who leave to the US are able to send remittances back to their families when work is good; others, unfortunately, leave and never look back. It is these women, who are living alone in Juventino Rosas, without jobs, whom we primarily hope to serve. However, there is also a tremendous opportunity to work with the other side of the coin – the men who are living in North Carolina.

Landscape on the way to La Huerta, another small town outside of Juventino Rosas

With this background, we were asked to come to Juventino Rosas to live among the people, learn their stories and their life struggles, and to gather background information about the culture, economy, and health. Our overarching goal is to provide support for the rural poor here in Juventino Rosas, specifically those affected by immigration. The high rates of depression among the women are thought in large part to be secondary to the split family structure and the dependence on remittances. We also know that to implement change, these women need not only medical help, but the ability to be independent. Because of this, the long-term plan is to establish microenterprise ventures within some of the poorest communities to empower the women, improve their financial stability, and by doing this improve their mental and physical health. Our specific goals for the here and now, therefore, are to gather the needed background information which will help determine if and when a microenterprise project would be feasible, and what the product might be. We are also laying down inroads and helping to locate other communities which might benefit from medical consults this summer, when there are another 14 medical students and a few physicians from UNC coming down for 6 weeks.
Mesas de Acosta - a small outlying town

Hitting the Road:
We’ve been here for five days now, and boy are we tired! We have already met with the delegation that came to the United States in October, the municipal president and all of his department heads, and a group of professors from the nearby technical institute in Celaya to discuss microfinance opportunities in the region; and we have visited five outlying communities to chat with the people. No one here speaks English, so our Spanish has been tested (and hopefully improved) daily. The days are long, but the work is enjoyable. We hope to visit two communities a day for the next 3 weeks (not including the weekends). We’ll see if we can keep it up!

The people here are wonderful, incredibly generous, and exceptionally kind. The President has loaned us a car while we are here; one of the department heads, David, is helping us compile data regarding population statistics, economic status, and local resources pertaining to the communities; and another department head is collecting data on water. With each visit to a new community we are welcomed with open arms, offered food and drink, and invited to people’s homes. The generosity of the people, despite their economic well-being, offers a lesson to be learned for us all. These are people who earn perhaps $4 dollars a day and who can barely sustain their own families, and they open wide their doors for strangers to come and visit and eat. Their generosity and compassion are beautiful in their sincerity and simplicity. In many ways, life here is beautiful, simple.
Local well in Agua Zarca - this supplies water for about 50 people

We’ll write more, hopefully this weekend. Take care.

We're Home

Buenos dias, amigos y amigas! Ya hemos estado aqui por casi un mes, pero solamente ahora estoy escribiendo. Disculpame, por favor. Nuestro viaje era excelente!!!

Hey everyone. Our apologies for not writing earlier. Lindasy and I have been back about a month now, and we are back to the grind. Lindsay is down in Charlotte this month on her pediatrics ICU rotation, and I am in Chapel Hill taking a dermatology elective. Fortunately, the remainder of the year will be together. Anyhow, we wanted to let everyone know that we made it back safely, and that we had a fabulous trip. Thank you all for your support and prayers as we ventured out into the unknown. We will write more later about our experience now that we've had some time to really think about it, and we will also add more pictures to the blog entries for your viewing pleasure.

Again, thank you to all of you for keeping up with us and for supporting us. It was a huge source of comfort to know that we had friends and family at home who were joining with us on aregular basis. Take care and many blessings to you all!

Centro Cristiano Para Sordos

Our time in Bolivia is rapidly coming to an end. It has been an incredible opportunity, and we have been blessed to see many different facets of God´s work here in an among the people; and we have thoroughly enjoyed experiencing the culture and getting a small glimpse of the beautiful country. We leave Bolivia on Thursday to meet up with Rory and Brett Sallach, as well as Chuck and Angela Barrier (friends from med school), and Anne P. Johnson (Lindsay´s former Sunday school teacher). However, before signing off for a while, we would like to tell you about an organization that we were fortunte enough to go and visit today. It is called the Centro Cristiano para Sordos - The Christian Center for the Deaf.

Centro Cristiano para Sordos is a Christian boarding school for deaf children, serving children from all over Bolivia, and offering schooling up until the 5th grade. It was founded by two missioneries in the late 1970s, who had been serving in Bolivia since the mid 1950s. The school has grown since that time, and is currently serving approximately 30 students, as well as deaf faculty, groundkeepers, and crew. The current director of the school is the daughter of the original founders , and she is here with her Bolivian daughters, (one of whom is Lidia, who offered us Spanish lessons while here with HOH), as well as her mother (the original founder).

There is a large deaf population here in Bolivia, but there are no other boarding schools available for these children, where the children can be prepared to integrate into society. The Centro provides not only room and board and school education, but also incorporates Christian teaching, church services, and Christian counseling for the children as well. It is truly an amazing work that has been undertaken, and the rewards are evident as the children grow, learn, and mature.

We were able to play with the kids today during their extended recess break, and we also toured the grounds and viewed the new projects that are underway (new boys and girls dormitories, etc.). The school is almost self-sustainable with crops, a private well, and room for livestock. This provides great opportunity not only for reducing the costs, but for developing a strong work-ethic and responsibility within the children as well.

While the majority of the children have families that they visit on holidays, at least five of the children are orphans, and have been "adopted" full-time by the Centro. The love that the faculty and staff have for the children is self-evidnet, and it is a great encouragement to see their good work. If you would like more information about Centro Cristiano para Sordos, they are in the process of developing a website, but their email address is as follows: ctrsrdos@albatros.cnb.net.
Thank you for reading along with us, and thank you for your prayers and support. We will try to update again over the next two weeks, but we might be without good computer/internet access until we return home on the 5th of June. Blessings to you all!