Sylvia's Journal

Yesterday started with a one-hour long interview over the phone with colleagues in Kabul. They asked questions about intent and then contrasted those with the realities on the ground. It was good I knew these realities because otherwise it would have been pretty difficult to respond to their queries (“given that x and y, how would you go about z?”). Much of the issues raised are familiar to me in other settings as well and are typical of our third party work (getting paid by one to benefit another) where it is not unusual to find beneficiaries bristle at the conditions and strings attached to the aid given to them.

After that a quick visit to the nurse practitioner to talk about the hot flashes that now drench me several times a day and interrupt my sleep big time. The breast lumps, diagnosed so far as trauma-related, kept her from prescribing hormone replacement therapy. Instead we will experiment with a combination of herbal supplements (evening primrose oil and black cohosh) and a low dose anti-depressant to deal with the sleeping. When I called our local health food store to inquire about the brands (I was to get the European, not the American brands) I was greeted with ‘oh, hot flashes huh?’ It must be big business now with millions of baby boom women consumed by these flashes. Now my daily pill requirements are starting to look like those of very old people; pill boxes filled with a variety of pills in all sorts of shapes and colors!

Nuha arrived for a last goodbye before she flies home to Riyadh next week. It was her fourth and last visit to Lobster Cove which she had not seen in full spring bloom yet. Her last visit was when there was snow on the ground. Now she has seen Lobster Cove in every season. Her brother Youssouf joined us for a lunch en plein air.

He brought his brand new camera which was put to good use right away. In Gloucester we visited the Fishermen’s Memorial which stands on a boulevard that is lined with hundreds of American flags. When, years from now, they will show these pictures to their friends, it will not be difficult to guess in which country they were taken.

Nuha and her brother are both outdoors enthusiasts and we talked about the Appalachian Mountain Club and its great lodges and trails in the White Mountains. They might try to squeeze in a hike in the White Mountains before Nuha flies home.

Since I still don’t know whether Axel and I will get on a plane to Kabul a week from Monday (and me from there to Addis at the end of the month) I used the rest of the afternoon to get myself organized for all these trips, the first one starting today to Charleston for our annual Organization Behavior Teaching Conference and the board meeting that precedes it.

If I think about how much I will be away this summer and how badly the garden already needs attention (weeding, fertilizer) I get a little overwhelmed and wished I could use up my vacation days that will go ‘poof’ on June 30th. But I am programmed otherwise.

The trip I hoped to make to Kabul with Axel, in just over a week, seems more and more unlikely and the limbo continues. I try not to get too upset about this, although I am disappointed. I have stopped to look too far ahead (since there is nothing to see) and instead am focusing on the work of now. It makes me forget the disappointment as it connects me to exciting projects and wonderful people around the world.

I received the most encouraging news from my team in Cambodia which has managed to get government health facilities to make special efforts to reach out to youth, with a focus on reproductive health. The 26 or so government officials who are the first to participate in the leadership program were rather skeptical at first. Others were also skeptical about them and had their doubts that anything would change. The health facility managers set what seemed fairly un-ambitious goals for their teams – but it seems they have been surprising everyone, including themselves, and surpassed these goals.

The senior leadership work in Ghana that appeared to be stuck for the longest time in the initial planning phase has come unstuck. Now it requires the alignment of schedules and a dates. And that’s where I bump into my uncertain future.

Another piece of work like it, concerning senior professionals as well, is in the planning stages for Central America. I am helping my colleague Diane design a process for getting senior leaders focused, moving and more confident in their ability to function well as a team and fulfill their oversight role for major investments in health programs. She will do the actual facilitation since I am not a fluent Spanish speaker, but we fantasize about doing it together. Given all the scheduling challenges, this is highly unlikely.

Last night we attended the annual meeting of the Manchester Historical Society. The average age of its members is probably about 65. Although on the young side of the median, with enough grey hair, we blend in nicely. There is always wine and an impressive buffet of finger food before we start with business. This helps with the socializing although I always manage to introduce myself to someone with a mouth full.

The business of the Society is conducted in no time adhering to the letter rather than the spirit of parliamentary procedures. This makes the business meeting a breeze. The last piece of business is always a motion to ratify any errors and omissions of the executive board, which we gladly did.

The highlight of the annual meeting is always a speaker with something interesting to tell us about the place we live. This year it was a gentleman who had written a book about Cape Ann. He told us many great stories, accompanied by slides, of the famous people who resided here, their houses, their houseguests and friends, and their writings about and paintings of Manchester, Essex, Rockport or Gloucester.

Everything is covered with a thin layer of pollen. We are in the midst of allergy season. My reaction to this is, I believe, intense tiredness; so much that I can’t keep my eyes open much beyond 8:30 PM. An allergic reaction to spring is a new experience for me. Now I can be more sympathetic to Axel who has been suffering for years.

I interrupted my workday yesterday with a visit to the ankle doctor. He had requested a CAT scan before I saw him. The scan did not provide any more meaningful information, nor did the doctor or his assistant. I think that the only thing my visit did was to help reduce payments for the hospital’s expensive machinery or, if it was already paid for, increase its profits.

That visit was definitely not a good use of our expensive health care system and insurance monies. When the doctor suggested that I go for other tests, or even come back in a year, I declined. The ankle is what it is and no miracle will fix it – the doctor said so himself. So why bother. But I am relieved that surgery was not suggested as an option.

There is no movement on the travel front except that everyone on this side of the Atlantic is now committed to the dates for our trip to Ethiopia. Since the phones were down or not working on the other side, in Addis, we don’t have any indication that ducks are lined up over there. No more news on Afghanistan either, except that, thanks to the US postal service tracking system, I know that the Afghan embassy in DC received Axel’s visa application. Limbo thus continues.

The various future scenarios produce an active dream life but there is not much I can remember when I wake up except the ‘active’ part. These scenarios aren’t just about where in the world I might be, from mid-June on but also about which body parts will be in what state of repair.

There are various scenarios about where I will be in a few weeks and months. The only things I know for sure are that this week I am at work, mostly in Cambridge, every day and that next week I will be in Charleston, South Carolina. What happens after that is murky at best.

We sent Axel’s passport off to the embassy of Afghanistan in DC for a visa, just in case I am offered the job there. If that scenario were to unfold I would need to decide quickly whether to accept or decline. This requires that Axel consents to the move. Going to Kabul first to see for himself will help him decide whether it is a move that has potential for him too. If I don’t get the offer things will be simple: we all stay home. But current reality is one in which no decisions have been made and we are in limbo; no particular scenario activated just yet.

Late June, early July a trip to Ethiopia is on the books, though not confirmed yet. Buying a ticket for this requires confirmation of the Ethiopian dates and the Kabul trip. Everyone is trying. At least I own two passports, allowing me to get two visas at the same time.

A few things are given and unalterable at this point. In late July I am teaching at the BU School of Public Health and my shoulder operation is scheduled for the first week of August. August is also election month in Afghanistan and all travel is banned. Somewhere in there is also a family reunion, a visit from my brother and nephew and the finest summer days at Lobster Cove.

Future scenarios for my physical health include at least one that seems likely: my right arm in a sling through most of August and part of September. I fantasize about having my left carpal tunnel symptoms alleviated by the same operation that did wonders on the right side – but there are no windows for that to happen. And this morning I will find out what’s up with the right ankle from the super orthopede at B&W.