Archive Page 269

Thursday, November 8, 2007

Lots of wild dreams this night. They are spinning around in my head and as I grasp the tail of each dream it vanishes. Much was about trickery and dishonesty, people hiding things that cannot see the daylight. I think they were triggered by the book I am reading, The State of Africa by Martin Meredith. Annette brought me this book when she visited us in October. It is a great read; A history of late colonial and early independent Africa. There was lots of trickery and dishonesty, on all sides, in addition to enormous brutality and total disrespect of human rights. Unfortunately, there is still much of that goig on. The roots of these weeds are persistent and very deep. During elections time you hear of course more about this than during quiet times. During day time I get more of this via the newspapers.

Yesterday’s sleepless night caught up with me after lunch. I left the office to take a nap. During the morning Josephine and I tied up many loose ends for next week’s workshop and squeezed in a trip to make a courtesy call to a senior ministry of health official, our only chance to see her as she was on her way out to Mombasa for all of next week. She is an important stakeholder. All in all in took nearly two hours sitting in traffic for this visit that lasted barely 10 minutes. Traffic has a domino effect on appointments, with each one being delayed but somehow never cancelled. Boston traffic is a cinch in comparison.

In the early evening I was on a conference call with three of us on cell phones form East Africa (Kenya and Tanzania) and another four sitting in a conference room in Cambridge. It was quite an accomplishment that we got our work done this manner. Joseph was actually on his way to the airport while talking on his cellphone with us. Amazing!

I think the entire week of work, my first in nearly 4 months, is catching up with me as well. I find myself walking more and more slowly and acting less and less like my energetic self. I clearly need plenty of breaks. It is good that the weekend is upon us soon. It will be a very quiet weekend, starting with a massage by Eunice early Saturday morning and probably another quiet Quaker meeting on Sunday. Those are the only plans so far. If energy can be saved up and accumulated for next week, this is when I’ll have to do it. Next week will be intense. The workshop starts on Monday and lasts throughout the week with a team that still has not gotten together (and will not, before Monday).

Thursday, November 8, 2007

After having been more or less pain free for a few days I was fairly crippled again yesterday. It was humid and overcast and I find myself always in more pain on such days. Luckily I had only one meeting in the morning. I met up with my co-facilitator William. We sketched out the design for our training of trainers (TOT) workshop next week and William told me about the progress of the teams that we started training in May. It was wonderful to hear about some of the transformations he’d seen and heard about as he traveled to some far flung areas to coach the teams in between workshops.

He, and others who’d been involved in the coaching, told me there are now a few more confident people working in a few more hospitals in Kenya. William had plenty of examples of how that confidence manifests itself at work. These stories are immensely satisfying to hear and make up for all the hard work that went into the design and execution of the program. Of course some teams did not do so well. We talk a lot about team leadership, but when it is missing it is usually because no one is willing to step up to the plate. No matter what we call it, leadership always starts with indviduals who are willing to take some risks.

After William left my shoulders and foot were so painful that I decided to go back to the hotel and take a hot bath. This helped. I also tried to nap but just as I was about to fall asleep Housekeeping knocked on the door, or my cellphone rang, so I gave up.

I left early for my physical therapy session, not wanting to show up late for my appointment, the last one of the day, due to traffic. I arrived just in time. It was an experience that was much different from what I am used to in Manchester. The physical therapist, Karen, is from Danmark, born in Malaysia, studied in the UK, has a home in France and settled down in Kenya for the last 30 or so years. I brought the notes from Julia, my physical therapist in the US, as a reference. Karen glanced at them and then got right to work. While my shoulders and neck were being limbered up with heat pads she worked on my foot the way I imagine Betty works on Axel’s arm: no nonsense and none of that wishy-washy gentle stuff. It was very hard work and quite painful at times, which satisfied my inner Calvinist (pain and suffering is good). After about half an hour she switched to my neck and shoulders. She does not have any of that insurance business here about not being able to treat two different body parts on the same day. Patients pay cash for an hour’s worth of physical therapy: about 45 dollars. Despite the pain and hard work I felt good enough at the end that I made two more appointments with her.

Next to the physical therapy practice is the restaurant where I had lunch earlier. I had an early sandwich dinner and then went home to finish some work and take care of business with MSH Cambridge where my colleagues were still in the early hours of their workday. And then I could not fall asleep for hours. It felt as if something hard and painful was brewing deep down and I prepared for a night full of revealing dreams. Instead I tossed and turned until the early morning hours and woke up without any memory of dreams. A bit disappointing.

Wednesday, November 7, 2007

I already know that my un- or subconscious is very active but I remain amazed how and why it picks up certain images or words during the day and spins them into magnificent movie scenes. One of my colleagues mentioned a party yesterday where the disc jockey, our very own Christian from MSH, played the YMCA song. She spoke about a thousand other things yesterday but my unconscious grasped this piece and spun it into a dream. I dreamed that I was at the YMCA and wanted to show Sita the cheerleaders that were marching through the streets. In the dream Sita was Dutch and had never seen or heard about cheerleaders. In order to get to Sita who was working up in the rafters (It must be all these invitations to world or regional economic forums) I had to climb up there myself. Someone helped me but it was either very courageous or stupid on my part as it was a bit above my ability and quite risky.

Yesterday I continued easing into work. I got a taste of early morning traffic in Nairobi but arrived in time for an eight o’clock meeting at our MSH office with first Abebe from Ethiopia and then Peter from Kenya. They are wonderful men with whom I had co-facilitated workshops in the past. It was nice see see them after all this time.

We then headed off for the US embassy to have lunch in the embassy cafetaria with USAID staff from the population and health office. This was the new embassy, on the outskirts of Nairobi (the old one was blown up some years ago). The security was intense. I had to give up my bags of green tea, two candies, lipbalm and much more. It was fun to see the security guards unpack my colleague’s bag. You learn a lot from people by seeing what they carry with them. It feels rather invasive this probing of something as intimate as one’s handbag. It was as if we were undressed in public. (We got everything back at the exit). The cafetaria was dominated by a huge (HUGE) screen with a football game going on, we were on American soil after all. I picked the seat with my back to the screen and watched in admiration how our USAID colleague eat her sticky and gooey spare ribs without getting anything on her white blouse. I admired her greatly. I would have been a mess. We discussed leadership and management in Kenya, of course, and got to know each other a bit better.

After lunch Ida took us around the outskirts of Nairobi in order to avoid as much as we could of the infamous and congested Thika road. Kristen and Joseph guided her expertly (with the help of maps) from the backseat through narrow roads that always seemed to have Garden in their name. Garden is a nicer way of saying rural I suppose. It was not a shortcut but more pleasant than sitting in traffic.

We arrived at the Safari Park hotel to see a group of nurses about some programs we are exploring and others we are launching. They were having a workshop there. In Nairobi everyone is always having workshops at one hotel or another. We arrived hours early because we did not want to be caught in the rush hour traffic leaving Nairobi on Thika road. As a result we had a very long wait (several hours actually) of sitting in a disgustingly beautiful garden drinking first tea, then sundowners. I tried the local pretend beer (Malta) which tasted rather malty and syrupy, more medecine, and a downer rather than a sundowner and really too sweet to even pretend. If Axel had been with us he would have, no doubt, be less disciplined and told his nerves to go to hell and partaken in the Kenyan sundowner ritual.

When the nurses emerged from their workshop it was nearly dark and we chatted by candlelight. One nurse had been in a virtual leadership program I led some years ago and it was nice to meet her in the flesh. It felt as if we were old acquaintances. I suppose we were.

Ida dropped us off at a Thai restaurant which has been in Nairobi for ever and, as always, was mostly empty. I have learned from Sita to suspect that it is a shell. But the food was good. Despite the slow rhythm of the day I was pretty pooped when I got home. I managed to squeeze the last energy out to review one document and participate briefly in a virtual conference that started yesterday about family planning in Francophone Africa. I marveled again at how easy it is to feel connected to a larger group of people who share a common vision through one’s computer, sitting alone in a hotel room. I am sorry I missed Axel’s Skype call. The eight hours difference is a bit much late in the day.

Monday, November 5, 2007

I did not think it was possible to dream about physical therapy. If I thought I could do without it for the next two weeks, I got a message to the contrary. In two-hour long stretches of sleep, punctuated by waking up, I dreamed up all sorts of schemes to fit physical therapy sessions into my work schedule. I cannot remember the details; it seemed all very complicated. So when I woke up I was surprised not to have to run off to an appointment. I guess I better make an appointment today.

I am learning about self care. Mary Wright is like my personal coach. She sends me frequent messages cheering on all my attempts at taking good care of myself. I am listening and so is my subconscious. One of my earlier dreams in the night was of a large horse trailer parked on the deck of an oceanliner. It was the horse that reminded me that the hay needed changing, and the water and food bins filled. I did that, which may explain the physical therapy dreams that followed.

So yesterday was my first day of work. I had only two meetings and everything took place at a slow pace, including my walking. I have finally slowed down to the natural pace at which most of Africa walks. It would be New York where I’d get into trouble, but here I fit in quite nicely.

After our morning meeting we went for lunch in a small sandwhich/deli type restaurant located right next to, indeed, a physical therapy practice. So I have the card and can call the number today.

I was rather exhausted and went to bed early after I had a long Skype chat with my colleague Sarah who is in neighboring Tanzania and later with Axel from home. I had brought my little notebook web cam in the hope that Axel and I could see each other but there is a Macintosh incompatibility and he could only see my Skype image. I also had wanted to show him my room. It is quite nice. I bought a bouquet of flowers yesterday (the markets overflow with flowers) which I put in a portable plastic vase that someone gave me a couple of years ago (was it you, Carol?). I am glad I stuck it into my suitcase at the last minute.

Monday, November 5, 2007

I just got a call that I will be picked up in a short while so this entry will be short. Yesterday was a restful Sunday. Ida and I did manage to go to Quaker meeting, a small and quiet affair with a cacophony of noises going on outside from the road and other worshippers. After lunch, just when I felt really sore, Eunice the massage therapist came with her folding massage table and gave me the most wonderful massage in my room. I took a bath and a long nap afterwards.

At the end of the afternoon I had asked Elias to come for tea. He is the kid who had found my name in the East African Aero Club guestbook and with whom I had corresponded for a few months. We had tea and talked about flying, dreams and not giving up. I liked him a lot. He is the same age as Sita and has led all but a charmed life. Somehow he got the idea of flying and although he has made some headway (he passed his ground school, which has already expired) he has a long way to go to pursue his dream of becoming a pilot with the Africa Inland Church. All I can do at this point is cheer him on, which I did. He calls me mum. We took a picture and then he left.

Ida picked me up in the evening and we joined my other colleagues Joseph and Kristen who are here for the week for dinner in a lovely restaurant. Despite the espresso I had I fell asleep quickly, slept well until a lone mosquito woke me up. After a couple of hours of being wide awake I managed to sleep through my alarm. The week has started. Off to work I go.

Sunday, November 4, 2007

It is Sunday morning in Nairobi. The city is already up at 7 AM. I am wondering whether it is too early to call the office of Friends International House to find out what time Quaker meeting is. I went there a few years ago. It is in a complex (International Friends House) where both the silent meeting (unprogrammed) takes place and the programmed meeting, in another building on the premises. The programmed meeting is noisy with much singing and loud preaching which goes on for 2 hours. At the end everyone streams out of their respective buildings and they greet each other with the words brothers and sisters. I asked Ida to come with me this time.

Ida made my welcome in Nairobi very easy. She had arranged for a ‘meet and greet’ at the airport to complement the wheelchair KLM arranged. At my arrival a wheelchair was indeed waiting at the door of the plane with a young woman named Karen. She wheeled me into the building and there was another young woman, Theresa, with a sign with my name on it waiting at the end of the jet way. I was pushed with amazing speed through immigration; they parked me near the baggage area and one got my suitcase while the other located my driver. It was the best landing in Africa ever. I also have never been more exhausted at the end of a trip. I could not have done without all this help.

In the plane the KLM staff put an empty metal container in front of my (frontrow) seat after take off. They covered it with a bunch of pillows and provided me with ice packs at regular intervals. The only difficulty was getting in and out of the chair. It was all very comfortable. I was able to do my foot and neck exercises from time to time, and stayed fairly limber throughout the journey.

At the hotel I found a note from Ida giving me the telephone numbers of a massage therapist who makes home (hotel) calls and a physical therapist plus two small washbasins that she had left with the concierge for my foot baths. It was the first thing I did in my room. After that I took care of my communications (internet set up and cellphone card) at the business office and went to bed. I slept a long dream-ful sleep. The only part I remember is a very long glass rowing boat and my surprise to learn that glass did not mean real glass but fiberglass when I noticed it did not shatter into a thousand pieces when it bumped into the side of a building. Something about expectations, I gather, being more resilient than I thought, may be.

By the way, Tessa filled her void quickly and now has a puppy.

Saturday, November 3, 2007

All our aches and pains were overshadowed by a call from a sobbing Tessa yesterday morning. Her pet rabbit Nijntje died, suddenly. Tessa was inconsolable. Axel and I cried along with her on the phone, wishing our arms could reach all the way into London to hold her. Her pain was made worse because she couldn’t locate Steve at first and there was no one to console her or simply be with her. Tessa had poured all her love in this little creature which she got on her 18th birthday and which had been so much a part of her life after high school. And now it is no longer there. Our hearts are aching for her.

Later, after we had hung up, it occurred to me that we got a glimpse of Tessa’s reaction when the news of our crash finally reached her last July. Not that rabbits and parents are the same, but when it comes to being the object of love, maybe they are.

This sad news colored the day, which was already sad because of our imminent parting; add to that the early nightfall, the leaves falling and hurricane Noel racing up the coast to soak the Northeast. It could easily have added up to a sense of foreboding and depression. But it did not. I was excited and looking forward to the trip while Axel knew that this going out into the world was another important milestone for me on my path to recovery. My excitement was matched by a most glorious sunset over Boston as Sita and Jim drove me to the airport. Axel watched it from the cove. The sky was lit up with brilliant orange and pink streaks of clouds against a dark background. I think the storm was announcing itself in full Technicolor.

Navigating the airport was a different experience than I had expected. I travelled with my plastic boot which helped me avoid a significant part of the security line which snaked for a long distance. I could not see myself standing in line that long and asked for a short cut. A couple of Brits were standing right where I was let into the line and got upset. When I pointed at my boot they softened a bit. They asked what happened to me. When I said ‘a plane crash’ all the women in the group crossed themselves and the men asked whether I was flying on Virgin. They seemed to think that I would be a liability on their plane. I told them I wasn’t planning on crashing ever again in my life and that I was going on Northwest which therefore would be the safest choice of airline.

Later, after security I discovered the stresses of being handicapped when the line in back relentlessly pushed forward while I was still trying to collect all my belongings and put on my boot. I know that travel is stressful, even for the totally fit. Security adds more stress and it becomes hard to see other people’s needs. We’re all in our own little balloons, trying to get wherever we want to go, in one piece and with all our stuff. That’s when the truly kind people stand out, like the young man who took my handluggage and said, hey, I’ve been waiting in this line for so long, I can wait this little longer, take your time.

I am posting this entry from Amsterdam. My next post, if there is anything to tell about a whole day of travel, will come from Nairobi, incha’allah. Please hold Tessa in your thoughts and prayers. She needs them.

Friday, November 2, 2007

Today will be entirely focused on my departure. There are no therapies and nothing to cut up the day. The suitcase is open on the bed downstairs and I have been throwing things that will need to travel with me in and around it. I have checked the weather in Nairobi and Holland so I know which clothes to bring. On the Nairobi end of the trip my friend and colleague Ida is securing airport assist, plastic tubs for my daily foot soak, a massage therapist and maybe even a physical therapist. I will be wearing my plastic moonboot for protection and comfort on the way from here to there. Not surprisingly, my dreams were all about travel. They were good dreams.

Yesterday was another very low energy day. It is as if my body has known, this entire week, that it needs to save up all its energy for the trip. I was never very good at being with low energy. Some people just take a nap but that is too radical for me. Before the crash, when I felt low I could go for a walk or a bike ride and get my energy back up. Now such physical activity is out of the question and I have not yet discovered other means to change things around. I did my foot soak, which helps a bit because I can walk better afterwards, and then I made a pumpkin pie, which made things worse because I stood on my foot too long (but smell and taste were worth it).

I had my orthopedic check-up yesterday. I first saw a physician assistant for about 5 minutes. He looked at my foot and asked a few questions. When I mentioned the continuing numbness and hypersensitivity of my foot (sole/toes respectively), he suggested the nerve might have gotten squished (not his words) in the tarsal tunnel. I did not know there was such a thing in my foot. It is like the carpal tunnel in my wrist. No one had ever mentioned this. It can take as long as a year to get better, or never at all. I was really taken aback by the way he said ‘never at all.’ There was a little hint of sadism in the expression on his face, as if he was still in Haloween mode. I figured he was a butcher or Freddie with the chainsaw. These things take a few days to wear off.

Then I got to see the real doctor for a couple of minutes. He wiggled my ankle and asked about pain. Good, good he nodded, this will take time. I discovered there is a formula. I love to hear about formulas; it is something I can hold on to, count off days, stuff like that. Recovery of muscle strength and soft tissue damage takes twice as long as the period in the cast. That would be 4 months. The next time I will see him, January 3, all should be well. Let’s hope the formula applies to me. These visits to my orthopede are very short. I think I am not an interesting case, since he took over from another orthopede and never got to operate on me.

Axel went by train to Brookline for his therapy session with Paul who could not make it to Manchester this week; a big undertaking. He took advantage of his time in Boston to meet up with Phil Karber for coffee and talk about adventure travel (without capital letters), a stop at the Paper Source for his card project and then back to North Station where he joined thousands of commuters for the return trip to the North Shore. He returned in great spirits and full of energy and participated in the cooking and clean-up while I marvelled at is energy (it is usually the other way around) from the comfort of my recliner chair.

Thursday, November 1, 2007

I woke up to a glorious sunrise with brilliant pinks meeting the brilliant oranges and yellows from the trees in an explosion of color. I tried to gather evaporating dreams but they slipped through my fingers like sand. I hung on to some pieces about a community construction event, people sitting together and having a good time after hard work. This is probably another form of advertisement for the event that Diane is organizing at the Manchester Community Center on Sunday and which I will miss, unfortunately.

There was also something darker in the dream but it slipped away. This is fine. I was going to bring all the dark stuff into my EMDR session with Ruth but she just got another grandchild and the session is cancelled. I won’t be seeing her until I get back from Kenya. I’ll put all that stuff in storage for now; a closet that is already pretty full.

Yesterday we went to MGH for a consultation with a doctor who stands on the top of the health care pyramid. The orthopede from Salem hospital called him quadernary care, since tertiary has already slipped into the suburbs (Salem, Beverly, etc.). We got up early to beat the traffic and had a hard time getting out of the house in time. These things remain stressful, especially with our forgetfulness. We had to return once to retrieve a missing piece of paper. I particularly don’t do well with such stress and there were a few tears on the way. But despite the traffic, and there was much, we made it on the dot and saw the doctor for a few minutes and his assistant (intern?) for a few minutes more. He gave us some good news and some bad news. The bad news was that he considered the movement that Axel had seen last week and about which we were so excieted was pretty meaningless. The good news was that the distance that the nerve has to cover as it is reinventing itself is much shorter than we thought; the muscles that govern the extension of his wrist and fingers start fairly high up, close to the injury. He ordered another EMG in 6 weeks. If there is a positive change then the healing is progressing well and nothing needs to be done. If there is no change he will want to do an operation and help the nerve along.

Axel went to OT in his pirate outfit: hat, patch and hook. He was the only patient who showed up in style. You’d think that a Muscularskeletal Center would take full advantage of its name at Haloween (they had a few skeletons up here and there but that is part of their normal decorations). At my PT office things were a bit more playful. My therapist was dressed up as a gypsy with lots of necklaces, bangles and scarves, making for a noisy session. The secretary greeted me with wings on her back; there was a cowboy, a Red Sox player and the most adorable little cat person (3 years old) who came by each treatment room sticking out his candy basket to us patients, lying on our backs, ill prepared for ticking treating. I had no candy to give.

We were both too pooped to go out in town and see the tricker treaters go from house to house. We finished the lobster pie and went to bed early. A trip into Boston, with all the emotions attached, was a bigger deal than we thought.

Wednesday, October 31, 2007

Today is Halloween. If all things would have been normal I would have gotten up very early in the morning or stayed at Ann’s house to set up the annual MSH Halloween display, a tradition that is at least 15 years old. Last year’s Haloween display at MSH included lots of hospital Johnnies. Little did I know that I would have my own hospital Johnnie a year later plus many other patient paraphernalia. We are entirely equipped to go as accident victims this year: Axel’s body brace, a neck brace, a walker, several splints, crutches and our Johnnies. If we add some bandages and fake blood we could be very real. We got the walking bit down pat. But I feel no excited about such a costume and little energy for dress up. So this will be the first year that Haloween will pass me by, alas.

My dream life was very active last night; dreams about letting a wild thing loose followed a dream about being stalked by the monster-of-having-too-much-to-do that was trying to drag me down into something that looked like quicksand; bizarre, frightening and very real. After the fist dream I woke up and quickly scribbled down what I remembered while still expecting arms to pull me into the muck. I was not able to distinguish Axel’s arms from the dream arms and pulled over to the side of the bed. I remember falling asleep again; no longer afraid but angry, about these arms. Poor Axel!

The good news from yesterday is that my cervical spine is fully aligned again. The vertebrae (C2, 3, and 4) have been coaxed back in line over the last 6 weeks or so. This does not mean the pains are gone. The muscles still need to be retrained but the tender spots are smaller now and massage calms things down easily. In fact, yesterday I woke up with my left shoulder and neck totally pain-free. It took a while to register this. Such a luxury!

The process of realignment is mysterious. The physical therapist only used very subtle movements. The exercises she gave me are hardly exercises: minute movements of my head that are easy to do and cause no pain. If there is any stretching involved I cannot feel it. I can do these exercises without anyone noticing. Before this experience I always assumed that getting vertebrae back in line required force, as one would yell at a soldier or kid who is not standing in perfect alignment with the others. Maybe this is what chiropracters do. The end result certainly shows that this subtle coaxing into position works and that my spine prefers straight over crooked.

We went for our weekly massages to Abi’s office in Gloucester this time as she could not make it to our house. This meant it took the entire morning. We emerged so relaxed that on our way back we both forget all sorts of things we had intended to take care of while in Gloucester. But we had not written things down. This forgetfulness is a little worrisome and we haven’t found a way to cope yet other than writing things down. It is when we forget to write things down that we are in trouble.

The parents of Sita’s friend Brian sent him to our house with a lobster pie which we ate last night. We are in charge of our own meals now but this was certainly a treat. Sita and Jim left for Western Massachusetts to make music with their friends and so we have the place to ourselves. Axel promptly served himself about a half inch of white wine. I protested faintly and then had an inch myself. It was the Lobster Cove Chardonnay (“Life is a Beach” says the label with a lobster in a beach chair) that Ted and his brother Gus brought back from Illinois.


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