It has taken me a while to start writing this post because I wasn’t sure how to start it. There obviously needs to be one more, a completion of this account of my experience. But I was stumped on what to title it, how it should begin. The end of the chapter? The end of the journey? The end of the beginning? Nothing seemed to describe things accurately because it doesn’t necessarily feel like an end. Yes, my time in Agok is over, and I have clearly ended that part of the journey. But, as all things with this experience, I continue to learn how much this time will stay with me forever. So, “Turning the Page” seems like the perfect way to start this- I’m turning the page. But first, saying good bye.
The last 2 weeks in Agok flew by. My work continued to surprise, amaze and humble me, usually all in the same day. While just a normal day had any number of adventures, one particular day stood out in a big way. I was working day shift and had a woman there who was in her 4th pregnancy (one pregnancy was a set of twins) and having mild contractions. I was fairly certain she had twins again as I could feel a head presenting and another under her ribcage, but that second baby was a bit harder to completely feel the position of. She was 7 centimeters dilated (for those not familiar, 10 centimeters is considered “fully dilated” and when a woman usually starts pushing. Sometimes, especially when it’s not her first baby or if the baby is premature, she can deliver at 9 centimeters). Normally this would be an no-brainer case; the patient would be admitted and we would just monitor her for progress. However, this woman was determined to go home. She told me, “Today’s not the day. The babies aren’t coming for another month”, and was quite insistent. Because she was so far dilated, her contractions were regular, and she was having twins, I felt uncomfortable having her leave. But of course, the decision was completely hers. I explained my concerns with her leaving, and asked if she would be willing to wait 3 hours and then I would recheck her. If, at that time, she was still 7 centimeters, I wouldn’t put up a huge fight about her leaving (even though I would still be hesitant); she agreed. Things got busy and I lost track of time. Four hours later I rechecked her and she was 9 centimeters but still insistent that the babies weren’t coming. I had to tell her, ready or not, the babies were coming. We talked a bit more and she finally conceded that today would be baby day, though this was likely due more to the fact that she had started involuntarily pushing than my powers of persuasion. I alerted the staff so we could have enough people in the delivery room. It also came to mind that we had an ultrasound machine now, and perhaps it would be helpful to do a quick scan. Why this did not come to me sooner I have no idea. We had just recently gotten the ultrasound machine so I was still adjusting to the fact that it was even an option. I asked the supervisor to do a scan and, much to our surprise, she noted that there appeared to be a 3rd ribcage. She wasn’t positive so we just made sure we had enough equipment ready for 3 babies. I felt horrible for not getting the ultrasound sooner, but she said we wouldn’t have done anything differently. The first baby was head down, and given her 5 previous vaginal deliveries, she wouldn’t have gotten a cesarean section this time around just because there were triplets. Looking back, the fact that I didn’t even think to do an ultrasound right when she got there, and that we just put our gloves on and coached her in her pushing efforts after discovering she might have triplets, both are shining examples of how much I had gotten used to practicing midwifery there, without all the bells and whistles of modern technology. Here I was, practicing the art of midwifery at its core, doing exactly what I wanted to do. How amazing! Along with the midwife assistant, we coached the mom through pushing. She, however, still seemed to be clinging to the “not today” idea and did not move the baby too much. Then, an older woman came into the delivery room. We couldn’t make out if she was the patient’s mother, a town elder, a traditional birth attendant or a care giver for another patient who just happened to be hearing what was going on. I could not understand the words she was saying, but I sure understood exactly what she was telling the women just by her body language- she was telling her to push! And man did she listen; the next contraction the first baby came out. She started crying right away, and I could tell by her size and the size of the mom’s abdomen that she was one of three. We did another ultrasound and sure enough, there were 2 babies head to head still hanging out inside. The woman started laughing when we told her she had 2 more to push out (we had warned her there might be a third so it wasn’t a complete shock). She had clearly gotten the pushing down and delivered two boys within 5 minutes of their sister. Both were breech, came out healthy and required minimal resuscitation. It was a pretty amazing site, and a day I will never forget.
My replacement was able to come earlier than originally planned which was awesome as her original start date wasn’t until after I left. While her position is much different than mine due to changes that were made during my last month, I was able to give her a general overview of how things run. And we had time to just socially chat; turns out she’s a midwife from Madison who went to school in a very small town in “nowhere” Wisconsin- Rhinelander!!! She couldn’t believe I knew where that was! It was so great to pass the baton to a fellow Wisconsinite (though, sadly, ANOTHER person from the States who doesn’t follow football!! Unbelievable!). I was so glad to have the time with her; I cannot imagine showing up for my first mission and not getting any handover from the person before me. It also provided an opportunity for me to really see how much I had become a part of life of Agok, or rather, how life in Agok had become part of me. Going through policies, explaining the day-to-day flow of things and reviewing paperwork were all so easy, and I couldn’t help but think back to how I had felt at the beginning, feeling like it was so new and foreign. The flow of the days and all the little nuances of everyday life had become second nature. As she asked questions and I explained things, it started to become clear all the ways life was so different in Agok from what I had been used to, and how drastically it was about change again for me. Before I knew it, my last few days had arrived. I had my last pizza night, during which I had to pass along the secrets of making the cinnamon rolls.
I had my last night of playing the Monopoly card game that had become a nightly tradition. And then I had to start the goodbyes. It was hard to say goodbye to all the people I was used to seeing everyday. Few times in life are there circumstances where you not only work but also live with the same people day in and day out. For better and for worse, these people had been my family, and it was hard to part ways. Some I knew I would be keeping in touch with for a long time, and many I knew I was saying goodbye to forever. Each left an imprint on my heart that I will carry with me forever.
The next few days were filled with travel, debriefing and rest. Debriefing is a time to talk with people in positions in the mission offices in Juba and Geneva about my particular mission: what worked, what didn’t, areas that need improvement, high points, low points. It was a lot of talking and for me, it was a time to start processing. A lot of emotion came out as certain things became clear that were hard to see in the middle of the mission. It also was very surreal to be on the other side of the last 6 months. It seemed to go so fast and so slow at the same time, like so much of life. I was so fortunate that after all that my brother was able to meet me in Italy to help me start to reacclimatize to the developed world. We planned some of the time out, but also left a lot open to see where the day took us. It was a wonderful time, and it is a trip I will remember forever. But it was not my usual relaxing vacation. It was 3 days before I was able to get through a day without hyperventilating about something, and those episodes usually involved large crowds. I noticed I was on edge a lot more than I usually am, and got stressed out a lot quicker over things that normally aren’t a big deal for me (like deciding what to eat when given more than 4 options on a menu). Luckily the cuisine choice was easy, but which restaurant to go to was just always a “woah!” moment. In the talks with my brother it also gave me my first taste of realizing life had gone on without me. No matter how much contact I had with people while I was away, it’s not the same as being there in person, or being able to talk on the phone regularly with a good connection. Life went on for everyone while I was in Agok, and i would have to catch up on all that. So I tried as best I could with him, and soaked in beauty and slow pace of Italy as best I could.
After one last bear hug from my brother, I headed to Geneva for a night before heading to New York City. This is when it started to really feel like I was going home. My entertainment system didn’t work on the 9 hour flight. Luckily, I’m now a pro at entertaining myself. After I got over the initial devastation at not being able to catch up on current movies (to which I reassured myself it would only be on the other side of the flight that I could catch up for sure), I just pulled out my books and hard drive filled with movies, podcasts and shows and went through ones I hadn’t yet seen. Something that previously would’ve really put a damper on a very long flight just caused me to shrug my shoulders and warn the crew for the next flyer. I got quite emotional going through customs when the agent asked how long I had been gone. And I was beyond thrilled to finally not have to think about what language I was supposed to be speaking. After 3 countries in 4 days 1 week, and 2 in 2 days the next, it was nice to finally be speaking English (yet still said “Graci” a few times. Thanks to the recent close to record breaking snow storm, New York City was a disaster. It was 4 hours to get from JFK airport to my friends’ house in New Jersey. By the time I got there I was exhausted and, as usual now, emotional. But I got huge hugs and lots of love which made it all worth it. The next morning I got even more love from “my boys”, the awesome 11 year old twins to whom I am Auntie Katherine, and who I witnessed coming into the work as their labor and delivery nurse. They showed me where the Oreo stash was, showed me all the snacks, covered me with blankets when I sat on the couch, brought me drinks, made me chocolate covered strawberries, were my sous chef when I made dinner, and hugged me first thing in the morning and cuddled with me at night when we watched TV. I couldn’t have asked for more. While not being spoiled, I went into New York City for more debriefing. At this point I was really done talking with people. And because my mission was through MSF-Geneva, those in the New York office don’t have much direct say in things related to my particular mission. This was mostly general HR, communication, organizational stuff. My first meeting of the day though was with the therapist, which was likely the best way for me to get started. It was a safe place to vent my emotions and get some feedback. And, after having a little time since my last briefings, I had been able to get ideas focused a little more and articulate them a bit more coherently, though the tears flowed just as freely. After talking with her I was told I wasn’t alone in feeling the way I did, which was somewhat reassuring, but also made it more frustrating because knowing that doesn’t exactly help me personally get through it. But it is what it is. After this, I was finally done with debriefing and could finally go home. So, 4 days ago, I came home. Seeing my mom for the first time since I left was so wonderful. She and my dad had an embarrassingly large banner and flowers for me. My big sister had a priceless sign as well. It was great to see them right when I got there and get the bear hugs I so desperately missed. Because, no matter how much I try to organize my thoughts and feelings, I just can’t get it done eloquently, mostly because they themselves are all jumbled up. So, in an effort to get this post completed before May, I’m going to resort to bullet points. I haven’t gotten to a place where I am able to talk about this experience yet with everyone. I’m still trying to process, and remember, and just give myself some time. This is where I’m at right now (and it’s pretty disorganized so beware).
I’m relieved to be home, surrounded by familiar things and people. I’m incredible grateful to my family for allowing me time and space to do what I need to do, but being available in case I do want to talk. And for allowing me to just start randomly crying because I found more socks. That’s right, socks are a BIG deal!
Simple things like deciding what to do for dinner, when given any option, can be too much for me to decide. I’m making a lot of quick, pointed decisions rather than considering all possibilities. I miss only having a couple options. Yes, they were the same options over and over again, but they were simple. Here there’s just too many.
It’s hard seeing how much life happened while I was gone. Talking to friends and finding out things that I wasn’t here for, things that I absolutely would’ve wanted to help them through, is so hard. It is also hard to now be seeing the aftermath of my grandmother’s passing. I am not able to start getting to that yet, but I know it’s there in so many ways.
Breakfast sandwiches, oh how I have missed thee! I had 3 in New York, each one as blissful as the next. The 6 month buildup did not disappoint!
Frozen custard- ditto!
I missed an entire Packer season. The whole thing! This fact is a tough one to swallow. Yes, Super Bowl Sunday is a family holiday in my house, and we will have massive amounts of food. But still, no Packers for me this year. That hurts. My only consolation is that it was not one of their most shining years. At least it wasn’t an undefeated season; they can do that next season when I’m stateside.
I am experiencing exhaustion unlike anything I’ve ever had, even after my most grueling race. I’m tired to my bones. And I can’t sleep through the night most nights. So this becomes a constant struggle.
I’m slowly trying to find me again. I laugh, I cry and I get glimpses of myself. But I cannot get myself to feel strong emotions. It just feels like I’m numb.
I find it’s easy to go through a day and forget the last 6 months happened. And then some small thing will happen and it all comes rushing back. A diaper commercial comes on TV. Someone will use 2 paper towels for something that would only take 1. Water comes out hot, and then cold, a big range of temperatures instead of just “on”. It’s all so new again.
I got to do some pretty amazing stuff, meet some pretty amazing people, and be witness to some pretty amazing things in the last 6 months. I’m so fortunate to have had this experience.
I miss random things about Agok. I miss it taking at the absolutely longest 2 minutes to get from the door of my tukul to the door of work. I miss being able to throw a load of laundry in a lunchtime (and by throw a load in I mean soak the clothes so they’re ready for a scrub and rinse after work). I miss having conversations with colleagues in our towels outside the showers. I miss the joy of a Coke in a 100 degree day, and of wine in a mug after a long day at work. I miss how much joy a slice of cheese or pastrami or a piece of chocolate can bring. Not surprisingly, I miss the sound of the fan at night. I miss the slow pace of life, of not being in a rush to get everywhere. I miss being able to walk across the “street” of my tukul to have a chat with a friend. I miss the beauty of the sky.
I’ve rediscovered the joy of a run. As hard as I tried, I never got into a good exercise routine in Agok and am now down to the smallest amount of muscle mass I’ve ever had. My skinny jeans now are more relaxed fit than skinny. So thanks to my incredibly smart foresight to have my winter running clothes here (go me go!), I’ve been pounding the pavement and it feels amazing. Not only do the endorphins help my energy, but I am getting back to my favorite stress reliever and problem solving method. While I do miss the kids yelling “How are you?” and waving as we ran down the road, and even coming up to run barefoot with us for a while, I do have my running companion here in the form of a furry 4 legged creature who is all in for my February boot camp.
I was so lucky to have so many people write, text, and send me things while I was away. Every single message, whether on the blog, on Facebook, in an email or sent snail mail meant so much and helped me get through a little easier so THANK YOU!!!!
I’m grateful for the people who have touched base since I’ve been back but have kept their distance and allowed me time to reach out to them further, hopefully without being slighted when it hasn’t happened immediately. I’m a work in progress everyday. And if you get tired of waiting, just tell me. Of all the things I got while I was in Agok, a Poker face is not one of them so my emotions are still written all over my face. You’ll know quickly if it’s too much.
There is a lot to figure out for the next chapter in my life. This adventure has changed my perspective on my place in health care and what I want to be doing. I know I don’t want to be away from home for 6 months at a time anymore. But I also know I have a passion for international health. How this will fit into my practice in the future I don’t know yet. But I will be working hard to figure that out. I’m excited to be at a place of change, to know that how I practice will forever be different, and for the better. But for the immediate future, I’m going to sleep. And stay in my pajamas as much as I can. And continue to work through processing the last 6 months. And sleep. And find a new place to live in Chicago. And run. And sleep. And reconnect with friends and family. And sleep. And…..
Thank you for taking the time to read this blog. My hope as I started this was to keep people updated at home about what was happening in Agok. I wanted to give people a little feel of what life was like, with all the good and bad. It became a place for me to work through things as well as I tried to organize events into coherent statements. It’s ofter not easy to articulate all that has happened, which is why it’s hard to start talking to people. Where to even begin? But this spot has helped me start and for that I’m grateful, even if no one reads it. So if you do, thank you for being on this journey with me. Again, all your messages meant so much. Thank you!!! And I hope that, by reading this blog, you have a little broader view of the world you live in and the work you do. Much peace and love to you all.