26 March 2013

The almost-doctor returns to Cameroun

Dear all,

I'm writing from Yaoundé, Cameroun. I will be updating my blog again during the next month, as I am working with Ascovime (www.ascovime.fr), an NGO here that does health campaigns in rural villages, among other things, incorporating clinical work and public health. 

I will do some writing in French, but Spanish...lo siento. 

I'm less than two months from my medical school graduation. 
Everything comes full circle. I took the MCAT weeks prior to leaving for Cameroon, the first time. I got my MCAT scores while in Bandjoun for training--my parents called. My fellow (then) Peace Corps Trainees knew I had been waiting to hear, and they were ecstatic for me--if I had to take the MCAT again, it would have been 3 years later, delaying medical school more (at the age of 22, I thought that time like that mattered). I saw my first surgery in Cameroon, a week and a half after arriving at post--December 30th, I think, 2005. I set foot in the OR in Mvangan in chacos and capri pants, probably with sunglasses pushing back my hair. My job was to hold down the patient's legs, so he'd stop kicking Doc who was trying to repair the perforated bowel piled in loops on top of his abdomen. I counseled my first patients, there--HIV, malnutrition. Learned and taught health professionals about preventative and public health. I ran a health district.

And then I applied to med school. Middle of my second year of Peace Corps service, June 2007, AMCAS--I turned it in the first day it opened; I'd had time at post to prepare the essays with help from my Peace Corps Volunteer friends. Everything was ready ahead of time because it had to be. I couldn't guarantee when I'd be in the city, and even if I was, when power would be working, when internet would be working...etc. Before that, I remember taking the (few years old) book of medical schools from the Case, our Volunteer house in Yaounde, and poring over it on the woven plastic mat in my house in Mvangan, by candlelight. I crosslisted schools by research rank, primary care rank, and school of public health (and then it turned out that the best one for me doesn't actually have a school of public health (well, at Berkeley, across the Bay), and I went for MFA and not MPH). I knew no one else applying, that year, I knew little more about the schools and process than what was in the years-old book, and everyone around me was supportive and helpful. A friend brought me my old laptop from the US, and when Doc's generator was on in Mvangan (and he always generously connected it to my house), I'd type furiously for my secondary essays, writing and editing otherwise by hand, and emailing/updating every 2-3 weeks in Ebolowa (almost missed an interview invite. Didn't). I scheduled all the interviews while I was in Cameroon, and I started interviewing a week after I returned to the US.

Medical school is why I left Cameroon. I very seriously considered extending my service for a third year and delaying med school, or staying for 6 months, or somehow going back to the States to interview on home leave and tell them I was planning to start in 2008--and then defer until 2009 after I got in. But my MCAT scores were expiring, for some schools (including UCSF), and so I left. In the end, I decided because I wanted Mvangan to have (two!! health and agro) volunteers for two more years, it was better to leave; I wouldn't have added enough time.

And for the first two years of med school, at least, I considered dropping out - frequently. Several per month. In order to go back to Peace Corps, do Peace Corps Response (then Crisis Corps), be a UN Volunteer...I was on email lists for all kinds of positions, and any time not being there felt like too long away. After being in the US for about 6 months (when I finished my service, interviewing for medical school, etc), I had the opportunity to go back to Africa, Kenya this time, for public health research (funded) - and I ran. I was away from Africa for 6 months. Then, 10 months. And now...three and a half, almost four, years. A friend said to me once, "it's hard to imagine there was a time when you'd never been to Africa." True.

I was called "dokita" for the first time in Cameroon; http://jenny-and-cameroon.blogspot.com/2006/05/paging-dr-jenny.html. I was introduced as "Docteur Stella, une etudiante..." by Dr. Ndom when I went back the summer between my first and second years of medical school. And now? It won't feel disingenuous. I'm returning to the States from Cameroon in order to graduate. I've finished all my credits. Really, I'm done.

In Cameroon, in Mvangan, I found the kind of medicine and public health that I want to practice. I had to leave in order to learn. My "back up plan," I told people, if I didn't get into medical school, was to stay, learn with Doc, and buy a medical degree (quite possible in Cameroon). Now? I'll be signing my residency contract in Cameroon and sending it from the Peace Corps office in Yaounde. 

When I was there, Bush and Cheney were on the walls in the office (in federal offices, required). We shuddered every time we walked in. Now? Much has changed.

My name is still on the wall, I'm told --- literally. My group decided that we would sign the wall in the Case when we COSed. Since then, some others have, but not all. My name, my writing, is still on the wall, just like it is in homeless clinic here.

As I was flying in last night.

The capital city is barely lit. At 2 miles up, it's 51°F. 66°F, a mile and a half.

You wouldn't know this was the second biggest city (I don't remember if Douala was more lit, arriving at night). Quiet. The only thing about this country that is. The rainforest, every night, was loud and exultant. Insects make noise, animals, people. Silence usually implied ear plugs. 
The way to the airport is dark. Pitch, in this almost-on-the-equator country with 12 hours of each day and night. 73°F at 3000 feet. The plane feels it, already. It was dark as we edged over the Sahara. Sahel. I know where we are and what it looks like. This, too, is rainforest. 

We land. The entire plane erupts in applause.

Outside, I will kiss my fingertips and press them to the ground. It's a mark of reverence, of respect. In African dance, we do this in front of each drummer, at the end. Here, I do it when I leave.

And every time I return.

On est ensemble - we are together - estamos juntos - bi ne vale!


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