La Paz

the closer the airplane was to landing in La Paz, the friendlier everyone got
people love coming home

0330 arrival left me wondering what I was going to do till the buses started running, but an Israeli woman offered to share her cab to the hostel where she had made reservations. seems some people plan things more carefully...

set my watch alarm to get 3 hours of sleep, not wanting to miss too much of my first day
woke up to an amazing view of a city oddly reminiscent of Tbilisi
steep slopes, mountains in the distance, suffocating traffic, entrepreneurship everywhere

once I embarked on my first mission (buy SIM card for cell phone)
I started seeing even more parallels to Ukraine and Georgia
Lada automobiles, cobbled streets, few traffic laws, minibuses where other passengers pass your money up from the back and then pass your change back to you.

I would say that there are a few more smiles than I am used to
perhaps due to the consistently sunny weather
and an abundant harvest of avacados, mangos, papaya and other things I have yet to identify


A friend from a Quaker foundation was kind enough to show me some sights in the afternoon, but once the sun set, I crashed and slept for 11+ hours. Have been trying to remember all of the adjustments that my body must be making for the altitude, but whatever they are, I´m sure that lots of sleep will help.

Off to find the bus station and a bus to Cochabamba!

A Place to Stand by Jimmy Santiago Baca

Perhaps the last book in English that I read for a while.

A wonderfully written account of Jimmy's triumph over a broken prison system.

A bit depressing, but like music in a minor key, somewhat more powerful than "happy" books.

Had my last exam of the year this morning.

Hope I passed all of them.

Packing this evening.

Philly tomorrow for reunion at HC.

Monday morning flight to La Paz.

Getting excited.

Things I learned from an alcoholic adult patient

Always ask if my patient would consider a trial of abstinence.
Also offer to set up an appointment with an alcohol specialist or family counselor.

Also important to fully explore the family and social context of my patient's drinking.

Things I learned from an adolescent patient

I should avoid conversation until I've finished washing my hands, and can turn and make eye contact with my patient.

If I need to take any notes, be clear whether or not my patient is supposed to see what I am writing. In general, try to refer less to notes.

Memorize the HEEADSSS adolescent screening outline to make sure that I don't miss any key areas.
- Home
- Education/Employment
- Eating/ Exercise
- Activities + Relationships
- Drugs, Cigarettes, Alcohol
- Sexuality
- Suicide
- Safety (+spirituality?)

Address confidentiality before asking about relationships and drugs. Then make those conversations as concise as possible, with many open ended questions, allowing my patient to take them as far as she wants.

Eat, Love, Pray by Elizabeth Gilbert

A bit of a lighter book. Very clear tone and well articulated. Got me to think a lot about the place of mindfulness in western culture. How much of life should be spend pursuing comfort and pleasure and how much needs to be focused on developing wisdom? I tend to agree that I learn most from situations in life that are often least comfortable. Also finished this book a few months ago, but just now getting to the blog post. 

Over the weekend, paced a friend to a PR in the Rochester City Half Marathon. Made me want to get in shape to actually race one. This morning I'm up early to study Spanish. Haven't managed to get through this introductory textbook yet, but I really want to keep chugging until the day I leave (27 days from now!).