Cochabamba Tour, 1 June, 2012

"Don't say your're from America", he warned, "some people will take that as arrogant because we're all from America". I remembered hearing this one other time, perhaps when going through customs on my way into France. The point is well taken, as I'm sure a South African can't simply claim all of Africa as his nationality. Still, it's really stuck in my head since Ukrainians never say spoluscheni shtatakh ameriki, it's just too long and difficult to pronounce, even if you are Ukrainian. But I'll work on changing my ways. I think E.U. will work, even though in my head, I just think of the European Union.

My time line is starting to sort itself out. I'll go ahead and splurge on a $100 flight up to Riberalta this Tuesday, since I have all of my stuff, some presents for N's family, and a care package from V to get up there. It's amazing that the bus would take more than two days while the plane takes less than two hours including a stop. I guess there really are many mountains and rainforests in the way. I'm excited for the flight. Hope I get a window seat.

Explored more of Cochabamba today. High points included fresh squeezed orange juice, 1400 stairs up to a giant statue of Christ, and a tour bus trip where I understood at least enough to turn my head the same way as everyone else…

Bus from La Paz to Cochabamba, May 30, 2012

After my huge night of sleep, I decided to have a more relaxing day. Went down for the continental breakfast (which was amazing with fresh milk and papaya), and then back to my room to look up some words that I really need to know. I've also decided that I need to quickly get a beginner's grasp preterite, present indicative, and future indicative so that I can express myself effectively.

The bus ride was wonderful. Things that happened in incomplete sentences include:

-bus broke down

-neighbor is first grade teacher and used baby Spanish to tell me about her family and her son's medical education.

-stopped at roadside pension and had an amazing bowl of soup.

-went downhill for 50km on a road that my dad would love to take his car on

-arrived in Cochabamba just at sunset and was met by an amazing amount of generosity. 

It appears that V is staying with a neighbor while I am here. I am left feeling slightly guilty as I can't figure out a way to repay all of this kindness. The only thing that I can think to do is take a package up to Riberalta for V's brother. And help V dig a compost pit. And maybe clean the house while she's at work. Actually, I'm sure the reason she moved out of her house is probably complicated and culturally motivated, but I know that I must accept before I seek to understand.

So now I've got to decide where it makes more sense to study Spanish. Here in Cochabamba there are some Spanish schools which are used to teaching foreigners. Up in Riberalta I would be mostly on my own. There are advantages to both. Also, having seen the quality of the roads and landscape, I am less excited to take a bus at the end of June all the way from the northern side of Bolivia to my project site in Mendoza, Argentina. Next time I have internet (which is when I'll post this), I'll investigate a few other modes of transport. Rivers are navigable in the north, and there are trains in the south, so I may be able to get to the Argentine border without a bus. The Argentine roads are supposed to be pretty good. Primero, Castellano...

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!).