Another Kind of Jungle

Approximately 12 months into this new location, I've realized I've written zip while in this city.

My jungle looks less like rain forest and more like concrete.

Instead of howler monkeys outside my window, I hear Boeings howl their descent into O'Hare.

The commute to work isn't a walk across a couple suspension bridges with an eye out for snakes, scorpions, spiders, and rogue bridge monkeys; it's a lot of stop signs and stop lights with serpentine drivers, tail riders, sudden stops, and jay-walkers.

A slower pace of day has been traded for 70mph on the freeway.

Plumbing is still an adventure, but not because I live in a jungle and our water source is from up the mountain, but because I live in a 100 year old building.

Come dusk, the symphony that fills the outside air isn't crickets or cicadas anymore. It's traffic a block away.

Green mountains are no longer the towering entities around me--sky scrapers replace them.

The drive to the Ultimate Frisbee field doesn't look like dodging pot holes on the dirt road. It looks more like a tollway with planes flying so close to the highway, I'm pretty sure some of the guys I play with could hit them with a Frisbee.

My place of employment no longer has 17 beds, it has more than 17 floors in 4 different buildings.

My patients are no longer victims of pit vipers, machete wounds, or hitting cows while going way too fast on a motorcycle without a helmet. They have now IV pumps that work and machines that can breathe 10 different ways or some that pump their blood for them.

I no longer live in front of the 2nd largest barrier reef in the world. I live in front of the 2nd largest Great Lake (by volume, for those of you who will fact-check me).

I can still find desperation and heart-warming hope. I can still find poverty and mind-boggling wealth.

I'm still on the look out for the neighborhood skunk that seems to follow me no matter which country or state in which I live.

My jungle looks less like rain forest and more like concrete.

My greatest adventure yet has gone full throttle while in this concrete jungle. Something I've never really understood, but tried to empathize with has become my daily struggle for months now. Some adventures are fun and exciting. However for this one, I'll quote Reepicheep from C. S. Lewis' The Voyage of the Dawn Treader and say, "Adventures are never fun while you're having them." It's one of those adventures. I'm sure I'll look back on this season (one I hope will eventually end....very soon), and marvel of how God carried me through this and how He orchestrated this season of my little life into His big plan. I started counseling because of it. I just couldn't take it anymore. I said nothing. I prayed. I questioned. Mostly, I just cried. After not too long, I met a great group of girls that felt like the family I had in Honduras. I still said nothing. We had a Bible study every week and things were looking up. However, my issues ran pretty deep and when the Bible study ran its course, my daily struggle came back in full swing. I thought about moving back to Minnesota, as if Chicago were somehow the source of problems. I knew I would only be taking the same problems with me. So to counseling I went. My counselor had me take a bunch of questionnaires and tells me I scored pretty high for depression and mild to moderate for trauma. Counseling was one of those things I didn't want to do because that meant there was something wrong with me. I felt it was my personal white flag, screaming, "I can't handle my own life decisions." This is ridiculous and I should never feel that way, but I felt that way. 
Kim, my counselor, has helped me learn a lot about myself. Things like how I will give everyone grace and the benefit of the doubt, except myself. Or how I'm not super great at processing negative emotions. Or how in friendships and relationships I will almost always put more focus on the other person. It's not because I'm a great listener and sooooooo self-less, but because I'm scared that if I share myself or Heaven-forbid become vulnerable in the friendship, that friend will leave (because of another lie: everyone leaves). And I will have given them a special part of me. That hurts. I'm not an anomaly in this. Some react by just not making friends at all. Not me, I want ALL the friends because extrovert and people are great and I want them to feel loved and heard, and known. I'll listen to your struggles until we're both blue in the face. However, I will not voluntarily offer much of myself because I don't think you care or don't care enough. You might care a little, but not enough to stay or to hang on. Again, it's ridiculous and I should never feel that way, but I felt that way.
What's the point of all this? I'm not really sure. Maybe it's to practice being vulnerable on an extreme level. Maybe it's just to process. Maybe it's to let you know I'm not perfect and I struggle. Maybe it's to let you know if you're in an adventure like me, if you struggle too, you're not alone. It's okay to talk to people you trust. It's okay to trust. It's okay to go to counseling. It's okay to heal. We can struggle together. Whatever kind of jungle you're in, wherever your adventures take you, I hope you know you're not alone and that God loves you and He loves me. However distant God or people feel, God hasn't checked out on us yet, and He won't do it now. Maybe one day we'll meet up and laugh again and talk about our crazy adventures that we had and remind each other how God carried us through them. Until then, I hope you hang on too.

Another one with a lot of pictures: December to May

 December!

OR Day: Today´s challenge includes how to fit your specimen
for the patient to take home into the specimen container.
Yes, they wanted to take it home. No, we don´t really know why.

Happy Lille Yuleaften (December 23rd)
from the House Sitters and our dirty plates!
Never heard of this holiday?
Ask your nearest Scandinavian relative. 

Feliz Navidad from Cinthia and I!

Lesson learned:
When you attack the boys on the hill
with water balloons on a sunny Sunday afternoon,
they just might wake you up on a rainy Monday morning
after you worked a night shift to throw them back at you. 

January!

Look who came to visit!
(Yes, we are wearing matching shirts)

View from the Water Tower, on our hill-mountain thing

Oh, so cute. Almost ¨print it out for Grandma´s refrigerator¨ worthy

Little guy just wanted to help with music for Fellowship night
(He was rewarded with death shortly after. Thanks, Minions)

Group Activity during Respiratory System class

When the student teaches her teachers,
she stands back and takes pictures of the chaos.

February!

¨Lizzie, on a scale from 1 to 25 how much do you love Ultimate Frisbee?¨
¨32.¨

Yes, we all wish we pull off that much cute and sass at one time.

We like our coworkers.
They let us kidnap their children and feed them ice cream and pop.
Then we send said children home. Enjoy, parents.

¨Suffering for Jesus¨

February´s Night Shift Project: Tame the ER

March!

Happiness is reuniting with old friends

And celebrating the lives of new ones

Community Star Wars Movie Night!

My parents came to visit!
Also, shout out to the child perfectly photo-bombing in the back.
I aspire to be you.

Sweaty, but happy:
my partner in crime (she also goes by Heather)
and I found the waterfall!

April!

Chocolate Chip Cookie Baking Night

¨Waiting their turn to help¨

Group Shot: We´re big fans of our missionary kids

Makeshift Tube Feeding for my patient on the ventilator:
refried beans, ice cream, water.
Not pictured: a multivitamin, carrot or tomato

Erlinda is my hero.
And I´m not saying that because I couldn´t figure out the blender.
Nope.

Not that I´ve ever had a favorite anti-venom before,
but this is my new favorite.
A lot of prayer and about 20 vials of this anti-pit viper venom.
Adding this patient to the list of
"Those who shouldn't have made it, but did." 

How to keep the ants away from your food:
If you can't outrun them, outsmart them.

Saturdays are Ultimate Frisbee days.
And this particular Saturday was also a Crash C-Section Day too.
Val (pictured) and I took care of baby
while Momma was in excellent hands in the OR.

May!

I really love these people. 

This little guy hung out at the nurse's station for DAYS without moving.

Hiking up to killer views of the ocean

Gracias for keeping up with me!

Blood that saves

I was on call last weekend. We had a patient who had come in--unbeknownst to us, with cirrhosis of the liver and pancreatic cancer. All that we knew at the time was that he had gastrointestinal bleeding and he was losing blood faster than we could put into him.

At Loma de Luz, we have a "walking blood bank". By that, I mean we have a list of everyone's blood type on a piece of paper in the lab. When a patient comes in and needs a blood transfusion, we call the person who matches the blood type and they give their blood. All is well and happy, right?

It just so happens that I share the same blood type as our dear gentleman with the gastrointestinal bleeding. Around 12:30am last Sunday, I received a radio call from the nurse on shift saying my blood was needed. This is an unusual way for me to start my conversations at midnight, after being asleep for a couple of hours. However, between my sleepiness-induced slurrings and my brain trying to decipher another language after shutting that switch off hours ago, we somehow communicated. It was not a vampire calling me. It was a medical necessity. Got it. I left on my roommate's 4-wheeler and zipped down the hill (Yes, Grandma, cautiously, of course), ready with a liter of water, granola bars, and a book.

After tracking down the nurse (who was helping deliver a rosie-pink newborn, as I walked in), I made my way to the ER. The ER is our designated "blood donation collection area". Nolvia, one of our excellent lab techs, joins me, as well as Elsa, a magnificent nurse's aide.

I have this pre-existing thing where I feel like I'm going to pass out at random times: like when my coworkers talk about blood, or I watch an IV be put in someone's vein, or someone's hernia is being repaired surgically, or I'm being tested for allergies. Random.

I have a new one for my unintentionally elongating list: donating blood.

After almost making it to a whole unit of blood donated, the next thing I know my arm hurts and Nolvia is telling me to wake up. And that I'm green. And my lips are blue. And that I did a weird contracting of my arms thing as I passed out. I guess I should be thankful since there are worse colors to be--like mauve or highlighter yellow.

Apparently, I passed out. I felt great after--well, not like GREAT. But surprisingly well-rested. Nolvia, however, did not look so great or thrilled with my 60-second rest of heavenly bliss. She looked whiter than the bed sheet I was on, which I then realized was wet. Upon further questioning of my witnesses, it was explained to me Nolvia very kindly tried to help me drink from my bottle of water, when realizing Lizzie wasn't looking so great. Then The Incident occurred. With my apparent sudden contracting limbs and color change, the bottle went flying as Nolvia tried to remove the needle still present in my antecubital vein. I was just glad it was water.

Just as I was getting ready to go home--driving the 4-wheeler, no less--it starts torrentially down-pouring. I hang out at the nurse's station and try to read my book. Ha.

The time is now after 3am and Dr. Ryan, my temporary downstairs and extremely kind neighbor, who had been checking on his patient, offered to follow me home.

As comical as that night might seem to me now, its purpose was short-lived. I made it. Our patient, Mr. D, on the other hand, didn't fair as well. When I got that midnight radio call, I didn't expect to spend my week looking at a bruise on my arm, knowing it's lasted longer than our patient's life.

My blood couldn't save him, nor could the blood of his family members or the other staff & missionaries. Our patient went into surgery to have an exploratory procedure to see if they could figure out why he was bleeding. There the surgeons discovered the condition of his liver and the cancer consuming his body. His body was weak. He never recovered.
After surgery, Oscar, our hospital chaplain, was able to speak to Mr. D in his brief moments in and out of consciousness. Oscar asked if he knew his Savior. He did--confirmed by his wife, who stood faithfully and silently by his side, along with his grieving sons and daughters.

We've left this week with heavy hearts, knowing the loss and grief Mr. D's family is experiencing. However, we rejoice knowing he no longer suffers or has a tube down his throat or aching fevers or exhausting, sleepless nights. He can rest in God's presence eternally.
I've also left this week with a renewed appreciation of the blood Jesus shed for us--a price that I can never repay, but pray to reflect everyday.

Although my blood couldn't save our patient, I'm thankful Jesus Christ's blood can. I'm thankful Mr. D knew that too.

The one with a lot of pictures- July to November 2016

Instead of a lot of words, here are a lot of pictures. 

I mean, you're still stuck with words, because it's a blog. Whatever. Enjoy various snapshots of life outside the hospital!

July--

The Army of Ants outside of our apartment--coffee grounds are our deterrent.

If they can make it through the maze of coffee grounds, they may pass.

September--

September 15--Independence Day Student Parade

What's Independence Day without beautiful skirts and typical music?

Or ballerinas dancing to Survivor's Eye of the Tiger?

Bilingual School represent!

October--

Left to Right: Third wheel/ Birthday Girl/ Master Quinceanera Planner

Red House (Singles) Harvest Party

November--

When the road washes out and needs to be repaired. we wait.

La Ceiba Dock

Also a popular fishing spot

Sightseeing before the grocery shopping adventure begins

As the two youngest, Brenda and I designated this "our park".

Thanksgiving Prep with the roommate and the adopted little brother from up the hill.

Thanks for keeping up with me!

The Hebrew Herbal Guru from Kentucky

He called ahead like so many of our patients do. Some call from the city closest to us, La Ceiba, wondering if they can bring their ailing family member from the public hospital. They tell stories of how the doctors have told them there is no hope for their loved one—there’s nothing they can do. Some come from hours away to our hospital that they’ve heard about from a cousin of a friend of a neighbor of a grandmother’s friend’s sister. “Can you help us? Can we come?” 

They call ahead because we’re so far away from anywhere convenient for long-distance travelers. What an even greater discouragement to travel so far, only to be turned away. Unless it’s for something specific that we simply cannot offer (like an MRI, CT scan, neurologist, etc.), I rarely hear anyone be turned away. 

I was working at the nurse’s station on a Sunday. The phone rang. Surprisingly, an English-speaker called this time. The rock-star nursing assistant who was working with me that day, Elsa, answered the phone and tried to speak with the mystery caller. I overheard the usual: “I’m sick and I need help,” “people in La Ceiba say they can’t help me,” And “Can you help me? Can I come?” Dr. Peter, our Emergency Medicine doc, was standing there with us, writing new orders for a patient, and he and Elsa switched places at the phone. 

My exhaustion—emotional from a very full census the previous week and losing two patients, despite our best efforts; physical from a non-stop morning, from not having eaten in a while, from not having slept well the night before, and on and on my excuses go—screamed, “No! No more patients—we’re full! We can’t take care of more. I can’t take care of more.” 

However, I am so thankful that so many things are much bigger than I am--the Bad Attitude-Hypocritical-Self Righteous-Self Absorbed Lizzie. We discharged 4 patients in the next 3 hours, providing more than enough time and space for another person. 

That patient was really sick. After a conversation with Dr. Peter, he ended up at our doors, accompanied by his wife. The patient looked distraught, hopeless, defeated, and weary. He embodied how I felt that Sunday morning. After eating some food, drinking some water, praying for an attitude check and a better perspective, I stepped back into the chaos and finished my shift--the Second Chance-Forgiven-Redeemed Lizzie.

We admitted the patient that day and I returned the next day to work my shift. It was also a shift of locura—craziness, but not quite the mass chaos it was on Sunday. At one point, my Honduran coworker and fellow nurse (also named Elizabeth) told me she had tried to give a medication through one of our patient’s IVs and was unable. She asked me to look at it and see if his IV was still working. 

If we can stop right there and slightly happy dance together at the fact that my coworker deemed me competent enough in parenteral medication administration to evaluate a peripheral IV—a specific skill that was not a part of Lizzie Nelson’s competency toolbox 4 months, barely even 2 months ago. I’M LEARNING, GUYS! There sure are great teachers here and it seriously has taken a whole international village to teach this child. 

Enough rejoicing (for now). 

Normally, we refer to our patients by their first or middle names—or by “Newborn *Last Name* *Second Last Name*” (because almost everyone here has two last names or might go by their middle name). However, it occurred to me as I walked into the patient’s room, none of us nurses had really referred to this patient by his name. It was always, “El paciente norteamericano” or “El paciente en 4A”—our nothamerican patient or the patient in Room 4, Bed A. There were 3 names on his chart and we had no idea which to call him.

We're a predominantly Spanish-speaking hospital. So this particular patient, as sick as he was, would light up every time someone would speak to him in English. Our encounter was no different. I explained to him what I was there to do, asked how he was doing, and got my supplies ready to check out his IV. He was sitting on a chair at the foot of his bed, liver cancer and hepatitis C and all, patiently waiting for me. I brought a chair next to him and started talking to him. 

I’ve had a bad habit for the majority of my life of hearing people in conversations without the intention of listening. It’s as if I had been merely waiting on my turn to talk. This needs to end. So I asked questions, looked him in the eye (when I didn’t need to be looking at his veins), and closed my mouth. He told me about how he was feeling: the discomfort, the lack of energy, the diarrhea, the side effects of all the medications we were giving him—everything. He told me about where he was from—Kentucky and how he’s lived in Illinois. His eyes grew sad with regret when he spoke of his children, but lit up when I asked about his grandkids. We talked about central Illinois and how he ended up in Honduras. He talked about his interest in herbs and botany. We talked about his Hebrew faith and how he had been ordained to be a rabbi several years before. He told me about he had been mistreated because of his faith and how he had walked away from God. He told me how he had been hurt by some who had claimed the Christian faith. He expressed intrigue with the hospital, because he knew we were a Christian hospital and we seem to be living what we say we believe. We talked about that. We also talked about hope and God and how through this experience he had a desire to walk with God again and to seek out his purpose. 

 By this time, I had removed his old IV, successfully started a new one, given him his medicine, and hooked up his bag of IV fluids. We had covered a lot of ground in a short time, but I'm sure we could have kept talking for much, much longer. 
Before I walked out of the room, it dawned on me this was the same patient I had dreaded admitting on Sunday. If he never would have come, I would have missed out on the most sacred, life-giving conversation I had had all week. I listened to his heart, hurts, regrets, philosophy of life and religion, and his questions about God and redemption (and even tried to answer a few). What a privilege! This humble, sweet man, who kept apologizing for all the work he was causing us (which he had no clue how easy of a patient he ended up being), was so thankful for everything we did, as if he was somehow unworthy of such care. I’m more of the impression that I was unworthy of caring for him.

“Oh, by the way, what do you prefer to be called?” I asked, before opening the door.

“Well, my wife calls me Dawid—it’s Hebrew for David.” 

“Do you like that? 'Dawid'?”

The Second Chance-Restored-Hopeful Dawid smiled as he said, “Yeah, I do.”

I smiled back and said, “Okay. Thanks, Dawid.” And I meant it.

Learning the Things

I've been learning about REST when I'm thrust into busyness; WAITING on God's timing and purpose; DEEP BREATHS because oxygenation is good for you; LOTS OF PRAYING because I really don't have everything figured out; TRUST in knowing my Creator, who holds me in the palm of His hand, does have everything figured out; SIMPLICITY because the biggest lies are the ones I tell myself and breed ingratitude; THANKFULNESS in all things, in all times, especially the hard ones; ENCOURAGEMENT and how deeply out hearts need to give and receive it; PEACE when crippling loss is all around; and PATIENCE with myself and not jumping the gun when things don't come immediately that can only come in time. 

And here's a picture of a lake, because it reminds me of all those things. 

I can't believe I get to do this

Back in 2012, in the secluded practical nursing program corner at good ole Itasca Community College, 22 of us sat behind our desks and tried to follow our instructor's PowerPoints. Some days were easier than others. However, more than once, I'd zone out from the lecture as the reality of this whole situation hit me: I am in nursing school. I have the incredible opportunity to learn how to take care of people. Wow. I can't believe I get to learn this. I can't believe I'm here. I can't believe I get to do this. 

I was 16 when I was accepted into that practical nursing program. Between the moments of awe and surreal wonder, there were quite a few tears (or hysterical sobs), giggles, panic attacks, pep talks, and borderline mental breakdowns. I don't pretend to know the depths of my fellow classmates' lives or the hardships they've experienced, but I feel confident in saying that year was one of the hardest for all of us.The perpetual stress drove us forward and frazzled us at the same time.

And still, maybe it was God's grace for strength for one more day, while whispering into my head: I can't believe I get to do this.  

Fast-forward to age 21 and I'm still thinking the same thing. The setting has definitely changed more than once since that classroom at ICC. The wonder still hits even after the most chaotic of shifts--like my first night shift back after traveling to the States for 2 and a half weeks for a conference and a wedding. I'm not trained in Labor and Delivery or in the Emergency Room. I'm also still learning how to take care of the admitted patients. Wouldn't you know on that first 10-hour shift back with just 2 of us nurses: 9 admitted patients, 1 laboring mom, and 1 ER patient? By morning, we had 12 admitted patients. My excellent Honduran coworker had the misfortunes of working with not only someone who has only worked with one pediatric ICU patient since she's been at the hospital, but also lost her voice right before heading back to Honduras.

It could have easily been one of my worst shifts yet, but we chose to laugh instead. We were behind almost all night. In the rare moments that our paths would cross, we would laugh, say "Ya casi!" ("Almost there!") and then keep running to the next patient, the next medication, the next blood pressure. The shift eventually ended. As I walked home on the rickety bridge, it hit again: Wow. I can't believe I'm here. 

Some moments are no-brainers for those surreal feelings.
-When I sit on my hammock with a cup of coffee, listening to the howler monkeys, waking up after working a long night shift.
-When my roommate and I decide to go to the beach and end up taking 20 kids under the age 12--babies and all-- from the Children Center and their fabulous dorm parents. We splash and run away from the waves. We get buried in sand and drink all the water we brought.
-When I stand with the other missionaries as we sing in our hot little meeting room about how great our God is, how faithful He is, and how loving He is--after we had to re-intubate our patient for probably the third time.
-When my roommate agrees to walk all the way up to the water tower with me just catch the last glimpses of the sunset.

Water tower: Sunrise/sunset watching place of choice

For now, the next shift starts soon. The plethora of what I've been learning at the hospital would be overwhelming and extensive. So I'll leave a lighter list of non-medical things that I've had to learn.

-How to use a HAM radio
-How to use a French Press (my roommate received one as a housewarming gift, and very kindly lets me use it)
-How to enjoy cold showers
-How to light a non-automatic pilot gas stove and oven. (we just upgraded from matches to a long-handle lighter)
-How to get cobwebs out of toasters (still accepting suggestions on that one)

The real MVPs at Loma de Luz.
Eat those bugs, guys.

Favorite tree in bloom;
View from the back porch hammock

Thank you, WikiHow and multiple YouTube videos

Thank you for walking this journey with me! It's also so surreal to have people praying for me and partnering with me--thank you for being a part of all this!