Some time to reflect

If I have experienced or learned anything as I’ve tried to be vigilant about life and living life — there are times when you have to take some time to reflect.

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Honestly, I barely have had time — although there are times in my line of work that force you (or anyone) to pause. Today was one of those days. Those moments when you just have to speak to that quiet voice in your head to take a breath, to quietly be thankful for the good things and the challenging things to God.

Not everyone has those pause buttons — and sometimes when you have those pause buttons in life, you aren’t ready for them. So, occasionally take some time to be quiet and listen.

I will be moving back to Saipan again before the end of the month .. more to come on that! I cannot wait to continue to share my journey with you.

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The forgotten islands

As part of my day to day job currently, I not only take care of my own patients that come through my department, but also serve as a consultant to patients from other departments. Over the course of the year, this has brought me in contact with a majority of different types of patients that cross the doors of the hospital I work in.

In light of my time in Saipan, I am often provided information on the patient by the consulting physician that I may not have been before. He’s from American Samoa, her family is in Guam, they are from the U.S. Virgin Islands, etc. As you can imagine, the U.S. Pacific Island territories are not exactly well known.

It’s actually quite confusing so I cannot blame anyone… but here’s a bit by bit run down.

There used to be ‘incorporated organized territories‘ that belonged to the United States. I.e. Alaskan territory, Northwest territory, Hawaiian territory — that officially joined and are part of the United States at this point and what is referred to when you say the “United States.” They are under the constitution fully.

Then, there are unincorporated organized territories that fall under the constitution partially. They interact with the U.S. federal government under the Department of Insular Affairs. This department is under the Department of the Interior which is responsible for administering federal policy (and funds and federal assistance) to these territories. Being an ‘organized‘ territory means that they have an organized government with a territorial legislature and judicial system that is authorized by the U.S. Congress.

This includes Guam, Northern Marianas Islands (aka, what Saipan is part of), Puerto Rico and the U.S. Virgin Islands falls into play. When you are born here, you have the rights of a U.S. citizen.

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Then, there are the unincorporated unorganized territories which mean the same but they do not fit the ‘organized’ definition as of above.

This includes American Samoa. As American Samoa falls in this zone where they are do not have an official organized government (as would be acknowledged under the U.S. Congress), they have their own constitution but they still interact with the U.S. under the department of insular affairs. When born in American Samoa you are U.S. national (unless you have a parent that is a U.S. citizen).

Here’s a map of the U.S. outlying minor islands which are other unincorporated unorganized territories.

us minor outlying islandsRecently I read a brief chapter about the American Samoa national team to the World Cup and their disappointing game against the Australians. It reminded me of the struggles of a small island nation where things like nutritional resources, regulation size equipment or fields are non-existent.. and also reminded me of the opportunities they have to participate in international events. It is unfortunate that these major failures are what bring these small island communities into the limelight. I hope that these forgotten islands one day are highlighted because of the great things that they are doing.  I’m grateful to be able to share what I’ve learned about these places and all the good that is happening there.

I am glad that those patients got to the continental United States for further care, but also know that is not an opportunity afforded to all the people that live in these ‘forgotten islands.’ While I am back in Saipan, I plan to be looking into one of the basic tenets of childhood health (anemia or low blood count) to find out more about what can be done for this in these Pacific Island communities.

(Images from Wikipedia)

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Almost a different world

Well, that passed by fast! 12 full days and a few plane rides. I definitely have said that this wasn’t EXACTLY a vacation considering I was working full time at the hospital, spending time outdoors/active, visiting a few new restaurants (and some old haunts), all while working on figuring out how things are going to work with my fellowship research project. A friend of mine wondered how I adjusted so quickly to being back in Saipan on one of the first days back — I guess when you hit the ground running, you just adjust. In processing everything on my flight back home, I realized how very different my life in San Francisco is from my life in Saipan. Just different.

It’s a good reminder to try and appreciate every moment and find the best out of everything that you are a part of.

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(It’s all about perspective!)

I’m back in San Francisco and apparently have missed a week of sunshiney goodness here. It’s back to work after a big grocery run and an afternoon cooking session to prep for my next two weeks of work. I’ll try to update this occasionally but.. if history tells you about the future, this may lay dormant again for a little while.

Here are some pictures from my last few days though!

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A few sunset shots

Sunsets here are not easily forgotten so I was looking forward to seeing a few again. I am lucky to be able to watch the sun set occasionally so am happy to be able to snap a few photos when I can. I definitely believe in appreciating the little things in life whenever you can to maintain a little bit of balance in your life!

IMG_0560 IMG_0561 IMG_0571 IMG_0574 IMG_0588 IMG_0593 IMG_0594As you can see, the prepositioned ships are definitely still around (I think of them as part of the Saipan horizon) although when I initially came they were all out to sea because of the typhoon warning. The waters have calmed and the weather is back to its norm. I’m definitely losing some of my paleness by some of my outdoor sports time but am still being careful with sunscreen and sunglasses!

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If you have a few hours in Saipan…

I had a morning without an agenda and wanted to get some outdoor time in without adding to my overall exercise burden*.

*Side note: I have probably done more ‘exercise’ in the last 5 days than I have in the last 5 months. Between Crossfit classes, a morning run with friends, an ocean swim, and portions of a triathlon that I did this morning, I definitely have upped my exercise quota!

So, with a rental car at my disposal, I drove up to the north side of the island for some picture taking (and ocean staring). It turns out I also got to do a little bit of tourist watching since there was a surprising number of tour groups at these locations. It was surprising not because these are not tourist locales, but because it has been good to see that the tourist industry seems alive and well.

When you drive north, you end up on the one road that goes north which is an extension of what is known as ‘Middle Road’. You pass a few villages and end up in a less densely populated area known as Marpi. Here, the electricity poles disappear (thanks to Friends of Marpi) and the traffic thins on the two lane road. (This is all relative, there is no traffic here anyway). Here, there are fairly well marked signs to the tourists destinations.

First on my list is my favorite place to go, Banzai Cliff.

IMG_1041Here you are at the top of the island with ocean ahead of you (and very occasionally apparently if the weather is perfect you can catch a glimpse of some of the Northern islands). Dolphins and whales have been spotted here before too if you’re lucky!

IMG_1033I love this place because it is usually quite and in the shadow of the northern cliffs (including Suicide Cliff) of Saipan. There are scattered memorials to those civilians that lost their lives in what was a horrific event during World War II as the U.S. troops advanced northwards and civilians (Japanese mostly) feared for the conditions they would be placed in because of propaganda and threw themselves off the cliffs with their children in tow. That part is horrible, but there are many memorials around reminding people of the need for peace and the casualties of war.

IMG_1034There is a small platform and you look out over the blue waters.

IMG_1049To the left, you can see the waters crashing onto the cliffs below.

IMG_1050From there, I drove to the Grotto by returning back to the main road and following the signs around the top of the island. The Grotto is a popular dive spot and you will always see tourists groups there with snorkels and dive gear. It was particularly rough when I went so I definitely did not plan to go into the water.

IMG_1051Here are some views from above to the cave/Grotto below. There is an underwater connection to the ocean so the light streaming in makes it a sight to see.

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Here’s a view from the platform above (and a papaya tree!) IMG_1054You can probably barely make out the hole below with the water. If you look really really closely you can see a guy in the lower right hand cave portion of the picture — a tourguide.

And then from there I went to Bird Island — probably the most photographed place in Saipan — and for good reason!

IMG_1058 IMG_1059The sun was out so you could see the aquamarine of the shallow waters. If you know the back Bird Island hike to that secluded beach you have access to some of the coolest snorkeling I have ever done (as well as easy access to the island when the tide is low). Be careful when the tide is high and I’ve been told not to try to circle the island because of dangerous rogue waves.

From there, I then drove just up the hill to Suicide Cliff. I used to do this as a run …. but my exercise level has been maxed as I mentioned above but, it is an easy drive with paved road all the way up.

IMG_1068Here’s the view from above looking down on Banzai Cliff and what is now the Veterans cemetery.

All in all, a quick way to get views of some of the most breathtaking portions of Saipan in a short period of time. I did feel ridiculously touristy by going to all these places, but I guess if you are here as a true tourist then you should at least make an effort to see these places. Considering they are all so close together, it can be done in a half days’ time.

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Photo dump

I worked the early part of this week and have been adjusting to being back in Saipan. A new addition they have added is an electronic health record! While it will take me more than these two weeks to get really familiar with this system, it is similar to the VA system used in the United States that I used while I was in medical school in Texas. It will partially counteract my slowly deteriorating handwriting that occurs throughout the day when you find yourself writing so much. It did hamper my efficiency though but I am sure it will enhance it once I learn the system well. All part of keeping up with the times! It will also be helpful in the future to be able to look at everyone’ s medical records easily rather than waiting for someone (or me) to walk down to the medical records department and shuffle through stacks and stacks of folders.

In between work, I have been able to meet up with old friends. I also am trying to get as much vitamin D as possible! By far the number one comment is… you are WHITE! (A casualty of being in the foggy area of San Francisco and being indoors for most sunlight hours!) I try to take 5 minute sidetracks in order to visit some old parks and places I used to run or hang out since I won’t be able to go everywhere during this trip.

I have gone back to using my Canon powershot in addition to my iPhone though for pictures so was able to snap a few pictures. When I plugged it in, I realized I haven’t uploaded pictures from my camera in awhile! Here’s some recent photos to share! I hope to take some more pictures this weekend and will keep you updated.

I am off of work the next two days and will be running and swimming (eek!) in a triathlon (I’m skipping the bike portion). It will be good to be back among all the athletes although there may be a disaster story to tell at the end of it!

Sunset from my apartment on the West Coast

Sunset from my apartment on the West Coast

Muir Woods hike

Muir Woods hike

Pau Pau Beach

Pau Pau Beach

Managaha Island... reminiscing my long swim from there

Managaha Island… reminiscing my long swim from there

Windy days post-recent typhoon make for great wind-surfing apparently!

Windy days post-recent typhoon make for great wind-surfing apparently!

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Back in the saddle.. kind of

So, it’s been a little over 36 hours here in Saipan after a long plane ride with multiple layovers, and I can confidently say that it feels (as one of my nurses said) “like you just took a long vacation and are now back.” Besides the fact that I am horribly out of shape and very pale, it does seem like I’m back where I have been comfortable before.

It’s been a packed day and half though.. I woke up after a catnap and a shower to go to clinic where I saw scheduled and walk-in patients and learned a little about the new electronic health record they implemented while I was out. During my lunch hour, I went to pick up my rental car and a phone card and saw one of my former patients and his mom which was such a joy. We had a good time just catching up. It was a nice surprise and a reminder that the world (or island) is a small place. In the evening in order to keep my slightly jetlagged self awake, I went to GetFitCNMI (my CrossFit gym) that has been totally revamped with so many new members to meet. This is where it became clear entirely how out of shape I really am compared to how I was last summer and how pasty white I am after all these days in the hospital/living in a cloud of fog. But, good for all these people who are getting fit and looking great there!

Today was my first day working in the hospital and there were a few more complicated patients so I had no choice but to jump right in. I spoke with families in Mandarin again, did medical referrals, provided phone consultation, and did all the other normal things I used to do. Besides taking a bit of time to figure out the electronic health record since i haven’t yet quite customized it to make things easier for me, it was just fun to meet with all the nurses, doctors, pharmacists, and other support staff again and just catch up. They were so welcoming and glad to have me back. I can tell you it felt like a warm reunion hug all day!

When I came, i kind of brought a typhoon with me although it has veered off and hasn’t really affected the islands much except for high winds and some rain and clouds the first day I was here. It has since cleared up so on the way home I knew I had to stop for a quick snap of the sunset and boats out on the water.

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In addition, had to stop by Vegetables Plus, my friendly veggie/fruit stand to pick up some goodies (and fresh coconut water).

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And then, after picking up some groceries, caught the sky turning pink with a glimpse of the moon.

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These two weeks are going to fly by fast. Here’s to trying to soak up every minute!

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