Life Back in Saipan Part Four

Back to our regularly scheduled programming…

Today I was at a meeting where we were discussing the welcome of new medical staff to the island. It brought me back to when I first arrived myself. In particular we were bringing up the experience of running errands in Saipan and how foreign that could be.

It so happened after my morning meeting, I myself had a day of errands so I paid close attention to the differences I noted.

1) Places aren’t exactly easy to find.

I probably fall into the category now where I just can describe where things are in Saipan but .. I can still see where directions can appear as quite the enigma for a newcomer. I clearly remember the first day I arrived, I went in search of one of the cell phone companies and after a lot of different questions about the location … the person blurted out, “you must know! just past the McDonald’s.” Thinking about that now it is VERY clear where that means but to a new person on island, that means nothing. It does not help that there are only about two or three major road ways — Middle Road, Beach Road, ?Back Island Road — and none of them are really labeled that way. I cannot even remember the real names! I think Middle Road is Chalan Monsignor Guerrero.. I think. (Most people reading this would say.. Chalan what?! I see why you call that Middle Road) As you can imagine, this makes it very difficult for someone to find a place. You cannot follow street names and there is a need to know all the major landmarks.

2) And then when you get there, it may not appear as you may think.

One of my errands was to drop off something for an incoming physician at the Medical Licensing Department. Sounds super official, right? Perhaps a description of where it is may be “On Capitol Hill, amongst the government buildings, turn right at the Medicaid building and you’ll see it there.” Well…. so you perhaps drive up Capitol Hill with trepidation with those directions and you find … this

photo 1Perhaps not as you would expect. It’s basically a little house on a hill. But, check out the view!

photo 2This applies for stores too. In general, people will tell you to go to a great restaurant or a must-see store and you expect a place with a flashy storefront. More than likely it will not stand out. There may be a sign over the door but most times it won’t be clear from the road unless you are really looking for it. Once you’ve been there once or twice, you will start using that place as a navigation point for other people — which only perpetuates the problem!

3) Knowing people comes with the territory.

I guess this comes with living in a small place. I NEVER would small talk with a store owner, restaurant chef, waitress, hairdresser, etc. I just historically have not been a person who likes to chat. (This comes up in my life at clothing stores especially. I almost get offended when salespersons try to help me at a store! It’s a bad trait of mine! I just would rather browse in quiet instead of someone running over as soon as I touch anything)

Back to the subject at hand though.. Here it is not uncommon that you will visit a place on the recommendation of a friend who happens to know someone who works there. For example today, I went to a store that I had never been in and asked for two people by name as I was looking at some bikes. That is pretty normal here and people offer great service. They remember your name if you refer people to them. If you’ve been here long enough, people will know who you are. The mere fact that people recognize you and perhaps will call you by name makes it feel like you are a close friend and special customer. (It also doesn’t hurt that I am a doctor so … that kind of gives you a certain level of fame I guess)

At the bank and recently when I was at my car insurance company, I walk in and they know exactly who I am — can anticipate the questions I may have, and may have already addressed it! Sometimes I still say my name out loud just because it seems too weird to me that they truly know who I am.

On the flip side, it has changed me. It has made me more open to talking with new people, looking them in the eye and shaking their hand — and taking a moment to hear a little bit of their story. I was just thinking today about how Saipan keeps me humble and keeps me generous. When I walked into a brand new store today and did not know the owner sitting in the corner, I introduced myself and we chatted for a few minutes. It was nice!

4) Things happen better in person.

I guess this follows from the prior statement. When I need to get anything done here, I do it in person. Today while I was at Capitol Hill, I wanted to check up on the status of my health insurance so went to another government building. I could have tried to call but I almost can guarantee that I would have gotten connected to the wrong person and never would have gotten my answer. I happened to be close by and a quick wait got me directly to the person I wanted to talk to and immediately got me access to the information I needed. If I hadn’t done this, I might have waited on an answer for about a month. This is just how things work on island time. Things need to get routed from one place to the other for official signatures and… everything just moves a little bit more slowly. While the rest of the world (okay, not the rest of the world.. just some parts) operates on immediate email responses, 100% connectivity with the answer to everything on the Internet — it is not so here. Do you want to know how to get ahold of a restaurant to make a reservation? It’s probably not in the internet.. use the phone book. Do you have a question about something? it’s better to just go there and ask them. You get the drift.

5) Keep your expectations low.

This is part of island life and you just have to roll with it. While there may have been an item at a store or a service available at one point, it does not mean that it is always available. This does make for some “hoarding” on island. I have seen a few Facebook posts about the presence of X product at a store — followed by comments that say, “Not anymore, person Y bought all of them.” I drove to a large store today to look for a certain type of grab-and-go food bar that I like. Nope, there weren’t any on the shelves. I remember the first few times this happened to me. I looked all over the store and even thought I had forgotten and gone to the wrong store! You just have to get used to not all stores having the exact same merchandise all the time. (And I do participate slightly in the ‘hoarding’… when I see something non-perishable I know I like, I perhaps… join in and buy a few more packages than necessary) Haha!

That’s about all I thought of on my day of errands today. These are some good things and bad things about Saipan life, but it’s important to see the glass half full.

photo(Speaking of which… a picture of a rainbow after a morning run yesterday as I got into my car to go to work)

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Another Transport Story Part Two

So, take two! (See part one here) It was time to depart again and this time, I triple checked with as many sources as possible that the flight was going to leave (this still was no guarantee).

I won’t bore you with the repeat story but basically we repeated what was done the night before and arrived in time for the flight. The flight was delayed about two hours which gave us some time to charge up the batteries (as you can tell, this is ALWAYS something on my mind during transports).

The new flight plan had originally allowed us a 7 hour layover in Guam so we were going to leave the hospital for a quick refresher (and charge of batteries) to a nearby hotel from the airport but with the flight delay we had to scrap that and planned to stay the couple hours in the Guam airport. They gave us some food vouchers at least so we were able to get some food and some coffee to keep us going.

One of the things I enjoy about transports is that you can really get to know the family. When you are in close quarters for so long, it’s just a natural side effect. This particular family really reminded me to cultivate my gratitude. The patient was traveling with the one person in the family with a passport, who happens to be the maternal grandmother. When asked about having a passport, I found out it was only for a one time trip to Guam. That was the only time she had been on an airplane a few years ago and has never been outside of Saipan prior to that. I realized how much I was asking — not just of the sick child, but of the sacrifice this family was making. This family member was bravely following us literally halfway around the world in completely uncharted territory. She didn’t know what to expect and probably had never heard of San Diego before (just like I hadn’t heard of Saipan before). What would lie there for her was unknown — while I prepared them for a long stay — I didn’t even think to mention what it would be like to live there, what she would have to do for food, etc (don’t worry, this is mostly all taken care of!) After talking for awhile and getting to know each other, the questions started coming out like — how would she communicate with her family? (She doesn’t have a cell phone and had no idea how that would work from the States)

This was such a good reminder to me about why I am doing what I am doing now. These people don’t have the resources necessarily but many of those we can provide. Support and help is available and our job is to make sure it goes to the right people and affects change. This babies’ world was forever changed when he was born — but so will his families’ for more reasons than just his medical issue. This reminded me about the joys of living here and realizing how fortunate I am to be able to practice generosity routinely here. Small things like getting an expensive coffee and delicious croissant on a layover or buying some food on the plane are NOT really a big deal in the grand scheme of things — but make a big difference in the moment.

Alright, that was a digression — but an important one. While I have spent the last few posts talking about the things that I enjoy about Saipan, I don’t want to ever forget the main reason I am here!

Next up after the long layover (with opportunity to charge batteries) in Guam, a flight to Honolulu. It is important to remember that when you travel with a birth certificate, you cannot transit through an international location. I never knew this until I did these transports. While it would have been easier to do direct flights to somewhere in Asia and then the West Coast, this would not work for this baby. So instead, we go for short flights across the ocean. This does have the benefit of allowing us times off the plane to recharge and regroup (our batteries and our sanity!).

Screen Shot 2014-08-16 at 9.41.23 PMHere’s us on the wheelchair provided to us during the layover. We let the baby stretch out and take them out of car seat (makes diaper changes easier too) and, of course, recharge our medicine pumps.

On the flight, we take turns taking care of the baby although sometimes we have to work together to get things done. You can only maximally just wish things remain stable, which in this case they did.. and also hope that your batteries don’t run out. One day, we will be on planes that come equipped with plugs and our lives will be SO much better (I know these exist, but for some reason they never exist on the flights I have been on).

There are benefits to staying awake during most of the flight.. including these kinds of views of sunrise from your plane window.

photo 1(1)Gorgeous!

The flight from Honolulu to stateside was also delayed unfortunately so our Guam stay was a bit longer. The problem with the delay was that we didn’t know about the delay until we were in the plane so the time on the tarmac was more time that our batteries were running without charge. Fortunately we had a back-up and about 2/3 the way through the flight, I switched over and there was no blip in anything.

Unfortunately we had to take another connecting flight when we reached the States to get to our destination so that added another bend.. Not only that, but when you land on continental U.S. soil but are transiting, you still have to go through customs! This made the layover super short since we weren’t able to just sit somewhere and rest and recharge. In addition, all the hauling from one place to another is difficult. We look for nice wheelchair operators at the airport because technically you are not supposed to put a carseat in a wheelchair (because you cannot secure it), but not being able to put the carseat in a wheelchair means that someone has to have the sole job of carrying the baby (usually me) and that carseat gets HEAVY!

It also means that the other team members (and often we have to enlist the help of the family member) have to help carry some of our equipment.

photo 3Here’s a portion of the equipment.. an oxygen concentrator if we needed oxygen on the flight and a bag full of emergency medications and tools.

Finally, after being at 5 airports and boarding 4 flights, we arrived at our destination city. Whew! This is the point that I splash some water on my face because I have to look less tired and be coherent for the patient handoff at the hospital.

photo 2(1)Here we are at the receiving airport where an ambulance came to get us. You can see the fancy equipment and laptop they have!

We then take another ambulance ride to the receiving hospital and arrive at the patient’s room.

photo 3(1)Here you can see the spacious room with the receiving nurses in the background getting the baby settled into its new temporary home. I then wait for the receiving doctors and hand over all the information I have about the baby as well as all the paperwork. This always feels a little anticlimactic. I’ve been on the receiving end of this type of information before at the large institutions that I have worked at — so I know that while they listen to me, they will probably repeat a lot of tests and reassess the situation. But, the more information I can provide the better — and usually I learn a little bit from the situation because I get to talk directly to the specialists that are going to taking care of the baby. They are always surprised by how many hours I have been traveling and what it took to get the child here. I always have been very appreciative of the respect they give me as the physician ‘out there’ in the world coming to their institution. That has been always really quite nice.

It is rather anticlimactic still because within usually a span of about 30 minutes to an hour, we’ve talked about everything that needs to be talked about, I’ve said my goodbyes to the family member and patient and made sure they are put in good hands, and then.. I make the trip home. Sometimes the flight schedule is such that you leave immediately and sometimes you stay a night locally. This time, I was flying out a few hours later so I hoped back on the ambulance for a courtesy ride back to the airport. There, I slept for the whole time until my connecting flight. Then… a lot of hops, skips, and jumps later that all blur into a long night of sleep (and some work on my computer), I’m back in Saipan again!

The length of travel always takes a toll on me, but it is part of the rewarding part of my job. I get occasional updates on how the patient is doing at the institution which is always good to hear as well. This time, in light of all the time differences, traveling back to Saipan made me skip one whole calendar day — and it happened to be my dad’s birthday! Oops!

I think I’ll just try to stick to one time zone for now :) but I’m sure more adventures will be coming.

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Another Transport Story Part One

I interrupt the regularly scheduled “Back in Saipan” series for another transport story. Basically, I plan to sum up my last 5 days. In sum, I was either in an airport or riding an airplane! Joy! (Actually, it truly is a joy.. stay tuned for more).

If you want to know the basics of what it means for me to do a patient transport, see this very informative post. There are so many things to prepare for and so many contingencies to be aware of. While this is part of what I enjoy about transports (thinking on your feet, etc) it can make for a stressful many hours of your life.

Earlier this week, we finally settled that a baby who needed to be transported off island was going to go to the mainland for a needed surgical procedure. The schedule was worked out for me to travel with the baby with a team including a nurse and respiratory therapist. This trip was a little bit less stressful because the infant did not require extra oxygen or me (or someone) constantly breathing for them. This means we can take our hands off the baby for a number of minutes at a time!

Here’s the play-by-play!

The time came and .. even more than most plane rides .. getting to the airport early is important. Besides getting in early to check-in, checking in with a baby who is traveling with a slightly unconventional form of ID (birth certificate) and traveling with an extra number of bags with lots of stuff which may be considered not-so-TSA-friendly all lead to a long process.

I had prepared the medications in advance and briefed my team on how things would go and what contingencies I had planned for. We carefully bundled the baby in its carseat (we do not have incubators to carry the babies in.. they just have to go in a carseat and we have to bundle them well) and some members of his family said their goodbyes and whispered their best wishes.

photo 1The first step is to go from the carseat from the hospital area onto a stretcher — and with each step you need to make sure the patient is secure and all of the medicines or lines or tubes that are attached are safely secured as well! Here we are pushing our way out with the emergency medical crew to our local Saipan ambulance.

Out the door to the ambulance. Of course, since flights into and out of Saipan seemingly can never leave at normal people times.. it is in the middle of the night right now.

photo 2 To the airport we go on a short ambulance ride. I’m a little scared to find out how much the ambulance ride actually costs, but I’m sure a lot.

Then, it comes the fun part. Check-in.. dum dum dummm! Usually we sit in a corner with the patient and the one family member who is allowed to travel with the patient while one of us takes all of our documents to the counter. We wait while they process our paperwork — which always seems to take much longer than a normal person. Finally, we usually get escorted by the airport police past the security line to the front of the line. Of course, by this point everyone is staring at you. I don’t know why that bothers me so much because I know that if I was the one watching even though I know what’s happening.. I would stare too!

Security is a WHOLE new beast. And you thought taking off your shoes was annoying. Usually one of us goes through to the other side directly with the patient while the others go through the normal screening process. That someone is generally me. I subsequently get a full body pat-down and usually have multiple swipes of the ?drug-detector machine on my hands and body. The patient has a whole other level of security. Usually they cannot safely be removed from the carseat at that time so the TSA representatives have to gingerly look through every part of the car seat as well as do as much as they can do pat-down the patient. It is for the safety of everyone, but sometimes I wonder how effective the pat-down of a baby in a carseat with multiple lines and tubes on them is. Regardless, we get screened.

In the meantime, another team member is usually going through the long process of explaining all of the medications (a ton of liquids obviously not in zip-lock bags and not less than 2 oz or whatever the limit is) and getting those thoroughly checked. You can imagine this takes a bit of time.

And then, we finally get through to the gate area. By this time, we are already tired and we have already sucked some life out of our batteries so we take the time (if we have any) to recharge.

photo 4We generally are able to find a place with a set of plugs — or people are accommodating.

And then…….. after all that and as you wait patiently for your flight, you find out your flight is cancelled.

This means not only is your flight cancelled, but you will not make any of your connecting flights! The frantic phone calls begin to get your flight plan rescheduled, to inform the receiving doctors at the other institution, to call back to the hospital to re-prepare the patient’s bed, to try to get the ambulance to come back to get you… Haha, good thing for cell phones I say.

You do the whole process in reverse and tuck the patient into their hospital location again. You re-write for all the medications which will likely be expired by the time you leave again and hope that the critical patient you are traveling with is able to travel as soon as possible.

At this time, I went home and literally laid down and fell asleep so fast that I don’t remember falling asleep! (When I woke up the next morning, I didn’t think my tiredness boded well for my repeat trip of 24+ hr plans).

More to come on the successful second half of this story soon! Stay tuned!

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Life Back in Saipan Part Three

One of the other big changes to being back here is my amount of exercise and outdoor time. This I have alluded to many times in the past and is not necessarily a function of being in Saipan — mostly about the people I have the privilege of being around here. One of the first questions I had back at work at the hospital was — are you still running? when’s your next event? It just goes to show you how much a part of my life it became while I was here.

It wasn’t like I completely became a couch potato back in the States but I did have less time and less easy access to physical activity. One of the reasons it is so easy for me to get exercise done here is that it is just a hop, skip and a jump away from wherever you may live on the island. Like all things in life that become habit, you still do have to work on making it a habit in the beginning — but once it becomes habit, it is part of your daily routine.

There are generally three components to the things I do here.

1) CrossFit

Screen Shot 2014-08-11 at 3.58.19 PMPer wikipedia, it is “Promoted as both a physical exercise philosophy and also as a competitive fitness sport, CrossFit workouts incorporate elements from high-intensity interval training, olympic weightlifting, plyometrics, powerlifting, gymnastics, girevoy sport, calisthenics, strongman and other exercises.”

(Side note: Girevoy sport? I had to look that one up. It basically is kettlebell lifting!)

Back when I was here prior, I was looking to cross train a bit and join a gym. There really are just two choices on island — Gold’s Gym or this newly formed gym called “GetFitCNMI“. I ended up choosing CrossFit for the novelty of having what I call a ‘group personal trainer’ with scheduled classes and workouts or WODs (workout of the days). Not only was it extremely difficult and pushed me beyond my limits, but it also came with a wonderful community of people and coaches and emphasized the ability to modify every technique to one’s level. This made the workouts within reach for mere mortals ;) and gave you goals to look forwards to.

I’m glad to see the gym here flourishing and now moved into a bigger space. While I have not been back yet for very long, I already have visited a number of times and look forward to more.

2) Swimming

Screen Shot 2014-08-11 at 4.08.49 PMWell, I am living on an island, right? When surrounded by water, use it! There are a few places I swim — although I don’t swim nearly enough and hope to make a consistent go of it. The water is always relatively warm and there is something about swimming and concentrating on breathing and nothing else that is relaxing but a good workout all rolled into one. Because of my erratic schedule, this is the hardest thing to plan but hopefully I will be participating more. I may not be swimming from Managaha again though this year… haha, we’ll see.

3) Running

Running has been a staple since my time as a pediatrician in training. It is always easy to do at any time and can be adjusted to your schedule easily. There are plenty of places to run here and having a few fellow runners doesn’t hurt. It makes it so I definitely get out and it’s nice to have company. This past Saturday, I actually went to a track and did a little track workout. Well… right now my running is more like barely-more-than-walking and I have a long ways to go before I can truly say I’m running again but slowly I’ll get back to it. Hopefully I will post some of my routes again via my Garmin watch.

Stay tuned for more about life back in Saipan. (and p.s. maybe a break in the posts to talk about an upcoming patient transport I have ahead of me)

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Life Back in Saipan Part Two

Part of being back in Saipan means that my diet has changed. I actually didn’t think about this at all prior to moving back although in general, I did realize that I would be “healthier.” Most of the time when I thought about my slightly healthier lifestyle, I thought about it as increasing the amount of exercise (which I will write about in another post). But, in fact part of being back here means a healthier lifestyle because of the foods I eat.

First of all, the shear fact that it is warmer outside and I am exercising a lot means that I am drinking a lot of water. It is possible that because I have to purchase my water (what comes out of the tap is potable but not drinkable because of the very high mineral content), I am more aware of how much water I am drinking. I look forward to moving into a place of my own because I will be able to get a large 5 gallon water bottle for my water supply rather than buying a couple liters from the grocery.

Secondly, while I could eat at restaurants here for relatively cheap, I do try to cook and have healthy fresh snacks available. The convenient snacks of the States may be available here but are generally pricier and it seems what makes it here is not the best for you anyway — i.e. You will always find Pringles on island! (not to mention Spam). This is facilitated by easy fruit and veggie markets. On Tuesday, Thursdays and Saturdays there are street markets (although Thursday is mostly tourist friendly and has 90% prepared foods) which adds to the variety.

This Saturday morning, I stopped by the Saturday morning ‘Sabalu market’ after a track running session so.. here’s a taste!

photo 1There are a number of tables of local fruits and vegetables. Mainly they are the same and they change based on the season, but you know they are fresh and, just like some Farmer’s markets in the States, you can buy a lot of stuff for a few bucks. From the stand picture above, I got some fresh bamboo shoots and some kang kong (water spinach, or as I know it in Chinese… 空心菜 (kōngxīncài) for a dollar each. photo 3Here’s a picture of a portion of the stands. I went earlier in the morning so there was still shade. Occasionally there used to be shrimp and today I saw a fisherman selling fresh tilapia.

photo 2There is always fresh coconut ready for a sip, pineapple, papaya and more.

Most of these markets offer also an opportunity for locals to share their local talents. (This is most on display on Thursday nights with various local groups performing) I’ve taken a video of some island music that accompanied my Saturday market shopping experience!

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Life Back in Saipan Part One

I have been noticing so many things both the same and different as I have started re-assimilating back into life here in Saipan so I figured I would separate it out into different blog posts. I have been busy here mostly getting back into exercise activities as well as jumping right into work and some of the administrative parts of my position.

One of the things that immediately reminds me that I’m back in Saipan is the sky, the blues, the sunsets so this post is devoted to those. It has been relatively cloudy for Saipan over the last few days with on and off quick showers and a downpour or two at night. I was expecting very hot and humid (not necessarily because the temperature here is so high, but just that I have lived in perpetual 50-60 degree foggy weather for a year) but surprisingly it has not been that bad. I vaguely remember my first attempt at a run outdoors here in Saipan and feeling like every pore in my body was “poring” out sweat and while I’ve definitely been sweaty and had my share of showers — it hasn’t been that bad.

As usual, let’s let the pictures speak for themselves.

beautiful beach road bluesThis picture above will probably become one of my favorites. I snapped it off of Beach Road on one of my first days here when the sun was bright so the blues of the lagoon on the west side of the island were gorgeous. I literally was running an errand but had to snap a picture with my iPhone and this was the result!

beach roda saipanStill beautiful and along the same Beach Road path but you can see the difference the lighting can make if there are some partial clouds or less shade that change the color of the water.

sunset saipan Here was sunset from a friend’s house overlooking the main part of the island known as Garapan. You can see the silhouettes of the hotels in this picture. The clearing under the clouds made for a very visible sun-setting.

sunset Here’s a picture from Garapan on a different night looking out at the sunset as well.

photo 3Not to worry.. you don’t have to be around for all the sunsets to catch the prettiness of it all. Here’s the view of Managaha (the island within the lagoon) from the balcony of a potential apartment that I may be moving to.

Life back in Saipan can be challenging/busy/different/etc but in the spirit of being grateful, I try to remember to appreciate things like the beauty it provides. Will share more things I’ve been noticing soon!

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Saipan happenings

It honestly feels (besides having two open suitcases with my clothes in them next to me) like I’m back doing what I was doing now just a year ago as if not much changed. There have been changes though!!
– getting back into exercise has been good but needs to be a conscious effort. So far I’ve swam, went running, and went to CrossFit and did a bit of what I could do which has been good, but tiring!
– there is a solidified electronic medical record at the hospital so I can effectively type notes, get lab results, put in orders, and.. in general, the system seems pretty sound and seems to be getting the job done. It is still paper records in the outpatient (i.e. in our clinics where people come for scheduled appointments) but they are going to move over to electronic soon.
– i have a new car, a bright, cute ‘lipstick red’ Mazda2. I had a lot of trouble with my used car that I had last time on island and in the end, a car with a warranty in a place that things rust out quickly would make my life easier and would be a worthy re-sale later on down the road. Having reliable air conditioning in the car has been a definite nice change.
– there are a few new shops and restaurants (and coffee shops) around that I’ll have to explore over time but that makes for some nice changes as well
– relatively new, fairly reliable 3G/4G cell phone service. So much for not being connected all the time while moving back here!! I’m still relatively attached to my email. While there are drawbacks to it, it does feel a bit more like home and hopefully will allow me to keep some more connected.

- This is for the worse for sure.. there are local elections coming up in November and there are signs EVERYWHERE for the candidates. This definitely makes for an eyesore and honestly the sheer number of them make it impossible for me to even have an eye out for one. It’s weird to me because they advertise all over with signs, but then when it comes to their platforms or what their politics are, it’s so uncertain to me. Much must be decided based on their last names and who they know or maybe private events that I just don’t happen to attend. Ideally the elections would go more than just what’s on the signs I hope! (and that some day they will put some regulations on how many signs can go up and where.. I’m sure the tourists think it’s weird too!)

I haven’t had that much time to explore again, but will start again once I get a lot of the paperwork and settling in done. I have a temporary place to stay but am on the lookout for a nice place to settle in after my temporary place is up. Once I get that, I’ll have a little more stability and will post more pictures. There is still a learning curve at work as well and soon I will have to start thinking more seriously about my research as well. I still really enjoy the people I work with and look forward to it.

There are some things that haven’t changed though too!!
– The wonderful sunsets — although I haven’t been able to capture one (yet!). It’s been slightly more cloudy these few days as there are some typhoons brewing in this area of the world so some rain and clouds.
– Fresh food that is locally grown. While not the sweetest or best quality, nothing is certified ‘organic’ here that is grown locally.. but it is. I’ve had some great pineapple already, some guava, and drank fresh coconut water again already. There definitely are not so good imported fruit, but you just have to know how to be choosy.
– Position ships. These ships out in the distance that are supplied for .. well, who knows what.. continue to loom just outside of the reef here in the waters of Saipan. I know it’s part of what keeps the economy of Saipan going and is part of US’s line of defense but it’s still strange to see them there on the horizon. But, it’s a totally ‘Saipan’ part of the sunset and view.

In other news, I may be going on a transport back to the continental United States late this week or early next week for a baby so will post more about what that’s like too!

Welcome back to Saipan! Still very very grateful for being able to be here and do the work I do here in my current situation. I’ve seen some patients I knew and was close to from before, and going into some familiar stores I’m greeted again with the familiar ‘Hi Doc’ followed closely by ‘it’s good to have you back’ which I cannot be more grateful for. It’s nice to know you are remembered and they are happy to have you back. It’s a small world here!

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