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