Life is Change

Greetings from Bhutan! We made it!

Life is change, or change is life, or maybe a little bit of both. Been in IT too long, and did a gap analysis, the gap being between last December and now:

Bangkok and flights: We had an uneventful journey from Portland to Bangkok. I had expected to see more evidence of water damage (we were pretty close to a canal), but the only thing I saw were some sandbags that had not been cleared away and more debris on the street than last year.  Alas, we met no dignitaries on the plane this time.

In and around the apartment: The apartment is, well, the apartment. There have been a few changes here and there—some changes in drapes and electrical appliances, but the dogs are there, the wet road is there, and the hemp still grows at the side of the road. No more combination lock.

Around town: .  It has been fairly warm the last couple of days. (Global warming?   Nah, no such thing. Just a bunch of scientists looking for funding and attention.) To my mind’s eye, there are fewer young people wearing traditional dress.  Everyone around town is displaying a picture of the royal couple; the marriage was only 6 weeks ago or so. In the pictures, the queen is an absolutely striking woman. The infamous “shortcut” down to the main town has been closed (pooh!). There is extensive construction everywhere.

Hospital: About 50-50 new nurses vs. those there last year. Didn’t see any of the docs yet. Two of the nurses went off to Singapore for 2 months for an intensive critical care nursing course. In addition to chart dividers, there are now some simple vent bundles, instructions for sterile suctioning of ET tubes, better equipment stocks; I am really pleased.  They are such nice people—genuinely glad  to see me again, and I was equally happy to see them. Patients at this point are quite interesting and will warrant more discussion—a 14 year old with a massive stroke almost assuredly from a rheumatically damaged mitral valve—sterile or septic? Not sure, only did one blood culture. A very unfortunate man with AML and pulmonary infection—the AML was identified as a consequence of the pulmonary infection—he’s getting stabilized before being sent to India for induction chemo. Finally, a woman with a global depression of mental status that is improving; probably a viral meningitis or encephalitis, but it’s hard to say without CSF analysis.

Me: Left leg is NOT happy on these hills. Apparently 30 minutes a day on a treadmill at a 12% grade, 4 mph is not the same as walking the streets of Thimphu. Hopefully this will get better. As Eileen said, this is exactly the exercise you need to do in order to strengthen the muscles you need to do this exercise.

Eileen: Still getting used to the place; walked around a bit on her own today; she’ll get started at the hospital tomorrow, we hope.

More as life unfolds here.