#I have this awful habit of delaying my actual decisions till the last minute. I need to stop doing this.

[brown-little-robin]

going to visit parents & adopted uncle & aunt for the weekend. is this a wise decision, given how much work I have to do? NO. Will it be good to see them? YES.

[watsonhealthproject]

T-1 Month Till Departure to Guatemala 0.0

It’s been forever because I am here trying to take in every second of every minute in this beautiful country with all of the people that I have grown to love. I feel good. I am learning loads. Most importantly, I am growing in ways I did not anticipate and it is so maddeningly satisfying. This post doesn’t do my experiences justice but here is my attempt to verbalize what is so often visceral. Enjoy! 

A Real Life Beating Heart in an Open Chest Cavity!

I had the very special opportunity to observe a surgery to fix an arterial septal defect. In short, this is a congenital defect that results in a hole between the left and right atria of the heart. This is problematic because it causes back flow of blood and in the longer term can lead to issues such as high pulmonary pressure. Watching this surgery was a true treat because I got to see, literally a foot away from me, an exposed heart beat and lungs inflate and deflate before the patient was put on bypass. The experience was one in which I was reminded yet again of the marvel that is the human body and the power that is modern medicine.

Interviews upon Interviews:

I’m excited to say that I have had the opportunity to interview members of the general community, in more formal ways, in the last few weeks. It has been a great treat and I learn a something different each time. One of the first things I ask is for people to tell me what being ‘healthy’ means to them. The World Health Organization officially defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Interestingly, when I ask people to define health, an overwhelming majority refer to physical well-being and more specifically, being in the habit of eating ‘healthy’ foods. To me, these responses suggest that people are hyper aware of how food affects their health but given that obesity is on the rise in Ecuador, awareness does not automatically translate to changes in lifestyle. Responses to other questions reveal why this may be the case, including but not limited to, economic restrictions. Very few mention social and mental well-being in their definitions although the topic of “stress” has often come up. 

Another interesting thing that has come out of these interviews is the importance of alternative or natural medicine. Most people seem to refer to it as a first line of defense but when that does not work out, they turn to western medical institutions. There does not seem to be a preference for one or the other but rather, a recognition that both systems have valid solutions that are differently sought after depending on the situation. This is super interesting to me because as an outsider, it is easy to assume that the two systems work in opposition. However, regardless of whether or not they are fundamentally oppositional, people utilize both without much apparent dissonance. 

People consistently refer to the same problems in the hospitals: long wait times, lack of medications, negligence, and the absence of humane treatment. Notably, people recognize that while the solutions are obvious, the actual realization of those solutions is quite complicated. Bureaucracy and politics is cited as the biggest barrier by both patients and doctors. 

Jornada de Endocrinologia 

I had the wonderful opportunity of attending an endocrinology conference. Some of the presentations went over my head because they were focused on tools that doctors can and should utilize when they make treatment decisions for patients. However, there were some really awesome physiology-focused conversations and some interesting perspectives on the state and future of health in Ecuador. Here are some things that really stood out:

- A lot of the scientific studies presented during the conference were from North America and Europe. Presenters noted that this is problematic because many of these studies are mono-ethnic and therefore not optimally useful for application in latin america where different risk factors, genetic make-ups, and lifestyles limit the applicability of the studies. This was especially true for studies that produced risk calculators and scales. There was an overall consensus that more Ecuadorians need to publish studies done in Ecuador. 

- When asked to choose between longer visit times or investment in better medicines, a doctor adamantly supported the latter. His reasoning reflected an opinion I had not encountered before. According to him: “patients misuse consultation time. When a doctor asks how they have been, they go into detail about things that are apparently irrelevant to their health and which is ultimately a waste of time. As a result there is no need to increase the length of time assigned to each patient but rather to educate patients about what consultations are for.”

- I liked the notion of “life style therapy”

- The quote of the conference was undoubtedly: “el mejor medicamento es la educación.” (education is the best medicine)

- When pathologies cost nations more money, they get more attention, even if they are not necessarily the deadliest.

- I learned that there is such a thing as abdominal obesity. 

Sexual Health: HIV/AIDS

I participated in a guided conversation about HIV/AIDS and the thing that struck me the most was the reality that disease can have a negative social impact on the lives of individuals, in addition to the mental and physical impacts. I think that I knew this subconsciously but this conversation bought this thought to the forefront and made us evaluate it thoroughly. ‘Social impact’ can have a lot of meanings but in this particular case, it refers to the relationship between the diseased individual and those around them. Unfortunately, there is a lot of stigma associated with HIV/AIDS and as a result, people that have the disease often face discrimination and isolation. As a result, the topic of confidentiality, access to information, and the question of the responsibility of individuals to inform sexual partners that they have HIV/AIDS came up. There were many interesting opinions!

Here are some of the questions that were initally posed to facilitate conversation that I challenge you to honestly ask yourselves and those around you. Evaluate your answers. Why did you respond as you did? 

- What is the first thing that comes to mind when you hear HIV/AIDS?

- How would you react if you learned you had HIV/AIDS?

- What would you do if you found out your neighbor had HIV/AIDS? Your friend?

La Mitad Del Mundo Adventures

They say that there is a ‘real’ and a ‘fake’ middle of the world (a few meters apart). There was so much to do and see that we didn’t make it to the ‘real’ equatorial line. However, I had such a great time that it doesn’t even matter!

New Friends 

My empanada cravings led me to meet a wonderful woman from the States and we connected instantly. Super grateful to have a friend who is my age and who comes from a similar background. 

Made a spontaneous decision to go out and get to know each other in the midst of uber-loud music, practically professional dancers, and a few performances that left us awe-inspired.

Just before this picture was taken, I had some amazing fish, yuca fries, morocho, and the ever so highly recommended fritada. Can you see the satisfaction in our eyes?

Trip to Guayaquil, Ecuador

I was convinced that I was not going to make it to Guayaquil but the minute I heard that a group from the dance academy were going for a salsa festival, I joined. I see these folks multiple times a week but when you live with a group of people, even if its just for 4 days, you grow so close so quickly and it is a truly beautiful thing. Grateful to these amazing humans for bringing light and joy to my life this past weekend. I had not laughed so much and so hard in a while! Highlights:

- Our instructors placed third in salsa pairs and second in bachata pairs!

- I tasted some awesome typical foods on the beach whose names I will not remember

- I swam in the pacific!

- I rather unsuccessfully danced salsa with real life professionals but was a star with the bachata moves :)

- Got to experience in its entirety what a dance congress/festival consists of and is like. 

- Roamed the streets of a coastal city in Ecuador. (note: the heat made me miss Quito’s cool breeze).

- Felt loved and at home in the most profound way yet

Thinking about the more distant future:

Princeton in Latin America: On one hand the idea of spending a whole other year abroad seems a little crazy. However, I am madly in love with Latin America and want to spend more time in the region. The only reason it seems crazy to me is that it would delay my entrance into medical school even more so and that is just absurd. I am currently debating what to do. I don’t have much time left to decide! 

Social Entrepreneurship: I think there is a great big opportunity for innovation in the area of chronic disease prevention and management and it is a very enticing field. I’ve got ideas and each day my experiences help to inform the development of those ideas. Perhaps I won’t walk out of this year with a job per se but a new social enterprise that could impact many lives. It wouldn’t be the first time that I took on a major project from scratch and built it up. It could be really fun and meaningful! Plus, it would allow me to apply the things I am learning in the most tangible way. I have ideas!

Medical School: To be completely honest, there is a small part of me that wonders every day if I should go to medical school. This is hard to admit and I have to ask myself where the feeling comes from since I’ve wanted to be a doctor for about as long as I can remember. I think what it comes down to is the fact that doctors are tied to a system that sometimes requires them to trade passion for medicine and love of humanity for efficiency and endless paperwork. It is quite unfortunate. 

It absolutely pains my heart that I have all but 30 days left in this wonderful country. In that spirit, this post would not be complete without an inspirational tidbit: 

“You get a strange feeling when you're about to leave a place, like you'll not only miss the people you love but you'll miss the person you are now at this time and this place, because you'll never be this way again.”

[florchis]

Fitzsimmons + #4?

Sorry for the delay! I’m going to assume you meant 4.teacher/single parent au because I already did 4.“Do you…well…I mean…I could give you a massage?” here. I hope you enjoy it!

Teacher needs to see me after school - [AO3]

The truth is, Jemma Simmons is used to being called to Peggy’s school for “teacher-parent meetings” that are actually concealed scoldings. Being used to them doesn’t mean that they are easier to swallow, though. Peggy has a free spirit and a brilliant mind, and maybe she is just a year ahead and not a thousand, like Jemma was at her age (maybe that is the problem), but still, she shouldn’t be reprimanded for wanting better and demanding more, and Jemma will fight tooth and nail for her right to express herself. Besides, if Peggy says that some teacher’s lessons are boring her out of her mind, there is probably truth behind her words.

That’s why Jemma gets to the school on time, with her impeccable work clothes and her polite smile on, but steeling herself for a bitter reunion with some old teacher that will complain about her child non-stop. She is on her best fighter-that-will-slay-you-with-words mode, but she is startled when, instead to a rancid, dusty cupboard excuse for an office, she is sent into the Sciences Lab to meet with professor Leopold Fitz. She gets inside when she gets there, because the door is open and there is no one waiting for her outside. It’s the first time that she has set foot on this particular room of the school, and the nostalgia about her own school days is so strong that it’s almost a physical sensation, with the almost toy-like microscopes and the photogates and the big can of hydrochloric acid, everything mixed together on the same counter top. Jemma waits respectfully inside, less than a foot from the door, but when after five minutes nobody has come to meet her, she starts getting impatient.

She ventures inside the lab, going by watch glasses with crystals of cobalt oxide and pendula all over the place, until she finds a tiny office with the lights on, and knocks on the door.

“Come on in!”

She freezes a little, because is that a scottish accent? She shakes her head, because it doesn’t matter anyway and opens the door to find a man around her age, with an electric circuit on each hand, talking animatedly- twirling around his full hands and raising his eyebrows- with two students that look at him like he hung up the sun himself. Well, this isn’t what she was expecting at all.

“Hello? Mr. Fitz?”

He raises his head and wow, those are some blue eyes. Jemma swallows with a little difficulty.

“Oh, yes, Mrs. Simmons! Sorry to leave you waiting, I was just finishing up with this guys for the science fair next week.”

He makes a gesture with his head and offers them the electric circuits. The boy and the girl take one each and go out of the office speaking a mile a minute. Jemma waits till they are out before re-starting the conversation.

“It’s Ms. Simmons actually, Mr. Fitz.”

He smiles a little and offers her his hand. Jemma shakes it a little more forceful than strictly necessary, trying to feel better about her undeserved nerves.

“Oh, just Fitz is fine. Would you like to take a seat?” Jemma looks around, and every plain surface is covered with toolboxes, wires, screwdrivers, even some parts that look almost robotic. She looks back at him with a raised eyebrow, and he has the good sense to blush a little. “Oh, um, let me…”

He vacates a chair just by putting everything on the floor and she sits on it as demurely as she can, while he leans on the corner of his desk. She waits a beat for him to start the conversation, after all he is the one who called her in, but he seems too lost in thought while he stares at her. Jemma clears her throat to reclaim his attention.

“Oh, excuse me, Ms. Simmons, it’s just… do we know each other?”

Jemma crosses her hands on her lap, and tilts her head.

“I doubt it. I’m sorry, but nor your name nor your face ring any bells on my head.”

He shakes his head, and starts rummaging through a folder. It looks a little like he is just doing it to keep his hands busy.

“I don’t know, I feel like I have seen you somewhere. Not… not in person, maybe a photograph or something? I’m sorry, I’m not making any sense.”

He extends a paper that looks like a report page on Peggy. She starts reading it, while answering with a light tone.

“Well, I’m no model, and unless you are keen on reading papers about neurotoxins, I don’t think-”

She gets interrupted by a startling noise, and when she looks up she realizes it must have been his fist against his other palm.

“That’s it! I read your last paper on the uses for different dosages of dendrotoxin, was that it? It had your picture on the abstract.”

She gaps a little, because what is doing a physics high-school teacher reading her very complex paper on pharmacology?

“I didn’t made the connexion sooner, because, well, Simmons is not that uncommon of a name, and besides, I just assumed that Peggy has her father’s last name. My bad. This is what I deserve for making heteronormative assumptions. But, well, now everything makes a lot more of sense,”

Is he for real? Jemma can’t tell, because she is busy considering if it would be too obvious if she pinched herself to make sure this isn’t a dream. She only manages to close her mouth and try not to sound too much like he caught her totally off-guard.

“Come again?”

“Well, I summoned you here to talk about Peggy’s creativity and enthusiasm on my course, and to discuss her amazing possibilities for the future, of course. It is only understandable that she comes from a household with such an amazing background on science.”

It’s the first time since Peggy entered the formal education system that Jemma has been called by someone who wants to praise her daughter instead of repress her, and Jemma feels like there is something on her pharynx that she can’t swallow. She tries to compose herself by handing the report back to him, because she can��t understand a word of his handwriting anyway.

“So, um, what did you want to discuss?”

His smile is radiant and, really, Jemma, get a grip on yourself, this man is your daughter’s teacher, for god’s sake, just because he is kind and attentive with Peggy doesn’t give you the right to think that his smile is blinding and that he has nice hands. Although his hands are very nice.

Fitz hands her a handful of college brochures, and her daughter is fifteen, is he out of his mind? But there is not enough saliva on her mouth to allow her to say a word- and, also, a nagging voice on the back of her mind reminds her that it would be very hypocritical of her to make a fuss about Peggy going to college early-, so he just looks at him while he talks and talks and talks, like nothing on this world could make him happier than discussing colleges with one of his students’ mother.

“So. I had an interesting meeting at your school today.”

Peggy raises her head so fast it almost looked like she had an electric discharge, and then realizes her mistake and tries to downplay it with a noncommittal hmm. Jemma bites the inside of her cheek to not smirk. Peggy is such an awful liar: she might be adopted, but there are certain things that are obviously nurture and not nature.

“With your physics teacher, that’s it.”

Jemma sits down next to Peggy on the couch, and hands her a cup of tea. Her daughter takes it and watches her carefully from over the edge of the cup.

“And what did Mr. Fitz say?”

“He thinks you should start thinking about college in the next two years instead of three. He says he is not sure that physics or even math is really what you want to do, even though you are good at them, and that you should start considering what do you want to do. He says he is available if you want to talk to him about prospects.” Jemma makes a pause to inspect her daughter’s face without dissimulation, and Peggy avoids her eyes. “He also told me that he already had this conversation with you, but that you told him that he should discuss it with me. Like I didn’t raise a young lady capable of taking her own decisions. Now, it seems to me like there are only two plausible explanations to why you would do something like this.”

Now Peggy is definitely looking at anything but at Jemma’s face.

“And what are those options?”

“Number one, you were afraid of bringing this up to me, and you wanted someone else to do it for you. Now, it would hurt me to know you feel the need to do something like this, but I won’t get mad and I want to know it. Is that it?”

Peggy groans like she always does when her mom gets “sentimental”, and even though Jemma knew that it was unlikely, it’s like a weight got off from her chest.

“No, mom, I was going to tell you, maybe not just yet.”

“Okay, then, that leaves me only with my second choice. Margaret Simmons, did you try to set me up with your physics teacher?”

Okay, that coy smile is definitely Daisy’s, and then again with the nurture.

“Did it work?”

“No!” Jemma wants to be final, but to be honest, there is no heat behind her words. “He is your teacher and I’m your mum and it could never work!”

Peggy gets up from the couch and stretches her arms behind her ears.

“I’m not hearing a ‘I didn’t like him’ in that answer.”

Jemma almost sputters her tea, and because she never made a habit of lying to her daugher, there is only one thing left she can say.

“I’m not going to do anything at the very least until you finish high school!”

Peggy smiles at her like Jemma told her that Christmas is coming early this year. It’s not until she is at her room’s door, leaving Jemma blushing and babbling behind, that she responds.

“All the more reason for me to graduate early!” 

Oh, god, I loved writing this, so, if anyone wants to read something else about this scenario, just let me know!