March 26, 2010. St. Augustine, Florida.

I am just wrapping up the last watch in the pale yellow pre-dawn before our day begins; we are at anchor in St. Augustine, just inside the inlet leading to the open sea, which I can see just a few hundred yards from where we are now. We were trapped behind the Lion’s Bridge for a few days while it was closed; it is an historic bridge at the entrance to St. Augustine inlet that has just been re-opened after 4 years of restoration–a beautiful bridge but looking at the sea through the closed bridge pylons was like looking through bars in a cage. Yesterday evening, they opened the drawbridge for us, and we dropped anchor safe and sound on the ocean side of it. Very, very frustrating to be stuck for a couple of days, but of such things is life at sea made. The sea is always the same–ever changeable, and always throwing up new challenges and new opportunities. All we can do is adapt as fast as possible, and we have learned to be good at it.

Dr. Cutler, a doctor from Los Angeles, and his family (his wife is a nurse and his 16 year-old son is coming to help out as well) are scheduled to meet us in Petit-Goave, and fortunately I made sure that Dr. Cutler knew that there was always the possibility of unforseen circumstances that could keep us from making our rendevous with incoming docs, and had contingency plans in place for several different scenarios., Dr. Tania Desgrottes–an anesthesiologist in NY and niece of Hughes Desgranges, Ministre du Cabinet for Petit-Goave and director of the health center where we will be working–has arranged for them to be picked up at the airport in PAP, driven to Petit-Goave, accommodated, fed, and started in the health center until we arrive in a few days and bring them onboard.

There was much to do while we waited for the drawbridge to re-open; securing 20,000 pounds of cargo well enough so that, if the boat is upside down, it will not shift (always ‘think inverted’ when stowing gear onboard), poring over the charts, arranging long-range radio contact times and dates for the different cruising nets we will be passing through, cooking, standing watches at night, tinkering with our systems and acclimating our ship’s cat and dog to life onboard. It is mentally and physically exhausting, but also exhilarating. To see the crew working pretty much 7 days a week for 11 months in defiance of heat, high winds, cold, and rain, to see the huge pile of 10,000 lbs of supplies and material collected at our house in Jacksonville (and 8,000 lbs of lumber and 2,000 lbs of tin roofing delivered to us in the marine yard) absorbed into Southern Wind, to be living on the boat and safely at anchor just inside St. Augustine inlet after so much time and hard work rebuilding her, to be stowing gear for departure, and most of all to have all the people in Flagler, Palm Coast and St. Augustine (and across the US) give us so much of their time, encouragement, and support has been an amazing experience.

I ran a marathon once, years ago when I was 19 years old. It was really, really hard—a lot harder than I anticipated (ah, the invincibility of youth). I remember the pain, definitely, and I remember clearly how difficult it was to go on. Everyone talks about how at this “point”, the point where long distance runners hit ‘the wall,’ some enormous effort of sheer will has to be made, and people have to look deep for something to make them go on.

I looked to my left and right, and the streets were lined with people I had never met, would never meet except in one brief moment where I ran (struggled) past where they stood. They were all there, taking time out of their day, to sit in front of their houses and blow air horns or stand at the sidelines yelling encouragement or spraying runners with a hose or handing cups of water to strangers passing by like ships in the night. It was THEIR will that helped me continue the race. I could feel it in every step of the last 12 miles; it was like a tidal roar in my ears on the last 1/4 mile stretch.

That is what we have felt during our entire time here. We have become part of the community, and it is the people here that have done so much for us that have made this all possible; that have helped us lift our heads and finish the last stretch of our long marathon. The funding from Rotary for our fuel for the Haiti mission, all the help from the guys in St. Augustine Marine Center, Rick, Cheryl and Tom from Polaris Marine, Don Capo of Capo Welding, Valerie and Mike Pippio (our surrogate mom and dad out here in Florida), Nick ‘The Godfather’ and Susan Bereda, Phil and his family, Clay Hansen from Hansen Marine, the guys at Marine Oil and Supply, Wilson Welding, Ed the Sailmaker, Amy and the Rotaract club at Flagler College…the list goes on and on; there are far too many people to thank. It was very hard saying goodbye to everyone; we tried to keep things as lighthearted as we could.

In the movie Big Fish, the protagonist struggles to understand and reconcile with his father as his father is dying, His father is a teller of tall tales, and his father’s oldest story is about a legendary huge catfish in the river that many people had tried to catch, and failed. The father claims to have caught this fish, fighting him in an epic battle in the lonely dawn. Finally, standing waist deep in the water, exhausted but triumphant, he holds this giant catfish gently in his arms. Even though no one is there to see, and no one will believe him, he releases it. And no one believes him.

The movie goes on to narrate the father’s life of adventures as he remembers them, some fantastical, all stylized in proper tall tale narrative. The movie focuses mostly on the people who drop in and out of the father’s life, some for a moment, some for many years–and all the people in the stories are larger than life.

What we remember from stories, what we carry with us after hearing them, is what lives inside us after the storyteller has finished and our lives move on. That is the important part of the story; the living part of the story that we make a part of ourselves, and the ways in which we become part of other people’s stories and they become a part of ours. “Thus do we live forever”–for as they say, a man is not dead till his name is no longer spoken, and I believe that a person is never truly dead while the effects of their lives in other people’s histories are still felt. The small and large ways that we serve each other reverberate forever down through time.

At the end of the movie, as the father is finally dying, the son carries his father to the river. Lining the banks are all the people whose lives have interfaced with the father…all the people through a long life of adventures, those he helped and those who helped him, are all there on the riverbank to wave farewell. The son carries the father into the water, and the father ‘”suffers a sea change, into something rich and strange.” His skin changes to scales, and his limbs to fins, and he becomes the giant catfish that he battled as a youth in his first story. Instead of dying, he grows stronger and swims from his son’s arms into the waiting embrace of the water, and passes out of the lives of the son and all the people he has known, becoming a story and a legend.

I have watched the riverbank of my life get populated with wonderful, generous, competent, effective people– many larger-than-life characters. There are no characters in any book or movie more colorful or more improbable than those I have met during this process–many people I may never see again but whose lives will always be a part of my story. I will carry them and their stories with me, and they will be there on the riverbanks waving goodbye when I have my own children to carry me (hopefully many years from now) down to the sea and into the water where the tide which brought me to this world will move me back to the source of all things.

For the last two years I have lived with no money of my own, always with just enough to eat and continue with our project–it has been very, very hard. I will remember this as the toughest period in my life so far—but, also, as the most rewarding. I will miss everyone here very much—these wonderful people– their stories will live inside me forever.

Now, a whole new phase of our project begins, and we will meet many more people who are out there, right now, somewhere on this earth on an intersecting course with us. I can’t wait to meet them all–every life is a story, and we will be made richer–not through money, but through the many stories that will become part of our lives and which are immortal.

We depart tomorrow morning on the tide. Who knows what is waiting for us out there? I did get some idea of the situation in Petit-Goave, Haiti, through one of my medical students, Wendy from Canada. She has flown ahead and has been working in the clinic and sending up-to-date info on the situation. Wendy has helped a lot, and has learned a LOT–exactly the result I hoped for when I first decided I wanted medical students in particular to come out and work with us. On her first day, Wendy was first-assisting on amputations and getting a lot of experience already–but more importantly, she has been forced to hone her clinical diagnostic and treatment skills, and has had the opportunity to practice medicine for what I call ‘patients, not paperwork.’ She is getting the chance to practice medicine the way so many of us in health care imagined it could be like when we first set out on the road to becoming doctors, and I hope-like so many doctors who go on medical missions-that she carries that clinical skill and genuine care for patients back to her work in her home country.

My experiences with medical mission-type medicine is that it is just you and your patient, and all of your focus is centered on using whatever you can to give the patient the best possible health benefit. You don’t always have all the resources you wish for, but it is challenging and rewarding work. There is more than one way to skin a cat, as the guys in the marine yard would say when we tossed around ideas for solving different repair challenges during the rebuild. This kind of work encourages innovation, creativity and problem-solving solutions.

I believe that improving World health and health in America starts with changing the way individual people think about health and health care—empowering and involving them in their own health care. Maybe changing the world starts by giving people the chance to grow and learn about themselves and others, one person at a time. Like the sea, enough small waves come together and suddenly a powerful rogue wave rears up and nothing can stand in its way. I hope that all the people we have met and will meet will be like the ocean waves…that in our wake, we can leave thousands of small changes in the way people think about health that will propagate through families and communities. And one day you wake up and there has been a sea change, and everything is different.

Wendy says that clearing of debris has started, but that many relief efforts have pulled out and that not as much relief is arriving. She says that there is concern that the focus on continuing to help Haiti after its total destruction is being lost–especially now, months after the quake, when malnutrition, exposure, epidemic disease, infections, and desperation are taking their toll, so our timing for Haiti–though later than we originally hoped–seems opportune. We are fully fueled for the crossing and have just enough funds to get enough fuel to come back (probably). The faster we get to Haiti and the faster we get back, the more time we can spend there helping, so it will be all sails up and engines on. We are, at the end of 11 months here and a year of organizing before that, stretched to the wire (so if anyone can help, please do–we need a cup of water and a spray with the hose during this last quarter-mile sprint!). We will be leaving without any funds for a prudent reserve in case of anything at all, which makes Sky and me very nervous (since the sea is one big contingency enforcer). We hope to receive some donations through our donate button while we are en route, so I am asking for any help anyone can give us.

The open sea beckons from beyond the bridge…and many living stories await us beyond the horizon. May the wind favor our passage and may we leave goodwill and health in our wake. Wish us luck and look for our next blog from the coast of Haiti in a few days…