For me the sea has always been where I turn for inspiration, solace, and wonder. The night I was born I breathed thick salt air and first heard the sound of long Pacific swells rolling onto whispering sand, and from that day my life was held forever in the sea’s net of wonders. My mom and dad were living in a beach motel in Southern California while my dad did his medical residency, and my first steps were on the sand and behind my dad as he made hospital rounds and home visits to patients. I can never remember any time in my life when I wanted to be anything except a doctor and a marine naturalist, and thanks to my parents, extraordinary mentors and opportunities I became a marine biologist and a doctor and have had experiences in both fields that make me grateful to be alive just for one of those moments.
My favorite thing about the sea is that it is not lonely; in the sea I feel connected by the water to millions of people around the world. I imagine millions of people of a thousand colors and languages and religions and nations all floating together in the sea’s embrace and connected across thousands of miles by one continuous, unbroken sea. When we float in the vast sea, only a little of it is holding us up, but that small part is connected to an unimaginably vast and powerful body of water. In the same way, this is how a people are strong. When we say ‘a sea of humanity’ we acknowledge that humanity–all of us together–are as powerful as the sea, which is always waiting to show what it can do.
Like every wave, every life is unique and beautiful, something I have experienced time and again through this voyage. In 2011 we saw our
10,000th patient, and although I am very proud of how many people have received care through Floating Doctors, what I am most proud of in 2011 was that as we expanded our project, we always stayed committed to the individual patient. Time and again, this has ultimately led to our being able to do more for more people than we originally anticipated and I have faith that we will remain committed to the single, individual patient as continue our voyage.
Long before I was old enough to venture over the horizon the last lands and seas had long since been charted, but fortunately the frontiers of health and the sea of humanity offer an endless horizon. Looking out over the Pacific horizon so many years ago I never envisioned that my greatest loves would one day combine in a mobile medical relief team exploring frontiers of health across the living ocean that washes all shores equally. I had no idea HOW I would pursue these two passions, I only knew with certainty that if I did not have them both in my life, I would never be happy, and so I would look out over the water or read Jacques Cousteau or trail after my dad on rounds, and dream of adventures on distant seas and future patients I would see and help.
But all the time a voice was urging me to move forward, always there was another voice…darker, more ancient; a more primitive vocabulary but it didn’t need sophisticated words…it has raw fear, self-loathing, shame, narcissism, and petty angst and selfishness. This voice, all my life, has whispered under my dreams, telling me I will never become a doctor, and never see the seas I spent my childhood dreaming of. Sometimes it spoke with other people’s voices, like during the year we struggled to rebuild Southern Wind after she had been donated to us and some people scoffed and said we would never make it, and it would never work, and we would all be killed and waste all the support we gathered…but here we are. Sky and I lived with fear as a constant companion for the whole tenuous first year of our project, when so often it hung by a thread, but (especially with my sister beside me and many hands outstretched to help us keep going) we were able to move forward, one foot in front of the other, and now here we are…going on a mobile clinic in the morning, more than 600 mobile clinics into our voyage.
I know now that this pessimistic voice I’ve always had spoke from feeling not good enough somehow to deserve attaining my dreams, and although as I got older (and continue to get older) the voice got fainter and fainter (I pretty much ignore it on autopilot now…most of the time), it took many years before I could–as my wise sister says–”Allow myself to succeed” without it being a struggle. We are always our own harshest critics and unforgiving judges, but as they saying goes: ‘You never know if you can climb the mountain until you try (REALLY try).’ And as a wise man said, is it really that frightening to succeed, and is it really, in the grand scheme of things, so terrible to fail? And there is always the third option (my favorite): sometimes when you fall, you find out you can fly (or learn how really, really quickly)–especially if hands are outstretched to help you stay in the air, and your ego (and the dark voice inside us) allows you accept the help that is offered.
The kindness and generosity I have seen people show towards us and to others fills me with hope that the daunting
challenges of our time can be survived. I am immensely proud of what my crew, friends and family, and all our volunteers and supporters have made possible, and incredibly grateful to be able to be a part of this voyage and to have shared it with such extraordinary people.
Even with all its faults, earth is a beautiful planet, and humanity, despite its many, many faults, is heroic. There are heroes all around us; it has been a great honor to work alongside so many of them.
“The world is a fine place, and worth fighting for.”
Check out these pictures; some of my favorite moments captured in 2011.
Please click on any of the photos to activate the slide viewer.
Wow, what a ride…a few days ago, Hurricane Richard passed almost directly over our position here on Roatan. For several days, we watched it approach, slowing down and gathering strength as it hesitated out in the Atlantic, almost as if it were undecided about whether to move northwest, as most hurricanes do, or to move directly west and sweep over the Isla de Bahia in Roatan. Naturally, we began to take elaborate pre-hurricane precautions, hoping that they would not be necessary.
We cleared all of our gear off the decks and lashed all the big stuff down tight, covered our bridge windows to protect them from flying debris, charged our batteries and filled our water, stocked up on food, added about a dozen dock lines and more fenders, and prepared to ride it out. These are the moments that are a true exercise in letting go; when you have taken all the precautions you can, and done everything you could–then whatever happens is beyond your control. The sea can be a very scary and intimidating place when you try to maintain the illusion of control on the water.
From the bridge, we waited, and tracked the storm on satellite imagery. As it came nearer to our position on the screen, the air felt heavier and heavier as the pressure dropped, and all of us–including Tweek and Giles, our ship’s dog and cat–started feeling restless and agitated…I guess it is true what they say, the waiting MAY not be the worst part, but it is surely no picnic!
First, the weather turned dead calm and still, the only change being the plummeting barometer…then came the rain, and then more rain, and then a LOT more rain…and then the wind. At first the wind wasn’t too bad, blowing at around 30-45 mph for the evening, but as 3:00 AM rolled around the wind began to pick up sharply, whipping the trees around us and surging the already full-moon high tide up over the concrete dock. Thank goodness we had had a chance to adjust and tune all our dock lines while the wind was still blowing only 30, since by the time the wind hit 79 mph it was difficult to move around safely outside.
The boat rocked and heaved amid the spiderweb of dock lines holding her out in the middle of the basin–one line snapped, but Captain Ed and Noah managed to get a replacement line around another cleat in time to keep us from being
pushed forward onto the seawall 8 feet dead ahead. As dawn brightened, the wind began to die down to gale force, and eventually petered out amidst a series of heavy showers into a preternatural stillness, and the first tiny patches of blue sky we had seen for days finally peeking out in the eastern sky.
Then all hands checked the lines one more time and turned in for some well-earned sleep–back at it in the clinics tomorrow! What did Graham Greene say about the sea.. “The ocean is an animal, passive and ominous in a cage, waiting to show what it can do.” The power of the Hurricane, this ‘little’ category one hurricane, gave us a brief glimpse at the forces that lie in wait under the deceptively calm waters and blue skies of the tropics.
The price of having even a chance of survival on the sea is eternal vigilance…when situations turn bad, they tend to do so quickly. Better to prepare thoroughly every single time than be caught out the ONE TIME you fail to take every possible precaution.
Live to sail another day!
On Wings Of Angels
A few days ago we did a house call from the RBC Center to a lady who was 6 weeks post stroke. The family’s house was at the top of a 35-foot steep slope, and she had pretty complete right sided paralysis. Her speech and cognition were affected badly; she seemed unable to understand questions and had no speech. She had a permanent indwelling catheter, and could eat and drink when fed but her swallow was affected and she seemed to be aspirating a little bit (saliva or fluid entering the lungs). Like most elderly or infirm family members in the developing world, she was being cared for at home.
There was not much I could do to help her improve, although her stroke was so recent that it was impossible to say how much spontaneous improvement she might experience over the coming weeks. We told the family to interact with her as much as possible and Annee demonstrated passive motion exercises the family could do with her to help prevent contractures and blood pooling, and discussed turning and bedsores. We talked about signs of urinary tract infection (always a danger with permanent indwelling catheters). And the folks from the RBC center are going to try and help out. Overall, the prognosis was not good, but there is one thing this lady had going for her that many elderly patients in the US and Europe never enjoy.
In the US and Europe, the general tendency is to stick elderly family members in nursing homes and visit them occasionally, usually out of some kind of guilt or obligation. I worked in Care of the Elderly in Ireland and I saw it everyday. The first time I did a house call on an elderly woman in Africa, who coincidentally had also had a stroke, I was ashamed of how we treat our elders in the developed world. Here in Honduras, as in Africa and Haiti and everywhere I have been, older people live with and are cared for by family members in their homes. They do this for two reasons—first, because they have no choice; there are few nursing homes to deposit and forget elderly family members. The second reason is because the culture in most developing countries has much more respect for the older generation, and elderly people get home care and attention from their families simply because that’s the way it is.
The granddaughter of the elderly stroke victim hovered over her grandmother, stroking her hair and talking to her. The family washed her and cleaned her, emptied her catheter bag, fed her and talked to her and interacted with her. Lying there paralyzed, she received the most tender care and inclusion in the life of the family. There may have been no advanced tech available but this lady was being wonderfully cared for. And a week later, she got some of her comprehension and speech back, and some control over her right side mobility. With love and more care, hopefully she will recover enough to regain some measure of independence, but if not I have confidence in the care I know her family will provide if she remains permanently disabled.
The RBC Center, para los ninos con incapacitados, is staffed and run by people who have extended the kind of care they would provide a family member to the kids and people in the community who have cerebral palsy, have had a stroke. Ashleigh has been there nearly every day she was with us, providing Occupational Therapy and Physical Therapy and helping the clinic workers learn new techniques of therapy.
I am amazed, and very proud of what Ashleigh has accomplished at the RBC Center. She and Annee started a Yoga class for the mothers of the handicapped children, many of whom have bad backs and joint pain from carrying their immobile grown children everywhere. The women who come to the center love the class; one 57 year old woman said it was the first time she had ever exercised, and she was so proud of herself. Peggy from Clinica Esperanza gave us a couple of children’s walkers, and a few days ago a 7-year old boy walked for the first time, and a 9 year-old boy wrote his name for the first time.
Ashleigh does movement therapy, sensory therapy, passive massage; pretty much everything—Supertherapist! Fridays are my favorite day…on Fridays I always go to the RBC Center and see patients, young and old. I treat a lot of gastritis and arthritis there; the moms of these kids have lots of stress and physically challenging lives. But on Fridays, when I am there seeing patients, I get to see what Ashleigh and everyone is doing—giving attention to the children, giving the mothers a desperately needed rest from the constant care they have to provide, helping people get their mobility and independence back. Annee, Sky, Noah, Sirin, Rachel, and Nick have spent many days working with the people at the RBC., and I love when we get to all work in the same place.
It is wonderful what can be achieved when you are helping somewhere long enough to learn the lay of the land and what the real needs are, and make the friends and connections necessary to undertake more ambitious projects. Of course, you also need outstanding individuals like the volunteers that have come out to help us. Ashleigh was amazing in action; when she went home it was a sad day for us and also for the clinic staff and patients and families.
The clinic closes for an hour at lunch, and we usually walk down the road to our friend Sherman Arch’s Iguana Park. Sherman is caracol, meaning of white descent but an islander who speaks the patois of the island. He is second generation here, and on his property iguanas are not allowed to be killed, so over the decades they have congregated. He takes in rescue animals, including monkeys and coatimundis, and does turtle rescue. He often feeds us at lunch and sometimes gives us rides back to the boat in his truck or the 37-foot skiff he made himself. He has been enormously kind to us, esta un bueno hombre, another angel we have met.
High in the air during a night flight across the dark ocean a week or two ago, I suddenly remembered a story I read years ago that seemed appropriate for the moment. It happened on the way back from a patient transport in the helicopter to the mainland, and I was sitting in the back thinking about what Floating Doctors became after starting so long ago as a decision made on the plains of East Africa, when I decided to go back to the developing world with more help. I contemplated the path we followed to make Floating Doctors a reality; I thought of all the heartbreaking setbacks and the glorious triumphs that were achieved by the goodwill of people who seemed to come out of nowhere to help pick us up when we fell, and encourage us to keep going, and who worked side by side with us.
The story I remembered is about a man climbing a tall, steep mountain in his dream. After a desperate struggle, he makes it nearly to the top…then falls. The story says that when it comes to the dreams perched high atop the mountains of your mind, it is sometimes a mistake to climb to reach them—but it is ALWAYS a mistake never even to make the attempt. If you climb, you can either succeed or fall. And sitting there in the helicopter, thousands of feet above the dark, luminous, serpent-haunted sea, I understood in a very literal way the third option mentioned in the story: sometimes, when you fall during the climb to reach your dreams, you find out you can fly.
There have been many angels who caught us when we fell and who helped Floating Doctors continue forward. I know I talk about it a lot, but I don’t care. I wanted to thank you all again very much, and to know how much it means to me that you believed in us and helped us and worked with us to make Floating Doctors fly—both in spirit and, riding the clouds over the gulf of Honduras, in literal fact.
June 28, 2010. Petit-Goave, Haiti.
“Another turning point, a fork stuck in the road,
Time grabs you by the wrist,
Directs you where to go,
So make the best of this test,
And don’t ask why,
It’s not a question,
But a lesson learned in time.”
–Green Day, “Time of Your Life”
Ah, calm seas and a gentle night breeze. Tropical Storm ‘Alex’ made things interesting for us over the last few days.
At the western edge of the bay of Petit-Goave, we were exposed to a 5-6 foot swell rolling straight into the bay, with 35 mile-an-hour winds holding us beam-on to the seas. Misery! Imagine that your house is the head of one of those bobble-head dashboard ornaments. During a break in the weather, we moved the boat under the mountains at the eastern edge of the bay, giving us much needed protection and a good night’s sleep. We are getting ready for the 800-mile transit to our destination in Honduras…fueling, taking on supplies, clearing the decks, lashing down gear, ballasting the boat, and the thousand small things that have to be done to clear Southern Wind for a crossing.
Most importantly, though, we are waiting for a weather window. Tropical waves are continuing to pass over this area. The water between here and Colombia is pretty rough and pushing north across our course to Honduras. Alex is messing up the whole western Caribbean—not a good time to push your luck on the water. Besides readying our boat for sea, we have also used the time to say farewell to our friends here and to catch up on some last minute patients. The farewells are very, very difficult for me—to see people and places that have become important to me grow smaller and smaller until they disappear below the horizon.
Before coming here—my first trip to Haiti—we had done so much reconnaissance (and I have already been to many places in the developing world) that I had a pretty good idea what to expect, but I also knew that there would be many things that would come out of left field and surprise me. From experience, I knew that for the first couple of weeks everything would be new and exciting, and that after a few weeks there would be things about Haiti that were chronically frustrating and upsetting. In this case, corruption in the government, the behavior of many other non-profits that are here, and human greed top the list for things that upset me in Haiti. But this doesn’t discourage me at all—EVERYWHERE I have EVER been, including places I love and would live in or revisit in a second, has things that I don’t like: the traffic in L.A., the lack of mountains in Florida, the cold in Ireland, the rampant HIV in South Africa, government corruption in Mexico, the mosquitos in Botswana. After a few weeks here, yes, of course there are things about Haiti that I don’t like, but I don’t care. No place is perfect, but as much as the challenges to rebuild Haiti seem overwhelming, there are still people here who have not given up, and neither will we.
If I am miserable and unfulfilled in one place, I’ll be miserable and unfulfilled when I go somewhere else, but I am doing what I dreamed of doing, after having (as Sky puts it) “frankensteined together this project that came out of your own head and watched it accomplishing everything you hoped it would and more.” At age 34, I am watching my dream come to life despite naysayers and constant challenges, with many hands reaching out to us to help us along our way. From childhood my dream was to practice this kind of medicine—the kind of medicine I watched my dad practice when he took me on rounds at the hospital as a child, and saw him provide in the homes of his patients and on the side of the road at terrible car accidents in Topanga Canyon where we grew up.
When your life’s dream is being fulfilled before your eyes is very hard to be unhappy and negative. The most common comment we have gotten, hands down, from older people who have met us, is “It is so great that you are doing this now, while you are young. You will never have to look back and have regrets about things you wish you had done and the places you have seen.” And when I look back down the years, hopefully many years from now, I want my halls of time to be lined with the faces of people whose lives I have connected with, however briefly, and in whose lives I left some kind of positive impact.
Well, at the end of our week here in Petit-Goave, it’s time to check how well we are meeting the goals for our project that I first envisioned over two years ago while working long nights in Irish hospitals.
I dreamed of a multi-skilled, highly adaptable relief team aboard a self-sufficient support platform that could use 21st Century medical technology, classical medical diagnostics and adaptability to different needs and resources to create long-term health benefits in developing world communities, making a difference one person at a time. Here we are, many months and many days of hard work later, and with many people who helped make this possible now a part of our story, anchored safely in Petit-Goave, Haiti.
For our first mission destination, I chose a tough location—Haiti: more than 800 miles from where we started, with huge challenges facing its people from every possible direction, a couple months after a huge disaster when people are still living in tents but many aid groups have pulled up stakes and moved on. If we could successfully conduct a mission here, I felt confident we could do it anywhere.
June 21, 2009. Palm Coast, Florida
Today marks the longest day of the year, and for us it surely was! We got up before dawn an piled into our rental jeep to head down to the beach and watch the sunrise over the water—a novelty for those us from the west coast, but we were thwarted by low clouds on the eastern horizon. Still, as we staggered out of the house in the pre-dawn (already in the high 70’s), the sky was a deep purple and shapes of houses and trees loomed out of it suddenly as we drove down the road to the Hammock Dunes beach nearby.
The sand is made of crushed clamshells and is multicolored; when we come here on Sunday afternoons to lie in the sun and recharge our solar batteries for another long week of work in on the boat, we never get fine sand stuck to us, which is nice, but we DO leave the beach with hundreds of little shell shards suction-cupped to us, and they are surprisingly hard to dislodge (since we discover them in our hair, on our backs, and other hard-to-reach places hours after we leave the beach).
We were all too tired to be chatty, and the pre-dawn is never a time for idle conversation—pre-dawn is when the world holds its breath like the audience at a concert, waiting for the first notes of the symphony while the conductor stands with hands raised, waiting to bring the whole orchestra into life. I think I understand why, at an intuitive level, so many religions originated with worship of the sun. The moments before it arrives above the horizon are filled with such expectation and faith (that it will, in fact, come up!) that every sunrise becomes a religious experience.
Today, a third member of my crew independently used the phrase “my previous life” to describe their life before they came here. So far away from the things that are familiar, working on something that is REAL and will leave a lasting mark in many lives around the world, many of the problems that seemed so important when we were immersed in them now seem more remote—and more than remote; they seem much less relevant to our lives and we wonder why we worried so deeply or hurt so badly or got so wrapped up in some drama or other. Our perspectives have changed. We are developing more perspective every day on the things that truly do matter—friends, service, honor, hope, determination, and family, which in the absence of our own relatives has been filled with each other. I still can’t get over how quickly we have all bonded, and it makes me think we just might survive long ocean passages as friends!