A country that speaks my language.

Just a quick photo today from the gift shop at Khor Virap. It took me a few minutes to get what Sam was pointing out when he drew my attention to the sign. Learning a second alphabet is really screwing with my dyslexic mind. I was happy to see that whoever made this sign used the same method of creative spelling that I would have in their position. 

Khor Virap

Today we were invited to go to church with the family. In the US, we do not attend church, so we were a little reluctant to accept the invitation, but thought that for the sake of cultural integration, we should at least see what services were like here. It turns out we needn't have worried. For our host  family at least, going to church was really more of a sight-seeing excursion than anything else- and what great sights there were to see! 

Instead of going to the small church in Shahumyan, we traveled about 5 miles southwest of our village to a monastery called Khor Virap, or "Deep Pit". It was in this deep pit that St. Gregory the Illuminator was imprisoned for 14 (or 40, depending on who you ask) years, and was later credited with bringing Christianity to the King of Armenia and securing Armenia's place in history as the First Christian Nation. It sits, perched atop a hill, overlooking the Ararat Plain on one side and with a magnificent view of Mount Ararat on the other. The Armenian-Turkish border divides the two, and can be seen behind the monastery in the picture below. 

Going to church with the family consisted of driving to Khor Virap, purchasing a few candles, and lighting them while saying quite prayers to yourself. It took about 5 minutes. We spent the rest of the day exploring the monastery's grounds and enjoying to incredible sights that were on hand.

From the very highest point on the monastery's hill, you can lookout over the cemetery (where, we were told, our host grandparent's parents are buried) and see the town of Shahumyan where we live. (It's in the picture above, in front of Karmir Sar, the Red Mountain, in the background).

After we had seed what there was to see at Khor Virap, we drove to a second hill from which you can see the monastery backed by Mount Ararat. Below is a photo of Sam on that promontory in a sea of vinyard fields- directly behind him is Mount Ararat, and in the far right of the photo you can see the church of Khor Virap.

The view of Ararat is really stunning. It doesn't quite translate in photos. It's difficult to capture just how much of the horizon is taken up by the huge mountain, but I think the photo below may be my best attempt yet. 

We haven't seen much in the way of wildlife in Armenia yet, but there were some pretty cool snails on the second hill. I can't think of some clever way to talk about them in terms of Armenian culture or history, but I really like this photo, so I'm sharing it here.

And that, in a nutshell, was our trip to Khor Virap. We got home safely- although my heart was in my throat the entire time we were in the car. Driving here is a little like Grand Theft Auto: The Real Life Edition, and this was my first time driving with someone other than a Peace Corps driver in something other than a Peace Corps vehicle. But fortunately, the ride home was relatively uneventful.

Tomorrow it's back to the grindstone: 10 hour days of language lessons and technical training sessions. It was really nice to have a day off today.

The Shadow of Mt Ararat

This morning was bright and sunny, but last night was a different story.

The storm rolled off Mount Ararat like an avalanche barreling down the mountain and washing over the village of Shahumyan. Within minutes of hearing the first distant rolls of thunder, fat raindrops fell against our window sill and wind tossed the fig tree outside our window back and forth.

By the time I made it across the room to shut the window, the wind had driven enough water inside that it had formed a puddle on the sill which had spilled over onto the floor. The noise of the wind furiously blowing through the fig tree's leaves subsided when I shut the window, but the storm continued outside. By the time I mopped up the water, the first flashes of lighting lit up the sky overhead.

We have been in Shahumyan for 5 days now, and the way Mount Ararat's presence quietly dominates the village's existence continues to surprise me. The mountain takes up most of the western horizon. There is no where in the village where you cannot look towards the setting sun and not see the mountain top. Although it is often shrouded by a thick cover of clouds.

To the east, there is the Karmir Sar, the Red Mountain. Although these mountains are more subtle in their presence, they are no less beautiful. Shahumyan lies between Mount Ararat and Karmir Sar, just south of a small city called Artashat, very close to the Turkish boarder.

I wonder what it must be like, to be an Armenian living in Ararat's shadow. Despite the fact that the mountain resides within modern day Turkey, Armenian still call it "our mountain", and the streets of the capital city of Yerevan are decorated with flags and billboards reading "191.5: Remember and Demand" in reference to the 1915 Armenian Genocide, perpetrated by the then-Turkish government, claiming the lives of some 1.5 million Armenians within the Ottoman Empire. The government of modern-day Turkey (as well as many other governments, including the United States) does not officially recognize the genocide as a such, referring instead to the Armenian deaths as part of the cost of war and political instability which accompanied the start of World War I. In the aftermath of the war, Armenia- like many smaller nations in the area- was made part of the growing Soviet Union, borders were redrawn, and Mount Ararat ended up in Turkey.

I wonder what it must be like to live with a cultural heritage such as this and to have such a dominating symbol of your people's struggle silently watching your village, like some constant eternal sentinel. I wonder, but I don't ask. I am still too new to this place and these people to ask such personal and probing questions. Maybe someday I will have a be better equipped to have these discussions, but for now I watch and wonder.

Shahumyan

So, we have both made it safely to Shahumyan. I was greeted with a warm welcome and great big hugs by our host family on the evening that Sam was ill and spent the night in the PC medical office in Yerevan. He joined us the following afternoon, and the family was equally happy to meet him. Our host mom is amazing, and has been cooking him a bland diet of boiled potatoes and eggs, which is exactly what he needs. 

The village of Shahumyan itself is small, centering around one central paved street (the rest of the streets are packed dirt/gravel or loose stones). Our host family's house is located just on the edge of town, and the village's only school is at the other end of the paved street. Each morning, we walk along the street to go to language class at the school, and see people going about their daily lives. 

Many people here have a two or three cows, and it's completely normal for folks to drive them along the street, trailing chains from around their necks, and once outside of town, use the chains to stake them in the brush along the side of the road. This system allows the cows to graze, and conveniently keeps the sides of the road clear of vegetation. It also has the unfortunately side effect of allowing the cows to poo both in the street and on the sidewalk, which keeps us (sometimes literally) on our toes while walking around town. 

We also see families walking to school, or sometimes to church. The towering Mount Ararat looms over the street in beautiful scenic views on clear days. Today was a good Ararat day, so I took a picture of Sam. Unfortunately, the mountain doesn't look nearly as large in the photo as it does in real life- I think it must be similar to the effect of a full moon, sitting low on the horizon: it always looks bigger in real life than in photos. 

So, that's it for now- we're safe, happy, and relatively healthy (Sam's been taking it easy, but has more and more energy each day). They're keeping us very busy, and internet is difficult to come by, but other than that, we don't have anything to complain about. Check back soon to see if I can rectify that situation. :)

Reality Check: I've been working in a first world Level 1A Trauma Center for too long.

We were scheduled to leave Aghravan Park Resort and go to meet our host families this morning, but Sam got quite ill last night, and so instead of heading to Shahumyan (the village where we will be living for the next 3 months), we headed out in our own van to Yerevan, the capital city where the Peace Corps medical office is located.

Without going into too much detail (always, it seems, uncomfortable for people who haven't spend prolonged periods of time around hospitals), Sam's symptoms consisted of pretty much exactly what you'd expect of a person newly moved from the US to a developing country. They were in not unusual in kind- most of our fellow Peace Corps Volunteers in Training (PCT's for short) were feeling similarly poorly to one extent or another- but when it got to the point where Sam was no longer able to hold down his oral re-hydration salts, I thought that enough was enough. The medications which were at our disposal had failed to alleviate Sam's symptoms, and without an anti-emetic in our med-kid, there really wasn't a way for us to adequately keep him hydrated on our own. A person who is loosing fluids with no way to replace them is only going to get worse, so I called the PC Medical Officers.

In my mind, this solution to our predicament was simple: pick Sam up, get him to a medical facility, dose him with Zofran (a drug to help with nausea), stick an IV in him, hang some saline, and within a few hours Sam would be feeling better. Where I come from, this is pretty much standard procedure- so much so that the nurses anticipate the orders from the doctors almost as soon as they see the patients. That is not the case in Armenia.

At first, we were urged to attempt to make use of our medical kit supplies, which we had already attempted without success. This did not surprise me- even the most sympathetic doctor back home tends to be at least a little wary of care given prior to their involvement (this serves to protect the patient from undergoing unnecessarily aggressive treatments if they merely failed to properly utilize more conservative methods earlier in their self-treatment). Even so, it was several more hours of unremitting symptoms before the doctors agreed to arrange transportation separate from the rest of the group to take Sam to their office in the capital city.

During this time, I found myself in the role of patient's family member really for the first time since leaving my job in the ER. Yes, I had helped a little when my grandfather had become very ill over the summer and passed away under the care of the kind and understanding hospice workers, but there really wasn't much patient advocacy to be done under those conditions: the hospice nurses anticipated my grandfather's needs better than any of the rest of the family- who were dealing with our own emotions and attempting to support each other- could. And so I found myself in a new position: as the wife of a person too ill to advocate for himself, and with the responsibility of representing those needs to medical staff. I admit, I prefer to be on the other end of the relationship. It is frustrating to be outside of the medical team- to have my carefully drafted reports, not disregarded precisely, but taken with a dose of skepticism. I was told to repeat watchful waiting protocols I had already enacted, delaying what, to my mind, was the clear and appropriate course of treatment.

This continued when we arrived in Yerevan. I don't know how Sam made it through the car ride- I can only imagine how miserable it was for him. As we got out of the car and got Sam inside, I thought that at last, he would be given an IV and an anti-emetic and be allowed to sleep. Instead, we waited for the rest of the morning and well into the afternoon as the PC doctors assured for themselves that Sam truly could not tolerate oral fluids. Admittedly, this process was drawn out by Sam who at this point just wanted to avoid more painful retching and refused to drink the salt water offered him by an increasingly distressed me. As the day progressed, Sam became more and more dehydrated, and began to develop resulting muscle cramps. But it wasn't until an objective drop in blood pressure was established that things were taken to the next level.

As I had hoped, Sam was given an anti-emetic injection and an IV was established. It took the better part of an hour to accomplish these two interventions. I sat outside Sam's room while it was done- feeling entirely out-of-the-loop. I am not used to being on the outside of these things, and it was extremely unsettling. Sam later would describe the process as "involving four hands at all times, half-a-roll of tape, and much heated discussion in Armenian".

When Sam's drop in blood pressure was noted, it had been decided he would stay overnight in the PC medical office while I would travel alone to our host family's home in Shahumyan. I was not happy about this decision, but there seemed little I could do about it.

After the IV was placed, I was allowed to say goodbye to a still very ill Sam, and got back into the van which had taken us to Yerevan from the resort earlier that day. I sat in the back of the van, watching the flat, rapidly darkening landscape pass by. I felt very alone, and a little afraid. I had not expected to be without my partner, heading into a new and unknown place. A small part of my mind found new empathy for the rest of the volunteers in our group who were taking on this challenge alone.

But most of my mind was occupied by a settling resentment towards the PC medical office. Why had they not believed me when I called at 6 o'clock that morning and told them Sam was unable to tolerate oral fluids? Why had it taken them until 4 o'clock in the afternoon to give him what I thought of as the clear, immediate, and appropriate treatment? Why had it taken them- two doctors working together- so long to place a simple IV? Even in his dehydrated state, Sam had great veins- why had placing the line been such a production?

It took me most of the hour ride to Shahumyan, stewing in anxiety and negativity before the answers to my questions came to me: The PCMO's behavior was only flawed when compared to my expectations based on a first world level 1A trauma center. It wasn't the PCMOs that needed to change, but rather my perspective.

Things here are not the same as they are back home- that's really the reason I wanted to join the Peace Corps in the first place. While I was correct that an anti-emetic and an IV would have been considered initial treatment back at the huge and bustling ER of Rhode Island Hospital, that does not mean that these measures are the most appropriate form of initial treatment at the tiny PC medical clinic in Yerevan. The truth is that for the PC medical office, an injection and an IV were a big deal. The doctors there were practicing the most responsible medicine they knew how by not rushing into invasive treatments. And when it was determined that such treatments really were necessary, they carefully took their time, seriously engaging with the process, to ensure that it was done properly. The fact was that my opinion on what was appropriate medicine here was flawed: although the interventions eventually taken were the ones which I had originally wanted, their significance here is not the same as it is back home.

This was the first time I had really had to confront the fact that we had traveled to somewhere very different from what I was used to. I admit that it's not easy to maintain this shifted perspective and I still find myself slipping back into judging the PCMOs performance based on standards which aren't really applicable here. But I try to retain the clarity with which I saw the situation while sitting alone in the back of the PC's van as much as possible. I suspect that I will come across many more such situations before our time in Armenia is up. I hope I am able to recognize them as easily.

Aghvaran

Since our arrival in Armenia 3 days ago, we've been staying in a resort hotel attending orientation conferences. During the day, the weather is quite hot (I think we're all going through a little bit of air-conditioning withdrawal, even if I don't like to admit it), but the mornings and evenings are cool, and it's pleasant to walk around the resort. 

I'm told this area is actually heavily forested for Armenia, and that people come to the resort to enjoy greenery that isn't seen in other regions. 

A short walk through the woods behind the hotel leads you to these church ruins. There is a plaque explaining the ruins at the head of the trail, but unfortunately, it's all in Armenian and I can't understand any of it yet. 

Inside the church's remaining alcove, there is this peculiar shrine: the walls are streaked with soot as if there are routinely fires (candles?) lit inside the alcove, and this floor and walls are littered with religous imagery. I wonder who still prays here. 

But my favorite picture from the resort has to  be this one: there are many small playgrounds for the children of resort patrons scattered around the grounds, but there also appear to be a host of local's animals who roam around the area, and sometimes to two collide. 

Tomorrow we're scheduled to leave Aghrevan and travel to our host families in the villages where we will be living for the next 3 months.

Last thoughts before leaving the US

Today was our second day of orientation in Armenia- mostly that translates to sitting in a conference room all day, with a few language lessons thrown in. I don't feel like I'm really interacting with Armenia all that much yet, so instead of my thoughts on this country, I'm going to share some thoughts I had as we were leaving the United States:

I tried to pay attention to the things outside the bus's windows. We were riding a coach bus from the staging hotel outside Philadelphia to JFK International Airport. For some unknown reason, the bus driver had decided to drive us right through downtown Brooklyn to get there. Inside the bus there was too-chilly air conditioning, but outside people sweated on the sidewalk. 

I watched the intense crush of humanity that is New York City with more attention than I usually would have. This was, after all, going to be my last glimpse of America before starting my service as a Peace Corps Volunteer. I saw men and women walking along the sidewalks carrying grocery bags. Families in the park. A few homeless people drinking out of bottles covered by paper bags. I saw a group of children playing baseball on the sidewalk in front of their stoop. We passed the Brooklyn Public Library and the Botanical Gardens. We passed bodegas and apartment complexes. As we passed through the city, I tried to take it all in and bring it with me. I wanted t obe able to remember this city thrumming with the heartbeats of its inhabitants and explain it to Armenia. I wanted to be able to recall this cityscape and be able to say "This is America". 

Too quickly, it seems, we arrived at the airport. The group was able to get our bags checked and get through security without incident- although Sam was randomly selected to receive a pat-down at the security checkpoint. The flight, transfer at Charles De Gaulle, and subsequent connection were neither particularly pleasant nor unpleasant, It took almost 30 hours total, but at the end of the (very long) day, we were in Armenia. 

A quiet moment...

I'm sitting in my hotel room at Aghrevan Park Resort. There are children playing on a jungle gym outside my window. It took almost a quarter of an hour before I realized they were shouting to each other in Armenian. Isn't it funny how kids on a playground sound the same wherever you go?

Considering myself, my hands...

I have been thinking a lot about my identity over the past several weeks as I transition into this new role of "teacher". It is not an easy transition for me, and I continue to struggle to feel confident and comfortable in the role.  I wrote this a few days ago, as we drove to Philadelphia for our pre-departure staging:

As  I washed the last of the dirt and grit out from underneath my fingernails, it struck me that my time as a Tiny House builder was, for now, over. The veneer of grime that I had accumulated over the previous six months and worn light armor during our build slowly gave way under the onslaught of steaming water as I enjoyed my last shower in the US. I reveled in the endless hot water, lingering over my hands as I washed the last physical traces of the past half-year away in preparation for the next 27 months.

My hands were changed from my time as a builder, My nails were short, blunt, and chipped in places- my cuticles raw from rough use. I had scratches and bruises over many of my fingers. I used to have delicate hands- well equipped for typing and note taking from my time as a medical scribe and a student before that. Now they were rough and robust with fingers still slightly swollen from the abuse of the last frantic days of the build. Red under the hot water, they looked almost sausage like; and as much as I loved building our own house, I was a little glad that the grueling process of the last 6 months was over.

Later that morning, I would be setting out with my husband, Sam, to serve for 2.25 years with the Peace Corps. We will be Teaching English as a Foreign Language in the Republic of Armenia. I had packed my bags the previous evening and Sam was almost finished packing his. We had tried to finish packing the night before, but at 2 a.m. decided we needed to get a few hours sleep instead. I had gotten up at 7 in order to shower.

I took my time- enjoying the luxury of half-an-hour with nothing to do but self-care, then dried off, got dressed, and woke Sam. We planned to finished packing and leave the house around nine. We were traveling to Philadelphia to meet with our Peace Corps staging group, with a one-day stop in New Jersey to say goodbye to my mom's family. There will be one day of training in Philadelphia, after which the Peace Corps will bus us all up to New York and we'll fly out of JFK to Armenia, where we'll live until November of 2017. I wonder what my hands will look like then?

Day Zero: Traveling to Armenia

S/P Application Day: 417, T-0 Days to Departure. 

It's  been exactly 200 days since I last posted on this blog, and the past 7 months have been nothing if not chaotic and character building. Building our Tiny House has helped Sam and I grow as individuals, grow as a couple, and has really helped me step back from the medical profession and gain some conception of myself outside of that role which as been so important and central to my identity for the past half-decade. (If you're at all interested in what that was like,, read about it at Molly & Sam's Tiny Adventure) I hope to be able to write about this in depth some time in the future, but right now I'm pretty badly jet-lagged, so instead of engaging in intensive introspection, I'll just summarize the last 96 hours or so. 

Our Peace Corps Journey really began 4 days ago when we finished the Tiny House, packed our things, drove to New Jersey to say goodbye to my grandmother, unpacked and repacked all our things, and drove to  Peace Corps Staging in Philadelphia. During this time, I think we slept a grand total of 4 or 5 hours. Finishing the Tiny House turned into such a rush job, that the night before we left home for the last time in 27 month, had hadn't packed a thing. We pulled 2 consecutive all-nighters to get everything into the proper weight/size configurations in our bags. 

After a day of team-building activities at Staging, we spend one night in a hotel outside of Philadelphia (quite close to Bryn Mawr, actually) before setting off on our trip. I don't know that I've ever been so tired as I was that night- we slept very well. The next day, all the volunteers and our bags piled into buses and set off from Philadelphia to New York, we we would fly out of JFK. Why not fly out of Philadelphia? Why not stay in a hotel outside of New York? I don't know. I suspect that this is more of the same logic that had Sam and I fill out a 50+ page long application rather than submitting simple resumes and statements of interest.

We got to drive through New York to get to JFK, which was a nice way to say goodbye to America for a few years...

And I was able to accomplish my first Peace Corps life-hack when my cheap carry-on  duffle broke halfway through security. What can serve to replace the broken carabiner and double as an awesome little gift for your host family? An I <3 NY key chain, of course. 

At some point in time during the flight, we took the obligatory Airplane Selfie.... And then suddenly we're over Armenia:

This is my first glimpse of the country we'll be living in for the next two years. I have to admit that I find the sight a little intimidating- those mountains look intense. They're telling us to put away our electronics, so I'll have to wrap this up. Hopefully I will have more time to write once we're semi-settled in country.