A Psychiatrist's Journal
A
cultural and psychiatric immersion/Tsunami relief
By Elizabeth A. Garcia-Gray MD
(Reprinted with permission of Dr. Elizabeth A. Garcia-Gray).
In
February 2005, I planned, managed and coordinated the
project for Dr. Garcia-Gray. Her journal accounts and work
with Tsunami victims was truly stellar. Dr Garcia-Gray is a
true humanitarian. For this reason, I recommended that she
be awarded the American Psychiatrist Association
Distinguished Fellowship. Dr. Garcia- Gray’s experience and
her journals will soon be published. Visit her web site at:
www.garciagray.com
THAILAND MISSION PROJECT TRIP
March 20 - April 2, 2005
The tsunami devastation shocked the
world. Especially when it hit places and people who were
innocently unprepared for the devastation. The countless
number of lives lost all at once, and the children and
families left behind and displaced, struck a resonating
compassionate chord in many of our hearts. It certainly did
in mine.
How quickly, much too quickly, life comes
and goes. "One day at a time" becomes an even wiser and more
pertinent saying. We ask our "whys?" And then we all observe
how the majority of the world responded with much kindness,
empathy and a compelling desire to help those who are
suffering. For many of us understand deeply the meaning of a
tragedy; the meaning of loss and agony. Thus comes the
feeling of love to serve others. To ease their pain the way
we wanted our souls comforted during sorrowful times.
Hopefully to bring sparks of Light in the midst of some
darkness.
In Emily Dickinson's “Not in Vain”, she
sensitively described the hearts of volunteers around the
world:
If I can stop one heart from breaking,
I shall not live in vain.
If I can ease one life the aching
Or cool one pain
Or help one fainting robin
Unto his nest again
I shall not live in vain.
That was how I started this journey. It was a journey of the
soul.
And that was also when my research to
help in some little way started. That took on a life of its
own. From donating to various non-profit organizations in
Network For Good to getting daily alerts regarding the
status of countries affected by the tsunami from CIDI -
Center of International Disaster Information. I also
contacted several non-profit medical organizations, but they
required a stay of at least 3-6 months and I only had
2-3 weeks of vacation time to give. Many volunteers globally
did the same. Even the children and teens throughout the
world wanted to do something. A worldwide outpouring of
volunteerism.
My job as chief medical officer, of the
child psychiatric services, for Seven Counties services a
comprehensive mental health care non-profit organization
was a mission in itself, serving people in the Louisville
community. One organization called and asked me whether I
could volunteer in Chad to work with the Sudanese Darfur
refugees, but again, they required at least a three-month
stay. If that were not possible, they wondered if I could go
to Indonesia within the week, but I was booked solid with
patients then and needed time to get back-up child
psychiatric coverage in my organization.
At one point, I was almost headed toward
Sri Lanka since I knew a team of doctors going there for
short-term work. But somehow I ended up reading about Global
Service Corps (GSC) in the “New York Times”, and that they
had mission projects for two weeks in Thailand. I was also
becoming more compelled to go to Thailand because I was
impressed by the interview on the news of Thailand's prime
minister. He requested help not necessarily on a monetary
level but for expertise especially in the psychosocial
aspects to rehabilitate the emotional damage caused by the
tsunami. Not too often do you hear the government of a
developing country say that they had enough donations for
now and seek what their people truly need.
So, I contacted GSC, but they said that I
was a bit late for the project. I had already booked my
plane tickets ahead of time and had already scheduled my
patients around those dates. It would have been logistically
difficult to change the schedule. GSC then re-directed me to
e-mail their In-Thailand Director. Interestingly, GSC stated
on their website that they were mainly project-oriented in
terms of volunteers working in hospitals and clinics or
teaching English, with Buddhism immersions, but not
necessarily able to help those wanting to volunteer for the
tsunami-affected families. This was mainly because their
project base was in Kanchanaburi, a province in Central
Thailand. They work with medical students and physicians who
want to do volunteer work in Thailand or Tanzania, where
they have their projects.
Somehow, after many e-mail exchanges with
GSC’s Thailand Director, Bruce, he was able to find ways to
coordinate for me to have an initial cultural and
professional immersion in Kanchanaburi with a Thai host
family. After that, he organized a way for me to be escorted
to the Phuket area affected by the tsunami in the south of
Thailand. He had contacted Dr. Kung, an OB-GYNE doctor in
the Pahon Hospital there, and she and her family would serve
as my Thai hosts.
Dr. Kung and I exchanged e-mails and
photos, and even through our e-mails, her warmth and
down-to- earth ways shone through. Bruce also said that I
could spend time meeting with a monk in one of their wats
(monasteries). It was important for me to understand the
religious and spiritual core of individuals and cultures as
it sets the standard norm in understanding their sense of
ideals and basic hope. In psychiatry, the sense of hope and
faith are key to mental health resilience.
I then spoke with my adult children and
family about the trip and showed them the photos of my Thai
host family and the detailed and helpful schedule that Bruce
e-mailed me. These helped allay their concerns. Bruce wrote
me the descriptive details of who would meet me at the
airport. Supposedly, a petite lady named Lek, with a red
Chicago Bulls baseball cap, would meet me right after I got
my baggage.
And I enjoyed the narrative of how he
ended up in Thailand and along the way married his Thai
wife. But most of all, it was heartwarming for him to remind
me that the Bridge on the River Kwai was in Kanchanaburi.
All of a sudden, I found myself whistling to the tune of the
movie's main melody. The Bridge on the River Kwai was a
famous movie that won many awards when I was growing up. And
that movie reminded me nostalgically of happy childhood
times with my beloved grandparents. Bruce was inspired by
the book the movie was based upon.
I then went with the flow and sent the
necessary paperwork to GSC that included copies of my
passport, my medical credentials and resume, background
information, personal mission statement and other necessary
data. After I paid my fees, GSC sent me a hard copy of
information about the trip, which included a checklist of
what to pack and bring.
My family, friends and colleagues
couldn't be more supportive. Some gave me little gifts to
give the tsunami-affected families. My heart would
sporadically beat faster thinking about going to Thailand.
In reflecting upon my other previous global missions, I
always came back with a much fuller heart and spirit. I gain
perspective about my priorities in life. Crystal clear
insights about love and life supplant the previously hazy
ones. And what I originally thought as stressors before
going on missions became just but a minor nudge in the
bigger scheme of things.
And as my favorite writer, the Lebanese
poet, author of “The Prophet”, Kahlil Gibran profoundly yet
simply mused, "The sea that calls all things unto her calls
me, and I must embark."
The following are excerpts from my
journal when I was in Thailand.
March 27, 2005, Sunday
The drive to the tsunami area - Takuapa Hospital- Khao-lak
3am sharp. Both Att and Sert, my GSC
staff and coordinators, were right on time. I said my
good-byes to Dr. Kung and her husband and gave them my
formal wais and then I gave them both a hug. I thanked them
for everything and requested for them to please give the
kids a hug for me. The children and their grandma were fast
asleep during those wee morning hours. I just couldn't thank
them enough for everything.
I missed them all already as we drove out
of their home. I couldn't have been matchedup with a better
family.
Att and Sert are such a gentle and very
thoughtful couple. They tended to cater to me and I felt
totally cared for in every way. They bought me lots of Thai
goodies for the trip - bottled water, tangerines,
coffee-flavored peanuts, and a treat that tasted like ice
cream waffle cones. We stopped virtually every three hours
for pit stops. The heat was intense and we were sweating all
over. My face was drenched and my hair was just frizzed-up.
Oh well. It would intermittently rain. Artificial rain made
by the king to help with the drought. The toilets were
tricky- very low on the ground. Frankly, I wasn't quite sure
how to use them and too embarrassed to ask Sert and Att.
They had pails to pour water into the hong narm ( toilet ) -
which was bedpan-like in style.
We grazed and ate. Att even tried to get
some tamarinds for me right from the tree. She found a thin
branch and tried to pick at the tamarinds until they fell to
the ground. It reminded me of my childhood days doing just
the same thing with a fruit called sampaloc in the
Philippines. I wondered if they came from the same fruit
family.
The scenery driving from Kanchanaburi to
Khao-lak was absolutely breathtaking! Mountain after
mountain. They looked like soft pastel paintings in dark
purple, lavender, pinks and peach. It got greener and more
lush as we got to the South. We then ended up in a place
called Pra-chuap. What a soulful place. Dreamy. It was
lovely to see the beach right next to mountains. We stopped
to take photos and then ate brunch in a nice hotel named Had
Thong Hotel (Golden Beach Hotel). I loved those little round
pancakes with coconut cream. And more exotic tropical
fruits.
We then proceeded to Sukhothai and after
several more stops, we finally ended up at the Takuapa
Hospital. There was a nurse there named " Oyl" who we had to
meet and who was in charge of organizing the tsunami relief
situation in six provinces there. Oyl was very friendly and
helpful. We toured the hospital and it was open and breezy.
I welcomed that cool breeze. It was a white building much
like the Pahon hospital but perhaps a little smaller. We
were offered some cool drinks and that quenched our thirst
in that heat. Sert and Att coordinated my schedule for the
next few days with Oyl. There was a room there especially
for tsunami relief conferences which had maps of the tsunami
affected areas and the updated numbers of displaced children
and families, the tsunami death toll, whether the injured
and dead were Thai or foreigners or whether they couldn't
tell the race from the extreme decomposition of the bodies.
We then tried to find our hotel. It was a
long drive. Roughly 14 hours. The hotel was in Khao-lak in
the province of Phang-nga. The area was the most tsunami
devastated of all the regions there. We finally found our
hotel - the Khao-lak Bayfront Hotel. My room number was 204.
Beautiful place. Right on the beach. We walked around and
explored the hotel grounds and sadly saw the devastation by
the beach. Half of the resort was going through
reconstruction. It was eerily quiet. On the left at the back
of the hotel, by the beach, were homes with roofs that had
been unshingled from the tsunami. Some debris on the beach.
They had flattened out the back area of the hotel towards
the beach and had replaced it with new soil that appeared to
be pinkish -orange brown in color.
The area was quiet and private. A haven.
Att, Sert and I walked around and took photos of an
incredible sunset. We literally watched the sun go down. We
did some walking meditation all around the area that was
literally wiped out by the tsunami. I prayed for those who
died and whose families were affected as well. I felt
tearful. I couldn't even imagine how those people must have
felt when the wave hit. Most of them were quite relaxed and
vacationing when it all happened. I contemplated about how
life was way too short and how it can be taken just like
that. Within a second. And how important it was to live one
day at a time. One moment at a time if possible.
Many died in the hotel we stayed in. From
the beach one can see the overview of the hotel. The lower
level was flattened out and the higher level remained quite
intact. And from that view, one can easily see the awesome
lushness of the mountainside with all the tropical trees.
Many coconut trees. Incredible trees that couldn't be
uprooted by the tsunami. The power of flexibility,
rootedness and pliancy.
There were many settlement homes built
and being built just down the road. Many businesses were
closed. We did some souvenir shopping. Mainly for postcards
for my children and some wrap around Thai silk skirts. When
we came back to the hotel I couldn't wait to jump into the
shower. It was probably the longest shower I've ever
taken. I relished all that water all over me. Fresh again.
It felt great! The hotel room was quite nice. I had a
king-sized bed with the softest sheets I've ever slept in.
It felt wonderful! There was also a balcony.
I wrote some postcards, journaled,
watched a little tv, mainly trying to understand Thai, and
went off to sleep. Approximately fourteen hours of driving
from Kanchanaburi to Khao-lak was tough tempered only by the
great company I had with Sert and Att , the wondrous scenery
along the way and the thought of serving others out there.
Being there was like being in the midst of a tropical rain
forest and also a beach. Everything one can ever want from
nature. No wonder people travelled from afar to vacation
there. Paradise-like.
Somehow that night, we also managed to
eat in an open-air restaurant. Thai curry on grilled fish;
chicken with a special Thai sauce and rice. It was good to
know Sert and Att even more. They were so soft-spoken and
practically talked to one another in a whisper. I liked
that. They were easy on the soul.
The next day, we were due for an
orientation about the tsunami relief at 8:30 AM. So we had
to leave at 8 AM. Breakfast at 7:30 AM. Yawning. The softest
white sheets beckoned me. Necessary rest to have more energy
for tomorrow's service work.
I prayed, meditated and serenely slept.
Match 28, 2005, Monday
In the heart of the tsunami mission
Breakfast with Att and Sert on the hotel
balcony. It was sad to overlook where the tsunami hit. We
could see the beach from the balcony. Thirty-eight
foreigners (farang ) died in this hotel. The forty lower
rooms of the Khao-lak Bayfront Hotel were demolished.
After breakfast, we drove off to Takuapa
Hospital. We met Oyl, the nurse in charge of helping
organize the tsunami conference. In the conference there
were around fifty or more people - nurses, tsunami
volunteers, psychologists, public health experts and the
only psychiatrist in the Phang-nga region area serving more
than 250,00 catchment population.
The public health man named Tik-ki did
the presentation and showed us an excellent power point of
photographs of the tsunami before and after the disaster. He
showed us how much rehabilitation and reconstruction was
being accomplished post tsunami. The pictures he showed were
quite moving, graphic and he drove his point across. He told
me later that he gathered those photos from various people
and locals who witnessed the tsunami.
The volunteer nurses were all wearing
bright pink. Everyone sat around a huge conference table.
After the presentation, the young, attractive and bright
psychiatrist and I spoke. She was very open to being
shadowed when she worked and welcomed the consultation and
the teaching.
Dr. Naiyana's English was quite good so
we were able to communicate fairly well. We talked about the
tsunami in general and about Psychiatry in Thailand
as well as in the USA.We also addressed
the issue of the children and families in the settlement
camps and she arranged for us to go there. She spoke with
the rest of her team from Phang-nga Hospital and then we all
went out together for lunch. They took us to a restaurant
where they said the locals loved. And the food truly was
delicious. Aroi.
Dr. Naiyana was a 27 year old
psychiatrist who was trained in Bangkok but was born and
raised in the northeast of Thailand. She was still single
and the youngest of three siblings. She said that her
parents visited her often. She also alluded to the fact that
most of her psychiatric in-patients were merged with the
surgical ward patients. She generally stabilized the acute
patients and then sent the more chronic ones to a
psychiatric hospital elsewhere.
It was enjoyable meeting the vibrant
team. They were very collaborative and explained what they
did in the rehabilitation phase of the disaster. They drove
around in a van to visit one settlement site to another. Dr.
Naiyana joined the team on Mondays to visit the camps as
part of her work schedule. The public health man who did the
presentation, I found out later, was an avid soccer fan.
So we talked about that in the van on our
way to the camps. He articulated that anyone who loved
soccer was a friend of his. Great then! Well, my experiences
in Spain came in handy. We talked about Johann Cruyff from
the Netherlands and Pele from Brazil , my favorite soccer
players of all times. And how I was so impressed by the way
Johann Cruyff played soccer and the way he just handled the
ball so adroitly.
I recalled times in Spain when literally
everything stopped when there were soccer games. And I
remembered having gone to a Barcelona soccer game and saw
Johann Cruyff do his magic. We talked about all these on our
way to the Phang-nga Hospital. I requested Tik-ki if I could
have a copy of his powerpoint presentation to share with
other psychiatrists at my work in Louisville and he said
that he was more than happy to do it. I appreciated it a
whole lot. Sert and Att were surprised that he easily
offered for us to have the powerpoint. Tik-ki also kindly
made a copy for them.
Prior to that, we all went to see the
children and displaced families in the settlement camps.
There were knock-down temporary aluminum houses. Some houses
were made of wood. Most of the families were under the
make-shift houses to shield themselves from the heat that
day. They moved slowly and quite languidly. The heat. They
quietly spoke with one another. There was an older lady who
appeared to be the matriarch of the family, and the nurses
told me that she had a near-drowning during the tsunami
and somehow miraculously survived.
There were 5 nurses to 68 people. They
have the basic medication necessities - Tylenol, alcohol,
antibiotics like Amoxicillin. Their medication shelf
also contained some band-aides, gauze, and a first aid kit.
The nurses were stationed underneath a temporary home and
appeared to all be in generally good spirits. They were
smiling and were very helpful when asked about what happened
if there was an emergency when they were not there. They
reported that they wanted to preserve the autonomy of the
families and a wise elder usually took charge in calling the
nurses when there was any emergency.
They also had a make-shift recreation
area. Several children and teens were quietly painting on
cloths. Tsunami themes. Like batik. I mingled with some of
the children and teens who were silently painting. There
were finished paintings hanging to dry everywhere. The
colors they used were bright and grabbed one's attention. I
quietly sat beside them as they worked on the batiks. I
didn't want to intrude on the teens as they were so focused
and engrossed in their art work. One teen did say that he
"enjoyed" painting the tsunami. Art therapy in action. My
sister Marissa, an art therapist would be very pleased. The
teens were very subdued. Very quiet. The younger children
were playing in a playground. Their movements were slow.
Voices - soft. Their faces sad.
The idea of teaching the children and
teens to paint their interpretation of the tsunami disaster
on batik cloths , I felt, was therapeutically brilliant! Not
only were they able to express their feelings via their art
works, they were also able to sell them to tourists as a
means of livelihood. This then helped with their sense of
autonomy and resourcefulness.
The nursing staff who were all smiles
said that they had been there since right after the tsunami
just hit and had many stories about the children's dilemma.
Many upper respiratory infections among the families. Also
allergic rhinitis. Many children had been depressed and the
staff work on keeping them busy to alleviate their grief and
sadness. A lot of the comforting and therapy were done by
the nurses in many cases. There were many stories about
near-drownings and about wounds and infections from
abrasions and lacerations.
The Ministry of Public Health had been
very efficient and effective in being on top of the tsunami
situation there. They currently have potable drinking water
and they have enough food that was sanitary. They were proud
that there had been no water-borne illnesses nor outbreaks
of diarrhea, vomiting nor nausea. They've contained a lot of
that. The public health had been very quick in responding to
the needs of the affected families.
Dr. Naiyana also said that the king's
royal soldiers - his army - had been extremely helpful to
the tsunami-stricken families. They did a lot - from taking
care of the dead bodies, to cooking for the displaced
families. The team was very respectful and grateful for the
way the Thai soldiers had been helping out.
We passed by several places on the road
that housed the many volunteers from all over the world.
Habitat for Humanity, World Vision , UNESCO were all there.
It was amazing to me how many coconut trees stayed rooted,
while the buildings were demolished. There were many
landspaces and moist soil areas where the tsunami struck
alternating with areas of construction.
The Thai want the tourists back. The
economy there was booming before the tsunami. One of the
king's nephews died during the tsunami right in the Princess
hotel resort that they recently built.
We finally drove to Phang-nga Hospital.
Dr. Naiyana had a spacious office in the hospital with her
own bathroom. She then took me to meet a 10 year old Moslem
boy who was having paranoid delusions and hallucinations
since the tsunami. She requested consultation about this boy
as she was baffled by his symptoms. Post-traumatic stress
disorder with psychosis. The boy was accompanied by an
extended family and a man who was originally from Italy who
claimed that he had been a volunteer in Banda Aceh,
Indonesia and Sri Lanka as well. He stated that he had been
helping there with the DNA analysis crew from Europe.
He appeared to have a good rapport with
the child and his family and spoke several languages.
However, Dr. Naiayana and I started to feel concerned when
this man kept insisting that all this boy needed was to be
allowed to run wild in the jungle " because he was a jungle
boy" rather than stay in the hospital. Unfortunately, the
child had relatives who suffered from schizophrenia and a
positive genetic history made things a bit more complex. We
wondered about childhood schizophrenia triggered by the
disaster. Or a combination of PTSD and schizophrenia.
He was treated with Haldol to reduce his
severe agitation and psychotic symptoms. He had EPS
(extrapyramidal symptoms i.e. muscular rigidity, dyskinesia
) from the Haldol and Dr. Naiayana and I discussed his
treatment plan to eventually reduce the Haldol very
gradually to even as low as 0.5 mgs twice a day and 1 mg at
night for maintenance. Or perhaps switch to Quetiapine but
Dr. Naiayana found the atypical antipsychotics " too
expensive". We still thought about Risperdone though, an
atypical which was probably a good choice eventually for
this boy. The boy had cogwheel rigidity but he was able to
smile although hardly spoke. He was able to follow
directions , walked slowly (bradykinesia) , but was
coordinated. Sleep was still a problem.
And as we observed him, he appeared to be
actively hallucinating, smiling inappropriately, staring in
space, and very distracted. He was paranoid but not
agitated. The Italian man kept talking to me about how the
Thai now didn’t trust foreign volunteers for instilling "too
much false hope " in them. And how many of the volunteers'
services were not really needed.
One of the boy’s relatives eventually cut
off this man and requested him to stop talking and
distracting us so we could provide consultation for the boy.
I reinforced the fact that Dr. Naiayana did the right thing
in prescribing medications for him. I told them that I would
have definitely prescribed an anti-psychotic medication for
the boy. And that Dr. Naiayana would eventually taper down
the medications to a maintenance level as he stabilized. And
that we needed to give some medication that reduced the
side-effects of Haldol. Artane. Low dose.
The family was appreciative of the
consultation and gave their wais to us. The Italian
volunteer and I also talked about how there were reports of
children being stolen and sold to pornography and pedophile
rings in Indonesia, Sri Lanka and Thailand. It was saddening
to know that there were those who tended to capitalize on
the misfortunes of others. He said that he was a
chiropractor but could not practice his craft in Thailand so
he ended up working as a Thai masseuse. Many of the
hospitals there had a Thai massage center. This man also
talked about how many volunteers were sent home by the
Indonesian government because they got mad at them for
trying to control things too much" . This was his story. Dr.
Naiayana and I reported him to the medical director to make
sure that he didn’t interfere with that boy's treatment.
Before I decided to go to Thailand I was
also thinking about going to Sri Lanka. However, a medical
volunteer who went to Sri Lanka told me about a volunteer
from our city who went to Sri Lanka. A therapist. He had the
full intention of volunteering his time for 3 months. In the
first two days he was in Sri Lanka, some locals reportedly
approached him and asked if he was an American as they
needed help. They reported to him that their children were
stolen. And supposedly the police may have been involved.
The volunteer reportedly called the US embassy and also
reported it to the UN who sent someone to track the kids
down. However, the tracker never returned and something may
have happened to him so the embassy tried to protect the
volunteer from retaliative violence by instructing him to
change his appearance by shaving his head and hiding out in
the jungle for a couple of days until they flew him back
home. This all supposedly happened in less than a week. I
have no way to confirm the truth or untruth of this story.
We said our good-byes to the Phang-nga
Hospital team for that day. Att , Sert and I drove down some
curvy roads back to Khao-lak. But first we got some Thai
massage. Really interesting. The place had several mats with
pillows on the floor, curtains and fans. Att wanted a foot
massage. Sert got his massage as well and I also did. We
were all in the same big room so we were able to talk to one
another and our masseurs. Thai massage. Hands, feet, elbows
, knees are all utilized by the masseuse. Lots of stretching
involved. 250 bahts for one hour. I think that it is great
that Thai massage is very much integrated in health, healing
and treatment in Thailand. After that we ate dinner. I felt
better. I like the stretches. I love that watermelon juice -
malakor. So refreshing. Back to the hotel. Tired. Showered.
Journaled. Slept restfully.
March 29, 2005, Tuesday
TSUNAMI WARNING in Khao-lak, Phang-nga , Thailand
Midnight! Frantic knocks on my door -
lots of rushing and urgent voice sounds and noises in the
hallway. Initially I thought there was an emergency that
required a physician. I abruptly got up, still in my light
blue -green surgical scrubs, and opened my door. There were
Att and Sert -- anxiously and hurriedly rushing to get their
belongings-- Att cried out "tsunami -- in 20 minutes ! ".
Their faces full of panic and fear. People were running up
mountain. People alternated in halfway screaming out about
the tsunami coming and silently dashing by us. I didn't even
think. I just prayed silently, grabbed my handbag which had
my passport and wallet and left everything else in the room.
After having met with the professionals
in charge of the December tsunami resettlement and care the
day before, I knew that we had to be 2 kilometers up-
mountain to be reasonably safe from the tsunami. It quickly
ran through my head that the probability of us dying was
definitely there because no one can run that fast in that
short period of time 2 kilometers up the mountain. Not even
the Olympic runners. Surely not. The tsunami hitting again
in the same area so soon. It made no sense. And yet it did.
After all, the geological and meteorological set-up was
there now for tsunamis after the first one in December 26,
2004. I didn't know. I didn't know much of anything at that
point.
The next 20 minutes. A tsunami. An
unusually large seaware produced by an undersea volcanic
eruption. A seismic sea wave. And in 20 minutes. Time. No
time. This became the longest journey I've ever taken in my
life. It was a journey from my head, to my heart and then to
my soul.
As I was crying out for Sert and Att to
hurry and leave all their belongings, I also started banging
on the hotel doors that we passed by to make sure that other
people were warned. Many times, during emergencies, people
start going in circles from confusion and panic, and it
truly is helpful to scream out and tell people to keep
moving. Some feel and become immobilized from anxiety and
fear. I started running as fast as I could encouraging Att
and Sert to hurry up and leave their belongings. I had on
thong slippers and was tying my surgical scrubs string belt
as I ran, with my black bag on my right shoulder.
I had my passport in my bag. It felt like
a horrible nightmare and yet strangely I felt a strange calm
inside. I normally don't even yell and here I was yelling at
some children and teens to keep moving as we went up towards
the parking lot in the higher ground. I kept firmly
screaming -- Go! Keep going ! Run! I guess that the
physician in me took over and started giving out verbal
orders thinking about their safety. At that point, Sert and
Att became even more anxious because, they couldn't find the
keys to their car and my heart about sank when I saw Sert go
back to the hotel room to find the keys. Oh no!
"Come back here Sert!" We could
just run up- mountain. We can't waste time.
The brave man went back to the hotel room
to find the keys anyway feeling that it would save our lives
for him to do that.
I just prayed really hard at that point.
It was a relief to see him running up towards us and he
rushed right into the car. Thank God.
Att and I started talking to Sert in a
very calm voice to calm us all down. But because of
naturally wanting to get out of there to save our lives, and
being in such desperate hurry, Sert accidentally backed up
and crashed onto a low concrete wall. My heart
thumped pretty hard at this point.
Okay. Breathe. Staying peaceful in the
eye of the storm.
Everything I learned about meditation ,
anxiety reduction, self-hypnotic focus on what we had to do,
and every psychological defense mechanisms, all balled-up in
one, went into effect automatically. The feeling of fight or
flight. And we were fleeing from the tsunami and we were
fighting time. That precious time.
That time that we normally waste doing
unnecessary things routinely and which we take for granted.
The minutes felt like years. 20 minutes.
No way. Yes way. Yes. We can do it. Yes we can. Just pray.
Att and I tried to calm down Sert so
he was able to drive. It was an inordinate amount of
pressure on him. Watching him put the keys in the ignition
felt like years. He must have felt like our lives were in
his hands. Att and I kept saying that it would be alright.
And in a way it really felt like that.
Bless his heart. Good man. And Att. What a lovely heart of a
lady. I thought that if I died then, that I felt blessed
being in the company of this very kind and tender couple.
They had been so protective of me in every way that I felt
at home anywhere we went.
Other cars were going chaotically up the
mountain. Some almost bumping onto one another and beeping
their horns. This was when my life truly flashed before my
eyes like a film. First a fast rewind and then an intense
fast forward. I felt all the sorrows and joys I've ever had
since I was a child in a very compressed manner. Very very
compressed. People I've loved and who loved me flashed into
my senses and vignettes of feelings of love and comfort
prevailed.
All of a sudden there was clarity in my
heart. Peaceful. A sense that all was forgiven. The wrongs I
have done. The wrongs that were done to me. A sense of
being able to look back at my own actions both good and
those I was not proud of. It was as if I was given a chance
to see my own soul from a divine perspective and still be
grateful for my life and the people who have been there for
me. The erasure of the record of any wrongs ever done by
anyone. Corinthians. Patience. Kindness. Compassion. Faith.
Hope. And most of all , Love.
I thought about one of my esteemed
mentors Dr. Wayne Oates. In asking him so many questions
about how to integrate some of the Biblical passages, he
gently and wisely said to me. " Liz, when confused, just
keep it simple. Just focus on the 2 main commandments - Love
God and love others." Brilliant sage. So after that, every
time I reflect upon my actions I worked hard in discerning
whether what I do or the decisions I make manifest the 2
most important spiritual mandates. Many times I fall short.
Way short. But I still get back on the horse and just allow
myself to follow those spiritual anchors. I believe that all
of us are God's children, no matter what religion.
I thought about my children, family and
friends. I thought how incredibly blessed I was to have a
family like mine. All so incredible, brilliant and loving in
their own ways. My dad. I wouldn't trade him for any dad in
the world. He would have known what to do in a situation
like this as he and my uncles have consistently done medical
missions in remote areas in the Philippines. Big-hearted,
generous, an excellent leader, very intelligent and would do
anything for the family, friends and for those who need his
help. My mom whose illness has served as an inspiration for
me to pursue my goals in life and who imparted her love for
piano and music to my sibs and me. My stepmoms. Such
family-oriented ladies. Both so lovely. I thank God for
their presence in our lives. My sibs. How I love my
siblings. They are all so talented and loving and we are all
so bonded even more so after Alex's tragedy. My little
nieces and nephews. They are so delightful and have given me
joy. And my cousins. How I love them. Who are truly like my
sibs as we grew up together in the Philippines. And all my
uncles and aunts who helped raise us all and imparted their
talents and best love to us.
I thought about all my friends. My
elementary and high school Prepian friends. They have given
me much heart's delight and a spirit of eternal youth. So
much laughter and unconditional love. My many friends at
work who were there for me during crucial times in my life
and who enjoyed my joys. How can I not feel grateful and
blessed?
My work. Our work mission to help those
who are suffering mental illness, chemical dependency and
developmental disabilities. My colleagues and friends, and
those who spent most of their lives in the service of
others. My patients. Their courage to slay their own
dragons. Their strength in dealing with the sorrows and
pains in their lives. I thanked them in my mind for allowing
me to serve them in some little way, and in having done so,
I felt served in my heart.
I thought about my relationships and the
fact that I was letting go. And briefly wondered if letting
go was truly the way to go in love. And my search to learn
and feel the unconditionality of love even more now than
ever. And the ability to concentrate on loving rather than
being loved. Since my divorce in 1997, I've withheld myself
from loving to the max. And I need to know the meaning of
loving like I've never been hurt before in this lifetime.
The divorce was generally amicable and my ex-husband will
always be family to me as he is the father of our children.
He also went to Sri Lanka to help out with a tsunami medical
mission with the Rotary Club out there. I loved my
parents-in-law who are now deceased. They were just like my
paternal grandparents who I absolutely adored. They all four
raised the bar for role-modeling what love for a spouse and
family should be.
But most of all, I thought about my
children and prayed for God to keep them in the palm of His
hands and surround them with his Light and love whether God
decided to take me then or not. I thought about Alex . My
son who gave me much joy. Very bright, sociable,
multi-talented, and how now he was in a place where he can
pray for us all. And how he is starting to see his own light
in the midst of darkness and illness. And that my prayer
that he can feel and give love again . A miracle in itself.
The prayer that we could be there to hug those who were
affected by his illness and console them and feel the
healing in all our hearts. Miracles. I expect them now. And
Jackie. My old-soul, loveable, beautiful, intelligent,
compassionate, philosophical daughter. She is a spiritual
trudger. And has profound insights for a young lady her age.
She has given me courage to face all that I had to face and
the thought of her helps strengthen my faith. Academically
on track and doing great. But even more, her heart is on
track. I thanked God for my children and to be allowed the
privilege of being their mother.
My priorities started to take on a more
orderly perspective. Peace in the eye of a storm. I started
to be clear about what really was important in my life. It
was not prestige, career, material things, pride, places,
self-will, fame, fortune. I felt a freedom in detaching from
things in those few moments. And realized the meaning of
attaching myself to what counted. Love.
It permitted me to experience the meaning
of what the Native Americans said about Love being the only
thing that is real and all else just an illusion. It sorted
out the meaning of applying all these to the relationships I
have and what was truly significant in a relationship. It
was a realization that love could rise above all pain,
angst, hurts, pride and self-centeredness. And what
counted was loving someone and wishing them their highest
good, no matter what. And that love has to do with giving
ourselves and a beloved the chance to clean slate and
forgive all past wrongdoings on a day by day basis. And that
the miracle inherent in faith and within the context of love
supercedes all human frailties.
It allowed me to want to take a genuine
risk, if I miraculously survived the tsunami, to love the
best I could applying spiritual principles. And that I knew
what I had to do if I ever came home alive. Loving does
involve great risks. It also involves letting go of fear.
And it involves a heartfelt commitment no different from the
faithfulness and belief I have in God. I realize that it may
never be the same. But that feels alright. For I now
understand the meaning of slaying my old self even more to
give birth to my spiritual soul. I opened my heart to love
with a renewed courage and with faith. I need to go where
love is. And I see it now.
Sert, Att and I parked on one side of the
curvy street that hugged the mountain. There were cars, vans
and pick-ups on one side of the street. And the people were
all lined up on the other side of the street where there was
a low concrete wall where we can overlook the Andaman Sea
beaches. Some of the kids were huddled around slumped down
with their backs to the low white concrete wall. Some were
looking at the waves coming in from the sea. A group of
Christian missionaries formed a circle and prayed . People
were wearing their pajamas and some were half-clad. There
were many teen-agers and children talking closely to one
another. Some Buddhist Thai adults were silently meditating
and were sitting down on the ground. One could feel the
anticipatory tension in the beginning. Some of the teens
were laughing, anxiously helping each other minimize the
idea of a potentially pending disaster. People started
frantically clinging on to their cellphones calling their
families. Someone then requested for us not to use the
cellphones because it was clogging up the telecommunications
system and we were needing to be able to communicate if the
tsunami hit. How I wished I had my ham radio there.
Someone started to increase the volume of
their radio and we had some Thai pop music on. It actually
helped. But then, I requested Sert to ask someone to turn on
the radio to the news so we knew our situation from the
outside world perspective. That would help us deal with what
we had to do if the tsunami did hit.
The news reported that there was an
earthquake in Sumatra, Indonesia - similar to when the
December 2004 tsunami occurred. Att called her daughter
and I requested for her to please tell her daughter to call
or e-mail Bruce Houser, my initial in-Thailand coordinator,
who was in El Paso Texas with his wife and son at that time,
so he could call my sister Marissa to let my family know
that I was alright. We had to go against the protocol of no
cellphone use after we heard that the news already hit CNN.
And we didn't want my family to be in limbo worrying about
me out there.
I spoke with some of the American
Christian missionaries. One pastor's wife was there with her
baby. A young blonde -haired lady who appeared exhausted
from the situation wearing a pajama bottom and white
t-shirt. It was fascinating to hear an American speak in
colloquial Thai so well . She told me that they were in a
4-day music ministry with the teens they were with, and they
normally lived in Bangkok. Her husband, who grew up with
missionary parents in Bangkok was also very fluent in Thai.
They came back to live in Bangkok for 4 years now and she
was very much in tune with the nuances of the Thai culture
which was great to know. I spoke with a couple of kids and
teens who were somewhat anxious. People started taking
photos and so did Sert.
Twenty minutes have passed and no
tsunami. We were much calmer. People started to smile again
and laugh a bit more. Less anxiously. Att and I talked about
a Plan B. Perhaps move to a different hotel higher up in the
mountains. People told us to wait until 3 AM before we went
back to our hotels. Att and I thought that it would be safer
to wait even a bit longer. The news reported that Banda
Aceh, Indonesia was being evacuated. And we were more
relieved when the news reported that the waves were headed
South away from Thailand.
Thank goodness. Big sighs of relief from
all. The " bahala na " Filipino attitude helped. Whatever it
is and will be, God will take care of it and that God knew
what He was doing. Let go and let God. Many cultures who
have been ravaged by disasters and wars end up having this
spiritual surrender attitude to deal with the overwhelming
atrocities of war and the trauma of disasters.
It was time to go back to the hotel. I
cherished the relieved smiles of the teenagers and kids.
There were teens and young adults scootering and
motorcycling everywhere. For indeed it would have been much
safer to be in one of those since they quickly and more
easily maneuvered more than cars all around the zigzag
mountain streets. We were all exhausted but obviously
grateful that the tsunami did not wipe us out. The air-con
in the room felt great. Wonderful soft white sheets. And
soft pillows. I marveled at the woodwork all around the
room. I prayed with much gratitude in my heart. Prayers for
my family and friends. And wished the people I loved, the
ones who loved me and the ones who may not even care about
me, and the rest of the world peace and happiness. I will
try to find an internet cafe tomorrow to communicate with my
family and friends to allay their worries. Especially my
Jackie and Alex.
Still March 29, 2005, Tuesday
The morning after the tsunami warning
I actually rested and slept for a few
hours after we got back to the hotel. Tired but full of
spiritual thoughts. I also thought about how we were warned
about the tsunami at 12 midnight and the other volunteers we
met said that their hotels were warned at 11 PM. I was just
glad that we were all still alive and breathing. And
thankful for the fact that we were even warned. And that the
tsunami somehow veered off away from Thailand. It showed how
important warning systems really were.
The few hours of sleep must have been so
deep that it seemed enough. I had no clue how I was able to
sleep that deeply that night. I must have just crashed from
pure exhaustion. I think perhaps thinking about serving more
patients give many of the medical volunteers more stamina to
give out there no matter what the circumstances. I dressed
up and went to the hotel terrace for some breakfast. Fried
rice, egg, watermelon and pineapples. This time I was up
before Sert and Att.
We drove through the zigzag winding roads
all the way to Phang-nga Hospital. It reminded me of the
zigzag roads to Baguio City in the Philippines. Baguio is a
wonderful resort area in the mountains and the weather there
seems eternally temperate and cool. My family and I spent
many memorable times there during the summers visiting my
aunt, a Mathematics college professor at age 19. The
mountain we passed literally felt like it was hugging and
cradling the main road within its bosom. We finally got to
Phang-nga Hospital and Dr. Naiayana was already seeing
patients. We waited briefly in the conference room. She
wanted me to first meet their hospital medical director Dr.
Sam-ian. Dr. Sam-ian was such a gentle , soft-spoken, kindly
man who was warm , receptive and very accommodating. He
seemed to be well-loved in the hospital and his staff
practically tripped over to happily greet him with their
respectful wais and smiles.
We talked for a few minutes and he asked
what he could do for us. I told him about GSC in half-Thai,
half English. And about my desire to volunteer in some way
for the tsunami affected families and children and to
network with other Thai psychiatrists for mutual teaching
and training, cultural exchange, and mutual interchange of
effective treatment ideas. And how I can serve them as a
child psychiatric consultant while I was there. They did not
have any child psychiatrists there and most of the
children were cared for by the pediatricians . The more
severely emotionally troubled children and adolescents were
seen by default by the adult psychiatrists. Dr. Naiayana
expressed her positive feelings about having a child
psychiatric consultant there and already thought about
patients of hers who were children and how she needed
consultations regarding their problems.
Dr. Sam-ian spoke English fairly well and
said that he was in the USA once and mentioned St. Louis.
Att and Sert brought some goodies from Kanchanaburi to give
to Dr. Sam-ian and Dr. Naiayana to let them know that they
were appreciated for their collaboration with us. Dr.
Sam-ian also made sure that I had something from Phang-nga
-- little round bread-like cookies with sweets inside. We
have something quite similar to them in the Philippines - we
called them " hop-ia". How thoughtful.
Dr. Naiayana and I saw several patients
that morning. Back to back and seamlessly. The nurses were
quite efficient and helpful.
Dr. Sam-ian and Dr. Naiayana (pronounced
Nah-yuh-nah) walked us through inside the hospital and made
time to show us the hospital grounds. He was especially
proud of the hospital's new Thai Massage Center and asked me
whether I wanted a Thai therapeutic massage done. They have
integrated Thai massage for therapeutic purposes there as
part of their holistic treatment. I spoke with Dr. Naiayana
about one of the patients we saw that morning who was
suffering from myalgias. She was on an antidepressant and
Valium and we talked about her need for the psychiatric
nurse to follow-up on the patient for psychotherapy. This
lady also had a post-menopausal syndrome and we discussed
more about holistic medicine. She was on an estrogen patch
as well. She may well be a good candidate for the Thai
massage and she thought that it was a good idea.
There was another patient -- a
Moslem lady who was wearing her religious weil. Islam is a
minority religion in a predominantly Buddhist Thailand. She
was very expressive, open and verbal. And she expressed her
fears about the potential teratogenic effects of Anafranil
and Valium. Dr. Naiayana tried to reduce her medications
because we found out that the lady was 3 months pregnant.
She expressed her anger at the previous psychiatrist because
she felt that the medication made her previous child
mentally retarded. Now she was afraid that she might have
another child with mental retardation while on the
medications. At the same token , she also felt fearful that
the agitated anxiety she had because of symptoms of PTSD
from the tsunami would re-surface. She lost several
relatives in the tsunami.
We talked about the risk-benefit ratio of
being on medications versus off. Dr. Naiayana translated the
questions for me and asked me what I would do for this lady
if she were my patient. I recommended an OB-GYNE consult,
very gradual reduction of medications especially the Valium
to prevent withdrawals. I told her that in terms of
benzodiazepines, we tend to prescribe Klonopin more in the
USA if there was a need for an anxiolytic as it was easier
to withdraw than Valium and Xanax. The withdrawal is
smoother. We advised the patient that the best for the baby
was no medications except for pre-natal vitamins. She was
another lady who could benefit from a psychiatric nurse
therapy. Since they lack psychiatrists, the psychiatric
nurses ended up with most of the follow-up therapies as
their psychiatrists virtually had no time.
We also saw a 7 year old boy who had a
history of rape by older boys and who lived with his
grandmother. His mother had abandoned him. Separation
anxiety Post-traumatic Stress Disorder and ADHD symptoms.
Some depression. Some relatives who died from the tsunami.
He was on Tofrani (Imipramine ) as he was also enuretic. We
discussed lowering the dosage a little and spreading the
doses more evenly throughout the day. The child was having
some breakthrough acting-out during the day. He was also
having some nausea at times.
There was a man diagnosed to have " Body
dysmorphic syndrome". He saw his face as something different
in the mirror and could not look at his own eyes. I wondered
also about major depression with paranoid symptoms. He was
on Haldol. Some psychotic symptoms start out as the feeling
that their bodies are morphing into something else. Almost
like Kafka's Metamorphosis. Sometimes the symptoms are quite
subtle that it becomes difficult to prevent the frank
decompensations. He had people he knew affected by the
tsunami.
Another gentleman over 60, was treated
with Fluoxetine. He had depressive facies, with the
downturned mouth and sullen saddened look, but overall had
been improving according to Dr Naiayana. He appreciated his
family support. He also had friends affected by the tsunami.
The patients were all generally respectful and soft-spoken
with the doctors. They were mindful of the psychiatrist's
time and knew that their session would be brief. They try to
get right to the core of the problem and Dr. Naiayana
maintained her gentle attentiveness and reflective listening
throughout the clinics.
Dr. Naiayana, Dr. Sam-ian and I all went
to a special room for lunch. We had time to compare notes
about medicine in general in the USA and in Thailand. We
talked about their need for more psychiatrists. We had fried
rice, egg and soup for lunch and refreshing cold water. It
was truly hot that day. Again all of us were sweating. I
thanked them both for allowing me to visit their hospital to
see patients. They have been more than gracious. We also
talked about how we needed to make sure that we set some
therapeutic boundaries with the volunteer we met yesterday
who was somewhat interruptive of one of the children's care.
The medical director listened to the reports and knew who we
were talking about. We three doctors agreed that we needed
to be aware of this man's desire to help out but also to be
aware enough to set limits with him when it came to the care
of the patients.
Dr. Naiayana showed me to the doctor's
lounge where I was introduced to several friendly, smiling
doctors who teased each other as old friends would.
Multi-specialties. In the back call room was a computer and
they were kind enough to allow me to use it so I could
e-mail my family and to let them know that I was okay there.
I caught up with Dr. Naiayana for the afternoon patients. We
went to re-visit the boy who had psychotic symptoms from the
tsunami. The boy was with his extended family and this time
without the volunteer. He was talking much more and smiling
more. No more cogwheeling nor muscle rigidity. Great! The
Artane was doing its work to lessen the extra-pyramidal
symptoms from Haldol which caused the child's muscles to be
stiff and very rigid. However he still had some nightmares
about the tsunami. He was able to talk about how he had
hallucinations of goats and monsters coming at him and
trying to attack him. He was definitely more improved on
Haldol and Artane. The extended family felt comfortable with
his care but proposed to also have the boy go home for
voodoo. I was initially hesitant until Dr. Naiayana said
that it was their custom to respect the beliefs of the
people and integrate them in their treatment. A wise custom,
I thought inside. Dr. Naiayana and I agreed and also
discussed a time limitation and that the child needed to be
back for medication stabilization and adjustment as needed.
We agreed on 2 days and then the family agreed to bring the
child back for more care. Treatment collaboration in action.
We then walked into the women's ward.
There was a young lady with schizophrenia on decanoate
medications. She was stiff, rigid, had problems
articulating, dry- skinned, and very slowed down. There was
another lady with depression, anxiety and panic attacks. She
needed much reassurance and wouldn't let go of Dr. Naiayana.
Supportive therapy done with a smidgeon of Cognitive
Behavioral Therapy. Aaron Beck's CBT .
It was time to go. A long yet very
rewarding day. I really enjoyed the time with the hospital
staff. I exchanged e-mails with some of them and I invited
them to visit Kentucky if they ever visit the USA. There is
nothing like knowing someone when you visit a different
country. We gave each other our sawatdee khas and wais.
The drive back to Khao-lak was scenic.
Again the curvy roads hugging the mountain (and the mountain
hugging them back) were starting to get to my queasy stomach
so I relaxed in the back of the car, meditated and
consequently rested and slept a little bit. I thought about
Phang-nga Hospital settled against a Bali-Hai type mountain
setting. And about such a bright, poised personable
psychiatrist with so much responsibilities for her young age
and training whose only desire was to get married and have
her children someday soon. A young lady who openly talked
about her first true love - a confidential disclosure
between psychiatrist to psychiatrist. I enjoyed her loveable
humanity even more and thought that they are fortunate to
have her there.
We took more photos of the Khao-lak
beachline. During that time, many policemen were guarding
the highway because the king's nephew had arrived there.
The Thai truly love their king and the rest of the royal
family. Back to the hotel for rest. Journaled some more.
Napped.
A knock on the door. Att. She excitedly
said that the sunset was beautiful. Photos. Beautiful sunset
indeed. We watched and took photos of the sunset until the
sun went completely down on the beach.
I thought of the song " Don't let the sun
catch you crying..the night's the time for all your tears.
Your heart may be broken tonight. But tomorrow in the
morning light. Don't let the sun catch you crying."
An old song. Brings back happy
memories in spite of the maudlin nostalgia of the song.
Innocent times in high school. And to think that all those
high school friends of mine, the Prepians, are still dear
friends of mine even now. We all found one another again
thanks to the internet. We always have reunions everywhere
in the world. And we all regress like children again. The
gut-hurting unstoppable laughter when we are together. A
timeless fountain of youth just by being together. All
because we were randomly schooled in an awesome experimental
high school where most of the teachers had their doctorates
or masters level education. Most of the students had plus or
minus 10 - IQ level. We all had to take a national entrance
exam to get in. Did it make a difference in our education?
We all think so. We still honor our teachers even now.
The Khao-lak sunset that day. Pinks,
light orange, lavender. Blue waters. Utterly peaceful. We
prayed for those who died in the tsunami again. Peaceful.
Calmness within.
We drove to the same restaurant that
night. The Jai Bungalow restaurant on the main strip. It was
like a hut-- decorated with white lights. Tourists were
starting to come but since the tsunami warning, many
cancelled their trips. The locals were disappointed. That
dinner was interesting. Sert, Att and I had more of a chance
to talk about them and found out that Sert was also a ham
radio operator! I was licensed Extra Class when I passed the
exams in February , 2004 and my call sign is N1VZ. November
- One - Victor - Zulu. In 9-11 and in disaster times, the
ham radios have been very helpful in terms of creating more
seamless communications. There are times when even the
cellphones do not work nor do the computers nor landline
phones. That's where the ham radio operators come in. I had
no initial knowledge about electronics except that I found
Physics interesting. And that helped me pass the amateur
radio exams besides studying so hard for them.
The hams are great. They are very
helpful. There was a story about a lady from India who was
on a DX-pedition ( DX- distant station ) with her team and
the tsunami hit in one of the islands off the coast of
India. She ended up anchoring and helping the communications
of the island with the mainland during those
turbulent initial tsunami times. I like our ham radio saying
" When all else fails... there's ham radio." My sense of
world geography has expanded since becoming a ham. I also
wanted to make sure that when I am doing global medical
missions in remote places with barebones or no
communications, that I could use the ham radio to help and
get help somehow.
Back to Sert. He said that he served in
the Vietnam war and actually volunteered. He served along
with Filipinos, Americans, Koreans and Australians and he
drove army trucks for them. Sert was in training for 6
months and then was in Vietnam for one year. He learned to
use the ham radio there. We talked about the veracity of
King Bhoumipol being a ham radio operator. Was it really
true? Many say yes. And was his call sign really CHO? We
talked about our ICOM ham radio rigs and about my dipole
antenna. Att said that Sert used to CQ every night. I
encouraged him to get his license again so we can do HF -
high frequency - contact.
He said he would. Small world. I slept
well that night. I felt happy inside. Absorbing and
embracing pockets of small joys in this life. And
remembering the feeling.
April 1, 2005, Return to Bangkok
" To affirm life is to deepen,
to make more inward,
And to exalt the will to live. "
~ Albert Schweitzer
Rest morning. I just slept. Contemplated.
Meditated. Took it easy. I moved slowly about the room and
read the Thailand Guide. I saw that they prided in Thailand
as the health tourism hub of Asia. Plastic surgeries, for
instance, which cost a lot in the USA. The prices in
Thailand are half the price for most procedures. People like
to go there because not only do they get their inexpensive
surgeries, but also they get an exotic trip and a vacation
out of it, for the price they would've paid in the USA.
Just some random reflections:
* Koh James Bond - ( Koh Phing Kan in
Thai ) - where The Man With the Golden Gun was filmed. Right
where I was. In Phang-nga.
* King Bhoumibol Adulyadej ( King Rama IX
of the Chakri Dynasty ) born in 1927 in Cambridge,
Massachusetts. His father studied medicine in Harvard. He
has reigned over 50 years and has done many public works
projects with a focus on the underprivileged. The king and
the queen have 3 children. Most royalties should be like
them. For their people.
* Thinking back to the day after the
tsunami warning. And how things were quite peaceful the next
day as if nothing really happened. What was past was past.
And all the volunteers went back to work and the locals
resumed their jobs calmly. Amazing spirits. People's
abilities to suppress traumatic experiences and extract the
good from it. And then the ability of people to move on and
live in the Now.
3:15 PM on the dot. It was one my
friend's friend. I went down to the lobby and somehow missed
her. When I came back I saw a very petite slender, smiling
Thai young woman in her thirties. Her English was fluent
because she went to Murray College in Kentucky. It felt good
to meet someone who spoke English fluently and knew
Kentucky. Instant rapport. She knew my friend from his
shipping business in Chicago. We took a cab to River City
mall next to the Royal Orchid Hotel for my fitting for the
bluish-purple gown I bought made out of Thai silk. They did
a great job and were supposed to deliver the gown to the
hotel. I have an appreciation for how Thai silk is made. We
walked around the air-conditioned mall. Hardly any tourists
or people there. More high-end stuff. A bit expensive. Many
Asian antiques. We just window-shopped and talked about life
experiences she had in the USA.
We then went back to the hotel to meet
another friend. There I met another very polite and
personable young lady. Both were contacted by our mutual
friend from Chicago also named Lek. Both ladies were quite
open about their lives. Even their love lives. They each
found out that they just broke up with serious
relationships. We irreverently laughed about all that and
talked about how they both met my friend Chicago Lek. So now
there are three Lek's in this journal. Dr. Kung's husband
Lek, GSC Lek and my friend Chicago Lek. Just to set the
record straight. We all laughed a lot together. Like three
sisters would.
We met another friend and his pregnant
wife at the Tapli-pling Restaurant. More seafood. More fish.
We all talked about life, jobs, hopes, relationships and the
tsunami mission. They were all warm and friendly and more
Westernized. One of them used to be a pharmaceutical rep in
the US and I requested for her to please check some drug
companies in Bangkok to help aid the camp settlement babies
in Khao-lak with some powdered milk. She said that she would
get on the ball with that immediately.
We had coconut ice cream for dessert.
They said they wanted to walk around. They all decided to
check out the Hindu temple. They were all Buddhists.
Curiosity. So we did. The temple was very busy inside. The
Hindu pagoda was so colorful. Some people were meditating,
some lighting candles, some doing flower and fruit
offerings. Incense everywhere. We all took off our shoes and
visited the temple. More religious and cultural immersion.
Then we drove to the Suan-lum Night
Bazaar. I liked the ambience there. Night lanterns and all
on the streets and restaurant-cafes. Lots and lots of
shopping. Too overwhelming. The stores were well-displayed
and organized. I found some beautiful shawls and Thai
silk ties to bring home as gifts to family and friends.
What a wonderful way to end this journey.
Having a relaxing easy time with friends of a friend. That
was nice of Chicago Lek to have arranged this to end my
trip. He actually called us all when we were in the
restaurant. So we all had fun with that. One of the girls
kindly picked me up at the hotel at 4 AM and drove me to the
airport. What an inconvenient time for her but she was so
gracious and sweet about it. Very nice young lady.
I was finally all packed. It has been a
trip beyond my imagination. I will forever be grateful for
this experience. I will not forget the many good people I've
met here and all the wonderful GSC staff who worked with me
to sate my soul in the desire to serve others. I thought
about the children and families affected by the tsunami, the
medical and nursing team, the public health crew and the
many volunteers from all over the world. One world united by
compassion because of a disaster.
My cup runneth over and my spirit felt
full. I learned a lot and taught some. I thank God for
allowing me to experience all these in this lifetime and for
reaffirming the thought that in this life, in this world,
there is one thing that truly counts above all. For when it
is all said and done, all that really matters at the end of
our lives, is how much we have loved.
"When all is said and done,
And the dust has settled in
I ask myself,
Did I feel all the Love I was given?
Did I give Life my optimum?
Did I Love all my maximum?
~
Elizabeth A. Garcia-Gray MD
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