The City

I like London. The humor, the tube, the diversity, the briskness, the futbol, the history, the squares..... My morning reading from Richard Rohr's Daily Meditations seems timely enough to share in its entirety.
"In America we don't have anything even close to Europe's great cities with fountains, cathedrals, promenades and parks. I know we've had two hundred years to work at it, but the point is, Americans don't dream of building a great city. The American dream is having one's own house. In America, we have moved from the Catholic consciousness of the community, of building the city of God, a great people, to taking care of our houses, protecting our neighborhoods, so that handicapped people and people of other skin colors don't move into it and kill property values. We have got to call this what it is: narcissism.
There's a world bigger than our families. The only way we can ultimately protect our family is to create and protect the entire human family."
Well said.
Once again to rail against narcissism on a blog is quite ironic. Nevertheless Father Rohr in a clear and concise way expresses a reason for us to think and feel globally.
And if you are so inclined and practical...
explore ready to use formulas(RTUF) to address malnutrition at validinternational.org and insecticide treated nets(ITN) to address malaria at theglobalfund.org/en/

Initial lessons

KB is my Nigerian housemate. He rents a room in Mrs Finch's house and attends the diploma course in tropical medicine with me. He is primarily interested in malaria because he directs a malaria control project in Nigeria. We have some discussion over breakfast and hit the road walking at 0800 to make our 0900 first class. The weather here is chilly and wet. He normally drives to work at home where he says the roads are hot and dusty. If he is walking, then a countryman will stop and say"Here doctor, please ride with me." We talk about the salaries of doctors in our countries and how much it costs to buy a car or send your children to college.

The day after I arrived, I bought an Oyster card for a month of unlimited travel on London's tube system. But once we'd settled in our routine, I had the card changed to "pay as you go" and placed 50 pounds on my card. About a week after we had been walking, I developed swelling and pain above my left ankle with crepitance(a squeaky feeling when I moved my foot up and down). Pitiful I know. The treatment is rest and anti-inflammatory medicine. I am taking the ibuprofen but I am continuing my 45 minute concrete surfaced, wet and chilly walks. Doesn't seem right somehow to use my oyster card though I'm sure KB wouldn't mind and probably insist I take the tube should I ask him. I doubt he'd allow me to purchase his tube ticket to accompany me though again I've not asked.

Sometimes it's about the "us" not the "me" or the "you". Tiny, trivial but tangible and a bit of a taste of things to come.

Questions

Questions generally begin with a what, why,how, when, where or who? Though I find "why" questions most intriguing and the answers multi-layered, the what questions are the starting point and require clear, concrete explanation. So to answer "What are you doing?"...

Until I complete exams on April 1st 2008, I am attending the diploma in tropical medicine course offered by the London School of Hygiene and Tropical Medicine. Class begins in the morning at 0900 after a brisk and sometimes wet 45 minute walk from north London to the All Souls Clubhouse classroom(temporary housing while construction occurs at the LSHTM). I walk with my housemate Kebir Ibrahim(KB) a Nigerian physician who works at home in a malaria control program. Class ends at 1700 followed by our walk home. To date the quiet evenings have entailed some reading and British TV watching in the room I rent from Mrs Finch.

Wednesdays are spent in discussion of cases or on rounds at London's Hospital of Tropical Medicine. Thursday afternoons are spent in the laboratory peering through microscopes at malaria infected blood smears or parasite cysts.

Perhaps more interesting is the question "What is tropical medicine?" Two professors have had a go at that question. Eldryd Parry co-author of Principles of Medicine in Africa and impressively experienced in the field, founding multiple African medical schools described it as a blend of poverty medicine and the medicine of climate. Tom Doherty, our course director, also emphasized poverty medicine and added that the patient population tended to be young, otherwise healthy people with reversible medical problems, often an infectious disease.

David Hilfiker MD author of Not All of Us are Saints describes his experience working with the poor of Washington DC and offers that his medical training did not specifically address poverty medicine. Though poverty medicine became his specialty as he worked with his homeless patients. He and my professors here emphasize that poverty medicine must consider more than the bio-medical problems. There are political, social and psychological considerations often under emphasized in traditional medical training.

I am fortunate to be learning from experts in the field teaching me poverty medicine.

Day after

After spending a day in Starbucks on the internet, creating this blog and talking about sharing my thoughts and feelings, my Daily Meditations by Richard Rohr included this thought, "We really need to be saved from the tyranny of our own judgments, opinions and feelings about everything...."

When we think of liberation are we talking about simply doing what we want to do, free from the demands of the other? From what do we seek liberation? Christianity speaks to dieing to ourselves and we are our own worst tyrants.

So a blog seems to be a counterintuitive response to this conundrum. Oh well I'm sure you all will help me out. You always have.

First Steps

Arrived in London to attend a three month course in Tropical Medicine at the London School of Hygiene & Tropical Medicine. Thanks to my friends and family for the send off messages. I hope to keep you informed with this blog. I have about forty classmates, fellow physicians from 5 continents(Antarctica and South America are not represented). My head in the books for three months may not lend itself to interesting experiences for blog postings. However I hope to spend this quiet time in reflection. The centering process could result in some thoughts or feelings worth sharing. Let's hope so and I look forward to hearing from you.