Match

Hours later I was still shaking, and I think I have yet to absorb it all.

Match day is kind of a big deal for medical students, and schools, and residency programs. At the same moment across the country (and the world actually), every medical student who will do a residency in the US finds out where they will be receiving their next 3-7 (or more) years of training. This is after a pretty lengthy and intense application, interview, and ranking process.

Pre-Match Day Retreat, 2011

The day before the match, we had a retreat to reflect on what medical school did to us. It was organized by the Gold Humanism Honor Society, a group of peers chosen for this honor by their classmates for their demonstrated excellence in clinical care, leadership, compassion and dedication to service. I am honored to be part of this group, and was very involved in planning the retreat. We had a huge turnout of students and got great feedback, which I consider a success. Many students invited physicians they admire to facilitate some small group discussions and we had amazing speakers including Dr. Rose Quirk, Dr. Ruth Westra, Dr. Tom MacKenzie, and a favorite standardized patient, Rich. It was great catching up with classmates and a wonderful transition to the next day’s activities.

Mom and Dad during breakfast, pre-chaos

On Thursday, March 17 University of Minnesota medical students invited family to join them at the McNamara Alumni Center for breakfast and the envelope-opening chaos to commence at 11:00 CST. I was not a bit nervous leading up to the day. I had put in my rank list 2 months earlier and was convinced I would be happy at any of my top choices. But the moment I was about to open my envelope it hit me, the significance of what I was about to see. This moment was going to tell me where I will live for the next 3 years, and the training I receive over that time will likely influence the rest of my career. And…it hit me that I really AM going to be a doctor, and soon!

Hometown friend and fellow graduating medical student, Cory, and I
staring at our envelope-laden table, waiting for some kind of signal

As we realize others are already opening, we start reaching...

Really? Can I open it?

Okay, stalling...pose for one more picture

My friend Justin waiting to see my reaction

And I surprise myself with a little squeal when I see my match

Showing Dad

My friend Katie is in Finland, with no internet access, so her dad opens her envelope and we call a random phone in Finland to give her the news

The map, showing where our classmates are headed

Match Night Party at the W Hotel,
celebrating with friends Christine, Maiken, and Katie

Some pictures of Ventura from my interview!
This is in December, no less.
Who wants to help me move?!

Networks: Great opportunities spring from an open mind

I am very blessed with the opportunity to travel. And I believe that past experiences allow for future opportunities. This recent trip to Costa Rica brought together many connections from different times in my life and I believe as a result of this trip, there will be many more adventures to be had.

Some of the connections…

Felipe and Yader were medical students from la Universidad de Ciencias Medicas (UCIMED), who I met while rotating at Hennepin County Medical Center (HCMC) in 2009. Felipe is now a physician in San Jose and picked me at the airport. His family (Roberto, Iliana, Luis, Nati) graciously hosted me in their home in Santa Ana the first 5 days of my trip. They fed me continuously, drove me around, and also brought me to their farmhouse near Orotina for the weekend. Yader is now an Internal Medicine resident at HCMC and we went out for dinner the night before I left where he provided me ideas of things to do in CR and phone numbers of his family, girlfriend, and best friend.

"Los Hermanos Herrera"

Luis and Felipe

Angie is Yader’s girlfriend with whom I went out to lunch and shopping on my last day in San Jose. David is Yader’s best friend who will hopefully be an intern at HCMC next year. He had me over to his family’s house where we had a great time laughing, eating great food, and drinking wine. Then we went out to some live music and later a club until the wee hours of the morning. His dad was impressed with some of the hikes I have done, and him and his wife invited me on a hike over the weekend. I took them up on it and spent my Sunday hiking 7+ hours up a mountain on the outskirts of the city.

"La Cima"

Xinia and Enaldo, at the top of La Ventolera

This trip was not work-related, but I did manage to spend a couple days observing in the dermatology department of one of the public hospitals in San Jose – San Juan de Dios. I was invited there by two dermatologists, whom I met in Minneapolis over 2 years ago. Dr. Osvaldo Monge and Dr. Jorge Sanchez came to lecture at the University of Minnesota Global Health Course and Dr. Monge attended a party I had at my house for participants and visitors in the course. It took me a couple years, but I eventually made it and saw some great cases in addition to being able to observe yet another health care system.

"Primos"

Kembly, Marcelo, Jonathan

La familia Villacis, my host family in Quito, Ecuador has family in Costa Rica. Berthie, the sister of my host mother, Maria Eugenia, has a son that moved to Costa Rica and now lives in San Jose (San Francisco, actually) with his wife and son. When my host brother, Rolo, saw (via Facebook) that I was in Costa Rica, he sent me his cousin’s contact information and I was able to visit them in their home while I was in town.

"Zipliners"

Part of the wedding crew in Arenal

Katie is a great friend who took the scenic route through medical school with me and I met her amazing husband Seth when they started dating. I am so grateful that Katie and Seth decided on a destination wedding in Tamarindo, Costa Rica...and invited me! It was an interesting group of guests from all over the world and I had a great time meeting, partying, and traveling with their friends and family. After picking up her brother at the airport, fresh from Lima, and meeting the group near Volcan Arenal, we explored the canopy and relaxed in the hot springs before traveling out to Guanacaste for an amazing array of wedding activities. I found some travel buddies within the group and continued the adventure with them after saying goodbye to the newlyweds.

"Travel buddies"

Beto and Annie with Omutepe and Lake Nicaragua in the background

Between the wedding crew, renewed friendships, new connections, and fellow travelers, I have no doubt more adventures will spring from this great trip!

Blink

Time goes by so fast, and things happen so quickly. I have not been great at keeping everyone updated. Since the last post, so much has gone on in my life, some wonderful and inspiring, but also events that I have had a hard time dealing with.

After leaving Uganda in June, I spent a summer in MN spending time with my family and old friends, making new friends, working, taking classes, and staying busy. I went back to Uganda for 3 months in September and we started enrolling patients in the clinical trial I have been working on. My basketball team, A-1 Challenge, made it to the national championship, but took second, again. I met amazing people and solidified friendships. But I also lost a good friend in an accident in Kampala, and that experience has had a deeper impact than I think I have yet to admit. And it is something I have to deal with before I can move on.

But life keeps going, and I have to keep running. I came back to the US in December and did interviews for residency. I continued working, finishing a rotation before going to Costa Rica for a few weeks. Now I am back and am going to try and put my thoughts down, so bear with me.

Life is an adventure.

Countdown

We now have less than a week before we leave this tropical country where we have built a life, made great friends, learned so much, and had tremendous adventures for the past 8 months. And although we are both sad to leave, we are incredibly excited to see friends and family (and dogs). We have so much to look forward to back in Minnesota – I have a new niece Afton that was born in March in addition to Jaren and Pyper, whom I hadn’t realized would be so hard to be away from. Summer, weddings, baseball, good (cold) beer, the lakes – all to be enjoyed with family and good friends – awaiting us!

Afton Arlene Vogt - March 26, 2010

It is always easier to leave somewhere when you know you will be back, and I recently made the decision that I will come back to Uganda for 3 months in the fall. Grant says he will come back at some point, although when he returns to blazing fast internet and HDTV, he may never leave the US again :)

It has been awhile since we last blogged, and a lot has happened since our trip to Rwanda over Easter.

A couple other Minnesota medical students, Renee Donahue and Andrew Day, came and worked at Mulago Hospital as they finished up their last few months of medical school and are now MDs. I was fortunate enough to watch all my friends graduate live on the web, and was sad to be staying behind and missing all the graduation festivities.

Our landlord, Fred Kitutu, invited us over to his house one Sunday afternoon and we had a chance to see his home and meet his wife and daughter.

Our friend Karin had her housewarming, another epic house party in Kampala. The girls and I spent much of the night gossiping and taking pictures with ridiculous poses - it felt just like home!

The following day was ANZAC Day, an Australian holiday, that we celebrated in style. Above, Team America is taking down The Rest of the World in flip cup.

My birthday fell on a Sunday this year, which happened to be the last weekend in town for one of our close friends, Guy Brennan, and we did a good amount of celebrating among our friends. On Friday night we sang (screamed) out tunes in the private karaoke rooms of a Korean restaurant. Saturday included lounging in the garden of a boutique hotel before heading out to a mask party thrown by my basketball teammates. Sunday started with champagne brunch at another posh hotel, followed by pool-side wine-sipping in the afternoon, and dinner at a great Italian restaurant with good friends.

Unfortunately, we have said goodbye to some good friends already this year, as with spring comes a natural migration of the expatriates moving on to new jobs, other countries, or back to wherever they hail from. Fortunately, we seize each of these opportunities as a chance to throw a party and reminisce over the fun and frustration of Kampala and fantasize about things we miss from home.

Other fun events in the past month – sundowners on Acacia, Gareth’s birthday with an ‘interesting’ yet delicious cake, Sarah’s surprise birthday party at Mel’s, wedding planning meetings (I will be a bridesmaid in Sept!), Wii and beer pong at Adam and Gen’s, and Mar-Louise’s baby shower.

Grant has expanded his repertoire, and in addition to being a poker star has become a Kingpin! Who knew that he was such a bowling phenom?! Our friend Adam Williams started a weekly bowling league in Kampala, and Grant had the highest score two weeks in a row, including a 206. His team ‘Living on a Spare’ will be sad to see him leave.

Basketball has picked up and we are now playing 4-5 nights a week. We are undefeated in the national league and recently avenged our 2^nd place finish last year by beating the defending champions. It is such a great opportunity to be involved in the community here, and is a big reason why I am coming back in September. My teammates are all young, intelligent, successful women, who have taken me in and I will miss each and every one of the ‘glamour girls.’

Although we finished working over a week ago, I have still been at the IDI and Mulago a few days getting things finished up before we leave. As a study team, we have a couple big projects starting in the next few months, and it has been a challenge making sure everything will flow together. I have loved my work this past year and will continue to work on it when I come back in the fall, but I need a bit of a break from it all right now. It will be good to spend time working US hospitals for a few months and apply for the next step in our training – residency.

In the time we have had off from work we have been able to enjoy some of the great parts of Uganda. We went to a beautiful lodge in the Mabira Forest for a couple days, complements of a voucher we won at the Irish Ball. It was a relaxing vacation in which we relaxed, watched monkeys, butterflies, and lizards, and were gluttons in the presence of the delicious food.

The mother of our roommate Emma was recently here from Sweden for 10 days. It was great to have her stay with us, although it made me miss my own mom even more. She treated us to a night at the Ndere Cultural Center, home of the Ndere Dance Troupe. It was a night of traditional dancing, comedy, and audience involvement in an open-air ampitheatre.

We still have a lot of social activities left to pack into our final week here in Kampala, not the least of which will be Grant’s 30^th birthday celebration this Saturday. Then, in between our usual basketball practices and games, poker tournaments, and bowling leagues we have final lunches, dinners, and drinks at our favorite restaurants (and patios). And then before you know it, we will be back on the other side of the ocean repeating the events in Minnesota! We both leave Tuesday, June 1 and I arrive in MN June 2, while Grant is staying in Amsterdam for 5 days and returning on June 7. Grant promises to write his final reflections of our time here while he is in Amsterdam next week.

Rwanda

This past weekend we spent our four day Easter holiday in Rwanda. We flew into Kigali on Thursday night and stayed at the Hotel des Mille Collines, the hotel made famous by the film Hotel Rwanda. This was where more than a thousand Rwandans were kept hidden from the genocidaires during the 1994 genocide. The next day we went to a bus company and reserved some seats for our trip to Ruhengeri, the staging point for gorilla trekking in the Parc National des Volcans (Volcanoes National Park). We got a little wet standing in the rain that graciously decided not to wait for us to get on our bus. I guess it is the rainy season. We also got a lot of conflicting information on which bus we were supposed to board making the situation somewhat more tense, however we eventually found out way. I think some of the employees were as clueless as we were.

Rwanda is nicknamed the land of 1000 hills due to it's mountainous terrain. It is densely populated and the people are largely subsistence farmers leaving very little land which is not being used to grow crops. The country has come a long way from the horrors of 1994. The country is very clean (no plastic bags allowed), the motorcyle taxis are registered and seem to have some sort of regulations they have to follow, and the country is developing very quickly (lots of construction, restaurants and businesses not mentioned in our guide books from a couple years ago).

Ruhengeri isn't much besides the place to stay before gorilla trekking. When we arrived in town we accidentally stumbled upon our hotel while looking for the tourism office, so that worked out well. Addresses don't really exist here, so you do what you can. We had dinner and sampled a few of the Rwandan beers, which not surprisingly taste exactly like all the beers from Uganda. They love their lagers in East Africa...why they need numerous different brands of the same thing is beyond me. It sure would be nice to enjoy an India Pale Ale...


What? Goats need exercise too...

The next morning we got up pretty early and took a ride to the park headquarters for the gorillas. We spent some time enjoying the scenery, got briefed on the whole process and were split up into groups based on which gorillas we would be visiting. After traversing quite possibly the worst "road" I've ever experienced, we arrived close to the tree line which coincided with the park border. It was really interesting to hike through some of the farm land before getting to the stone fence (meant to keep the animals in) marking the start of the park. We walked about 10-15 minutes into the park and were met by the trackers who stay near the gorillas during all daylight hours as poaching is still a very real concern (even though these beautiful creatures are nearly extinct). I felt like a kid in a candy store and had a few brief chills as we walked upon our first gorilla, the vice president. Our group contained 19 gorillas total including 3 silverbacks...this was the #2. We followed him to the rest of the group and spent the next hour literally standing amongst the group who were having a grand old time just laying around, eating and playing (the youngsters). We were entertained by a mother with her breastfeeding baby, a little guy picking fights with the others while basically performing for our group, and various gorillas just doing their thing. It was quite entertaining and definitely worth the (fairly expensive) cost. The hour didn't last nearly long enough, but it'll be something I never forget.


I couldn't convince them I was the only weapon we needed...


Could it be the mythical kingdom of Care-A-Lot? (Bonus point if you get the reference.)


Ruhengeri in the morning fog




Someone needs a bib!


Got sawdust?







We went back into town, checked out of our hotel and purchased bus tickets to Gisenyi on the shores of Lake Kivu which forms part of the border with the Democratic Republic of Congo (DRC). The drive took around 1.5-2 hours and was just as amazing as the previous trip. When we arrived in Gisenyi we obtained a taxi this time choosing not to rely on fate to point us in the right direction of our hotel. We walked along the lake to check out the other hotels, which was somewhat confusing considering they all had different names (or had disappeared) than was represented in our guide books. It was getting pretty dark, so we decided to eat at our hotel and get to sleep early as we had been up since quite early.


Lake Kivu (the mountains in the background are the DRC)


Side street in Gisenyi

The next morning we were slowed down by rain but eventually were able to go out and explore Gisenyi. Of course the sun rode into town and handed out some swift justice, but my head is now nearly finished peeling. Some highlights of Gisenyi include the amazing views of Lake Kivu, the proximity to the DRC, a dump truck tipped over in the oversized rain gutter along the side of the road (he probably was trying to avoid potholes only to end up in the ditch...smooth). We purchased another bus ticket back to Kigali for our final night to be spent in Rwanda.

We stayed another night at the hotel Rwanda and went to New Cactus for dinner. They had pretty good pizza and are a popular expat hangout. We also were able to experience our first slightly "good" beer in E Africa. Turbo King, which is basically a lager with some food coloring masquarading as a dark ale, was not too bad but my standards are basically in the cellar considering what is normally available to us. At least there is South African wine!


Kigali

Our final day was spent walking around Kigali and experiencing the Rwandan genocide memorial. It was intense to say the least. Really made me disgusted with the international communities ignorance towards the plight of the African people even in the most dramatic of circumstances. The sad thing is that it still continues to this day.

Time Marches On

We have really gotten busy over the last few months and our blog has suffered the consequences. Work has really picked up, especially for Ann. Her Lumbar Puncture study is up and running and she's handling most of the work on her own. I help out with some database updating and helped a little with the patient interviews at Mulago Hospital. The Neuro-Cognitive Deficit Study for Patients with Cryptococcal Meningitis is nearing its beginning, so I have been working on preparing forms and making sure the study will begin smoothly. Ann also continues to prepare for the Antiretroviral timing trial. I have also been lending a hand in the creation of various forms (of which there are many) for this study. We will learn in April when the funding will arrive which will determine the start date.

We took a trip to Tanzania so that Ann could run in the Kilimanjaro (as in Mount) Marathon (she ran the half) which was in Moshi. It also offered the opportunity to visit some friends from the U of Mn who live in Arusha. The race was set against the backdrop of Mt. Kilimanjaro, which made for an amazing sight, unfortunately the clouds obscured the mountain most of the morning. Elvis, a ninja, and an albino in a lion suit took part in the various distance races offered. We went on a two day safari to Tiringiri National Park and the Ngorongoro Crater. Tiringiri was ok, but not any better than Murchison Falls NP in Uganda. The tsetse flies actually made it much worse. I seem to have an exaggerated reaction to their bites and was covered with terribly itchy welts for the next week or so. One bit me on my knuckle and my entire hand literally swelled up. It was very uncomfortable. The crater was by far the best safari experience I've had in Africa. It's largely grasslands populated with all kinds of exciting creatures. We saw lions (12 or so), black rhinos (9ish, all from a distance), elephants, zebras, african buffalo, various types of antelope-like animals, hyenas, flamingos, ostrich, and crested cranes (the national bird of Uganda in which I've seen zero).


Arriving in Tanzania


The runners and their fancy visors.


Safari truck


Crested crane in the Ngorongoro Crater


Mr. Monkey enjoying the view in Tiringire NP


Mr. Baboon


Somewhere in Tiringire NP


The safari crew above Lake Manyara


Papa lion


Funny looking cows in the Ngorongoro Crater


Young lion hanging out on the ridge of the crater


The horde

We attended the Irish Ball last weekend. It's in celebration of St. Patrick's Day and the (real) Guinness, Bailey's, and Jameson were free and in full effect. Not being a big fan of whiskey made it easy to avoid the Jameson but it's safe to say I could have used less guinness (and wine). Ann had a basketball tournament that weekend, so we called it a night around 12am so she could get some sleep for her games Sunday. Her team got 3rd in their first tournament/games of the year. She's definitely excited to be playing organized basketball again.


At our friend Sam's graduation dinner.

We paid for our gorilla tracking permits in Rwanda, where we'll be going over our 4 day Easter weekend (hopefully with a blog post soon to follow). We'll be spending some time in the capital Kigali, Lake Kivu, and Ruhengeri, the staging point for the gorillas. This is probably the one thing I absolutely have to do while in Africa even though it's not cheap. Rwanda is apparently beautiful in stark contrast to the devastation that took place in the 90's.