Tuesday, November 19, 2013

14 March 1999, Operation Smile, The Philippines

I’m on my way. Blessed and cosseted and fussed over by family and friends, fretted over by Trev, and worried myself by the plague of health difficulties dogging me for the past few weeks. I am off. Somewhere over Canada, within 1000 miles of the Pole or so our pilot claims, I’m flying nonstop to Tokyo then on to Manila. Tomorrow night I meet the various players in the Operation Smile mission I will participate in. It is difficult to sit here, still, after all the preparation. I know I’ve not done enough. Imagining conditions and dynamics halfway around the world is just that: imagination.

As a last minute stand-in, I scrambled to get ready, to gird my loins as my friend Bonnie would term it. The hurry and the planning of the past few weeks make me, not complacent in attitude, but anxious to fly – to experience the experience. I know part of the get-ready work is to be open to it, to expect the surprise, and welcome it. I feel it now with attendant butterflies. All of the tired clichés apply: roll with the punches, make lemonade when life serves up lemons, etc. This is the element of my mission I am ready for even if I can’t remember all the medical jargon and the few phrases of Tagalog I’ve drilled into my thick skull. I know how to take the unknown part, the shock-part not in the itinerary or listed in the mission plan. I know what it is like when chance throws a big punch, a baby you don’t recognize. I carry this with me and hope to gently testify. I intend to work hard. I expect to learn. Terri, the speech pathologist who served on last year’s mission to Cavite, the location where I will be working, told me she wanted to give but came away with much more. And so: I travel to the Philippines with a somewhat selfish design and, I hope, not too many illusions.

On this note I christen this particular travel journal of mine: a record of learning and reflection for the next few weeks. I anticipate the visitation of memories, a testing of whatever mettle exists within me. I wish to spin my cognitive wheels a few times and churn out observations as best I can for further examination.

(Later) 14 March 1999 Over the Pacific

My life carried me here, a fourteen-hour flight from New York to Tokyo, in a circuitous fashion. I serve as the representative mother on my mission team, because I am the mother of a special child. I am here because I am divorced. That bitter parting spurs me to grow, push my limits, and force myself outside the safety net. I’m here for the curiosity, adventure, and the goody-two-shoes factor. My pain can be put to use: to help soften someone else’s. What a waste if it were just that, left as pain: lonely nights in fluorescent-lit children’s hospital wards, anxious hours and days spent picking through medical texts, talking to other families, quizzing doctors and surgeons. I am an expert, an expert on Trevor only, but still an expert. During my accumulation of knowledge I didn’t dream it could be extrapolated into something worth offering to others. In many ways it confounds me now. It’s difficult to see the road here through the pain and the blame, self-doubt, horror, and sometimes terror.

I must do this. It would be wrong for me not to. I recognize the element of selfishness. I make this journey for myself. To face it again. To face it down. 

9:42 AM, 15 March 1999, Manila, Philippines

I checked into the hotel last night after a crowded flight from Tokyo, so crowded it seemed people were sitting on each other’s laps. I was lucky to sit next to John, my team leader for the Cavite mission. We were both tired and there was a high noise level but I did get to pick his brains a bit and try to clarify for him my anticipated role in the surgical mission. I liked him, a laidback Midwesterner, calm and intelligent but approachable in a way many surgeons in my experience are not. He seems glad for every support he can get and agrees there is a need for patient and family education, the role I hope to fill on this trip. I drew a bit of confidence from his endorsement. This is his fifth mission to the Philippines, second as a team leader, and first mission to this site, Cavite. He said our mission will be the second of the usual series of five Op Smile makes to a particular hospital/location. They try to address the initial crush of unrepaired cleft lips and palates in a given district and, at the same time, educate and train the local surgeons. After five yearly visits the goal is to leave a mission site self-sufficient enough to care for arising cleft cases and the referral of more difficult diagnoses. The Cavite team is one of five traveling to different parts of the Philippines at the same time. Our team will be closest to Manila, an urban site on the same island, Luzon.

Last night - really early this morning, I think it was around 2 AM local time, all of the teams convened in the banquet hall of our hotel. We picked up our IDs, itineraries, and other paperwork, listened to an abbreviated speech from the exhausted Op Smile Philippines coordinator, drank orange juice, and ate pieces of what tasted like angel food cupcakes and, after chatting it up with old friends and new acquaintances, dispersed to our room assignments. I managed to meet briefly with the only other Family/Patient Educator, Joe from Chicago. He is enthusiastic and full of concrete plans for each stage of his assigned mission. Unlike me, he’s had months to prepare and plan what he will do. Since I was asked to attend less than a month ago, filling in for someone with a family emergency, I am feeling rather unprepared next to his list of intended activities and suitcase full of supplies. My guess is I bolstered his confidence a bit.

I would call Joe a young adult. He was a participant in my Colorado training, though I didn’t get to know him well at the time. Joe has a cleft lip and possibly a cleft palate, although it is hard to tell. His speech is flawless and the surgical repair on his lip, to my experienced parent’s eye, is excellent. He is a handsome young man who I can’t help but admire: strong drive and a clear intent to spread and share the strength he’s gained from personal experience. I wish him well.

Joe made me wonder if I match his enthusiasm. It was clear to me during our training in Colorado the two groups selected to serve as trained Family/Patient Educators, affected adults (most in their mid to late twenties) and parents of affected children, held different perspectives on “appearance differences.” Clearly, the people bothered most by the grueling, in-your-face, reality-time training were the parents. Affected adults seemed to recognize the anticipated grizzly aspects of the experience and take it in thoughtful stride. I wonder, I know, this will affect our respective approaches and attitudes on these missions. Joe may, or may not, experience difficulty relating to the parents here. On the other hand, he’ll know exactly where the patients are coming from. I am only a parent who experiences “looking different” vicariously through my child. I am lucky to have a socially acceptable visage, to pass for “normal” at all times. Will it work against me in this setting? I will soon find out.

Time is topsy-turvy. Last night, after exchanging several sentences with my roommate Karlene, who is also on the Cavite team, I slept the sleep of the dead. Waking up was like starting to breathe again, abrupt gulping, gasping, and sputtering. I am dutifully watching my water intake, only bottled – even for brushing my teeth. I lost my camera. I think I parted with it when I went to the lobby early this morning to see Joe off on his flight to the southern city of Davao. Did I leave it in my chair when they called his bus? Oh well, my visuals must come from writing. So far dawn brilliantly lights a waking Manila, a lush, tropical, and very metropolitan place. The smell here is of hot tarmac and coconuts, and the clinging tobacco smoke of old hotel drapes. I haven’t met any natives that have trouble understanding me. We are warned to stay near the hotel in case of schedule changes. Flying in last night we crossed miles and miles of lighted civilization. Beyond this eighth floor window there is sprawling urban development. However remote I am from Connecticut and the tri-state center of the universe, there is an abundance of life here: heated, tropical, crowded, and dissonant.     


I must bring my bags downstairs. The bus leaves for Cavite in 20 minutes. We settle in to our living quarters tonight. Tomorrow we start a week of screening patients for surgery next week. Work begins.

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