Apparently it only rains three times a year in Iraq…

…and yesterday was one of those three.  Or at least it was raining that morning and when we asked our driver how frequently this occurred he said simply: “three times.”  We interpreted this answer to represent annual number of days with precipitation but I suppose we could actually be witnessing the third recorded occurrence of rainfall in this desert region (further confirming my speculation that snow is nonexistent here outside of snow globes) 

…but I think it is a lot more likely that he just didn’t quite understand what we were asking. 

This happens frequently in these environments where two languages have to intersect for understanding to occur.  You ask a question, it gets translated, you get an answer, it gets translated back to you and it doesn’t quite make sense, or doesn’t quite answer your question…there are so many links in the chain where communication has the potential to break down that it is difficult to pinpoint where that break down may be occurring. 

Add to that a few extra languages and accents and it is amazing that anyone ever understands anything on these trips. 

Especially this trip; this is the most diverse group I have worked with to date.  We have several Americans and a British guy who live in the U.S., a Mexican from Monterey, a Korean woman from Australia, an Australian woman from Australia, a Dutch woman from Holland, two Belarusians, and one American who lives in Kenya.  We are dealing with native languages of English, Russian, Arabic, Korean, and Spanish and still somehow managing to communicate.  And for the most part we are doing a great job at teaching and understanding each other. 

But I’m still left to wonder exactly how often in rains here in Iraq.

Christine, Christine, & Kristen

Yes.  There are three of us.  We have Christine the American ICU nurse that once worked at my current facility, Lucille Packard Children’s Hospital, but now lives and works in Washington D.C.  We also have Christine the German intensivist who has worked in Chicago and I got to have an extensive conversation about rock climbing with over breakfast this morning.  And we have me, Kristen, the latest exotic specimen to join the team here in Najaf. 

The slight variation that my name puts on the theme seems to be quite novel to the locals.  Or maybe it is that I am just a new face that showed up near the end of the trip.  Hard to say.  But they really seem to like me.  Today I was pulled out of the ICU by one of the local guys who gave me, with great sincerity, a small box as a gift in thanks for my coming to Iraq to work with this team.  I accepted my gift graciously and later opened it to find…. a snow globe. 

Yes.

An Iraqi snow globe!  With little globs of white stuff that fly through space when the globe is shaken and settle gradually to the bottom.  It has a temple as the interior image.  A snow globe, like you would buy at an airport in Chicago or New York.  But I don’t think you can actually find these at airports in Iraq….and I’m fairly certain that you can’t find snow anywhere in Iraq.

I forgot about the Kleenex napkins…

 I thought that was so funny when we were in Nasiriyah last year, that the “napkins” on the dinning room table were actually boxes of Kleenex in pink and blue.  They fall apart in your hands when you use them to wipe your mouth but man–o-man they are better than nothing when it comes time to do that. 

The first couple of meals here in Najaf at our guesthouse were definitely consumed in the absence of any form of napkin-like material.  Awkward….someone finally said something about not having any “tissue” and within minutes two rolls of humble toilet paper showed up at our table. 

I guess that’s just how they roll here in Najaf. 

Sweet! No drama in leaving Istanbul and no drama entering Iraq.

What a relief.

I did have to wait for what felt like an eternity at the visa counter in Najaf however.   An hour can feel that way after a few days of airplanes, airports, and hotels.  But I made it with a little assistance from my local contact.  The same local contact provided me with a wild ride to our guesthouse…very glad that there were seatbelts in the car; I think we narrowly avoided three accidents during what couldn’t have been more than a fifteen-minute drive. 

I arrived to find our beloved surgeon at our guesthouse, prior to heading into the hospital for the day, smoking a cigar and playing video games.  He provided me with a synopsis of our trip so far and also a run down of how the last trip, Nasiriya , went just a few weeks ago.  Also got an update on the whole Iraqi program and what the goals are for each site.  So far, things seem to running quite smoothly here.  We have a four bed ICU and most of the children have done well in the OR and been quickly extubated and sent to the floor.  The TGA that was operated on yesterday apparently looks great and will be extubated today.  This child had the fourth arterial switch ever performed in this country.  The previous three have been performed by our team over this and the last trip. 

After my briefing, the night crew arrived home and I got to meet my nursing counterparts from Washington D.C. and Australia, as well as a German intensivist.  I am generally bad with names but the fact that I am here with two other nurses named Christine should make things at least a bit easier to remember.  We ate breakfast together and then had a quick drink and visit before we all went to bed.  I wasn’t anticipating sleeping all day but I didn’t wake up until my roommate started getting ready to go in for her shift.  They all just left the guesthouse a bit ago and I am here waiting for day shift to return home.  I’m excited to see my old friend Pasha (Pavel, Habibi…) my Belarusian intensivist friend, and Frank, a remarkable nurse educator originally from London.  And then there are the new faces to be introduced to as well. 

Not sure just yet when my first shift at the hospital will be, though I suspect it will be either in the morning or tomorrow night.  So for now, time to relax and rest up for what will hopefully be an uneventful trip. 

It’s a beautiful day in Istanbul!

Sunny and around 45 F.  Found my hotel shuttle, found my hotel, took a much needed shower and I’m going to take a shuttle downtown here in a few to see some sites!  I’m still holding out hope that the woman who was my Istanbul connection might be able to meet for dinner or something.  Maybe grab another nap (I have been sleeping in 2-3 hour chunks for over 24 hours now, and feeling pretty okay about it so far).   Then back to the airport around 0100 to catch my 0300 flight…should be in Najaf just in time to start the day. 

But leaving Istanbul might actually prove to be a bit of a challenge.  Apparently, everyone in the team so far has run into a little difficulty boarding their flights.  Hopefully things will have been worked out by the time I get back to the airport tonight but we will see.  The last person to arrive in Najaf got pulled out of line while boarding her flight by the officials who were convinced that she must be trying to board the wrong flight…why on Earth would a blond American woman, traveling alone no less, be headed to Najaf, Iraq?

So, once again, wish me luck!

I’m a little nervous about this trip…

 …but only a little. 

It is our first trip to this site.  If I recall correctly, the last time I was in Iraq I was on a second and a third mission to each site and we were still deeply mired in the figuring things out stages.  Those trips did not run entirely smoothly.  To say the least.  And this trip, our first time in Al Najaf, will be when we really assess the environment within which we will need to work.  This is the trip that we get to figure out if local meds just don’t work, or that there is no sink in the ICU, or that we have to worry about running out of oxygen from our wall set-up.  You know…

…details. 

This trip will also be a little different for me personally because I am arriving late.  Last one to the party.  And one of the last to leave.  The rational for that being that in the event that there are children who must remain in the ICU when it is time for the team to leave, that it would be great if we had sort of an ICU skeleton team to get them out.  So it will be myself, another nurse from D.C., and my Belarusian intesivist friend from previous installments of my blog, Pavel.

It is going to go by so fast…

Right now, sitting in JFK waiting for the next leg of my flight.  Off to Istanbul!  I have a much needed a hotel reservation for my seventeen hour layover and am hoping to take in some local sites.  I had arranged for a friend of a friend to show me around but sadly we had a major miscommunication about when I was going to arrive.  She showed up at the airport looking for me just as I was leaving my house to try to catch my first flight…I received a few very worried emails just as I was about to leave my house.  And unfortunately, she will not be able to meet me tomorrow.  But like I said, I have a hotel lined up already so that will help.  I think once I get a shower and maybe a nap I will be ready for a little adventure. 

Wish me luck!

Well, I’m all packed and I don’t leave for another 13 hours.

 My bag is overweight again.  It always seems to be on these trips.  I have my essentials, which are arguably more than is absolutely essential.  But I also have diapers and stuffed toys and liquid Tylenol and bubbles…and three bottles of liquor (last time I checked, southern Iraq was still pretty freaking dry).   I took the coloring books and the baby blankets out of my giant suitcase and put them in my carry on which gets the weight down on my suitcase to just shy of 70lbs, the reasonable upper limit for overweight luggage. 

So, like I said.  All packed.  And now what?  What am I going to do until  my plane takes off?