Sunday night in Gulu, Uganda. The room in the surgical ward at Lacor hospital is small and stuffy. There’s just enough space for a bed against each wall, two metal chairs and a small desk. The metal shuttered window against the south wall lets in mosquitoes but no air movement. My white shirt is sticking to me as we screen patient after patient. One of our team members takes vitals, another fills out forms and organizes the surgery schedule and a local intern and the patient’s attendant help with translation. This means that there are six people in the room at a time, all tired and hot and sticky.
We review the dirty medical records that are kept in a folder or a plastic bag or up against their body. The patient slowly and carefully unties and unwraps a series of clothing articles that cover the catheter or enlarged or diseased organ. Once the problem is identified and the procedure explained and the forms are completed, he is directed to the nursing station by pointing through the window. Nods and thanks are exchanged and the man (or less commonly, the child, and even less commonly, the woman) slips out through the door as another patient pushes his way in. The vacated space on the long wooden bench in the crowded hallway is quickly scooted over by the next yellow card-holding patient.
It had been nearly forty-eight hours since arriving at the airport in Kansas City, full of anxious energy, anticipation and caffeine. My week had been tremendously busy right up until the moment the talkative Uber driver loaded my three suitcases, carry-on and backpack into the back of his new Honda Pilot and mansplained everything from the population density/public transit correlation to the number of pockets in his favorite pants to the problem with kids these days all the way to KCI. I was still getting over a cold that made it impossible to lie flat without coughing and so hadn’t slept in days.
Kansas City to Atlanta to Amsterdam to Kigali to Entebbe to Kampala to Gulu and still no measurable sleep. But adrenaline carried all of us as we were finally able to begin caring for the people that we had been dreaming about for months. The smoky humid air, the smiles, the babies, the amount of beautiful humanity packed together in the tight spaces of the surgical ward, they had been waiting all weekend on the grounds of the hospital and many had waited for months or even years to be seen, to have the chance to have their problems addressed, despite crushing poverty and the miraculous impossibility of having a medical team travel eight thousand miles to see them.
Ten days later and I was somehow on the Grand Street Bridge, which stretches over I-70 in the north part of the downtown Kansas City loop. It was dark and unseasonably hot and humid. Seven of us had arrived in a pickup, unfolding ourselves out of the truck to greet the waiting people. Or at least they were waiting for something. There were people with burns and depression and hypertension and rashes and varicosities. Many were dehydrated and intoxicated and loquacious and we worked through them one at a time. Taking vitals, filling out history forms, sitting on the curb or standing along the railing, they were examined and their stories were absorbed. We filled prescriptions and dressed wounds and reassured. We gave hygiene kits and water and I began to dissociate as the days merged and separated and then recombined.
It had been so long since I had slept for longer than three hours and after an incredibly busy clinic at my day job, stopping only for french fries on the way to meet the others for our night on the streets, drinking grapefruit flavored Red Bull between stops and typing patient information into the laptop as it rested on the white hot hood of the truck, it all felt the same. Whether a dark humid night seeing addicted, mentally ill, forgotten, and discarded people on a bridge in Kansas City or under similar conditions in a small room in Uganda screening the poor and unlucky for surgery, it all became one in my mind.
The fact that I hadn’t rested in between, that my mind was still in Uganda as I saw homeless patients in Kansas City, that many of the health care workers were the same, that the gratitude and the desperation and the grinding poverty were the same, I felt like I could see Lacor from that bridge. Like there was a thin place that connected the two, that connected all of the people around the world who are hurting and hungry and anxious and lonely and sick. The billions of people that overwhelm us with their need and with their very existence. The people that in the end are no different than me. As I existed in the fever dream on the bridge and in the exam room separated by time and space and yet existing simultaneously I felt a love and connection that transcended all of my senses. I was always and forever where I needed to be in those moments and in all moments.
Peace and love,