Tis the Season...

well it's high time that i post something, or so i've been hearing from various sources. So i thought i'd add to the blog some festive photos (renae, i actually thought of spelling photos "fotos" to go with "festive"...).

i recently had a Christmas party for my department (Internal Medicine/Pediatrics Combined Residency Program) - residents, families, staff, attendings, even some students who are interested in our program. there were about 30-40 people there throughout the evening. i loved it! an answer to prayer for the use of my home.

i wish you all be here with me in my little home. Caron came this week, with Annabelle and Violet. What a treat that was!! Thank you for coming, girls.



i hope the season is a blessed one for all. Immanuel, God with us. Praise the LORD.

a day in the life...

as i have reflected on my day, i realized - what i've seen and done and heard and felt today is rather amazing, and not a "normal" job.
i stood at a 67 year old man's bedside for almost 2 hours, telling the nurse what to do to keep his blood pressure up, his heart rate down and try to get his heart into a normal, safe rhythm, what medicine and fluid to administer, what tests we needed to order, which bodily fluids we needed to send to the lab for cultures, and what antibiotic to start to keep the infection i was suspicious of from making him any sicker. and he's doing ok now.
i pulled a tube out of a woman's side/chest wall where it had been placed to treat a pneumothorax (when air gets into the space around your lung and the tube sucks it out).
i walked in to my other patient's room to find the floor covered with her bodily fluids (and solids). and then i walked out again.
i watched and listened (and prayed) as my attending doctor told a patient that she has advanced lung cancer, already spread to multiple sites in her body.
and this is what i do every day. what a crazy life! and i love it.

i want to be like Cliff

when i'm 75 (and hopefully sooner...) i want to be like Cliff. I met him last weekend through a friend of a fellow resident who goes to church with Cliff. he took 5 of us girls sailing for an afternoon on the illinois river/lake peoria in his 24 foot sailboat, giving each of us a chance to steer, sharing about sailing, kayaking (he does that too), his faith and his experience of the LORD Jesus in His life. i hope i get to spend more time around this active, youthful, wonderful, joy-filled, godly, reminds-me-of-my-grandfather-ly man. thank you, Cliff!

seeds

so i've had a little box called "Basil Mini Pot" for years. maybe 3, 4 years... ever intending to actually open it and plant the seeds and grow my own basil. i've moved it from my first apartment in Omaha (on Cass) to the Glen Arlo and then to Julie's house... it somehow made it through the nearly 2 years at Julie's house and became a part of the many boxes that joined me here in my own, new house in Peoria, Illinois. it was unpacked, put on my kitchen counter, and left there for me to see daily for several weeks. one day last week i was seized with "i must just plant these stupid seeds!" and stop toting them around from house to house.
skeptical that these small seeds in a plastic packet would actually grow now, after 3 or 4 years, i followed the instructions, put them in their "Mini Pot" and left them on my window sill.

AND THEY GREW!!! little sprouts, pushing up soil, still able to spring to life after years in a plastic packet - without nourishment, light, attention, soil, water... their potential remained.
this gives me hope somehow. that seeds planted in my soul, and not attended for a while, are still capable of growing and bringing forth life with even the smallest amount of overdue attention. may it be!

the transformation

here are some pix of the new look on the inside of my house... enjoy. (sorry about the arrangement of the photos)

a new look

so the blog has a new look! ... for a new season, a new state, a new town, a new job, and all of the news that goes along with such. and just because. sometimes we need things to be changed around, spruced up. so here it is.

my first day of school...

or rather, residency!!
"Hello, I'm Dr. Venable" is getting more and more easy to say after the first few days. at first i kept thinking - i feel like i'm pretending to be my grandfather. but i'm wearing the long coat and the pager and the name badge that says "Katherine Venable, M.D." I've been working with/watching a dermatologist named Dr. Swaminathan for these first 2 weeks, i had my first clinic this morning where i see my "own" patients. My first call night will be next friday, when i work in the hospital and actually admit patients who are sick enough to need inpatient hospital care. that will be a little scary, but i'm looking forward to it. this is such a privilege!

some pictures from the last few weeks

Lou Karre, M.A. in Counseling! from Covenant Theological Seminary. Congratulations, Lou. i'm so proud of you!!! me, Jen Allen and Lou here after her ceremony.






a beautiful, enchanting child at Bethany Beach, DE where i spent memorial day weekend.







Amazon Hope II - in the Baltimore Harbor on a publicity tour, on it's way to Iquitos, ETA July 2006.







Me and my almost-90-year-old Grandma Peg at cousin Jacob's wedding. She's super cool - just returned from a 3 week trip to Germany to visit my aunt.

washing Sammy the cat. though Julie got a bit of a bath as well...

2120 W. Laura Street ... come by!

we went (renae and i, to Peoria)
we saw.
i bought.

it's gorgeous inside, original woodwork on floors and moldings, built in 1935, kitchen accented with white and black tile, bright natural lighting everywhere, a lovely yard with a swingset, 3 bedrooms upstairs and a bonus room in the attic. i'm excited to receive this beautiful gift from the LORD!
we walked in 1:23pm and by 1:28 i knew it was perfect. we left the house at 1:43 and by 2pm we were at the realtor's office drawing up the offer. i submitted the offer by 2:30 and the selling agent picked it up at 2:45. at 6:45 i received a call saying that my offer was accepted with no changes and we'll close on June 2nd.

and there's a lilac bush in front. renae prayed for that.

The Vine Trust

so as i've been perusing the web looking for pictures of the Amazon Hope ships, i found a great site for the organization, The Vine Trust. check it out. lots of pictures and more background on what i joined. this is in conjunction with Scripture Union of Peru, the local organization. The Vine Trust in based in the UK. just so good to get my mind off of my own little life and see more of the world.... enjoy, and let me know when you want to join me there...

Some stories from Amazon Hope

the first week:
i was a translator for Dr. Wendy Slater, a 37 year old, spunky physician from Scotland. we had a great time together and i enjoyed being able to facilitate her relationships with the patients and staff as well. it was a strange dynamic being the one to know both Spanish and English (though at times i didn't think i knew English when speaking with the Scottish group.) there were 6 members of the team from the UK - 2 doctors, one dentist, one pharmacist, one nurse and a dental nurse.
In addition to the UK team and me, the Peruvians included 6 crew members and Captain, Luis the chef, John G - lab tech/pastor/general asst., Nimia - nurse/pharmacy/everything else, Dr. Ronald Ramirez, MariLou - midwife, Yodimi - health dept. nurse, John V. - registration/lab/etc. and Fransisco the dentist.

One of the patients that was most difficult to see was a woman in her 30's with a husband and 6 children who was brought to the boat on a stretcher. we were told that she had a vaginal infection - for 2 years. beyond that, we eventually learned that it was actually cancer and that she had an infection on top of that. she was in excruciating pain and had been losing weight - many concerning symptoms indicating that she did not have long to live. John G. (pastor), Dr. Wendy and I met with her and her husband to see how they were doing, knowing that there was no medical treatment we could offer. She told us that she knew Jesus Christ and that she and her family trust Him. We prayed for her, for their family and John spent a while encouraging the husband to love his wife to the very end, to be with her. we gave her Ibuprofen and several antibiotics to treat the infection component. it was humbling and emotionally painful for us to see her leave on the stretcher after her husband carried her up the stairs from the hull of the ship. John reminded Wendy and me that though we could do little to ease her physical condition, we as doctors have something even more important to offer - the hope of eternal life in Christ.

Another group of patients i saw were the elderly, lovely men and women who had cataracts or pterygium (a condition where the tissue on the surface of the eye becomes ridge-like and grows across the eye eventually obscuring vision). these beautiful "ancienos" (in spanish - ancient ones :) ) still work in the fields, eeking out an existence for themselves and their families but can barely see. the most frustrating part of these visits was telling them that though there is surgery to treat both conditions, we were not equipped to do it. however, each time i said this, i asked them to pray with us that Amazon Hope II (see picture, and click on link to see it's progress) would be coming soon and with it, the facilities and staff to do cataract surgery and other general surgeries.










One of the most interesting patients i saw was a woman in her 50's whose concern was a rash on both of her legs. first of all, this was not the first patient i treated for a rash. nearly every patient had some sort of skin complaint. however, this patient was different in that her rash looked much more uniform, less due-to-bad-water, and she had had it for 5 months. Dr. Ronald, my dermatology (and everything else) consultant, had also never seen anything like it. i could see him start to think harder than he usually had to when answering my questions about skin problems. i suggested a possible etiology, which he accepted as within the realm of possibility (for any of you medical people - my thought was a purpuric rash due to thrombocytopenia). we ruled it out with a quick blood test - literally, a prick to see if she bled and bled. she didn't. his next question to the patient was "have you had any change in sensation in your legs?" much to my surprise, she said yes. he tested her sensation by having her lay down on the exam table and asked her to say when she felt his touch on her leg. he scraped one of the lesions with his pen cap (note the sophisitcated medical instruments we used...) and she said nothing. harder. nothing. after a few attempts in different parts of her leg, and her silence continuing, he turned to me and said, "i think it's lepra." or, leprosy. something i had only heard about in the Bible and maybe once in my microbiology class during 2nd year of medical school. we advised her to go to the government hospital in Iquitos where she could be tested for FREE and if found to have leprosy, treated for FREE as well. this is a patient i will never forget. nor will i forget Dr. Ronald's amazing skills in clinical diagnosis.

... back again

i arrived safe and sound in Iquitos on the night of March 25th. the 14 days on Amazon Hope were perhaps one of the most amazing times of my life. seeing, feeling, experiencing, doing things that few people in the world will ever see. we attended to over 2500 patients (medical, dental, immunizations and obstetric visits).
the days that followed were full of last times seeing people, goodbyes, my camera being stolen, getting ready to leave, and much, much travel. i arrived in the USA on March 29th, exhausted, with a sinus infection and intestinal problems where i was met by Caron (with annabelle and violet), Julie, Renae, Joie and Brook. Thank you so much for welcoming me back!
i now have no pictures to post of the boat experience until i track down the people from Scotland who were with us for the first 10 days of our 14 day journey. the rest of the time will only live in my memory and heart. i'll be posting some stories in the days to come. i'm sleeping a lot this week.

As for residency...
i will be joining the staff of the University of Illinois St. Francis Medical Center in Peoria, Illinois starting June 21st! This was somewhat of a surprise, but it is at the Hand of my Sovereign, All-Powerful Heavenly Father whose purposes stand firm forever, who does everything in faithfulness and love for His children. and so it is. my anticipation is growing and i am eager to see what is in store for me there. and to start working as a doctor. finally. the program is well established, primary care focused, family-oriented, involved in the serving the community (especially the underserved because it is a Catholic Hospital), sees a great diversity of people, are interested in preparing me for what i want to do in the future. and as an extra bonus, the financial benefits are amazing. i am thankful that this is where i will be for the next 4 years.

Graduation is May 5-6, 2006. come if you can!
and from thence forth, i'll get to sign my name with an "M.D."

I will cry out to God Most High,
to God who accomplishes all things for me,
to God, who fulfills His purpose for me.
Psalm 57:2

Amazon Hope

tomorrow i leave for 2 weeks on the boat, Amazon Hope. it will hold a crew of 4-5 Peruvians, 8 Scottish medical personnel, 5 peruvian medical personnel, and me, the lone americana who will also be translator for part of the time. and many, many patients. we´ll see patients in the "hull" (if i remember boat anatomy) where there is a "consult room" which will have curtains making it into 3 and a dental room. we are going on the Rio Ucayali to the communities live on its banks. http://en.wikipedia.org/wiki/Ucayali
so i´ll be gone for these 2 weeks without email access or phone so please don´t worry if you don´t see anything on my blog or hear from me for that long.
just pray. pray for safety and health, for strength to see so, so many patients all day, for skill and growing ability in Spanish as i will be translator for the first 8 days (none of the team from scotland speak spanish), and then continued skill as i join Ronald in seeing the 100 patients a day after the group from Scotland leaves. for the people we´ll be serving, pray that they would not only be helped and blessed by the health care, but also know why we do it - because Jesus Christ loves them and we are His hands and feet on earth to show them that.
the boat is quite nice - though old. i´ll have an air conditioned room for sleeping and i´ve been told, very good food all these days. we´ll have the chance to get off and walk around in the communities where we stop, so i won´t be entirely ship-bound for 13 days.
another item is that i won´t be finding out about where i´ll be doing my residency until i return on the night of March 25th. pray for this time of waiting for me.

thank you, thank you.
off to the jungle i go...

if you´d like to help...

i´ve been thinking about how to respond to the comments i´ve received and emails saying... "i wish i could send medicines or supplies..." or "what can i do to help".
today i came upon a way:
we are out of vitamins for kids (who all have anemia)
we are out of cough syrup for kids (and all of them have some viral upper respiratory infection that makes them cough all night and not sleep)
we are out of reading glasses (the kind you buy at the grocery store for $1.75)

SO... to start with, if you are willing, email me at katvenable2006@yahoo.com and let me know if you would like to contribute money, how much and what i should buy "for you" here. you can reimburse me when i return. it is very difficult to send supplies in the mail because of customs issues here. they rarely reach the intended party, unfortunately. so while i´m here, i can at least purchase some of these things for anyone who would like to help. and remember that even a little of our US currency goes a long way here.

thank you.

El Día de la Mujer

today i was greeted with a rose and wishes for "happy day"... the day of the women.
i had no idea this was a holiday. i received many wishes for a happy day. and a little gift. and lots of kisses on the cheek - which is a typical greeting hello and goodbye. but more today than usual. all the women at the clinic recieved a flower and a gift.
a lovely tradition i think we should observe in the USA.
here i am with nimia and melissa who both work at the clinic. they are lovely and sweet and a blessing to work with.

Amy

this is my patient Amy. she´s very sweet and about 6 months old. her mother brought her in because she has had fever for several days, as well as cough and is not well. She is like the other 30 or 40 kids under the age of 2 i´ve seen in 2 days with the same symptoms. it´s an epidemic of some upper respiratory infection running rampant among these people who live so close together in such poor conditions.
Amy, however, i´m pretty sure has pneumonia. i´m only pretty sure because i don´t trust the accuracy of my physical exam skills... because that´s all i have here. in our lab we can´t check to see if her blood shows signs of infection. we can´t do a chest X-Ray. so only my hands, ears, eyes, mind and her mother´s description told me that she has pneumonia.
hopefully, it will be responsive to high doses of Amoxicillin. not the best choice for pneumonia, but again... all we have. i try not to think of the 2 babies i admitted to the hospital in Ecuador with pneumonia who had been treated with Amoxicillin at a different hospital for 7 days before... and had gotten worse. just pray that the LORD will make up for all we lack and bring healing to her little body.

Belén

Some more thoughts and commentary on where i work every day.
Belén means "Bethlehem" and yesterday as i was appalled by the filth and trash and smells and sights, i kept thinking about how a place like this could be called Bethlehem... Bethlehem, that lovely place we think of where Jesus was born, a quaint little town with full inns and a cozy stable with a rustic, straw-filled manger where our Savior, the King of Heaven, was born... where noble wise men-kings and humble shepherds visited, where angels sang and a bright star shone overhead...
How is it that someone named this place Bethlehem?, i kept thinking.
however, as i´ve continued to reflect, Belén is the perfect name for this place, because Bethlehem, beyond our Christmas card images (which are more likely a product of Hallmark than reality), is the place all humanity associates with the miracle of Jesus´birth into this world. and that miracle, at it´s core is that Jesus, King of King and Lord of Lords, humbled Himself to become human so He could sympathize with our weaknesses, save us from our sinful, hopeless life and demonstrate His love for us in that while we were yet sinners, He died for us. and He lived among us - in all our filth and sin and poverty, both spiritual and physical.
"For you know the grace of our LORD Jesus Christ, that though He was rich, yet for your sake He became poor, so that you through His poverty might become rich." (II Corinthians 8:9)

(my taxi driver, Luis)

Hogar de Belén

that´s the name of the clinic where i´ll spend much of the next month. it means "Home of Belen". you can´t imagine (i´ll try to post pictures soon) how true this is. it is distinctly different than all the other buildings there. it is cement, white, clean, solid amidst (literally) a sea of filth, wooden shacks that float, despair and little that is sure or solid.
to get to work today i was picked up (they use one of my favorite verbs for this action - coger - which can mean to catch, to take, to get) by the doctor, Ronald. on his motorcycle. i climbed on behind him - i think that was the first time in my life to have ridden on a motorcycle. it was pretty fun, actually. and an adventure amidst the crazy traffic of mototaxi´s here. we made our way to the "top" of Belén ... where he left his motorcycle in a locked garage of sorts. then we descended the stairs to where the water begins. if you can call this water - it´s filth. sewage. grey and thick-looking. all manner of stuff floating in it. and scores of people everywhere. walking in it, canoeing around it in, living in shacks that float on it. and the ´water´is supposed to rise more this month. this same water is part of the Mighty Amazon.
our taxi to the clinic was a low-riding, wooden canoe. i got in trusting that it would hold all 3 of us - me, Ronald and our "driver" who was a boy of maybe 11 yrs. it did. and he rowed us through the water streets to the steps of the clinic, partly submerged. we pulled up, disembarked, and walked up the dry, solid steps.
a waiting room filled with people, a pharmacy/lab (which can do urine analysis and malaria blood tests, nada más = nothing more), 2 consultation rooms, a dining room where the children´s programs are held including lunch. there are a second and third floor which are being finished.
i saw close to 20 patients today. mostly on my own, consulting with Dr. Ronald when i wasn´t sure what to do or how to diagnose and treat without my usual tools of lab, X-ray, etc. the majority need more than medicine can offer them. so i gave a lot of vitamins, ibuprofen/tylenol, anti-parasite drugs and prayed. prayed for wisdom and understanding in spanish and of their lives. and prayed for food for them. for a day when they have a toilet in their house and clean water. for a day when they don´t have to live in filth. for them to at least be blessed by spending some time in the "Hogar de Belén", hoping they were able to find hope and light and peace there.
after afternoon devotions with the staff, we left. in a canoe, to the water´s edge, and then in a mototaxi to my clean, lovely hostal. the contrast is almost palpable.
i get to go back tomorrow. i can´t believe that this is actually my life. and i can´t believe Belén is actually theirs. i covet your prayers - for them, for me.

Iquitos

i arrived on March 1 at 7am. yes, that´s when i arrived. and praise the LORD, i was met by a lovely woman from Scripture Union named Rosi, the wife of an administrator with the organization named Carlos. i spent yesterday resting and meeting several other people and trying to sort out (have yet to figure out how to say that very useful phrase in spanish) my housing situation. we´re trying to find a family for me to live with. currently i´m staying in a room on the 4th floor of a clean, lovely hostel that looks out over the Amazon River. and costs about $7.50 a night.

To give you a word picture of Iquitos... (photos to come)

• people come here by boat or by plane.
• it´s a city of about 1 million people.
• the primary mode of transportation is in a mototaxi (half motorcycle with a seat behind for passengers and a little roof overhead)
• it´s ON the Amazon River
• there are "CyberCafe´s", lots of stores (all kinds - clothes, shoes, electronics, motorcycles, bread/food items/the usual junkfood selection and drinks shops) , major banks and government offices, a government hospital, a dozen hotels-hostals, some restaurants (including a 60´s style burger joint that appeals to the foriegners called Ari´s Burger) several squares, lots of churches, lots of people, lots of noise, lots of mototaxis, lots of heat. today, for about an hour, lots of rain.
  
• the top 3 reasons foreigners come here are... 1. Tourismo de la selva (jungle tours) 2. Tourismo sexual (no translation needed) 3. Tourismo de brujeria(tourism of witch craft)

So that´s where i´m working. More specifically, in an area of the city that i wrote about the last time i came here (Peru trip June 2004 with Zion Church) called Belén. I´ve recently learned in my study of spanish that Belén means Bethlehem. I´m still trying to sort out the spiritual implications of that.
I´m working in a new clinic in Bélen which wasn´t there in 2004. only the foundations. if you´d like to check out the website for Scripture Union Peru, it´s http://www.unionbiblicadelperu.com
search around a little to the Medical tab and if you can switch it to English, or if you can understand enough in Spanish, you can read about the clinic and the work going on here. The medical work is fairly new, as largely this organization helps children who have been abandoned by their parents or whose parents cannot afford to feed them or care for them. hard to imagine, i know.

using "we" instead of "i"

is the theme of the last 9 days. Julie and i (we) had a fantastic time together - seeing, doing, experiencing, talking, talking, talking, listening, eating, hiking, sleeping a little, and just enjoying a grand adventure. i was the primary communicator with anyone who speaks Spanish, and it took a few times to get used to asking questions with the "we" form of all the verbs. one of the hardest things for me in this new language is the conjugation of verbs, but it was a pleasure and delight to get used to using the "we" form for 9 days.
to give an overview of our travels:
Feb 19 julie finally arrived, 12 hours late after being diverted to Guayaquil, Ecuador due to thick cloud cover over Quito. Much rejoicing and a fairly quick turnaround to the bus that took us 5 hours south to Shell. arrived without incident. basically went to bed.
Feb 20-21 my last day on call. and a busy one. julie kept the camera all day and took many photos of me "in action" as well as was an excellent resource for a very complex medicine patient who came in at 2 am. she ended up in the ICU and i don´t know what happened to her yet. we basically didn´t sleep that night and i wrapped things up the next morning at the hospital (see photo - some of the people i worked with and my favorite patient, Darlen with her mom. Darlen was burned badly about 2 months ago and comes now for dressing changes. she sang songs for everyone including my favorite, "arriba doctorita!"). in the afternoon we went to a wildlife preserve and saw some jungle animals. great fun! (see photo of julie with rebecca the monkey on her head).

Feb 22-23 goodbye Shell and off to Baños, small city in Ecuador where i would want to live if i had to pick a place. Baños = Baths. as in thermal springs from "al dentro del volcán" (inside the volcano) which have been channeled into pools where people can go and soak. we went only for about 45 minutes (way too short) and paid $1 each for this fantastic experience. also around Baños we hiked, visited some INCREDIBLE waterfalls and soaked up this charming, quaint little town at the foot of majestic mountains. a highlight of Ecuador for me. (Photos: Pallon del diablo waterfalls, thermal baths at the foot of a waterfall and our dinner entertainment)

Feb 24 goodbye Ecuador... off to Perú. Landed in Lima(so nice to fly with a friend!) and were welcomed warmly by various Peruvians who helped us get to our lovely hotel. We both decided that this busy, loud city of 9 million people was NOT the highlight of the trip, but it served to allow us to travel on to the next adventure: Machu Picchu.

Feb 25-27 Cusco, the Sacred Valley and Machu Picchu. Not having known all that much about this wonder of the world, i was eager to go because it is renown the world over and especially in south america. and i´m here... so i should see it. well my tune has now changed after seeing it: Machu Picchu is a MUST SEE in this world. the price in money and time to get there is completely worth it. proabably the most incredible thing i´ve seen in my life. Julie and i had a grand adventure getting there, complete with multiple modes of transportation: plane to Cusco, little van to Otallantaytamba, train to Aguas Calientes, feet to Machu Picchu, bus back down the mountain. these pictures aren´t going to do it justice, but perhaps give you the itch to visit. it is steeped in history and mystery (and rain when we were there...). incredible, incredible... no tengo palabras sufficiente! (i don´t have sufficient words...) Photos: boarding the train, the mountains from inside the train, Aguas Calientes, Julie starting to ascend the steps to Machu Picchu which we started at 5am using our headlamps, and the ruins.

And that was the way i spent the last 9 days. Fantastic. Julie - thank you so much for coming to a different hemisphere and continent to encourage me and have a fantastic adventure! it was a JOY to spend such great time together in these amazing places.