So, I never promised I’d finish this blog on my actual deployment. Here’s the next installment.
The remainder of Costa Rica was fairly uneventful, after my first few days as site leader. In the interest of morale, the ship’s Commodore granted us “non-liberty liberty” in Puntarenas, the port town where the ship was moored. As I mentioned, this was a cruise terminal, so was relatively touristy and therefore safe. Over the course of the 14-day mission stop, we were allowed 3 evenings off the ship, in a strictly regulated “liberty zone,” with the same “shore patrol” personnel that were ever-present during liberty. This pseudo-liberty gave us an opportunity to enjoy the local cuisine (food only – alcohol was strictly forbidden) and shop for souvenirs, all while wearing civilian clothes. As I’ve mentioned before, the chance to get out of combat boots and our heavy uniforms was always welcome and really improved everyone’s spirits. Unfortunately, some of my assigned nights ashore followed very long MEDCAP days, but I managed to take advantage of all available “off ship” time. There were several great ice cream shops in our liberty zone, and I had my first ever banana split with corn flakes on top and mango and jello at the bottom. Corn flakes: thumbs up (really!). Mango and jello: not so much.
Mango and jello notwithstanding, many of you will be surprised to learn that I was quite adventurous with the local food. You will be less surprised to learn that I paid for it in Costa Rica as much as I did in other countries. I maintain that consuming raw fish in developing nations is not the wisest idea. Unfortunately, my most severe GI bug of the entire mission came at the end of one of my site leader days in Costa Rica. The day was otherwise going smoothly and I was even able to see patients (in addition to running the site). One of my last patients of the day mentioned that her stomach was upset, and I realized that my stomach was upset too. Before I knew it, I had to excuse myself and spent the remainder of the afternoon vomiting behind the auditorium where the MEDCAP was ongoing. When we finally made it back to the ship later that day, my ASLs escorted me to Sick Bay, where I was given TLC, Cipro, and a fantastic medication called Zofran. That night happened to be one of my “non-liberty” nights. Not wanting to miss out on one of these rare occasions, I used the opportunity to find a local convenience store where I purchased ginger ale and crackers. Not the most auspicious night out, but enjoyable nonetheless.
Costa Rica was also where we were given our second (and final) “beer on the pier” (BOTP) extravaganza. Loyal readers may remember this event in Puerto Quetzal, Guatemala, where we were issued 2 beers after showing appropriate ID. This BOTP was no different, except that we were prohibited from leaving the pier (and thus wreaking havoc on the town of Puntarenas) once we had had our beers. This rule resulted in the world’s most inefficient and ridiculous arm-banding/ cutting/ list-making/ ID-showing experience, but it was still fun. We ended up getting pizza in town, and bringing it back to the pier, and thus enjoyed pizza and beer together on the pier. I love the ingenuity and tactical mindset of our nation’s sailors.
As in the previous several countries, I arranged a tour of the local/ regional hospital in Puntarenas. The scenery around the hospital was incredible (gorgeous ocean views), but the hospital was one of the least capable facilities that we had seen. This surprised me, given the otherwise comparatively advanced medical system present in the area. I was also able to travel to the nation's capital (San Jose), as part of an Emergency Medicine SMEE (subject matter expert exchange). Yes, I realize that I am not an Emergency Medicine Subject Expert, but I happened to be good friends with one, and it would have been considered rude not to go...right? Plus, I would never turn down the opportunity to tour Costa Rica with a local physician! We got to see the Poas volcano (very cool) and several parts of San Jose. We also managed to make it to the larger regional hospital in the city, so the trip was validated, in my mind, at least.
We left Costa Rica on or around the 12th of August (hard to remember, now, honestly). Then began our last long voyage at sea. We transited the Panama Canal (for the second time), and I couldn’t believe how long it had seemed since our first trip through back in April. I really felt like a seasoned sailor, watching all the new additions to the crew and their excitement at passing through the “ditch.” Funny to think I had been in those same shoes (or on that same boat, haha!) less than 4 months earlier.
At this point, those of us who had been on the ship from the beginning of the mission were starting to feel the strain of 4+ months at sea. Many of the crew (I would estimate at least half) had turned over by this point, and we were surrounded by new people (we called them “NPs”). I have to say, we were not friendly to the NPs. It’s a little embarrassing, in retrospect. For the most part, we (the “core crew” of physicians and nurses who had been on the ship “from the beginning”) did not bother to introduce ourselves or become friendly with the NPs. You might even say we excluded them. We were a little resentful, I think, of their enthusiasm, their optimism, their excitement about the mission, and their good humor at what had become truly awful food in the galley and a ridiculously pathetic selection of merchandise in the ship’s store. They thought the abandon ship drills were “fun,” they hopped out of bed at the first sounds of “Reveille,” and they (unknowingly) took our regular seats at the nightly operations briefs. In general, they considered themselves “ship’s crew” (the nerve!), and we didn’t like it one bit. Many of these NPs had boarded the ship at the end of the Costa Rica mission stop, and were scheduled to fly home at the end of the Haiti stop – so their participation in the mission lasted 2 weeks or less. We were jealous of this, I think, but again, in retrospect, having the NPs on board was a smart move, on someone’s part. After 4+ months, the rest of us were exhausted. We needed fresh blood and motivation to get us through our most difficult stop of the mission: Port-au-Prince, Haiti.
How’s THAT for foreshadowing?
