If you've read my last post, you''ll see I'm not as homesick as I used to be. That's a huge sigh of relief for me. When I moved to Linares, I was sure I would make more friends, which I have, but they're more hospital friends than friends outside the hospital. And when that didn't come to fruition, it lead to some pretty insane decision making:
1) On the first Monday of me being in Linares, some very very sweet interns invited me to hang out with them and they taught me how to make a delicious traditional chilean alcoholic drink. But then I smoked with them, and as I got more high their words got more mumbled/modismo'd. Soon the social situation was reduced to me sitting there watching mouth-a-gap as this one girl bad mouthed other students, nurses, and matronas in the hospital to a group of 5-6 other people in her class. And they were just fixated by this one-woman show that wasn't even good. Overtime I tried to excuse myself to leave, but I was told that if I waited, I would be given a ride home. So I watched this spectacle for 2 hours when I easily could've taken a cab home for $2.50. 
2) I had sex with someone who has shown me several times even before we had sex this time just how much he does not respect me. But I'm addicted to oxytocin and needed a fix and he is cute and I knew he was a good cuddler. I'm still reflecting on this one. 
3) Good times: On Tuesday I had worked in the afternoon clinic with a wonderful OBGYN who works with adolescents in both pregnancy and gynecological care. I boldly asked her if we could meet to discuss research topics, which she agreed to do and I was invited to her house for dinner on Saturday! It was a magical experience in that this chat of ours was both intellectual and familiar. I was socially amped afterwards. But I was facing another Saturday night alone. So I decided to head to Santiago to find those new running shoes I needed and to go climbing the next day. Problem was that it was 8:00pm and there were no more buses to Santiago until Monday. I was told that if I waited on the highway by the police patrol where all of the buses coming from the south need to stop, then I could get a bus that way. This is when the nightmare starts: When I got to the police patrol, they were taking away the cones, indicating that the patrol was over for the day. But I am not one to give up on travel plans once they've been initiated. I ended up hitchhiking with an evangelical dude with some sort of grandiose personality disorder in a big cargo truck driven by a much less verbose but probably equally religious campo man. I tried to book a hostel from the truck as my friend scolded me on WhatsApp for making such a rash decision, but Google doesn't work on my Chilean phone (actually.) As we went through the toll booth about 40km out of Santiago, we were told by the cashier that there was a serious accident in 10km. At this point, it is 11:30pm and I am without a hostel arrangement. The less religious guy took advice from the more religious guy (hahah why is this a running theme in the world) to take a detour to the micro bus we would eventually need to take to get to center city. The detour lead us to an underpass that the truck cannot clear. We had to take another detour that involved both trucker and evangelical MEN leaving the truck to back it out of a rural road (see how self-destructive this is?!). Evangelical man now has another idea of where to go (again, why are we listening to him? this is the man who previously said that it was God's doing that we breathe while we sleep. NO DUDE! We breathe while we sleep because of an involuntary reflex controlled by baroreceptors and chemoreceptors ugh!). This is when I start speaking up, saying that none of these detours makes any sense. They tell me to relax, which is when I explain to them how scary it is for me as a woman to be with two men I don't know at this late hour. Then Evangelical man tries to reassure me by saying that when we get down from the truck then I will only have one man to worry about (!!!). Evangelical man and I eventually get out of this truck, take a colectivo to center city. Good. Now we're in Santiago. Evangelical man wants to make sure I get to a hostel safely. Ok fine. The first hostel doesn't have space for me. While Evangelical man and I are walking to the second hostel, we happen to walk by the church where he had stayed for 3 months, at which point Evangelical man tries to make creepy ghost noises to demonstrate how old the church is. Not helping. When we can't find the 2nd hostel because it was one block further than expected, he drops me off in a low budget Chilean hotel run by 2 women where I agree to his pressurized voice to stay in the dingiest room for 24 lucas ($40) so he can finally go home. When he's finally left, I tell the women that he pressured me to stay there and that I just need to find this hostel. This is where the nightmare ends: The women are incredibly understanding and empathetic to my plight and walk me to the hostel (9 lucas for a night = $13). The 2nd hostel happens to be the same hostel my best friend and I chose to stay in during our 1-day stop in Chile 3 years ago!!!!!! I'm in bed by 2:30 am. The next day in Santiago was WONDERFUL!!!! I went shopping, got new sneakers, got clothes I didn't need, went to Starbucks, and went to a climbing gym/ate chocolate cake with fun chilean climbers/did my first climbing in 4 months!!!!

Its times like these where the bad times are so bad but the resulting good times are so good that I wonder if being derailed into a bad situation is actually worth it.... Is my impulsiveness/spontaneity/need-to-move/need-for-adventure/wanderlust a flaw to rebuke or is it a positive trait to nourish? 

And this is sometimes where I find myself in modern culture... that who I am naturally does not fit with what is safest. When I need to be adventurous and in the sun and around people, a male-dominated and violent and lonely world tells me that it is safest indoors with Netflix. When I find myself loving someone openly, I am told to be careful or else I will get hurt. When I find myself enthusiastic and wild and honest, I am told to be careful to not seem unprofessional. I do not think my spontaneity is an inherently flawed trait to repress or extinguish. It just means that I have to work hard to make the world a place where it is safe to be naturally me. 

It's not like I don't miss home anymore, I definitely still do. I miss the proximity of my friends and family, English slang, the certainty that I won't get culturally misunderstood, and I really really really miss online shopping. I'm not a shop-a-holic at baseline but, man, I wish I could easily get another pair of Asics running shoes or take advantage of the H&M and REI sales all over my newsfeed. 

Despite missing all of this, my anxiety is definitely decreasing!

And it started when I heeded my perfectionist mother's advice, I just need to care less. I've given up trying to be the perfect foreigner that agrees to everything and just smiles and nicely nods her head to everything. Now that my spanish is improving, I'm starting to ask for clarification, to explain my perspective, and to exercise a little rebellion. I have finally fully explained to my chilean family that I DO LIKE SALAD, but I don't vibe with the Chilean trend of eating salad after a meal so I just don't! (I promise I do like lettuce! Actually fuck that. Lettuce with avocado is a boring salad.) My friend and I went out to the same bar twice this weekend and didn't come home until 4-5 am both nights!!! I'm getting over heartbreaks, and the chilean guys are showing me that they can be just as silly as american guys (so they deserve the same eye rolls. They can kiss my "me encant"ASS). I'm channeling boredom into my running, and finally just yesterday after a month of training, I didn't feel exhausted after my run, I felt exhilarated! So now I'm looking into 10Ks and half marathons. I'm still terrified trying my spanish on new chileans I just met, but WHATEVER. Caring is exhausting. 

After one more week of living with the cats in Talca, I'll be moving to Linares. Linares is home to the hospital where the Universidad Autonoma students do their rotations. So I'll be living closer to my colleagues which will help the loneliness. And I'll be working with OBGYN patients!! delivering a few babies, teaching women how to kegel, inserting a few IUDs, treating a few PID/TOAs, being second surgeon on a few c-sections... I cannot wait. 

**The attitude of this blog post is brought to you by Florence and the Machine, which the lovely cafe employee is playing for me.**

But first lets talk about the weekend!!!! I had a wonderful time playing in the Women's ultimate frisbee tournament in Santiago. 5 women teams went head to head over 3 days, and our team "The Sharks" from Vina del Mar came out in 4th place. This was the first time that I was a more experienced player on a women's team and the first time that I was expected to be a Handler, so I was thrilled that we won anything! Not to mention the thrill of bonding with people over a common love for a sport. Both the female and male Sharks stayed in an abandoned grandpa house that my friend's family owns and we had BBQ and drinks after games, ugh so fun. After the 3-day weekend/frisbee-love-fest, I was sore in body and rejuvenated in mind. FELT GREAT!!!

I had my first full-blown conversation about abortion the very next day. Setting the stage: I feel that up until this point that I've gotten to know Dr. V pretty well over the last 3 weeks. He respects his patients, has a beautiful family, is supportive/kind/encouraging when I need to voice my concerns or learn a new word, is a goofball/weirdo, and, best of all, thrives in evidence-based medicine. So when we were at the end of the clinic day on Tuesday, and he asked if the USA had an abortion law, I took a deep breath to brace myself for deeply intellectual conversation. At first, the conversation was a lot of him asking questions and me explaining my stances. We touched upon several topics such as the resources needed to raise a child, a woman's right to her body, and how and when most women go about getting an abortion in the US. It was pretty clear to me from our conversation that Dr. V was of the opinion that a fetus is a life worth preserving even if it's a few cells big (just from how I phrased this sentence you can tell how I felt about that). But then the conversation took a weird turn. Dr. V's voice turned from curious to confrontational/authoritative. He suddenly compared abortions to euthanasia of people with terminal illness. I thought I didn't understand the Spanish, so I asked for a clarification. And then I heard a stranger argument; if we allow abortion, parents will abort all children with Down syndrome. And then I heard something stranger; the reason why Chile has Teleton (a nationally televised annual fundraiser for sick children) and other countries like the USA don't have Telethon is that we abort all of our sick fetuses so we have fewer sick children. 

Is it just me or did that just sound crazy on so many levels.... ? How did the doctor that has been teaching me evidence-based medicine for the last two weeks not do his homework on this one...?

Here's the math: 

1) Generally speaking, two-thirds of US abortions are done before the 8th week gestation, 90% (nearly all) of abortions take place by the 13th week gestation which is the end of the first trimester. 
2) You can't diagnose chromosomal abnormalities, like Trisomy 21/Downs, without amniocentesis. Given that its an invasive procedure (risk of fetal loss is 1/200) doctors don't want everyone getting amniocentesis. Therefore, there are several screening tests before the ultimate confirmation test. The earliest and most effective screening test is called the Cell-Free DNA screen, and is reserved for women with a higher than average fetal risk for Down syndrome. That's women over 35 years old, women with a previous pregnancy with chromosomal abnormality, and women who've had high risk demonstrated by other less effective screens. Its a blood test that you can get starting at 10 weeks and you get results 2 weeks later.
3) Random Google searching has taught me that the rate of Down syndrome in US live-newborns is 0.00142. The rate of Down syndrome in Chilean live-newborns is 0.000336. The Chilean rate is actually lower than the US rate, not higher...

In summary, by week 13 the end of the first trimester, 90% of US women seeking an abortion have received one and a US doctor is counseling her highest risk patient that the fetus MIGHT have a chromosomal abnormality. You can't purposefully abort a fetus with Downs if you never knew it had Downs. What is this slippery slope everyone is so afraid of? 

So, why does Chile have Telethon and the US doesn't? I don't know! Maybe Americans are just assholes! 

On another note, I watched a matrona (a nurse practitioner who specializes in women's health and maternity care) do an intake today. The patient was a  17 year old girl who didn't use protection with her high school boyfriend and now had an unplanned pregnancy. Upon discovering she was pregnant at 20 weeks gestation, her boyfriend broke up with her. Her face showed no emotion when we held the doppler to her abdomen and she heard the fetus's heartbeat for the first time. I remember wishing Dr. V was in the room with us, wondering what he would have said to this patient to excuse the society that wasn't giving her any options. 

Its been a while since I've posted, I was waiting for something good to happen. I only have about 20 minutes to post so I'm not going to edit. Pure free flowing thought. 

So I cried at clinic twice this week. I know it was unprofessional of me, and I tried to stop myself, but the questions "are you ok? are you sad?" are my triggers. I can point to specific things that upset me.

• The first time I was trying to explain to my friend Diego quietly at lunch that my Chilean family doesn't talk to me and when they do its only to scold me or remind me of how to do things around the house. They frequently and actively say to each other right (in front of me) that I can't understand them. I was told that my 1.5 years of trying vegetarianism were done incorrectly if I gained weight and ended up needing to be a omnivore for energy purposes. I'm an alien in their house. Isolated from the center of town without a car. I often tip-toe around so no one hears me. I get comments about my room not being clean, but its small without a bookcase. The lovely Dr. Valenzuela who I'm working with overheard my whispers and asked later if I was sad. Waterworks.
  
• The second time I was trying to do an intake with a couple who hadn't done their lab work before the appointment. The doctor had left the room to take care of administrative things knowing Diego and I could manage, but Diego was bored on his phone, and there was nothing I could do from a management perspective without knowing the patients' numbers. I tried to conduct interviews but the patients didn't understand me, Diego was encouraging the patients to answer their phones instead of answering my questions, there was a landline ringing next to me, nurses and Dr. Valenzuela were running in and out of the room doing administrative things, and the patients had illegible medical records (why won't the computer accept my prescription for donperidona? because its spelled domperidona.) I was overwhelmed and fed up with trying. It was noticeable. When the patients left, I was asked if I was okay. Waterworks. 

Even though I cry in front of the doctors, I keep being told that my feelings are legitimate, that homesickness is okay, that it takes time, its a process. The validation is beautiful, the support is desperately needed. I find solace in my runs after work! I discovered a lovely little hill that gives me a view of the Andes! If I had a car, I wouldn't have gone passed the hill! I bet the family doesn't even know its there with all that time they spend indoors and in cars.  I know that I leave Talca soon to go live and work with OBGYNs in Linares in about 2 weeks. I will be closer to chilean friends there and we can finally get coffee or beers and chat after work!! 

Anyway, on the upswing!!!! I'm going to Santiago today for a 3 day All-Womans Ultimate Frisbee Tourney!! So excited to run around and explore! Smell fresh trees! Be in the sun! Eat a lot of apples! Chase down plastic discs! Its gonna be great :) Hopelessly optimistic about this weekend. See you all on the other side.  

Positives:

• I went to a medical student party in Linares Friday night to celebrate a student's birthday!!! Linares is a small town about 45 min south of Talca and its hospital is where students from Universidad Autonoma do their rotations , so its further from Santiago but its got a ton of friend potential :) So we partied hard into the Saturday morning hours with drinking games, birthday cake, and dancing!!
  
• A friend helped me discover that Talca has a tiny bouldering climbing wall :)
  
• The same med-school friend was thrilled to learn that ultimate frisbee is a real thing and wanted to learn how to play! mwuahahahaha
• I was the only medical student working with my doctor in the rural clinic of Pelarco on Friday so I got to do 1/2 of all the work instead of only 1/4 or 1/5 :) Such a fulfilling clinic session!
• Our family moved to a new house on Sunday. The house is bigger and has heating!!!!!!!!!!!!!
• I started reading El Principito (the little prince) in Spanish as a new vocabulary project. Hope to translate 10 pages a day.
• They're switching me from primary care patients to the prenatal+contraceptive patients in Pelarco for the next two weeks. 

My vent session: 

• Friday night while driving in taxis to the club, I thought some of the accents people were suddenly using sounded German, so I said so. Suddenly people were heiling hitler in the taxi. Mortifying. I told people to stop but they didn't. Then the boy squished next to me in the cab told me that the US was obsessed with 9/11 and that life is supposed to go on. Given the viscerally shocking aggressions + being drunk, I got upset. My friend who has been to NYC took me to the bathroom to help.
  
  • Apparently the German thing was a misunderstanding, they were using the Barcelona accent with lisps when I told them that it sounded German, and in their defense they started to heil hitler to show me that German was different than Catalan. Still offensive, but I found a way to forgive it. 
  • Apparently people here remember where they were on 9/11 but no one really understands the significance. So I just need to get on their level about it and not be sensitive about it. Ok. 
  • Somehow had fun the rest of the evening. 
• We moved to a new house on Sunday. Its still "in Talca" but its 100% suburbia. Every house looks exactly the same and we're far away from everything I've gotten to know and I don't have a car. Now that I have internet its better but wow I felt entirely disconnected from everything on Sunday. It was anxiety provoking. 
• I love this family but man it can get a little heavy handed sometimes.
  
  • "Don't get lost!" "Where is your jacket?" "Do you have your keys?" "Do you have your phone?" "Why doesn't it work?" "Be back before it gets dark" GUYS IM 27 YEARS OLD I WILL SURVIVE A WALK AROUND THE NEIGHBORHOOD. 
    
  • "Does your family serve salad at dinner with the dressing already mixed in?" -- "We don't eat salad at dinner." -- "You don't eat salad?!?!?!!!" -- "No thats not what I said." -- (next day) -- "jajaja Ryan hates eating salad" OH MY GOD.
• I discovered a cute cafe in the new area we live in on Sunday. Its takes up the first level of a square house. Taken aback by its cuteness I immediately snapped a few pics. I then got scolded by an owner and a relative for taking pictures of a "private place". I tried to explain but had no spanish words for everything I wanted to say. I deleted the photos and bought a cookie to show I meant no ill will. I felt really really off about the whole thing, and knew that my gringa-blunder would be the featured story at that family's dinner. 
• I got a manicure today in the new area we live in today (Monday). It was bad. The manicurest was an amateur who needed practice, and she was being taught by a Venezuelan lady who could not have cared less and was on her phone the whole time. I don't mind being practiced on but what didn't help was that the manicurest was deaf and mute. I took out my notebook and pen to communicate with her which she loved <3. I had to cut one of my own cuticles and showed her how to do it. Then the other lady took a jar of old dried exfoliating cream, told the manicurest to rub the cream on my hands, and then have me wash my hands. I don't think I have to explain how the actual painting-job turned out. At the end of my manicure, I wrote on a piece of paper to my friendly manicurest that this salon was too far away and her boss was too aloof for her to gain actual experience there. This all went down while the owner of the salon and this Venezuelan woman had a candid conversation about the shooting in LA and the Venezuelan woman brushing it off saying, "people die in my country all the time!" Dear US Congress, pass some goddamn gun laws so that our violence does not get equated with Venezuela's violence!!!!!!!!!!! 

Last positive: you've made it this far in the post, you deserve good news. 

• I met a cute chilean medical student nicknamed Barry on Friday. We kissed. When he was in his last years of high school he did an exchange for a year in Minerva, Ohio so speaks a good deal of English. We've been getting to know each other. DO NOT ROLL YOUR EYES MOM I SEE YOU.  

But that's not enough!! It's like having blurry vision that's only in black and white; I can see enough to not trip on a piece of furniture, but I'm not getting the nuances, the sharp lines, the colors. Sadly I fill in all the missing details with my assumptions and shoulder shrugs. A good friend said that I have an obvious face for when I'm no longer present in a conversation because of all the spanish. 

One of the issues is that I don't have a grasp on pronunciations. My brain is still mapping out sentences as they come in. Examples of a few blunders that I had the courage to challenge as they happened: 

• ​"hecho de menos" is what my brain wrote out when my friend said "echo de menos el hospital". He said "I miss the hospital", and my brain translated as "hospital made of 'de menos'" which made no sense. But hecho and echo sound the same!
• "pudiera de ver dada la vuelta" is what my brain wrote out when someone said "pudiera haber dado la vuelta"  (you could have made the turn-around). What my brain wrote made no sense but haber and de ver sound the same!
• in english we say i'm, he's, n', etc... chilean spanish does this but to the max. Sentences often just sound like a series of space-syllable-space-syllable-space-syllable. It's impossible to understand. 

Before I go about feeling too badly myself for crawling up this mountain, non-native english speakers have to learn how to differentiate "close" "closed" "closet" and "through" "threw" "thorough" "though".

Still I'm getting a little tired of needing to defend myself every time i hear "Ella no me entendió." My knee jerk reaction is to be frustrated and angry. Dudes, sometimes I do understand! And when you say that, it's rude. 

Positives for today: 

• My friend Diego understood all of the frustrations I expressed above. It was so nice to be validated by someone who is chilean. 
• Josefa (4 y/o) and I took our first ever walk/adventure together! We walked to the local supermarket to buy ourselves doughnuts :) The only rule was that she was not allowed to stop holding my hand. It was so fun!
• I ate doughnuts. 
• Tonight, my host family helped me edit my first "words/modismos" blog entry to the correct spelling :)
• I advocated for my elderly female patient today with a Candida rash. The doc (male) wanted to wait for ALT and AST to return before treating it with oral antifungals, so after the visit, I ran after the patient's daughter to educate her on how to buy the anti-itch OTC steroidal/antifungal cream in the meantime. 
• The lineup for Chile's Lalapalooza in March came out recently! Pearl Jam Red Hot Chili Peppers, the Killers, Imagine Dragons, Lana Del Rey, LCD sound system, Chance the Rapper, Wiz Khalifa, KYGO, Galantis, Milky Chance, Spoon are just those that I recognize!!! Gonna be crazy!!