Newlyweds on the Run

Everything comes to an end

2011-05-03T06:45:00.001-05:00

Even good things must come to an end

The old proverb is sad but true. Today is our last day in Stockholm, Sweden. It was also my last day as an official medical student. Whoohoo! I turned in my ID badge and access card at the hospital, changed out of my scrubs and headed downtown for one last hoorah before getting on a plane for Minnesota tomorrow. It has been an amazing trip - full of delicious food, excellent museums, great sightseeing, wonderful company, and pretty good weather (except there was a spring snow/rain shower today). Last weekend we hung out with Kris and Leila and little Vilheim - they have been wonderful hosts and answered all of our stupid questions, "Why is everyone wearing sailors hats?" (Seniors in high school get "capped" with a sailor's hat - much more attractive than our silly hats - a month before the actual graduation and they wear them proudly.) or "Should we go with all our dormmates to Uppsala for Valborg?" "Heck no!" they said. "It's the center of the party (i.e. a bunch of kids getting wasted and puking on the train)." No thank you!

(Sunset over Stockholm)

Graduation
This Friday, I will change my name and graduate from medical school, Dr. Catherine Pastorius Benziger. It's a busy time as we have to find an apartment in Seattle, move all our stuff, and see all our wonderful family and friends before we go but we are very excited to start a new chapter in our lives. Thanks for all your support and encouragement.

(Seth and Katie at Kris Ekelund's cabin on Furusund Island)

(Ann and Katie with the Gamla Stan "Old Town" Island in the background)

(Ann and Katie in the Saluhall in Ostermalm)

"Two roads diverged in a wood, and I --
I took the one less travelled by,
and that has made all the difference."
-Robert Frost, The Road Not Taken

Adventures in and around Stockholm

2011-04-26T03:44:00.006-05:00

Djurgarden vs. Malmo

My friend Kris generously bought us tickets to his favorite soccer club, Djugarden, currently in the top flight in Sweden. The season had recently started and they were hosting Malmo, the previous season’s champion. Djurgarden plays its home games at the stadium that held the 1912 Olympics, so the setting was very cool. The game was hard fought, and a crucial twist came near the end of the first half when the Djurgarden keeper was red carded after a mental blunder (a hand ball outside the box). The home team valiantly fought in the second half, and seemed destined to earn a point with a draw until this moment of brilliance by a Malmo player in the 90^th minute. By far the best part of the game was being in the crowd that was constantly chanting throughout and trading cheers back and forth with their fans on the other side of the stadium.

(Home supporters waving flags)

Vasamuseet

Hands down one of the best museums we visited on this trip, and I will say now the pictures we took will not do it any credit.

(Katie in front of the ill-fated ship)

The Vasa was built in the early 1600s to be the best ship of the Swedish fleet. However, on its maiden voyage it made it only 150 meters before it keeled over and sank. It turns out the ship was poorly designed and was too tall for the amount of ballast the ship contained.

The ship sat in Stockholm’s waters until its location was discovered in the late 1950s, and in 1961 it was raised from its watery grave. Amazingly the ship, as it sits today in the museum, is 95% complete! The mix of brackish Baltic Sea waters combined with fresh water remarkably preserved the ship. Not only did we marvel at this gigantic boat in front of us, but the museum was supremely interesting as it discussed the boat through many different lenses – it discussed its history, the engineering feat to raise it from the waters, it forensically discussed the remains they found to explain the background of the people who worked on the ship and even had facially reconstructed some of the crew members. It also looked at the scientific aspects and of the difficulties of preservation. The museum did a great job ensuring the almost everyone would be fascinated by some aspect of this ship and its remarkable story.

(Detail of craftsmanship of the stern - this and the entire boat was painted in bright dazzling colors.)

Easter Weekend

Katie had a four-day weekend so we used it to our advantage to explore the archipelago that surrounds Stockholm. Consisting of roughly 24,000 islands, it looks very similar to the Boundary Waters – calm bodies of water of varying size and rocky shorelines covered with birch trees and evergreens – and are largely accessible only by boat. On Saturday we took a day trip to Sandhamn, at the far eastern edge of the archipelago. We made sure to show up early so we could get a seat on the outside of the ferry so we could enjoy the view.

(Our ferry is on the left, prior to departure)

(View from ferry in Stockholm of Gamla Stan)

However, as the boat picked up speed the temperature dropped dramatically and by the time we arrived in Sandhamn, we were about the only ones left outside. We had toughed it out under small fleece blanket wearing hat and mittens while everyone else had sought the warmth of the interior of the boat.

Sandhamn is a cute little village on the Sandon island that consists of people’s summer homes/cabins and is a popular summertime hotspot for sailors and urbanites escaping the city.

(Typical archipelago cabin style and colors)

We had a great day: hiking around the forested island, eating a picnic lunch along the shore (and chilling our wine in the freezing cold water), and enjoying the sun while sipping on a cold beer bought from Sandhamns Vardhus - a bar and hotel that has been around since 1672.

On Sunday we were invited to Kris’s parent’s summer home on another island, Furusund, in the archipelago. This one could be accessed by a two hour bus ride but wasn’t a special long distance bus, but just your normal every day city bus. It was an odd feeling to be on a city bus in the middle of the woods but it got us there quite efficiently – the benefits of socialism! Much like our ferry ride to Sandhamn, the bus ride felt like we were in the north woods of Minnesota. (After spending time in the archipelago it is no wonder that the Swedes immigrated to Minnesota since it must have felt so much like home.) It was a vacation to be lazy, so we took their 6-month old Vilhelm for walks in his stroller, watched movies, read books, and ate delicious meals that Kris and Leila made for us.

(Where we spent most of our time relaxing and soaking in the sun)

We were truly pampered this weekend and spent as much time as possible outside as the weather was simply beautiful - so much so that Katie and I got a little sunburned! An endless fascination for Katie and I were the huge cruise ships that went by their house. The house is located on the route where the cruise ships to Scandinavia and the Baltic enter and leave Stockholm. I think we were caught up in the juxtaposition of feeling like we were back in Minnesota, only to have those illusions shattered by the huge cruise ships towering over the cottages as they passed by through the channel.

(Cruise ship returning from another Baltic Port)

It was a great way to see a different part of Sweden and spend our second to last weekend. However, our last weekend may be even more exciting as it is Walpurgis Eve & May Day!

Valkommen till Sverige! (Welcome to Sweden!)

2011-04-17T15:02:00.000-05:00

The Sjukhuset
This is how I start my patient encounters at the Karolinska Sjukhuset (literally, sick house or hospital).

"Hej hej, jag heter Katie. Jag talar inte svenska."
(Hello, my name is Katie. I do not speak Swedish.)

I have taken exactly one 3-hour Swedish course (mind you I missed the first three classes so this was like getting thrown into the deep end blindfolded and in a straight jacket and was just as bad as passing into a more advanced level of beginners Spanish when I first arrived in Peru).

"Hur ar det?"
(How are you?)

However, since my great grandfather, Joseph Youngquist's, immigrated from Sweden and my blue eyes and blonde hair make me look the part, Swedish, I figured I might as well try to learn how to count to 10 and say a few phrases.

"Hur sager man "even though I look it, I am only 12.5% Swedish" pa svenska?"
(How do you say "even though I look it, I am only 12.5% Swedish" in Swedish?)

I am doing a 4-week general surgery rotation which involves seeing patients in the endocrine, breast and general surgery clinics and scrubbing into cases in the operating room. There are no residents on our team - just four medical students (Christos from Greece, Swapan from India, and Ann Vogt and I from Minnesota). We are all living in the dorms (the newlyweds go back to college living and Seth says he did not sign up for this - dorm photo below!), but it's nice because we are only 10 minutes by bus to the hospital.

"God morgon!" "Good morning"

We arrive around 7:45 A.M. and change into our mandatory white scrubs (every hospital worker must wear these to avoid bringing in germs from outside and at the end of the day you put them in the hospital laundry and get a new pair). Then, we head to the wards to see some patients and then have fika, or "coffee and cake" break. There are coffee machines everywhere and it seems that everyone is looking for an excuse to have fika (it's the equivalent of Australians or the British taking morning and afternoon tea). After wards, we either head to the operating room or clinic and are finished in the early afternoon. Not a bad last rotation to finish up before graduation after nine years of rigorous college/graduate education!

"Jag ska ta en kurs i svenska och kirurgi"
(I am taking a course in Swedish and surgery.)

(Ann and I in our white scrubs)

Infection control
Last week, we were unable to work for the first few days because we did not have our MRSA results yet and they have very strict infection control policies (unlike the USA where it is estimated that 1 in 3 patients who enters a hospital acquires an infection - make sure you remind your doctor to wash their hands!) We are not allowed to wear rings, bracelets, earrings, necklaces, nail polish, etc. The signs on the doors show photos of petri dishes with colonies of bacteria growing from these things AFTER someone had "thoroughly" washed their hands. I also learned that alcohol-based hand sanitizer is much better than traditional soap and water.

Stockholm Citybikes
Public transportation is amazing here! We can get just about everywhere by the metro, bus, local train, or good old fashioned bicycle. Seth and I bought 3-day passes for the Citybikes program this weekend and we got our money's worth as we have spent the past two days biking non-stop!

(We rode our bikes to the top of Mosebacketorg and out overlooking Slussen and Gamla Stan)

(Ann, Seth and Katie on Skeppsholmen with a view of the Gamla Stan on our bike outing)

This is a city made up of 14 islands and we biked on or around at least half of them this weekend. We biked from Sodermalm (where Mikael Blomkvist in "The Girl with the Dragon Tatoo" lives) through the old town, Gamla Stan, (where we watched the changing of the guards are the Royal Palace), and then over to Ostermalm (design district) and to the smaller islands of Skeppsholmen, Kastelholmen, and Djurgarden (where we visited the amazing Vasamuseet), and today we biked from Kungsholmen up to Lidingo Island (to see Millesgarden) - I can't think of a better way to explore a city!

(The changing of the guard at the Royal Palace Kungliga Slottet - quite a spectacle with a full band and everything!)

(Seth posing at Karl Milles' sculpture garden at his residence on Lidingo Island)

(Our single dorm room with a private bathroom - thank goodness it is only for one month!! We had to buy an air mattress and some blankets and sheets at the original 1960s IKEA)

(Gamla Stan - the old town - narrow alleyways and cobblestone streets with lots of restaurants, historic buildings and shops)

(Seth along the riddafjarden (canal) soaking up some sun after walking around all day)

Weather
The weather is getting nicer - daily highs in the 50s and sunny with lows in the 30s at night. It reminds me of Minnesota spring and all the trees are budding and the flowers are starting to bloom. It is a great time to be here because Easter is a HUGE holiday - not as a religious holiday, but as a secular one full of traditions of painting eggs and getting together with family and friends. It is seen as a chance for all the urban Swedes to escape to their summer cottages for the first time after a long, dark winter. Everyone takes a 4-day weekend (at least) and goes to the beautiful Baltic coast or archipelago or into the countryside. We have been invited to Seth's Macalester friend, Kris Ekelund's cottage, and can't wait to tell you all about it!

Glad Pask! Happy Easter!

I love Paris in the springtime!

2011-04-14T17:23:00.000-05:00

Je t'aime Paris! Le meilleur endroit pour une lune de miel

After Seth and I travel to a new place, we always make our "Best of" lists in a little black moleskin notebook. We decided to share with you our "Top 5" categories from our wonderful honeymoon in Paris (and a few photos too).

Top 5 Alimentaires (foods)
-Foie gras
-Steak Tartare x3
-Canard (duck), which was in our prix fixe menu every day!
-Suckling pig in spicy sauce at Le Pre Verre....mmm so good until I found out it was actually a 2-6 week out piglet :(
-Freshly made crepes with nutella and bananas

(Dressed up for our last prix fixe dinner)

Top 5 Memorable Moments
-Paris St. Germain (PSG) soccer game versus L'orient and despite a nil-nil draw, we had fun sitting with all the hard core fans who were yelling the whole time.

-Hanging out under Pont Neuf and along the Seine watching the sunset and then the Eiffel Tower sparkle. Then planning ahead and packing a picnic dinner (baguettes, prosciutto, goat cheese and strawberries and bottle of wine) the next night to sit on the Ile de la Cite with thousands of other young, hip Parisians after resting our aching feet by taking an hour and a half boat ride around the most popular sights, including the Eiffel Tower (we would kiss every time we saw it on the whole trip).

-Buying a Shaler etching of the Seine at night in a gallery nearby and then getting to drink champagne with an Australian couple who had purchased a smaller painting by a more famous person that was at least 10 times more expensive.
-Watching the hustle and bustle of the Quatier Latin from a sidewalk cafe on a beautiful Saturday afternoon
-Hanging out on a beautiful spring afternoon in the Luxembourg gardens. We especially enjoyed watching dozens of children eagerly wait for their sailboat to make it across the fountain so they could push it with their stick to the other side.

Top 5 Overall Places
-Getting lost/overwhelmed in the museums - The Louvre and Musee d'Orsay

-Going to the "Just Art Paris" exhibition in the Grand Palais

(Panoramic view of Paris, the Seine, the Louvre, and many of the streets that we wandered over the 8 days we were in the City of Love.)

-Walking along the canals - Seine and Canal St. Martin

-Spending hours wandering around the busy Sunday morning farmers market at the Marche del Algier and then sorting through knick-knacks, $4,000 vintage dresses, and unbelievable antiques in the endless allies of the Marche aux Puces St. Ouen.

-Petit Trianon part of the Versailles garden - a little village for the queen and her 19 children!

Top 5 Things We Learned
-Paris has the most efficient metro of any city we've ever been to!
-Two of the most important architectural buildings were initially rejected by the Parisians when they were built but are now city icons - The Eiffel Tower and Centre Pompidou

-The misperception that Parisians are rude if you can't speak French - simply not true!
-Fashion is #1 here! Converse "Chuck Taylor" All-Star shoes were SUPER fashionable among the younger generation, as well as silk scarves and other accessories! nearly every street we turned down seemed to have designer boutiques.
-The Louvre was built on the old city fortress.

(Katie in front of a Murano glass exhibit at the Centre Pompidou.)

(All the trees and flowers were blooming for spring. Seth in front of Notre Dame.)

(The statues on Notre Dame Cathedral)

Sacre Coeur

Belgium - land of chocolate, beer and the Manneken Pis!

2011-04-10T15:31:00.000-05:00

After a disappointing realization that car rentals in Germany were out of out budget, we abandoned our plans to go to Baden-Baden in the Black Forest in Germany and decided to catch a train to Brussels, Belgium. We spent two nights in this charming city and walked the cobblestone streets on the information center's recommended Comic Book and Art-Nouveau walking tours. We walked and walked and walked some more until our feet started to ache and we need to recharge with some famous Maison Antoine "pomme frites" and a little dark chocolate. We learned about the history of comic books in 1940s - did you know the Smurfs were made by a Belgian? We were able to practice our French too before heading to Paris as it is one of the national languages along with Flemish.

Katie in the center of old Brussels.

Seth and Katie outside our hotel on the Grand Place before we got our hair (and Seth's beard) cut!

We stayed in a hotel on the Grand Place, the main square, and toured the City Hall, visited the Brussels City Museum and Magritte Museum, and then caught an afternoon train heading to Paris on Friday. It was a great new city to explore. Besides getting drenched in the rain on our first afternoon, we enjoyed walking around on the old narrow cobblestone streets and admiring the different architecture - from gothic to art nouveau.

I will never forget walking around the corner of a small street and seeing the small fountain of the famous little boy peeing, the Manneken Pis statue, which we had seen souvenirs of in EVERY store but had not seen the real thing. I was quite surprised by how small and cute it was!
On the day that we left, he was dressed up like a school boy!

Moseying along the Mosel

2011-04-04T16:10:00.005-05:00

(The Piesporter vineyard along the Mosel - very steep and only accessible by boat)

Day 1: We planned to spend a few days with one of my college friends, Jenny, and her boyfriend Christian who live in Trier, Germany – a city we knew very little about. We did no pre-trip research as we figured the locals could show us a good time. This was one of those serendipitous occasions where we were blown away what we got to experience. Jenny picked us up in Luxembourg in the late afternoon after a day of travel from St. Petersburg. (This could be the subject of its own blog post as St. Petersburg has one of the most budget international airports we have ever been too and it felt more like a tiny regional airport in a developing country. But boy do they take their security seriously - we had to go through screenings twice before we were even able to get our boarding pass!)

Trier is only about 45 minutes away by car, and when we got there we met Christian, and we went out for dinner. We knew good times were ahead as we quickly learned at dinner that the Mosel River, which runs through Trier, is the river valley where Rieslings are made – one of our favorite white wines.

Day 2: Unfortunately Christian had to work a few hours on Saturday, so the three of us headed to Luxembourg for the day. Luxembourg is not a very touristy city and happens to be a major business and banking center due to its low tax rates. Expectations were low, but they were easily exceeded. We first wandered around the shopping district and came across two squares with weekend markets – one antiques and the other food. Par for the course, Katie quickly found something to buy which will be a great memento of our trip. After poking around for a couple hours and buying some food for dinner, we went to the Casemates. Luxembourg was built on top of a hill and heavily fortified, as was common with many European cities. The Casemates were part of the fortifications that were recently excavated. We were able to explore the ruins and were given great vantage points of the city. Tired after a long day we headed back to Trier where Christian, an amazing cook, made us a delicious dinner.

(Katie & Jenny at the Casemates)

Day 3: Jenny and Christian generously decided to show us the region and our first stop was Burg Eltz, maybe one of the most picturesque castles in all of Europe, or so we were told by Rick Steves. As the trend of “things being closed in the off season” continued, not only was the castle closed for tours, but a large portion of it was surrounded by scaffolding and plastic as repairs were being made. We did hike down to the castle and walk around it a bit, and the setting in the valley was absolutely amazing. After the castle we cut over to the Mosel to drive along its winding banks. The river is dotted with many old towns and the hills from the river are covered with grape vines. We stopped for lunch in Cochem which is a lovely town that has a castle perched above it, a perfect spot to eat. Afterwards we kept driving along the river and stopped for dinner and a wine tasting. It wasn’t like a tasting in Napa or Sonoma, but we were about to try 5-6 different types of Rieslings, and it was the perfect way to end the day.

(In the beautiful river town of Cochem)

Day 4: As it was Monday, our hosts had to work so Katie and I were able to explore Trier – which offered more than we ever have imagined. Founded in 15 BC it is the oldest city in Germany, and more importantly at one time was the “northern” capital of the Roman Empire, exceeded in importance only by Rome. Of the Roman ruins still standing the impressive was the Porta Nigra, one of the old gates to the city. It still stands after 18 centuries and was constructed like the important buildings at Machu Picchu, without mortar of any kind.

Due to Trier’s importance in the Roman Empire, it was a major religious center too and is the seat of a Catholic Bishop. The Dom, a Roman cathedral, is truly awe inspiring in its size and architecture. Legend also has it the tunic Jesus wore when he was crucified sits in a magnificent reliquary. The last site we visited of historical note was the birthplace of Karl Marx – who was born and raised here in the early 1800s.

(Katie in front of the Porta Nigra)

Day 5: Katie and I decided to rent bikes and bike along the Mosel River in the opposite direction we explored the preceding weekend. The guy at the rental shop told us we should go to Saarbourg, so off we went. There are walking and bike paths along both sides of the Mosel and we had a glorious ride on a sunny and 60 degree day. After two hours of pedaling we made it to Saarburg which was yet another picturesque river town capped with a castle and a waterfall. We ate lunch, Katie (surprise, surprise) went shopping, and I walked around the city a little bit before we needed to head back to Trier. It took us a little longer to get home as my knee was hurting a bit, but we got bike in time before the bike rental shop closed. All in all we estimated we biked 36 miles! Christian yet again made a magnificent dinner that Katie and I devoured as we had burned so many calories during the day.

(Katie in front of the falls in Saarburg)

We had a great time and that was due to our generous hosts Jenny & Christian. Not only did they put us up for several nights, but they fed us, and took a lot of time out of their busy lives to show us the sights. Fortunately they have family living in Tacoma, so hopefully we can repay the favor in a few years when we are living in Seattle!

St. Petersburg by the numbers

2011-03-27T15:12:00.030-05:00

St. Petersburg, by the numbers (in honor of Ms. Hutchinson who always writes the best blogs):

(We don't talk about this church, St. Nicholas, but we liked the photo)

2 - the number of times it took us to try to get to Tsarskye Selo in Puskhin. After the trains were down and our problematic map reading (who knew Moscovsky and Moscovskaya Stations weren't the same!?!), we abandoned this day trip and opted for a relaxing day in St. Petersburg and decided to try again the next day to find the metro station and bus out to this quint town. The Tsarskye Selo, or Tsar's grand palace, was built for Catherine the Great as a summer home. It's over a half mile long and was restored recently so the facade and indoor rooms are just as stunning as they were 200 years ago. The Great Hall was our favorite - 9000 sq. foot room lined on each side with gold mirrors and tall windows overlooking the majestic gardens, this would be quite the ballroom. Also, I forgot to mention the amazing amber room - floor to ceiling of mosaic amber panels that words cannot describe (and we weren't allowed to take photos).

4 - number of golden-winged griffons, sculpted by Pavel Sokolov, on the famous Bank Bridge. We stumbled upon this small pedestrian bridge over the Griboedov (Catherine's) Canal on our way home from Nevsky Prospkt one afternoon.

5 - number of pink limousines we saw on Nevsky Prospkt, the main shopping street. Many of the hummer-type limos were filled with teenagers and we saw one pull up to the McDonald's even with a photographer in tow! Weird.

29 - number of years to restore the unbelievable mosaics in the Church of the Savior on Spilled Blood. From floor to ceiling, 1cm x 1cm tiles were replaced after the Soviet's neglected this amazing and colorful church.

40 - the number of years it took to build St. Isaac's Cathedral (from 1818-48). It was fully restored after a period of neglect during the Soviet era and is quite impressive not only inside, but when you climb up along the dome and get a panoramic view of the whole city on a sunny, although quite chilly, day.

47 - the street address to the Nabakov Museum (which was across from our hotel), where Vladimir Nabakov (author of "Lolita" and other excellent literary works) grew up in St. Petersburg before fleeing to Europe at the beginning of the revolution.

60 - miles per hour the taxi driver drove in the middle of the city. Despite not having any freeways in town, the drivers here often reach blazing fast speeds when the light turns green, as if there is a race to get to the next light.

96 - the number of columns in the Kazan Cathedral. This Cathedral resembles the Vatican's St. Peter's on the outside but it awkwardly situated in the middle of fashion and shopping area on Nevsky Prospkt.

2.5 million - the number of annual visitors to the Hermitage Museum. With nearly 3 million items in the collection, this is definitely a place that we'll need to visit again! Despite spending an entire 8 hour day wandering the rooms and going on two guided tours of the Diamond and Gold rooms, the Hermitage's six buildings (four of which we were allowed to visit - Winter Palace, Small Hermitage, Old Hermitage and New Hermitage) comprise about 120 rooms that were filled with archeological artifacts, art work from the 13th-20th centuries, and many gifts to the Russian tsars (or looted during the war from the Germans). In part, because this museum was the Winter Palace of the tsars, the ornate decorations made it the most impressive museum I have ever been to. It was the equivalent of the Vatican Museum, British Museum, and more in one! I was overwhelmed and extremely impressed to say the least. Next week we are headed to the Musee D'Orsay and Louvre which will be impressive as well but I doubt they will surpass the Hermitage.
A foreigner invited to one extravagant event in the Winter Palace in 1778 wrote: "The wealth and opulence of the Russian court exceed the most fanciful description… The sumptuous brilliance of the court apparel and the abundance of precious stones leave the magnificence of other European courts behind".

Joensuu and the North Karelia Project

2011-03-21T09:12:00.000-05:00

Joensuu
The city of Joensuu (pronounced "youn-soo") is a modest town of 75,000 people in the region of North Karelia.

The Non-Communicable Disease Seminar participants, Seth, and I traveled by train for five hours (440 km) north through large pines forests and fresh white snow to North Karelia. One could easily confuse this place for a town in northern Minnesota and I suppose that's why the Finns and Swedes settled in Minnesota - they were good lumberjacks, they could survive the cold winters, and they love to ski!
The first day in Joensuu, we visited the headquarters of the newspaper, Karjalainen. They are the largest daily newspaper and reach over 80% of the population in the area everyday. "How can that be?" you might ask, well the Finns not only consume the most coffee per capita, but they read print newspapers the most too - 34 minutes daily per person! They have 32 daily newspapers and 166 non-daily in a country of only 5.4 million people. They told us about the partnership that they have with the North Karelia Center for Health to promote healthy behaviors and develop a "reality" show of 8 people trying to be healthier - quitting smoking, exercising more, and eating more fruits and veggies. They use journalistic flavor to appeal to the readers and promote healthy lifestyles.

(Katie standing outside the Joensuu City Hall where our international crowd met the Mayor and Regional Council members.)

Hospital visit
Next we visited a primary health center which was very nice but only had 10 clinicians for 150 beds and none who worked the night shift. Not sure I'd ever want to get seen there but alas, they assured us that nurses take on a lot more responsibility here and manage most of the chronic disease management and screening visits and that most of the beds are long-term beds, aka nursing home type, and have six-month waiting lists. A doctor is available by phone and all emergencies are transfered to the Central Hospital in the next town where specialists were covering 24/7. Nurses and doctors are civil servants here, like teachers and politicians, and are not compensated well. Most doctors in this area work in private practice.

Taxes
The Finns spend 46% of their income on taxes! However, they spend half as much as we do ($2331 vs. $5401 per capita) on healthcare per capita. Nearly 100% of babies are born in hospitals and their infant mortality rate is the second lowest in the world to Norway. Healthcare is mostly free in Finland ($12 per visit and minor medication fees). The school system is amazing! They are one of the most literate countries in the world and their schools include a free home-made balanced lunch for all students up to grade 9, free transportation if you live over 3 miles away, and free university tuition. All of their teachers must have a Masters in Education.

Folk singing
That night, the Finnish Heart Association invited us to a special meeting in the next town over. While we were on the bus, I got a phone call from my Dad who had attended my Match Day Ceremony where I found out that I matched at the University of Washington - Seattle for Internal Medicine. I was giddy waiting for the call and nearly in tears when we found out because we were so happy!! When we arrived at the meeting, we were greeted by a choir and soloist who sang "songs about the heart" they said. There were speeches in Finnish by the president of the association, our hero in cardiovascular disease prevention, Pekka Puska, and the town leaders. Then, we had to stand in front of everyone and introduce ourselves and afterwards a few people came up to us but did not speak any English so we had to pull over one of the Finnish participants to translate. It was a great evening and Seth and I celebrated with our new Australian, Nigerian, Bahranian, and Finnish friends over dinner and wine in the hotel afterwards!

(Photos will be posted later)

Back in Helsinki

Helsinki is the northernmost urban area of a population over 1 million, and there is much to do and see in terms of it's design business and history, starting with the centrally located Senate Square and Lutheran Cathedral. The master of the Finnish Art Nouveau was Eliel Saarinen (1873–1950), whose architectural masterpiece was the Helsinki central railway station and the city hall in Joensuu (photo from above).

If it's too cold, you could always spend a day getting lost while shopping in the eight-floor department store, Stockmann's!

St. Petersburg

Seth did not mention how wonderful the styles of the women is here - furs, furs, black tights and boots! Men are dressed in less stylish but still warm fur hats and wool coats, and some even carry leather purses. It's wonderful and cracks me up every time we leave the hotel. More blogs to follow about the Hermitage who's director once said "We can't say we are the #1 art museum in the world, but we aren't #2." We plan on spending all day there tomorrow. Thanks for reading!

St. Petersburg to Petrograd to Leningrad to St. Petersburg

2011-03-20T11:51:00.003-05:00

We have traveled to all of those cities the past day and a half! However, that is simply due to the fact that those names all represent the same city, present day St. Petersburg. The name changed over time due to the prevailing political winds.

(Katie in front of a frozen canal and the Church of the Savior on Spilled Blood - an amazing church which deserves its own blog post)

This will be just a quick blog post of our early impressions of the city.

Economics - Thankfully things here are cheaper than Finland. The cultural sites are slightly cheaper than American standards, but the rest (clothes and food) largely seem to fall along what we would expect to pay in America.

Fashion - This is one fashionable city, especially as seen along its main shopping drag Nevsky Prospekt, where the people, largely the women, come dressed to impressed. Currently in style are boots (preferably knee high), fur, and bangs.

Architecture - this is an amazing place that many call the Venice of the north due to its many canals and waterways; although it may more closely resemble Amesterdam. The buildings are large, colorful, and ornately trimmed. It seems like you could constantly be taking pictures of the architecture. One downside to traveling at this time of the year is that the canals are still frozen solid - we are in awe of this city so far and we could only imagine how much more amazing it would be in the summer.

Smoking - Russians love to smoke, and can do it cheaply. Apparently a pack of Marlboros only sets you back the equivalent of a $1.50. It is hard to get used to as smoking is permissible in restaurants here, but thankfully the ones we have chosen so far haven't been too smokey. Also a blast from the past is the option of the smoking or no-smoking section. Doesn't it seems like ages ago when we were last asked that question?

We skipped an update in our blog about our trip to the northern Finland town of Joensuu for Katie's seminar. She will provide that update in a few days and this weekend we will update you on the rest of our time here in Russia.

Helsinki

2011-03-16T07:18:00.009-05:00

Appropriately, I sit in a café with a cup of coffee writing this, my first*, blog post. I say appropriately as the Finns consume more coffee per capita than any other nation in the world (Katie’s colleague opined that it must be due to self-medication to deal with the long dark winters). Our trip began last week with the shortest 9 hour flight I have ever taken – it went by quickly and before we knew it, we were in Paris waiting for our connecting flight to Helsinki. (One side benefit of having to follow my wife around the world was earning status on Delta. The status has allowed me to book exit row seating – which was a godsend for my long legs.) We arrived in Helsinki on Friday afternoon and Katie and I explored the city that weekend before her training started.

Helsinki is a small compact city which made the site seeing quite easy – what has not made the site seeing so easy are the layers of ice and water on the sidewalks. For some reason most buildings do not remove that from their sidewalks, and the city’s solution is to throw down small rocks to help you gain traction. It was a bit odd at first, but after a fall free weekend that must be some reason to that madness.

Katie and I packed in a lot in those days going to museums, visiting markets, exploring the City on self-guided walking tours, and taking the ferry to Suomenlinna – the City’s Maritime Fortress. Helsinki is a great starting point for our trip as English is widely spoken, the City is small and intimate, and we can get our “traveling to foreign land” legs under us. In addition, we learned a lot about the history of the region, a history I was very ignorant of before coming here. For example, did you know that Helsinki was considered Axis-Lite? While they didn’t fight alongside the Nazis, they did receive arms for allowing the Nazis to move through Finland to occupy Norway. Due to this assistance, as war reparations Finland lost a large portion of Karelia to Russia.

(notice all the ice in the bay)

(KTP keeping her eye out for the pesky Russians)

One downside to this trip is traveling during the tourist offseason. Time and time again I have been thwarted as many museums, parks, and tourist sites are closed for repairs or to change exhibitions. This has been frustrating, and hopefully we don’t run into that issue in such a major way again.

We are off this afternoon to Joensuu as part of Katie’s training. The trip is about 440 kilometers and about halfway from Helsinki to the Arctic Circle. By looking at maps, I am guessing that it will look a lot like northern Minnesota - plentiful lakes amid the pine/spruce trees. We come back on Friday, and then head to St. Petersburg on Saturday.

* As this is my first post, there are still some blogger.com nuances I need to figure out. One are pictures and possibly appropriate sizing - so please bear with me.

Making the healthy choice the easy choice

2011-03-15T15:29:00.000-05:00

*Seth will be giving you an update on Helsinki tomorrow, this is just a quick update on my seminar.

The Non-communicable Disease Training Seminar in Helsinki, Finland is fantastic! I highly recommend it to anyone who is interested in public health and population-based interventions for chronic diseases. It is based on the North Karelia Project that took a truly population-based approach to treat cardiovascular disease (CVD) in a population of lumberjacks and farmers that were dying at a young age of CVD. They were the folks who claimed, "Veggies are for rabbits" and said "I'll have some bread with my chunk of butter, kiitos (thank you)" who consumed 40 pounds of butter per year! Therefore, their diet (and tobacco use) contributed to their high cholesterol, blood pressure and mortality rates in the 1970s. Simple interventions - smoke-free workplace campaigns, margarine for butter, substituting skim milk for whole milk in schools, increased vegetable subsidies and consumption, and increased physical activity - made a dramatic difference for this community.

Who are we?
I am one of two people from the USA attending the seminar, which thankfully is held in English. There are 24 of us who come from all over he globe: Tanzania, Ethiopia, Thailand, Iran, Finland, Japan, UK, Australia, Bahrain, and the USA. The goal of the seminar is to discuss theories and share ideas for us to bring back to our countries or institutions in order to promote prevention. Specifically, the World Health Organization has emphasized four factors: tobacco, diet, exercise, and alcohol use. I've said it before, but let me re-emphasize, the global burden of cardiovascular disease is HUGE! Eighty percent of all CVD is in developing countries. The costs of pain and suffering from both chronic and infectious diseases are disproportionately affecting the poor. Many of the deaths from these causes are avertable - either preventable or treatable. Building cath labs is not going to solve this problem. Prevention is the only sustainable, affordable, and feasible public health intervention that has been shown to decrease this epidemic and decrease other chronic disease as well as delay or post-pone mortality so that people can live more healthy, productive lives and contribute to development and decreasing poverty in their countries. Often, the factors that contribute to disease are outside of the control of the individual and are deeply rooted in society (socioeconomic, cultural and environmental factors).
Get Healthy Before Wealthy
Some argue that helping get people out of poverty - for example, providing clean water, sanitation, and education - would improve their health so why bother with chronic disease management? Well, the truth is development is slow to decrease poverty and not real effective for improving health. If we help strengthen the health systems and make people healthier now, they in turn will do more to help improve development and decrease poverty.
In a nutshell
How to start a prevention program? First, involve the stakeholders, policymakers, and community as managers and directors of programs from the beginning. Then, use working groups to try to understand all the health and non-health existing resources and challenges in the community. Then, target the primordial, primary and secondary interventions using medical and social behavioral methods. Examples include individual behavorial changes like quitting smoking to lifestyle changes in the community, like smoke-free campaigns. Improving nutrition, encouraging physical activity, and improving medication adherence for treatment of disease are also important interventions. Finally, building infrastructure to treat the high risk people in the community.
"Make the healthy lifestyle the easy one."
Successful programs are those that are multi-dimensional, target the whole population, complement initiatives in place, are sustainable, and have adequate time and funding to complete the intervention(s). In all cases, making the healthy lifestyle or behavior the easier choice is key for a sustainable and effective intervention program. If only we could do this in the US too!
"Only those who see the invisible can do the impossible."

Mr. and Mrs. Benziger!

2011-02-25T17:26:00.005-06:00

Oh what a night!

We had a wonderful time with 90 of our closest friends and family over the past 12 days in Costa Rica. It was wonderful to have so many people join us in paradise for a little bit of everything: hiking, zip lining, and hot springs in Arenal to salsa dancing, surfing, and sailing at sunset in Tamarindo.

Thursday started with a group catamaran sailing trip on the Marlin del Rey. It was the best and biggest sail boat ride ever! We knew everyone on the boat (which made it so much more fun) and we were dancing, sunbathing, swimming and keeping the bartenders busy for 5 hours.

On Friday, Seth's parents hosted a delicious groom's birthday dinner at Dragonfly in Tamarindo - arguably the best restaurant in all of Costa Rica - fresh tuna fillets, salmon and tempura tuna sushi, linguini and raviolis, mashed potatoes and veggies and cake. The bar was busy there, too! After dinner, the owner surprised us with a live band and so everyone went outside and danced barefoot in the sand until our feet hurt and the place closed down. It was awesome!

Katie with the Peruvians who made the trip "Up North" for the wedding!

But the highlight for me was definitely saying our "I do's" on Saturday evening on the Tamarindo beach and then being serenaded by the latino trio singing "Besame." The wedding was fantastic - 1,000 times more perfect than I had planned! Everything from the orchids in my bouquet to the playlist we threw together to the birds of paradise centerpieces to the buffet and lactose-free cake - it was all perfect! At the end of the night, just about everyone got thrown or jumped in the pool (the groom was thrown in first and broke his glasses). Even my mom and I jumped in, hand in hand and in our dresses.

The ceremony at El Diria in Tamarindo, Costa Rica

Walking into the reception as Mr. and Mrs. Benziger

Katie and JoAnn right before jumping in the pool!

The following week was R&R. We were able to lounge around the pools. Waking up and going out our sunset/ocean view porch to feel the Pacific ocean breeze calling our names. We spent the mornings surfing, boogie boarding or just jumping in the waves. Then we'd walk a mile or more along the beach and watch the slugs and crabs in the tide pools while the pelicans would fly up and dart down into the waves to catch their prey. We'd grab lunch at the swim-up poolside bar and then watch European soccer games all afternoon while basking in the sun. The best part was that every where we went, we'd run into our best friends or family! One day (when we were sick of running into our friends and family) we escaped to the Los Alto de Eros Spa for a couple's massage and romantic dinner. It was the best massage ever and much needed after all the stress of planning a vacation for 90 people and a wedding! After our massage, we were left alone to go in the jacuzzi and watch sunset but we were son interrupted by a dozen HUGE frogs and a few Howler monkeys (and we even saw an armadillo on the drive home). It was amazing!

It was hard to go home yesterday to the 10 degrees F and 18+ inches of fresh snow but it will be a trip that we will never forget and I'm sure we'll go back again soon!
Love,
Katie and Seth
P.S. More wedding photos to follow when I get the originals from our photographer! Here are some from my sister, Anne's Picasa album (click on the photo to see all of them):

Click the photo to see A LOT of great wedding photos by Seth's buddy Chris.

pura vida

Click the photo to see my brother Dan's Picasa photos.

Click the photo below to see lots of photos from my bridal showers and some wedding photos from my mother, JoAnn:

Costa Rica - here we come!

2011-02-10T17:30:00.001-06:00

We're going to the beach and we're gonna get married! I can't believe we leave in only two days for Costa Rica! We are so lucky to have amazing friends and family who are joining us for our destination wedding. I'm excited to get out of the -25 degree tundra in Minne-snow-ta and relax on the beach in Tamarindo and go ziplining through the rainforest at Arenal. I can't wait to spend time with some of my bestest friends and family and Seth's bestest friends and family too. When we return, we will be packing up our apartment and moving our stuff back to my parent's house (one last time hopefully) before heading to Europe for seven weeks. I will finish my medical school rotations in Sweden and we will travel to Helsinki, St. Petersburg, Trier, and Paris to visit the sights and some old friends. We will try to upload photos and blog along the way so stay tuned!
Pura vida! Costa Rica, here we come!
Love,
Katie and Seth

Our engagement weekend in Lima, Peru, after swimming with the sea lions.

Atop sugarloaf in Rio de Janeiro last New Year's.

Riding the water taxi in Chicago with Seth's parents condo in the background. We have been fortunate to have many wonderful adventures together and look forward to many many more!

Despedida

2010-05-25T07:18:00.001-05:00

Despedida
Kartik, Sarah, Dan, Beto, Kiran, Miranda, Leora, Dani, Callae and me at my despedida at Pescados Capitales.

Despedida in Spanish means farewell and is usually associated with a party. Well the last five days have been one big despedida leading up to today - my very last day in Lima, Peru. First, my cleaning lady came over and made some amazing ceviche for Miranda and I on Thursday. I gave her two bags of stuff (clothes, shoes, toiletries, games and pens for her nephew - she love it!)

On Friday, I bought a chocolate cake and had a little party with my co-workers at Cayetano University.

On Saturday, all my gringo friends (and Beto) came to Pescados Capitales for a delicious dinner and my waiter friend, Alex, even gave us a tour of the kitchen and wanted to add me to the VIP wall where they learn about what their regular customers like. (You know you have a good life when one of the fanciest restaurants wants to put you on their VIP wall.)

Congrats Dan on your graduation!
On Sunday, my friend Leora hosted a wonderful despedida brunch where we drank mimosas, cooked pancakes and french toast, and at lots of tropical fruits. Sunday night, my brother and I went to the Arambulo's to introduce him to my Peruvian family and also say one last goodbye. I teared up saying goodbye to Luis, who insists that I will always be his hija (daughter) even if I'm a rubia (blond).

Last night, our "chicken mama" Dr. Silvia Montana, took our Fogarty group to dinner at Jose Antonio's for a delicious traditional Peruvian meal, complete with picarones and Pisco sours.

"How are you feeling?"

"A life rich with emotions is a rich life," so they say, which means I basically just won the Powerball! I wish! I'm all over the place with emotions: sad to leave my friends, my life, my new family in Peru; happy to see my novio (finace) and my family and future in-laws (who are so kindly picking me up in Chicago); anxious about adjusting to the way of life in the US (like being on time and how to greet people - the Peruvian kiss is not very acceptable in the US); stressed about getting my papers submitted and poster made before my upcoming trip to China; excited to go to some of my closest friend's weddings and see friends from home; nervous about actually throwing toilet paper in the toilet; anxious about having to drive a car; assured that my brother will get along fine without me; grateful for all Peruvians (and gringos) who made me feel at home here; overwhelmed by all the unfinished work I have to do; concerned that I might not eat ceviche for another year; but most of all, I'm happy.

Me, Dan, Luis and Miranda on my last night out on the town. Why isn't Luis smiling?

Happy that I had this amazing opportunity, happy that I spent time getting to know some awesome people, happy with the work that I've done, happy with the adventures I've had this year, happy that I finished packing last night and can enjoy my last day, happy to see Seth, happy to give my mom a big hug and tell her I love her, happy to go running with my dad, happy to ride my Fuji Roubaix (my bike) again, happy to eat a cheeseburger, happy for it to be summer, happy that nothing major happened to me, happy to plan our wedding, happy to apply for residency, and just generally happy to be back home.
Thank you, thank you, thank you!
Thank you Beto and the Arambulo's for being my family and taking me in as your daughter. Thank you Romina and Bruno for showing us your city and making us feel at home. Thank you to the gringas (you know who you are) for being such a great support group and showing me how to work hard, eat well and always have a good time. Thank you Pierina for being the best Spanish teacher. Thank you Omar for driving me and all my visitors around Lima. Thank you Jaime, Antonio, Sanja, Julio, Joe, Bob, German, Jennifer, and Cesar for helping me with all my projects. Thank you to my family for keeping me company on skype all the time. Thank you friends and family who came to visit so I could show off my new home and this amazing country. Thank you Miranda for being my best friend in Lima and putting up with me and making your way into all my wonderful memories even though you weren't there all the time. And last, but not least, thank you Seth for being my rock this year and coming down to visit three times when I didn't go home once. Thank you for letting me have this incredible opportunity to move abroad and I promise I'll never leave you behind again. I love you!

Thanks for reading. I am delighted that I have had so many followers on my blog this year. I hope to update it now and again but you should follow my brother Dan's blog.
Until my next adventure, "Ya me despido. Muchas gracias por todo, que te cuides y hasta luego!" (It's time to say goodbye, thank you for everything, take care and I'll see you later). Besos (kisses)!

Love,
Katie

Four blondes take Peru

2010-05-16T18:19:00.000-05:00

By Cara
For more photos, please click on Cara's Picasa album:

Life is hectic. We all work long hours and have a million other things going on, but for me, I can always slow it down to go visit an awesome new place. And particularly if it involves hanging out with a couple of my best friends--Katie, Jackie (my roommate from when I lived in London) and Annie, i.e. All-American Annie, my freshman soccer buddy at Macalester College. Jackie, Annie and I went to visit Katie during the last week of April and had an awesome time. I'm positive we were a handful, but I think Katie enjoyed herself just fine and hopefully she's now fully recovered... let me begin.

Lima
Jackie and I arrived on a Saturday night, and true to form, demanded Pisco Sours before we did anything else. Literally, less than 2 hours after landing we had the famous Pervuian drink - in both hands. We spent our first evening hanging out with Katie's friends in what we thought was a typical Peruvian restaurant (turned out to be Mexican, details...).

The next day, after a couple hours of reading bridal magazines in our underwear, we made our way over to the Arambulo residence to have lunch with Katie's "host family"-- Luis, Charo, Beto, and Jorge. Katie knows how lucky she is to have found these people who have essentially taken her in as their American daughter, but let me reiterate. Our afternoon exploring a market, hanging out, and cooking with the Arambulo family was definitely my favorite of the trip! They are truly wonderful people who were excited to invite me and Jackie into their home and get to know us. Jackie spent the remainder of the trip scouring menus looking for "arroz con pollo" because she loved Charo's version so much. Dan (Katie's brother who is about to live with them for a few months) should buy his sister an extra birthday present this year for forging a relationship with these wonderful people! Note to Arambulos: if you're ever in DC, call me up!

Luis and Katie enjoying Pisco SoursJackie and Beto sitting on the patio drinking Pisco sours while Katie and Charo and Jorge slaved away in the kitchen.
Katie, Cara, and Jackie dressed like real Peruvian chefs

After lunch Beto drove us to central Lima where we walked around the Plaza de Armas, by the Rio Rimac, and into a locked enclosure under a bridge to see an antique Spanish cannon (still not sure what this was about but apparently it's worth big bucks).

Jackie, Katie and Beto in El Centro, Lima
Jackie and Cara

We then went to the Lima City Ballet's "rendering" of Swan Lake. Though extremely amusing thanks to one pair of particularly tight, white/see through spandex, but the New York Ballet they were definitely not. Issues included staying on point, dancing in-sync and occasionally dropping ballerinas - it was quite laughable. After ballet we went to do karaoke and discovered that singing in Spanish is actually hard and we really don't know the words to our favorite Juanes song, "A dios le pido."

Dani and Katie singing/yelling karaoke

The next day we took a walk around Miraflores and San Isidro and made Katie try on every white dress we saw (don't worry JoAnn - she didn't find any she loved).

That night we went out to an amazing ceviche dinner with Beto and his friend, Sebastian (who happens to love blond American girls). Wasn't he in heaven.. yes. Pisco sours number 11-19 were consumed here.
Beto, Katie, Cara, Jackie and Sebastain at arguably the best ceviche restaurant in Lima, Pescados Capitales.

Cusco
The next morning Jackie and I took off for Cusco and spent most of the day walking around the old city, taking pictures of creepy mannequins, and buying things for $5 or less. We were concerned when the first question from our hotel was "Would you like to rent a heater for $6 a night for your room?" and looking back on it, we probably should have, though we do love cuddling.

The next day we had to find a way to get to Piscacucho, where our train to Machu Picchu was leaving from, so we hired Juan Carlos the taxi driver (JC!!!!) to drive us around the Sacred Valley for the day. It was a really cool trip. JC stopped at beautiful overlooks along the way, for awhile it was nearly every 60 seconds ("Other photo, si???" "Uhhh okay...")

Then to an animal rescue farm where Jackie fell in love with the ugliest dog known to man - a Peruvian hairless dog.

Then to the ruins at Pisac (highly recommended!!)

and Ollytantambo (not too bad if you like stairs).

We made it to the train station and took the train with all the other gringos to Aguas Calientes, a really lame tourist trap of a city where everyone goes to bed at 8pm. Jackie and I spent an hour or so looking for a bar, restaurant, really anywhere that had people we could talk to, and then resigned ourselves to hanging out with ourselves, and drinking pisco (are you catching on to the theme here?).
Jackie doing what she does best.
Cara doing what she does best (notice how much more of a light weight Cara is...).

Machu Picchu
The next morning I had Jackie out of bed at 5am and ready to go up to Machu Picchu. Everyone we spoke with told us to get there early if we wanted to climb up Waynapicchu, the super steep mountain in the background of every classic Machu photo, as they only allow the first 300 hikers of the day up. We ended up being numbers 30 and 31 and slogged our way to the top of the mountain in record time (think 45 minutes of stair-master with slippery rock stairs), expecting the world's greatest view of Machu Picchu. Instead we saw abyss.
Cara "slightly" pissed about the view.
Jackie LOVING the view!

In fact we saw nothing but abyss for the next 3 hours, but then got really lucky when the clouds finally parted, and we got an amazing view.

For anyone planning a trip to Machu Picchu: ignore the warnings to get up there at 5am. Sleep in, eat brunch, get a pedicure, go up around 11am. Seriously.

Jack and I couldn't wait to get out of Aguas Calientes, and made it back to Cusco that evening. We made up for being lame the night before and found a party full of Dutch people celebrating the Queen's birthday. We were definitely the only Americans in the bar as evidenced by the fact that nobody else was "beating the beat" if you know what I mean. I definitely wish we had a Queen...

Puerto Maldonado
Finally done with Cusco and the altitude we boarded a plane the next morning for the Amazon! The first clue that something was amiss was when we met up with Katie and Annie who were dressed like explorers, while Jackie and I had brought jean skirts, tank tops, flip flops, and eyeliner ("What do you mean you didn't bring pants???" she said.) However, Jackie came to the rescue with two pairs of hot, black yoga spandex, which we paired with sweet rubber boots.

The "Wilderness Explorers," Annie and Katie, and the "Beauty Queens," Cara and Jackie, sporting our new rubber boots.

For a much better play by play of the jungle you should definitely read Katie's description in her blog. I will say that we saw a lot of ants, a really sweet frog, poisonous spiders, we had to get up at 4am one morning, I chewed on a leaf that made my mouth go numb, and the night hike was the most terrifying thing I've done in awhile (there are jaguars in this jungle!!!).

The night before we left was my buddy Annie's 25th birthday (she's getting so big!!), and we managed to celebrate in style with a 350 sole tab ($130) (this is impressive for a Peruvian bar in the middle of the jungle). Annie was a great sport, letting us relive the days when she was a freshman, by helping her make bad decisions all evening long. We got dancing lessons from a few of the guides, and to top the night off, went running into the jungle to continue celebrations (I wasn't nearly as nervous for this night hike!) The night ended up better for some (I had a great time!) than others (poor Johan), but was definitely an experience we'll never forget.

Lima
Back to Lima and we capped off our awesome week with $5 pedicures, more shopping, more friends, and lots more pisco (why hasn't anyone introduced me to this before?).

All in all, Peru is an amazing country and I would encourage everyone to visit at some point. Though we felt like we saw a lot in our short time, there are so many other places to visit-- Puno, Arequipa, beaches, Katie could probably name like 10 more-- and I'd definitely come back. Machu Picchu is incredible, the Sacred Valley was gorgeous, and the jungle was definitely an experience; however, by far my favorite part of the trip was seeing Katie and living her life for a few days-- seeing her apartment, walking around her neighborhood, and meeting her friends. She has carved out a pretty great existence for herself in Lima and that's impressive for just living there nine months.

So I'll finish with this: Katie, thank you thank you thank you for such an AMAZING week! It was wonderful to be able to see your life in Peru, and understand what you've been up to for the last year. I know you are sad to leave and it's going to be hard, but we are so excited to have you back!

Viva las gringas!

Cara's full picasa album:

Vamos a la selva!!!

2010-05-16T09:04:00.000-05:00

So they say third time's the charm... and my third visit to the Amazon rainforest was quite an unforgettable experience. My awesome teammates from Macalester College, Cara and Annie, and former flatmate in London, Jackie, came to visit me for a few weeks. While they were going to Machu Picchu, I was busy getting my heart attack chart review study done (yes, I do actually do a lot of work here) and then we met up in Puerto Maldonado for the weekend.

Oxbow Lake
The heavy rains the days before we arrived made the road to Infierno inpassable and so we had to climb down the mud banks to the boat to get to the Posadas Amazonas Lodge. Jackie and Cara had a very different image of the jungle than Annie and I (and clearly didn't read my packing list that included pants, head lamps and bug spray). We were the "Wilderness Explorers" in our REI gear and binoculars and they were the "Fashion Specialists" in tank tops, mini skirts and flip flops. Luckily, Jackie packed two pair of hot yoga pants that they wore with their sexy rubber boots. "Mind the gap." :)

Me, Annie, Cara and Jackie hiking in la selva

Friday we arrived at our luxurious lodge with our rooms that are open to the jungle. We climbed the tower and watched parrots and hawks from above the canopy. Fortunately, none of us are afraid of heights.
Jackie and Cara at the top of the tower

After dinner we took my flashlights and went on a night hike. Big insects and jumping poisonous spiders were some of the highlights and turning off the lights and standing among the darkness and listening to the sounds of the forest was an experience I'll never forget. Luckily for Cara, we did not see any snakes.

We woke up very early on Saturday and watched sunrise over the Tambopata River and hiked to an Oxbow Lake - an old part of the river - that currently is home to a family of river otters - an endangered species with fewer than 200 left in Peru. We went piranha fishing, birdwatching, and took lots of photos of a black caiman. Later we hiked to a macaw clay lick and sat in silence for an hour and saw nothing. On the way back to the lodge there were lots of dusky spider monkeys and saddle-backed tamarins. Next to the lodge was a big anteater climbing a tree. I love the jungle!

Taking a nap on the hammocks

Giant anteater

Cara and Jackie on the Tambopata

Trouble with a capital T
It was Annie's 25th birthday in the jungle and we racked up a 350 soles bill in one night (and put another 15 large beers on another group's bill and played dumb the next day). Whoops! What a crazy night! I'll leave the details to them as I did the typical "about to be married and go to be early" thing.

The next morning...

I love Peru! How many places in the world can you live and fly slightly over an hour for about $120 and be either land where there are gorgeous white-sand beaches in the North, snow-capped mountains in the Andes, deep canyons with condors in Arequipa, or the selva (rainforst)? Not many!

I'm getting ready to leave. I started packing my two large suitcases. Today, I'm going to have lunch at my empleada's (cleaning lady) house in the out-skirts of Lima and bring her and her nephew lots of "gifts"(stuff I don't want to take back to the US). My friend Annie and I went last weekend and had a great time playing pick-up soccer with the street kids - I bet they never thought two "sisters" and a little girl could take on 8 boys and win. Go girls!

Annie, Cara and Jackie - thanks for coming to visit! I love you girls!

It's going to be very sad to leave as I really love it here and I found that between soccer and learning Spanish, I can really connect with people and "fit in." Peruanos are the nicest people you'll meet and if you haven't been her before and you ever get the opportunity, I would not miss it for anything. Thanks for reading.

Mis amigos

2010-04-28T14:51:00.000-05:00

Beto, Miranda, Leora and I out for sushi last week

This really has been an amazing year and it will be hard to leave. It's so great to have such good friends! It was really wonderful to have my friends from home: Carolyn and Bridie (thanks so much for taking care of me), Margot and Aric (thanks so much for celebrating our engagement), Cara and Jackie (these girls can drink more pisco sours than any other guests), and Annie Borton (arriving tonight) to share this wonderful experience in Peru with me and meet my "Peruvian" friends: gringos and Peruvians.
Here are a few photos from the past few weeks.
Engagement party
Delicious cake

Fogarty friends

Peruvian friends

Margot and Aric with Seth and I out for ceviche at Canta Rana in Barranco

Can you see the beautiful ring?

Despedidas (going away parties)
It's going to be a sad last month as I've grown very close to many people here and we are all leaving in the next two months. It's exciting to be getting home but it's also the end of a mini-era, que trista!

Colin's BBQ despedida party on Christina's roof.

Cara and Jackie arrived just in time to go to the despedida at a Mexican bar for margaritas (Jackie thought it was Peruvian... soo cute)

The best surprise!

2010-04-16T19:31:00.000-05:00

The story
On Thursday night I was out for sushi with a few friends and got back to my apartment in Lima around 11 and was sitting at my dining room table when the doorbell rang around midnight. That's quite unusual especially considering visitors usually have to buzz the front door to get let in. Anyway, I hesitantly opened the door to see who this sly guy was (he was covering the peep hole too) and it was Seth!! I screamed "Oh my God!" and jumped on him. I was so surprised to see him and I after a few minutes of kissing and being in total shock I asked him, "What are you doing here?" and he got down on one knee and asked, "Will you marry me?" and showed me this little black box with a sparkling diamond ring. "Of course...YES!!" I replied, nearly in tears.

Katie and Seth on a three-way skype call with my parents, sister and cousins (who were all in on the surprise) at 1 A.M.

Katie and Seth shortly after he popped the question.

My friend Miranda had helped arrange the whole thing and it was a wonderful surprise! Miranda, Seth and I celebrated with a delicious ceviche lunch at the famous Chez Wong's.

Katie still very much in shock and very happy eating delicious ceviche at Wong's.

Miranda and I at Wong's.

Later, some of my friends here threw us a mini-party last night with balloons and streamers and silly string. Then we drank lots of bottles of champagne, ate cake, and went salsa dancing. It was great! Today, my friends from med school, Margot and her husband Aric, and Seth and I went swimming with the sea lions.

It has been a wonderful engagement "vacation" and I'll be very sad to see Seth leave tomorrow. The ring is absolutely perfect in every way and the proposal was the most memorable way I could possibly imagine.

More photos and wedding details to come...

Playing on a global field

2010-04-08T08:48:00.000-05:00

I was recently published in the Minnesota Medical Foundation's magazine, Minnesota Medicine, for an essay I wrote about my Fogarty experience. It was very fun to write this article because it allowed me to reflect on my time here and synthesize some of my otherwise disjointed experiences. I hope you enjoy it.
Click here: Playing on a Global Field

So it turns out they call Ecuador for a reason...

2010-04-07T15:13:00.000-05:00

... it's on the Equator!

All the American girls I met while waiting for my friend Emily to meet me in Puerto Lopez, Ecuador.

Ecuador
So if there was one thing I learned in my week in Ecuador, it is that Ecuador is actually on the Equator and despite applying SPF 55 like a billion times... I was a nice shade of strawberry red after my vacation to Puerto Lopez and the Isla de la Plata and Montanita. I live at precisely the 45.0 degree North latitude in St. Paul, Minnesota, and honestly didn't know quite where the Equator was other than it was far away from home and I crossed it at some point on my way to Lima, Peru.

Puerto Lopez
I am living in Peru on a tourist visa and need to leave the country every 90 days and since Ecuador is close and pretty inexpensive (except for my scuba diving splurge) I decided to take a long weekend. My good friend, Emily Howland, who hiked the Inca Trail with Seth and I back in November, is living in Tena and took two 12-hour buses (mas o menos) to meet me. Despite her bus breaking down, we met at our hostal in the small fishing town on Wednesday afternoon. There were two other girls who checked into the hotel earlier that morning - one of which was from Minnesota and studied at St. Scholastica and the other from Wisconsin who happened to go to... MACALESTER (where Emily and I went) - small world, eh!?! We hired a mototaxi to take us to Los Frailes, a beautiful white sand beach in the Machalilla National Park.

We walked along the beach (Emily nearly died when we saw a 5 foot snake) and went for a quick dip before the park closed. The boys in the mototaxi were waiting and on our way back along the highway the mototaxi broke down. We flagged down a big truck carrying some furniture and hopped in the back. By the time we got back, the sun was setting so we ordered up a pitcher of strawberry daiquiris and some patacones (fried plantains) at the beach side cabana "Monky, monky" and swung from hammocks while we watched the sunset.

The next day we walked along the beach and talked to the dozens of fishermen, and businessmen from Quito (12 hours away) and locals who had come to buy and sell all the fish and rays and sharks that had just come in. Overfishing is a huge problem world wide and seeing all these baby hammerhead sharks made me very sad. Besides tourism and over-population, over-fishing is taking a toll on the environment, especially in areas like the Galapagos. Many fish are being fished to extinction and fishing causes other populations to be at risk - sea lions are killed by fisherman for eating their catch, turtles and sharks get caught in nets and die, and many birds get caught in long-line fishing nets. Sharks are also illegally fished for the popular "Shark fin soup" in China and their populations are in danger, too. It makes me very sad to see such a wonderfully natural place being destroyed. I hope to get to the real Galapagos soon.

We had organized a boat tour to the Isla de la Plata , aka "Poor man's Galapagos." It was a nice hour-long boat ride and only one girl got sick. The water was a tropical turquoise and the beaches were beautiful.
We hiked around the island to see the blue-footed boobies and nazca birds nesting.
It was like 100 degrees and despite the sunscreen, everyone burned.
We got to go snorkeling after lunch but since the water wasn't very clear, we opted to do dives and flips from the second story of the boat instead. The locals were very impressed.

After another night having caprihnas in our hammocks along the beach, we decided we had seen enough of this fishing town and hopped a bus down to Montanita, the biggest surf town in all of Ecuador. Emily had spent a few weeks there when she studied abroad in Ecuador in college and as soon as we arrived, all these lifeguards (I guess surf boys gotta make a living too) recognized her. We had a great day laying on the beach, watching the surfers, buying cocunuts from beach vendors, boogie boarding, and hanging out with the surf boys at the beachside parties at night. We only stayed one night, which was plenty as there's not much to do other than buy hippie jewelry, eat overpriced food, lay on the beach, and go surfing (don't get me wrong there were plenty of people who had been doing this for months, but it's not my cup of tea).

I wrote Seth a love note in the sand (only a week before he flew to Lima to surprise me)

Scuba diving
Emily Howland and I on our last night in Ecuador

Emily had to leave for Quito on Saturday night and so we had our goodbye dinner at the delicious Whale Cafe while we watched the sunset. Due to some communication errors (I swear my English is better than my Spanish) I almost missed the boat to go night scuba diving. Unfortunately, I had to say goodbye while running down the beach and waving goodbye. I'm so glad I made the boat because it was totally worth it!

It is nearly impossible to accurately describe what the ocean looks like at night - one really has to experience it. We assembled all of our gear under a million stars and there was no moon (which was better for night diving). I was a little nervous since I hadn't gone scuba diving since the Red Sea in Egypt in 2007. Jorge, our dive master from the Galapagos, was very chill and helped me.
Some of you might be thinking, "Why would you ever jump into the ocean at night - aren't there bad things out there?" Well, the attraction of the night diving is to see many living organisms and fish, which can be met only at night, watch sleeping fishes, and see the different colors at night. I wasn't worried about sharks since they prefer colder water and the captain assured me there weren't any, phew.
We all had flashlights but after submerging to 30 feet and getting our bearings and touching some of the sleeping fish that floated by us, we turned the lights off, let our eyes adjust to the "darkness" and then the ocean lit up! It was absolutely incredible!!
If you've seen Avatar, there is a scene when they are running through the rain forest and all the plants start to illuminate which is the only thing I can think of to compare to this. As soon as we moved anything or blew air or any moved, the bio luminescent organisms were activated and would light up. As my eyes adjust to the stars, just like when I lay on the edge of our dock at the cabin at night, the more "lights" I saw. Pretty quickly, I saw schools of fish swim by (well we only saw the trail of each fish and not the actual fish) that had been scared by our flashlights and swam off before we could even see them. We saw little sting rays on the floor scurry off as we swam over them. It was like I was hallucinating and temporarily transplanted to outer space. It was an incredible experience and unlike anything I had ever imagined!

The next day, I went back to the Isla de la Plata for a few current dives where we jump in and drift with the current and the boat picks us up after an hour wherever we ended up. We saw schools of fish in the thousands, turtles, rays, pufferfish, huge parrotfish, butterflyfish, angelfish, and so much more.

Guayaquil
I flew home from Guayaquil and on Monday so after checking my bag in the AM, I spent the afternoon exploring the city. Guayaquil is the largest city in Ecuador and it's tourism industry is growing. It felt like Puerto Alegre in Brazil meets New Orleans - a mix of historic neighborhoods with an industrial port.
I had the taxi drop me off along the Malecón 2000, a restoration project of the historic Simon Bolivar Pier. I walked around the Parque Seminario (aka Iguana park) where there were nearly 100 iguanas chillin in the tree, benches, and on the side walks.
It reminded of me of being in California in 1998 and playing with my cousin Justin's iguana.

I wandered to the Las Penas neighborhood to hike up to the light house. Like the Santa Teresa neighborhood in Rio de Janeiro, it's built on a hill and has classic houses and spectacular views from the top. Along the many steps, I peaked in 400-year-old houses that had been converted into art galleries.
View of the Malecon 2000 from the light house at the top of Las Penas.

One one of the 444 stairs, I rested to take in the view and started talking to a nice old Ecuadorian man who invited me to sit down and chat and drink some cold (bottle) water. He told me about his 20 children and growing up in Italy and he showed me photos of his family and copies of his children's birth certificates (yes, that was kinda weird but it's because I didn't believe him). It made me really appreciate being able to communicate in Spanish and how much more fun and interesting it is to be able to talk to the locals when traveling.
He told me about three giant Galapagos turtles that live in the Polytech University and so after I made it to the top, I watched these GIANT turtles try to wobble very slowly around their home in the square for a half hour, caught a cab to the airport, and was back in cloudy and gray Lima with my very delightful Ecuadorian stomach bug that landed me in the Lima emergency room a week later but that's a story for another blog.

Thanks Emily for a great trip!

Books to read

2010-03-28T23:37:00.000-05:00

Before packing for Peru, I read our Fogarty "survival guide" that said to bring a lot of English-language books since they are hard to find here. I packed about five and figured that would be more than enough as I doubt that I had read five books for leisure in the past year (now med school books... that's a different story). Anyway, I had no idea how desperate I would be for reading material! I would never describe myself as an avid reader but I enjoy reading and the hour-long bus rides to and from the hospital are perfect for leisure reading. Lately I read a book a week.

Here's the short list of what I've been reading lately and would love your suggestions/recommendations:
1. The Canopy by Angela Hunt (based in the Amazon by Iquitos, Peru, I enjoyed this adventure of a team searching for a cure for a deadly disease and the not-so-subtle message about faith and transformation)
2. Freakonomics by Steven Levitt (son of one of my med school profs)
3. Kite Runner by Khaled Hosseini (the first half was amazing, the second half was ok, and the movie made my cry at least 5 times)
4. Three Cups of Tea by Greg Mortenson (Wow! Great book and I would recommend that everyone reads it to better understand the philosophy "To educate a man you teach an individual, to educate a women, you teach a community.")
5. Stones into Schools by Greg Mortenson (More about building schools for girls in Afghanistan post-9/11)
6. Lolita by Vladimir Nabokov (amazing literary work and very witty but you have to get over the unusual erotic predilections of the main character)
7. Bridge over San Luis Rey by Thornton Wilder (based in Peru in the colonial era - entertaining)
8. Twilight by Stephanie Meyer
9. New Moon by Stephanie Meyer
10. Omnivore's Dilemma by Michael Pollan (very interesting/highly recommended - this book makes you think about what it is you are actually are eating and where it comes from. They say, "You are what you eat," which basically makes us a bunch of cobs of corn as we consume enormous amounts of corn-fed meat and high-fructose corn syrup.)
11. Food Rules by Michael Pollan (everyone should try to follow these simple rules about what you eat)
12. Hitchhikers Guide to the Galaxy by Douglas Adams (very entertaining)

Next up:
1. Eat, pray, love by Elizabeth Gilbert
2. River Town: Two Years on the Yangtze by Peter Hessler (in anticipation of my trip to China in June!)
3. (Your recommendations here)

Gracias

Where are all my charts?

2010-03-26T15:48:00.000-05:00

Ah the joys of research!
I have been working a ton lately and have not had much time for traveling. Oh the real world...
As a Fogarty Scholar I am doing cardiovascular disease research in Peru and despite not blogging a lot about it, my fantastic readers, today is your lucky day - I have something to blog about that's related to work! My work usually consists of spending a lot of time on my computer plugging in equations into STATA, making tables, re-making the tables 50 times because we keep changing the the methods and research question, searching PubMed for references, reading PDFs and highlighting them on Skim (a much better PDF program than Adobe or Preview and it's free), writing manuscript drafts, and Skype-ing with my mentors in the states. In the past month, I have spent more time on buses going to a from work than I have spent eating and exercising combined (sad, I know). I often take the bus over an hour each way to Cayetano hospital, tracking down doctors on the medicine wards and shadowing them until the have time to talk with me for 20 minutes and then take the bus an hour back.

I am excited to tell you about my new study: a retrospective chart review study looking at in-mortality after cardiovascular disease events. I am hoping to show a difference in in-hospital mortality between men and women and describe the factors that are strongly associated with mortality after a cardiovascular event in this population. My goal was to review 600 charts based on my sample size calculation and 10% missing charts, which meant we would review all the charts from 2005-2009. Luckily I have a partner-in-crime, the amazing Jennifer Milla.

She is a recent Peruvian medical school grad (so jealous), aka doctora, who is applying for residencies in Spain. We were supposed to start data collection 3 weeks ago but due to IRB delays and people being out of town when we needed their signature, we did not get approval to start until last week.

Soooo excited to have my first project stamp of approval!

That's when the trouble started... first, I did not exclude all the duplicate medical record numbers so in my list of 600 I only have 518 unique entires. Second problem, due to the large number of missing charts I'll be very happy if we get 450 (but realistically we will probably have around 400 - fingers crossed...). Third, our most recent pitfall is that the woman in charge of the charts, Senora Julia, refused to pull our charts last week and now will only give us 10 charts per day as it's "too much extra work" for her staff AND they will only look for them after 4:30pm! The hospital is not in the best neighborhood and leaving after dark is not a great idea for Jennifer or myself. Julia refuses to let us pull our own charts... oh how I wish they have electronic medical records! So at this rate we have officially completed 32 questionnaires and won't be done until July (and I'm leaving at the end of May) and that doesn't include the time it takes to enter the data. Oh well... we'll figure it out and we may just need to bribe someone so we can get it done. Welcome to the wonderful world of research!

Overall, it's a great experience and I find that I really only learn from my mistakes anyway (I hate how that works). I have enjoyed setting up my own project, writing protocols and ethics approvals in English and translating them to Spanish and then back to English again after they changed a dozen times. Thank goodness for Jennifer, who recently completed a thesis to graduate from medical school, who knew all the hoops we needed to jump through, like what little old lady behind the counter in the convenience store across the street from the University who you have to pay $1 to write the "official" cover letter presenting our protocol to the ethics boards and where the chief of medicine's office was and where he has coffee to track him down. Between our meetings and training Jennifer to do the chart abstraction my Spanish has really improved. We talk on the phone but we find text messaging and email to be a little easier as I still have a hard time discussing anything besides, "Where are you?" "What time are we meeting?" and "I'd like that chifa delivered, my address is...".
Learning what hoops to jump through in both the US and Peruvian systems had been very interesting and I find being flexible and having other projects to work on alongside is really the only thing keeping me sane yet a little crazy too because I am swamped with work right now. I enjoy going to rounds at the hospital in the AM and seeing a 39 year old patient who looked like she was in a concentration camp and weighed about 60 lbs. She has severe toxic thyroiditis where her body makes an anti-body to the TSH receptor and her thyroid is SUPER overactive and so her metabolism has increased and she is basically skin and bones. I don't think I will EVER see that again.
Medicine clinic waiting area

Basically, I am working on eight or so projects with four different groups/studies and have three IRB approvals (the bane of all researchers existence - especially in global health) and am waiting on one more for a total of four (the most that any Fogarty in Peru has had before me was two). I had one paper accepted in Diabetes Care and one abstract accepted, which I will be presenting at the World Congress of Cardiology in Beijing in June. The same abstract we are revised and are resubmitting next week to Atherosclerosis on carotid-intima media thickness in this population. I think it has been a very successful year and I'm happy to have accomplished most my goals, namely learning Spanish.
Cayetano
I'm standing in the middle of the street and on one side is the Cayetano University and hospital, on the other, a funeraria with a hearse parked in front. How morbid...

Adios!

My longest bus ride in Lima yet - 1:45 min

2010-03-08T21:27:00.000-06:00

Caraballyo

Last week I went to have lunch at my cleaning lady's house in Caraballyo, a peri-urban town on the outskirts of Lima. Ten years ago hardly anyone lived in these arid hills but now they are lined with colorful mud and brick houses built by migrants from the mountains. Many people who live in this area live in poverty and make less than $100 per month or just over $3/day. I pay her $3/hour which I think it a bargain and after I visited her house and realized how long it took her to get to my house by bus - over a hour and half - I raised her wage to nearly $5/hour! My apartment has an empleada's room with a bathroom and shower and I learned that it's because they don't have showers in the slums.

I'm not sure I can adequately describe their living conditions but basically they live in the Lima slums and they are very poor. They laid some bricks between two other one-story brick houses and left room for a door and moved in. Their walls are the outside of their neighbors' houses. Wall-to-wall is about 8 feet wide. Their front door is a piece of plywood without a handle or lock. They use a piece of bamboo to "lock" it. For the past three years, they did not have a roof over their house but last week they had saved enough money and her husband build a tin roof.
When I arrived, her husband was watching a DVD of a Peruvian band playing traditional music from Cayamarca where they are from. He invited me into the living room/bedroom/kitchen where I sat on one of two twin straw-filled beds with alpaca blankets and watched the music video on a small color TV. Behind the TV was a plywood wall that separated this bedroom, where Lucha's brother and mother sleep, from her "master bedroom" with a full size bed and an armoir with a large mirror. They do not have a bathroom - only a hole out back with a piece of wood covering the hole that you squat over.

Their kitchen table was used to prepare all the food and then wiped off and set right before we ate. There are basically no appliances - no refrigerator, no microwave, no blender, no coffee pot, no dishwasher, no counter space, no cupboards; only appliance is an old gas countertop stove. There are only two electrical outlets in the house and a single light fixture (a single bulb hanging from a wooden beam above the kitchen). They have one large utility sink with a cold water tap. They have two small chickens that peck at the crumbs on the dirt floor and since it is very uneven we used an old newspaper to level the table and chairs before eating.

In total, their house is about 8ft by 40ft mas o menos. It is very simple compared to where I come from or where I live in Lima.

It happened to arrive the day that they were having a "road paving" party for the 1.5 mile of newly paved raod that the government just finished. After a delicious ham served with potatoes and rice (carbs are a very common source of calories for poorer Peruvians and is contributing to obesity, especially among women) we moved the chairs outside to socialize with the neighbors. I was asked if I was Catholic and if I could be the godmother of Lucha's next door neighbor. I didn't know what to say (or if I had understood him correctly).
Luckily, the fiesta was starting in the park so we headed over to join the crowd. We all walked the full 1.5 mile of road, smashing champagne bottles every 200 ft and chanting and singing along with the guy who had the megaphone.

I was very impressed how proud this community was of their new road and despite living in rather poor conditions, everyone looked very clean and well-kept wearing big smiles wherever they went. I also found it rather ironic that they paved a new road yet hardly anyone owns a car. They get around by mototaxis or walking so I guess for now it's just a nice new sidewalk.
Breaking bottles on the new pavement

Lucha on the right with the family from next door.

My 12th visitor
My medical student friend, Bryan Sundin, visited me for a few days before going to Cusco for a 6-week rotation. He came to the hospital with me for a few meetings and we walked around El Centro and had a Cathedral Pisco Sour at the famous Hotel Bolivar. It was grea

Making ceviche at my apartment
Lucha and her husband came to clean my apartment last weekend and offered to make lunch. I had a few friends come over and bought all the ingredients for ceviche - raw fish cooked with the acid from lime juice - mmmmm sooooo good!! It cost 40 soles to feed 10 people delicious ceviche where it's usually 40 soles per plate when you go to a fancy restaurant (and they did all the dishes!) I'd have to invite them over more often!

I could eat it all! NOT!

Choclo (corn), papas (potatoes), and ceviche!

Other activities
We found a bar that actually has real beer and not watered down crappy Peruvian beer. Here is a group of my friends enjoying some good (and expensive) European beer and pizza.

Santiago's birthday
My Spanish teacher, Pierina, has a 5 year old son who specifically requested that I come to his birthday party at Bembos (like Burger King). The kids played in the indoor playground and danced to music. Even the adults were entertained by the magician pulling the rabbit out of a box. The cake was delicious and poor Santiago was very very sad when the party was over.

In addition to my Christmas in Peru, the trip to Caraballyo and Santiago's birthday party were cultural experiences that I'll never forget.

OK, back to work since I have to go to Guayaquil and Puerto Lopez, Ecuador, next week to renew my visa. Chau!

Strangers in a Strange Place

2010-02-22T16:40:00.000-06:00

I'm working on the YouTube link to a special surprise thank you video to my family for taking time to visit South America, spending time with me, and being flexible and having an open-mind, which made my job as the travel agent/tour guide/translator much easier. I hope you appreciated this wonderful and beautiful country and the amazing the people that I am surrounded by everyday as much as I do - I love it here! Miss you!

Special guest blog today, "Strangers in a Strange Place"
By John Pastorius (Katie's D.O.D - dear ol' dad)
Let me make one thing clear before I tell you about the amazing time we had in Peru for the past 2 weeks thanks to our wonderful travel planner/daughter, Katie; NO HABLO ESPANOL.
I can’t believe that I didn’t know how great a vacation a trip to Peru would be, or the variety of experiences one would have in a trip to Peru (even if one doesn’t get to see its number one attraction, Machu Picchu). It’s like going to Yellowstone Park and not seeing Old Faithful, but realizing you still experienced an amazing world you didn’t know existed. So I’m telling you all now, visiting Peru needs to be on your “bucket list”.
If you are Anglo Saxon and live in the US, especially Minnesota, you take many things for granted - being in the majority, speaking English, insulated houses with floors, flush toilets, refrigerators, schools, education, literacy, health care, owning a car, freedom from earthquakes, etc., etc., etc.. An observation I made in Peru is even a bankrupt person in the US is better off than 99% of the people in Peru.
We saw the damage done by the earthquake in the Pisco area Aug 15, 2007, much like the one that occurred in Haiti. Houses still in shambles, a school and hospital still not finished, large pot holes in the road, and people living in shanties. We saw many areas of people living in shanties, even in undamaged areas.
We saw the damage done by the excessive rain and flooding in the Cusco area, affecting mostly the shanties of the poor built on the flood plain of the nearby rivers. The abject poverty we saw throughout Peru was very disconcerting to this writer. If more Americans traveled abroad to see what living conditions are like in third world countries, they would better appreciate what they have and why we need to, in the words of Michael Jackson, “Heal the world, make it a better place, for you and for me and the entire human race.”
Now to our Adventures in Wonderland (i.e. Peru)…
We were four gringos who arrived in Lima late on Saturday, February 6th, JoAnn and I (Katie’s parents), JoAnn’s sister (Senorita Rita), and her partner Colleen. Katie had arranged a taxi ride to take us to her apartment but gave JoAnn her best birthday present ever when she surprised us at the airport with her boyfriend, Seth. February 6th was JoAnn’s Birthday. The first tears started flowing, as we hadn’t seen her since mid-July. I wish we didn’t have to worry when loved ones travel to third world countries, but we do. Another thing we take for granted in the US, Law enforcement throughout the country.
On Sunday we rested after staying up till 4am “catching up” with each other. That afternoon we had a fun time at a nice get together put together by Katie’s good friends in Peru, Bruno and Romina, hosted at Bruno’s parents house. There we were served our first Pisco sours, the national drink of Peru. And has a herbinger for things to come, we saw Bruno’s 3 snakes and large turtle. It was a wonderful introduction to Peru and reassuring that Katie has found such very good friends to support her when we cannot. It was very awkward though when we couldn’t speak to Bruno’s parents except through Katie’s interpreting as we, “No hablo Español”. The first of many times we developed empathy for immigrants who come to the US who, “No hablo Ingleis”.
The remainder of the trip can be broken into four segments-Paracas, Cusco and the Sacred Valley, the Amazon excursion, and Lima. I find it difficult to be succinct because of the awe and wonder of all we saw, did and experienced in these places, culturally and spiritually, the diversity of the plants and animals we saw, the diversity of climates - desert, beautiful, tall, green mountains, the Amazon Rainforest, the colorful, crowded (9 million people) Lima – all balanced against the poverty we saw everywhere, and being barely able to speak the language.
On Monday the 4 gringos, plus Katie and Seth, headed down to Paracas for 2 days. I believe Katie has already blogged you on that. The coach bus ride down to Paracas took us through the desert area of Peru, past the slum areas, and amazingly saw shanties of people still trying to live in these areas, trying to eke out a living. And I felt the same where everywhere we went in Peru, poor, hardy people trying to eke out a living.
The highlight of our trip to Paracas was the boat ride on a beautifully sunny day to the Isla Ballestas where we saw thousands of birds-Cormorants, Pelicans, Terns, and Humboldt penguins. We also saw seals, sea lions, and dolphins. Like humans, birds excrete also, called guano. Know anyone who needs a job? Every few years they hire people to work for 8 months to collect and shovel up as much guano as they can for the local fertilizer companies who like it because of its high nitrogen content. They say the job pays well and your stay on the island is free (personally, I think the job stinks).
After a day of rest back in Lima, the 4 gringos headed off to Cusco without Katie, to the mountainous highlands south of Lima. When we initially planned our trip, we had 3 goals in mind – to visit Katie, see Machu Picchu, and to see other parts of Peru if we had the chance. January and February are the rainiest months of the year in Peru, so we knew we were taking our chances when we planned to come to Peru in February, but what we didn’t count on is the rainiest rainy season in over 50 years, wiping out both the famed Inca Trail and the train route from Cusco to Machu Picchu. So no Machu Picchu. Can you imagine planning a trip to Egypt to see the Pyramids and not get to see the Pyramids?
As disappointing as it initially sounded, we got to spend 4 days with our very knowledgeable guide, Leo, and very fast driving Raul, seeing the Cusco and Sacred Valley area, seeing many other very good Incan ruin sites, and arranged a trip down the Amazon, most of which we would not have seen had Machu Picchu been open, and our trip was better because of this.
In Cusco and the Sacred Valley, we saw the most beautiful green mountains we have ever seen, an advantage to going there during the rainy season. In the US we are used to having tundra on mountain tops at about 10,000 feet. Here they are green to at least to 18,000 feet because of the rain and close proximity to the Equator. We saw llamas and alpacas and learned how they color the yarn and weave their beautiful tapestries. We learned of the Incan religion, and culture, of their use of the Condor to represent the sky and things above the earth, the Puma to represent the earth, and the Snake to represent life underground and the after life.

We learned of the history changing event when the Spaniards, led by Juan Pizzaro, defeated the Incas at the battle of Cajamarca in 1537. The conquerors were accompanied by the Dominican priests and soon large beautiful churches were built on top of previous Incan religious sites. While it destroyed the previous Incan site, the New World wealth contributed to the churches being beautifully and magnificently adorned with beautiful works of art including statuary, wood sculptures, frescoes, and paintings. We found this beauty in churches we visited in Cusco and Lima. Even if you are not Catholic, it is worth visiting these magnificent “art museums”.
With the subsequent intermarriages of the native Peruvians with the Spaniards, almost everyone in Peru is mestizo, resulting in no bias or prejudice based on skin color. As John Lennon said, “Imagine if you can” a United States with no bias or prejudice based on skin color.
The combining of these two races has resulted in what I would arguably call the most beautiful people in the world. Many of the women’s and girls’ faces are stunningly beautiful. And this is not just a male opinion, even Katie commented on seeing a woman at an airport she called the most beautiful girl she had ever seen.
The most memorable thing of our trip to the Cusco area blends the stunning natural beauty of the land and the amazing architecture of the Incas, such as Ollantaytambo, Tipon, and Sacsaywaman, with the beautiful dresses, clothing and beautiful multi-colored weavings, shawls, blankets, etc. of the native people. These beautiful people in their Joseph-like clothes of many colors are a photographer’s dream.
The other striking feature was the lack of modern farm implements. The area is very fertile and they grow a lot of corn, potatoes, and beans. But there were no tractors. The fields were plowed by yoked oxen. Corn and potatoes were picked by hand, often from amazingly terraced fields high on the mountain sides, some of which were built and used by the Incas 1000 years ago.
If you ever go to Cusco, we recommend staying at Hotel Marani for $32 per room per night, eating at Jack’s (large quantities, reasonably priced) where we ate twice, and having a late afternoon beverage at Duffy’s pub next to the Cathedral, with a table by the window with a beautiful view of the Plaza de Armas, the city of Cusco, and the surrounding green hills. That view from Duffy’s is imprinted in our memories forever.
On Monday, February 15th, we flew from Cusco to Lima, met Katie at the airport so she could accompany us and be our interpreter, switched planes, and flew to Iquitos to begin our Amazon excursion. There are a variety of companies that offer Amazon trips, and we chose one of the Explorama options, since it was the only one with several features that appealed to the women in my group-hot showers, air-conditioning, and a pool (with waterslide, which you can also go down head-first or backwards on!). I’m having a hard time figuring out if we somehow missed out on something by not having to rough it more, but there is something to be said for being able to clean up after sweating like a dog and liberally applying Deet and sunscreen to avoid harmful interactions with mother nature.
We were very lucky in that despite being in Cusco and the Amazon rainforest during the rainy season, the rain gods looked favorably on us and we almost never got rained on, (but sweated as much as if we had)!
We were also very fortunate to have a wonderful guide for 4 days, Roldan. He was born in a village a short distance from where we lodged and has worked for Explorama for 25 years. He is a gentle man with a gentle spirit and a walking encyclopedia of the Amazon rainforest. He knew every plant and tree and flower, every insect, amphibian, reptile, mammal, or bird by their English and Spanish names. He knew uses for just about every plant we saw. He recognized all the birds by sight, by their calls, and how they flew. He was incredible. He obviously has a deep love of nature (as do I), and he enjoys sharing his knowledge with everyone.
We saw beautiful birds-scarlet Macaws, Amazon Green parrots, Jacanas with their beautiful yellow wings, the beautiful orange blackbirds, and the large hanging nests of the Oropendulas. We saw iguanas and racerunners, bizarre turtles and very large frogs and snakes.
Now to appreciate the snake stories, you have to know that JoAnn has ophidiophbpia - a deathly fear of snakes-. She would have been tickled pink if we didn’t see any at all. But no trip to the Amazon would be complete without seeing macaws, parrots, monkeys, piranhas, and snakes, right?! Well we saw all of the above.
Our first night at our Amazon Lodge we went on a night walk through the Jungle armed only with flashlights to look for nocturnal animals. Is your heart beating faster and the theme from Jaws playing in your head yet? Katie and I could not talk, convince, or cajole Rita and Colleen to come with us, but somehow Katie convinced JoAnn to come along – “oh the things we do for love.” The huge 8” long frogs, tarantulas, and scorpions were neat to see. Soon we heard another group shouting to come and see a “serpiente”. Roldan, Katie, and I rushed to see the snake-a 30-foot long Amazon tree boa in a nearby tree, leaving JoAnn alone, in the dark, armed with only her small flashlight, stuck in the midst of a moral dilemma – move to join us and see the snake, or stay put and be alone in the dark jungle, fearing another snake or something equally bad might attack her as she stood there alone. Soon we could hear, “Katie, come back here,” repeated over and over, each time a little louder and a little more panicked. No more night jungle walks for JoAnn.
On our second day there we went to visit the Yagua people, a tribe whose name means “red skin”. They use the juice from a red fruit to paint their skin red, partly for decorative purposes, but mostly because it is a natural mosquito repellent. We danced with them, they taught us to use blow dart guns, we learned the men had long hair and wore green shirts to confuse enemy tribes as to who was male and who was female. We saw the smallest monkey in the Americas in a tree there, the pygmy marmoset. We had the cultural experience of a lifetime with these gentle spirited people.
One of the days we went piranha fishing, or should I say Piranha feeding. Despite seven people using about 200 pieces of cubed beef, we only caught about 8 fish. It was amazing how the Piranha’s could eat the meat with their razor like teeth and yet we felt very little tugging on the line. They fried up some of the Red Piranhas we caught that day, and presented them to us beautifully at supper that night. They were fantastic.

On the way to go fishing we saw pink river dolphins and stopped to take a short walk to a pond with large water lilies. Almost 2 feet wide, they can support a sleeping child. Along the path there were some local people paddling canoes and showing us a few things they “found” nearby, a sloth that was fun to hold, and a 6 foot long anaconda that I mustered up the courage to hole, while JoAnn stayed a long way back. So in one day, I held a Piranha and Anaconda in my hands. Now there’s something you don’t see everyday.
Our third day there we traveled two hours down river to the Explorama lodge for a walk on the canopy tops. This is an amazing series of 19 platforms at various heights, the tallest over 100 feet high, connected by swing ladders, some over 50 yards long. It was an amazing view from these swing ladders and platforms. The main reason to go there was to see birds as the Amazon rainforest is home to 20% of the worlds birds. We only saw one bird that day but walking on the ladder swings at the tops of the trees (which felt like the top of the world) was so cool that seeing birds would have only been a bonus to the experience of walking in the sky.

As we returned to our lodge at Ceiba Tops (named after the large Ceiba trees that are your typical rain forest tree-over 100 feet high, large canopy branches, 10-20 feet wide, and hundreds of years old - they remind me of the tree in “Avatar”. You think it might be more than coincidence?) (see photo below),

we took a short cut between bends in the river in a parade of motortaxis from one side of Indiana, Peru to the other side. This is the major motorized mode of transportation on the few roads in the region, especially in Iquitos. No trip to Iquitos could be complete without a ride in them. They are like motorized rickshaws. I can’t imagine being a rickshaw operator before they were motorized.

But the short trip through Indiana, as well as our side trip up or down the Amazon and its tributaries again brought us close to the poverty, small thatched shanties without doors, windows, or floors, and lots of children, some playing as all kids do, and some working. We saw kids fishing on the fiver, families washing clothes and bathing in the river, a husband and wife netting fish together. We sometimes think we work hard for a living here in the states. Most of us haven’t a clue what living is like for the poor in third world countries. We haven’t a clue. Until you see it first hand. And then you are changed.
On our last day in the Amazon, we got up early to go bird watching, where our guide pointed out over 20 types of birds to us and knew all their calls-our favorites were the Jacanas, Kingfishers, and white headed tyrants.
After returning for breakfast, it was off to Monkey Island, where a gentleman has started a refuge for orphaned young monkeys, whose mothers were killed for food, their tails, or by illegal poachers and discovered in the street markets. The monkeys were very happy to see us - and our crackers! They jumped up on us, and climbed on our backs and heads. One of them wouldn’t let go of me, I almost brought home another souvenir. We saw wooly monkeys, spider monkeys, and several types of tamarins. Our favorite was the small tamarin who loved to sit on the owner’s head, and my head too.

After lunch we took the boat back to Iquitos, and Explorama’s bus took us from the river back to the airport to return to Lima. On the bus to the airport, we passed by a large farmer’s market with banana vendors everywhere, the roads were filled with colorful motorized rickshaws, and we realized that only the main road was paved, every side street was a dirt road, mostly lined with small adobe, doorless, floorless houses, with children playing in the dirt.

On Friday, February 19th, the 4 gringos went to the old part of Lima, El Centro, while Katie worked. We saw the beautiful Cathedral, the Presidential Palace surrounded by armed guards even during the changing of the Guard ceremony. We went to a Park where we could see the multi-colored houses filling the hillsides of Peru. Katie joined us for a drink at the oldest pub in Lima, then we caught what was supposed to be a “short” bus ride to see the magnificent water fountain park at night. It turned out to be the most entertaining bus ride of our lives! Vendors would come on the bus hawking candy or ice cream treats. Beggars would stand in the front and give a loud 5 minute speech of why they were down and out, or poor, or handicapped, then they walked around asking for donations. But the highlight of the hour-long 3 mile ride were the 2 guys who walked on, each of who could play a flute or windpipe and sing pretty well, complete with microphones and karaoke machine. We were held up in traffic so long they played 4 or 5 songs. We now have their CD, which only cost 5 soles ($1.70). What a wonderful prelude to the beauty of the water fountain park that night, with 23 multi-colored fountains to wander by while watching the throngs of people enjoying the park on a warm summer’s Friday night!
Then an adventure begins. Do you know what an adventure is? It is a trip that doesn’t go as planned, or, as JoAnn likes to say, life with me. As we left the park, Katie arranged for 2 taxis to take the 5 of us to a pizza restaurant close to her apartment. JoAnn, Rita and Colleen got in one taxi, Katie and I in the other. Unfortunately the girls’ taxi driver did not exactly know where to go, and I had ended up with all our “life lines”, a cell phone programmed with Katie’s number, the piece of paper with her address and phone number, and the keys to her apartment. When the girls didn’t show up at the restaurant after 10 minutes, we started to worry. After 30 minutes we were very worried. We have heard stories of “taxis” taking tourists to shady areas of town where they are robbed, or worse. So with trepidation, we took a taxi back to her apartment where thankfully we found them waiting safely outside. Seems they drove around enough until they finally found Katie’s apartment. It would have been easier if one of the three of them had remembered the name of the street she lived on, or the district she lived in, a little earlier. Imagine a taxi with a driver in front who speaks no English, 3 gringos in the back seat who “No hablo Español”, who first keep saying, “pizza, pizza, pizza”, then later “casa, casa, casa”, but can’t tell the poor man where to go. Back in Katie’s room, we had Domino’s deliver. We watched the Olympics, but it is not the same when all the commentary is in Spanish while we “No hablo Español”.

On Saturday it was time for some last minute shopping in the uptown-like Barranco area where we found some great souvenirs, and enjoyed a wonderful lunch with Ceviche, one of the top Peruvian dining delights, along with some flavorful Risotto and Calamari.
Then back to Katie’s apartment to clean up, tearful good-byes, and a cab ride by Omar to the airport and the flight back to reality. Our visit to Wonderland was over. But the awesome time we had there will live forever in our memories.

Flight to Peru - $1400
Trip to Paracas - $500
Trip to Cusco - $1000
Amazon Excursion - $2000
Seeing your daughter thousands of miles from home - Priceless.

Paracas and the island of birds

2010-02-14T13:39:00.000-06:00

A sea lion trying to seduce a nice female.

Paracas
My aunts, Rita and Collen, my parents, John and JoAnn, and my boyfriend, Seth, and I took a four hour bus ride to Paracas last week to spend a few days in the desert and going to see the Islas Ballistas. It was amazing! We stayed in a nice bungalow for $150/night that fit all six of us and we ate our meals and hung out by the pool at the VERY fancy 5-star Hotel Paracas (ex Hotel Liberador), aka "an oasis" as JoAnn would say.
Paracas is only a few miles from the town of Pisco which was destroyed by a 8.0 earthquake two years ago. It was quite eye-opening to be on a nice (but their wasn't AC and it was humid) coach bus from Lima driving down the PanAmerican highway passing though towns where most people live in extreme poverty - that means they make less than 1 sole (or 30 cents) a day. Traveling through Pisco, a town that once was 10,000, and is still struggling to rebuild their schools, hospitals, roads, etc., years after an earthquake makes it hard to imagine what Haiti must look like now and how long it will take them to get back on their feet again.
Islas Ballistas
Every 5-7 years teams of 200+ workers (most from the mountains) live in the shacks on the islands for 6-8 months and scoop guano (bird poop) all day, every day. I guess it's a good job since they get a steady income but our guide on Paracas said you could never pay him enough money to do that job. It smelled pretty bad from the boats - I can't imagine LIVING and WORKING in it all day! Ew! Our guide works everyday as a taxi driver/guide, his wife works seven days a week for 25 soles/day at the fish meal plant, one of 10 in the area that process and export sardines and fish meal to the US and other countries, and his 15 year old takes care of the 13 and 3 year olds, and 7 month old at home. It's a very different life than most we are used to in the states but they are that despite losing everything in the earthquake, they are grateful that everyone in their family survived the earthquake since hundreds of others weren't so lucky.
After the two-hour boat tour where we saw various birds (Humboldt penguins, Guanay and red-legged cormorants, Peruvian booby, terns, and lots of pelicans and gulls)

Thousands of cormorants flying out to sea to catch anchovies
and other animals (sea lions, seals and baby seals, and bottle-nosed dolphins) but no whales.

Seal (or is it a sea lion) resting on the rock in the Islas Ballistas

We went to have lunch in the Reserva de Paracas (a peninsula that is a national reserve for desert habitat) with pictureque views of the red sand beaches eating very fresh calamari and sole (a delicious white fish) and swam in the refreshing (albeit frigid) Pacific Ocean.

My Dad, Aunt Rita, Aunt Colleen, me, my Mom and Seth in the Reserva.

Work news
My abstract "Common carotid artery intima-media thickness in healthy Andean adults: The PREVENCION Study" was accepted as a poster at the World Congress of Cardiology in Beijing, China in June so I'll be traveling to my sixth continent in as many years and I can't wait! Send me your suggestions if you have been there or know anyone who lives there. Thanks
Happy Valentine's Day
Happy Valentine's Day Seth! Thanks for the wonderful roses.

Our last sunset in Lima before Seth had to go back to the cold tundra of Minnesota.

Happy belated 60th birthday to my wonderful uncle Jim!

Happy 26th birthday to my amazing cousin Molly Ann. Wish I could be there to celebrate! I'll make you a Pisco Sour this summer...

Plans this week
We're off to Iquitos, a city of nearly 500,000 in the middle of the Northern Amazon where it's about 100 degrees and humid. I'm not sure my mom and aunt will be able to make but but thank goodness our Ceiba Tops lodge has AC and a pool. I can't wait to be back in the jungle even if it's not-so-rustic.

Chau!

Rains at Machu Picchu

2010-02-03T23:53:00.001-06:00

As many of you probably heard, the rainy season in the mountains has been devastating for the very popular tourist destination - Cusco (and nearby citadel - Machu Picchu). Apparently the famed Incan city is untouched as the incredible aqueducts have drained all the water from the city but the 40+ mudslides have destroyed part of the railway to the citadel and the city below. Since there are ONLY two routes to the citadel - rail and hiking - and they are both closed it WILL NOT be possible to visit Machu Picchu until April (at the earliest). Last week, over 2,000 tourists were stranded, many who were hiking to Machu Picchu and were not aware of the damage and had to either hike another few days to Ollantaytambo or wait for the Pervian government to send police and military helicopters to evacuate them.
An update in the local Peruvian paper yesterday states:
The railway to the citadel was blocked last week when parts of the line were washed away by floods and mudslides caused by torrential rains that battered Peru’s southern Andean region. “We expect it will take eight weeks to repair the railroad tracks and (Machu Picchu) will be able to receive tourists again,” Pérez told Radio Programas Peru. “Of course we are advancing on different fronts.”
Peru’s Civil Defense estimated Friday about 23,500 people had been left homeless and more than 37,000 people lost part of their property. Flooding devastated 14,000 hectares of agricultural land and destroyed 4,000 homes. Some of the property destroyed was in Machu Picchu Pueblo, where buildings were built too close to the Vilcanota river and swept away when it flooded.
Blog of the humanitarian relief efforts
Living in Peru photos
Peruvian Times article

My parents are coming this weekend and we had to change their itinerary to go to the jungle rather than spend a week in Cusco (and now I get to go to Iquitos - lucky me!) I would definitely recommend going to Cusco if you are coming to Peru but only for 3-4 days.

Some recent photos

2010-01-27T23:38:00.000-06:00

Life is good. Cusco is underwater/flooded. Cross your fingers that my parents will be able to go there in three weeks. I've been working like crazy on a few more manuscripts and revising the other two that we submitted while working three days at INCOR. Seth's parents are in town visiting and we had a very nice dinner with them last night and their Illinois alumni tour group with a special treat - traditional Peruvian dancing from the various regions in Peru. It was very entertaining!

Observing an open heart surgery in the OR at INCOR (above).
Below is the Hospital Almenara where I am on rotation/observing in the National Heart Institute (aka INCOR).

Seth and I had dinner with his parents and were entertained throughout the meal by a traditional Peruvian dance show.

Seth dancing with the little Peruvian

Seth's parents, Kim and Bob, and I with the dancers at the Country Club Hotel in Lima.

Huancachina

2010-01-21T11:23:00.000-06:00

A dune buggie flying up and down and over and around the dunes near Huacachina

Family
It was so good to see my brother, Dan, and my sister, Anne, when they came to visit me in Peru last week. They had an amazing trip and have their photos here:
We hung out in San Isidro and Miraflores, explored El Centro, and took them out to a fun bar with lots of my friends here in Barranco.

Saturday we headed down to the oasis Huacachina in the Ica district with my friend Romina to go sandboarding. Five hours later - after stopping for every Tom, Dick, and Harry (or I suppose it was more like ever Juan, Luis, and Jesus) even if it was two blocks from the bus station - we made it to Ica.

Sandboarding
For anyone who hasn't been sandboarding before sandboarding is your warm weather equivalent of snowboarding, yet somehow very different. Wearing shorts and a t-shirt with sunglasses and riding a dune buggie to the top of the hill is a bit different than my usual experiences snowboarding. Having done much snowboarding, I feel confident saying that that experience has very little to do with your success rate getting down sand dunes while your feet are tied to a heavy piece of wood by velcro. My first run I tried to turn and fell, hard, on my tailbone. I am still feel it over a week later. My brother was the most successful (I think he used a whole chunk of wax though) and the rest of us decided to opt for the skeleton style sledding approach by the last dune. Back at the Oasis we waiting in line for an hour for pretty bad pizza and then retreated to the Bob Marley lounge in the hostel we hung out until early in the AM.

The good, the bad, and the ugly.
*Good: getting airborne on the buggy going over a few hills
*Bad: my brother nearly puking from motion sickness and the car breaking down/wheel stopped working on our buggy - Yes, Mom, it was very safe...
*Ugly: The 11 year old kid wiped out and got knocked out flying down the last dune and tumbled 20+ feet before landing limpless in the sand. Needless to say we all started running to help and I quickly realized my medical Spanish is not nearly good enough to function as a doctora.

Farewell dinner
We had plans to go to get antechucos (cow hearts) from the street vendor in San Isidro but luckily for my sister our plans failed as they (and most other stores) are closed on Sunday. We opted for greasy sandwiches instead, sorry Dan - you'll have to come back.
Overall it was a great trip and fun to see my family who I hadn't seen in over 6 months!
Photos of us at the Circuito del Aguas in Lima

Seth and I in the most beautiful mall, Larcomar, that overlooks the Pacific Ocean

Ringing in the New Year, carioca style!

2010-01-09T14:51:00.000-06:00

Katie on Sugarloaf overlooking the 2.8-mile long Copacabana beach

Seth and I met at the Rio de Janeiro airport on my birthday and we welcomed with the customary two-cheek kisses and delicious Portuguese style feijoada (homemade stew of beans with beef and pork meats and yummy farofa) by the de Oliviera family in Ipanema. We quickly changed into our swim suits and t-shirts since the heat and humidity was almost unbearable. Fernando, a good friend of Seth's from Macalester, and his wife Lesile arrived shortly after us, and it was a full house at the de Oliveira.

Sushi dinner with the de Oliveira family (Alex, Cesar, Fernando and Gilsa) in the Jardin Botanico neighborhood.

Despite the heavy rainfall and mud slides in parts of Rio, we explored Rio de Janeiro over the next few days with our friends. They took us hiking from the Botanical Gardens to the Corcovado, explored the Museo do Arte Moderne, ate cod balls at a famous Portugese bar at the bottom of the tiled stairs in Lapa, ate pastries at Cafeteria Colombiano and last, but not least, partied like real Carioca's from a penthouse apartment overlooking Copacabana beach for New Year's.

View of Ipanema on the hike

Monkey chilling in the tree on our hike

When we got to the Corcovado the clouds had moved in an we could hardly even see the "Cristo Redentor," Christ the Redeemer - and couldn't see the 360 degree view of Rio. The statue was first built in 1931, and went through major renovations in 2000, after nearly 70 years of wind and weather damage. It stands an amazing 100 feet (38 meters) tall, and his arms are outstretched to welcome everyone into the fold, or possibly to brag about a fish he once caught that was THIS big.

New Year's 2010
It will be very very difficult to top the delicious Caipirinha's (fresh drink made by mashing fruit and mixing with cachaça or vodka), catered food, 15 minutes of fireworks shot off from eight barges anchored in the bay, with over 2 million people dressed in white enjoying the music on the beach, a great DJ and dancing til 6am. It was incredible! (Seth will upload more photos from this night.)

Beaches
Typical view (if you know what I mean) of Copacabana beach

We didn't make it to the beach until the new year when we nursed our hang over with fresh coconuts on the beach, sleeping under an umbrella and swam in the waves. Everyone walks around the city's tiled sidewalks in swim suits and sarongs, men only wearing shorts or whitey-tighty looking swim suits (see above photo), and everyone wears Havaiana's, the trendy Brazil flip-flops, or are barefoot. The sun was hot on Copacabana and in the afternoon walked to meet our friends on Ipanema beach. The next day we drove for a few hours (mostly stuck in Rio's HORRIFIC traffic) and stopped to surf at Barra beach - 28 miles of white sand with HUGE waves to play in.

We were invited to dinner at Fernando's brother's apartment with his family and Alex's wife's family. The best part of this trip was being welcomed into local Cariocan's homes. Dinner lasted until 3am and even Alex's father-in-law who was 72 years old and a retired pediatric cardiothoracic surgeon stayed up.

Our last day, Seth and I went to take the cable car to Pao do Azucar, the famous Sugarloaf, for another 360 degree view of Rio. The long line was definitely worth the wait as we saw the tiny Mico monkeys and had great views of the Guanabara Bay and Copacabana beach.

We miss you Rio... just kidding, we're back!
We woke up early to get to the airport only to get booted off (semi-voluntarily) in exchange for a generous voucher and few nights at a 5-star hotel overlooking Copacabana beach, all meals included, ocean view, and a rooftop pool. We had to buy more sunscreen but that was about it. Then we did the same thing on the Wednesday flight but flew to Porto Alegre, the 11th largest city in Brazil in the southernmost state of Brazil (next to Uruguay and Argentina) so I could get to work on Friday at INCOR. I did feel a little bad abandoning my brother and sister who were coming to Peru to visit me the next day but I had arranged for my amazing friend, Miranda, who had keys and was crashing at my place anyway, to greeth them before they headed to Machu Picchu, Puno, and Arequipa the next day. I can't wait to see them next week when we are all in Lima again!

Lima, Peru
Back in Lima, it's cloudy and gray. The locals say it's because of "El Nino". Checking the weather updates from the Northern Hemisphere makes me thankful that I am in the Southern Hemisphere despite the rain. Seth is going to start Spanish classes on Monday. I just submitted two articles: one to Diabetes Care and the other to Atherosclerosis. I'm working three days a week at INCOR where I get to practice my Spanish, see lots of heart problems and feel V/VI murmurs and learn from the amazing doctors and residents from Peru.

Te desea una Feliz Navdiad de Peru!

2009-12-25T12:44:00.000-06:00

"H1N1" in the Cow Parade in LarcoMar, Miraflores.

Last night was my first Christmas Eve away from Minnesota (or for that matter my parent's house). I was kindly "adopted" by the Arambulo family and was invited to many casas (houses) as the "daughter they never had" (they have three boys, the oldest is a good friend of mine and my running buddy, Beto).

The festivities started around 9 PM. I arrived early to help Beto's mom, Charo, wrap toys for all the sobrinos y primos (nieces/nephews and cousins). Beto is celebrating Christmas in the US with his girlfriend so it was only his parents, Alberto (Lucho) and Chado, his younger brother, Jorge and his best friend Andrea who are both deaf, and I. I found it was easier to talk to them in English since they only read lips and my Spanish was too difficult for them to understand (ouch!)
We stopped by the house of their middle son, Javier, where he lives with his girlfriend, her parents and their adorable three year old son, Nicolas. The house was totally decorated with lights and had a fake Christmas tree with bows and tinsel and a room full of gifts for Nicolas. We drank Pisco sour, took photos, and chatted with their family before heading out to Lucho's mother's for dinner and presents. They served a delicious turkey baked in an Oriental sauce (mmmm muy rico!) with more wine and Vino de Higo (fig wine that is very rich Peruvian dessert wine).

In Peru, Christmas is celebrated like New Year's where everyone waits until midnight with a glass of champagne to say cheers, light off fireworks in the street and play with sparklers, eat dinner, and then open presents. After midnight as the sounds of fireworks blasted outside, we stood around the Nacimiento, the nativity scene (clay figures about 5 inches tall that was constructed to look like a mountain and occupied an entire corner of the living room. They had a manger with Mary and Joseph, shepards, 20+ sheep, cows, roosters, goats, cougar, etc. like it would have been on Christmas Eve nearly 2000 years ago. I noticed that Jesus was missing when I was admiring the scene earlier in the night and I quickly found out why. After the toast, the grandmother pulled out baby (6 inch) Jesus and made a wish, kissed his forehead and passed it around. We all made a wish, kissed baby Jesus and then she put him in the manger. The three wise men were on the table on the other side of the room and I found out that they will be making their way to the scene and will arrive on January 6, the Epiphany.

We opened presents and then went to our final stop - Charo's sister's house in Surco where the four sisters and their families were waiting to exchange presents and drink more wine. The kids had fallen asleep and some of the adults were dozing off as well. Everyone has someone in the family that they exchange with and it's a surprise so they describe who the gift is for and you have to guess. Needless to say the festivities lasted until 3 AM.
This morning we slept in until 10 and then Lucho and I went for a 6-mile run ("So we could drink more wine today" he said). We ate a light breakfast and got ready for another feast. This was more Thanksgiving dinner esque with a HUGE elaborately decorated turkey (that we didn't even cut but that sat in the table for looks), a huge cut of pig, more turkey, 12+ side dishes, 20+ bottles of wine and a punch bowl with some sort of Sangria-like mixture but with Pisco and white wine - mmm dangerous!).

Elisa, a doctor-to-be, playing with her new toys.
The kids opened presents, the 20-something-year-old "kids" hung out outside, and the "adults" sat around the dining room table talking.
This was very similar to my family gatherings but with a lot more people and (no offense family) much more flavorful and elaborately prepared food (probably because they had two maids helping cook all the food). I will admit I miss the Snickers salad but the lucuma torta was delicious! I was properly stuffed by 8pm and took a cab back home and watched a movie in my apartment.

My favorite memory of last night was when my family sang "Feliz Navidad" to my Peruvian family over skype. It was great! My little cousin David was enthusiastically leading the chorus and hand signals but immediately after the song was over he ran back to the TV to play Wii. It was great to see the foot of snow on the pine trees and all the lights at my house but, I'll be honest, I kinda like wearing short sleeve shirts and capris and not long underwear this time of year! This will be one of my most memorable Christmas's and I feel so lucky to have been invited into the Arambulo family (thank you Beto - we missed you!)

"Muuuun Walker" in the Cow Parade in Miraflores.

Tomorrow I'm going to pack for my vacation to Rio de Janeiro, Brasil. I can't wait!

No more climbing mountains, U's victory, and murmurs galore

2009-12-12T00:01:00.000-06:00

Hope you have your coffee ready... this might get a little long.

Defeated
There are only a few times in my life when I have really felt defeated (losing in PKs in the NCAA tournament, barely passing first SHELF exam, etc). Last Friday morning was one of them. I enjoy hiking and in the last year have done some amazing trips in the USA (Superior Hiking Trail (autumn and winter) and Pictured Rocks National Park) and in Peru (Laguna Rapagna, Inca Trail, Colca Canyon and now Volcano Chachani).
I was supposed to summit the volcano Misti with a few of my friends but we all had to work so I went with a different group to a higher mountain, Chachani, instead. At a towering 6,090m (19,977ft), Chachani is the highest volcano in the region. To get there we drove on the worst dirt road and at the highest elevation I have ever been at in an old beat-up, filthy dirth Toyota 4x4 who's engine was roaring and whose tired I thought were going to pop from the boulders in the road. I'm glad we didn't die on the way up and they let us off around 5,000m to climb to base camp (approximately 5,200m (17,060ft)) for the night.

Once our backpacks with our tent, sleeping bags, mattresses and food were packed, the five of us (two girls from Sweden and a boy from France and I) started the painfully slow walk to camp.

Shortly after arriving I had a mild headache and took a nap in our tent (I was sharing with Sebastian from France) before dinner. My heart was pounding and I had the chills since the temperature up there was around freezing and I had not brought enough warm clothes. I felt weak at dinner but ate and went straight to bed after sunset (see below)

to get some sleep before waking up at 1am to climb to the summit. I tossed and turned and at around 9:30 I had an urge to get out of the tent but the zipper was broken and I could not open it in time before puking all over my sleeping bag (and luckily - for him - not on my tentmate). I grabbed a plastic bag and threw up a few more times, stuck the bag outside and tried to fall back asleep with my head pounding and heart racing, doubting if I will have enough energy to wake up in the morning to climb.
At 1am, we woke up under the stars - the milky way spanning from north to south, Orion and the Southern Cross on either end - and packed our things to started another painfully slow walk up the mountain. After crossing two passes of adjacent mountains, El Angel and Fatima, with at least three hours to go over an ice field and up another peak, I decided to call it quits, enjoy the view, and wait for the group to return and not ascend the summit. If I hadn't been carrying my ice axe in one hand and walking stick in the other I may have tumble off the mountain as my legs were so weak and I was losing my balance every other step.

I have never felt so bad at altitude before. The total climb time from base camp was seven hours, and only three hours to descend. As soon as I got back in the 4x4 by noon I was feeling 100% better and by 11pm I was back in Lima at sea level. I guess that means no more mountain climbing for me for a while which is fine since I think I prefer the more scenic trails with waterfalls anyway.

The best sporting event of my life

My friends Jonathan, Josh and I went to the final game of the Peruvian soccer season between the two top teams that were tied for first - Universitario and Alianza. It was the same team I saw with my friend Romina back in September but this was a completely different experience. Stadium Mundial, with over 70,000 fans, was unlike any other sporting event I have been to - better than any Twins game, the BC vs Notre Dame football game, the men's Olympic half pipe in Italy, the Argentina vs Peru World Cup Qualifier, this was on a whole new level. Passion doesn't even come close to describe these fans. Their love for their teams is in their blood and everyone gets really really into the game, and so were we.
Real quick, the play-by-play:
1. We scalped tickets outside and hoped they were legit
2. Walked a mile on the Universitario's side of the road past riot police

3. Bought sweet 15 soles jersey's to try to fit in
4. Got searched at the gate and almost lost our belts - who knew you couldn't wear a belt to a game?
5. Paid a man 2 soles to find us seats in the sold out stadium

6. Arrived just time for the teams to take the field and everyone start throwing paper confetti and giant balloons and toilet paper which COVERED both goals and most the sidelines.

7. Ate an overpriced chicken sandwich and kola real (the fake Coca Cola).
8. U forward was taken down in the box - PK! "He shoots he scores!!!!!!!!!!" The stadium goes NUTS! There were fireworks, flame sticks, smoke bombs, noise makers, and everyone is jumping around screaming with joy.
9. The game gets dirty and players are diving left and right, the play stops a lot but the refs do a good job calling the game.
10. 10 minutes left and U's captain, a burly Italian-looking long-haired Argentinian sweeper goes up for a header with Alianza's forward and smashes his face breaking his nose and the other guy's skull. The Alianza player goes down hard and starts to have a seizure.
11. Play resumes and the tension builds as the clock ticks down. The opposing fans start lighting everything on fire and the riot police run around like chicken with their heads cut off trying not to let anyone throw anything else in the burning piles.
12. As the referee blows his final whistle, the U fans at the end of the stadium rush the riot police and start climbing the 30 foot fence and about 40 get onto the field to celebrate with their heroes. I can't imagine what these games would be like if they served alcohol inside!

13. The U fans are told the stay in their seats until the Alianza fans have time to leave and while they present the trophy to U for winning the league.
14. We try to beat the rush and leave with the Alianza fans in our U shirts and Josh almost got jumped outside while trying to find us a taxi.
15. Back in Miraflores everyone is going nuts and cars are honking, fans are parading around Parque Kennedy celebrating U's victory. So we join the riot and sing:
Ese es la "U",
el mejor de los equipos,
el mejor de los equipos,
ese equipo se llama la "U",
¡la "U"!

It was pretty freaking awesome!

Murmurs galore at EsSalud
I started a clinical rotation in the Institut Nacional del Corazon (Heart Institute) at the hospital EsSalud this week. I LOVE it! I forgot how much fun it is to work with patients and this national referral hospital see EVERYTHING with regards to problems with the heart. In my first two days I heard more murmurs and saw more bacterial endocarditis than I probably will in my entire career! They have two cath labs on the other side of the 1000-bed hospital which means when someone has a "Code Red" aka heart attack, you have to wheel them down the hall to the elevator to the 1st floor, through the hallways of the clinics past the pharmacy to the cath lab. Realistically, if you have a code, you're probably a goner. Their clinic has lots of echocardiography machines and a room of treadmills. Their students and residents work round-the-clock like we do. Their nurses are great even though the RN to patient ratio is 1:7. I can't wait to go back and I am glad I waited until my Spanish was better to work with patients because even though I don't know most of the words, I am learning the importance of the physical exam and Dr Stillman would be proud of my auscultation skills (even though you can hear some of these murmurs a mile away!). I am comfortable (maybe too much so) speaking in Spanish and sounding like an idiot because that's the only way I really learn.

Feliz Navidad!
I will be staying in Lima for Navidad and going to a friend's house to celebrate with his family and then I will be flying to Rio de Janiero, Brazil, to meet my boyfriend and his friends Fernando and Leslie to celebrate my birthday and New Year on Copacabana beach.
Muchas gracias for reading and I hope you have a wonderful holiday and Happy New Year! Adios!

Trucha and rafting in Arequipa

2009-12-07T17:31:00.000-06:00

I have been taking Spanish classes everyday with Beatrice from 9-11am and then working on seven projects (in various stages from needing IRB approval to finishing touches before submitting to big journals) all day and night. Tonight, I was invited to the house of one of my mentor's in Peru, Dr. Josefina Medina. She and her husband had me over for "coffee," which turned into three hours of talking about my family, their family, medical stuff, research, Peru, etc. (in Spanish) and drinking a few apple martinis, Pisco, coffee, Real Kola, and eating cheese sandwiches, ice cream and chocolate cake, I was very content. Their house is beautiful and has a central fountain inside and every bedroom overlooks it. They also have a nice garden with a small swimming pool. I was very impressed and grateful for their hospitality.

Rafting
After working all weekend (literally until 1am on Saturday) I took a little break and went white water rafting (grade 3+/6 rapids). I highly recommend it! It was very exciting except we had a novice guide who didn't speak English and couldn't steer. The other boat had the English speaking guide but I got moved since I "speak" Spanish (go me!). Our guide was pretty bad at giving us commands, which consisted of "Delante" "Detras" "Alto!" "Pesos derecha" "Pesos izquierda" "A dentro!" and basically steered us into just about every rock in the river. He had to get out nearly a dozen times in two hours to push us over and then leap back into the boat as we flew through the rapids. I will admit that part of the problem is that the rainy season starts in a few weeks so the river is very low right now. However, the other boat didn't have many problems. The canyon that the Rio Chile runs through was absolutely beautiful! There were a few 10ft drops that got my heart racing and one time our guide got us perfectly stuck perpendicular to the river between a rock and the wall of the canyon. As our guide is yelling "Pesos derecha" to avoid the rush of water pouring into our boat, the other boat comes flying over the rapids and T-bones us. I thought for sure we'd tip over but somehow both boats made it down and we didn't have any major catastrophes. We were back by lunch and I almost wanted to do it again. But alas, there was work that needed to be done.

Trucha
For lunch today, Josh, Katie and I met at the trout farm on the outskirts of Arequipa and ate in a cute wooden boat on the Rio Chile. For only 15 soles ($5), I had delicious "ravioli de trucha" that turned out to be fried wontons with fresh trout - absolutely delicious!

Afterwards, I climbed to the top of a hill nearby to the mirador (lookout) where I could see all of Arequipa - a city of over 1 million people - and a perfect view of the Volcano Misti (that I will be climbing in a few days).

I was exhausted by the time I got to the top so I sat at this tienda and enjoyed the famous ice cream from Arequipa: Queso Helado.

Colca Canyon

2009-12-03T19:24:00.000-06:00

Bottled water in the Canyon: 10 soles ($3) (usually only 3)
Night in a hut next to hot springs: 15 soles ($5)
Eating fresh trout over rice and french fries every night: 5 soles ($2)
Squatting over the hueco (hole), legs shaking/aching, breathless at 9,000ft, overlooking the canyon 2,500ft below: Priceless

Generally the trek is 2-3 days, but we took an extra day so we could see the waterfall at the start of the canyon. It is merely a trickle right now compared to in the wet season in February and the boys were tired so they took a siesta while Katie and I went exploring in the boulder field below.

Trekking in Colca Canyon, Peru
My friends who are working in Arequipa on Chagas disease, Josh Siembieda and Katie Maloney, and I, just finished a four-day hike in the Colca Canyon - twice as deep as the Grand Canyon. I had arrived from sea level (in Lima) less than 24 hours prior after an exhausting and delicious Thanksgiving Day feast with over 50 American and Peruvian friends, two 25lb. turkeys, and lots of yams and potatoes and cheap Chilean and bad Peruvian wine.

Day 1
We woke up at 3am to take a bus from Arequipa to Chivay and Cruz del Condor where we watched the Andean Condors cruise within 30 feet of us.

We ended in Cabanaconde at lunch time and had trout with rice and french fries and we stared our hike. At the canyon lip, Cabanaconde (10,700ft) is the main town where all the small villages (spread out over the approximately 35 miles in the Canyon) go to for for education, trade, and transportation to Arequipa. We hiked over four hours downhill on soft rock to the Colca River and at the bottom (6,600ft) our legs were shaking and the smell of rotten eggs was overwhelming. There was a geyser and hot springs next to the small hostal called Llahuar (our room had a bamboo door, rock walls, dirt floor and a tin roof, and three mattresses). Don't worry - we inspected the room for chirimachas (the bug that carries Chagas).

Our local guide, Rolando, didn't speak any English so it was great practice for us.

Day 2
Since we had to carry our own packs, I tried to pack super light and it still felt heavy. I didn't cut holes in my toothbrush but I only brought the following items (including what I was wearing):
Backpack with 1 pair of pants, 1 shorts, 3 shirts, 1 jacket, 1 hat, 2 socks, 1 shoes, swim suit, travel towel, arm warmers, 1 flip flops, 5 underwear, 1 bra, sunglasses, SPF, hand sanitizer, TP (a MUST!), toothbrush, glasses, contacts, gallon of water, small first aid kit (Josh used the moleskin for blisters, I took 250mg of acetazolamide twice a day for altitude prophylaxis, and if it wasn't for the Advil on the last day when we hiked out I would have died), headlamp, Freakonomics book to read, iPod for the bus ride, travel pillow (this goes everywhere with me), camera (thank you Mom and Dad), battery charger (but none of the towns had electricity), phone (which didn't get any reception), trail mix and Swedish Fish (thanks Mom), and last (but not least) a photo of my dog.

We hiked up and down, then up and down some more, crossed the Colca River and then hiked up and up and up and up some more until we arrived in Fure. We stayed the night in Fure (9,000ft) with no electricity and no road (except the one for mules and trekkers), but they had water from an elaborate aqueduct system that dates back to Incan times when they terraced the whole mountain for agriculture. We ate dinner - fried trout, rice and french fries - over candlelight. It was chilly at night but without lights we were all asleep by 8.

Day 3
Quick video in the morning on the third day of the Colca Canyon and Colca River.

The third day we hiked from Fure down to "the Oasis," also called Sangalle (7,100ft), where we stayed at El Eden, a hut with dirt floor, bamboo walls and a palm leaf roof but it had a sweet swimming pool and was surrounded by palm trees and avocado, papaya, banana, orange and other wonderful fruit trees and flowers. It really felt like an oasis compared to the Arizona-looking cactus-covered canyon surrounding it.

Josh feeling "bad ass" and at home (he went to U of AZ) in the desert with of eagles, snakes, lizards and picaflor (hummingbirds).

Day 4
The last day, Katie and I woke up at 4am to hike out of the canyon (up 3,600ft). We were passed by many mules but it only took us about two hours (most people do it in 3-4). We enjoyed a not-so-refreshing Coca Cola Zero and some eggs for breakfast and hopped on the public bus by 9 to Cruz del Condor to catch one last glimpse of the famous Peruvian Condors, which we did.

Each part of Peru that I visit (besides Lima) has a very unique culture and customs. This areas is known for it's embroidery and the hats are the finest example of this. The women work very hard in the fields but are always wearing elaborate vests, long silky shirts, thick dresses, long braids, beautiful hats (our guide said a whole outfit costs over 1,000 soles ($300), which is more than a month's pay for most people - can you imagine!
Overall we hiked around 33km (20 miles) and our legs were sore and much in need of a trip to the Chivay hot springs - six large swimming pools fed with HOT water of varying degrees. The sunset as we drove into Arequipa was great with the mountains/volcanoes surrounding the city.

I can't wait to climb the Volcano Misti (19,000ft) next week - it's only a two-day hike with 12 hours up and 2 hours down!

Moving

2009-11-22T16:07:00.000-06:00

Seth on our bike ride with Chorillos and Baranco in the background before his shoes were stolen at the beach while we were sitting right next to them and he had to bike home barefoot!!

I'm moving tomorrow. I'm not moving particularly far away - the next suburb over - and I'm still in a foreign country - Peru - and as anxious I am to get my own place and not have a Peruvian roommate anymore, there is something sad about leaving. Maybe it was that when I came here not knowing any Spanish I had my roommate and neighbors who I could talk to. Maybe it was that it was the first time in over four weeks I could unpack my suitcase and hang things in a closet. Maybe it was that I could cook meals and not go out to eat for every meal (even though we go out a lot still).
What makes a place home? Is it the bed? Is it the people you live with or your neighbors? Is it going to the coffee shop nearby and getting to know the baristas? Is it being able to pronounce your street properly so that the taxistas know where to take you at 3am? Is it the fact you have your own bathroom with TP? Is it a pet or a plant? What makes your home the place you call home?
I love traveling and moving is a natural part of that experience. I find that I always call Minnesota home and only after living somewhere for at least a month or more can I call my new temporary residency "home." Once you live somewhere long enough to call it your "home" leaving that place means leaving memories (good and bad) and can be a bit emotional.
In my short life I have had many many roommates: from week long roommates at soccer camp to Boston and Macalester College roommates. I have lived with over 20 different people since high school (Kelly, Lizz, Sarah, Emmy, Mel, Laura, Sara, Bret, Sophie, Sam, Rosa, Anna, Camilo, Joey, Shannon, Eric, Mom and Dad (and Wynston), Val, Cara, Jackie, Val, Miranda, and Johnny) and after living on a couch in London to having nice apartment in Miraflores, I have called many different places home.
I am excited to move to San Isidro with a panoramic ocean view with beautiful sunsets every night. It is next to a delicious rotisserie chicken restaurant and next to a park that is part of the Malecon (the parks on the cliffs above the Pacific Ocean). It is a large three bedroom and I will be hosting a large Thanksgiving Day dinner for over 40 of our American and Peruvian friends (some who have never had a proper Thanksgiving Day feast). I am very excited to explore a new area that's quiet and more residential but also a little sad and anxious that I somehow acquired a ton more stuff in three months and am NOT going to be able to pack it in two suitcases.

My new apartment building is basically the first tall building (in the middle of the photo) - the first tall one after the group of buildings on the right.

No pumas nor jaguars nor anacondas but look what we found in the rainforest!

2009-11-16T16:57:00.000-06:00

Our Refugio Amazonas lodge 5 hours upstream from Puerto Maldonado
Puerto Maldonado, Peru
After we hiked to Machu Picchu, we took the train from Aguas Calientes to a nice bed and breakfast in Huaran (we highly recommended the Green House). We relaxed for a few nights and then had to wake up early (again) to take a taxi from the Sacred Valley to the Cusco airport where we boarded a plane and hopped over the Andes to Puerto Maldonado (near the Bolivia border). Flying in was amazing as it was almost all "downhill" and the untouched rainforest looked like an endless plate of broccoli with a big red piece of licorice (the Tambopata river) squiggling through it.
The airport's runway was roughWe were picked up by our tour company and taken by bus to the office to drop off our luggage that we didn't need to take to the selva (rainforest). Seth and I had re-packed our stuff in the airport into one small black bag and it was amusing to see the office packed with people and their HUGE suitcases trying to shuffle things around.

Our favorite animal of the trip - the saddle-back Tamarin (pocket monkey) - that jumps sideways from tree to tree.

QUICK NOTE TO ANYONE GOING TO THE SELVA: 1) go in the dry season; 2) if you can't do #1, make sure to pack lots of bug spray and ONE main outfit to wear over and over that you don't mind getting mud, more mud, bug spray, sweat, purple rainforest dyes, and more mud on with another outfit to lounge around the lodge in at night. You only need flip flops as you have to wear rubber boots to go hiking on any of the trails. Don't bring electronics since they only have electricity from 5-9pm, but don't forget your camera charger (like I did).

Since it had down poured the past two days, the road to the port was flooded which meant we had to go to a port farther down river. That doesn't sound so bad except that the river was SUPER high and it added a few hours to our boat ride up river to the Refugio Amazonas lodge. We saw lots of wildlife on the boat (see photos below - P.S. thanks Mom and Dad for the early Christmas/Birthday gift). We navigated up a very fast current in our narrow wooden boat around lots of logs and we arrived in time for a delicious dinner.

The highlights of the animals we saw are shown below. My personal highlights were seeing monkeys, going to a local farm and learning about (and tasting) all of the different rainforest fruits and learning how cheap they are in the local markets (the farmers are definitely not making money on the prices we pay in Lima or you pay in the USA), and seeing a big bicolor-spine porcupine at night chewing on the plywood in the laundry room (glad he wasn't in my room)!

Our guide saw Capybaras (the world's largest rodent) and weirdest thing we saw. The porcupine is the third largest rodent behind the capybara and beaver.
Red Howler monkeys at the Tambopata rainforest control checkpoint. I loved listening to them call out to the forest and mark their territory - very unique grumbling sound.
Macaws at a clay lick on the Tambopata river.

A Hoatzin in need of a haircut.

Giant chicken tarantula. Luis fed him grasshoppers that he caught.
Long-nosed bats that camouflaged very well into a dead tree on the side of the Oxbow lake.
White-lined fruit bat on a tree on our first hike. One night when Seth and I were playing cards, we saw a bunch of big brown bats flying into the lodge eating all the insects! They are really swift: quick and quiet.

Wild turkey in the tree. One of the many common animals that I didn't know lived in the rainforest. We also saw a red brocket deer, red squirrel, mosquitoes (lots of them), giant grasshoppers, fireflies, and others.

Super cute squirrel monkey that was spotted by our awesome guide, Luis.
Seth behind the blind at the clay lick nearly falling asleep waiting for the macaws and parrots to come down from the trees to lick the clay. We hiked over an hour on a trail that was flooded and had water nearly to our knees but it was worth it.

It rained, a lot. Can, can, can you do the... toucan!
Strangler fig tree in the Tambopata Reserve.
Hiking in the mud. Do I look like a wilderness explorer or what!?

Seth and I on the boat on our way to kayak down the Tambopata river. The current was so strong that we hardly had to paddle and we basically floated sideways (next to logs) as the rainforest passed us by. Too bad there wasn't much wildlife as the river was over 13 meters (usually around 3-5 meters in the dry season) and we couldn't see the shore.

Our bedroom with a nice hammock next to the wall that is missing/open that overlooks the rainforest. We had bednets to keep out the mosquitoes and giant grasshoppers and spiders.

Seth and our local (and short) guide, Luis, and I. He was awesome and very knowledgeable!

Better get back to work on my Fogarty projects (the PREVENCION papers, Center for Excellence projects, Heart attack perceptions retrospective analysis, and writing a few protocols for projects to start after the new year). Chau!

Machu Picchu

2009-11-12T22:06:00.000-06:00

My boyfriend Seth left today to go home to the freezing cold state of Minnesota. We enjoyed two great weeks exploring Peru and its diverse landscape. Here are some photos from Cusco and our 4-day hike to Machu Picchu along the Camino Inca (Inca Trail).

Seth eating a fancy dinner of guinea pig (cuy) at MAP cafe in the Museo de Precolombino in Cusco the night before we started the hike. Not too bad except when you consider that you used to have guinea pig as a pet when you were a kid... poor Spike.

Saqsaywaman is an old temple overlooking Cusco and is one of the highlights of our trip (besides Machu Picchu). The rocks were rolled on logs from a quarry 8 km away. Look how big they are! They are carved to fit perfectly together and have withstood many earthquakes and are a fantastic Incan site that everyone who comes to Peru should try to visit.

Our group at the top of the third pass on the Camino Inca (Inca Trai). My friend Emily Howland, fellow Macalester soccer player and her friends, Devon and Anj who are traveling around the world, went with us and we met other awesome people in our group.

Steep steps with lots of people taking breaks. Our day packs had everything from bug spray and SPF to sunglasses and rain gear - and we used all of it everyday! Seth and I hired a porter which was a life saves as Seth wasn't feeling great for the first few days. It's part of the initiation into Peru but nonetheless it is not fun to be sick while hiking.

Our favorite ruins - Winywayna - with a nice hike down to a hidden waterfall (thanks Lizz for the tip) behind the terraces.

Can you see Seth?

The clouds in the valley next to Machu Picchu.
We woke up early every morning to hike but the last day was the worst as we had to get up at 3:45am to stand in line at the check-point until they opened at 5:30am and rush to Machu Picchu for sunrise. It was chilly and dark and it rained for the last hour of our hike before the Intipuku (Sun Gate, where you can see Machu Picchu for the first time). The valley was covered in clouds and we couldn't see anything when we got there. So we waited... and waited and finally walked down 45 minutes to the terraces above Machu Picchu but still, nothing. More waiting... ate our AM snack but still nothing but clouds. Then we climbed down to the entrance to check our bags and explore the ruins when all of a sudden the clouds lifted and you could see everything (except Winapicchu) but it was great!

An alpaca on Machu Picchu (or is it a llama- i can't tell the difference) but they are very cute.
Overall I would highly recommended this trip except November is the beginning of the rainy season and it rained everyday! Friends who have done this hike warned us and I will warn any adventurous readers who want to hike it - two of the four days are climbing up (and sometimes down) very steep stairs at altitude (12,000 ft or more). It's not easy (except our guide had an 80 year old on one trip so it can be done).
After a two-hour tour from our guide Jime (pronounced Jimmy in English) we relaxed on the terraces enjoying the beautiful views until our tummies were rumbling and it was time for lunch. It was weird to get on a bus after hiking. It was a bit confusing to be hiking and seeing lots of amazing ruins and going over mountain passes of over 13000 ft and camping outside when it was 40 degrees F and then seeing tourists with purses and make-up who were speaking dozens of languages on our last day when we hadn't showered. Oh well. The dirt road to Aguas Calientes, a horrible tourist town full of people who are only in Peru to go to Machu Picchu, had lots of switchbacks (with all the money that Machu Picchu makes you would think the road would be paved). We ate lunch at a restaurant that our guides get a commission for taking us to but the food was ok. Emily enjoyed a real coffee (none of that instant stuff they had on the trail) and we said goodbye as Seth and I boarded the train to Ollyatatambo for a few days in the Sacred Valley before heading to the Amazon (next post).
What a great trip!

Love/Hate

2009-10-28T11:21:00.000-05:00

Living in Tumbes has made me realize what I love and hate about living Miraflores (in Lima).
Love about Miraflores: having hot water and taking a nice hot shower
Hate: paying extraordinary amounts of money for rent and utilites (by Peruvian standards since it costs $350 to rent a 1br in Miraflores and 150 soles ($50) in Tumbes)
Love: being next to the beach (even though it's rocky) and watching surfers
Hate: that it's rarely sunny to enjoy going to the beach. Tumbes is always hot and sunny but we're inland from the beaches. After our trip to Mancora last weekend, however, I will say that cold showers feel good on your sunburns!
Love: friends with cars and motorcycles so that you don't have to worry about being run over on a mototaxi or being stuffed into a combi
Hate: the traffic in Lima; it's just like LA!
Love: not having guard dogs barking all night
Hate: listening to car alarms going off instead
Love: having a kitchen and microwave. you can only eat out for so many meal and when it's all rice and no veggies it get a little frustrating.
Hate: paying gringo prices at the tiendas and street vendors
Love: going dancing at the clubs
Hate: paying 20 soles to get in
Love: going for a run along the Malecon and the ocean rather than run stairs in my apartment in Tumbes
Hate: breathing lots of car exhaust
Love: sushi
Hate: over-priced food and menus (a set salad or soup, entree and desert for one price) since you can eat menu here for 5 soles ($2)
Love: good coffee since everything here is instant
Hate: paying for it - in a country that produces a lot of coffee you'd think it's be next to free but all the good coffee is imported from America and has imported prices.
Love: speaking English
Hate: being able to speak in English. Only Heather, Miranda, Colin and I speak English in Tumbes
Love: not having to wear bug spray because the mosquitoes eat you alive. I also love not having little bugs in my bed, and tiny ants climbing on my stuff and in the sink and shower.
Hate: how urban Lima is
Love: not throwing my used TP in the basura (waste basket)
Hate: thinking about where all my garbage goes - hopefully it's not in the big dump pile in the shanty town by the river...
Love: 24 hours/ 7 days a week electricity and never having to deal with power surges
Hate: 24 hour internet because I can work the entire day and never leave my apartment

Only two more days in wonderful Tumbes. It's growing on me even though there are only 4 reasonably good restaurants that Heather and I frequent for lunch and dinner on a rotating basis. I'm sick of going out to eat all the time, taking cold showers and not running every morning but I'm going to miss the blue sky and hot sun and the wonderful field workers. I will probably be back in March for a few months but we'll see...

Hasta luego!

Puerto Pizzaro and Mancora

2009-10-25T23:23:00.000-05:00

Puerto Pizzaro

Puerto Pizzaro is a small fishing town 8 miles from Tumbes. The combis that I take to get to the Proyecto all go to Puerto Pizzaro so yesterday I decided to take the combi and not get off and explore Puerto Pizzaro. I had no idea what to expect and four hours later I was overwhelmed and stuffed. After arriving I was swarmed with men in neon green shirts who work for the motorized tour boats. I wasn't expecting to go out on a boat, I just wanted to walk around and explore, but after the 6th man came up to me to show me photos of the crocodiles, Isla de Amor (where lots of honeymooners go), and Isla de los Pájaros (where the Magnificent Frigget bird nest), I thought maybe I should go check out the mangalares (mangroves). I stopped to take a photo of the fishing boats (see photo) when a nice older man asked me if I'd like to go out on one of those boats. In Spanish, he explained that he has a motor/row boat and for only $10 (much cheaper than all the neon green t-shirt guys) I could have him take me on a private tour. The only stipulation was that if I liked it then I would tell my friends to go to him in the future.

It was the best $10 I've ever spent on a tour. I had my own wooden boat and 70 year-old guide, Juan, who took me on a romantic ride through a labyrinth of tidal channels to a crocodile farm. Then we went to see the frigget birds and then to the Island of Love where I sat next to the water and ate a big plate of chicarrones (fried calamari, fish, and shirmps) and listened to the waves.

The mangroves are a very important food source for numerous species of crustaceans, molluscs, fish and fauna and humans enjoy conchas negras. The tides change dramatically and by the time my tour was over the channel to the crocodile farm was too shallow for motorboats.

Thousands of magnificent frigget birds nesting on the island. Males have bright red breasts and the chicks are white. Quite an incredible site!

Mancora
Two hours south of Tumbes, Mancora is one of the greatest beach/surfer towns in Peru. My friend Heather who I'm working with in Tumbes and I went to spend the day in the sun and swim in the Pacific Ocean. My friend Miranda decided to meet us there and we had a great night (and day) in this surfer town eating delicious seafood, drinking Piscos and bad Peruvian beer and dancing at a club on the beach until 5am. It was a great day in the not-too-hot-but-feels-great-85-degree-sun if only my three applications of SPF45 would have been more effective! I'm totally fried (but really only in the places I forgot to reapply sunscreen). I bought a couple sarongs and Heather bought an awesome hammock for only 50 soles ($18) at the cute markets. I love Peru!

Me, Heather and Miranda enjoying some Pina Coladas at a restaurant on the beach.

Next week
I have one more week in Tumbes and then I am going to Lima for Halloween and to meet my boyfriend Seth there. We will be going to Cusco, Machu Picchu, Sacred Valley, and Puerto Maldonado for the next two weeks.

Field work

2009-10-17T15:59:00.000-05:00

Most people have no idea what it means to go out and collect data in the field. Let me try to briefly explain what I am doing in Tumbes, Peru.

For the project that I'm helping with right now we are trying to answer the question "Did the 1997-98 El Nino have an effect on the growth of children in Tumbes?" In order to do this we need to screen over 2,000 kids to find a 0.2 difference in the age-standardized variation of children who were 0-36 months old during those years. Basically we go to these small towns in the Tumbes district where we recruit one child per household (that were randomly selected from the Proyecto's census records). We knock door-to-door (if there is a door that is) and confirm that the kid lives there. Then we ask to talk to an adult, preferably a parent but older siblings and grandparents are fine too, to answer a 30-minute questionnaire and consent to let us measure the kid's weight, height, triceps skin thickness and percent body fat the following day in school.

There are three local field workers who have been trained to collect the data and work full time, waking up at 5am to go to the field. We meet up with them around 8 to 10-100 miles away go to the schools. Some schools are only elementary school in the morning and in the same classrooms they have high school in the afternoon, and some are vice versa. Some towns are big enough to have two separate complexes for each. Basically we don't know what kids we are going to find until we get there and even then a lot of kids don't go to school everyday in which case we have to come back the next day.

This best park about this job is the kids. They are wonderful! They are so inquisitive and beautiful. They are very polite but love to stare at me. The families invite us in and invite us sit to on their very nice plastic chairs while they stand. Others have 1970 floral-patterned brown couches that are comfy. No one really wear shoes. Everyone has one television and a large poster of Jesus in their living room.

Motocars at one of the major intersections in Tumbes

If you haven't noticed, the entire area here is poor and rural. However, I can't imagine why anyone would want to move to Lima or the USA because they have everything they need here. People who are the richest of the poor have a nice life. Most people who are born here never leave and their entire family (and extended family) live in the Tumbes area. Downtown Tumbes has a church and center square and in total Tumbes is about 8 blocks long. Some "richer" families send their kids to the neighboring towns (that we've already been to the schools) but then we have to go back. The reason we can't do the measurements in the house is that most houses don't have a straight wall for use to set up the height measurements nor do they have plugs that won't blow our impedence machine. It's amazing how quickly you can tell what families are "rich" since their floors are "tile" and they own a horse rather than donkeys and occasionally have motocar (see photos) instead of bicycles. Most families make between 150-300 soles/month which is less than $100/month. I can't imagine but they all seem very happy and that's really what's the most important.

It's very interesting work and I love it!

View from Heather's third floor room - arguably the "best view" in Tumbes. Pretty nice, huh?

Buenos Aires and Tumbes

2009-10-14T16:02:00.000-05:00

I am exhausted. I arrived in Tumbes less than 24 hours after arriving from Buenos Aires on one of the best vacations of my life! I have lots of work to do and I can't wait to get experience working in the field here but first a quick summary of my trip to BA.
-Thursday: arrived with 5 girls to the hostal and ate at Cafe El Federal in San Telmo.
-Friday: toured the old mansion and now museum El Zanjon. Very cool. Ate at a cafe on Defensa in San Telmo and for dinner got dressed up to go to Bourgognie in the Alvear Palace Hotel - super fancy and expensive but the best meal I can remember.
-Saturday: Ate delicious sushi in the tea house at the japonese gardens and then watched Argentina's Natonal team sneak by a horrible Peru soccer team in a world cup qualifier game while it was POURING rain!

-Sunday: San Telmo antique markets all day with tango in the streets.

-Monday: Met fellow Fogarty, Lisandro, and his wife and wandered around Monserraut and San Nicolas and then went to the Recoleta markets outside the famous Recoleta Cemetary where Evita is burried. Flew home in the evening, did laundry, uploaded photos, went to a few meetings in the morning and re-packed for Tumbes.

Lots of peaceful (and entertaining) protests in Buenos Aires during Ferria de Colon (Columbus Day).

Delicious ice cream on Calle Florida

This is 9 de Julio, the widest avenue in the WORLD! 11 lanes wide with a HUGE obelisk at Ave de Mayo.

Tumbes
The Proyecto Eliminacion de Cisticercosis has established a great place to do research in Peru. Fieldwork here is easy because of the great work they have done over the years. Quick background, Tumbes is the northern most district in Peru and where I am staying is only 30km from the Ecuador border. The Proyecto is on the PanAmerican Highway (yes we hitchhike the PanAm to get to and from here) and is a few acres surrounded by acres of rice fields (and lots of mosquitoes). There is a brick wall outside and inside is a clinic, a lab, a pig pen (where they are slaughtering pigs right now to study cysticercosis), a soccer field (of course!), a three story building with the first two floors are offices with lots of computers (and wireless internet) and an apartment on the third floor. There is another guest house with screens for windows and a kitchen which is where my friend Miranda is staying.

I am staying in an apartment with the neurologist from the Proyecto in the neighboring town 4km down the highway. Tumbes is a small city but has a main plaza and a few hotels and even fewer gringos (Americans). The community has lots of smaller neighboring towns and the whole area is very poor. We are measuring kids height, weight, body fat, and talking to families and having them fill out a questionnaire to assess whether El Nino has an impact on stunting children. I've never been in a place like this. We ride around in mototaxis which are motor bikes with carriages on the back. A nice dinner costs $3. We measure people's wealth by the number of animals that they live with. In one household you can have many families with all their animals (ducks, pigs, donkeys, etc).

Today we went to two schools, a primary school and a high school. It was very fun but it is hot and humid here and i was dying! Tomorrow I am going with the field coordinator, a RN, to do home visits to finish some questionnaires and then meet up with the other two field workers to do more measurements. These women are very nice and we hire a driver to take us and the equipment around all day for $20 (which is a ton of money). None of them speak any English! I'm already getting better. Hasta luego.

LimaKids

2009-10-07T21:10:00.000-05:00

LimaKids is an organization that was started up a handful of years ago with the mission of providing medical care and outlets for street kids of Lima. They have weekly "rounds" in which they find and work with children on the street as well as a monthly policlinico in which a physician tends to their medical - and often social - needs. They've also organized an elaborate soccer league that has grown, and more importantly, has had great success over the past several years in building kids' self-esteem and teamwork skills. Teams are organized around orphanages, who come together weekly for games, with a final tournament at the end of the season. I am just finishing my season with the San Fransico 15-17yo boys team. The orphanage celebrated their 8th anniversary on Friday and the kids put on a great show for the teachers and members of the community who volunteer often. LimaKids has other projects as well and they're always looking for ideas/volunteers. Check out LimaKids for more info.

If you are in Lima and are reading this, there will be a great fundraising event for this great organization the weekend of October 17th in Miraflores. Email limakids@gmail.com for me info. It would be fantastic if you all could learn about and support what many of us here in Lima think is a great organization. If you can't make it and you're still interested in donating, use this site: donation link.

Eduardo with two orphans at San Fransico.

There is also a Facebook page, where you can get info for the event and become a member of LimaKids and donate to LimaKids. It's through the Saranac Rotary Club, which manages funds for the group so don't worry if it's not the right title, it's still the right org! Click here to join the facebook group

Muchas gracias a todos y espero que todo este bien. Thanks again.

I'm off to Buenos Aires with my friends Miranda, Kara, Rebecca and Ali where we will shop, eat, drink and dance all night and hopefully take a day to go to the beach and do some cultural things. On Tuesday I'm off to Tumbes for a few weeks doing field work. I'm very excited since it is something I have never done before and no one will speak Spanish. Hasta luego!

A week in the life of KTP (a post for another day).

2009-10-01T12:06:00.000-05:00

So I prepared a wonderful blog post that was going to have photos of the places that I go to often - my wonderful apartment in Miraflores, the friendly doorman, my fantastic coffee shop Sama, my grocery store Metro, my corner bodega, my salon where we get manicures and pedicures for $8, my combi stop, the boys from the orphanage, etc. However, last Sunday I went to the annual culinary festival at Parque de Lima (it was similar to a Ribfest in the States where restaurants sell smaller portions of their best meals and you get to sample ALL of them) with my friend Romina and her cousins. After a whole day of eating delicious Peruvian dishes, like risotto, fried pork, and cerviche, eating desserts, like queso helado, drinking Pisco sours, getting interviewed by a local television station, getting the famous Gaston's signature in my "Native Potatoes of Peru" book, and shopping at the market where people were selling specialty items from all over Peru, my camera was stolen.
Stolen. Just like that, gone.
It was a little deja vu as less than four years ago when I was at the Olympics in Italy my camera was stolen out of my bag when I was on a bus after the short-track speed skating event. I was devastated then and I am devasted now.
We reported it to the police who were nearby who were sympathetic but said there is nothing they can do. Romina escorted me to my combi but I was hesitant to get on, hoping desperately that if I stayed around the park maybe I would find the thief. The light was about to turn green so I said goodbye to Romina and got on and rode home, very frustrated and ticked off. How could I be so dumb? Why didn't I put my camera back in my bag and not in my pocket where some 4'11" 40-something red-head Peruvian woman could take it? Didn't I learn anything from the last time? How am I supposed to get a new camera?

Well after beating myself up for a while I decided to look on the positive side. 1) I'm pretty good about uploading photos on a weekly basis so only the photos for this post were lost. 2) My camera was a little outdated. It was a Canon A710 with only 6 megapixels and a 10x zoom. Not shabby but there are better ones out there. 3) I have plenty of great memories and an overstuffed stomach to remember the day by and plus now I have something to write home about and maybe this will make a good "Christmas and Birthday" gift from my parents as both holidays are close together and tend to mesh into one anyways.
Hasta luego.

It's not about winning or losing

2009-09-26T23:26:00.000-05:00

Today was our second soccer/futsal game with the team that I help coach, San Fransico. I woke up early (8am) and took the usual combi to the shelter/orphanage. Usually with traffic it takes me an hour to get there so I plug in my iPod and listen to Coffee Break Spanish and jot notes in my a notebook.

I arrived shortly after 9 and all the boys were yelling "Gringa, gringa es aqui!" "The American is here!" The private combi/van was supposed to show up at 9:30 to take us (me, Eduardo and his wife, and the 8 boys) to the game but by 10 I was getting a little worried. The kids were starting to get restless and kick soccer balls at each other and over the orphanage wall so that they would have to tell the security guard to open the 15 foot black metal door and they could have a chance to run away. It never works and I think they lose more balls that way.

Anyway, the combi arrived and it took us another hour to get to the orphanage where we were playing (for our 11am game). Good thing I got up so early! So I live in a posh area of Lima. All of our roads are paved and our houses have roofs. The area we went to for the game was in the north of Lima. We turned off the highway onto a dirt road with lots of burning trash, super skinny dogs, bodegas (convenience stores) with gates shut, lots of street venders selling fruits and vegetables, and little three wheel buggies transporting mother's and children around the neighborhood. The brick buildings that surrounded us looked like they were never finished being built but they were and people lived there. Their clothes hung from clothes lines on the roofs and an occasional satellite dish meant someone could watch the Premier league futbol (or maybe American Football, who knows) on their TV tonight.

The orphanage walled in but once we drove inside it was much nicer than I expected based on the surrounding area. A dozen small houses with lots of grass and trees a central futsal field. We played 5 versus 5 futsal on a cement court that was about the size of a tennis court. We lost the game 3-6 after hitting the post no less than 8 times and giving up three goals on turnovers by passing back after a kick-in (John Leaney would not be happy as he always told us, "Always throw it down the line."). The kids were pretty upset but got over it once we got back in the combi and they could look at all the pretty girls on the street and drink their Coca Cola - both are a treat when you are locked inside an orphanage all the time.

In work news...
I have been very very busy working on a few data analysis projects. Not only am I learning Spanish but I'm learning Stata and SPSS syntax. AH!

On a high note, I just found out I'm going to Tumbes for a few weeks in October (after I get back from Buenos Aires with 6 American girl friends) to work on a field project there. I will be helping collect anthropomorphic measurements on children as part of an El Nino study but more importantly I am going to be learning how to set up my own project in Tumbes, work with locals on data collection, and get to know this very rural town where NO ONE will speak English (except of course for the three other gringos who are there working on pig slaughtering and chronic obstructive respiratory disease studies).

Why Tumbes? You might ask. Well a number of years ago a researcher from Peru did a great job setting up an epidemiological study on neurocystercercosis and has been collecting census information on the area. It's a great size, we have data on everyone who is born and who dies, who moves in and out, and ever have all their animals accounted for. Tumbes is located on the beach and the ocean is warm and the sun is hot. It will be nice to get out of Lima for a bit. I can't wait!

Know your cardiovascular disease risk

2009-09-23T12:21:00.000-05:00

I came across some interesting articles in my overwhelming literature search on what is known and not known about CVD in Latin America.

For busy physicians, there are four challenges in regard to a patient's CVD risk (Cooney et al. JACC 2009): 1) How do I identify people who are at increased risk of a cardiovascular event? 2) How do I weight the individual effects of all the causative risk factors when assessing a person’s risk? 3) How do I stratify that risk to determine who needs lifestyle advice and who needs additional medical therapy? 4) How do I ensure that I am not overmedicalizing those persons who are at low risk of an event?
There are various risk scoring systems that doctors use to answer these questions. The most well known is the Framingham risk score but it is unknown if it is a valid scoring system for different ethnic populations, say in Peru. That's one of my projects here.

So, do you know your CVD risk? Framingham and other risk calculators have been developed based on people who are at risk for events and emphasize secondary prevention after disease has developed. For young people (<45 year) your Framingham risk will be low unless you have a genetic profile that predisposes you to CVD (high cholesterol or triglycerides) but primary prevention and modification of risk factors at this early stage is where we have the greatest opportunity for prevention of CVD and subclinical disease. The earlier the better.

Did you know that it is recommended to exercise at least 2 hours per week? That's it. That's only 30 minutes 4 times a day or 10 minutes 2-3 times per day. How many of us actually get 2 pathetic hours per week? How much time do you spend watching the Twins or Viking (or Packers) games? How much time do you spend in your car? The elephant in the room in the healthcare reform debates is our culture of inactivity and eating poorly. Walking 2 hours per week can lower your blood pressure more than popping a pill and it can decrease your risk of CVD and stroke by 25% not to mention it can help you lose weight.

Below are current recommendations based in risk and age. See where you fit and take the first step in lowering your risk now! It may be cutting down on smoking, it may be going for a walk or a longer walk but we can all do something to lower our risk and put me out of a job! :)

Work update

2009-09-20T17:13:00.000-05:00

Hola de Peru! I have been working a lot lately; lots of meetings with various people including my advisor here, Dr Jaime Miranda, the program director at NHLBI, Dr Cristina Rabadan-Diehl, and the Executive Director of UnitedHealth Group (based in MN) and former BMJ editor-in-chief, Richard Smith, and attending a conference on hypertension (in Spanish) so I'm sorry if my frequent (and fun) posts have fallen behind.
My Spanish comprehension is getting much better but I find that I talk to the gringos in English a lot and so my speaking ability is vastly behind. Unfortunately, my wonderful Spanish teacher, Rosalie, is moving to Spain to start a Master's program and is leaving me :( For one of our last classes we went to see the Cuerpo Humano (BodyWorlds) exhibit that was here and I learned a lot of medical vocabulary and taught her a thing or two about the body and diseases.

Research Projects
Here's a quick run-down of the projects I'm working on. There is a potential for this to turn into a two-year assignment as there is a lot of work to do and only one of me (and Antonio the statistician I work with) to do it.
Study 1. PREVENCION (a Spanish acronym) study looked at the prevalence of cardiovascular disease (CVD) risk factors in a cross-sectional sample of the adult population of Arequipa, the second largest city in Peru. The primary investigators are Dr Julio Chirinos and his mother Dr Josefina Medina. I got IRB approval from University of Washington last week to do data analysis and write manuscripts about the normal variance of hemodynamics in this population and specifically where prehypertensives and hypertensives fall based on healthy normotensive curves. We are using measurements from impedence cardiography (something in know little about) but need to train myself in so we can use this technology for study #2 in the spring. I hope to submit an abstract to the World Conference of Cardiology by the end of this month for the Conference in Beijing, China in June 2010.
Study 2. PERU-MIGRANT (PEru's Rural to Urban MIGRANTs) study was designed to investigate the magnitude of differences between rural-to-urban migrant and non-migrant groups in specific CVD risk factors. We will be continuing field work in Tumbes, which is near Ecuador, in the mountains region of Ayacucho, and in an urban area San Juan de Miraflores. The study was Dr Jaime Miranda's PhD work and is the basis for the NHLBI and UnitedHealth Group's Center for Excellence. We will be screening an additional 2000 people for CVD and 1000 for COPD starting in March.
Study 3. LASO (Latin America Study of Obesity) study combines over 12 databases, including the two listed above, to look at epidemiological trends in Latin America. I have not submitted a project proposal yet to LASO but if I run out of things to do with studies 1 and 2 (unlikely) then I always have this one.

Dr. Katherine Luke

2009-09-15T09:20:00.000-05:00

This was an email I received a few days ago about a wonderful person who I've only met twice but will remember always for her bright smile and amazing personality. She was recently diagnosed with a rare form of breast cancer - the same terrible form that my dear friend and former soccer coach's wife, Carrie Leaney, also suffered from. Katherine will be dearly missed by many as a friend, mother, and wife but her spirit will live on in her memories and through her beautiful children. If you so desire, please consider contributing to her children's educational trust fund.
-
Dr. Katherine Luke, a graduate of Macalester College and a recent PhD in the Joint Doctoral Program in Social Work and Sociology at the University of Michigan, passed away unexpectedly on the morning of Saturday, September 12. Katherine shone personally and intellectually, leaving an indelible mark in the hearts of the many friends and colleagues who loved, respected, and admired her.

Two weeks ago, Katherine was diagnosed with inflammatory breast cancer, an aggressive and rare cancer. After finding out the cancer was quite advanced and had metastasized to other organs, Katherine began chemotherapy on Friday, September 11. This Saturday morning, Katherine passed away.

A memorial service and celebration of Katherine’s life will be held at the First Unitarian Universalist Congregation in Ann Arbor today, September 15th, at 2pm. All are welcome to attend to honor our amazing friend. The First Unitarian Universalist Congregation is located at 4001 Ann Arbor Saline Road in Ann Arbor, MI, 48103.

Anyone who had the opportunity to know Katherine knows that her children, Nicholas and Alexandra, were the absolute light of her life. Her husband Michael Pryplesh, mother Ginger Luke, and stepfather Don Cherry, have communicated to us that the best way to honor Katherine would be to create a loving network of support for her children—showing them how much they are loved and valued every day of their lives—not just today, but tomorrow, in five years, and when they’re twenty or thirty years old.

Future logistics for continued day-to-day support for the family will come in part via the Helping Hands site: Helping Hands. You can register on the site to receive updates as they become available on ways in which help can be provided.

If you have any photographs of Katherine, the family has asked that you please post them to the website above (or email them to zakiyal@umich.edu) so that that they may be included in the service.

In lieu of flowers, the family requests that donations be made to an educational trust fund established for Katherine and Mike’s two children, Nicky and Ali.

Donations to this fund can be made via check to: Ginger Luke and Don Cherry, 5202 Bradley Blvd., 5202 Bradley Blvd., Bethesda, MD, 20814.

Your love, support, and prayers for Mike, Nicky, Ali, Ginger, and Don during this terrible time, are greatly appreciated,

Sincerely,

The friends and family of the Luke-Pryplesh Clan

Arequipa and La Punta

2009-09-08T09:32:00.000-05:00

Arequipa
A view of the main plaza in Arequipa with the Cathedral lit up at night.

Romina and I flew to Arequipa in the Southern Highlands of Peru on Friday in order to meet with Dr. Josefina Medina, a cardiologist and the principal investigator on the PREVENCION study. We departed the plane with a view of the full moon rising over the picturesque and dormant volcano, Misti. Dr. Medina is the sweetest Arequipenan woman that I have ever met and was very excited to show me all the technology that she has in her cardiology office. Thank goodness for Romina, my friend and translator, as my Spanish is improving but not sufficient to understand scientific meeting by myself. I was very impressed by Dr. Medina’s computer skills and by the wide array of cardiovascular prevention techniques that she uses in her clinic, including echocardiography, arterial pulse wave, sphygmography, and others.

La Punta
After our meeting we took a taxi on a winding mountain road with sheer cliffs down past Mollendo to La Punta, a small town on the beach where Romina’s family is from. We stayed at the Punta del Sur, the largest building in town besides the church. It didn’t take long for the gringos to become the talk of the town. Her uncle is a very prominent figure in the town and owns a lot of farm land and recently built the very nice hotel with solar panels for hot water which was a big bonus.
He drove us around in the back of his Toyota pickup truck up to the giant “Jesus Blanco” for a panoramic view of the beach and fertile green valley.

It was a stark contrast to the desert and dry brown mountains that we drove along.
Then, he took us along the beach and through his never-ending farms where he employs over 70 women to pick crops. Rice is his biggest crop and a close second are artichokes (photo below) since the value of sugar cane has dropped recently and export demands for artichokes have soared in the past few years. Next time you eat an artichoke heart, look at where it came from.

Next we went to the chicken coop where he keeps his prized roosters for cock fights.
There was even a cock ring where he trains these beautiful birds.
Photo of Josh and Tio (uncle) with the beautiful roosters.

Then he drove us through the valley to his prized possession – his bull. At nearly one ton it is an impressive animal and surprisingly friendly. He gave us kisses and let us rub his nose.

Later we went to lunch at this delicious restaurant with great views of the valley and river running though it where they catch fresh fish and crawfish. It was delicious until all of the gringos got sick the next day in which case I can only assume it was lunch.
Back to Arequipa
We returned to Arequipa and toured the city during the day. Since it is 7,800ft (2300m) above sea level, we undoubtedly felt a little altitude sickness upon our return and didn’t sleep much.
The city is nestled in the valley between towering, snow-capped mountains and it’s beautiful! The sky is always blue, the sun is always shining, the roof dogs are always barking, and the neighbor’s roosters are waking you up at sunrise. It’s weather and topography are similar to Arizona and nearby are the two deepest canyons in the world - Colca and Cotahuasi – that I will hike by the end of this year.

This colonial city is build of white volcanic rock, called sillar, and has largely withheld the test of time and numerous earthquakes. The Catedral de Arequipa is the largest building in town and forms one side of the popular Plaza de Armas. It was built in the 1544 and was reconstructed in 1844 after suffering much damage from fires and earthquakes. Recently, in 2001, a cathedral tower fell after a earthquake but has been restored. The streets are narrow and many are for pedestrians only and are lined with small tiendas (stores), cafes, and restaurants, while other restaurants have balconies that overlook the Catedral, Plaza and its central fountain.
Nearby is the Monastario de Santa Catalina (St. Catherine‘s Convent) that was established in 1580 shortly after the Spanish conquest. My proper name is Catherine Ann, after my great grandmother Catherine Youngquist and I believe she was named after this saint. I might start telling people my name is Catalina since when I say “Katie” everyone says “Que?” since it’s not a common name here.

At its peak, over 200 nuns and their servants lived in this city and since the nuns took vows of isolation it because a city-within-a-city. Currently 20 nuns still reside in a private part of the convent and the rest has been open to the public for 40 years. The narrow streets are beautifully painted with reds, blues, and whites, and flowers and fruit trees line the courtyards and streets. The nuns are famous for their baking and I enjoyed a delicious alfadore in the café after wandering this tranquil little city for over an hour.
I met my friends for another delicious meal at Tradicion – rocotta rellena (stuffed red peppers) and queso helado (yummy fresh ice cream) while a very talented band played traditional Peruvian music.

On our last night there were fireworks on this large bamboo structure in the main plaza but before the lit the big structure a man holding a bamboo toy on a stick with fireworks was in the street. My friend Jenni got caught on fire from sparks flying.

Romina and I about to board the plane back to Lima after a wonderful long weekend. I miss it already!

Half marathon

2009-08-30T20:32:00.001-05:00

Video of the Nike 100th Media Maratón de Lima 21K race.

Map of the route.

I did it! The course was great and very flat. We started on the narrow streets in El Centro de Lima and it was amazing to see thousands of red shirts contrasting the yellow and white colonial buildings. There were fans and musical entertainment along the whole route and the police stopped all car and combi traffic so the air was clean. My friend Miranda came out to cheer us on as we ran by her apartment near the Malercon. It was so nice to have a fan.

I paced myself well and when everyone else was dying in the final 4 kilometers, I passed a lot of people. I find great satisfaction running with kilometer markers rather than mile markers as you feel a greater sense of accomplishment as you pass more of them (even though the distance is the same). The final stretch was beautiful though the Circuito Magico del Agua where you weave between these 13 amazing ornamental fountains but you are looking (or dying) for the finish and the water is blocking your vision until you come around the main fountain and 100 yards ahead is the big red banner with the clock ticking and a 10+ person orchestra entertaining the thousands of fans.

Last year at the Earth Day Half Marathon in St. Cloud I finished in 1:50:31 but yesterday and ran the Media Maratón de Lima in 1:49.22. Whohoo!!
A couple of Kenyans won it.

After the race I went to get a bandaid for my quarter sized blister and while I was chatting with the paramedic a girl got thrown into the truck who had collapsed. Having had some experience working with Dr Bill Roberts at the Medtronic TC Marathon, I helped check her vitals and her hands were freezing. I put her feet up and took her socks and shoes off and covered her in blankets as the paramedic was setting up oxygen by nasal cannula. After a few minutes she woke up and I gave her my gatorade and water while I went to turn in her timing chip and get her medal. She was about my age and she thanked me. It was great to get a little clinical medicine experience and practicing my medical Spanish (not quite up to par but working on it).

Final results: here. I was 31st in my age group 18-34, 563rd overall. Anyway, there were over 3000 people (about 800-1000 women) so that's not bad.

My friends, Beto and Kara, after running 13.1 miles (21 kilometers). Go us!

Today, I think I need a massage since my IT bands are killing me and stairs are a little difficult to descend. Ciao!

Paragliding in Miraflores

2009-08-29T15:25:00.000-05:00

The classic view 5 blocks from my apartment of Larcomar (the big shopping mall in the cliff) in Miraflores with a nice view of the neighborhoods, Barranco and Chorillos, along the ocean.

The weather today was wonderful and sunny with a cool breeze off the ocean. There were lots of paragliders and surfers and it reminded me why I love it here. It's amazing how sunny weather can change your mood!

Eliot Brown, a friend of mine from Macalester, stayed with me for a few nights. It was fun to have my first visitor in Peru and we discovered the airmattress had a small leak so I'll have that fixed for the next person who comes, don't worry. We played ultimate frisbee at the US Embassy and ate delicious cerviche (raw fish and seafood marinated in lime with some picante) and tacus tacus (beans, rice, and lots of seafood) and drank chicha morrado (delicious juice made of blue/purple corn), mmmm. Ciao Eliot!

My Lima half marathon is tomorrow morning and I'm not quite ready, oh well. The weather should be perfect - 60s and overcast. My friends Beto and Kara are running with me and I'll post photos tomorrow.

LimaKids

2009-08-27T13:12:00.000-05:00

LimaKids is a great non-profit in Peru that was started by a previous Fogarty scholar who's mission is to support for children and adolescents living in orphanages or in socially risky situations. Basically kids who are either living on the streets or in extreme poverty or both, and who are highly vulnerable to violence (physical, psychological and sexual), sexual exploitation and substance abuse. LimaKids runs a medical clinic and soccer clinics but their biggest project is organizing a soccer league for over 20 orphanages around the city.

I went to the coaches meeting last night where we discussed the rules for futsol (5v5 soccer played on a cement court with a heavier ball) and then all the coaches played for two hours in the park nearby. There were dozens of futsol cement courts, filled with people playing pick up, and a few grass fields with men's teams playing under the lights. There was a skateboard park and a few basketball courts as well but the action was on the soccer fields. It gave me the chills to see so many people out in the park late at night (9pm) playing my favorite sport ever - futbol!

I was not prepared to play; I was wearing my glasses, a nice shirt and dress pants since I had come directly from my clinical research training course at the pharmaceutical company, Merck. I played anyway because this was an opportunity I could not pass up and within 15 minutes marco cuatro veces (scored four times) and needless to say they were impressed and I had myself a small fan section from outside the park fence. I had a great time and I can't wait to help coach Eduardo's team, San Franscico (15-17 year old boys). Eduardo has never coached before but he is the only coach that speaks English which is why I got put on his team. I think we'll make a good team.

So I've never coached boys but I've coached pre-teen and teen girls for over 6 years so it can't be much different, right? Let's hope so...

Our games are every other Saturday and we train on Friday and Saturday's, which will keep me busy and get me out of Miraflores.

FYI. A group of us will be running a 10K in October and will be raising money for LimaKids. Any amount that you can contribute at that time would be amazing and really make a difference for the street kids in Lima.

Serving sizes

2009-08-24T15:03:00.000-05:00

This is the popular Minnesota Lions Tap burger and this kinda stuff just doesn't exist in Peru! I ordered the mediano or medium burger from Bembos (the fast food chain here that's across from the McDonald's) and the serving sizes just aren't the same. The patty was like a normal size, the fries were definitely a US small and the drink was like 12oz (definitely a small). Next time I'm going to order the grande but it's no wonder we have health problems in the US.

My new job!

2009-08-24T11:30:00.000-05:00

I am very excited about my new job at the Center for Excellence in Peru. My advisor is Dr Jaime Miranda who recently finished his PhD on the Peru MIGRANT study, which looked at the effects of migration on cardiovascular risk factors. Interestingly, migration from rural areas to Urban areas contributes a lot to obesity, especially in women. We have been approved from the NHLBI to enroll 2000 Peruvians in our epidemiological study on cardiovascular disease project and we'll enroll 1000 for the chronic COPD study. We will start field work early next year in Tumbes and Lima. I am currently working hard on developing some proposals for a few abstracts using the previously collected PREVENCION and PERU MIGRANT database, among other large databases in Latin America that our group has access to [the Latin American Study of Obesity (LASO) database]. I will help our group (of 4 people) apply for more grants to enroll more people or start other projects, like national stroke and myocardial infarction registries.

Today I am going to a clinical research training course at the Merck offices in Lima. It's two days of intensive training on biostatistics, research design, protocols, running clinical trials, etc. but in SPANISH! Eeeks! I'm bringing my medical Spanish dictionary in my bag, just in case :)

Altitude cares very little about your fitness level

2009-08-22T23:00:00.000-05:00

The 4.5 hour hike to laguna rapagna in the central highlands of Peru was a moderately difficult hike, except given that we started about 11,000 ft, I'd say it was by far the hardest hike I have ever done. I hiked Bartle Frere in Queensland - 10 hours with leeches covering my legs and falling from trees - and that was nothing compared to the heart pounding, head throbbing, breathlessness that I experienced after hiking only 5 steps at 14,000 feet. I can't imagine ever being able to climb Everest (over 29,000ft).

From the moment we stepped off the coach bus from Lima I was dizzy and cold. It was a mere 2 hours from sea level driving on a beautiful winding road that reminded me of the drive from Loveland to Estes Park, CO, along a nice stream surrounded by sharp mountain peaks. This drive went through more mining towns and the road was very narrow that make it difficult to pass slow trucks and took twice as long as it would in the states. The sky was perfectly clear: baby blue and sunny. I had forgotten what the sun looked like living in Lima for the past 3 weeks where there is always a haze. I'm glad I had sunscreen today!

We packed headed up a rocky road that had endless cut-backs but passed a few farms with hay roofs and rock fences. Generally, I felt out of breath after about 25 steps and had to stop to slow my heart and sometimes find a rock to sit on to catch my breath. I even took my acetazolamide as instructed.

At the beginning, the group of 30 (half Peruvian and quarter Americans working at the Embassy and a quarter Fogarty-related people) were very slow moving as some people could only make it 15 steps before stopping. Two people had to turn around after 30 minutes. Basically for the next 6 hours, the group spread out based on how many steps (30 vs 20 vs 10 steps) you could go without resting. There were three Peruvian guides and their three beautiful guide dogs spread out to make sure everyone knew where they were going.

We hiked along a deep valley and passed over small waterfalls and streams. As we skirted around a number of mountains we were constantly climbing in elevation. As I reached the final clearing before the last big climb, one of the guides was waiting and we had a quick conversation in Spanish. My Spanish comprehension isn't great but I swear he said that it would only take about 30 minutes, maybe even only 20 for me, to get up over that "wall" to the lake (see tired-looking photo below). An hour and 15 minutes later after stopping every 4-6 steps to catch my breath, I made it and it felt great!

I finished my lunch and took a long siesta while I waited for my friends. In the end we all made it to the beautiful turquoise lake at 14,000ft surrounded by snow-capped Andes mountains. It only took about 2 hours to get down and we were very entertained by the llamas and sheep along the way.

It was a beautiful day! The views were unbelievable and my legs are unbelievably tired. I guess it's good cross-training for my half marathon next weekend, eh?

Llama's chasing Christina down the trail.

Llamas and sheep are skeptical of us and hesitantly pass us on the trail.

Picarones!

2009-08-21T20:45:00.000-05:00

Leora, a Fogarty from NYC, is trying her first picarone "pee-ka-ro-nay".

The food in Lima is fantastic! I did get a little sick last week but I am over it and back to eating all the comida peruano that I can find. My favorites are the postres (desserts), including arroz con leche, churrios (filled with wonderful creams - see below), tres leche, and picarones. Here's a video outside the Monasterio de San Francisco where we saw the catacombs. We explored El Centro de Lima and ate some more delicious picarones (basically a funnel cake dough but made with sweet potatoes and fried in a ring-shape served with honey).

My friends Miranda and Jenni have been keeping an excellent blog about our trip in Peru and have lots more about the delicious food here with photos! Check it out: Pinas Peruanas.

Futbol in Lima

2009-08-21T20:28:00.000-05:00

I went to see the #1 club team, Universitario, play the worst team, Bolognesi, at the HUGE municipal stadium in Lima. Unfortunately, the better team, despite played most the game 11 vs 10 and having lots of crazy fans with flags, drums, and torches, could not defeat the hard-working team from Tumbes (by Ecuador). The game ended 0-0 but not without some excitement. A Bolognesi player was thrown out for tackling from behind and injuring a player and at least two others did the same and got yellow cards. The field and stands were lined with policia wearing helmets and holding shields (you can see them lined up below the fans). They don't serve cervezas, which is probably a good thing, but they do serve Inka Cola (tastes like bubble gum and is florescent yellow and everyone here loves it) and U-kola (a cheap, rip-off, watered down Coca cola). Overall, the quality of soccer (futbol) here isn't great, which mi amiga Romina warned me about, but being in the outdoor stadium, having a little boy shine your seat and a woman bring you coffee and a chorizo sandwich (after overcharging you because you are American), and hearing all the dedicated fans yelling and banging their drums, it was totally worth it!

Tomorrow we are going to hike Laguna Rapagna. It's 11,000ft at the base and the 6 hour hike goes to 14,000ft. I took my acetazolamide and I'm bringing a gallon of water. Should be fun!