Pesto Pesto Pesto!!!

This week in our CSA box we got our bulk share of basil. Throughout the season, we get little extra bulk produce. Earlier in the year we got an extra half flat of strawberries. Don't think I have any photos of the shortcake we made. But believe you me, it was yum yum delicious.

Towards the end of the season we'll get a bunch of potatoes, onions, shallots, garlic, and a pumpkin.

But this week it was all about basil. And I didn't quite realize how much two pounds of something can be! That is a lot of basil.

So yesterday I went to work making pesto. I'm pretty happy with the results. And I'm very grateful to Hillary and Bubba for lending me their food processor. It would have been quite a task to do this by hand. Instead, it was pretty quick and harmless.

And the results are lovely. The freezer is a little more stocked. And I've got some for giving away. Let me know if you are a big pesto fan, and I'll either bring you over for some dinner or send you home with a treat.

Summer Harvest

Our CSA box from Helsing Junction Farm has kept us on our toes keeping up with eating our vegies! Each week we get a box packed full of treats.

One of my favorite new recipes is a purple potato salad with feta, mint, and peas. I'll find the recipe and post it one of these days.

Lentil soup in the making. It was a rainy summer night. Tom Waits played on the stereo. A pretty great combination I'd say. And it turned out quite good. I'll be making it again, likely on the next rainy night.

Mija likes the vegies too. I've never met a cat who so enjoys leafy greens! She must be mine.

Purple Potato Salad

4 cups storage potatoes, coarsely diced (they of course don't have to be purple, but it's prettier that way)

1/3 cup fresh mint leaves

1-2 cups new peas

1 cup crumbled feta

¼ cup extra-virgin olive oil

Boil diced potatoes as above. Combine ingredients.

Easy, tasty, and beautiful. Thank you Barbara Kingsolver and animalvegetablemiracle.com

Pears and flowers

Last weekend Richard and I ventured down to Columbia City to pick pears at my friend Barbara's. She has a beautiful old tree, and so do her neighbors on a few sides. It was once an orchard. And she has one of my favorite tools, a fruit picker! It's a metal basket on the end of a long, long pole. So you can reach up into the tree and snag your fruit of choice, and if you're lucky, it lands in the basket. Because the tree was already dropping so much fruit, the disruption of pulling at one pear would knock a few from neighboring branches. So we would pick one, then duck and cover for the fall. And then we scavenge.

We didn't get as many as I thought I would. A ladder would have been helpful. But we got a small harvest to bring home for ripening. After sitting for a week, about half the pears were nicely ripened yesterday, so I got to work drying pear slices and cooking up the rest into pear butter. The house smells cozy and delicious.

I've also been photographing flowers that I see while out on walks, in hopes of remembering them and growing them one day. These are a few of my favorites this year.

Berries Berries Berries

I went a little crazy picking blueberries this summer. It made me extremely happy to come home with buckets full of blue. I made four or five trips out to the Mercer Slough in Bellevue. Some days I only picked two or three pounds. Other days I picked seven!

Then in one lovely trip down to Olympia with Paul and Katherine, I picked twelve pounds in only a few hours! It's always hard to pull myself out of the blueberry fields.

My freezer is now fairly well stocked. But if I came across a few more ripe berries, I'd absolutely pick some more.

The littlest garden

After two years of living in our townhouse, I finally got something growing out on the deck. My first summer here was a little hectic with moving in mid-summer, and being in my first nursing classes. And I was away all last summer. So finally I got going with it this year. I have my tiny little deck outside my room, and I got together pots from around the house (and a few donations), and went to work. I am growing lavender, mint, fennel, parsley, two kinds of oregano, basil, and two cherry tomatoes, sungold and yellow pear. Plus some pink geraniums to give some girly beauty. Tomato harvest has been small, but it makes me happy to go out and pick a handful. I'll definitely grow sungolds in the future. Probably pass on the yellow pear.

I Heart Vacation!!!

Time for travel

We had our last day of class on Monday, and an extra day of clinical at Hospital Mexico on Tuesday. I went out for a celebratory Peruvian meal on Wednesday night. And Thursday morning took off for Rancho Mastatal, an incredible find in central Costa Rica. Rancho Mastatal is an environmental learning center and sustainable living community in a town of about 150 Costa Ricans. It is run by a young American couple, who have a nine month old baby with them. And they run an internship and volunteer program where you can go learn about sustainable living and building for three months at a time. Or you can just go for a few days and enjoy the beauty and the good food and good company. I traveled with Rosa and her friends Nava and Chana, visiting from home for the week. Staying in this beautiful place includes three fabulous vegetarian meals a day, made from local produce and dairy, and require a half hour walk to and from each meal. The walk during the day was sunny, hot, and gorgeous. The walk home after dinner was quite dark, with expansive sky and stars, and a lot of anxiety about poisonous snakes we might come across in the road. To put aside our fears, we sang loudly as we walked, and kept our eyes and headlamp on the road. We spotted one snake on our second night, and it stayed on its side of the road while we scooted past on the other side. It was still closer than any of us wanted, but we didn't end up with any trouble.

Our stay at the Rancho was shorter than I would have liked, but I'm so glad I made it there (thank you Alyssa for the recommendation). I traveled with three other girls, and on our full day we went on a gorgeous hike in the rain forest before lunch, and spent the afternoon at a swimming hole we found after hiking through a bit more of the forest. I lifted the pictures above from the Rancho's website, but I'll get others up soon-ish. The two above represent a bit of what the rain forest looked like. Nava commented at one point that she felt like she was in the movie Honey I Shrunk the Kids, as the plants were all rather enormous. And so much green. So so much green. It was fantastic. 

I took a taxi and three buses home today, and am back in my little room at the seminary. I'm not sure that I mentioned I've been living in a seminary for the past two months. There haven't actually been any seminary students here during our stay. I guess it's still summer vacation or something. But there have been large groups of nuns or other groups here on religious retreats for periods of time during our stay. For the most part we stay out of their way and they stay out of ours. And this is where I've lived and studied during the quarter.

Tonight, as with many Saturday nights, there is a loud party happening somewhere not very far away. I have no idea where it's coming from, but the music is loud enough that I can recognize many of the Latin pop songs they play. It will probably go on for a few more hours, and return next Saturday. By then I'll be far away, lounging with family on the beach. 

I'll be hanging out here until Wednesday morning, when I'll head out on my 10 day trip with family. Afterwards I'll have a weekend to do what I choose, then another week traveling with my roommate Richard from home, and the two of us will travel back to Seattle on March 24th. I feel so lucky to have had this quarter in Costa Rica, and now to be done with the quarter and have time for travel and vacation before heading home. I realize that most of you reading this are in the middle of winter, and I wish for you some sun and warmth. I know I have it pretty good down here, and I am aware of that fortune every day.

Lots of love.

Elizabeth

Clinicals at Hospital Clinica Biblica

I spent last week at Hospital Clinica Biblica. HCB is a private hospital in San Jose. It is rather well known for medical tourism. Americans can fly to Costa Rica, have a face lift or a boob job or maybe even a necessary procedure, recover in some fancy hotel, then go on sightseeing tours, all for less than it would cost to do the same procedure at home. HCB was build in 1920, but recently was renovated and now looks like a very new fancy hospital, nicer than most of what I've seen in Seattle. The only problem is the maternity unit was particularly slow this week. They average about 90 births per month, so in three days you would think there would be at least a few women in labor, birthing, or in postpartum. But I didn't end up seeing any births, either vaginal or cesarean. The picture above was my most exciting moment. I got to give a full bath to a one day old baby, then dress him and bring him back to his family. Usually, the nurse will bring the baby out to this little bathing room, and if the father wants to come along, the nurse will explain to him her very specific way of bathing a baby. With this baby, the father wasn't there, so I got to do the honors. I loved it. 

Unfortunately, aside from that bit of excitement, I sat and read a lot. So it wasn't the most enlightening maternity experience I've ever had. I'm glad to have had a good experience at Hospital Mexico. I spent one day in the high risk antepartum and postpartum unit, which I described below. And I spent one day in Labor and Delivery, where I saw 5 babies born in about 4 hours. It was intense. The unit is more of a ward, where women labor two to a room, with curtains instead of doors, that are usually open. They mostly lay in bed and writhe. And then when they are sufficiently dilated, they are taken to another little room to give birth, still laying in bed. It was hard to stand by and be present for. I tried to get in and do my doula work when I could, but the environment made it hard. And there are no pain meds offered during labor. No epidurals, no fentanyl. When a woman says she's in pain, the common response is "of course you are, your birthing a baby." And no walking or massage or baths. One woman was brought into a shower. I'm not sure why exactly she did and no one else. But the next time I saw her, they'd decided she needed a cesarean, which I was able to watch. I went into the OR when the anesthesiologist was attempting to put in her epidural. He poked her various times, and I'm not sure what the decision process was, but the next thing I knew they were putting a mask on her and giving her general anesthesia. I asked a nurse later why she got that, and he just said "some women request that." I can't imagine she requested it mid-attempt at putting in an epidural, but whatever. I went ahead and watched the procedure. I've been in the OR for a few cesareans with doula clients before, but I'd never really watched it. I was always up at the mom's head, behind the curtain. Now I've seen the whole thing, and I'd be okay to never see another cesarean in my life. It just looked brutal. They do an initial cut into the different layers of skin, fat, and muscle, and then the surgeon and whoever it is that's standing on the other side of the mom put their hands inside the abdominal muscles and each pull in opposite directions. I'm sure it's something about stretching being better than cutting a bigger incision, but I thought it was horrible to see. 

We got one day in the Neonatal Intensive Care Unit, where they have babies in 4 different areas. Some are premature and not in very good condition. Others are premature and just need to continue putting on weight. Others are unstable for some other reason. I didn't really like being there. For one, we couldn't touch the babies. I understand the liability issue of it. We were just observing at that hospital. But having personal touch seems so important for these little creatures. It was sad to not be able to offer that. I also didn't like it because it was just so hard to see all the preterm babies. They look like little aliens. I know that's a horrible thing to say, but it made me really uncomfortable. So I guess I won't be working in the NICU anytime soon. 

Next week I will be in the community clinic. Based on my classmates experiences there, I'll be giving injections most of the day. It will be good practice for me. And it will be nice to be in a community clinic rather than a hospital.

In the meantime, I went to Jaco beach for a quick trip last weekend. It was fabulous. Beautiful beach, with an almost full moon that comes out long before dark and brightens with a gorgeous pink sunset. I'll be heading back to the coast at least twice more before I head home in five weeks.

This is a quiet weekend. We all went back to the private hospital for a Valentine's childbirth class this morning. And we have class all day for the next two days before Tuesday-Thursday clinicals. 

But everything continues to go well. I'm still excited to be here, and I'm excited for next quarter, where I'll be continuing on a maternity unit for my senior practicum.

Hasta pronto.

Clinicals at Hospital Mexico and Guarderia El Manantial

This is us with Alan, one of our professors here. He just finished his Masters, and is an "enfermero obstetrico" which is the equivalent of a nurse midwife in the U.S. He's currently working in a NICU, and helped us in our day in the NICU at Hospital Mexico.

In the nurses office at the Guarderia. Here we're with Ricardo. We've met quite a few male nurses here. It seems like the male female ratio is a little more even in Costa Rica than in the U.S. but I haven't actually seen statistics.

Helping the toddlers to sleep after lunch. A highlight of each day at the Guarderia.

Sleeping butt up. Very cute.

Mary distracting this little one on the scale with her pen light while I get his weight.

We've been divided up into small groups for our clinical experiences here. I am with Mary and Erica, who are above in pictures with me. We spent three days in a Guarderia, which is a childcare organization that gives pay-what-you-can full day childcare for low-income families. The parents must be employed to have their children here, and every two weeks they pay whatever they are able, which can be as low as a few dollars. The children range in age from 1 to 12 years. If they are school age, they go to school and come to the center in the afternoons. If they are younger or on vacation, they spend the whole day here.

We each spent a day with Ricardo, the resident nurse. We did physicals, including eye exams and a head to toe assessment for a few kids, and helped when kids would come to the nurses office with belly aches or bumps from the playground and other everyday child maladies. The three of us together gathered heights and weights for three classrooms, including the nursery. These toddlers definitely did not appreciate us laying them down on the ground to be measured. But we were able to distract them well enough with toys while getting their weight.

The best part of each day was helping in the nursery at lunchtime. After lunch, all the kids toddle back to their classroom and each one is plopped down on a little potty bowl. Then they get their hands washed and teeth brushed and all lay down on mattresses. We helped get each one to sleep by rubbing their backs until their eyes fluttered and finally closed. Not exactly nursing duties, but pretty cute.

I may head back to the Guarderia for one or two extra days at the end of our program. Each Monday, the nurse and social worker head out to do home visits with the kids' families. I think it would be good to see where the kids live and get to interact a bit more with families. 

We'll see if I get distracted and head back to the beach, or get in some volunteer time. Such difficult decisions.

I can't figure out a good way to post pictures

For some reason it's been very hard for me to get pictures up on here. Either the connection is too slow, or they just won't load. Very frustrating.

But here are two pictures from a weekend trip to the cloud forest in Monteverde. It was beautiful, and I'm looking forward to going back. 

After much delay, here goes....

I’ve meant to start a blog for a few weeks now. My goal was to join the 21st century and replace my group emails with this blog. I hadn’t yet found the inspiration to get going with it, due to a busy class, study, and travel schedule, and frequently slow internet connections. But I’ve finally gotten around to it. I hope you find it somewhat interesting, or at least get a bit of an idea of what I’m doing in Costa Rica, if that is something you want to know. So here goes….



We had our first day of clinical today. It was different from my previous clinicals in so many wonderful ways. The first and biggest difference for me was that I wasn’t filled with dread the night before, which is a welcome change. This whole quarter has been a welcome change for me, as I feel a renewed excitement when I think of my soon to start career in nursing. The last few months were quite a challenge for me, as my disinterest in various nursing positions only seemed to grow and grow. But now I have returned to an aspect of nursing that first pulled me in ten years ago. I feel more and more sure that I want to work in maternity, and would be happy to work with women during pregnancy, during labor, or supporting women during the postpartum period. All of it sounds great to me, and it feels so good to be excited about something like this again. I felt similarly during my AmeriCorps experience as a doula, and the return of a voice telling me I’m doing the right thing feels significant.
I spent the day on a maternity unit, working with high-risk patients. Some women were pregnant and having complications, while others had recently given birth and were recovering from complications from their pregnancy or labor. We saw much of what we’d just studied in classes: women with pre-eclampsia, pre-term labor, and placenta previa. I worked mostly with one nurse, a man named Ivan who has been working in maternity for 13 years. He was caring for 12 women, and didn’t seem at all stressed or bothered by the workload. He also seemed perfectly happy to let me follow him around and was happy to explain anything I didn’t understand. (As a side note, this is not technically part of our clinical rotation. It is an additional week of observation. We are only allowed to provide patient care in the private sector, which we will do over the next few weeks. So today we were in Hospital Mexico, a large public hospital on the outskirts of San Jose. Some classmates have made a comparison to Harborview in Seattle). But back to what I actually got to see and do…. Ivan helped me put on fetal monitors and do a Non-Stress Test, something I’ve seen many times with doula clients, but never gotten to actually do. And I’d never really known what the providers were looking for when they looked at contractions, fetal movements, and fetal heart rate. Now it actually makes sense, although I’m still learning to read the monitor strips. I also got to do manual monitoring, which means that both Ivan and I put our hands on a woman’s belly and counted the contractions we felt during a ten minute period. Crazily, through my many birth experiences with doula clients, I don’t think I’ve ever actually felt a baby kick or move when I’ve had my hands on a woman’s belly. So that was very fun. And I got to use a Doppler to listen to a fetal heart rate. It was all pretty simple, but I loved it all. And at the end of the day, after getting up at 5:00 a.m. to leave at six to get to the hospital by seven, it’s now late afternoon and I feel happy and energized, instead of drained, only wanting to lie on the floor and stare at the ceiling.
Some of my classmates were on the Labor and Delivery unit, where I will be on Friday. My lovely friend Rosa observed a twin cesarean for a woman who had had severe preeclampsia, and just before her scheduled cesarean, she experienced a 45 second tonic clonic seizure. She also got to see two vaginal births. So in one day she saw her first four babies born.
Tomorrow I will spend the day on the newborn unit. They try as much as possible to keep newborns with their mothers, but when a baby is premature, or needing intensive care, they are kept on another unit. So I’ll be there tomorrow. And Friday I’ll be in Labor and Delivery. Then next week we start our three weeks of actual clinical. I’ll be in a children’s day program next week. We’ll do well child checks and maybe some health education projects. The following week I will be in a private hospital, working in Labor and Delivery. And the last week I will be in a community clinic, working with an obstetric nurse who does prenatal care, pap smears, immunizations, and home visits. I’m excited for all of it, and I’m considering setting up some additional volunteer work at the end of my quarter. So far I like the idea of continuing in a Labor and Delivery unit, but I’ll wait and see what else becomes a possibility. In the meantime, I’ll try to work backwards and write a bit about what I’ve already seen, done, and learned in these first few weeks. The quarter is moving quickly, so as usual, I’m always trying to get myself caught up. Hasta pronto.