Tag Archives: lee ling

Halloween 2016

Halloween 2016 fell on a Monday school night evening. This was also a Monday social security day – the end of the month when senior citizens come to Kolonia to collect their social security checks and go shopping. That income is important in many families here, and falling on a Monday meant that the Halloween shopping weekend would likely have been negatively impacted. In local parlance, October 29 and 30 were a “broke weekend.”

Tristan and Kisha Halloween 2016
Tristan and Kisha Halloween 2016

The weather was acceptable, only a brief passing light rain shower in Dolihner, otherwise generally dry conditions.

Perhaps the largest factor was that last year Halloween fell on a Saturday night. A weekend with no school the next day.

Whatever the underlying factors, numbers were down year-on-year. Groups are a very roughly estimated with overestimation more likely than under. That said, the front porch saw a drop from 90 groups in 2015 to 79 groups in 2016. Traffic began around 18:35 but by 20:30 no further trick or treaters arrived on the porch.

Halloween group sizes 2015
Halloween group sizes 2015

Note the nine outlying groups in 2015 – groups with more than roughly 15 candy receivers, including one up near 45 and another above 50. The differential in the number of groups is a drop of only eleven. The lack of large groups, however, meant raw numbers of individual candy takers was down more significantly.

Halloween group sizes 2016
Halloween group sizes 2016

The numbers were down even more significantly. The count of candy receivers in 2015 was 590. In 2016 only 416 showed up on the porch, a drop of 174 trick or treaters. Average group size also dropped, primarily a function of the drop in the number of large groups and the absence of any group larger that 35. The household thought that the choice to block cars from driving up the interior road negatively impacted the large group counts. My sense is that the large trucks used to haul the big groups of kids from other parts of the island may not have been as available as they were on a Saturday night last night.

In 2015 the average group size was 6.56 with a standard deviation of 8.90. In 2016 average group size was 5.27 with a standard deviation of 5.50. The median, however, increased from 3 to 4 year-on-year.

We again used the dual bowl system. One twenty-five dollar bag of better candy and a single 330 count bag of Hershey Kisses. Elterina added in three bags of additional small candies that may have added upwards of 90 candies to the Kisses bowl. We would end the evening with candy on hand.

For those who want to play with the raw data, the data is available in a Google Sheets spreadsheet. Analysis was done using Google Sheets with the above charts prepared using the Google Statistics add-in for Google Sheets.



As those who follow me may be aware this age year is an age year of reflection. I am the age at which my father passed away. As a runner I seem to be in better physical shape than my father was at this age. While his risk at my age was a heart attack, my larger risk this age year is the traffic I joggle in amidst on an evening run.

This evening was a particularly poignant nightfall. As is the custom I headed to the state morgue to join family in keeping watch until an off-island brother can arrive for the funeral. I had been visiting when I could over the past few evenings. I knew those who came and went, and how they were connected.


Tonight when I arrived at the morgue the faces there confused me. They were from other connections. I gradually realized some were connected to the passing of a wonderful wife and loving mother I heard about earlier in the day. Her remains were in the morgue. There were other faces there, friends and family, that did not fit into either of the deaths I knew of.  And I saw a third coffin.

I learned that a third friend had passed away and that the remains were also there at the morgue. The third friend was someone who had come many years ago to Pohnpei and had made Pohnpei their home. A family who had hosted them in their early years on Pohnpei sent members up to note that they would handle the burial. The family even noted that Mwohnsapw Isipahu was awaiting the arrival of the deceased. I was comforted by the love shown.

In this age of social media I am more aware of the passing of the loved ones of friends. People I might not directly know, but whose passing directly impacts people I do know. There are not more people passing away, social media simply surfaces deaths more efficiently than I would normally stumble across.

When the funeral is far away I always wonder what I can to be of comfort. As do others, I offer my prayers and condolences. These are what I can do yet they seem insufficient – a friend who recently lost their father said that a memory will return to their mind unbidden and then they  fall to a million pieces all over again at the sense of loss. The living are left to comfort those whom the deceased is survived by.

While this is an age year of reflection and contemplation, and few know when they’ve seen their last sunrise, I expect to see a good many sunrises to come. Still, I will leave this suggestion, should you be around in some future decade when my passing surfaces on social media – when you are wondering what to post or perchance do, to go out and run a mile. Run a mile and lose yourself in thoughts of those you’ve known, those you’ve loved, and have lost.


Although I returned to a written reprimand (non-attendance graduation) and docked pay (missed six non-teaching work days), three weeks off the rock in December and January refreshed me to my bones. By not consciously thinking about teaching for twenty-one days I find I have some new curricular ideas and a reservoir of energy with which to work.

Vacation, as in traveling to somewhere distant, is a curious activity. There is little to suggest that traveling into unfamiliar places with unknown dangers would have been a survival benefit to our ancient ancestors. Staying home almost always had to have been safer. Yet the deep allure of travel is present across cultures.

Micronesians arrived in these islands on voyaging canoes, long journeys over open ocean. That first canoe, or canoes, had to be traveling uncharted waters. The question “Are we there yet?” as unanswerable as “Where are we going?”

For those on a voyaging canoe the journey was only partially calculated risk, a gamble that what lay beyond the horizon was worth the risk. Yet as modern voyaging canoes have shown, capable navigators could hold courses and make return voyages. Navigators had skills in finding islands in the vast Pacific, reading swells and clouds. Those sailing lived off the sea as they traveled.

Arrival at a new island that was large enough to support life had to be thrilling. The new island would look strange and unfamiliar, and that would make the arrival all the more exciting. That aspect of travel is still there for my tropical island raised children. The “islands” they visited are not just different, they are exotic beyond their imagination.

Cloud Gate Chicago
Cloud Gate

One can see the Cloud Gate in a computer image, the skyline reflected by the gleaming curved surfaces. Being there is viscerally different. The brain suddenly comprehending the size of the Cloud Gate while not comprehending the scale of the buildings just across Michigan Avenue. The sound of the city, of traffic, distant sirens ever-present, cold air whipping across Centennial Park and past one’s ears.

Our brains adjust to the daily world around us and eventually treat the sights and sounds of home as background noise. Home is rarely exotic on a daily basis. For those who commute past a wonder of the world, the sight is a daily occurrence, an ordinary event. For children who regularly see the Cloud Gate, the structure is far less remarkable than for children raised on a rain forest island of coconut palms.


For a child raised in Alaska, snow is a given. For a child raised in Micronesia, a first meeting with snow is beyond magical. In that moment of discovery and joy one’s brain is completely flooded with wonder. That sense of wonder is contagious, even an adult can feel that sense of seeing the world anew.

Ancient humans undoubtedly traveled primarily out of necessity. The need for a new food opportunities, uninhabited lands for ever-expanding families, or to escape a deteriorating life situation. Survival sometimes favored those brave enough to move, to abandon the place in which they knew how to survive. The new environment presented new challenges and required a sharpness of mind. Today travel is recreational, but the sharpness of mind, the attention the new environment requires, is still there.

In that absorption of the mind with the new surroundings is a dropping away of the mental load of the daily ordinary which was left behind. The brain gets to do a reboot and reconfigure, a refresh of the brain circuitry. Upon return from the journey, the mind retains the benefits of the refresh. There is a sense of being recharged and re-energized. While constant, continuous travel likely becomes mentally exhausting – travel would be the daily ordinary for such a person – for those of us resident for years in one place, travel can be refreshing in a very deep sense.


“That’s a stupid thing to do in the road!” called out an obese forty-something gentleman as the taxi passed me out by the Nett municipal offices. He was right. Running and juggling – joggling – in roads with no shoulders is stupid. Although being called stupid by an overweight, out-of-shape forty-something on an island of diabetes, heart attacks, and high blood pressure left me wondering whether the gentleman was in any position to judge the wisdom of specific  lifestyle choices.

The swimming pool beyond dusk

Darkness has fallen at the pool. The sound of young men challenging to each other as they  rack off push-ups rolls out into the humid night air. The language is local, the message is universal. Young men pushing themselves to be the toughest. Young women with the broad shoulders that the butterfly brings walk along the edge of the pool. Out of the gloom appears a more slender figure of a younger swimmer, my daughter. At up to a decade younger than some of the older swimmers, she seems almost out of place. As if a middle school student wandered into a collegiate athletics camp. Yet she seems comfortable and at home, undaunted by the age difference. Driven to swim by her own internal fires and unfazed by the impending competition. She is amazing.

On my way back through Kolonia town a young man with his hair dyed carrot orange  called out, “Wonderful! Awesome!” This also surprised me as what I usually hear is “Doh me ehu!” or “Give me my ball!” Not that I took any child’s ball, just that in a world where everything is shared he who has three balls must share with those who have none. Therefore one of the balls I am using logically belongs to the child.

As I trundled up what was some ancient ridge line, now the main road through Kolonia, I wondered whether I was stupid, wonderful, awesome, or – most likely – none of the above. Entertaining, maybe. At least to the many children who call from cars, “Kilang ohlo!” Somewhere between childhood and adulthood a running juggler shifts from being an amazing sight to being stupid.


Thirty years ago this spring I was invited to a Center for Assessment and Stateside Training (CAST) as a prelude to a possible invitation to join Peace Corps Ghana. I had put on my application that I would serve anywhere but Africa. In 1983 I knew only that there was a drought affecting a wide swath of Africa. When I get stressed out I tend to eat, I thought that a drought and food shortage might be stressful and that I would have the wrong reaction in the midst of a food shortage. So I naively put that I would serve anywhere but Africa.

When I filled out the application I was not seriously considering Peace Corps, I was looking at a number of possible post-graduation options and at a job fair day in 1983 I had filled out the application along with many other inquiries. The “recruiter” noted that I checked childhood allergies and said that would probably knock me out of consideration. The months went by and I never heard back, so I did not think again about the forms I had filled out.

Then in 1984 an invitation to a CAST for Ghana came in. The CAST would be a week long session of evaluation and assessment in Harper’s Ferry, Virginia, at the end of which Peace Corps would decide whether to invite a candidate and a candidate would decide whether to accept that invitation. Ghana had received volunteer groups every year except 1983. By 1983 Ghana was considered a difficult posting with a high early termination rate. No new volunteers were sent in 1983. Usually a new group overlaps a pre-existing group by a year, but with no 1983 group and the 1982 group finishing up in 1984, the 1984 group would have few other volunteers in country.  The CAST was intended to pre-select a group that was ready for the challenges that Ghana was thought to pose.

I had no real intention of going to Africa, but I thought a free week’s vacation in Harper’s Ferry would be fun and so I traveled to Washington DC and then on up to Harper’s Ferry for the CAST.

The assessors at the Harper’s Ferry CAST were, as I recall, all Americans. I do not now recall clearly, but my recollection is that some, if not all, were returned Ghana volunteers. There was one Ghanaian among the assessors, the in-country nurse for Peace Corps Ghana, Clara Donkor.

Clara decided I was trouble based on my being a Kwaku and informed me that she was adopting me as her son. When she did that I realized that if I was accepted into the Ghana program at the end of the CAST, I would at least have to go to Ghana out of respect for this woman I had just met.

I remember Harper’s Ferry as a week of group cooperation games and occasional mind games. When we were asked what lasting impact we hoped to have in Ghana I replied that I hoped to leave behind at least a pile of rocks. I do not recall how that went over, but I did make that pile of rocks in Akropong. Just last month I very intentionally piled up some rocks in area where I was planting some local medicinal plants. Wherever I go, I make sure I pile up a few rocks, my homage to that commitment I made in Harper’s Ferry. I have changed the lives of so many rocks over the years!

Although I had thought I might be rejected by the assessors, I suspect Clara put in her support for me and I found myself invited to the next stage of training in Mount Carroll, Illinois.

Dana in Mount Carroll
Mount Carroll


In Mount Carroll a different team of returned Ghana volunteers gave us a crash course in teacher training with a focus on the educational systems of Ghana. There was also a fellow from South Africa who had a role in the training. The training used a site that had been the home of Shimer College at one time.

After stateside training in Mount Carroll, the group flew to Accra for an initial week of in-country training, followed by village based training in Akrofufu, Eastern Region, and then another round of teacher training in Nsawam. The training was so long that at least one candidate terminated due to the length of training. Another volunteer terminated in the first week because conditions in country were “too dirty” for her.

I recall watching Mars, prominent in the southern night sky in Mount Carroll. That first night in Ghana when I looked for Mars, the planet was not there. We were outside performing libation, but my eyes were on the southern skies. Where was Mars? The change in longitude meant a shift in time, but I knew that should not affect the position. I tilted my head back and looked straight up. Mars. Straight overhead. I knew in an instant I must be near the equator. That was the moment I realized I was no longer in Kansas.

A day or two in country, I recall joining an excursion out towards Winneba, happily eating and drinking whatever I was offered. By the fourth day I was hit hard by shigella dysentery. The cramping was intense. Clara prescribed Donatel but the assistant nurse heard Tylenol, which did nothing for the insane cramps that hit every nine minutes. I eventually moved into the dark and rather dismal Accra elementary school bathroom, spending a night on the seatless porcelain toilet in the dark, in too much pain and discomfort to seek help. That experience was so powerful that years later when I had amoebic dysentery I ignored it for a month. The cramps were no where near as bad and I could could for far longer than nine minutes before needing to find a toilet.

The rest of the volunteers went on to Akrofufu for village based training. I was down on the order of 18 pounds at that point. I do not think they expected to see me again, I was a probable medical termination. Clara moved me into the Peace Corps office and I recovered. I did not want to be medically terminated because there might be times during a journey out of country that I would not be able to get to a toilet fast enough.

Before I left Accra I met with a doctor who informed me that the shigella strain I had contracted had tested as resistant to the anti-biotics available in country at that time. He essentially congratulated me on recovering on my own.


I think some of the other volunteers might have been somewhat surprised when I showed up in Akrofufu. I, on the other hand, felt rather bullet proof. I had survived a dysentery that was not treatable, why quit now?

Host family Akrofufu
Host family Akrofufu

Summer 1985, inspired in part by a Ghanaian French teacher who had traveled the Volta region with only a change of underwear, I traveled in a portion of the Eastern region for a few days wearing only my Ghanaian cloth and carrying nothing. No backpack, no change of clothes, wearing only my cloth, my teacher’s identification card in one pocket, some Cedis in my other pocket.

I stayed with relatives of my roommate for a night, and then headed up into an area off the main routes, into the hills to the east of Koforidua, north of Nkurakan. I wound up spending the night in a small village with a family who insisted I sleep in the only bed in the house.

The next day I was asked to teach at the local elementary school, and I did so.

I headed back towards Akropong the next day.

Although my journey was brief, I have never again traveled so light, so minimally. I also remember feeling comfortable. That was one of those moments in life when one has a new understanding of oneself. Walking along a road I had never walked upon before, wearing only a traditional cloth, carrying nothing, and feeling completely at home. Feeling that this is the most wonderful place to be at that moment.  In the one place I had once said I did not want to go.

As a student in elementary and secondary school I had failed to learn French (elementary school), German (middle school), and Spanish (high school). In response to some question a foreign language teacher asked, I said that I had no plans to go anywhere outside of the United States, would never need to function in a foreign language, and had no desire to function in a foreign language nor in a foreign culture. Walking along that red clay back road above Nkurakan I changed everything.

Shanalin in Ghana shirt
Shanalin in Ghana shirt

Thirty years ago I began the process that has led to a life lived abroad.

Ending of Sailing

With me being gluten free, the house has not seen a homemade pizza in many moons. With some persuasion from the gluten free head of household, a mother and son team whomped up pineapple and portugese sausage pizza using fresh pineapple from the patch outside of the house.

Our home grown pineapples are a variety not exported and have a wildly sweet flavor with an undercurrent of pineapplishness. 
She tends to eat scrambled eggs and rice with her fingers, but fritters get cut with a knife and eaten with a fork. She thinks different and does different. She may be my Apple child.
With the sailing coach leaving island, and the owner of the dock having moved to another home, the children’s sailing club is going on indefinite hiatus. There is a farewell picnic scheduled, but these two have a swimming meet that day. So this is their last chance to skipper a sailing boat. Very appropo that a brother brings his sister to shore for a final time. 
As with all things, there are beginnings and endings. The beginning is filled with promise, hope, and anticipation. The ending is sad and bittersweet. The Saturday dock has been a lively place for over 18 months now and my children have made many new friends from a culture with whom they do not usually get a chance to interact. I too have come to know some on the dock and now recognize them around town. 
Pohnpei is this way – Taekwondo came and went. Activities come and then fade away again. Children of different cultural cliques gather for a while and then disperse yet again. Parents connect for a time, and then go about their own ways. And those who leave the island tend to disappear from our lives here. Sometimes we see an occasional social media image or post, maybe a rare email, but otherwise those who leave vanish into the wider world.
Maybe only the rock remains, watching as a sentinel as the one flight a day makes its final approach past Peipalap bringing in new sets of parents and children, takes away other sets of parents and children.

Cheering from the sidelines

My son tagged the wall as he came in second in the 50 meter race. As he surfaced, the first place finished gave him a high-five. Both of the swimmers beamed with energy and shared excitement. On the sides of the pool their teammates cheered the one-two finish.

Swimmers start their race off the blocks
My daughter gets a good start

As the racing day progressed parents called out to the their children to push harder or to swim just a little bit further to reach the wall. Parents cheered and celebrated. And when one very young swimmer, alone among his age group, chose to swim the 100 meter butterfly solo  – four laps of the 25 meter pool, everyone around the pool was cheering the little fellow on. I think he thought it was a two lap event as a timer had to tell him at the 50 meter point to do two more lengths of the pool. Which he obediently did.

Swimmers leaving their blocks at race start
My son coming off the blocks for a 50 meter event

I walked along the side of the pool saying nothing, taking pictures. I suppose I should have been cheering as my son and daughter racked up first, second, and third place finishes in their age group. When my daughter was the only female swimmer to join the open 200 meter individual medley, that was exciting. Her team really shouted encouragement to her. Even my wife, normally rather placid and reserved, shouted “Go!” 

Breast stroke leg of a 200 IM swim
My daugher in the 200 IM, breast stroke leg of the race

I was proud of both of them, and I said so, but I realized I was a terrible fan as I was not much of a cheering sports enthusiast. I enjoyed seeing the camaraderie among the swimmers, the group support. In the water or by poolside, the competitors were never alone.

Two young swimmers
Two young swimmers

Later that day I hit the road for a one hour run out into Nett. I am trying to get my legs back around to half-marathon endurance condition. I know that I will be at the back of the pack running alone. I am almost always alone. A road runner practices alone on a road and then races, around here at least, alone on the road. There is no cheering from the pool side, everything is inside one’s head.

The half will be in 32 Celsius heat at 4:00 in the afternoon, humidity at 80% or higher. Heat index of 42 degrees Celsius or higher. Tropical sun or possibly tropical rain, but likely both. Conditions that would likely halt a modern big city American marathon length race. If the day is sunny, the race will devolve into a heat survival sweat house grudge match. Runners not against runners, but the runner against the insane heat. Those races are purely mental. Mental plus swimming pools worth of water and electrolyte fluids.

And the cheerleaders are only in your head. The road, around here, is a quiet place. Running is a different sport – little wonder it is not a multi-million dollar mega-machine sport like American football, European football, American basketball, or American baseball. There is no one place one can go and see the entirety of a road race. One cannot sit and watch the whole thing while enjoying beer and hot dogs. On an out-and back half, the runners disappear from the starting area and reappear well over an hour later. Not much to watch.

So I stood by the pool and watched as all the kids swam, proud of their efforts, knowing they too are wrestling with their own mental race in their own heads. Pushing their own limits and discovering they too can break through and do things they only hoped that they could do. Or for the little guy who did the 100 meter fly, do things they never imagined they could do.

College of Micronesia-FSM 5k run

The College of Micronesia-FSM annual 5k launched only two days after my ethnobotany visited Paies, Kitti, to observe a Sounkawad led kousapw perform their nopwei with rahmedel. Although 36 hours had elapsed, I was keenly aware of my own data that suggested six, seven, possibly even fourteen days until one’s endurance running muscles are completely recovered from the impact of sakau. Some of the data I looked out hinted at  an ongoing long term impact.

My son inbound
My son inbound to a 40:48 finish

I would finish the 5k in 29:59 clock, 30:41 with the parking lot loop, despite having felt that I had pushed hard throughout the run. Muscles are not the only impacted system. The lungs are also hit with some sort of impact on the functioning of the lung. Possibly related to the damage done to the cholesterol linked skin repair mechanism.

My daughter on her way to a 55:50
My daughter on her way to a 55:50
Shrue and Pelma
Shrue and Pelma

Although slow, I was the first male faculty across the finish line. Santryco on my right was joined by his 19 minute 12-and-under son in front of me, Reloliza is between President Daisy and myself. Christina, Cindy, the 12 and under female winner, and Leslie round out the picture. Gary, picking up the master’s trophy, had already left.

Nice breakfast duo
Nice breakfast duo

On Sunday evening I went out and pushed hard, running without joggling for an hour and 26 minutes, covering 12.9 kilometers from Dolihner out to Dausokele, back up to the airport, and then home.

Good Friday

In keeping with tradition, the Women’s Christian Association of the Kolonia Kosrae Congregational Church presented the Good Friday passion play.

Preaching to the disciples
Preaching to the disciples
Last supper
Last supper
Betrayed by a kiss
Betrayed by a kiss
Darkness descends upon the world

In the darkness the women recite scripture from the crucifixion punctuated by passion songs sung a capella.

Curtain call
Curtain call


Every new year’s eve is different, the end of 2012 was all the more so. A trip to Kosrae for a toeny – gathering – Christmas. At four in the morning of old year’s day, our eighteenth wedding anniversary, a night fright trip through desperately pouring rain in a van leaking gas fumes and no air conditioning system. She was admitted and later found to have a high white blood cell count. The location of the pain suggested an appendicitus. Other possibilities included adhesions or an ascending UTI.

Hospital ambulance bay

2013 was ushered in from inside a medical outpost of limited capacity. In the smaller hours of the morning a Nipastu in the next bed over said a new year’s prayer for those in room one and beyond. In the quiet darkness there is a sense of loss of control that illness brings. A fear of what lies ahead. Prayer fills the dark silence with a small voice of hope and a trust that somehow the road ahead will be bearable even if not survivable. One is no longer alone in the dark.

Maybe we are not treating some of the chronic diseases in room one correctly. High blood pressure, high blood sugar, weak cardiovascular systems are not necessarily improved by seven days a week, twenty-four hours a day of bed rest. Would not some physical therapy, some exercise, component be beneficial?

Walking on a treadmill. Light weight strength training. Under supervision with vitals monitored. Diet and exercise seem to me to be key treatments, but in room one there is only lay in bed around the clock. This cannot be good. What is the current research based thinking on the treatment of these chronic diseases when they reach the point of medical admission to hospital?

The smaller things are indeed joyous in the limiting world of room one. Coffee. Hot. In the morning. A hot cup of coffee and the morning sun banishes the terrors of the night.

Visitors. A chance to chat, catch up on events beyond room one.


The life of a topang is about minimalism. Limited surface area for living, limited options for engaging the brain. A topang can sit in a chair. Perchance sleep on a vacated bed. Gaze through a dust encrusted screen at a window sized slice of the world outside.

The view from the window

There are unending empty hours for the topang, punctuated by the occasional needs of their patient. Sometimes the patient is released and goes home on this island – chronic diseases do not mean that one is released due to being cured. Sometimes the hallway whisperers carry the news that a patient has gone home beyond this island, beyond this life, their last rasping rattle hanging in the dead air. The topang now seated outside of the room, head hung low, tears running down their soft brown face. A topang’s final charge is to faithfully report the details of the passing of their patient, over and over again.

The topang lives in a world where there are only those two outcomes possible. Life. Death. No shades of gray. There are only the two extremes of joy or desolation. All other emotions are amplified to these extremes.

After a term of seven-twenty-four work, a quadruple overload, I had committed to doing absolutely nothing over the break. Goal achieved. Eat. Sleep. Sit. Repeat. Seven-twenty-four. My world is a No Exit life in room one. I could leave, but a topang is duty bound to remain with their patient.

In room one I am junior topang. Rose is senior, taking care of Nipastu. I look up to Rose, she can sit and look out the window for hours without betraying the slightest restlessness. Being Rose, getting my own over active mind to simply zone out for hours, becomes a personal endeavor for me. To be able to do nothing, think nothing. To just exist.

The topang’s topang, however, is Arcie. Arcie remains with her patient, assisting with all the maturity and grace of someone decades older. In evening she comes around and visits many of the chronic longer term patients. She is genuinely interested in their well-being. Her parents ensure that she gets home for showers and meals, but Arcie always insists on returning. She was born to be a care giver. She has a need to care for those in pain and suffering. Her bright smile, her encouragement, and her endless optimism that accompanies youth, lifts everyone’s spirits. If a positive mental attitude helps people recover, then Arcie may be one of the most powerful medicines in the hospital.


Night settles back in. My patient appears to be improving, but the night ahead is long. If something is going to go wrong, then it will go wrong in the small dark hours of the morning. The joy of seeing improvement creates the possibility of desolation. One might want to return to the middle, but there is no middle, only recovery or not. Joy or desolation.

A topang is unwatered, unfed, tolerated but technically ignored by the official processes of the hospital organism. The topang ekes out an existence as a symbiont providing care and companionship in exchange for excess food. Blanche DuBois’ kindness of strangers is the life blood of the topang. A family chooses to make dinner for everyone in room one, bringing a sense of celebration of the new year.

New Years Day dinner

With room one again full, the topangs sleep where they have always slept, on the floor between the beds. Nipastu has the wall bed, my patient is in the middle of the three beds along the south wall of room one. Three more beds are arrayed on the north wall. Rose and I sleep on the floor between those we watch over and care for. As I fall asleep on my kiyaka I realize that for my eighteenth wedding anniversary I am sleeping next to a woman who is not my wife.

A massive bang. The hospital plunges into darkness. Then the sound of a generator coming up to speed. Automatic transfer switch. Outside the window the high school is suddenly lit up like Christmas tree. External lighting on every floor is energized. The residents of room one sit in the dark and watch the twinkling lights of the empty high school. A baby cries in the darkness in the children’s ward across the hall. I make a mental note to myself, “If on life support, run a really long extension cord across the road to the high school.”

Nurses with flashlights eventually come around to check on patients. The nurses here really are wonderfully caring, personable, and treat patients as members of their own family. Which many are. Eventually the power returns and the routine of the night returns.

Nurse Yonis is waking me up. Something has gone horribly wrong. She is crying. On duty. “Dana, come help us!” she pleads. Out in the hallway I hear someone shouting “Security! Pang security!” She runs out of room one, and I follow at a run. We run out the front door where too few people are struggling to move a heavyset man on a stretcher out from the back of the ambulance. I immediately grab the stretcher, as does another man who I recognize as a patient in the hospital. As we move the stretcher into room three – nominally the intensive care bay – I am mentally confused. The man on the stretcher is my patient’s doctor, the doctor on duty. My mind is reeling. Why is the doctor on duty on a stretcher? Coming out of an ambulance? And not apparently breathing. Non-responsive. The nurses are clearly operating in a state of shock. Their team leader is the man down. Yet the nurses work quickly and rapidly, taking control of the situation and beginning treatment. I leave the room as another doctor rushes in and return to room one where the news had preceded me.

A patient had passed away this evening. The world of Kosrae is a small place of interlocking family relationships. No one else in the hospital was in a medically critical condition. Most of the patients are dealing with chronic diseases of one form or another. The patient’s home was nearby, thus there was nothing unusual in the doctor accompanying the body of the deceased to his home. A way to honor the patient and reassure the family.

In the small hours of the night essentially only a skeleton crew is on hand. The doctor had helped lift the patient and become winded by the effort. He then accompanied the body. Not more than two minutes from the hospital he had what would later be deemed to be sudden cardiac arrest.

From room one we could hear the heart monitor flat lined and the attempts to get the heart restarted. The whole hospital is an open air space, no wall goes all the way to the ceiling except for the children’s ward. So the whole hospital was silent as all listened to the unfolding tragedy.

The doctor’s wife arrived and burst into tears when she learned her loving husband was gone. We cried with her, for her.

The nurses then carried on tending to their patients right through to the end of their shift. There is no crisis counseling here, no time off to process handling the death of a life time friend and colleague. The professionalism of the nursing staff that night and into the morning was beyond impressive. The nurses definitely had the right stuff, the above and beyond the call of duty right stuff.

By the next day my patient was deemed dischargeable and my role as a topang would come to a sudden end. The now deceased doctor had ruled out an appendicitis and adhesions. His final diagnosis, made not more than twelve hours before he passed away, was that the pain was due to a UTI. A later follow-up check would effectively confirm this diagnosis. He had given me back my patient, my wife. Tragically, his family lost him.

Patient and topang