My Singapore hospital experience

Several people have asked me about medical care in Singapore. Since I've gotten an up close and personal tour, I thought I would share a few things I've seen with my medical friends.

Singapore is known for its excellent healthcare. It has been a model for efficient and quality service. There are public and private hospitals and both are meant to be very good. I was in a private hospital, so I can't speak to the differences in the public system.

1. In the ER, the MD evaluation is almost more like a triage. Patients are called into a proper doctor office for evaluation. The ER is primarily staffed by house officers, basically graduates that have not chosen a specialty. Residencies are not required. The physician decides how to disposition the patient-either discharge, observe, or admit. Then the patient is moved to that area. The doctor I saw immediately decided I should be admitted and I was moved to a bed.  I was admitted directly to the GI specialist who gave orders for initial labs and IV fluids.

2. The admission nurse brought me a list of rooms and prices and asked me to choose my room. It was like a hotel list with room sizes and amenities ranging from double room to extravagant presidential suites. I ended up in a basic suite where my specialist was already there waiting for me, even though it was 11 pm on a Sunday night. (He told me he lives across the street from the hospital). The whole process from door to done took less than 2 hours.

3. Being a private hospital, a deposit or insurance was required on admission. I asked what happened if you are unable to pay and was told you are discharged to the public hospital. Every test was discussed associated with a price. Every test from routine bloodwork to colonoscopy was a choice with agreement on the price. It reminded me a bit of a car mechanic. The mechanic calls to tell you what they found and how much it will cost to fix each thing. It was odd but honest. Luckily, our overseas insurance takes good care of us and we had no concerns.

4. That being said, few tests were done. The only bloodwork I had done was on admission. No cat scan. Only the basics. When I would ask something specific, my doctor relied on the good ole physical exam to lead his decisions.

5. Back to the room choosing, the first night I heard a baby crying. I asked the nurse about what I heard and she told me the woman in the next room had just delivered. So there's obviously no separation of wards. Not sure how I feel about that-a brand new baby next door to a terrible infection and common nurses caring for both. Infection control is obviously a necessary priority.

6. The nurses on the ward work as a team instead of assignment to a patient. Each nurse has a role-medication nurse, vitals nurse, discharge nurse, etc. The medication nurse wears an orange construction looking vest that says "do not disturb" and makes rounds dispensing all medications from locked cabinets in each patient room.

7. This may be related to my suite, but my experience was like staying in a hotel. Food comes on tableclothed trays, coffee maker and hair dryer in the room, even high end toiletries in the bathroom. Amenities including reflexologist, masseuse, and acupuncturist are available as well (I did not partake.)

8. On discharge, patients are expected to make their payment in full. No billing. No outstanding debts. Private local insurances aren't a thing here so there are no insurance company talks, except for pesky expats like us. Prices are prices and are non negotiable. Simple.

Overall being the hospital sucks but this was the best of a bad experience. Maybe my experience is specific to my quirky, sweet Dr. Leong, but I felt very lucky to be cared for here.  It's a different system, but it seems to work well. Singapore is small, so it's difficult to argue that some aspects could be applied on a larger scale, but interesting to see there might be another way.

Mile 10

My favorite teen show was Beverly Hills 90210. You might remember that Dylan McKay had some recurring family drama that left him living in the Beverly Hills Hotel for much of the show. I always thought that seemed so exciting and glamorous. Let me just say that Dylan did not have three young children. He did not accurately portray the difficulty of homework, laundry, or living with no space. Annoyances of loud nights, housekeeping schedules, and full parking lots were not adequately expressed. I'm disappointed, Dylan. Hotel living is not all it's cracked up to be.

Luckily, as of today, we've graduated to "house camping" as we like to call it. We have 4 mattresses to sleep on (3 that we needed to buy here and 1 borrowed from a new friend), a plastic card table and 5 metal folding chairs, a tv, and another borrowed twin mattress functioning as our living room couch. Our sea shipment is continuing to float somewhere off the African coast and will not arrive to us for another month. The house itself is mostly ready. We are waiting for mosquito screens for the open bathroom windows (and so are sleeping covered in Bug spray with citronella candles everywhere), ongoing electric issues when we try to run all the air conditioners at the same time, and setting up internet. My frustration is high and patience is low. Regardless, we have a secure space, great neighbors, a pool in the yard, a kitchen and a washer/dryer. Things are slowly looking up.

I apologize that this post is sounding a little whiney and pitiful. I readily admit that these are first world problems. I know how lucky I am. I constantly remind myself that we are healthy, safe and happy. We have a place to sleep, food, a great job and school, and family and friends that we love. I don't equate my situation to any real hardship.

 But this is the hard part. It's like a marathon. I started out excited and full of adrenaline and determination. Now, 10 miles in, I'm questioning what I'm doing. I'm exhausted. I'm beat up. I can't see the finish line......but I know it's there. I have to remember how great it will be at the finish. It's worth it. A friend once told me that the transition and settling phase is the sacrifice we make for this life. If that's true, then I will happily continue to pay my dues.

So I keep pushing through right now. I am leaning on God and my faith in his plan.  I am not strong or brave or good at this part. But I don't have to be. I only have to be faithful.  I am not a believer in the saying that God never gives you more than you can handle. He absolutely does. He gives me more than I am capable of time and time again. And He does it to remind me that I need Him to handle it. I am not in control. I can't do it alone. So I remain joyful even when I'm frustrated or scared or stressed. These trials are temporary but His love, and my faith in it, are eternal.  My work is keeping my eyes on Him in the middle of race. Some days it's hard work. It's never ending work. It's the only work that matters.

Consider it pure joy, my brothers and sisters, whenever you face trials of many kinds, because you know that the testing of your faith produces perseverance. Let perseverance finish its work so that you may be mature and complete, not lacking anything. James 1:2-4.

First impressions

Today marks the 1 week anniversary of our recent closed eyed high dive into Malaysia. It's been a whirlwind but I can say that I think we're holding our own. With the boys now at school and Micah starting work today, I've been left alone with my own thoughts for the first time. It's crazy, a little scary and a lot overwhelming. I wanted to try to organize the huge whirling mass of experiences and first impressions in my head. So here goes...

The trip
The travel was generally easy, other than the stress that comes with a family of 5 living out of a hotel for 2 weeks now. Flying on the heels of another air tragedy, my anxiety was at a high, but I made it onto the plane, which I consider a win. The boys were troopers, as they've proved they always are and took full advantage of their bumped class status. Tyler repeatedly came back from the plane toilet heavily scented as he was impressed with the complimentary cologne. Owen enjoyed every button a million times over, reclining his seat, closing his window shade, raising the pod divider, etc. The electrical system functioned well under strain. Barrett enjoyed the air sickness bags, as is his reponse to total exhaustion due to marathon movie watching and refusal to sleep. Luckily, it only began the last few hours of the final flight and passed that evening.

The area
So I must admit, I was a little (very) on the fence about Malaysia. Singapore, yes, no problem but this just over the border thing had me worried. I had read and heard some expat remarks about the border town stereotype that left me uneasy. We have only just begun to explore, but so far it is amazingly beautiful. It's quiet and green and warm. We've seen monkeys on the side of the road like squirrels, pass a coconut plantation of endless palm trees just next to the school, and watch the harbor boats sailing by. I can't complain. I still do have a level of uncomfortableness from a health background. Raw chicken, barefoot stores, mosquito armies, stray dogs have me seeing salmonella, hookworm, dengue fever, and rabies. That takes some getting used to.

The food
You can smell it when you step out of the airport. It's a mix of salty sea air and spices. It's powerful. It's very tasty. Considering that we are without a kitchen, we've been solely eating out. The older boys have been adventurous finding favorites with mango curry and laksa. Owen is a but pickier, true to form, but has found rice and noodles are always options. The biggest change coming from Norway is the price. A dinner of all five of us runs about $30. Crazy!

The school
The school is a British establishment's international campus. It's huge, like college campus huge. Multiple buildings, boarding options, a pool, track, climbing wall, art and drama building, etc. It is very proper with strict uniform requirements, merit and demerit systems, and house affiliation (as in House of....we are Hunt as opposed to Seymour, Chichester, or Merlin). Honestly, it feels like we might pass Harry Potter at any time. Fun fact, the school was actually the inspiration for JK Rowlings' Hogwartz. All that said, the teachers and kids are friendly and welcoming and the boys all came home smiling. They have a long day, until 4:30, but have private instrument lessons, sports, religious education, and design technology as a part of their school day along with the academics including Mandarin Chinese. It's intense but my boys do best with structure and clear guidelines so hopefully it will be a good fit for them.

 The house
The house is perfect for us (and I will make sure to credit Micah with the housing choice. He's 2/2 folks). It's a brand new house so right now there are several small kinks to repair, but nothing major. It has a lot of outdoor space and pool and a neighborhood park next to us. It also has 2 kitchens and a maids quarters (the boys are currently calling that the time out room as that has been its major function thus far). Concrete and modern, it is polar opposite from our Norway house, but it will be a comfortable home. Many of the school families live in the same neighborhood so the boys will likely have close friends. I am anxious for our furniture to arrive so we can begin enjoying it.

The people
This has been my biggest surprise. I suppose i grew accustomed to the eye diverting non small talking of Norway, so smiling, nodding, and speaking to strangers has caught me off guard. We look different here, of course, so there is a lot of staring, but somehow it's not at all rude. People have been very friendly and helpful for the most part (and we tend to look pretty in need of help at times). The expat population is close knit and have already included me in gym class, coffee morning, and grocery store expedition offers. I appreciate the hospitality.

Overall, we're off to a good start. I am relying a lot on my Norway experience. When moments are difficult, I can remind myself that it was so hard in Oslo in the beginning as well. We are just at the beginning of this adventure, I know there is so much more to see and learn. Not everyday will be easy. I won't always love it. Sometimes the sacrifice is really glaring. But I also know that there will be moments when I will say "oh, okay God. Now I get why I'm here."  Patience and persistence, trust in Him. That's my mantra. Now, I need to go repeat that a thousand times before I venture out to drive to pick up the boys again. Time to be brave.

Goodbye Norway

I'm really bad at goodbyes. I feel like I can never find the right words or setting or emotion. So it often ends up coming out as an awkward blubbering mess.
This change has proved true to form. We've had our time for goodbyes with friends and school and activities and teachers and I cried through them all. I may or may not have cried in the middle of pizza with my family. It's pathetic.

With all of that checked off the list, mistakenly I thought my tears were under control at this point. Then today, with all of our possessions headed off in a truck that hopefully makes it onto a Malaysia bound ship, we turned over the keys to our house. Spending our last night living out of a hotel room, I realize that I hadn't prepared myself to say goodbye to this place, this country, Norway. It's different this time. We left Texas knowing it was still and always will be home. Our house, our neighborhood, our country remained intact. Leaving Oslo is different because those deep roots aren't so secure. We don't know if we'll be able to come back or when. It feels more permanent.

But then as I've talked to God this afternoon and prayed, I found some truths that are pulling me up. We may be physically leaving Norway, but my experience here has become a part of me that will continue to grow. I am changed. I define myself in a new way. It is not leaving one place for another, but an acceptance of all that I am.
I have learned things from amazing people, visited amazing places, had amazing experiences, and I've been blessed to live this adventure with Micah and my boys. It's been incredible. I take pieces of each of these things and molded together, they have made me who I am. My memories are more than thoughts or photos, they are me. God has laid out this beautiful path and as I'm trusting in Him and brave enough follow, I am finding my plan. I am thankful for each good bye and each tear. “How lucky I am to have something that makes saying goodbye so hard.”

A change of heart

Some of my family members might tell you that I have a history of being bad at change.
At age 6 we were relocating from Missouri and I distinctly remember wrapping myself around a bed post and telling my parents they could NOT make me move. Nevermind the fact that said bed was moving as well. Not the best choice, but that’s where 6 year old emotion gets you.
As an admittedly self-absorbed teenager, I dug my heels in when we moved after I finished high school into the city…almost 30 whole miles away from my life! To be clear, my bedroom did get relegated to the “sun room” which was a non air-conditioned former porch at the back of house. You would have been bitter too.
Micah and I’s biggest conflict in our decision to move to Norway was taking our kids away from home. He (who had never moved at all as a child) claimed it was no big deal. I (who moved 5 times in 10 years growing up) argued that he had no idea what it was like and how hard it was to be new.
So it’s pretty ironic that now, we have chosen to relocate our family yet again to a whole new world. I wanted to continue our adventures abroad. I hoped we would have another opportunity to extend our time.  I looked forward to all the places that have become possibilities. So what’s changed?
I’ve been inspired by our adventures.  We have delved into Norway, taking in as much culture, experiences, people as we could possibly fit in. We’ve explored with excitement all of Europe. We haven’t counted down days or wallowed homesick (at least for long). We’ve lived every minute and I’m proud of that.
I’ve been inspired by my boys. I came across a blog post about third culture kids recently that read “I love that they look at a map and see friends instead of stereotypes.” That’s it. The boys have unknowingly been exposed to so much and they have no idea of any underlying attitudes, fears, or labels that may be related.  They love different – in themselves and in others. They have learned as we’ve traveled and they’ve learned from the kids from all over the world who have become their best friends. Their world is without borders.
I’ve been inspired by my friends. When it feels like I’m a million miles away from home, and believe me those moments do exist, I can rely on the family we’ve found here. These friends are brave and smart and giving. They understand what it’s like to be away from home on Thanksgiving or not understand the language or be waiting with anticipation on your sea shipment to finally arrive. The connection is forever and strong.
I’ve been inspired by God. Just when I got to the point that I was finding my Norwegian groove, God threw me yet another curve ball. It was unexpected and my first reaction was similar to my childhood examples. “Hell no, we won’t go!” But as I relaxed and prayed and really listened, I understood that as much as I try to make it, it’s not my plan. God leads me and I will follow. His world is amazing and beautiful and wonderous and He’s letting me experience it. I am full of praise.
I spend these last few days in Norway grateful for my memories and my growth and my family’ strength. It doesn’t mean that I don’t have many a sleepless night right now filled with anxiety and worries and sadness that goodbyes are coming soon. But they aren’t filled with regret. New adventures await and we are ready to jump in.

Timeout to focus

I’ve been writing a lot these days as part of my master’s program…like “quality collaborative contributions on 5 out of 7 days” plus intensive research papers every 2 weeks and final submissions every 12 weeks. It is consuming. It is exhausting. It is worth it (I tell myself).

But as I sit in the Bekkestua bibliotek (to avoid procrastinating by working at home) trying to write about public health strategies for disease prevalence in Central America, I realize I haven’t REALLY written in a long time. I haven’t had the time to reflect on myself. Okay wait, let’s be honest, I haven’t MADE the time to reflect on myself, my mission, my motivation. I’ve been stuck examining the trees and have been missing the beautiful forest surrounding me.

I’m a juggler. I’ve got a lot of projects and commitments going on right now, as I know a lot of us do. I run from working at the school, to working on my schoolwork, to leading the parent association, to planning medical mission work, to planning travel, to finishing my medical continuing education (you would think my master’s program would cover that but the state of Texas disagrees with you) on top of my priorities of being a wife, a mom, and friend. I’m not complaining here, it’s just that I find these moments when I let all these things in my life take over and I find myself running to keep up. It’s in these moments that I realize I tend to feel overwhelmed and stressed and far from God.

So, today, I’m changing that. I might not be able to change it tomorrow or next week I might find I feel like I’m drowning again, but today I am putting aside all the deadlines and emails and papers and STUFF, and reminding myself of my focus. I'm taking a timeout. So with Nicaragua on my mind, today I choose to remember how grateful I am for my experience and growth there. Here it goes….

My trip to Managua this summer was different. I always find it awesome that no matter how many places I travel and how sure I am of what to expect, God always challenges me and shows me more on each trip.

Our group partnered with three churches in communities in need of help. I was able to hold medical clinics arranged by the local groups for the communities they served. These clinics are absolutely my FAVORITE thing to do in life. Absolutely nothing makes me feel fuller than laughing with the kids and holding hands listening to people. What really struck me here though was how accepted and a part of their community I felt. Some of that was logistics, my clinic was only one of many projects so I was often left to my own accord apart from my American group. But so much of it was the people. They were welcoming, loving, willing to share their homes with me. I was in awe.

The first day was very busy. I saw patients in a concrete shell of a room without electricity or water. After, I headed to the pharmacy on the back of a vespa with the pastor to pick up medications. That night was 4^th of July and the church surprised us at the end of the worship with homemade fireworks and a version of Celine Dion singing God Bless America. I laughed and cried at the same time. What amazing people!

The second clinic was in a different outdoor church structure where the church had invited community families, many of whom were gang members, to be seen. They were sweet, grateful, intelligent, hopeful. Our trips to the toilet consisted of walking down a dirt path through mango trees, past roosters and chained pit bulls to a home in the barrio. We ate together (mmmm, gallo pinto is my favorite!), we watched world cup football, we played. It was a beautiful day.

The final clinic day was spent caring for residents at a senior center. After I finished there, we took a bus (a shelled out van with a young boy yelling destinations out of the window) to another barrio to meet up with the rest of the group. We spent my last evening dancing and singing with the local kids together, making friends for life.

Despite language barriers (better described as my completely fumbling Spanish in which I mistakingly called a friend “gorgeous” for a day instead of “brother” and answered “only at night” when I mistook being asked if I was “married” as “tired”) the connections I made with people I respect and love were strong. It is so humbling for me to spend time with these people. I let go of my selfishness and judgments and find myself. I find myself content. I find myself real. I find myself seeing God clearly.

In all of my chaos, I  still have no idea where my path is leading, but I do know that continuing to step outside of my comfort zone, to force myself to see beyond my bubble, to be brave when I don’t feel like I can,  is to follow God. “Spirit lead me where my trust is without borders, let me walk upon the waters wherever you would call me. Take me deeper than my feet could ever wander, and my faith will be made stronger, in the presence of my Savior.”

Home from the pharmacia. Completely normal, right?? He wanted me to drive....maybe next time

New friends. Miss them all

Clinic smiles

Morning coffee, beautiful country

My sweet friend Matthews. We had lots of giggles and games this trip

This girl. My heart. She's a keeper

One year later

I haven’t posted in a long while – trying to catch up…

So it has been a year now since we left Texas and settled down in Norway. That seems so crazy. In some ways, I feel wide eyed and clueless, like I just arrived but in other ways I feel very comfortable in my home, like we’ve been here forever. Looking back over the past year, so much has changed –  but there are still moments of frustration that I forget that. Every morning on the way to school we do "grateful" when the boys list what they are thankful for. Sometimes, it's ninjas or pizza and sometimes it's mommy or daddy or Texas.  Some days I also need the reminder that I am grateful for this experience and how far I’ve come. So here’s my 2014-one-year-later-I-really-love list, for my review on a regular basis.

1.    I love how my boys are growing. As I write, Barrett is off 4 hours away north on a week long school ski trip. They are cross country skiing about 6 hours every day, snowshoeing, ice climbing, having the time of their lives. But mostly, they are learning independence and responsibility. He has called home twice and sputters out in about 30 seconds how much fun he’s having and that he has to run. I am in awe (sniff, sniff).

2.    I love winter (I can’t even believe I am writing that). In the past 2 weeks we’ve been downhill skiing, cross country skiing, ice skating on a frozen pond, and luging (yes, that’s a real thing and it’s unbelievably fun). As opposed to last year’s survival tactics, this year we are living in and enjoying the snow and outdoors. Yesterday I was standing at the top of the ski mountain looking out and was absolutely stunned at the beauty.

3.    I love the friends I’ve made. Friends that bring you chicken soup when you’re sick, laugh with you, love your kids, work out with you, email things like “I don’t need to practice. I am a natural twerker.” I wouldn’t love this place without them.

4.    I love traveling. Oh, the places you’ll go! You’re off and away!” That’s our new family motto. We are getting to see so much of the world and share it with the boys. They are learning to try new things, be good travelers, enjoy culture and history, be open minded – skills I am so grateful they will use all through life.

5.    I love the slower pace. Crazy frustrating at first, now I’ve learned to love that no one is ever in a hurry. It’s very peaceful and has forced me to slow down and be in the moment. Borrowing a good friend’s phrase “I am practically Norwegian!”

6.    I love going back to school. I have the opportunity to pursue my passion and I can’t explain how amazing it is to be discussing topics like justice in health care, how to help impoverished communities, and sharing kindness to improve the world with classmates from all over the globe. I am soaking it all in and can’t wait to put it to use.

7.    I love Micah. There is nothing better than sharing all of these memories with my best friend. I am so proud of him.

When we landed here a year ago, I was desperate to understand God’s plan for putting us here. I still don’t know exactly where I am headed, but I can see the changes and the growth in the past year. I am following His path and once I finally relaxed and accepted that,

It.

Is.

Amazing.

 I can’t wait to see what’s in store for us this year!