Tuesday, September 9, 2008

Culture Shock

Today was our first day of clinical back in the United States. As I walked to HUP in the morning, I couldn't help but think of Botswana. I thought about how I won't get to walk home in clogs covered in village dust anymore and how I had to say goodbye to a culture where there didn't seem to be such a thing as being late. There will be no more lengthy tea and lunch breaks or nurses that give inspirational pep talks about loving others to halls filled with waiting patients. We also won't have to turn patients away because we've already used our four speculums for the day or feel the pit in our stomachs when we ask about a patient's nutrition and they look at us with blank stares that say "I don't have any food".

It's already been one week since we've returned from Botswana and needless to say, some of us are experiencing quite a bit of culture shock. Life in Philly seems more-or-less normal, but we've come back forever changed. It's hard when you're bursting with stories to tell, but most people just want to change subjects after you said your trip was good. It saddens me that I can't speak in Setswana anymore or say hi to everyone I pass on the street without receiving strange looks. It's also hard to confront the affluence of American society. We've seen such poverty and such wealth in such a short period of time. Princess Marina is probably the best hospital in all of Botswana and HUP has recently reached top 10 in the US, but the disparity between the two is huge. At HUP we have negative pressure rooms instead of open windows, we don't have to use gloves sparingly, and we don't run out of drugs. Patients don't sleep on mats on the ground and we don't have 30:1 nurse to patient ratios (that definitely wouldn't make magnet status!). Part of me wants to respond to all of this by shaking someone silly and yelling, "Stop complaining! You don't realize just how much you have! There are more important things in life!" Another part of me wants to shut out everything I saw in Botswana and go back to life as it was before we left. I suppose the trick is to find a healthy balance. I never want to forget the lessons I learned in Botswana, but I also don't want to shut out American culture so much that I can't share what I've learned and affect it. I don't know how to do this yet, but I guess this is the next adventure and challenge.