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I Miss This

My wife and I are in Chile, far from home for me, but close to her childhood beginnings. In fact, the reason for relocating was to be near her parents. They have taught me how to be a native. While I personally love exploring this picturesque and diverse country with a rich culture all its own, I miss many events of my own family back home. I am so thankful for cell phones, Instagram, Facebook, and tweets. It is important to stay connected if you live abroad. Many of my readers are in the same boat and have joined my blog followers to share common concerns. Over time, I have become more acclimated, but I always welcome a visit home for a special reason.

I recently flew to the US to spend time with the whole gang assembled for my niece’s birthday party. It was a good opportunity to see everyone all at once. You must be efficient when the visit is short. I didn’t want to be the center of attention, but it happened anyway. I wanted to greet people and not fade into the woodwork. My niece and her friends were frolicking in the backyard above ground pool while I circulated among the adults. I asked the host where he found this pool from, and he told me to check out https://homepoolsplus.com/. They were fine with this separation of interests and we all joined together when dinner was served. Given the focus on swimming, there was an elaborate table of goodies and a barbecue going on the patio. It was an outside feast with a pot luck array of specialties of the family. I certainly miss this food. I grew up with it and can practically taste it when I get nostalgic and remember the smells and sights.

A beautifully-decorated homemade birthday cake was dead center on the long cloth-covered buffet table. It looked yummy and inviting. I had forgotten how much fun kids’ birthday parties can be—singing, blowing out the candles, cutting large pieces and frosting-covered faces of the tots. After my niece and her entourage returned to the pool, my relatives started to ask me a multitude of questions about life in Chile and how my dental practice was going. I was flattered by the interest and was glad I had a few colorful stories to tell. I wanted to give everyone an idea of the locals and how friendly and welcoming they are.

Some wanted to know if I would ever return. This is not a question I could answer. “Ever” is so definite and final. I might well come back some day with my wife. Life is full of change. You chase new opportunities as they arise. Sometimes this leads you to unexpected places. Personally, I am open to a period of time in the US, but it is a decision for a couple together. Meanwhile, I am thrilled to be in South America, a country of vast variety and culture. I relate everything I can about it, hoping to make people want to visit for an extended vacation.

Going a Little More Native

Everyone rides a bike in Chile as few can afford a car like in America. It is an extravagant luxury to be sure so when you see them, you make assumptions about the owners. There is also public transportation, primarily the bus. It will take you most anywhere. I do have a car at present. After all, I have had one for years and years. It seems odd to me to go on foot. It makes much more sense to go by bike and you can get a decent hybrid bike for under $500. Now that’s a savings. Think about the gas and oil expenses for an automobile and all the necessary repairs. With a bike, you are free to roam and it doesn’t cost you much to do so.

I love bikes anyway so that helps me make the decision to sell the car. Even though they are practical, they are also fun and they take you wherever you want in a jiffy. They are easy to house in the garage or backyard unlike a car that takes up a lot of space. Often people end up parking them on the street in front of the house as there is either no garage or it is full. Life isn’t like in the U.S. where you have all kinds of room. You have to make decisions as to what needs proper housing. The lifestyle in Chile is modest and it doesn’t pay to get an expensive house when you don’t have to.

Think about the freedom a bike offers. You see them everywhere on the roads—around the city, going out into the country, and especially the boondocks. You can tote most anything on your bike as most come with a basket in the back. You can stow whatever you need for the day and then some. After all, bikes are the messengers of the country. They deliver goods at short distances upon demand. This is not limited to lunch or dinner like in the U.S. You might order something from a general store and it will arrive within minutes. Personally, I like walking in my neighborhood when I am not riding a bike because you see so much of the life that goes on. That’s what I like about living in a foreign country. I don’t want to be distant from the action and the best way I know to participate is to do your own shopping and errands. I do this as work permits as I am office in my medical office. I try to take time at least one day a week to get out among the people.

I love weekend trips on the bike, my wife at my side. You can roam and rove as you wish. You see lines of bikes on the road seeking the peace and quiet of the countryside. The scenery in Chile is so beautiful and a bike is one way to explore it. I believe in making an adventure out of my new bike. As a result, I know I made the right decision.

Another Minor Adjustment

We moved to Chile for work purposes and also to be near my wife’s family. As such, we are with them a great deal of the time and help out with small projects. Time being precious, we try to be efficient with what we do to make their life more comfortable. For example, my father in law complains that he is cold virtually all the time. Maybe it is that crystal clear air that reaches right into your bones. Rather than listen to the gripes, I decided to take action. It was easy enough to purchase a small but efficient space heater for the living room. It has an automatic shutoff feature for safety and he avows that he is more comfortable. It seems that a minor adjustment in in his life style makes a huge difference for all concerned.

With electrical appliances you have to be somewhat vigilant. One day he left the heater running day and night causing an electric burnout. The heater shut off but we couldn’t get it to start up again. What frustration. The gripes about being cold started up again and reminded me to rapidly get the device fixed. You become dependent on these little niceties in life and it is far easier than starting a fire. The problem was finding someone who knew how to fix the heater. It isn’t a marvel of engineering and should not have been a problem but I searched far and wide for a repairman. You can’t just get anything you want in Chile at the drop of a hat. Modern conveniences are there, but with limitations. If they break down, you just buy a new one. I wasn’t willing to resort to that and give up. After some digging, I did find a repair shop that seemed to know what they were doing although it looked like they specialized in small kitchen appliances. I dutifully turned over the heater, begging for help. I want a happy in law. Meanwhile I found a nice, cozy blanket in my storage trunk that I thought he might like. He liked it so much he stopped asked about the heater. In about two weeks, it did return stronger than ever but I did not get the blanket back. Now I was the one cold all the time. You have to be tough to live in a foreign country and learn to make do.

Now everyone I know wants a heater having seen the one I bought my father in law. Plug it in an instant warmth. As soon as the sun sets, it goes into action. You have to have one large enough for your space or you need more than one for the living room and bedroom. The kitchen stove takes care of that room. You can keep it perpetually warm. It seems like we are always in a fight against the elements. You learn to become practical and enterprising.

A Much Deserved Break

I work hard and there isn’t much time for play. You know when you get to the point for a much deserved break. I wish I could take a hike in the beautiful countryside or visit another city or village. After months on the job, my wife and I decide a trip to the coast is long overdue so we can spend some free time relaxing together on the beach. And they are glorious. Some beaches are simply more spectacular than others. We looked into the matter and selected a place we knew would be ideal. We counted the days until our departure. We had people cover for us in terms of our responsibilities so we felt unencumbered by the trip. We packed up our gear, trying to limiting it to the essentials so we would not have to haul too much stuff. We are the kind of people who almost like the rudiments of camping rather than having to unpack multiple bags. Who needs more than a few necessities of life. Beach gear is pretty basic: a towel or two, bathing suits, and a change of sun wear. Flip flops replace shoes and shorts pretty much are the expected attire.

We thought we had planned our packing well and got to our destination with all bags intact. Nothing was too heavy or cumbersome. We couldn’t wait for our first day on the sand under the light of the blazing sun. The sky was an intense blue with no clouds to mar its perfection. We laid down our towels, ran to the water, and went for a swim. After a few hours, we realized that some degree of comfort was lacking. We didn’t have any of our portable beach chairs with us, even the basic wooden and cloth fold up kind. Not wanted to lay my head so close to the sand, I really craved the ease of a chair to support my back. I could then be upright and watch all the goings on at the resort. I wandered about a bit looking for a source of these chairs. Surely the resort had a rental. I soon spied one close to a nearby hotel where the guests expected more than a few amenities. I quickly asked for two chairs that I could rent day by day. My wife was thrilled when I returned chairs in hand. She had the same idea about avoiding lying flat on the hot sand. She wanted to be able to read sitting up, take photos with her digital camera, and perhaps have a drink or a snack. I think we were not well-equipped to continue to enjoy our day.

I don’t know why we hadn’t thought about our own portable beach chairs to bring them with us. There was plenty of room in the car. If we had, we wouldn’t have faced the dilemma of the rental service running out of chairs. We had to wait a few hours to acquire the two we needed. It didn’t spoil the wonderful time in the sun, but it was a slight hitch in our plans.

Chilean Air

I relocated to Chile with my wife for some very good reasons. As I am an oral and maxillofacial surgeon, it is one place where I am seriously needed. There aren’t many doctors in this field who elect to give up their lives at home and go. Plus it is where my wife’s family resides. It is hard work, but very much worth it because I love giving people back their smile after traumatic events or devastating disease. A cleft palate is a disfiguring thing that is all too common in outlying areas where treatment is not readily at hand. There is so much to be done as the people are not in a position to provide surgical procedures for themselves financially. You no doubt have seen the photos of the sad cases of children needing immediate attention. So I ply my trade and someday perhaps I will move on. Maybe not because of the terrible air quality back home. It is so pure and crystal clear in Chile. When you breathe the air you feel a purification of your lungs. You want to be outside a good part of the time to take advantage. I have become adjusted to a new standard and I would need an air purifier at home virtually round the clock if I went back. Moving to Chile has probably extended my life with the clean air. I was dependent on an air purifier for my asthma but felt it was insufficient to battle the air quality I was subjected to.

An air purifier can help you out if you have allergies, asthma, and any respiratory ailments. They are marvelous machines that take up little space but pack a medical wallop. I didn’t even know about them for the longest time as they are not a fixture in every home in the U.S. Some areas experience better air quality than others so you have to know the readings if this is a health issue for you. If it is the filters on these purifiers can eliminate dust, pollen, spores, bacteria, and all kinds of allergens and pollutants of which there are ample where I used to live. When you know there are heavenly places on earth like Chile, it makes you ready to go and leave the air purifier behind. Instead, you have Mother Nature’s natural gift to the region. You have to go to Switzerland or the French Alps perhaps to experience the same degree of air cleanliness. I love the beauty of the country of Chile in any case, so the air quality is another added attraction. Living in the mountains as many do you can avail yourself of something sublime. You take in a few deep breaths and they don’t resemble anything you remember back home. The combination of air, scenic beauty, rich folk culture, and unique lifestyle are all I need to call this my second home. If you haven’t visited, you have a real treat in store. Pictures can’t do it justice. Get on a plane, my friend, and join me in paradise.

Nearly Ready to Open the Doors

Opening my own practice is probably the only good thing about this whole situation. My father-in-law had a setback the other day and got disoriented, then violent. My wife called me at the office in tears, begging me to come home and help. Since I don’t have any patients yet, it wasn’t a problem. But I am concerned about what happens if I am in the middle of a procedure. Some surgeries take a significant amount of time, and once a patient has anesthesia, I cannot just get called away.

I talked to Marco, my mother-in-law’s next door neighbor. He has been their neighbor for years and knows both my mother and father in law fairly well. He’s also familiar with the situation. He is a fairly large and strong guy. I talked to him about the situation. He already knew a little of what has been happening. Since he only works part time, he offered to be of service if things get out of hand again. This was a tremendous weight off my shoulders. The plan is for me to schedule surgeries only on the days that he is home, and the ladies know to go to him on those days. We made a large calendar of the dates so everyone knows what they are and we gave Marco a copy. Maybe I am being optimistic, working around non-existent patients and their unscheduled procedures, but we are in this for the long haul. I want to have a plan in place so that I don’t ever have to worry about what is going on at the house.

The office is the only place that I feel like my old self. I have my staff ready to go. Everyone starts next week. I have all the furniture in and installed. All the consultations and follow ups will be done here, and the actual procedures at a surgery just a bit down the street. Tamara made up some flyers and had them printed—she’s always been better than me at graphic design type stuff—and also ordered me some really nice business cards.

It’s a far cry from the state-of-the-art facility I worked at before but is slowly starting to look like a fully functioning and legitimate doctor’s office. It is hard not to be excited about that. My own office. The appointment calendar is a little bare at the moment, but we do have some appointments scheduled, so there’s something. I want to be busy but not too busy, if that makes sense. I want to be able to help out the family—that’s why I’m here, after all—in both a monetary and physical sense. Right now I am skewing a little too far to the presence side, as I’m home a little too much and stepping on toes, but I don’t want to get so busy here I neglect my duties as a husband and caregiver. I guess it is all about balance. Hopefully, it won’t be too hard to find the right ratio.

Why Relocate?

When my wife Tamara first approached me about moving to her native Chile, I have to admit, I thought she was crazy. It is a gorgeous place that I love visiting with her, and we always have a wonderful time, but moving there? It seemed like such a bizarre suggestion that I made her repeat it. All I could think of was the million reasons why it was a bad idea. I was making headway at the large practice where I was working, she loved her job, and we had bought our house only the year before. I thought that our lives were headed in the right direction and honestly I was pretty content. The week before, she had been talking about starting a family. My second thought was that if I just waited her out, she might drop the whole thing, and I wouldn’t have to say no.

Then she told me that her father was ill, showing signs of dementia, and she was concerned that her mother wouldn’t be able to take care of him properly. As the only child, this duty then fell to Tamara, and she rightly assessed that this was a hands-on situation. She could go there and I could stay here, or I could relocate with her and we could give it a try. It was likely going to be a long battle and she really didn’t want to have to do it alone.

I thought about it, and I realized I wouldn’t want to do it alone, either. Nor did I want her to. So we gave notice at our jobs. The head surgeon at my clinic started to give me a hard time but was very sad to hear about my father-in-law. His own father has Alzheimer’s, and agreed that we were doing the right thing by supporting Tamara’s family. He warned me that it might be a long and ugly fight, and that at some point, we would probably need to hire a home nurse or something, that it would be a hard decision for us but to remember

Once that was done, we started packing up the house. I couldn’t believe how much we had after only a year there. At first we were going to rent it out and hire a property management company to deal with everything but a prospective tenant offered to buy it instead, for more than we paid. He even wanted the furniture. It was such a weight off our shoulders, and not something we believed was a possibility. It was yet another affirmation that what we were doing was the right thing.

Our belongings are packed, our papers are in order, and in just a few days, we’ll be moving in with Tamara’s parents….

Wish me luck. I’m going to need it.

Hiring a New Staff

Hiring a New Staff

Now that I have an office location secured, on to the next step: hiring my own staff. I’ve never done it before but went into the process thinking it would be straightforward and easy. The reality was much different. All I have to say is that it is a good thing that I am a decent Spanish speaker. Nobody would mistake me for a local by any means, but I was able to conduct interviews without looking like an idiot the last few days. Whenever I had trouble, I would say something in English and often the interviewee would know what I meant, and the communication problem was solved.

That helped significantly, and the forward momentum felt really good.

I asked Tamara if she would want to work at the office, at least at first, to help it get off the ground and she told me no. She wants me to use the extra money we got from the sale of our house and just hire everyone so that she never has to feel like she isn’t pulling her weight at the office and with her dad. She said she did not want to be caught between working for and supporting me and what we’re actually here to do: lift some of the burden off her mother. Which, in a way, I am doing also—I certainly hope to be able to contribute to the household financially once everything is up and running and I get some patients.

I have a receptionist now who has worked in offices before, appeared to have a pleasant phone manner and can type rather quickly. She also seemed to understand a decent amount about the billing process here, which is good because I have been reading and studying about it at night and it hurts my head. Of course, I never really had to deal with that in the U.S. except as a patient; we had a rather large billing department that handled the mountains of paperwork that the American healthcare system requires. I’ve been assured that the process is actually easier here once you understand it, but I don’t and so it was a relief to find someone who not only does but is willing to show me as we go. Thank goodness for Constanza.

I had reached out to another surgeon when I got here; he works at an area hospital. He set up a meeting between me and a dentist that he knew, and I asked her if she’d like to come into the practice as well. She is still mulling it over, which I can understand. She hasn’t been very happy at her current place of employment, which the surgeon knew and was the reason he recommended her in the first place. I am hoping that one of these days, something will happen at her office and she’ll realize she doesn’t have to put up with it anymore. Then she’ll call me and tell me she’s in.

Fingers crossed.

Recruitment and Advertising

I wanted to get the word out about the fact that I was looking to hire people for my new office. One of the major problems I have with being in a place I’m not very familiar with is not knowing what to do in these types of situations. My mother in law suggested help wanted flyers, and Tamara and I thought it was a great idea. We made them up ourselves and put them up everywhere we could think of. At the area hospital, at every bus stop in I think a five-mile radius of the clinic, and a few other places (I am not sure exactly where, because on the second day, Tamara and her mother were muttering to themselves and snatching flyers left and right; they disappeared with fistfuls and a heavy duty staple gun). I spent a pleasant afternoon with my father in law where we watched a very exciting football match, and the ladies came home sans flyers. It seemed to do the trick, because I had several candidates to choose from for the positions I needed to fill. It was a long couple of days, true, but I couldn’t believe how easy it was. I didn’t think we would find people so fast.

Once I had my team selected, we went back around to remove the flyers. I didn’t want anyone to falsely think that positions were still open; that seemed unnecessarily cruel. The flyers we affixed to concrete and metal poles with tape apparently were not very secure and nearly all had already disappeared. Made the job easier for us, I guess. The ones on wood and bulletin boards, however, were all still there. I have to say, some of them were covered in graffiti but those heavy duty staplers really helped to hold the posters on there. Tamara and I ripped them down the best we could, careful not to damage anyone else’s signs. Some I was able to use a pair of her father’s pliers to retrieve the staples but with others, we actually ended up leaving the staples behind. Too difficult to get them off. The stapler really did its job and those things weren’t going anywhere!

Because the first flyer campaign was so successful, Tamara whipped up another one announcing the grand opening a week and a half later. It has been good exercise and a surprisingly pleasant way to see the neighborhood while putting them up. It took us two days to distribute them all, as people noticed us tacking up the flyers and had questions. Again, that heavy duty stapler was a lifesaver! Just two hits with that thing and the flyers were as good as painted on.

My legs are tired, my hand is a little sore, but I am really happy. I feel like I am moving in a good direction here and I can’t help but be excited about it. I can’t wait to get back to improving the lives of my patients and doing what I was trained to do.

Maid, I’m Not

Here is an embarrassing confession: I don’t think I’ve vacuumed since I was a teenager. And it was probably early teens at that. My family had a housekeeper and I was usually too busy studying to notice if the carpet ever needed cleaning. Heck, I don’t usually notice it now. Just ask Tamara! But here at my in laws, I am required to pitch in whenever and wherever I can. My wife was driving her dad to a doctor’s appointment, and he wanted my mother in law to come as well, so I was going to be home alone for the first time since we’d moved here. Before they walked out, my mother in law asked me if I wouldn’t mind cleaning a little.

Really? That’s a bit like asking me if I’d cook dinner. Unless you want microwavable containers of mac and cheese or ramen noodles, I am NOT your guy. It took me 20 minutes to even find the vacuum (for future reference, it is in the hall closet. When I told Tamara this later, she looked at me like I had two heads. Apparently that is the FIRST place you are supposed to look, because if a house has a hall closet, chances are there are coats, various other types of weather gear and vacuums. This is a thing, a thing that I was blissfully unaware until now. Anyway, once I found the super-secret-but-most-common hiding place ever for a vacuum, I brought it over to the carpet.

Then I couldn’t find the on switch. I can perform complicated, hours long surgeries. I have extensive medical training. Yet, for the life of me, I could not figure out how to get the thing to turn on. When I finally saw it, I have no idea how it was so hard to find, and boy did I feel dumb. I got the vacuum going finally and vacuumed every place I could think of. When I went to dump the bin out, I could not believe the amount of dust and hair and who-knows-what was in there. The clearly have the best vacuum cleaner because it works pretty well. I didn’t think the house looked messy or dirty before, but after seeing the fresh vacuum tracks on the floor, I realized what a huge improvement it made. It made me feel a little bad that I never vacuumed the house that Tamara and I lived in; honestly, I wouldn’t have been able to find the vacuum even if she’d asked me to, but I made a promise to myself that if we ever had our own place again, I’d pay more attention to my surroundings and maybe pitch in a little more. Vacuuming the floor inspired me to see what else I could do. I opened a window to let in some fresh air, and then I went down the street and bought the ladies some fresh flowers. I put them in a pitcher I found and put that on the table. The house looked a lot better by the time everyone got home, and they all seemed incredibly appreciative of my hard work.

First Patients

Things were super slow the first two weeks my doors were open. It was hard not to take it personally and remind myself that I just started, that being slow right now did not fortell the future, it did not mean the practice is doomed to fail. It is difficult to remain positive when things are looking so bleak at home. I try to put everything aside when I walk in the doors here but I think it would be easier if I actually had a steady stream of patients. During the first week, it was not uncommon for me to let everyone go early. I would just sit at the desk and stare at the empty appointment calendar, waiting for the phone to ring.

Luckily, during the second week, it did start ringing and I’ve been able to start doing what I do best: helping bring their smile back to people. It has been a huge relief to get back into the swing of things.

Today, I completed my first surgical procedure here in Chile. There was a young man who had been hit by a baseball that had bounced up from the ground and caught him under the eye. He didn’t go to the doctor at first, which I cannot believe because it must have been excruciating, but finally decided to see his regular doctor, who recommended he come to me. I knew it would pay off visiting all the primary care doctors in the area. The procedure took several hours but I am very happy with the results.

I have also seen a little girl with a cleft palate and lip, who will be coming in for to have what will be the first of several surgeries next week. Based on all of her images, I do not forsee too many problems and I am confident that things will improve greatly for her each time. I do not anticipate too many follow up surgeries once the cleft issues have been corrected.

The dental side of the office has been steadily increasing in pace as well. That has been nice. My partner likes it too. Any surgical procedures necessary are handled by me, which works out well. I will be extracting some wisdom teeth early next week before they erupt and misalign everything else in the patient’s mouth. Her jaw’s not all that big, and it would end up being a huge issue.

It is peculiar having everyone pay up front, though. I mean, it makes sense, but it isn’t how I’m used to doing things. Constanza is excellent at the front desk and I am very grateful that she’s on my side. I have seen her be firm with patients and although I don’t always understand everything they say, I know she is always trying to do right by me and the office.

So things here, at least, are looking up. It’s really nice to feel like I am helping people again.

Prepping the Office

The people who had this space before me painted it a dreary grey color, and we talked with the owner about repainting it. He readily agreed as long as I paint it white before I leave. I thought about arguing that the previous tenant seemed to have no provision in his lease but Tamara shook her head in warning at me. There wasn’t really anything else I could do because the office location was hands down the best one we’d found and the price was very reasonable. So I just smiled and nodded and said that was fine.

It isn’t a huge office, but…there is a lot of wall space. I figured it would take a week, or at least a very costly professional, to get it all done. But I was talking to my father-in-law about it during one of his really good periods and he mentioned that he has an air compressor and an air paint gun in a shed in the yard. I checked them out and sure enough, everything was still operational. I couldn’t believe it. The air compressor is electric and didn’t even look all that old. It made me sad to think that my father in law bought this, taking what looked like excellent care of the compressor and tools under the assumption that by doing so he would be able to use it for years to come. And now there are days where he doesn’t even remember these things are out there in the yard, and days that are worse even than that.

I went with Tamara to the store to pick out paint, mostly for her translating skills. She talked to the owner and explained to him what we were going to do with the paint, and he was able to give us instructions on how to thin it, how to hook everything up, and how to clean everything once we were done. He recommended a few colors and then we chose one—it is a very light blue, almost a white. It should be very easy to paint over, and because it has the primer mixed in already, it would cover that ghastly institutional grey that was already there.

Tamara helped me prep the office. Since there is no furniture, this didn’t take long. Drop cloths on the floors, taping around windows and trim. We opened a few windows to allow the paint fumes to disperse and then Tamara went back home to help her mother with dinner. I haven’t been around too many power tools, but I had listened to the store owner, and again when Tamara explained it, so I felt like I had things pretty much under control. I prepped the paint and fired up the compressor. There was a bit of a learning curve to get everything to go on evenly but once I figured it all out, the walls were done quite quickly. I couldn’t believe how much time the air tools saved me. It took me the better part of two days, not a whole week.

I got everything cleaned up, brought it all home, and put it back where my father in law had stored it. I hope that one day he remembers it is all there and uses it for something.

I Love Smiles

I Love Smiles

We’ve been here for a little bit and the dust has settled. My father-in-law is doing OK. He remembers me most of the time, but I’m usually the first one he loses recollection of, which makes sense. We are all choosing to focus on the good days and hold on to those for now.

I am working on securing a location to open up my own practice—it just seemed like a good choice after leaving the old surgery. It is like a promotion this way, or at least that’s what I am telling myself. The pay isn’t going to be as good, especially not at the beginning, but at least the cost of living won’t be so bad. And there’s no mortgage to speak of, so that’s something.

We are trying to treat this part of the trip like a weird, prolonged vacation—going out and sightseeing, trying to enjoy everything we can. But I’ve missed working. I love my job, and I know that isn’t something that everyone gets to say. So being away from that has been difficult. As selfish as it is to say, that’s probably the hardest thing for me about being here.

I like helping people, that’s all there is to it. When a parent comes to me with a child who has a cleft palate and I know that I can make everything better, that is an awesome feeling. Seeing that child smile—actually smile—for the first time is the greatest sight ever.

It’s the same no matter what the cause for me—accidents, injuries, birth defects, disease. I don’t care if you got punched in the jaw or if you dipped so much that your jaw basically rotted away. I don’t look at the why of it, that isn’t my job. My job is the how. How are we going to fix it, how are we going to get you back to you? How people look does have a significant impact on how they feel about themselves. Especially their face. It is how others identify you, and how you identify yourself. When the person staring back at you from the mirror no longer is the person you picture in your head, it can be hard to deal with.

And I can make it better. I can’t always get you back to you 100% of the way, but sometimes I get pretty darn close. It has been so rewarding for me, and to not have that right now has been difficult. I’m in a strange country where I’m not completely fluent in the language, away from my own family, and I really struggle with that. I am really glad that I am moving forward with opening my own surgery. I need to be able to put my skills to good use, I need to feel like I can improve life for someone. As much help as we are providing to my mother-in-law, we’re not doing any good for Tamara’s dad. What he has is something that in all my years of schooling, I have learned only one thing: that is it only going to get worse.