The starting point (the first of seven daily entries)

            I am 43. Up until this point, my life has gone pretty much according to script. I grew up Gainesville, Florida, a small college town. I did my undergraduate work at Duke University in Durham, North Carolina where I was “pre-med” like the majority of students, although my major was in history. I graduated from medical school at the University of South Florida in Tampa in 1993, and I was accepted into Internal Medicine residency in Portland, OR at Oregon Health Sciences University. Both of my grandfathers were doctors, my dad is a doctor, I have an uncle who is a doctor, and several doctor cousins.  Suffice to say, I was not breaking any new ground. Family conversations were often spiked with medical doctrine.

            It was during my 3 years of residency and 1 year of chief residency in Portland that I was first confronted with “alternative medicine” as a plausible therapeutic option. The “left coasters” as we easterners call California, Oregon, and Washington inhabitants seemed to have more interest in alternatives to standard “western” practices. In the internal medicine clinic and on the general hospital wards, I was forced to consider the potential interactions and side-effects of non-prescription alternative meds. Ginko, ginseng, saw palmetto, and St. John’s wart were all the rage. Not to mention the Chinese herbal remedies brought by our Asian patients of which the ingredients largely went undiscovered.

            My schooling in “non-western” medicine continued during an 8-month stint in Ghana, Africa. How and why did I end up in Ghana, you might ask? I have had a lifelong fascination with Africa since watching, as a child, Mutual of Omaha’s Wild Kingdom hosted by Marlin Perkins. This interest was further sparked when learning about cool tropical diseases in residency. I spent my spare hours during chief residency plotting a way to spend some time in Africa prior to starting a real job. Being geographically challenged, like many Americans, while trying to arrange a position in Uganda I accidentally signed up for a volunteer position in Ghana. As you may know, Uganda is situated in Eastern Africa near the famed wild life reserves often seen on Wild Kingdom, while Ghana is far to the west.  Western Africa is most noted for the crush of humanity rather than the call of the wildebeest!  Fortunately, my geographical incompetence led to one of the best experiences of my life.

            I arranged a posting as a volunteer doctor in Pramkese. This is a small village of a few thousand persons in the south central region of Ghana, a temperate, previously forested region, just 6 degrees off the equator. After convincing my fiancée Beth to join me on the adventure, I began planning in earnest. I assembled my own library of medical texts on tropical medicine, pediatrics, obstetrics, and basic surgical techniques. I wanted to be ready for anything.

            An interesting aside… my fiancée, with whom I was “living in sin” according to her North Carolina relatives, sprung a zinger on me one evening in the weeks leading up to our departure. Just as I was pulling up the covers to my bed and snuggling into my pillow, Beth tapped me on the shoulder and produced some legal appearing documents. She and her mother had decided that it would be best if we were legally married prior to going to Africa in case any mishaps were to occur. In a moment of weakness, I agreed to what sounded like rational judgment. Of course, I woke up in the early morning covered with a cold sweat fearful that I may have signed away my bachelorhood. Who knows how my opinion of my fiancée would change while living in a remote village with no electricity? I begged out of the agreement the next morning, managing to keep my independence intact, much to the chagrin of my future mother-in-law.

            My preparations continued in anticipation of the big day. I learned how to prepare my own microscope slides to diagnose malaria. I beefed up my tropical medicine knowledge. My dad even gave me last second instructions on how to perform an emergent cesarean section! (Basically, throw some betadine on the mother’s abdomen, cut with scalpel, extract baby, and call for help).

[Stay tuned… tomorrow I am introduced to traditional Ghanaian medicine]