fearfully and wonderfully made

A lot has happened in the past couple of days! I hardly know where to begin.

I suppose I can start off by sharing about the Shilin Night mMarket. This was QUITE the experience. We were told to keep our belongings close, stay in small groups, and prepare for a crowded place where thieves are rampant. Perhaps I am too naive but there wasn't a moment where I felt frightened. As a matter of fact, I have felt safe throughout this entire trip. Even the other night when a group of us got lost. I suppose I just look at times like these as adventures. Getting lost and finding our way on our own was a part of our adventure. Back to the market story...the Shilin Night Market is famous and we quickly found out why. We took the MRT from Mingde Station to Shilin Station and before we even walked out of the train station we could see that the streets and sidewalks were jam packed full of people. First we crossed to a sort of restaurant section, covered with a pseudo roof under which dozens upon dozens of small restaurants were set up. Food is prepared right out in the open. Most stands did not have seating. Every few feet, the scent of the air changed. Talk about sensory overload. I found something particularly interesting during this time...as we walked by one stand, Julie, my nurse preceptor from the first day pointed out a stand and explained they were preparing a type of Chinese medicine. She said "Yuck! It smells like medicine". But I LOVED the smell. Clearly, all humans associate certain scents with different things. What smelled like gross medicine to her was a whole new smell to me that I found beautiful. After quickly walking through the rows and rows of chicken skewers, Chinese jell-o, and starfruit, we came out to be greeted with the most gigantic piece of fried chicken and a milk tea. The chicken, although I could have never finished it, was delicious...it was the famous Two Peck chicken that we had tried a couple days prior, but in different form. As we were standing enjoying our snacks, two groups of teenage girls approached us and asked for a picture with me. I am not entirely sure who they thought I was but it was sweet how shy they were. Julie told me I should start charging money for my photograph and autograph. A large group of nurses (and their families) joined us on our jaunt so as to help us barter and, most importantly, to keep any of us from getting lost. Alicia, Laura, and I were joined by my buddy Julie; Sammy, one of the head nurses, and her husband and two young sons; and finally, McDreamy, as we so lovingly named him. You see, this cardiologist in his late twenties is the youngest Assisting physician in the hospital and Julie explained to us that all the nurses at Cheng Hsin are in love with him. He was the doctor that explained the catheterization on the new machine to me my first day in the hospital. Julie teased me the whole time saying that the only reason he came was because he thought I was cute. But that is neither here nor there. There is no possible way to explain the Night Market. One has to experience it for themselves. Essentially, it is ally after intersecting ally of tiny shop after tiny shop. None of the stores have doors. The entrances are as wide as the stores themself and people walk in and out of this busy place with ease. McDreamy told us that if you come during the day, it is almost completely abandoned. Most of the stores were filled with clothing, shoes, or jewelry. I bought an adorable pair of flats for less than 12 American dollars and then Julie convinced McDreamy to buy each of us a scarf. Our guides explained that every night market begins with a temple. Down one of the allies we found a small Buddhist Temple and we were told that once a temple is built, people begin selling food around the temple, and it eventually spreads like wildfire until, a few decades later, it becomes what we saw the other night. After a couple hours of walking we met at Shilin Station again to take the train back home. We arrived back at the dorms after 9pm. It was my turn to share for devotions and, although slightly underprepared, it went alright.

On Thursday and Friday I moved over to the Medical Intensive Care Unit which is on the same floor as the Surgical Intensive Care Unit where I had spent my two prior days. Chou, my nurse, was amazing. My patient was a 79-year-old Chinese man who came into the hospital about 3 months ago because of a pressure sore he had developed on his coccyx (tailbone). Shortly after admission, he developed aspiration pneumonia. He had to be placed on a mechanical ventilator and was transferred to the ICU as he worsened. He also has Type 2 Diabetes, chronic renal failure, hypertension, and a slew of other conditions. Chou explained to me that his EKG has twice shown ventricular tachycardia, resulting in her having to perform CPR and defibrillation...yes, I said TWICE. I was glad it didn't occur while I was there. Although he could not communicate, he nodded slightly when Chou asked permission for me to be there and he slowly reached out his hand to hold my own. I was able to do a lot with Chou that I had not had the opportunity to do in other settings. She explained everything she did and why, making my days there amazing learning experiences.

Friday morning, upon arrival to the hospital at 8am, we were told that a heart at the Veteran's Hospital in Taipei had just become available and that at about 10am we would be able to watch a heart transplant. I spent the first 2 hours with Chou on the MICU and then eagerly met my colleagues to change into scrubs and enter the OR. The Cardiology department now has a brand new, state of the art, gorgeous niche of the hospital with several operating rooms. So new, in fact, that they just opened on Monday! When we first arrived, they were prepping the patient, so we went next door where another cardiac surgeon was performing a Coronary Artery Bypass Graft (CABG). While the physician's assistant was harvesting the patient's vein that the doctor had just removed, he busted out the whiteboard to explain to us the details of a CABG. He then told us what would occur during the transplant and then calmly excused himself, explaining that he needed to complete his surgery. It was surreal. We were then divided into a couple groups and were able to move between operating rooms. First, I watched the beginning of the heart transplant. Three surgeons and one nurse stood over the patient as they opened his chest wall and hooked him up to the bypass machine. As I stood and watched I could not help but think how gorgeous the blood flowing out of his body, through the machine, and back in was. I think God likes the color red. Although it was one of the smaller rooms, at one point there were over 15 people in the OR at once. I then moved over to stand on a stool above the head of the bed of the patient receiving the CABG. The doctor, again, explained as he went. To sew on the vein, he used the smallest suture I have ever seen. It was one of the most delicate, complex, and beautiful things I have ever experienced. The OR nurse preceptor grabbed a few of us again and brought us into the angiography room. They had just received the new heart and needed to see how well it functioned before they transplanted it. An angiogram utilizes x-ray to test the patency of the blood vessels and chambers of the heart. The x-ray picks up short video clips as a contrast medium is injected into the heart. Although the donor was older and a smoker, it was a beautiful, healthy heart. In the time it took for us to remove our led vests, a doctor had returned to the angiography room with the old heart. The patient needing the transplant had diabetic cardiomyopathy so his old heart was about 3 times the size of his new one. We all put on gloves and handled his still-warm organ. Even more wild than the fact that it was still warm, was the fact that, although it was no longer in his body, electrical impulses were still being transmitted. In essence, his heart would still occasionally attempt to beat. It moved like it had a mind of it's own. Wild! We were then all invited to return to the operating room where the transplant was occurring and remained there until almost 3pm. We watched as they attached valves, arteries, veins, and nodes; shocked the heart; and, quite violently, shook the patient to remove air from his heart. One of the most amazing things that I learned from this procedure was how they get the heart to stop and start. After removed from the deceased patient, they insert a cardioplegic solution; essentially, freezing cold potassium. To get the heart to start beating again, it takes one simple thing...blood. Yes, just plain old blood and a heart will start pumping again all on it's own. How amazing!!! We truly are wonderfully made creatures.

After the procedure we all returned to the dorms to change for yet another amazing opportunity. We had a 4 o'clock appointment with the Ambassador of Nicaragua, you see. A day before, my classmate Laura was working in the Emergency Department when he arrived after injuring his knee. He explained to us that he immediately spotted her blonde hair and was thrilled to see an American nurse in Taiwan where he has been living for over 2 years. He and Laura chatted in the ER and he gave her his email address. She emailed him that night and he invited us to the embassy the following day. William Tapia is an adorable man in his 60s. Quite the engaging and charming fellow, he speaks 6 languages, including Chinese, Japanese, Italian, French, Spanish, and English. We were offered Nicaraguan coffee, cookies, and good conversation. At the end of our time with him, he offered each of us a packet of achievements of the country in the past few years (which he insisted was not propaganda), 2 brochures regarding travels to his beautiful country, and a square crystal for each of us engraved internally with the name and seal of the country.

Back at the dorms we were able to do laundry, clean, and even watch a movie! During devotions, we reflected back on our day and were all dumbfounded by what we had seen and done. We have been given opportunity after unbelievable opportunity. It's baffling. I don't think any of us have been able to fully grasp the magnitude of what has gone on in the short week since we have been here.

It is Saturday here and Lunar New Year's Eve!! Year of the TIGER! At 4pm, we will divide into groups of two to join various families for a New Year celebration in their homes. Sonya and I will be going to Dr. Lai's home. Dr. Lai is the Chief of the Neurology Department. Yes, this will be slightly intimidating but I do not doubt that their hospitality will make us feel welcome and I am sure our time will be wonderful. Our professors insisted they have us home by 9pm because we have to work in the morning. Nothing is open on New Year's Day and most nurses have the day off but we will be on duty in exchange for having Monday off. All I know is I am excited to be getting my red envelope. If you do not know, Chinese New Year is comparable to Christmas for Americans and elder people administer red envelopes to youngsters, such as ourselves. These red envelopes contain money :) I think it is a pretty smart tradition.

I apologize that this was so jumbled and disorganized. There is so much I want to say but my mind can't quite keep up. I know I am not doing my experiences or my emotions justice when attempting to type them out, but I am doing my very best.

I posted some photos on facebook last night but my computer kept shutting off as I was attempting to upload the 2nd album. I'll try to ad more...hope you enjoy. My computer is still having issues, unfortunately, so keep it in your prayers :) On that note, I need to retrieve my last load of laundry from the dryer.