Nicaragua travel report - Day 2

The 2nd day we arranged for a guided kayak trip of the Isletas de Granada. Our tour guide was an Austrian expat who was named Fernando or Ferdinand or perhaps both, just in different countries. Anyway, we started our day with a hearty nicaraguan breakfast at a nice little cafe that would soon be our favorite breakfast place:



I picked the traditional Nicaraguan breakfast of huevos rancheros, let me tell you it was the best huevos rancheros I've ever had:


My mates picked various things, but the standout was the bacon and also this pineapple pancake with real pineapple bits built in, they were really good pancakes with a combination of a crisp surface and sweet fluffy insides:


They also had great coffee there, it was strong and was the best cup o joe I've ever had! We proceeded to the isletas, passing through the crowded beaches (it was a Sunday) of Granada. Our tour guide says the favorite past time of nicaraguense is to go to camp out at the beach over the weekend and have lots of sex, I don't doubt it!

On to the Isletas!



The isletas are basically small islands, some of them get completely submerged in the wet season while others are large enough to support houses and small communities. There was an isleta with a house built by two gay men from New York City:



We took a break on one of the isletas:


...where two of our mighty explorers professed their undying love for each other:


...over fresh coconut juice:



And our fearless misunderstood/sleazy? austrian guide:


We would save these coconut meat for some monkey feeding/drama later on:


The story is that, on a nearby isleta, many moons ago, some ingenious person took 6 or so monkeys to this isleta and let them loose. The isleta is the size of a football field, maybe smaller, surrounded by water and the monkeys can't swim. So they're pretty much trapped on the isleta. Thus is borned a tourist attraction. The monkeys survived all this time on food given by tourists who go by on tour boats. Tourists like us. Although typically they would just come on a motorized boat. Feeding the monkeys was a little complicated, we would have to paddle close and put coconut meat on the end of our paddles and reach over to the monkeys so they could pick the coconut off the paddles. We did this for quite a while and it was fun, until the monkeys got...violent. They were grabbing paddles left and right and they were charging us from land when we got too close, mind you they didn't dare get in the water. but it was scary nonetheless...I of course was not scared....although I did get yelled at by my boat mate who had extreme monkeyphobia...sorry no pictures, I was busy feeding monkeys...

So we continued on our way back home


Afterwards we had a nice lunch in town where we found another lunch time deal, tons of food for $3 or 60 cordobas:




...then we walked around the city where the girls got many catcalls for their sexy dresses....i didn't get any catcalls from the hot nicaraguan women...i guess they don't dig asian guys, they don't know what they're missing.


In the evening we had arranged to meet up with Ferdinando at a salsa place. Actually, he invited himself to our festivities, because zees is how zey do it in Austria ya!


The story is that, he was either trying to make friends (4 hot tamales in our group) or trying to get more business out of us because we said that we were interested in horseback riding the following day. He said he'd help us set something up for horseback riding before he parted earlier in the day, but later in the day we'd setup something through our hosts at the guest house, Alvaro and Meghan. So basically at the end of the night we told him we were good with our plans and he offered to drive us to the horse place for $10 each, which is highway robbery in Nicaragua. So thus ended our relationship vith zee Austrian. Misunderstood? Sleazy? You decide for yourselves, he was, however, knowledgeable about the isletas and the kayak trip was great I thought. Perhaps zees is just how zey do it in Nicaragua no?

The salsa place was great, we had some live music too:


Overall a great and memorable day that was!

Nicaragua travel report - Day 1

For Spring Break me and some friends decided to go to Nicaragua for a cheap vacation. Some background first: We were considering various other places at first, but then it was difficult to get people to commit because of cost issues. Nicaragua had become the poorest latin american country as of April 2009. Even Haiti was wealthier than Nicaragua (before earthquake, ahem)! To us that meant fun on the cheap! PERFECT! Just on that premise alone, we booked our $350 plane tickets to Managua. Later we would be freaked out by stories of kidnapping and literally highway robbery, as in they will rob you while you are driving on the highway and leave you destitute in the middle of nowhere, central america! So we were a little worried about safety, just the mere mention of Nicaragua, evokes images of revolucion and ak-47's in the hands of guerilla rebels and drug lords trafficking packets of cocaine in vagines and anuses. Seriously, this is what our families, or at least mine, said to me (maybe just a tad less dramatic). Fearful of airline cancellation fees, we set aside our panic and went ahead full steam planning our probable one way trip...

We had a couple goals in mind, we didn't want to spend our spring break week running around all over the country. We wanted rest and relaxation with a little bit of adventure. So we decided on two places, a colonial city called Granada for a few days and a volcanic island in the middle of central america's largest lake for a little middle of nowhere adventuring!

Fresh faced and naive, we boarded a train to NYC...


One thing that really sucks about Philadelphia air travel is that it's supposed to be a hub, but really it's not, it's like a large regional airport. Tickets to international destinations cost an arm, a leg and a mortgage on the house you would buy after you pay off your student debt. Traveling by bus 2 hrs north to NYC provides much cheaper access to the world!

The flight was uneventful except for the almost getting lost in Honduras because the itinerary forgot to mention that we would be randomly stopping in Honduras. Like dippy tourists, we got off and almost didn't make it back on the plane after we figured it out.

Upon arriving in Managua, we got conned into taking a $50 cab ride an hour south from Managua to Granada. Ok so we were going to take the Chicken Bus, see example below:


we were told that chicken buses are dangerous for gringos like us and that we should take the nice taxi. It was worth it I guess, we didn't start our day in Nicaragua by getting lost in Granada or Managua. It was a good warm up to Nicaragua

GRANADA, Home Away from Home!




It was warm, the city was beautiful, the guest house we stayed at was magnificent. The combination of almost 17 hrs of traveling and warmth and sun and finally being THERE made for a very happy first day in Granada. We had trouble deciding on a place to eat, thinking back now, we really should've just picked any place, you really have only one option for local food: rice, fried beans, fried meat, fresh veggies that's probably almost as dirty as a used petri dish. The food was good, not great, but it was good!

I think that first meal we gorged ourselves on the delicious local beer called Toña. They were cold and they were cheap! less than a dollar a bottle! We explored the market area a little before coming home to nap.







There was a lot of poverty there, we saw it first in the markets and also in the peripheral areas of the city. The nicer areas of Granada are in the city center around Parque Central. That is where the tourists congregate. As you go further away, you see the real granada, gone are the remodeled colonial homes around the city center, replaced with broken down colonial homes and dirty streets. There is a huge class divide according to our hosts, and there is a range of classes among the city, each class thinking they are better than the classes below them.

In the evening we wanted more comidas tipicas, which are your local Nicaraguan food. A friend and I shared the following, which costs $13 total


Note that that is a very large plate and that everything is fried. We were then treated to a show by flame twirlers



We closed out the evening with a light stroll around the city center and called it a night:


stay tuned for kayaking the mysterious isletas of granada, uncovered from its watery berth once every 12 moons

breakfast burritos

Back in late February, we had our Block 3 midblock exams. Me and a friend studied like madpeople. I made these delicious filling breakfast burritos:


They were easy to make, but I think I forgot how to so here's the recipe to the best of my memory:

* 3 eggs scrambled with a little bit of white pepper powder, the oil from chiu chow chili oil, a quarter of a red onion, pinch of salt
* 1/3 of spam can, cut into bite sized pieces and browned until crispy
* 1/2 cup of medium soft cheese (I used cheddar once and swiss another time)
* Ketchup to taste
* Sriracha to taste
* 1/2 lemon, squeezed over eggs & cheese for some "liquidity", add before adding spam to maintain crispness of spam bits
* Tortillas, toasted, browned however way you prefer.
* makes 2 burritos

Optionally, you could add a dollop of sour cream and/or guacamole for more "wetness" to the burrito.

the finished product:

Clinic update

Had clinic tonight, we set up a triage to screen for diabetes among our patient population. One of the first years, a good friend of mine tested a patient with a random non-fasting blood glucose of 135 last week. The threshold to see the diabetes nurse was 140. His gut told him to take the patient to the nurse anyway, nurse orders him to come back fasting the following week. Today, the patient came back (fasting blood glucose is diagnostic for diabetes), and the blood glucose is 300. A first year did this, he pretty much saved the patient from untold problems down the road had it not been caught.

Although it is not a place to teach students, we have setup a program that has so far been fruitful and I'm so proud of my classmates who undertook this project. We're making a difference in the lives of people!

Other updates, the clinic has gotten volunteer ophthalmologists providing services. Unfortunately, we've lost support from Drexel's affiliated hospital to do free lab work. Right now we are not doing blood testing for our patients. I'm looking into point of care devices to do blood testing and some grants to pay for it. I have the whole summer to figure it out since I'll be sticking around here to work at the clinic. It's part of a paid summer program offered by Drexel.

life update

Dear friends and family,

I apologize for not posting in the past 2 months. I have been on a soul searching journey these past 2 months. I believe I have come to a resolution that I am satisfied with.

I have been failing classes at school and I have kept this from even my closest friends at school. I will have to remediate most classes this summer. I do not think it is responsible of me to continue to waste money and time to become a mediocre physician, let alone the consequences of my actions as a physician. I have therefore decided to leave medical school to do pursue another adventure.

That adventure was a subject of much consternation. I found my answer, however, in Nicaragua. I saw farmers growing tobacco, mangoes and rice. The kind of life they led appealed to me. I had grown to love Nicaragua in the short time I was there. Therefore, I have decided to pursue my love and my passion and move to Nicaragua to become a farmer. In the past month I have begun to take agricultural courses at the local college. This is the reason I have been absent from my regular group of friends as well as my classes. I believe I am ready to go out on my own and grow fields of produce.

I have plans to grow mangoes, tobacco for cigars in the dry season and rice and beans in the wet season. I will finish out the year and I will depart immediately in June. I will of course move my father with me as I think he will like the tropical climate as it resembles the land of our birth, Indonesia. It will not be an easy life, but life is an ever changing landscape and each new turn brings different adventures and challenges. I believe we are on the cusp of something great for myself and my father and I hope you can respect and support my decision. Thank you for all of your support in this failed endeavor, I will hopefully see my aspirations bear fruit in Nicaragua.


Sincerely,

HS

Snow! lots of it!

Philadelphia doesn't really get all that much snow in a season. There's maybe one huge storm that dumps a few inches of the fluffy white stuff. But this season, we had a huge storm before winter break that dumped 22" in the course of 1 day! It was kind of insane and I drove around in it because my friends and I decided to spend the day at another friend's house in the city, we live in the burbs. That was the night my bumper fell off, yes, it fell off. I tucked it in the trunk and zip tied it back on when I got home. Anyway that's another story.

Last weekend there was another huge storm that dumped about 18" of snow! That set new records. I didn't go out driving this time, in fact people got tickets when they got caught driving out in the snow. It was nuts! Nothing was running for about a day and a half, no trains, no buses, no nothing. Clicky the pictures for more of said storm:




Devastating aftermath:


Tomorrow, is the start of another potential doozy, that would be another huge snow storm if you've zoned off the past couple paragraphs. If you doubt the seriousness of such a storm, see here. Looks like we'll have to put a hold on the snowman making!

By the way

UPDATE: 56" total so far, record=65" in 1995-96

spaghetti with meat sauce...

...is possibly my most favorite dish to eat ever! It started with my mom's spaghetti sauce and then it evolved to my own, over-seasoned sauce both of which I loved and can eat tons of in one sitting if it didn't go directly to my hips! So I'm sitting here thinking while not studying, how can I make the sauce differently, with more oomph? Well I thought of the meat, I've tried using 3 types of ground meat (beef, lamb and pork) and it tasted good. So then I moved on to another favorite, chorizo. I realized that chorizo is seasoned ground meat in pig intestines and I could use it to make spaghetti sauce that has a latin infusions! Imagine, chorizo, anato seeds, fajita seasonings, taco seasonings infused into homemade red sauce!

My next goal, stay tuned!

The Late Christmas Poem that was sent on time!

I sent this to most people on Christmas day, but I thought I'd post it here now so that Christmas may someday be extended into January................

GOOD MORNING!

I was going to do this over mass text message and single handedly max out my monthly text messaging limit in one fell swoop (that's how much I care about you guys, nevermind the impersonal nature of mass text messages!). But then i found out that you can only mass text to a maximum of 8 people. So I refused to compartmentalize my friendships into groups of 8 because, well, that's just not right, it's also a royal pain! So here's your annual Christmas Morning Greetings and I'd like to do it in song, without the song part, so just the lyrics I guess, well then that just makes it a poem doesn't it, so your Annual Christmas Morning Greetings Poem!

May your Christmas be Joyous
With lots of love and singing
Let your voices ring in chorus
And the tree lights agleamin'

May your gift-giving and present-receiving be merry
And the wrappings impressive
Most importantly, may your presents be very EXPENSIVE!
(Optionally, In $$$ or in Love)

May your wishes come true
And your bellies be full
If your family drives you up the wazoo
Just remember you'll soon be back at school


Alright yo, I'm tired of trying to rhyme, it's too early! Sorry if that wasn't relateable to some of you, but rhyming is damn hard, so deal! And to close it up, here's a picture of a Christmas Cat. Yes it's an ages old tradition that we've all somehow missed...

Merry Christmas!

Happy New Year

Sorry for the lack of updates. Not much to update really, just studying lots and other life stuff. Went back home for 2 weeks for break and got to see my pops. I hung out with him, mostly ate and saw movies. He loves the new place, although there might be some thievery problem. I can't make out if it's him losing his stuff or people stealing stuff. It'll be cleared up with time hopefully. I saw friends and it was not nearly enough time to see everyone I wanted to see.

I got a new camera so I'm posting pictures up on my web photo album. It's at: http://picasaweb.google.com/henrysiem. I update that more often than I do this because, well, pictures do speak a thousand words. Although some actual words can help too once in a while.

So I'm finishing up my second block, we've got 4 this year. Another 10 weeks and we start our primary care practicum, more on that in another post. We've got an exam next week and also our individual process assessments where we prove that we can think logically, come up with hypothesis, find data and ask questions that will lead us to supporting our hypos. We get a paper case that says person A has a problem and here are their lab values. We have to think up hypotheses and come up with issues to research. We come back 24 hrs later and present to a member of the faculty our findings and our support for the hypothesis. It's supposed to be fun and I'm a little bit excited to do it! It's the first time that we'll be independently working towards a diagnosis!

Spring break is in 6 weeks and me and 2 of my friends just bought tickets to go to Nicaragua. In case you're wondering where that is, it is in Central America just north of Costa Rica near the Central-South American border. It is a land of lakes and volcanoes and it is also the poorest country in latin america, making it one cheap travel destination. We're hoping to have a relaxing 1 week lying on the beach and swinging from the tree tops, fitting in volcano surfing in between!

I have a physical examination to do on 2 standardized patients tomorrow. It's our first time touching other people besides ourselves. It should be fun and exciting!