Wednesday, September 3, 2014

Rewiring my brain

I'm 17 weeks pregnant. That's just three short weeks away from the halfway point. I've had three check-ups and each time we've "seen" the baby. First it was a bunch of black and white shadows that made no sense to me. Then it was a bunch of black and white shadows that made no sense to me, but included one pulsating splotch that our doctor said was the heart. I believed him. Finally, we saw the clear form of a baby, and even though he or she looked a bit like a creepy alien, I felt overwhelmed with fuzzy emotions.  

Despite all the baby sightings, this next appointment will be my first real appointment. So far I've been seeing the doctor under "confirmation of pregnancy" appointments. Really?? We're still confirming it after seeing splotches that tell you there's a baby forming (they didn't tell me... it's just my nauseous body confirming it), after seeing a heartbeat, and after seeing the little alien baby outline?!? But, indeed, my first real appointment is in three weeks when I will be halfway done.

The first time we visited Dr. Bolnga I had no idea what to expect. We turned into a small compound protected, like everything else in Madang, with a steel fence and barbwire. The guard opened the gate for us and pointed down the gravel road to the back building. It reminded me of medical offices in the States, in that there are no obvious signs to help guide and direct. There's just the building, which looks unfortunately like all the other buildings nearby, and it's up to your resourcefulness to find the right glass doors. Only there are no glass doors to Dr. Bolnga's building or office. We parked and walked around to the back of the building which faces an empty field and the Astrolabe Bay. After figuring out that the bottom offices belong to World Wildlife Fund, we made our way up the concrete steps decorated with various potted, tropical plants and found the door marked "Hope Specialist Health Care Limited." We added our shoes to the pile at the door and made our way down the poorly lit hallway to the cramped waiting room. It was already full of women and, despite the small air conditioning unit, it was hot. There are no set appointment times, it's simply first come, first serve. So we waited and waited, again not unlike our stateside prenatal visits. For that first appointment we had Ray with us and smack in the middle of the room was yet another leafy potted plant with an oh-so-enticing-to-a-toddler-if-they-could-read sign that said "Do Not Touch." Of course she wanted to touch. She just knew it was forbidden with her toddler radar. While we waited we intermittently kept Ray away from the plant and watched her get cozy with our fellow patients in the waiting room. The exam room was small, like most. Unlike most it didn't feel like an exam room. It just felt like an office with a bed in it. No stark white walls or paper sheets on the bed. No scale. No obvious medical paraphernalia or anatomy class pictures on the walls. Just a desk, a bed with regular sheets, an ultrasound machine that looks like a 1980s computer, and some chairs. In my cultural framework, that doesn't inspire confidence. I'm trained to equate knowledgeable medical practitioners with pristine facilities and paraphernalia. And labelled pictures of the muscular system. 

Dr. Bolnga's office building
We met Dr. Bolnga back in 2011 when I spent a couple of nights in the Madang Hospital for dysfunctional ovarian cysts. He was good then and he's good now. In fact, Dr. Bolnga is one of the best in the South Pacific. He trained in Australia and received the highest score (they call it the gold medal) of everyone that took their final test in the South Pacific Commonwealth nations that year. That means he beat students from places like Australia and New Zealand, and this test is apparently quite difficult. He's good. And though I know this about him, our appointments have felt haphazard and not at all what I grew to expect from my doctor's appointments during Ray's internment in my belly. So they feel wrong even though they aren't wrong. They're just different.

I walk away from each appointment less disconcerted than the last. I'm slowly becoming more accustomed to the vast cultural differences in how Americans treat pregnancy and how Papua New Guineans treat pregnancy as manifested through my highly competent but completely laid back PNG doctor. My brain is rewiring itself to accept this new kind of medical care as "good" even though it looks totally different from what I culturally define as "good" medical care. In the end, I would have no qualms staying here for Baby Garbo's birth if I knew that Dr. Bolnga would be the attending doctor and if the medical facilities he had to work with at the hospital were better equipped for complications. Neither of those is true, so we'll head to Australia with his blessing and thank God that in the meantime Baby Garbo is in unfamiliar, but excellent hands.    

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