So this is superficial thrombophlebitis

Yup, this is one of my clots (in the shape of either the Loch Ness Monster or Dino from the Flintstones). Mary drew the outline so we would know if it were growing or shrinking. Basically, the area is reddened, raised, firm, warm, and painful. There is a smaller area lower on the right leg that is similar, that is the older clot area that I originally went to the ER on Saturday night for.

Servant Leadership

Hello again. I know it has been a long time since my last post, and if there is anyone out there who is still checking in on this thing, thank you. I want to share a post from a blog I read. It is by an emergency room nurse in Australia named Ian Miller, and I really enjoy his posts. This one in particular caught my eye. It is on servant leadership--a topic I remember well from my publishing days. It was a hot topic "back then" and I think is worth learning about. You can see Ian Miller's blog at www.impactednurse.com and the article on servant leadership is at the link below. Just cut and paste if the link doesn't work.

http://www.impactednurse.com/?p=2003

See you all soon. Nathan

Happy B-Day Brian

Happy Birthday to my brother, Brian.

My but it has been a long time since I last wrote. I wonder if anybody is out there. I really should post something on this site. Hate to have it sitting out there with nothing to do. I will look around and think about what I might have to say and get writting again. Hope to see you all soon.

Mary says at the very least I should mention that I have been an RN for over a year now. My how time flies.

I found this article on www.change.org in the global health section. I think it is a brilliant reflection on what we can learn from the business world in addressing global health issues. Check it out:

http://globalhealth.change.org/blog/view/coca-cola_and_public_health

Edgewood Nurses in Guatemala 2009

Yes, they are going back. For all of you who enjoyed the blog last year (a year ago already, can you believe it!) a new crop of Edgewood students are soon headed back to Guatemala to continue the tradition. You can follow their journey at http://enfermeriaguatemala2009.blogspot.com/. A friend and co-worker of mine is taking charge of the blog for this year's trip, and I can't wait to read what they experience. Vayan bien.

New Report Out

There are two new reports out on the status of the Millennium Development Goal the UN set to reduce by 2/3 the number of children dying before their fifth birthday by the year 2015. So many of these deaths are preventable, and revolve around access to clean water and sanitation. For more information check out the report from Water Aid at http://www.wateraidamerica.org/includes/documents/cm_docs/2009/f/fatal_neglect_wateraid_america.pdf (please cut and paste in your web browser if this doesn't link does not work). And be sure to check out the rest of the site at www.wateraidamerica.org.

"The aid system is not responding to the causes of child mortality in a targeted
manner. The Millennium Development Goal to reduce by two-thirds the number
of children dying before their fifth birthday by 2015 (MDG 4) is seriously offtrack.
In Sub-Saharan Africa, on current trends, it will not be met until 2064."
--from the Water Aid report Fatal Neglect: How Health Systems Are Failing to Comprehensively Address Child Mortality.

More on Water, this from UNICEF

Another Cool Water Video

Neat video for a charity org that builds wells and trains well drillers around the world. I am still all about the water and hand washing.

Today I officially became Nathan RN!

Finally!!!

It has been well over a month since I last posted, and many, many things have happened. I have now officially graduated from Edgewood, although the diploma still has not arrived so I still have an empty diploma cover. I have a job working as a nurse in the ICU here in town. I was working there as a nursing assistant, and am now trying to make the transition to nurse in the same unit. Fortunately all of the nurses I work with have been very supportive, and I have a great preceptor, so I think the transition is going fairly smoothly.

I did finally get my temporary license from the state, so I am a nurse, I do still have to pass my boards, and then I can call myself an RN, and I am very much looking forward to that. There are days that I still can't believe that I am now working as a nurse. I get to take care of people, work in scrubs (which is practically like working in pijamas), and walk around with a stethoscope around my neck. How cool is that.

Yes, I am still out there. I am happy to report that the semester is over and I am now a graduate of the Edgewood College School of Nursing! The ceremony was last Sunday, and I now have a beautiful black diploma cover. The diploma will be coming sometime in the spring after the registrar's office verifies all of our grades and graduation requirements, etc. Something to look forward to.

Officially we graduate on January 10th, and I will take my nursing boards sometime after that. In the mean time I will start working as a graduate nurse in the ICU at Meriter Hospital on January 12th. Something else to look forward to.

I will miss Edgewood, but will still have some contact there, at least for the short term. I hope to be able to go back and speak to next year's group of Guatemala students, and I am meeting with Chris Bell to talk about some ideas for projects for next summer's trip next week, plus a couple of other things may be brewing. Who knows what will come up next. Stay tuned.

I am going to try to keep up a little better with the posts than I have in the recent past. Maybe I can post some of the info I have gathered about global health, water, sanitation, hygiene, or I can fill in some of the things I did this past semester in clinicals. If anyone is still out there, let me know if any of these things might interest you. I still have Guatemala on my mind, but this can now really be a much broader blog. After all, the title does say Nathan in Nursing, and I am one big step closer to being a nurse now.

My how time flies. I must apologize for the great delay in updating this blog, but I have been rather busy with classes and work.

I do have some exciting news. Hand washing has made it to the U.S. Yes, this semester I will have the opportunity to bring the hand washing clinic to Madison. A classmate of mine has a connection with Wingra School here in Madison, and she mentioned that the school is looking for some projects to do related to health etc. I, of course, volunteered the hand washing thing we did with schools in Guatemala, and the school is interested. CLEAN HANDS AROUND THE WORLD! That may become my new mantra, I don't know yet. Just trying it on for size.

Anyway, this is just one of many exciting things going on this semester. I absolutely love the public health semester. If only I had know about this years ago. I am doing a thing called Participatory Photo Mapping as part of my clinical with the Public Health Department of Madison Dane County. For more info on PPM, check out http://www.la.wisc.edu/ppm/. It is really a neat idea, and the kids we took around last week to take pictures of their neighborhood seemed to really get into it. This week we get to talk to them about the photos they took, why they took them, and what they think the photos say about their neighborhood. We'll see how it goes.

I had to write a reflection on my experiences in Guatemala for class this past week, and I am including some of it here. The entire thing is a bit long to add at once, so I am going to do it in stages. Here goes, I hope you like it....

I am not even sure where to begin something like this. Looking back over my journal/blog, and looking through my photos and those of others, I can see just how much we accomplished and how many different situations we experienced over a relatively short period of time. I have been thinking off and on over the past two weeks about how to try to write down my reactions and reflections about the trip. There are so many, and one thought seems to tumble into two or three or four more. This could (should?) be an everlasting exercise. The question may not be what did I learn from my three weeks in Guatemala, rather, what am I continuing to learn from the experience.

That being said, I will begin with some general impressions. Having lived and spent time in Latin America, I had some expectations of what Guatemala would be like. I expected to see poverty. I expected to see extremes in living conditions. I expected a slower pace to life and work than in the United States. In many ways these were the conditions that I also experienced. I did see a slower pace. The occasional two hour lunch, some quiet relaxation in the central park in Antigua. This is not to say that people in Guatemala are not industrious. Our visit with Franklin and As Green As It Gets showed quite clearly that there is an entrepreneurial spirit that is alive and well within Guatemala. If ever there was an inspirational success story, Angelica and her bag factory is that story. It showed to me how just a little money and expertise, used wisely, can make a huge difference in someone’s life. The time we spent with Franklin was of great value to me. It showed me that small changes can add up to meaningful differences in peoples’ lives. It makes me wonder if there is a model here that can be used for other endeavors or in other locations. Are there other people and organizations that have created similar systems in other parts of the world?

Dr. Oscar also made me wonder about systems and opportunities. One research project that I thought about doing (indeed am still thinking about) is how he and other like-minded doctors work together to take care of the health care needs of the poor in and around Sumpango. Dr. Oscar has a real passion for his work and a compassion for the people that he treats. The respect that others in the surrounding community have for him is fairly obvious to see. People come from miles around to be seen in his clinic. As he perceives new needs in his patient population he learns new techniques and gets further training. He saw a need for better prenatal care in Sumpango, so he went back and learned not only OB but also how to use an ultrasound machine. He saw an increase in diabetes and hypertension, so he went back and learned more about treating those patients. If there are cases which are out of his area of expertise, he is able to refer patients to other doctors who share his concern for the poor, and who he knows will treat these people regardless of their ability to pay. This informal network is an interesting concept for me. I was especially interested in it after talking with Carlos, my Spanish teacher at MAYA. We were having a conversation about health and health care in Guatemala. He works three jobs, and has a variety of options for his health care. One of the options is to use the national clinic system. It is free, but severely understaffed, overcrowded, and often lacks supplies and medications. He mentioned that often he will go to the clinic and be seen by a doctor, who may prescribe something for him, but the clinic pharmacy will not have any of the medication on hand. He them has to go to a pharmacy and purchase the medicine himself. He also pays a monthly fee for social security, which allows him access to a different set of clinics. These clinics, although not as understaffed and overcrowded as the public free clinics, are still not as well provisioned as a private clinic, and probably nothing close to most clinics here in the U.S. The costs at these social security clinics are paid for through his monthly social security payments, as is his medicine, but again, the pharmacy often does not have what he needs in stock. He can either try back later, as they tell him “maybe tomorrow, maybe not,” or he can go to a pharmacy and purchase the medication. Finally he can go to a private clinic, where he will have to pay out of his own pocket the costs of the visit and whatever medications are prescribed. Access to the doctor is better at the private clinic, but costs make this option prohibitive for all of his and his family’s health care needs. Dr. Oscar provides many of the services the public clinics do for the poor, and he is willing to work with whoever comes to his door at whatever level of payment they can afford. This is a very different image of Guatemaltecos than Freddie presented at Camino Seguro. I am sure there is truth in both images. Dr. Oscar is a compassionate man who has the opportunity to make meaningful changes in the health and well-being of the community, and I feel honored to have played even a small part in helping him make some of those changes.

Good morning everyone. Just sitting around waiting for class to begin so I thought I would do a little updating. I got the chance last Thursday to do a little presentation to the Kiwanis club in Belleville, WI. Spoke about 20-25 minutes about our trip to Guatemala and (of course) the importance of hand washing. Somehow I just can't get away from it. It was a wonderful evening in Belleville, and the audience, although small, was very interested and receptive. If anybody else wants a presentation, let me know. We'll see what we can work out. I've got plenty of photos to choose from.

Hope all is well for everyone out there in cyberland. I have to go learn something.

Today was the first Guatemala class since we came back. It was great to see everyone again, although we did miss Laura and Chris. So many plans to make, presentations to plan, papers to prepare. Three weeks in Guatemala seems a breeze compared to classroom work. It will be fun to see if we can inspire some "young" nursing students to try going to Guatemala next summer with our presentations. We will be talking to both the first and second semester students. First we have to figure out what to say. How do you distill three weeks of incredible experiences into a presentation of an hour or less? So much to say, so little time to say it. Anybody have any suggestions?

I leave you with a quote from Margaret Mead which I recently read and love. "Never doubt that a small group of thoughtful citizens can change the world."

As the weather turns cooler and fall approaches I look fondly back to the three warm weeks spent in Guatemala. OK, some of the days in Guatemala were downright hot, almost unbearably so, and a couple of days were quite cool, especially one I remember 2/3 of the way up a volcano in Sta. Maria de Jesus. But I really do look back on those days from time to time.

We have started school again at Edgewood, and I am both happy and sad to say it will be my last semester as an undergrad there. I am to graduate in December. But before I can graduate, there are a number of things I must do. Of course there are classes and clinicals to pass. But that pales in comparison to the most important tasks of the semester...Guatemala presentations!

Yes we must make some presentations about our trip and some of the research we did/are doing related to the trip. I know we will be presenting something that will be open to the college to attend on November 10th. I am on the syllabus for my community/public health clinical to speak on Nov. 21st. Fortunately I was warned ahead of time that I would be on there. Imagine my surprise if I hadn't been warned before the syllabus was handed out. I also may be presenting to the Kiwanis Club of Belleville later this month (I hope I find out soon) and some of us/all of us will be doing something for the first semester Nursing 210 class. Lots of work ahead of us in preparing our projects and presentations.

I am happy to report on that front that I do have a powerpoint just about complete on hand washing. Yes, I know many of you out there are surprised to hear that I have any interest in hand washing. But I do, and if I do say so myself, it is going to be a masterful presentation. I don't want to give anything away, because I think I may use it, or at least part of it, when I speak to my community/public health class. However, at some point I may figure out how to post it to this blog so that y'all can experience a little of what we did to promote hygiene in Guatemala, and maybe learn something about global health in the process.

On this wet, rainy, cool fall-like night I leave you with warm thoughts of black sand beaches and warm evenings in hammocks. Duerme bien.

Welcome back to class everyone. It was good to see my classmates, but I have to ask where the summer went. Seems like we just left Maz 103 (one of our favorite classrooms, ha!) and here we are right back in that room.

It was pointed out to me today that we only have 108 more days to graduation. I think it is a little too early to start the countdown, but....

Now to homework.

In honor of the start of a new semester, I give you school scenes:

Yes, I am still alive and writing, just not writing much at this point. Summer is fast coming to a close and my last semester of nursing school is about to begin. During the coming semester the Guatemala students will be doing a variety of presentations to groups, andf I hope to keep everyone updated on what we are doing and where we will be. I am just hoping that I will have the chance to do a few handwashing revivals around Madison.

I wish all of my fellow students a fun and studious semester.

Hello everyone. I'm expanding outside of Guatemala a little today. Just got back from the annual Edgewood College School of Nursing Tee Up for Nursing golf outing/fundraiser. Had a wonderful time at Nakoma Golf Club on the west side of Madison. I was greeting people on the 17th tee and trying to get people to bid on a Kohl Center suite for a UW women's basketball game provided by US Bank. It was a beautiful day for golf, I only wished I could have played. A big thank you to all who participated, and a special thanks to my fellow nursing students who volunteered at the event. I hope and trust it did well for the school, and that everyone had a good time.

I promise to write more later. I will probably expand the blog into other topics (still school and nursing related) and not just Guatemala stuff, although I will still have some of that mixed in as we start to do presentations and other things around campus and the Madison area.

As you can see below, sometimes transtions can be difficult. After three weeks in Guatemala, coming back to the US was hard for some of us, myself included. Going back to work, settling into the routine of summer, not hearing Spanish, having to drive myself places. It can be rough coming home. Mary and Sam have helped ease the transition with their interest in my Guatemalan adventure. Even so, after almost a month back, I sometimes miss Guatemala. It's enough to drive a man crazy.

Fortunately, I don't look like this too often. I hope my "sisters" have had good transitions back home. I miss y'all.

Sorry it has been so long since my last post. Thought I would pull out some of the nurses and kids pictures to share with y'all.

In an ongoing effort to take every available opportunity to embarrass and humiliate myself, especially on the web, I am including this video excerpt from our trip. I hope you enjoy watching this as much as we enjoyed making it.

It took us three weeks to nail down the choreography for this. I don't think we ever completely got the lyrics right. We do have a couple of different versions of this taped. We weren't sure the camera was working, so we did it a couple of times. We are, after all, truly, madly, deeply dedicated to our art. We are still waiting for a call from Savage Garden about touring dates.

For those who were unable to catch it, here is the interview Dawn and Nancy did with Leigh Mills on NBC15's 5:00 news on Wednesday. I think they did a fantastic job. Thanks, Leigh, for the chance to tell a little of our story.

Good evening everyone. Just wanted you all to know that once again we are making the news. Leigh Mills at NBC15 here in Madison will be interviewing Nancy and Dawn for the 5:00 news. It will air about 5:10 on Wednesday the 18th. Very exciting. I am including here some of the pics I sent her from our trip. They include:

A photo of the soccer balls we gave to the kids at the Orphanage in Patzun
A couple of photos of us teaching the comedronas how to take blood pressures.

A photo of the doctors and nurses in Chiquimulilla learning newborn resuscitation.

And I had to get a photo of me teaching kids about washing their hands.

I hope you like these, and watch for the interview on channel 15's 5:00 news!

A few more pictures. This set is from a day in Dr. Oscar Paredes' clinic in Sumpango. While Erin, Karen, and I taught the volunteer bomberos (firemen) CPR for infants, children, and adults (a two day process), others were working with students and pregnant women teaching about handwashing (I didn't have to do it!), problems in pregnancy, and other issues, while still others worked in the clinic seeing patients.

We start with Karen and Erin teaching the bomberos:


Dr. Oscar had a pinata for the afternoon's festivities. We filled it with candy and bottles of vitamins, an interesting combination to say the least. We also got to hang the pinata, although I'm not sure that Jenna is holding the pinata in exactly the right way. Turn your head and cough Mr. Pinata:


Well the pinata stayed aloft, and everyone, including the bomberos, gathered on Dr. Oscar's roof to take a whack:

And as you can see we all were quite successful:

Finally, here is Karen with our newest CPR graduates:

I thought some photos of what we did would be good to post too, so here is the group of comedronas (midwives) we taught in Chiquimulilla.

And here are the nurses and doctors in Chiquimulilla who learned newborn resuscitation.

Here are some views of the volcanos that surround Antigua. These were taken from the roof of the Hotel El Carmen. The first photo shows the volcano Fuego, which is the active one I wrote about a fews weeks ago. The last photo is of Agua, the inactive volcano outside of town.

Now for a variety of landscapes from Guatemala:

On our way to Chiquimulilla, a sugar cane field in the foreground.

Outside the clinic in Chiquimulilla.

I promised you all some pictures when I came back, so here is the start:

Here is the clinic in Chiquimulilla we volunteered in.

Here we are in Chiquimulilla, with Jeanette, our friend and translator, and her husband Juan Carlos in the middle; and Dennis and Elvira, our hosts in Chiquimulilla.

I will do the photos in small groups of two or three at a time. Hope you like them.

Good morning everyone. Yes we are all back in Madison, and most of the smart ones of our group are hopefully already in bed. Obviously I am not one of the smart ones. I am a blogger.

A very long day, but I did want to pass on something from the day before I go to sleep. We made it to the airport in Guatemala City without major incident, and were waiting patiently for our flight. The plane arrived, and off came a group of high school students from the California Bay Area. Their faces were full of awe, excitement, anxiety, nervousness. Probably much like our faces three weeks (or was it a lifetime) ago. And here we were, the grizzled veterans, imagining (with some envy) the adventures that are in store for them. Reluctantly we pass the torch of Guatemalan discovery to them and board the plane.

Good night Gentle Readers. Sleep well. I will write more to you later.

Well folks, this is probably the last post from Guatemala. We leave tomorrow at about noon, and are planning to be at the airport about 9:00 in order to give ourselves plenty of time for checking in.

Today we took a fascinating tour of Camino Seguro (Safe Passage) that I wrote about yesterday. If you didn´t get a chance to see their sight, take a look. I put the link in yesterday´s post. Our guide from Camino Seguro started us off in the city cemetery, which interestingly enough is a great place to view the city dump. It was very eerie looking at the dump from the cemetery. There are vultures EVERYWHERE! Hundreds of them circling the dump, in the trees, perched on the tombs. Very surreal. And anywhere there are birds, there is bird poop. It got all over the van, and in one student nurses hair (I am not mentioning any names here. Getting vulture droppings in your hair is not necessarily something to write home about, but it is something to blog about if it happens to somebody else). Another kind of spooky thing about the cemetery. Apparently the family actually rents the space. Everyone in the cemetery is burried above ground, and if the family doesn´t pay for 2 years, the grave is emptied of the coffin and it is simply dumped over the side of this very big hill into the dump. We honestly say an empty broken open coffin sitting on the side of the hill overlooking the dump.

We couldn´t stay long in the cemetery. It is also not a safe place to be. Lots of gang activity happens in Guatemala City, and the spot in the cemetery overlooking the dump is also the place where bodies are dumped after a gang hit or other killing. I know this is not a very cheerie blog posting, but I figure I might as well share the bad with the good. Just one more eye opening experience for us here.

After looking over the dump (visitors can´t actually go into the dump itself), we had some better experiences with Camino Seguro. We toured the day care center that Safe Passage started and runs for the children of the people who work in the dump. They have a capacity of 60 children ages about 6 months to 5 years, and currently have 54 kids in the school. It is a beautiful place in the middle of so much poverty. The school, and the neighborhoods that these people live in are built on the landfill of the dump, and there is a constant smell of trash and methane. The neighborhood names are also a bit surreal. Esperanza (Hope), Paz (Peace), Libertad (Liberty), and Regalo (Gift). The school has Guatemalan teachers and volunteers from around the world. The kids get breakfast, a midmorning snack, lunch, and an afternoon snack. For some, this is the only food they get for the day.

We also toured the older kids school and clinic. One of the goals, according to our guide, is to simply provide an opportunity to these kids. For some it is the opportunity at a little education, for others it is the opportunity to get a couple good meals a day. For many, it is the opportunity to survive another day. Their entire operation runs on donations, as so many things like this do here in Guatemala and around the world. As we did in order to make this trip a reality. If I can preach for just a moment, consider giving to a cause. If you do already, thank you. If you don´t, please think about doing something, giving something. We couldn´t have done all that we did in three short weeks without donations and gifts, and we have seen firsthand the effects that donations and gifts can make. From Camino Seguro to As Green As It Gets, and so many in between, there are people in need of help, and every little bit helps.

OK, enough soapbox preaching for the time being. It was a fairly somber group after the dump. We had some lunch, and decided for our last afternoon in Guatemala we needed something different. Laura promised all of us a hug if we would take her to the City Zoo, and we took her up on her offer. Off to the zoo. So many highlights, but two things stand out. The Howler Monkey (Laura´s main reason for wanting to go to the zoo in the first place), and the crowd of elementary school kids that crowded around us asking questions. So many questions. They were so eager to ask us about anything, and so eager to learn. It was very cute to see them all. Much thanks goes to Dawn and her translating abilities, for fielding many of the questions and providing answers.

We had an opportunity to reflect and share about the trip this evening. Lots of emotions, lots of laughs, a few tears. All of us have changed in so many ways over these past, very fast, three weeks. We will return to the U.S. as very different people than when we left. Some changes may be obvious (no I haven´t lost 20 pounds, that wouldn´t be a change, that would be a miracle), some may be more subtle. But we have all been touched by this trip, and I am convinced that we will be forever affected by it. We now have a special connection, and I would be willing to go on another trip like this anywhere with anyone in this group. I only hope next time I can take Mary and Sam with me.

Well, I think I have written enough for one night. I´ll keep writing if you keep reading. See you all tomorrow (ok, maybe Thursday very early in the morning). Buenas noches.

Good evening everyone. We are approaching our last full day here in Guatemala with mixed emotions. We are all eager to see our loved ones, but we feel there is still so much we would like to do and see here. We want to come back home, but we hate the idea of leaving. Oh well.

We had an interesting day today. We had the opportunity to tour the two large public hospitals in Guatemala City today: Roosevelt Hospital and San Juan de Dios. Both of these hospitals serve the general public, which means that they both serve the people who cannot afford to pay for private hospital care. We met some fascinating people who are very much overworked and underpaid. We toured the neonatal intensive care units in each hospital, the intermediate care unit at Roosevelt, and the pediatric intensive care unit and the pediatric emergency room at San Juan de Dios. It was an eye opening experience for all of us. What they are able to do with limited resources and staff is amazing, and yet we can only imagine what it would be like if these two hospitals did not exist here. Rooms filled with babies on ventilators, and row after row of warmers and babies. Roosevelt only delivers high risk pregnancies, and San Juan de Dios has about 300 births a day. Once again I have to say check back after we return, so you can see the pictures from the hospitals.

Roosevelt Hospital has one, yes one, latation consultant for the entire hospital. She is a truly inspirational woman. Breastfeeding is not a popular thing in the city, most women in the city use formula. She is fighting an uphill battle to try to get more women to breastfeed, and to try to get support from the nursing staff to try to encourage their patients to try breastfeeding. We were lucky enough to eat dinner with her, and she stayed and talked with us about her experiences and the difficuties of her job.

Nancy and Karen are already planting seeds for next years´trip, talking to the neonatologist at Roosevelt about what we can do to help him in his hospital. I hope that next years group has as much fun and gets as much out of their experience as we have over the past three weeks.

This evening we were also lucky enough to learn from Karen´s extensive knowledge of the natural sciences. We read about the difficulties the rains in Wisconsin have caused, including the tragedies faced by Lake Delton. We have had rain and clouds for the past week and a half or so, remnants from a variety of hurricanes and tropical depressions, and Erin asked where all the rain in Wisconsin was coming from. Karen, with a perfectly straight face told us ¨clouds.¨Where would we be without her keen insight.

Tomorrow we are off to the Guatemala City dump and Safe Passage. You can see and read more about this program at http://www.safepassage.org/. After that, a free afternoon. Some are wanting to go to the city zoo. After spending three weeks with this wild bunch of women, I think the zoo might be a little tame for me.

I finish this post with a personal note. We have celebrated a couple of wedding anniversaries on this trip, and we celebrated one more today. I want to wish a very special happy anniversary to my wife, the true love of my life. Thank you, Mary, for 18 of the most wonderful years of my life, and thank you for letting me trot off to Guatemala. Without you, I would not be even half the person I am today. All my loves, my love. Nathan

Good evening everyone. We have landed safe and sound in Guatemala City. We are staying at the Seminario Anabautista Latinamericano (SEMILLA). Basically we are in a kind of dorm area, but it is comfortable, and once again we have been very well fed. Spaghetti, fried chicken, fresh salad, watermelon, and fresh coffee. The ride to Guatemala City was a long one, with a very important stop along the way...for ice cream! Oh, and to stretch our legs...with ice cream! We took a great group photo, with about half of us hanging out the windows of the van, and the other half on the top of the van. The poor man from the ice cream place volunteered to take our photo. I don´t think he realized just how many cameras were going to come out of the van for photos. The people in the ice cream shop were quite entertained by watching us scramble to the top of the van, get our picture taken, and then scramble down.

We still have so many suitcases that we had left the larger ones in Antigua at the CLM and we only took ¨overnight¨ bags with us to Santiago Atitlan. Eric got us to Guatemala City and then turned around and drove back to Antigua with Karen to get the suitcases. Eric has been an incredible companion on this trip, part driver, part guide, part interpreter, and an entirely good friend to all of us. I think he has been entertained by us, and has certainly learned a few things, like CPR and midwife issues. He has been a real asset to our trip and we will certainly miss him when we leave.

I can´t say that I have very many pithy things to say this evening. Too full from dinner and to tired from the trip. I will say that some of my sisters layed out some of their purchases from the market this evening, and it honestly looked like we could have had our own little market right here. ¨¿Que estas buscando?¨ ¨¿Una bolsa?¨ Lots of beautiful things are coming back to the states with us. Make sure you get your orders in early for the Quetzal bird key chains. They´re going fast. (sometimes I have to add things in that may not make a lot of sense to you, my gentle readers, but for the folks on the trip they are hillarious, at least I hope so). BTW, I am using a keyboard that has some ¨mystery keys¨on it. I don´t always know where everything is. I only just discovered the upsidedown question mark (the equals, plus sign key, I have no idea where those signs are on the keyboard, I hope I don´t need them) and the ñ and Ñ (which is the colon and semicolon key, but I did accidentally find both of those symbols, shift comma and shift period) Everything is a learning experience in Guatemala.

There is a big spoons game going on in the courtyard down below. I promise we will try to keep it down to a dull roar so we don´t wake any of you up tonight. If we do disturb your sleep lo siento mucho.

Hasta mañana.

It's a beautiful day in the neighborhood. The sun is (kind of) out, the air is brisk and refreshing, and we are off to Guatemala City. It will be hard to leave the Posada Santiago. It is a beautiful place, and they have taken great care of us here. The food is great, the views unbeleavable, and the rest and relaxation very necessary. I think we all have been refreshed and ready for the next adventure, which is...

Guatemala City. Yes, we are off to the capital for a couple of days. The big city. It will be a big change for us, we are getting used to a more layed back lifestyle, especially after this past weekend.
One quick note to all the boyfriends and husbands out there. Dawn's husband sent her flowers here to the Posada today. He has set the bar pretty high on the romance scale.

Gotta go eat breakfast. I hope to be able to get on in Guatemala City, but if I can't, see you all soon, and check back when we return because I will be adding photos.

Good evening everyone. We are here at the lake still, enjoying a little R&R. Today we went to visit some of Karen's friends who run a foster home/adoption service here in Guatemala. They are originally from Green Bay, and have been working and living in Guatemala for a number of years. Currently the government in Guatemala is revising the adoption laws and there is a moratorium on adoptions, so they are only fostering kids. They have had as many as 34 kids at one time in their house to care for, many are orphans or come from abusive homes through the court system. They do not charge anything for placing kids in adoptive homes, a rarity here where adoption had been a money making program and the system was corrupt and abused by some, hence the changes being made in the laws. They have a beautiful home and the surrounding countryside is amazing.

It seems I have been saying (or at least thinking) that the countryside is amazing here. All of Guatemala is amazing. They say that Guatemala is the land of permanent spring. I have no reason to doubt it. The countryside is amazing, and the people we have met have been very friendly.

Most of us spent the afternoon at the market. I know this comes as a shock, but it is the last chance for a market for us, so we had to take advantage of it. A little shopping, a little bartering, a lot of looking, and back for a little afternoon siesta. Don't tell Nancy, but my sisters have worked up a little dance routine. Very professional looking. It's a good thing we are studying to be nurses, though.

Gotta go. Dinner awaits. Off to Guatemala City tomorrow, and home in just a few days.