Back in Korca

Thursday morning I watched Catherine and her sister get into a London cab and drive off to Heathrow. The Peace Corps was flying them first class to Dallas, with a connection to Tucson. She has done remarkably well and the rate of early recovery is the best prognostic sign for brain injury. We have good reason to be hopeful. The latest plan was for her to see a doctor in Tucson early the following week and then request a referral to Barrow Neurological Institute in Phoenix for a comprehensive assessment.

I walked around Kensington Park for the rest of the day and then took the Underground to Heathrow for my flight. I had scheduled to fly through Rome and then on to Tirana. Flights in that direction had some problems, perhaps related to the evacuations from Libya. I had to rearrange my flights but, after spending the night on a bench in Terminal 4, was able to leave early the next morning on a flight to Rome with a close connecting flight. The flight was slightly delayed and then parked on the ramp, so we had to be bused to the terminal. I raced through security and then to the departure gate where we boarded another bus. We were taken to a plane almost next to the one on which I had arrived. I had hoped my inbound flight would park near my connecting flight. I have to be more specific on what I wish for.

I caught the bus from Mother Teresa International to the city center and then walked to the Peace Corps office. I walked past the dentist’s office and tried to figure out where Catherine had been hit. There were so many potential places. As one rides on buses or furgons through Albania one see many marble shrines to mark places where people have been killed in accidents. They usually have a name, dates, a photograph and some artificial flowers. One can see similar, but makeshift, markers along roads in Idaho.

I spoke with the country director and other staff that had been so helpful following Catherine’s accident. I thanked them for their support and understanding. It almost made up for the bad experience I had with the nurse that came out to London from the Peace Corps office in DC. I tried to take care of some of the administrative items from the Close of Service conference that had been held in Korca while I was away. Maybe it was jet lag, but when I tried to open the files I downloaded at the office in Tirana, my computer wouldn’t cooperate. Maybe I’ll figure it out when I catch up on my sleep.

I had phone calls and texts from friends, both volunteer and Albanian. Now that I was back in Albania and knew they wouldn’t be exorbitantly charged, I took the calls and thanked them for their concern. I promised to visit Catherine’s host family as soon as I could. When I walked into my apartment, I found a banner above the kitchen door from all the volunteers who were at Close of Service conference. It was covered with notes welcoming me home and wishing Catherine a quick recovery. There was even a cut out of a jet. How appropriate.

Saturday morning, I sorted through the large bag that the Peace Corps staff had left in my apartment with all the pieces of the medical machine I had brought back for Dr. Isufi. He arranged for his son to drive to my apartment and bring it to his office. In the afternoon, after assembling the pieces with glue and tape, we plugged it in. Much to my amazement it worked and successfully went through the set up test program. The French baggage handlers that had dropped kicked the box marked “fragile” across the tarmac in Paris had been thwarted by tough, US made construction. We went out for coffee to celebrate, but I begged off a celebratory dinner. I needed sleep more than food. Also, we still have to make sure it functions correctly, so a celebration is a bit premature.

On Sunday morning, I met the volunteer from Bilisht who is leaving early. She has been a good friend of Catherine and me, and it was sad to see her off on the furgon to Tirane. After that, I walked to the church where I met my friends from Preka School and the group of nuns who have also been such good friends. I thanked them for all their support and prayers. We have a lot to be thankful for.

The afternoon was sunny and bright and not too cold. Another volunteer from Korca and I hiked up the road to Mborja, a village east of Korca, and along a gravel road by a creek in a canyon leading into the mountains. We doubled back along a side canyon, through a shallow covering of snow under a grove of pine trees, and clambered up to the ridge where the cross overlooks Korca. We walked back along the paved road in the late afternoon. Benny, the caretaker at St. Theodor’s, a small orthodox church I frequently visit on my morning walks up the mountain, was working on the grounds. When he saw me he ran out to the road to enthusiastically welcome me back. I showed the interior to the other volunteer. It has some of my favorite icons in Albania and, thanks to Benny, it is well maintained.

Later in the evening, I met my friend Lawrence for coffee. Even though he is from Malta, he appears to have picked up some Albanian customs from his long tenure in Korca, so, of course, it involved a meal as well. I may be wrong. Malta is part of the Levant and may have its own, similar, tradition of hospitality. They are certainly taking in thousands of refugees from Libya, including hundreds of Americans that were recently brought there by ferry from Tripoli.

Monday, I went to the health education office at the Directorate of Public Health. The nurses and lab technicians I work with all asked about Catherine and wished her the traditional wish for a speedy recovery, which, in Albanian is “te shkuare”, that is, “to be as you were in the past”. That seems both an apt and difficult wish.

I also learned that my nurse counterpart was enthusiastic about going to a meeting in Tirana on Tuesday at the Ministry of Health. This was planned to honor the work of Peace Corps health education volunteers throughout Albania and to commemorate the 50th anniversary of the Peace Corps. All the volunteers, staff and principal counterparts had been invited. I was hoping she would beg off because she has so much work to do in her home, taking care of her young son, her husband and his parents, as is the responsibility of young Albanian wives. She felt this meeting was a special one, and worth the trip. Although I would rather remain in Korca and work on my projects with Dr. Isufi, Dr. Jani and at the Preka School, it would be awkward for her to be without “her volunteer”. I don’t look forward to another nine hours in furgons to and from Tirana and, yet another night at Fredi’s. Maybe I can also stand in for Catherine with her counterpart nurse from Permet. I know that would please Catherine.

This is London

With a few minor delays we all finally arrived in London. Catherine came by air ambulance, her sister and older daughter by American Airlines from Dallas and me and the younger daughter by British Air from Tirana. Transport from the Gatwick to Kensington was made more interesting by a Monty Pythonesque experience of each information desk person giving conflicting instructions. For example, we were sent back and forth twice between tracks going in opposite directions at Victoria Station and then the tube station where we were told to get off turned out to be wrong. We finally got in a cab and were safely delivered to the hotel the Peace Corps had reserved. The cab driver questioned me if I meant to give him so large a tip. I assured him I did. Since the PC is supposed to be an austere organization and relies so heavily on the internet for communication, it would have been considerate had they booked a hotel that was no quite so expensive or had internet service for less than $15 an hour extra, but at least it was walking distance from the hospital. We all settled into our rooms and then headed over to the ICU at Cromwell Hospital.

England is much more liberal than Albania for visiting hours and they were also much more aggressive in getting Catherine awake and off the ventilator. They changed her to short acting medications and, after repeating the CT Scan the next morning, began to taper sedation. Catherine showed some worrisome signs of increased tone and posturing which I later found out were likely due to the medications, but then opened her eyes and began breathing. Soon the endotracheal tube was removed and she was talking. Much to my relief, she remembered who I was. By afternoon she was taking a few bites of food and sips of coffee and sitting up briefly in a bedside chair.

On Saturday morning the rest of her tubes were removed and she was transferred out of the ICU to a private room on a locked ward. She was mostly talking appropriately, but a bit confused, confabulating and impulsive. Still, her underlying charming self was evident, as she was smiling, joking and enthusiastic. She had some mild difficulties with balance and coordination. Physical and respiratory therapies were continuing, but occupational and speech therapy did not work weekends at this hospital and she would not be seen for evaluation until Monday. This is where going to a hospital more specialized in brain injury would have been beneficial, but at this point, it is not causing any significant problem. I would like her to get a thorough evaluation rather than gloss over any deficits, since these are better attended to early on rather than trying to be remediated after they create untoward complications. The nurse from the PC office in DC does not seem to agree with that, but I don’t think it is an unreasonable request. She has made it clear that because I am not family, I really don’t have any say in the matter. Maybe it is too much to ask that since I am also a Peace Corps volunteer who has been affected by this accident, she might have some duty to be a bit more considerate of my feelings, but I can’t fault her for being focused on Catherine. We all should be. Whatever, we’ll see what Catherine’s attending neurosurgeon thinks, although I haven’t seen him around since yesterday morning. I think he has been busy with surgery at another hospital.

Catherine was pretty upset at waking up outside of Albania, but seems to be accepting the fact that her Peace Corps service is completed. I expect that when she is well enough to travel on commercial airlines, with her daughter and sister as escort, she will be transported stateside for whatever rehabilitative care she requires. If I am able to weigh in on the decision, it will be in a program of the highest competence and reputation. When that is accomplished, I plan to head back to Korca to finish up my projects. If Catherine does well enough, maybe she can fly back to Albania to say a proper “mirupafshim” to her many Albanian friends and her fellow volunteers and PC Albania staff. Maybe that is a lot to hope for, but the fact that I can consider it at all seems nothing short of a miracle.

Reanimacioni

I had planned to write this next post about the Close of Service conference which is scheduled in Korca next week. As I said before, plans change. “Reanimacioni” is the Albanian word for Intensive Care. I saw that word for the first time by the elevator in Spitali Hygeia in Tirana on Tuesday evening.

A few minutes after I walked into my apartment in Korca for the first time in more than two weeks, my cell phone rang. It was Fredi, who rents inexpensive rooms to Peace Corps volunteers who stay in Tirana and provides all manner of helpful services for volunteers as they learn to navigate the busy capital city. He told me he had just learned that Catherine had been taken to Military Hospital. This is the hospital that all ambulances take patients to in Tirana. I immediately called the Peace Corps medical officer and was told that she and the country director were on the way to the hospital. I tried to call Catherine. A short while later, the medical officer phoned to say that Catherine had been hit by a car and they were having her transferred to one of the new and well staffed private hospitals in Tirana, Spitali Hygeia. I had noticed the large, modern building when we rode the bus into town on Friday. I think I pointed it out to Catherine. The country director got on the phone and authorized me to leave my site and come to Tirana. That was nice of him, but I was on my way, whatever. I walked past the city center to the furgon stop and caught a ride with the same driver who had driven me from Tirana in the morning.

Several calls on the long ride back told me that Catherine had been hit by a car when crossing a busy street while walking back to Fredi’s from her close of service dentist appointment. The older lady who had hit her had actually stopped to help. This is unusual in Albania where any accident will result in protracted hassles from the police. She had contacted Fredi by calling the last number dialed on the cell phone. Fredi called the Peace Corps office and then called me. At first, she did not seem severely injured, but was confused and combative and then lapsed into coma. Rather than have me take a bus or a cab across Tirana to the hospital, the country director arranged to have a Peace Corps car meet me outside the US Embassy which is on the furgon route into Tirana. This was both worrisome and appreciated.

The Peace Corps programming and training officer was in the car. As we drove to Spitali Hygeia, he told me the Peace Corps office in Washington, DC, was contacting Catherine’s family and would make decisions about medical evacuation, if necessary. He offered to let me stay at his apartment, if I wanted. We met the medical officer and her Albanian assistant at the hospital reception area and took the elevator upstairs. The neurosurgeon spoke with me, and, after gowning and washing our hands with disinfectant, led us in to see Catherine.

It was a scene I have seen many times before, but never from the perspective of a loved one. She was unresponsive with tubes in her nose and mouth. I held her hand and stood there as long as they let me. After half an hour, increasing levels in the chain of command of the ICU nurses asked me to leave. I resisted until the ICU medical director explained that they wanted to limit stimulation and would I please leave now. This seemed a bit strange since stimulation is a main treatment of arousal problems, such as coma. Otherwise the medical care seemed fine. I tried hard not to be confrontational. This is a bit of a stretch for me. Perhaps I have learned something in the Peace Corps. Maybe it is just old age.

The next day, Catherine’s daughter arrived from Germany where she works at a hotel in the Alps. I had only met her once before when she visited Albania before starting her new job. Several of our good friends from our group came to Tirana to offer help and moral support. Many others emailed and texted kind words and a willingness to help in any way needed. Thank you very much, it meant a lot.
Many Albanian friends from Korca , Permet, Thane and Tirana called and some came to the hospital, although few were allowed in to see her. All were shocked and concerned. We have two groups of nuns in Korce and Bolivia, the Precca Society, Greek Orthodox, Muslim and Jewish friends busy praying. We have remarkable coverage. Inshalla, Catherine will have a rapid recovery and be incredibly angry that she was taken out of Albania before she could finish her service. She had planned to travel to Leskovik on Friday to do her breast cancer presentation for a group of women at the medical clinic and then travel on to Korca for the conference.

The Peace Corps office in Washington decided to transfer Catherine to a hospital in London. I don’t know much about this institution, but I have asked knowledgeable friends back home for their opinion. Meanwhile, Catherine moved and responded a bit when they allowed the level of sedation to decrease slightly. Other family members are meeting us in London tomorrow afternoon. We’ll see how things go. I am hopeful, but realistic and considering rehabilitation possibilities in the US. We will have to consider PC preferences, and I have to respect that I am not family and really have no say in the matter.

The day of her transfer, the country director drove us to the hospital for a last visit on the way to the airport. Her site mates from Permet came with us to see us off. Catherine’s host family from Thane was at the hospital, the father, two daughters and a son-in-law. They wanted to see Catherine, even though I had told them repeatedly when I phoned the night before that they would not likely be allowed to see her. I don’t think the authorities realized how close Catherine is with this family or maybe they judged them by their worn clothes, not realizing that they had worn the best clothing they owned. They were obviously hurt and felt a lack of respect that is probably the most significant offense in Albanian culture. This was assuaged by taking the whole group to coffee in the hospital café. There were many toasts to Catherine’s speedy recovery. I promised them we will return to visit them in Thane and made their youngest daughter promise to work hard in school, as Catherine would want. We parted at the hospital entrance and headed off to Mother Teresa International.

The country director was kind enough to grant me administrative leave to follow Catherine through her initial treatment. This is extremely considerate, since, again, I am not family. I have up to 45 days, which saves me from the prospect of early termination. I appreciate that. I have projects that I wanted to complete before leaving Albania, but there are other priorities for now.

A Visit Home

I am posting this because the whole purpose of this blog was to relate my “Peace Corps experience” and my visit home was certainly an important part of that. Anyway, it is mostly written. The next post, however, supersedes this one. The next post supersedes everything.

Pilot lore has a “rule of three”. If three or more glitches occur in the preparation for any flight, a wise pilot puts the plane back in the hangar and launches on another day. Accidents are forged by a chain of events. Break any of the links and disaster may be averted. As they say, “it is much better to be on the ground wishing you were in the air, than in the air wishing you were on the ground”.

My first trip home in almost two years was in early February. This was timed to allow me to attend a required course to renew my instructor pilot certificate. This is easily done with a two day course, with the stipulation that it be renewed before it expires. Reinstating it after expiration is a bear. I had taken the course just before I left home to join the Peace Corps, but it is only good for two years. A Peace Corps term of service is 27 months. While the course can be taken on-line, the paper work has to be submitted in person so the applicant can be verified by government, picture ID. The Peace Corps allows three “free” leave days related to courses needed to renew professional licenses. Attending the class at home had the added benefit of seeing my old instructor pilot buddies that I have done this biannual requirement with for the past two decades.

I had to leave for Tirana a day early since the protests on the Friday before I left had resulted in three deaths and scores of injured and on the Friday I planned to travel to the airport there was protest of that. The Peace Corps security officer let me know that a “stand fast” order would be in effect on Friday, beginning at 8:30 AM. That meant I had to stay where I was at that time. To comply I had to travel the day before to Tirana and stay the night with a friend in the city. I got on the 8 AM bus from Korca to Tirana. After waiting half an hour, the driver told us there were not enough passengers, so there would be no bus today. The passengers got off the bus and found furgons instead. The next morning I caught the airport bus and loitered for 20 hours until my flight was scheduled to depart. This was probably a good idea for me personally, since my route of travel required me to walk across the center of the city in the middle of the time of the protest. I read a couple of books and had a great meal at the airport café (for about $8. Try that at any other international airport in the world). The custodians at the Tirana airport were very nice about letting me sleep on the benches. At 2:30 AM I was able to check my bags all the way to Boise. My flights to Budapest, then Paris, then Salt Lake, then Boise even left on time.

There was a list of 50 items or so to accomplish. These included everything from meeting with my accountant to go over tax stuff to donating blood. With the help of many friends, I was able to get through most of it. In fact, if I haven’t explicitly said this, Peace Corps service, especially at an advanced age, requires the help of many people back home. These include my trusted friends who have my power of attorney and have sent in tuition checks for a kid in college, signed contracts for rental of my home, made money transfers so I could pay my taxes, and so many other things. I have already mentioned my aviation friends who have supported the Aviation Club of Korca. It continues, mostly to their credit, to the benefit of kids from kindergarten to high school. I have no doubt it is unique in the Balkans, and probably in the Peace Corps, as well. My home librarian helped me get online books on tape and e-books, something that has been invaluable. My banker helped immensely when the arrangements I made before I left proved to be wrong. The people in my former office let me know about important mail and helped me solve many problems. The staff office of my institution helped repeatedly with questions that arose about online access and email. Good friends helped with storage of furniture, boxes of books, clothes, papers and accumulated detritus of 60 years. My old convertible is on blocks in the hangar of a good friend and will be great to drive when I get home next summer. That same friend made sure I had wheels while I was home for my visit. Even my sprinkler guy sends me encouraging emails from time to time. I think the Peace Corps should provide some recognition of partial Peace Corps service for those back home, who make it possible for volunteers to work abroad for 27 months. In my case for sure it is definitely a group effort. If I have not officially thanked all of you, I would like to do so now.

I got in some skiing and some flying and even did a clinic to benefit two worthy local causes (Wilderness Within Reach which flies disabled people to backcountry ranches for a weekend each summer, and ACE Academy put on by the State division of aeronautics to teach high school students about careers in aviation- I wish I could enroll some from the Aviation Club of Korca in that). Dinners and parties were appreciated, and, while it was absolutely wonderful to see everyone, I did gain about five pounds.

As planned, I packed mostly books and donated equipment for my counterparts in Albania for the trip back. This included a 20X20X20 inch box of electronics for Dr. Isufi, the number one item on his wish list when we first met. It barely complied with the current weight and size limits for the airlines. It was well padded and marked “fragile” and had my name and address of the Peace Corps office in Tirana written on it inside and out. No doubt you have guessed that it wasn’t on the carousel at Tirana International after I arrived.

It was a chain of errors, of course. I should have checked more carefully on the routing when I checked in. I should have checked at each stop to make sure it was transferred, especially in Paris where it had to change airlines, but I was lulled into a false sense of security by the ease with which my large checked bag had made it home. I had forgotten another flying maxim, “when everything seems to be going right, you are obviously missing something”.

I spent the weekend in Tirana because the Peace Corps medical officer had scheduled my close of service physical exam for Monday. This has to be done within 90 days of leaving and we wanted to use my travel through Tirana to get it out of the way. My friend, Catherine, from Permet, met me at the airport to help with the large box that never came. With my still limited Albanian, I filed a missing baggage claim with the lost luggage office at the airport. Early the next morning I emailed Delta and Malev airlines to ask for help. On Monday, I talked with the Peace Corps staff and enlisted their help as well. I fretted as each day passed and I heard nothing.

Catherine and I celebrated Valentine’s Day under this cloud. We went to a wonderful Italian restaurant in the trendy Bloku district of Tirana and went to a French pastry shop for dessert not far from that. I left early the next morning to catch the bus back to Korca. There was no bus again, so I caught a furgon. Before I got to Elbasan I got a call that the box had been found, but was damaged. The Peace Corps staff was arranging for it to be delivered to them and they would bring it next weekend when they came for the Close of Service conference at the Hotel Grand in Korca beginning on Sunday. I worried if all the pieces would be there or if it would still function.