"Who put the hyphen in Troy?"

Right when I got to work today, Tonya and I left for the the HR Department of the hospital to get me an official ID badge. The person in charge of HR is Lisa Ramos, who also happens to be the only Spanish interpreter for the hospital. She said that she would be willingly to let me help with some of the translation whenever a doctor called for her services. This would definitely be a good way for me to get involved with the Hispanic community.

Back at the hospital, Tonya and I worked out some of the paperwork we had to submit to Minda like the Memorandum of Understanding. We tried to work out a schedule for Friday since Tonya was going out of town. Tonya arranged for me to work with the other Tonya in the Helping Hands Free Medical Clinic. We decided that it would be a good idea for me to get a head start in there today though since Tonya Martin had to finish up some more interviews. I followed Tonya McKenzie back through the "dungeon" as it is affectionately called to the Clinic. She gave me tour of the facility again, but this one was more detailed. She walked me through the process of a patient coming in for a visit. They start off with Miss Carolyn who screens all of the patients for business. Basically she sits down with them and makes sure they have all of the proper paperwork to be eligible for the free clinic. They then go into a holding type room where they can have some privacy to get meds or discuss what they need. After that, they get the basics checked in one of the room like heart, BP, glucose level, etc. They are then moved to one of 2 procedure rooms for whatever services they need. With the recent grant money they were able to buy a new EKG machine and that was in one room while the old EKG was in the other room. That room didnt even have any instrument for looking inside ears. All they had was a cheap flashlight. It was surprising that they did not even have basic equipment like that. I asked why it seemed like there was so many supplies for dealing with diabetes in the clinic, and she told me that diabetes is the number one ailment of people who come in. She said the majority of people actually are diabetic. Asthma is a close second, especially with smoking being so prevalent. Tonya then showed me where they store the medicine and the process for documenting its arrival and dispensation. After that, she spent a long time going through exactly what each paper means in a patients chart and described exactly what services they offer and what the eligibility requirements are. There people have absolutely no health insurance, not even Medicaid or Medicare. I asked what the average income of people were who came in and Tonya replied $12,000 to $15,000 per year. It is hard to imagine the quality of living for these people.

A went back to the nursing center to wait for Tonya Martin to get out of her interviews. It took longer than I expected so I basically sat around doing nothing for an hour. I skimmed over some of the copies of forms Tonya McKenzie has given me, but that didn't take long. I wandered around outside again and was about to go get lunch by myself from the cafeteria when Tonya came back. We went over to the cafeteria together. I found out that lunch was free for me from the cafeteria so that got me pretty excited. And today was chicken tenders, fries, and apple pie. It was all delicious, even for a nursing home cafeteria. Tonya and I ate outside in the courtyard. She told me a little bit about her employment history and how she had been an ER nurse, and started a Home Medicine business, quit that, and then became the Administrator of the Nursing Center. Deanie (sp?) joined us and they discussed some of the difficulties they have with relatives coming into the nursing home and accusing them of mistreating their loved ones. They said it is hard for these relatives to realize the bigger picture when they don't come that often. They also talked about the guilt many of them feel for placing their loved ones in nursing homes and they take it out on the staff.

After lunch I sat in on a conference call with Tonya and Jerolyn. It was a speech done by CMS (the nursing home rating system) on how to earn a 5 star rating. It sounded like pretty boring stuff to me since I wasn't really that familiar with the technical terms and forms they were referring to. The residents were having activity time outside. The activity for today was horseshoes. I watched as the wheelchair were rolled around in a circle with the post in the center of them as they took turns tossing horse shoes. When one of them scored, everyone threw their arms up in excitement and joy. They all looked so happy. I was glad that I got to witness this from the window. It was much more interesting than the conference call.

Tonya McKenzie came back and got me for some more orientation. She showed me where all the bathrooms were and some of the empty space they were hoping to turn into a lounge. The "door" to this "lounge" was actually a whole in the wall in the medicine room that I had been in earlier. However, before, there was a bookcase that has been covering the entrance but was now pushed aside. It had a secret passageway type feel to it. Tonya gave me the assignement of going over the papers she gave me to proofread spelling and grammar and to make sure the readability was easy and on the level of a 6th grader. In Marion County, the average reading level is that of a 6th grader.

I finished up kind of early for the day, and Tonya Martin was leaving early as well since her husband had gotten free tickets to the pre-opening of the Freestyle Music Theme Park that used to be the Hard Rock Theme Park. She was glad that I enjoyed the clinc. Tonya told me that the other Tonya had been really excited I was coming to work with them this summer when she first found out about me. This made me feel really good. I then realized that I would be able to help the most and "serve" in the free clinic, while I would gain experience and opportunities to benefit myself through the Nursing Center. I got a ride home with Leslie, the secretary, since Alice was still at work.

After hanging around the house for a while, Charlotte and I decided to go for a walk around town. We went pretty far down main street and then took the bike trail and back roads back through the neighborhood. There is a lot of stuff you miss while driving. We saw some quaint antique stores along the side of one of the blocks. We then encountered a group of kids probably a little younger than us. We didn't say anything to each other, but we were pretty sure we could feel them staring at us as we walked past them. I guess we really seemed like outsiders. We admired all the architecture of the old homes and how simple yet pretty they were. Once we turned around we found a beautiful meditation garden next to the Presbyterian Church. You have to walk underneath a trellis to get in and immediately a smell of honeysuckle envelops you. We stayed there for a little bit and then continued our trek back. We kept an out for the library but didn't really find it. We decided to take a little detour and go up the steps to the courthouse. We were admiring the iron work on the steps when we realized that there were letters and words worked into the pattern. On the way down the steps on the other side we realized it was the name of the architect, Hayward Bartlett. Continuing, we found a small side alley that was actually well kept. It had a trellis with ivy at the entrance and landscaping and a brick pathway. We then discovered it right next to Tio's (which we thought was Italian but then others claimed it was Mexican, but then we saw it was advertised as International food). We got sidetracked by a fountain on the way back and realized it was the biking trail so we walked back through that way to the neighborhood. We saw a lot more kids out playing in the park and on the tennis courts which was nice since we hadn't seen many people our age yet.

Since Alice, Noelle, and John Deans had gone with Dr. DeMarco to dinner and symphony in Florence, we decided to go out to eat tonight. We ended up going to T-Roy's. The general consensus was that it was satisfying food, but overpriced for what it was. I decided to make it my goal to try all the sweet tea at every restaurant so I could deicide what was best. This sweet tea was very sweet, but not obnoxiously sweet. It definitely had a sense of drinkability. The onion rings were actually the best onion rings I have ever had, or at least that I can remember.

Back at home we watched Ocean's Eleven, and I worked on proofreading the documents for Tonya. It was already pretty late so we didn't do much else for the night.

I'm Fixing to Do Some Good

I was pretty excited for my second day working at the nursing after having such a great day yesterday. Alice and I drove to Mullins together for the first time. For some reason her GPS wasn't working so we had to wing it direction-wise. We actually faired pretty well navigating the town. We arrived in Mullins with plenty of time to spare.

When I walked inside the building, I was surprised at how many of the staff and patients I immediately recognized. I was also comforted by the fact that they remembered me too and my name. They set me up outside of Tonya's office since she hadn't arrive yet, but Tonya got their quickly. She had me start right away on filling out all of the paperwork that the HR department sent over for me. I had to read an orientation handbook, a guide on confidentiality, and take a test on those packets as well. Most of it was pretty straightforward and not too difficult. I probably could have taken the test without even having read the packets. If only school was that way too . . .

I was in the middle of going through all of those when Tonya invited me go with her to the local radio station in Mullins, WJAY. She was going to do a spot on the air advertising the nursing center. I had heard her say something about this yesterday to some of her coworkers and was secretly hoping I could tag along. Obviously I was thrilled when I could. The radio station was a small concrete building in between Marion and Mullins not really near anything else. The DJ was the only person working there so he let us in. His name was James "Pee Wee" Hayes. I would definitely describe him as being jolly. He was super friendly and nice, as have been almost everyone I have met down here. We had apparently gotten there quite early so all three of us just sat down in the studio and talked a little bit. They went over exactly what they were going to say in the "interview" and Tonya told James what questions she wanted for him to ask her. Some of the main points were that 1.5 million people are in nursing homes. Last week was National Nursing Home Week. Nursing Homes offer more skilled specialized 24 hour care than assisted living centers. Nursing Homes do not have to be permanent--many have temporary rehabilitations and go home. And more things like that Both of them were also interested in how hard Duke actually is. I responded saying I thought it lived up to its difficult reputation (at least from my experience with premed classes). As they wrapped up the TV spot, James shocked me by saying "And we can't forget about Intern John from Duke University (in his most radio host announcer voice possible) who provided much information for us. Say hi to every, John." Of course, I said "Hi Everyone." Short and sweet. James was definitely interested in having all of the duke interns come back sometime to do a show on the radio and I think this could be an exiting opportunity for us. I got his business card so we could do some business in the future. What I took away from this experience is that you really need to do something that you truly love. Both Tonya and James stressed that to me.

Back at the office, a psychiatrist had arrived and was working with some patients. I went up and got to see some of the work she was doing. The psychiatrist was Dr. Bhatt from Conway. She was new at the nursing center and this was only her second time here (psychiatrists come every 3 months or so). Mostly what she did was look at the charts of patients that the nurses had flagged. Dr. Bhatt would look over the old psychiatrists notes on the patient, her own notes from her last visit, and take into consideration what the nurses told her. She would then fill out a new sheet with what changes needed to be made in the medications. I always have a hard time remembering, but psychiatrists CAN prescribe medicine, psychologists CANNOT. I learned some of the shorthand doctor lingo like F/U = follow up and a circle with a minus sign in it means NO. Dr. Bhatt was also very friendly (there seems to be a trend here). She took time to explain to me what all of the different medications did and how it affected certain neurotransmitters. Of course, my experience from Neuroeconomics helped out a great deal when she talked about dopamine, serotonin, and acetylcholine. It was a little unnerving thought that she didn't even see hardly any of the patients. She only observed briefly about 3. She said that geriatric psychiatry was not her specialty and can be difficult sometimes with limited communication. She compared it to children's psychiatry because of limited language capabilities and slow metabolism. Another unnerving that fact that I came upon dealt with Patients' Rights. Under that clause, a patient can refuse or request any medicine they want. I developed a new hatred for those cheesy medicine commercials because I didn't realize how much they target old people. A lot of the residents sit in their beds and see these commercials and feel compelled to try them and the nurses must honor their requests. It can get complicated. I also got to hang out with some of the nurses that were helping out Dr. Bhatt, notably Joyce. I was impressed with how compassionate they were and how much they cared about the residents. They keep a secret stash of Coca-Cola for one of the patients and they always know when he comes around wanting it with lunch. He doesn't even have to ask. Dr. Bhatt left me with some helpful advice. She said that if you become a psychiatrist you will NEVER be out of work because they are always in that much of a demand. She also was excited that I went to Duke because I must know a lot of Indian people (she gave the example of people with the last name Patel), and she was ecstatic that there was a girl named Khadijah BHATTi living here in Marion with me.

I then went back downstairs to the office with Tonya and finished up all of my paperwork. Some of the other administrators (Leslie and Jerolyn) brought pizza so I just ended up having that for lunch. For drinks, Tonya and I got sweet tea from the cafeteria that they always keep in stock throughout the day. However the sweet tea is TOO sweet so Tonya showed me the trick of mixing half sweet and half unsweet. Perfect combination, if you ask me. Some more people joined us from pizza, including Deanie (sp?). I really didn't do much work after lunch at all actually about none. Tonya had to run off and do two interviews for administrator postitions. The nursing center recently had 3 important people quit and they are scrambling to find more people ASAP. Apparently what happened is they downsized positions and just gave existing offices more responsibilities. But those people couldn't handle more responsibilities so they quit. While she was interviewing she gave me some information to read about the Helping Hands Medical Clinic, including some stats and the grant report. This is coming to be one of my major projects of proving how they used all of the grant money and wear so they can get more. However, it didn't take me long to read all of that stuff so I just kinda sat around doing nothing. I wandered in the courtyard a little bit, but that was it. It was a little disappointing to not have anything to do but I justified since I had a pretty exciting morning.

Alice came and picked me up. Apparently she had an even more unproductive and boring day than me. We are hoping that our enthusiasm from day one wasn't just all glamorous and now the real summer is sinking in. I have faith though that it will be good. Alice and I did decide to go to lunch together though sometime soon during our lunch break.

John Deans and David Womble and I decided to buckle down and get our gym memberships. The gym in the hospital was better than we expected. We all had to squeeze in the cab of John's truck so it was pretty tight quarters. John Deans let us do the honor of shifting the car into reverse and drive.

At home we talked about some of the ethics dealing with the family refusing chemo for their boy and pretty intense topics like that. This was left over night so I fixed myself some Mac 'N Cheese. We caught most of the finale of American Idol. The house was overwhelming a Kris Allen fan so we were glad that he won. Although Adam Lambert put on quite the show. PS - WHAT WAS HE WEARING?!? I finally taught Charlotte how to play Euchre so hopefully we can play sometime soon! Once again, I am the last person up. It is going to be an early morning (although not as early as John Deans!).

The Duke Intern

Tuesday signified the start of our first day at our internships. For my internship this summer, I am working at under the Marion Regional Healthcare System at the Mullins Nursing Center and the Help Hands free health clinic. My supervisor for the summer, Ms. Tonya Martin, picked me up at our house around 10:30 a.m. today. Usually Alice would be giving me a ride to work everyday, but Tonya had a senior staff meeting from 8-10 today that her boss assure us as being to boring for me to attend. Since I am working in Mullins, Tonya and I had about a 15 minute drive to work from our house in Marion. Tonya is really nice and very friendly and we immediately got along well together.

Tonya drove us into the back entrance of the nursing center and we made our way to the front from inside. I met some of the staff who work there. They all seemed really nice and friendly which is definitely a good thing since I will be spending 9 weeks there. The first thing we did was take a tour of the facilities. There wasn't much on the first floor. Most, if not all, of the administrator's offices are on the first floor with of course the main desk. There's also a smoking room for patients who still smoke. According to Tonya they had to implement a policy about smoking in the nursing center in order to contain the smoking. If the residents were previous smokers they could smoke; however, if they had not smoked previously they would not be allowed to start the practice. Only one person in the building is allowed to have a lighter as well. There is also a nice outdoor courtyard on the ground floor. Across the courtyard there is the employee cafeteria which apparently has pretty good food. I'll have to be the judge of that and try it sometime though. I also saw a rehabilitation room that looked like a lot of the equipment they used needed some rehabilitation themselves. Also in that room was an alcove for employee fitness that had some funky treadmills from the 70's. Tonya also decided to set up my office in that area of the hospital as well. It is a little gloomy with no windows or anything, but there's a nice desk and a computer. Hopefully I can spruce it up a little bit over the 9 weeks! Oh, and also across from the administrative offices they had the beauty parlor where the residents got their hair cut, and the activities room. In the activities room today, they had the bingo store. When they play bingo they win fake money and during the bingo store they can buy items with that money. Some of the women's strategies were to buy only things they absolutely needed like extra tissues and soap, while others opted to spend the money for gifts for their friends and family. One woman was pleased with the handcloths she bought for her daughter.

We rode up to the second floor with some of the bingo shoppers and there I got to meet a lot of the other patients and nurses. The nurses seemed almost a little intimidated of me when I was introduced as the "Duke Intern." There was a little eating area for those that could not make it downstairs themselves for food. We saw a room that was really well-kept and decorated by the patient's family. We also saw a woman's room who did beautiful paintings in her prime. Now that the she has aged, the only way to calmer down when she gets into a fit is to give her some crayons and paper. The third floor was pretty similar to the second. I saw some of the machines they used to lift the residents into their beds. I also met a woman who was convinced that my name was Kevin. I insisted that it was John and started to walk when she said, "Boy, come over here!" Of course I obeyed and spent another minuted convincing her my name was John.

Back on the first floor (did I mention that the elevators are really slow?), Tonya asked one of the male residents if the he was feeling okay because he looked a little down. His response was just "I'm fine. I'm fine. I'm fine." He obviously wasn't, but that is all he cared to share with us. Since I am also working with the Helping Hands free health clinic, Tonya gave me a tour of that as well. Even though it is in the same building, the entrance is in a roundabout way so we decided to take a shortcut through the bowels of the building. Through some double doors on the first floor of the nursing center we entered what used to be the old hospital that closed sometime around 1997. It was actually a pretty dismal sight. Everything was in disarray. It looked like a creepy/scary hospital from a horror movie. Ceiling tiles were falling down, lights were burnt out or flickering, old hospital beds were shoved up against the sides of the walls, walls were partially torn down, the floor has black stains on it . . . I think you get the picture. We followed the maze around and found the entrance to the free clinic's office. There were two nice ladies in there. One of them, whose name was also Tonya (last name McKenzie), would be my supervisor for when I worked in there. Tonya Martin described Tonya McKenzie has being an amzing woman whom she admired for her dedication to her patients since she even took money out of her own pocket to pay for their visits when they couldn't pay themselves. However, she has a lot of skepticism for the health system itself and focuses too much in its faults sometimes. I feel like that may be a lot of people's opinions around here.

We spent some time going over the various paperwork I needed to fill out then decided to take a lunch break. Tonya took me out to a local Bed n' Breakfast called Webster Manor. They serve a southern style country home cooked meal that is an all you can eat buffet. It was quaint and very cute. The food was delicious. This is apparently one of THE places to eat in Mullins. After lunch, we took a tour around the city of Mullins and saw some of the more prominent neighborhoods. I saw the Pecan Point neighborhood and the "Horseshoe" street. A lot of important people live on the Horseshoe like surgeons and judges. Both my supervisor and her twin sister also live on the Horseshoe too.

We didn't really have a whole lot to do after the lunch, just more paperwork. The only snag in our plan was that I had to have a 2-step TB test before I could work in the clinic so I would be a little bit behind. I got the test today, but I have to wait a week for results to come in. While I was waiting in there, Tonya was notified that one of the patients had passed away that morning. It made me wonder what happens behind the scenes in that sort of situation.

Since Alice was going to be a little late today, Tonya just decided to give me a ride back home. She had to go by the hospital anyway which is pretty close to Marion. On the way home, and throughout the day, Tonya and I talked about a lot of things--especially about the problems that face the area. Tonya talked about her decision to put her kids in a private school over the public school, the limits of Medicaid, the economy's effect on the lack of growth in the town, and a lot more. I look forward to hearing more about all of her thoughts.

Overall, I am really excited after my first day of the internship. So far, it has exceeded my expectations and I am looking forward to tomorrow and the next 9 weeks.

Back at home we all exchanged stories of our first days. Everyone seems to have really enjoyed it and is happy, albeit exhausted. I took another nap! John Deans came out with Mr. DeMarco's grill so him and David Womble served up some huge burgers and hot dogs for dinner. We spent so much time talking after dinner that we didn't even realize that it had become 9:00 p.m. already! The day flew by. Everyone took it pretty easy tonight. I think we are all excited for tomorrow to start!

The Calm Before the Storm

First thing David and I did today was go to the bank to deposit our checks. However, the closest Bank of America was in Florence, which meant we had a long drive ahead of us. It takes about 30 minutes to get there. It is pretty much a straight shot there, but the speed limit changed like every mile. Totally ADD. After we deposited out money and walked out the door, a man called out to us. David had dropped some money and he was returning it to us. I guess that makes up for Santa Claus the other day . . .

Today seemed to be a day full of errands since we also made a trip to Wal-Mart (Supercenter!) to buy all of our grocery's. I let everyone else take care of all the communal food, so I went ahead and bought my secret personal stash of food. The only stuff I really had to buy of course were my things I wanted to put in my bagged lunch. Basically everything that I got was what I had for 4 years straight in high school.

Right next to the Wal-Mart was the gym, so we all made a stop of their to get signed up at the hospital's fitness center. We weren't really sure where to go since the hospital is kind of a big place, but we figured that the emergency entrance was probably not the right place . . . Anyway, we ended up finding it. The gym was a little nook near the main entrance of the hospital. The staff was friendly and gave us all applications, so we will be all set for our first visit.

All of this running around got me pretty tired, so when I got back I ended up doing my favorite thing--I took a nap. A 2 hour nap. It was very nice. I woke up just in time for our first group dinner, cooked by Chef Khadijah and Chef Alice. They served up some delicious spaghetti and salad. Actually A LOT of spaghetti and sauce. We will be eating leftovers for a while now!

Now we are just sitting around the living room and watching Diary of a Mad Black Woman (thanks to the new DVD player we bought!). My supervisor will be picking me up at 10:30 a.m. tomorrow for my first day on the job!

Welcome to Marion, SC . . . Population: 7,042

It's about the end of our first full day in Marion, South Carolina. I got to our house yesterday around 12:30 p.m. so it has been about 36 hours now that I have been in the small town South. After visiting the house in Cheraw, SC, I was little hesitant about what I may find. However, I was pleasantly surprised by how nice the house was. And "pleasantly" is definitely the right word to use because the house is quite quaint. It has the old Southern feel and is decorated festive to boot . . . almost with a bit of Christmas cheer! David, John, and I ended up taking the bedroom with the bunk beds so it looks like John Deans and I will be rooming together for another 9 weeks . . . good thing that I brought Rachna and Libby's beautiful finger-paint artwork! We explored the house a little bit and found some nasty surprises (I HEART UNC). A little bit before dinner, some of us decided to explore downtown Main Street to see what was going on. Saturday was actually the Fox Trot Festival which is apparently one of the biggest events of the year. My expectations for the festival were low, so when I caught a glimpse of the carnival rides and all of the people, I was definitely surprised. It seemed a lot like the NC State fair with the hordes of people and stands that sold fried-just-about-everything. Deej and I decided to get a smoothie (which we had been craving for a while now) from one of the vendors. While I was standing in line, waiting for my smoothie to be made, the man in line behind came around in front of me and picked a wad of cash from beneath the table. He didn't ask if the money was mine . . . he just pocketed it and said "Merry Christmas." This wasn't really a big deal or anything, especially since the money wasn't mine. However, my natural reaction would have been first to figure out who the cash belonged to.

Walking "the strip," we saw more food and novelty item vendors and got to see more of the shops and businesses along the way. As we were walking, it was quite clear that we were outsiders in the community. This was mostly because most of us were clearly in the racial minority (especially Deej and Alice). I am not really used to this coming from private schools so this was a new sort of experience for me. It is not that I felt uncomfortable . . . OK, well yeah, I did. We came to the end of the road, where there was a karaoke stage set up with some Marionites who were singing gospel songs. We listened to a few then went on our way. They were no American Idols, but not terrible either.

For dinner, Minda took us out to Pizza Hut where we had our first "challenge" of ordering and sharing pizzas with everyone. I would say we passed, since I definitely left feeling quite full! We made a pit stop at Piggly Wiggly to get some food for the next day afterward. When we got back to the house we had a surprise party for Lauren's birthday, with cake and everything. In the evening we had some pretty intense card games going and then watched some excellent youtube videos.

The next morning I woke up to the lovely sound of Minda's voice. We were having our makeshift retreat in our house. Actually, in our living room right next to my bedroom! We talked about all the essentials and necessary things for living together for the summer. In the afternoon we had some free time and I decided for go for a run around the neighborhood. After making an interesting set of turns I ended up finding the park, the track, a football stadium, and the bike/running trail. After I managed to find my way back to the house I ended up going back to the park with Alice, Lauren, and John on a walk. On the way we got caught in the rain and had run back. We were soaking wet. There were no piña coladas. However, what DID have piña coladas was Zapata's restaurant. We all went out and met up with the DeMarcos and Minda for a last meal. The chips and salsa were excellent (and spicy). Our end of the table dominated on chip destruction (yeah Brandon, Noelle, and Charlotte!). Minda left us a few hours ago, so now we are officially on our own, and ready to start our summer!