Today I woke up still feeling exhausted from the long and hot bus ride home from siem reap yesterday. At this point in the trip I am missing my family and friends back home and the constant change and uncertainty  of the entire trip is really wearing on me. I'm learning to adapt quickly to whatever is thrown my way and to just go with the flow but that is definitely something that I struggle with. With all that being said about how I felt before we even left the hotel to what I am feeling now after the day is over is a complete 360 degree change. We started out the day by hopping onto tuk tuks to ride over to the hospital. Once we got there we split up into groups. Some helping with nursing check offs, some observing in the hospital and some catching up on journaling. I chose the group that was catching up on journaling since I hadn't even started the journals for community health. I worked on those for a couple of hours then we headed to lunch that was provided for us at the hospital.

After lunch the community health group headed to do home visits. As I was on the bus riding to the home visits it was extremely hot (as usual) and being in scrubs did not help at all. Once we arrived at the village my feelings started to shift from frustration, and annoyance to grief and shock to see how the people of this village lived. There was a big group of us so we split into 3 different groups. One group went into the village to do two home visits while the other two groups stayed back at the mobile clinic at the front of village. My group went last so I was sitting at the clinic for a while before I actually got to go into the village. While I was waiting there were so many women bringing their babies and children to the clinic to get medicine. Most of the babies were unclothed and all of the children were barefoot walking around in the dirt.

My time finally came to go into the village and meet the two families we were bringing rice and fish sauce to. I really didn't know exactly what to expect but what I saw definitely was not it. Walking to the houses we had to walk on huge concrete cylinders that were placed into feet of water and sewage in between rows and rows of huts the people of the village lived in. The smell was absolutely awful. My heart was absolutely broken for these hundreds of men, women, children and babies that had to live in conditions like that. What amazed me the most was that in the midst of all these terrible conditions these people were living in, there was a smile on every single one of their faces. That especially goes for the children that were living there. They were so happy when they saw us and started running up to us giving us hugs and high fives and a couple of kids even chased after us because they didnt want us to leave. As we were leaving I thought to myself if the people of this village are as happy as they are living in these horrible conditions how could I ever be unhappy about anything? I immediately felt so humbled and even guilty. My perspective of this whole trip completely changed after leaving the village. I am so very grateful that I got the opportunity to go on the home visits. It has been my favorite thing on the trip thus far. Every time I feel myself getting frustrated because something changed or didn't go a certain way, I'll think back to all of those smiling faces and tell myself if those people be happy in the situations they are in so can I, no matter what.

This whole trip I have been noticing "the little things", most of which have broken my heart. The personal items in store bathrooms indicating that people both work and live there. The cardboard lying on the street where people slept the night before. The pain in the eyes of children who have had to grow up too quickly. The angry, upward-thrust jaw of a prostitute who has had to defend herself over and over again. This country looks like paradise until you get close enough to see the reality for many Cambodian people. After seeing these things for a few days I was beginning to feel helpless and hopeless. However; today at the emergency hospital in Battambang, I noticed the power of some other "little things". Smiles, bubbles, play-doh and coloring books brought relief to suffering children. Some teaching about pain assessment and documentation will help nurses at the hospital to better control their patient's pain. Donating blood will help save the lives of some patients. All of these things reminded me of the positive influence a single person, who is willing to serve, can have on a group of people. With two hands and a willing heart we can provide relief. The power of the little things I saw today sparked a new passion in me. It helped me to realize that I am not powerless as one person. I can still inspire hope.

"Yet this I call to mind and therefore I have hope: because of The Lord's great love we are not consumed, for His compassions never fail." Lamentations 21-22

Mission to Cambodia 2013

Today (Wednesday) we arose, packed our things,  and ate a breakfast of fruit, bread, white rice, and hard boiled eggs with a spicy noodle dish. Then we boarded the Mekong Express bus to ride a 6 hour drive from Siem Reap to Phnom Penh. The Mekong Express is titled “Limousine Bus Express.” There is a bus stewardess that wears a dressy uniform and serves us Wet-Ones packets and snacks in a box. The snack consists of two pastries and a bottle of water. The bus is wired for wifi, however on this trip the wifi wasn’t working. It is also considered a limousine because there is a bathroom on the bus. We set off driving down the main highway which happens to be the only two lane paved road that connects Siam Reap with Phnom Penh. The bus has air conditioning but today, this too is not working very well. In fact, hot air is coming out of the air vents. There is a consistent noise of the bus honking. In Cambodian culture you do not honk at other people because they cut you off you are angry at them. Here, you honk to warn the other traffic that you are driving up behind them and they need to move. It’s a safety rule. There’s also the noise of a clap or slap on the knee as many flies, gnats, or mosquitos,  are being killed. After driving for 2 hours we are all sweaty, tired, and a little miserable. We stop in a small town next to some roadside stands selling nuts, beans, mangoes, and crickets.

We cross the street to a buss stop restaurant/hotel and make our way upstairs to an air conditioned room.  We order sodas and iced coffees and share our snacks consisting of cookies, chips, and peanut butter crackers. After 30 minutes we board the bus again preparing for the four hour drive we have left. While sitting on the bus several of us start talking about the heat and before I know it we are laughing. I’m laughing so hard that I’m crying and we can’t stop giggling about how ridiculous we all are. It’s HOT! We are sweaty and sticky and a mess. This is not exactly the fun part about a mission trip. Its not the favorite moment we all want to frame in our mind and take back home with us. Although for me, it is. In this moment I realize that even though we are miserably hot and exhausted and probably suffering from dehydration, as a team we are sharing life together. The good, the bad, the in between. That’s exactly what we’ve been doing these past 11 days.

I enjoy road trips because they provide a decent time for reflection. Looking out the window I see rice fields, dirt roads, houses made of tarps and spare wood, half dressed children running around playing, small trash piles, and trash spread out in family’s huts. There are small farms, people working in the fields, small road side stands, and temples. Numerous Buddhist temples. Sometimes the temples have sides that are open allowing me to see a Buddha statues inside of them. Sometimes there are really big temples in the fields. The extravagant colors and fancy architecture do not fit in the surrounding poverty. Yet almost every home has a small temple at the entrance. My heart is broken for the people of Cambodia. My heart is broken for the impoverished. For the brothels in the cities where I know that sex trafficking is a prominent thing. For the begging and hungry children and their parents at the bus stops. My heart is broken for the people of Cambodia.

"Then he said to his disciples, 'The harvest is plentiful but the workers are few.  Ask the Lord of the harvest, therefore, to send out workers into his harvest field.'" - Matthew 9:37-38

"We are indeed fortunate to have someone with Dr. Brown’s extensive academic preparation, and her notable teaching, clinical and administrative experience, assume this important position," said Taylor in making the announcement.  Brown takes the place of Dr. John Halle who is returning to the classroom full-time.

Dr. Brown holds a BS in Physical Therapy from Daemen College, Amherst, NY; the MS in Physical Therapy from the University of North Carolina at Chapel Hill and a PhD in Neuroscience from the University of Texas, Dallas. Prior to arriving at Belmont, she served in administrative roles at the Vanderbilt Bill Wilkerson Center, as Acting Chair for the Ithaca College Physical Therapy Department and as Interim Chair at the UT Southwestern Allied Health Sciences School, Department of Physical Therapy.

Since joining the Physical Therapy faculty at Belmont in 2005, Dr. Brown has served the University, the College and the Department in an exemplary fashion. She is active in the American Physical Therapy Association at the national level, is experienced with academic accreditation requirements and is the out-going University Institutional Review Board Chair. Additionally, she has led several medical mission trips, working to establish numerous partnerships in order to support these efforts and to make the experience more meaningful for both students and patients.

Mission to Cambodia 2013

My day started with a lot of questions. I questioned why am I here, what am I doing, and God, what is your purpose? We have reached that point in the trip where everyone is tired, people are ready to see a change in the work we are doing here, we are all wondering what our purpose here is, and we are needing strength and positivity again. It is something that we have heard will happen during the trip, but never thought would actually happen. It did. I knew I wasn’t alone with my feelings. Even though I had all these questions, for some reason I felt like today would be different. It was. I had been praying all this time that God would open my heart and let me see what I need to see in Cambodia that will make all this time worthwhile.

Today we went back to the hospital again. This was the last day we would be spending here, for tomorrow we are heading to Bottambong. I was not expecting too much today, because we were doing nursing check offs for the nurses who work in the hospital. The first time we came to the hospital, I did not do or see very much. It was not a busy day, so I was not expecting anything more of today. After a couple hours of doing the check-offs, Mrs. Morse switches up the groups, so some of us can go and observe various parts of the hospital. She sends Emily Eayre, Taylor Bonds, and me to the ER. They treat the ER as a faster clinic type setting, and it is free. We ask the nurses how it has been so far, and they reply with a little laugh, “there are no more patients today.” I thought, “Oh, great. Another slow day.” There was only one patient in the room. Little did I know, that this patient would have such an impact on my experience in Cambodia, and become something that I will remember forever.

We open the curtain to Bed 3 to see this tiny and frail old lady, with her two children, straddling the back of a wooden chair. We see her chest X-ray up on the board. It is very obvious that she has fluid in her lungs, so we proceed to ask the doctor what exactly is wrong. This precious old lady has pleural effusion. A pleural effusion is a buildup of fluid between the layers of tissue that line the lungs and chest cavity. We sit back and watch four doctors try to think of a way to get the fluid out, so the patient can breath better. As one doctor is putting in a needle between the ribs to numb the area, three other doctors are brainstorming about which needle should be used to drain the fluid. After three different needles are pushed in and out of this poor woman’s back, they finally choose a needle. They stick it between two ribs on the woman’s back to get to the lung that is filled with the most fluid. With only a needle and syringe at hand, they start pulling the fluid out, filling up three catheter size syringes. It took them a while to figure out how to hook it up to a tube, but they finally hooked it up and the tube drained the fluid from the lungs into a small gasoline tank.

At this moment, Emily, Taylor and I had a look on our faces that we will never forget. You could tell we were all feeling the same way, and could not believe what we had just seen. When we walked out of the room to take a lunch break, we all broke down. I do not think any of us felt more helpless, more questionable about our faith, or more heartbroken. At this time, I reflected on our devotional we had that morning. It contained the scripture at the beginning of this blog: James 1: 2-4. It talked about keeping your endurance, for when times get rough that is when God can take over your heart. When he is testing your faith and when you are most vulnerable, that is the moment that God can step in, show you his plan, and open you eyes to what he needs you to see. Today when I was most vulnerable, feeling down, and loosing faith as to what God’s plan for me was while I am here, he tested me.

Before we were about to leave the hospital, I asked if I could go back down to the ER. I felt a really big urge to go back down, even if the tiny, brittle, old woman was not there, I felt the need to go back. When I entered the room, the woman was not there, but there was a new chest X-ray. It showed lungs that were closer in size, a trachea that was midline, and a label that said “post” on it. The doctors said that they had taken out 500mL of fluid from her lungs, could have taken out more but did not want to take out too much, and she was well enough to be sent home. This new chest X-ray gave me hope, it gave me peace that the woman was feeling better and got to be home, and it really opened my eyes to the work we are doing here in Cambodia. I little smile and love goes a long way. Through trials and tribulations, God’s light can shine. He can take a hard and difficult time, and show you his beauty, his timing, and his perfect plan. Best of all, he will always give you the endurance you need to carry on and do the work that he provides you the opportunity to do.

Today I feel blessed. I feel positive. I feel helpful. I feel like I am doing what I can do in Cambodia. Whether big or small, our team is making a difference here.

“For I know the plans I have for you, declared the Lord. Plans to prosper you, not to harm you. Plans to give you hope and a future.”     Jeremiah 29:11

Mission to Cambodia 2013

"Smile! When you walk, smile,” he said. Niron, one of the individuals assisting us on this trip, was simply giving us a short message, and while motos and tuk tuks were zooming between us on the busy streets beside Sihanouk Hospital, neither the environment nor the simplicity of his message detracted from his meaning. Instead, both added to what he was really saying: these people are grateful to have you, and even if you do nothing but smile at them, you are making a difference. As Mrs. Taplin would say, you are planting a seed.

It is challenging to immerse oneself in a different country, especially a developing country. Discovering one’s purpose in this immersion is even more difficult; this is why Niron’s simple message to smile was so encouraging and set the stage for us to be bold and compassionate. Today was a big day for most of us, and while I could lead you through a chronological narrative of the day’s events, this would detract from my purpose in writing. I want, instead, to share tidbits of memories from the day. Small situations and stories that define the culture, the service we are providing, and the growth we are enduring.

I had an impromptu lunch today with a man named Borey. He also worked for the hospital. We talked about Cambodia, the state of health here, and similarities and difference between Cambodia and America. Borey was kind enough to teach me a few extra words in his language, and I returned the favor by answering his questions about American obesity and how much we love our big macs. The conversation was clearly a win-win. He taught me how to say “Yes” correctly. In English the spelling translates into “Barth.” The pronunciation, however, is actually “Baaht.” It sounds like the “baaa-ing” of lost sheep just with a “t” on the end. The lost sheep example also pretty much sums up how I feel about trying to learn this language.

Some of us received the opportunity to go on HIV home visits. This experience was one of the most rewarding and also one of the most sobering. One of the most exciting parts was playing “dog, dog, goose” with some of the children at the village. I know the name is wrong, but sometimes when you ask for the word “duck” to be translated, the translator hears you say “dog.” This leaves you saying the wrong word in a different language, teaching the game with the wrong word, having 15 or more Cambodian children laughing at you, and ensuring that no one who played or witnessed ever forgets the Americans who called their children “dog, dog, GOOSE!” What can you do? It happens, right? And we all know this is a pretty solid way to build relationships across cultural barriers.

Also during the home visits, we met a man with 4 children whose wife had recently died from lung cancer. When we first heard his story before going into his poverty-stricken home, I was sad. The story was tragic. I felt the emotion, but I wasn’t upset. We walked into his home, had some brief conversation, and I prepared to take a picture. Through my camera lens I noticed a bra hanging on the wall behind the man and his youngest daughter. I froze. Chills crawled. My heart broke. This was real. It was no joke. It was no sad story. The man’s wife had died 10 days ago. Her clothing was still hanging heavily throughout the home, and the man and his children were still grieving.

As an individual, I can absorb, understand, assimilate, or sometimes block the big things. Mass poverty, poor hygiene, lack of adequate nutrition, are all widespread problems in Cambodia. But the little things, the little things are hard to block. They drip through the cracks in the mental walls, are the backwash of assimilating the big things, and seep through the pores of your mind. The little things don’t get cleaned up. They stick to everything, and they do exactly what they are supposed to do. They make the story more than just something to be heard. They make things real, make them tangible, make them personal, and if you’re lucky, they make the broken pieces of a distraught heart just a little bit softer. And this is truly the blessing in disguise.

This blessing is how you smile when you walk, and this is how all of Cambodia with the pain, the suffering, and all of the big things that make waking up in the morning seem impossible, can smile, too.

The picture above was my favorite smile today.

Danny Smith (left), Awards Chair of TPTA, and Alan Meade (right), Vice President of TPTA, recognize Dr. Michael Voight as TPTA Educator of the Year.

Dr. Michael Voight, Professor of Physical Therapy, recently was named Educator of the Year by the Tennessee Physical Therapy Association (TPTA).

Dr. Voight was nominated for this honor by a former student, Dr. Ashley Campbell.  “In his life, Dr. Voight has educated thousands of students and clinicians, and I am lucky to be among that group,” said Campbell.  She added, “as a student, Dr. Voight guided, encouraged and challenged me to be the best.  He taught me by example what it means to be great, and to never be satisfied with good.  He never ceases to amaze me in his passion and dedication to the profession of physical therapy, especially the education of both future and current clinicians.”

Dr. Voight has taught orthopedics at Belmont since 1998, the year after the graduate program in physical therapy was initiated by the university.   In addition to his full-time role as professor, Dr. Voight serves as Editor-in-Chief of the International Journal of Sports Physical Therapy, consults with a number of noted golf professionals for the Titleist Performance Institute on the prevention, evaluation and treatment of golf injuries, and lectures extensively at various conferences, symposiums, and congresses both nationally and internationally, having given over 600 professional presentations on a variety of orthopedic and sports medicine topics.

In years past Dr. Voight has worked or consulted with a number of professional sports organizations, including the Philadelphia Eagles, Miami Dolphins and Tennessee Titans of the National Football League (NFL), the Miami Heat of the National Basketball Association (NBA), and various teams in Major League Baseball (MLB), the National Hockey League (NHL), and Major League Soccer (MLS).  Early in his career he became active within the United States Olympic Committee's Sports Medicine Division. He has worked at the Olympic Training Center, Olympic Festivals, Pan Am Games, Olympic Games, and has had the opportunity to travel to almost all of the different continents with various Olympic and national teams.

Most recently, Voight has worked with the Medical Commission for FIFA (the International governing body for soccer) and the Professional Golf Association (PGA).  He was selected in 2011 as a Catherine Worthingham Fellow of the American Physical Therapy Association (APTA), the most prestigious honor granted by the organization which recognizes those who have made lasting and significant advances in the science, education and practice of the profession of physical therapy.

Mission to Cambodia 2013

Yesterday we had the privilege of seeing one of the wonders of the world and the largest religious monument in the world, Angkor Wat. Along with Angkor Wat there are a number of temples that were also built in the area. They were built in the 12th century by the Khmer King Suryavarman II.

We started the morning off at 4:45 am with a tuk tuk ride to Angkor Wat for sunrise. It was a beautiful sunrise over the reflecting pool with the 5 towers in the background. After sunrise we were able to walk through the temple taking in all the detailed wall carvings and complex architecture. A few of us fell behind the group and were last to pile into the tuk tuks to venture to the next temple. Our tuk tuk driver (Lucky Blue, as he told us to call him) pulled off to the side of the road and asked if we wanted to ride elephants to the next temple, Bayon. What an opportunity! The elephant Emily and I rode was named Teeplae. Everyone in our group was able to ride an elephant and I think we can collectively say it was such a fun experience!

After the temple Bayon, we went to Baphuon, Preah Khan, and Ta Prohm. Ta Prohm was my favorite temple because of the different trees growing over the temple and the unique carvings on the stone columns (including one of a stegosaurus). After a full morning in the hot sun we grabbed some lunch and were even seated in an air conditioned room in the restaurant.

In the afternoon we split up into groups, some went shopping at the market, some went to the Cambodian Cultural Village, and some just stayed at the hotel and took a much needed nap. I happened to go to the Cultural Village and learn a little more about the history and architecture of Cambodia. We saw miniature replications of the buildings in Phnom Penh like the Royal Palace, Independence monument, and the national museum. There was also a place for us to try archery. It was a first for many and lots of fun for Mrs. Morse and me to teach the others how to hold the bow and arrow.

For dinner we went to the Koulen Restaurant for a buffet dinner and a traditional Khmer dancing show. Then a trip back to the night market.

Needless to say it was a very long and hot day for us, but the entire day was such a blessing. I believe that in order to better help the people in Cambodia it was a much needed day to take in some of the sights and learn more about their culture. I am so thankful for this group, they all have such big hearts for the people and for each other.

The American Nurses Credentialing Center (ANCC) administers the the advanced practice nursing examination for family nurse practitioners. More than a quarter million nurses have been certified by ANCC since 1990, and over 80,000 advanced practice nurses are currently certified by ANCC. ANCC certification is accepted by governing boards throughout the United States as well as insurers and the military. The program validates nurses’ skills, knowledge and abilities and empowers nurses within their professional sphere while contributing to better patient outcomes.

Clayton McWhorter (left) and Dr. Richard Treadway (right) presented the first McWhorter Society Distinguished Service Award to Barbara Massey Rogers (center).

Belmont University’s Office of Advancement recently established the Clayton McWhorter Society, a giving society intended to further the work of Belmont’s health science programs. The new group, which held its inaugural membership lunch on May 2, is named in honor of long-time Belmont supporter Clayton McWhorter and will directly benefit the College of Health Sciences & Nursing, the College of Pharmacy and the new MBA for Healthcare Professionals.

Clayton McWhorter’s leadership and role in the development of healthcare industry giants HealthTrust, Inc. and HCA have made a strong impression in the field of healthcare. In 1996, Clayton, his son Stuart, and a close business friend created the venture capital firm Clayton Associates, which quickly evolved into a hub of strategic business development activities related to new firms in healthcare, technology and diversified services.

His relationship with the University began in the late ’80s through an invitation from Jack Massey “to get involved with Belmont,” and 25 years later, Clayton McWhorter continues his generous response to Massey’s challenge through his support of a variety of programs and initiatives.

Belmont Vice President for University Advancement Dr. Bo Thomas said, “While Clayton’s many achievements are based on sound business principles and bone-deep ethical standards, in the end it is his commitment to making a difference in the lives of others and giving back to the community that has sealed his enduring success and legacy. Belmont University counts itself fortunate to be among the many who have benefited from Clayton’s generous spirit and friendship. Through the McWhorter Society, Clayton is now challenging others to ‘to get involved with Belmont’ just as Jack Massey encouraged him to do years ago.”

Dr. Richard Treadway, founder of Psychiatric Solutions and long-time friend of Clayton’s and of Belmont, is the first chair of the McWhorter Society Board of Directors, which includes a number of leading healthcare professionals along with Belmont healthcare leaders. At the luncheon, Barbara Massey Rogers received the first McWhorter Society Distinguished Service Award for her tireless support of Belmont University, including her service on the Belmont Board of Trustees and the Massey Advisory Board.

In addition to an invitation to the annual McWhorter Society luncheon, Society membership includes inclusion in special business and healthcare forums, panel discussions and events as well as an opportunity to network with Nashville’s top healthcare professionals. For more information about becoming a member of The McWhorter Society or the programs outlined within, please contact Willie Young  at (615) 460-6179 or Bo Thomas at (615) 460-6434.