Jamaica, New England, and back to Richmond

Cycling around my parents' home in Weyers Cave, VA made me realize that I appreciate this scenery even more than shores of the Caribbean

A new semester arrives:

It's been a well-spent six weeks away from the dental school (I'm definitely ready to get back to my dental studies!). I enjoyed serving in Jamaica for two weeks with a dental group and was glad to spend time with family camping at a state park on the Chesapeake Bay, as we have annually done for nearly 15 years. I was delighted to shadow a medical director and his team at several nursing home facilities in my hometown and provided an in-service talk on oral hygiene to one of the facilities' nurse teams. I joined a group of bicyclists for a five day ride in the Finger Lakes region of NY; cycling over 250 miles, the group raised funds for Mennonite Central Committee's reforestation and environmental education efforts in Haiti. Returning from upstate New York for two days of orientation at the dental school, I am able to evade the heat and humidity of Richmond for several more days while at a summit in Falmouth, Massachusetts with the National Interprofessional Initiative on Oral Health, to which a senior medical student (the founding president) and I (the current president) have been invited to share about VCU's student initiated and led Inter Health Professionals Alliance. I regret not being enrolled in any gerontology courses this semester, as I am advised to get a taste of the challenging second year of dental school before taking on an extra academic load, but was delighted to receive an invitation to join the newly formed Long-Term Care Dental Access Work Group for the Virginia Dental Association. I look forward to all the academic and extracurricular aspects of my third semester of dental school. As the opportunities continue to roll in, I hope I might discern how to 'pull in the reins' before a person or situation has to be burdened with the task....but so far, excitement is overshadowing such prudent caution.

These little reptiles would appear in the morning and evening to take care of some of the insects at our guesthouse in Jamaica

The 'Tree House' guesthouse offered an ocean-hovering porch on the coral-laden shore

Locals (and those traveling from a distance) await dental treatment at the Helping Hand Dental Clinic

The cheerfully busy dental clinic

A shy but friendly Jamaican

My last two days in Jamaica were spent at a children's home near Montego Bay

A jolly family portrait

Picking guineps with Jerome, who unceremoniously gifted me a bracelet he'd woven within five minutes of my arrival at the Robin's Nest

Reflections from Jamaica:

Walking down a dusty neighborhood street without the validation of scrubs in the late afternoon (just as locals emerged from their homes to begin evening fellowship), I wondered how my trespassing might be enriching rather than disruptive. Informal interactions often involve pleas for financial attention, requests for a response to comments about physical appearance, or simple mutual passivity. The staged feel of such exchanges seems empty and draining, perhaps because certain expectations are assigned to each side. An unscripted (and therefore unexpected) response on either side of the interaction might provide an avenue out of such impersonal junctions into more enriching exchanges.

Trying to look forward after a brief greeting, as we passed a group of Jamaicans near a small grocery shop, I focused on lightly tossing my newly purchased mango. Not hearing the beginning of the address, I comprehended, "Can I have a mango?" Regretting that my mango-tossing attracted attention, I turned and tossed the mango with a smile, turning back around to continue my trek. Being called back, my mango-requesting friend approached to return the mango, saying, "It's OK; take it back," which I clarified, "Are you sure? You can have it." His response, "I didn't know you would be so kind," caught me off guard. The statement seemed both insulting and flattering, perhaps hinting at an underlying intent for the exchange. Uttering a sheepish "Thank you," I resumed my mango-tossing journey, feeling content and hopeful about the positive fingerprint I may have left on the interaction.

The Jamaican's surprise at my "kindness" caused me to wonder how I succeeded or failed at showing the same characteristic in other situations during the week. I cherished the occasional complement from a patient about having enjoyed the treatment, performed by a "gentle and kind" clinician and am challenged to return home and seek opportunities to thus surprise people.

****

Opening the shutters on an early Jamaican morning to a beautiful country scape with mountains in the distance, I hear goats, birds, and chickens starting about their daily business. Someone starts pounding a hammer on a construction project and the never-ceasing breeze ruffles palm branches; meanwhile, waves rush somewhere in the background. Waking in such a setting on several mornings, I consider what it would be like to call this land home. Would I arise a bit earlier, before the sun becomes harsh, and pick up my hammer to join the neighbor on his project? How long would it take before I would stop hearing the unique sounds of animals and nature? When did I cease to thus stop to listen and look at my surroundings in the States?

One of my friends commented on a picture I sent by saying, "Jamaica looks and sounds like paradise." In my response, I expressed my desire to be content wherever I go, hopeful that if we fully appreciate, respect, and love our homes and surroundings, they would indeed be paradise (perhaps even akin to the Kingdom of the Heavens, as the gospel of Matthew talks about). I return to my home with fresh eyes and ears, hoping to be more conscious of my surroundings and my intended interaction with them.

Sunset on the artificial reef at Kiptopeke State Park on the Eastern Shore of Virginia, a place that has become an annual time to retreat and reconnect with the family after being scattered and distracted during the school year

I attended the Virginia Mennonite Conference assembly, the theme of which was "See the signs of God's Kingdom among us"....this was my favorite sign

The MCC Finger Lakes bike ride logo on our complimentary t-shirts

Soufrana Elistin, a Hatian woman, receiving seedlings as part of the MCC reforestation and environmental education programs that we raised over $50k for during our five day ride. Her quote on the back reads, "These trees are our lives. They allow us to eat and make a living and send our kids to school." Soufrana rode with us in our jersey pockets as we cycled over 250 miles in tree-abundant upstate NY

Seneca Lake, one of the Finger Lakes, all of which were carved into the land by glaciers

One of our camp sites...I have definitely become fond of evergreens and wildflowers on the side of the road 

Seneca Falls, a historic town for the women's rights movement

Stopping for a refreshment and directions while on a detour

My first set of business cards....dental appointment cards adapted to represent the student initiated and led interprofessional outreach organization at a summit of 43 national leaders in the health professions who are passionate about cross-disciplinary collaboration to address oral health disparities in our country

Article response to a conference sponsored by the Christian Medical and Dental Association:

“Get up,” Jesus told him, “pick up your mat and walk!” I sat awe-stricken as the story continued to be read at a weeknight prayer meeting, imagining what it would be like to receive these words from the Messiah and at the same time hearing the Spirit echoing exactly this address into my own heart. Revisiting the story of Jesus’ third miracle, according to the gospel of John, after attending this year’s Emerging Leaders in Dentistry (ELD) Symposium has allowed me to continue reflecting on the abundant words of wisdom and life experiences that were shared at the meeting. The story of Jesus’ radical healing encourages me to apply what I heard and saw at the symposium to my life as a disciple of Christ, dental student, and future oral healthcare professional. I’ll review several moments from the symposium that caught my attention and will try to convey how I’ve been inspired by the above-mentioned gospel story to apply those snippets.

A foundation for the symposium was quickly established when Dr. DeWitt Wilkerson challenged us to transition from thinking about success towards striving for significance. He reminded us that God seeks those that are available, not necessarily those that are capable to do His work. Dr. Wilkerson encouraged us, in considering the trajectory of our career paths, to use strategic planning, asking ourselves the question, “What would things be like if they were the best they could be?” and then taking action to get there, as apposed to using the mundane past-present-future projections of long-term planning. Dr. Peter Dawson demonstrated how to verbalize genuine patient-centered care by recommending that we use phrases like “Help me understand your concerns” and “Let me help you understand.” The symposium then took on the role of a summons, as we were stretched to consider how to more fully merge vocation with ministry as Christian dentists. Captain Michael Marks aptly noted during a dentist panel discussion, “Ships are safe in a harbor, but that’s not what ships are for.” Ms. Joan Forrest, inviting us to intentional life and practice, suggested, “If you don’t know where you’re going, any road will take you there.” Dr. John Hall’s Sunday morning message challenged us to admit that “dentistry is a key,” pushing us to consider, “Which lock will we use it to open?” Being somewhat facetious but truthfully direct, he offered 3 items of advice on how to “ruin your life and miss your calling”: 1) pursue the American Dream (disregarding God’s purposes), 2) be unequally yoked (with a life-partner who is hesitant to pursue God’s will), and 3) continue listening to truth without acting on it (becoming progressively more calloused). Interacting with a diverse group of students, dentists, and other healthcare professionals during meals and throughout the symposium deepened the words that we heard and helped put life into the concepts that were presented. The three brief days left us all looking forward to returning with other colleagues for the following year’s symposium.

Now if we return to the five colonnades of the pool in Jerusalem called Bethesda, we would see a man lying on his mat amidst a debilitated crowd. Perhaps some of us would even recognize a part of ourselves in this person.  As for many of the others, his life has been reduced to a restrained existence, likely dominated by the expectation to receive his next provision, necessary for the continuation of life as he knows it. A mutual longing for liberation hangs in the air around these pools. Juxtaposing such hope, a rival tension is felt.  Healing is seemingly scarce, offered to those who faithfully wait for the angel’s descent into the pool. Waiting and recognizing the stirring water is not enough; one must be swift enough to reach it first. This particular sick man has been there for 38 years! He ardently waits for his turn to experience the healing stir of the waters, which he earnestly believes will free him from his confining ailment. He must look patiently content, though, since Jesus approaches him asking, “Do you want to get well?” Perhaps justifying the excuse that he has accepted as reality, the sick man responds to Jesus by explaining that he does not have someone to help him reach the stirring water before another takes advantage of its healing power. Here, Jesus doesn’t move to a more optimistic cripple or rebuke him of his doubt in God’s abundant and unlimited healing potential; neither does He offer advice for finally succeeding in the plan he may have depended on for nearly four decades. Jesus simply commands him into healed action: “Get up,” Jesus told him, “pick up your mat and walk!” The Messiah doesn’t just allow him to leave his mat healed to do what he pleases; Jesus tells him to pick up the mat he’s lied on for 38 years and walk with it, a controversial thing to do on the Sabbath, mind you. The sick man doesn’t contend with Jesus, offering his latest plan for reaching the stirring water first. Nor does he refuse to accept the charge of walking with his mat, which is likely mangled and soiled from long-term use. He must not have thought twice about Jesus’ words because we read, Instantly the man got well, picked up his mat, and started to walk. The gospel story goes on to tell of how Jesus was challenged by the pious Jews for healing on the Sabbath, and we don’t know what became of our healed friend, except that Jesus told him to sin no more. Perhaps he was given the liberty to develop an abundant life in his own creativity, springing forth from his healing encounter with Christ.

I will close by sharing a few questions that I’ve considered in thinking about being such a mat-ridden cripple, while trying to sort through highlights from the ELD Symposium: What has developed into a comfortable mat for me, whether or not I realize its confining nature? Do I gravitate towards a company of people that are also seeking healing into a more abundant life? How well-developed is my plan for retiring or moving off from the mat and how does this oppose the ability of God to act through me on His own terms? Whose additional action do I expect to catalyze my healing, and what hindering excuses result of such expectations? How will or do I react to Christ’s radical call to healed action? Am I willing to be ridiculed or even rebuked for carrying a burden that is seemingly meant for my stationary comfort? Jesus challenged His disciples, according to Luke’s gospel, that “Much will be required for everyone who has been given much. And even more will be expected of the one who has been entrusted more,” but we are also comforted by what the gospel of Matthew recorded from Jesus’ address to the crowd: “Come to Me, all of you who are weary and burdened, and I will give you rest. All of you, take up My yoke and learn from Me, because I am gentle and humble in heart, and you will find rest for yourselves. For My yoke is easy and My burden is light.” Accepting how the Spirit has chosen to speak to me through the ELD symposium, I resolve to be grateful for the blessed burden of a career in dentistry, as well as the burden of the gospel; but most of all, I am grateful that I may commit both, as I commit my life as a whole, to the One who Paul recognized “is able to do above and beyond all that we ask or think according to the power that works in us.”

Shoreline pebble-seeking is always such a fun endeavor--you never know quite what will catch your eye and end up in your hand! Isn't that how much of our life comes together? : )

It's been a privilege to work in design team exercises with national healthcare leaders  to brainstorm how to incorporate oral health into interprofessional education and clinical practice. It is inspiring to consider developing a future contributing to such a strong collaborative network of diverse experts.

Vocation vs. livelihood and my research lab postulancy

I moved to my new home at the start of May (in the midst of exam week) and have enjoyed hearing the reassuring hum of the nearby trains, making their daily circuits.

May and June rushed by as the end of spring semester flowed into a fast-paced summer session. I enjoyed moving to stay in the home of older friends whose children are off to college/work and visiting the homes of those with whom I attend church to help out with spring home projects (I was also grateful for their generosity in supporting my impending service trip to Jamaica). Constructing and teaching a five-week introductory organic chemistry workshop for a small group of undergraduate pre-health professional students reminded me how much I missed tutoring/mentoring and made me wonder if teaching might someday become more than a summer job. I was eager to begin my studies in the program of Gerontology with a course in Geropharmacology (I think the geriatric world has enchanted me!). Visiting a national leader on health literacy (especially oral health), I was challenged to consider a career in Public Health Dentistry as an academic. Returning for a second summer to work in the microbiology lab, I evaluated my long-term fitness for scientific research. Attending pathology class every morning with my dental classmates, I wondered how my current involvements might channel together in the coming years. These experiences have prompted the following two rabbit trails of thought.

I enjoyed visiting the University of Maryland School of Public Health at the start of June. I was surprised to pass a campus farm while searching for the right building...I think this school is on to something!

I joined some friends for a cookout in Ashland. Rooster, the grazing horse, was very friendly and gracious in allowing us to share his space for our fire.

Vocation vs. livelihood

One of my older friends often says that youth is the time in which one must discern where to go, with whom, and how. In trying to perceive what the majority of my adult life might entail, I’ve wondered about the difference between vocation (a calling: finding or putting meaning into one’s career) and livelihood (simply doing a job well in exchange for life’s necessities). Are these mutually exclusive from each other, depending on your given stratum of opportunity? Or is one of them a mythical illusion? In my naivety, I stubbornly cling to the existence of a vocation; I refuse to accept the idea of spending almost every day of my life doing something meaningless. In striving to recognize my special niche, I speculate whether my vocation will be a balance (simultaneous involvement in a blended assortment of my interests), a progression (focusing on one interest and transitioning through others over time), or a coincidence of the two. It would be nice to pursue my current involvements with these realities unveiled, but Soren Kierkegaard aptly noted: “Life can only be understood backwards; but it must it must be lived forward.”

Across the street from the emergency room and the dental school is an enclosed garden that suggests a 'getaway' feel from the rest of the busy medical campus.

Postulancy in a microbiology research lab

When I found myself scanning images in the dark microscopy room late at night and dozing off between scans the next morning, I recalled researchers’ comments about the sleep they didn’t get due to grant deadlines and speaking arrangements. When leaving the lab with a heavy feeling akin to guilt from the uncertainty of adding cells to a certain plate (knowing that the next day’s growth would reveal the omission), I wondered about a spiritual devotion that may come with scientific research. Hearing investigators talk about “elegant experiments” and doing “pure science,” I came to the realization (which might exist at least in part) that scientific research is a form of asceticism, a form of post-modern monasticism. Knowing that there is a process for entering a monastery, I investigated the various levels of belonging and was able to draw some parallels (I hope that I am reporting accurate information on this process). A layperson can enter a monastery for several weeks as an observer, where he/she might learn about what life there is like. If interest in monastic life emerges, one can become a postulant for several months, trying out a life committed to monasticism. If not scared off by the work and traditions of monastic life, one commits to life in the monastery as a novice, doing much of the work but also being involved in prayer/study. After some time of being an exceptional novice, group discernment may promote one to become a junior, who spends less time working and more time in prayer/study and leading others at the monastery.

It’s not surprising that any organized group (including a research lab) should follow a similar structure. I found myself relating to the position of postulant, investing myself in the lab more than an observer but not quite committing as a novice. It was telling for me to recognize being bogged down in the techniques and procedures of doing science. Perhaps because of all my other involvements, I did not often sit down to study my results and seek out what they might mean for the theory of science. The Principle Investigator of the lab, on the other hand, is very familiar with every lab member's project but only takes up the pipette to do wet lab work once in a while. Being a proponent of active discipling after Jesus, I strive to connect my actions with my beliefs, but see that I’ve not done exactly that in the research lab (focusing more on the techniques while neglecting to appreciate the theoretical essence of science). I was privileged to hear Dr. Peter Dawson speak almost a week ago at a dental conference and appreciated the contrast he made between success and significance/purpose. I am grateful for my “postulancy” in the research lab but will allow others that are able to bring significance and purpose to successful lab work to continue the important work while I continue pursuing my passions elsewhere.

Clouds move in on a stormy Thursday afternoon. With tornado warnings, an organic chemistry workshop was canceled for the evening but microscope image analysis proceeded on the ninth floor of a medical school research building. The Children's Hospital construction site must have collected a lot of water during the storm.

I purchased a mandolin several weeks ago and aim to gain proficiency during the remaining month of my summer break. I look forward to serving in Jamaica for two weeks starting this Saturday and will eagerly report on the trip as well as a cycling/camping tour in New York. I'll be returning to a fall semester at the dental school before I know it!

It was very comforting to return to the Valley after completing my Part I National Dental Board Exam. The city of Harrisonburg continues to blossom in diversity of people, something I've missed while living in Richmond.

Why Gerodontics? (aka Geriatric Dentistry)

...down at the James River pipeline walk with a visiting cousin

Finding candy and Russian Easter bread ('Paskha' or Пасха) in my mailbox after a long school day and cold ride home was very pleasant. I have such a sweet (literally) mom : )

Long-awaited signs of spring...

It has been a year since I returned from Latin America. Where did I expect to be at this point?…maybe I hadn't made too many specific goals for myself. I was glad to be starting a new phase in my life, excited to welcome all the new experiences that moving to Richmond and starting dental school entailed. I definitely agree that I can trace some of my current passions and realities to that internship, but I'm not sure that I could have predicted how each individual experience would contribute to my current aspirations.

Arriving in Lexington a bit early, I stopped by the town's (NHSC Scholar-eligible!) Community Health Center.  They recently received a grant to transition from a free clinic to a sliding-scale, self-sustaining health center and have employed a retired dentist for two years until they can recruit a full-time dentist; they will also start a school dental outreach program in August 2013. During the State Science Fair at VMI, for which I served as a student judge with the Virginia Dental Association (VDA), I met the dental director of this health center (who practices privately and reported visiting some of his home-bound elderly patients, which are a major and growing population in Lexington). My enthusiasm for the center's advancements and my eager questions were welcomed and a visit may be arranged for later in the summer. Perhaps they might be able to use my public health-leaning energies in three years : )

A frosty football field on the VMI campus on the morning of the State Science Fair....

Jeremy Jordan (D2), me (D1), Dr. Timothy Russell (director of the VDA Science Fair awards), and Brian Mahoney (D3)...part of the VDA judging panel.

In looking back at my progression after returning from Latin America more specifically, I am amazed at how my interest in geriatric dentistry (and the elderly, overall) has developed throughout the year. I can't credit just once source for this inspiration but am convinced that every brief exposure has added to the still-assembling puzzle.

Last week, on the same day that I was accepted into the Gerontology graduate program at the VCU School of Allied Health, my older sister (an RN, wife, and mom of two toddlers) received notice of her acceptance into the JMU/SU Midwifery Program. When she prepared for her interview the previous week, she reflected to me that her decision to pursue midwifery was partly inspired by her pre-teen discussion about my mother's experience with the iatrogenic (clinician-caused) death of her firstborn son (the ethical, medical, and social problems with how the situation was handled). This made me wonder if my developing passion for the elderly emerged in part from incompletely understanding or experiencing my grandfather's struggle with Alzheimer's Disease. Partly because my family lived far from our grandparents and because I was young when he died, his condition and how it affected the family became a mystery to me, especially in my teenage years. I found myself trying to uncover these questions in college, choosing to write a senior ethics capstone paper on genetic engineering and human enhancement and interviewing my aunts and grandmother about their role as his care-takers for a paper exploring Attachment Theory (changes in attachment patterns that occur during the progression of Alzheimer's Disease for the affected individual and their families). In biochemistry, I gravitated towards choosing to present an article on amyloid plaques (prevalent in Alzheimer's Disease brain tissue). In all these endeavors, I found myself seeking the benefit of experiencing such a condition (reconnecting with those that were hard to connect with, fully being a part of your genetic lineage and embracing your own heritage, and experiencing an intense form of the universal disease of aging: increased inflammation load with decreased antioxidant capacities). Perhaps I will continue these explorations as I pursue training in Gerontology or they will serve as an avenue into something else (more dental-related?!).

I seemed to pack away these undergraduate interests when I traveled to Latin America and discovered a fascination for public health. Although I had worked mostly with children in schools and adults in villages, I was deeply impacted by visiting a Catholic "asylum" for abandoned elderly and handicapped individuals in Peru (see April 2012 posts A and B). Upon returning to the States, I was disappointed not to be able to initiate or plug into a dental education outreach program in elementary schools (...it seems that more qualifications are necessary here than in Latin America to attempt to do good). Participating in all the Mission of Mercy Projects that the dental school offered, becoming Community Service Chair for my class, and even visiting University of North Carolina at Greensboro's School of Public Health open house (to investigate what pursuing the community based research-laden Doctor of Public Health degree entailed), I wondered how my DDS training fit into the big picture that seemed to be dominated by interest in public health. Resolving that a concrete skill in dental surgery would always be useful in the grand scheme of 'helping people' in any way, I tried to focus more than half-heartedly on my dental studies.

Over Thanksgiving Break, I carpooled with an EMU classmate who was in her first year pursuing MD/MPH training at Eastern Virginia Medical School. Exchanging perceptions about the first year of health professional school and the transition from undergraduate pre-health education into our programs, my classmate told of her experience as a nursing home CNA prior to being admitted into medical school. She commented on the lack of attention to oral healthcare amongst the caregivers and the struggle of offering oral hygiene to some residents. I told her about encountering The Lucy Corr Village free dental clinic in the Fall 2012 VDA Journal (a Chester, VA nursing home had recently opened up an in-facility, two-chair clinic in which residents could receive cleanings and treatments; the center also hoped to educate caregivers on the importance of daily oral care). This conversation stayed with me over the holiday weekend and was revisited on our return to Richmond. It became evident to me that children were not the only ones unable to adequately access oral healthcare services; furthermore, programs shedding light on and addressing such problems for the elderly were far more scarce than those existing for children. By the end of the semester, I had visited the Lucy Corr and was put in touch with a board member of the VHCA/Virginia Health Care Association (a state network for long-term care facilities) to investigate the possibility of combining my NHSC service commitment with addressing the need for improving oral health in institutionalized (as well as independent) elderly. I also sought out possible residency/fellowship programs for training in geriatric dentistry/gerodontics. This made my fantasy public health training and career path a little muddy : /

Beginning the semester with more visits to the Lucy Corr and meeting with the VHCA, I consulted with any experienced dentist/faculty that promised an ounce of compassion for the elderly as to the history, realistic needs, and possibilities of a career in public health-oriented geriatric dentistry. After sitting in on a VDA Public Health Education committee meeting as a student representative (where I met Dr. Timothy Russell and was invited to participate in the State Science Fair at VMI), I was able to interact with several public health dentists, VDA board members, and the dean of our dental school during a networking luncheon. I was encouraged by the dean to start a geriatric study club at the school (as our curriculum does not specifically address geriatric dental care). My interest was eagerly received by a VDA board member who anticipated that he could 'count on me to be part of the VDA's next steps in this critical field.' Also, I eagerly participated in an MCV pilot study in which a medical student and I visited a senior mentor (residing in a retirement community) for several weeks to interact with her and get an idea of what it means to age. The hope is that this is an effective way to introduce first year professional students to gerontology in an interprofessional setting. Perhaps the experience will become a part of each MCV campus school's curriculum in the future. Now that this topic is on my radar, I recognize many dental or medical-related journals/articles currently being published address the 'looming baby-boomers,' the oral-systemic health link, and interprofessional education and collaboration in practice (especially important in meeting geriatric needs). Enrolling in the Gerontology program at VCU, I hope to gain a bio-psycho-social perspective on aging so that I might better navigate the non-dental aspects of providing dental care to the elderly. I had hoped to offer an interventional study to several nursing homes in the Valley this summer (evaluate plaque, educate/motivate for oral hygiene improvement) but am finding that there is quite some resistance from various fronts (administration, residents, caregivers, a few from every group involved) to such a project. Witnessing how attempted educational workshops/training sessions at the Lucy Corr (an established clinic!) are easily avoided and ignored, my desire for this summer is to simply interact with elderly and their caregivers to better understand the how's and why's before trying to intervene. Is this the 'roots-up' approach that I was so excited to encounter during my Latin America internship?!

In my dental school application, I quoted Einstein, who said that "once we accept our limits, we go beyond them" (I encountered the quote on the syllabus of a self-guided Calculus course that I did the summer when I applied to dental school). In the personal statement, I admitted that as an immigrant child, I was faced with a dilemma when I realized that I was significantly different from my peers and might not ever completely assimilate: I had to choose between being inferior or extraordinary. Thus, my life has seemed to take the pattern of defining, meeting, and often exceeding my limits (exemplified by my perseverant entrance into the second-grade advanced reading group, becoming a conflict manager in 5th grade, and entering my first college course at age 15). Thinking that I'd almost 'arrived' when beginning dental school (on my way to a settled career in dentistry), I must have found it natural and subconsciously necessary to seek out the next limit. Gerodontics may provide exactly that! Working with the elderly provides a challenge (interprofessional collaboration and treatment of a bio-psycho-socially complex individual), an avenue for enacting justice and providing a needed service (something that has also become an organic and essential part of my life), as well as a place where I can offer compassion, honor, and an earnestly caring and most-humanely humble connection with another human being. I've made quite a few elderly friends and find interacting with them more satisfying than with some of my younger friends; perhaps this is like enjoying the taste a ripened fruit rather than a tart one. When so many take for granted what our geriatric population has to offer, I don't want to miss out on all the fun!

...So that's where I've wandered so far : ) Perhaps this is why there aren't too many 20-year old dental students--Most folks are smart enough to figure things out before they begin a graduate degree. However, I am convinced that one opportunity opens up into the next (life as a journey where we lay down stepping stones and connect dots, "Day to day pours out speech, and night to night reveals knowledge"--last post from February 2012). I look forward to reflecting in the future on where this new stepping stone will project me from here.

Alya, me, and Tayyaba represented the D1 class in the Molar Roller Bike Ride that occurred during the dental school's reunion weekend 

...Riding alongside the James River with some dental classmates and colleagues

An EMU senior photography major's project showed '100 Pictures, 100 Stories' of women of all ages, each commenting on what they enjoy most about being their age. I was most interested in the above half of the exhibit : )

EMU: "A Christian university like no other" The morning rain forced us inside the gym for the ceremony (a graduating class of just over 400 makes that possible...) but things calmed down in the afternoon so that graduates, families, and friends could mingle on the parking lots and lawns.

Another exciting recent occurrence is the publication of an article to which I contributed as a dental 'professional' (student). Titled Health disparities among highly vulnerable populations in the United States: a call ot action for medical and oral health care. I have been very fortunate to become involved with the Inter Health Professions Alliance on the MCV campus and will likely serve as the student group's president during the coming school year. Along with continuing the monthly Kroger Outreach blood pressure screenings, offering Educate Then Advocate instructional sessions for all health professions students, and reaching out to pre-health undergraduate students, the group hopes to implement an oral health focus in light of the oral-systemic health link that has recently been emphasized. This summer, in partnership with the IHPA's overseeing office, I've agreed to lead a 5-week Introduction to Organic Chemistry workshop for pre-health undergraduate students that are involved in MCV's acceleration program. Needless to continue, this is an exciting group in which to be involved.

You might be able to see the little worm on the lower right hanging from a thread of som sort (perhaps if you click to enlarge the photo). These guys have been hanging around during the past few weeks from nearly every tree. They've kept me alert while cycling and I've learned to dodge them from afar. I nearly swallowed one when smiling a couple of days ago...I am reminded of my friend mocking me for subconsciously smiling during our track meet races in middle school 

It's been fun to avoid studying for tomorrow's physiology final by taking notes en route, but I come to a close, lest I neglect to value in practice (ie, tomorrow's exam) the current opportunities that I have been provided with.

Visiting San Salvador during spring break

February flew by with the demands of dental school and I was refreshed at the start of March by joining a group of professional health students and clinicians for a service trip in San Salvador, El Salvador. Pictures tell some of the story:

My Father's House International, the orphanage that we came to support, works to reconcile separated families while lovingly caring for children before the process is complete.

Dr. Ed Read, one of our group leaders points out the area in which we are serving while we drive back to the hotel after the first day of clinic.

Another one of our leaders guides an elderly lady towards the triage table. 

Medical consults under the tents.

Physical therapy exercises

A great dental experience for all!

Dental corner of the beach-side clinic

Holding down a toddler for anterior extractions is no fun. I bet his mom felt the same way.

I really enjoyed praying with each patient on this trip...it's not something that I'd done on other service trips

These sisters posed in front of a church across the street from the town hall in which we held a clinic

Ed (MD) and Debby (RN) Read are the Christian Medical and Dental Association student group leaders on the MCV campus.  It has been such a blessing to get to know them and be involved in the group since starting dental school.

I'm looking forward to Easter weekend and hope you enjoy it also. Nearly one more month and I'll have completed my first year of dental school! That feels like an accomplishment, considering that we've lost 4 classmates so far...but it also is a joyous and frightening reality check for the fact that I will be a practicing dentist in just over three short years!

San Luis, Mexico and a new semester

Yes, it says "beef and pork tacos" in white on that small building.

The church building reflects the rising sun in a small neighborhood of the city of San Luis, Mexico.

Rows and rows of salad greens, cabbage, cotton and other cash crops...

The day after finishing fall semester exams, I traveled to San Luis, Mexico to visit several schools and churches with oral health workshops and tooth brushes/paste. I enjoyed my 9-day trip (except spending a long night and morning of Christmas Eve in the Pheonix airport) and spent the holidays with family in the Valley. Returning to a new (second) semester, I felt a new sense of belonging in my green scrubs, among 93 other first year dental students. I've enjoyed getting involved in several legislative/lobbying days with the Virginia Dental Association and the Virginia Oral Health Coalition. It is inspiring to meet dental and non-dental professionals who are passionate about educating politicians about the realities of oral health care and the requests of the profession to better meet the needs of various populations. During exam week and during the past few weeks, I have had the opportunity to visit a long-term care facility (aka nursing home) dental clinic and am continuing to explore gerodontology. Realizing the great need for increased access to oral health care for the elderly population (and acknowledging that the baby boomer population may require a bulk of time from my generation of dental professionals), I am excited to start a geriatric dentistry study club at the dental school (our first meeting will be next week!). I am also ecstatic about getting involved in an Inter Health Professionals Alliance at VCU, which runs a monthly "Kroger outreach and health screening" session at a local grocery store (serving undergraduate college students as well as the surrounding residents of all ages, many of whom are uninsured). Hereafter, the group would like to focus their efforts around oral health, linking it to systemic health. That gives a public health-attracted dental student like me another avenue of distraction (and then I ask myself why I'm not getting straight A's in dental school...). In any case, I become giddy to imagine how I might blend my interests in public health with dental clinical skills and the perceived needs of the geriatric population.

I think we left nearly 400 tooth brushes/pastes at this school. The kids loved the cars and princess handles of the brushes. I hope they remember what S. mutans does in their mouths and reach for their gifted hygiene supplies.

Many enjoyed brushing, touching, or looking at Carlos' (Charlie's) huge teeth. They were all convinced the crocodile's dentition was real.

I attended a 'worship and music leaders retreat' several weeks ago, the theme of which was hospitality. Among other interactions and messages, it was intriguing to hear from a Benedictine Abbot from Minnesota talk about their tradition and monastery's norms regarding accepting guests/visitors. Below is a poem that I found when later thinking about the topic.

During an evening outing to Rumorosa, a high elevation settlement near Mexicali, Mexico, we took refuge from a heavy rainstorm in a schoolbus that was transformed into a cabin by the parents of the pastor's wife. 

While we waited for the rain to subside, we tried to warm up the poorly-insulated school bus with this nifty stove. A nearby tienda (shop) sold us some sausage, tortillas and cheese for a great meal.

The pastor's mom and niece sell furniture that the pastor's brother makes out of pallets. He stains the wood with a diluted mixture of pen ink and finishes the furniture with candle wax. I hope to make some of my own furniture someday, too...via creative measures such as these : )

Hospitality

I asked Love to help me
greet the stranger in myself.
I knew how to open my door to the world
and greet everyone out there as friend
but I didn’t have any kind of welcome
for the impoverished one within.
She was the weakness I couldn’t acknowledge.
She was the pain I didn’t allow.
She was the leper I’d tried to cast out the city,
the one who cried at night in lonely places.
I thought that if I let her in
she’d cause me no end of trouble, and I was afraid.

But Love helped me to prepare a feast.
We set the table, Love and I,
and then I did it,
I invited my stranger.
‘Answer the door,’ said Love.
‘You have nothing to fear.’

She came in slowly.

I put my arms around her
and embraced her in her rags
and we wept together for years of separation.
I sat my stranger at the head of the table,
gave her the best of food and wine
and, claiming her as my own,
began to introduce her to my friends.
‘But who shall I say she is?’
I whispered to Love.
‘I can’t call her a stranger now.’
Love smiled and said, ‘Don’t you know?
She is the Christ.’

Joy Cowley
Aotearoa New Zealand

My cousin and I visited an art museum in DC on New Year's Eve.

The first and second year dental classes collected toys for tots before Christmas (I'm community service co-chair of my class this year).

Some of my classmates posed for a mock representation of our 'injection day,' when we practiced two injection techniques on each other. My eyelid and nose were only numb until lunch time : /

 Upon returning to Richmond, I was asked to write about my short experience in Mexico for a church newsletter. I decided to reflect on what these kinds of trips mean for me spiritually. Below is the entry:

Now we see but a poor reflection as in a mirror; then we shall see face to face. Now I know in part; then I shall know fully, even as I am fully known. 1 Cor 13:12 (NIV)

Whenever I am away from home, I have found that I learn about my usual surroundings and myself more than if I were actually there. Interacting with people that are different than me, living in circumstances that are different than those in which I live, becomes like gazing into a mirror, trying to discern the image of God that I ought to see. I am able to look at my reflection with greater clarity when aided by the contrast that cross-cultural encounter offers. My short 9-day trip to San Luis, Mexico allowed for such ‘mirror-gazing,’ two reflections from which I will share.

In a book that I’d brought along and read at the start of my trip, Leonard Dow proposes the idea of the “professionalization of poverty” as a concept for the praise-worthy task of choosing to live simply (as opposed to making do with what you have).¹ While eating two simple but hearty meals a day with the Mexican pastoral missionary family, traveling by bus and on foot to neighboring cities, and washing my clothes in an outdoor water basin (a pila), I wondered how I loved God and my neighbor in my daily activities and how I might make adjustments to do so more directly without “professionalizing” the gesture.

It was an honor to be a guest in the home of the pastor’s mother for a night, watching her cook beans over an outdoor fire and roll out dozens of tortillas for the day. While surveying the family pictures, wedding portraits, and art hanging on the walls, I encountered a plaque showing one of the siblings uniformed and armed, while kneeling on a field; to the right of his picture was a letter of gratitude to his mother. When inquiring of the pastor whether the church considered themselves pacifists, it was explained to me that Mexico was a peace-loving country, the military of which spends its time in the mountains chasing the drug traffickers as they grow their crops, and that supporting the military as a church was how we are to “submit to our governing authorities,” as Paul instructs us to do in his Epistle to the Romans. When I struggled to explain without sounding threatening that I wasn’t sure that taking anyone’s life for any reason was fulfilling God’s will, I wondered if maybe my perspective might be called “professionalized pacifism.” I exist in a country and social network in which I can claim my right to free speech or religion (among other privileges) and where I do not feel a constant threat to my life. Many would say that this is as a result of the country’s strong militant action. From this comfortable peak (to which I might deny militant credit), is it too easy for me to ignore the complex history of violence in other lands and demand a perspective that is outside of what experience has taught those groups to believe? Perhaps a heavy dose of compassion is necessary in keeping us earnest in our longing for peace.

Visiting numerous groups of children in schools and churches, I hoped my oral health lessons and toothbrush/paste-gifting were received as a sincere desire for their well being rather than just another donation from the local church or the US. Nonetheless, I am grateful to have had yet another opportunity to visit people in their homes in San Luis, Mexico. Karen Armstrong writes, “Unknowing remains an essential part of the human condition. Religion is at its best when it helps us to ask questions and holds us in a state of wonder—and arguably at its worst when it tries to answer them authoritatively and dogmatically.”² I am hopeful that while each of us walks our paths of faith we take time to interact with those that may seem to be on a slightly different path. In considering our differences, perhaps exchanging the gift of contrast, we might more clearly see the reflection of God’s image in us as a diverse family of believers, awaiting the day when we will all see God face to face and share our one and true faith eternally.

¹ Longacre DJ. 2010. Living More With Less. (pg 47)

² Armstrong K. 2010. Twelve Steps to a Compassionate Life. (pg 118)

Last Friday, I acquired a flat tire six blocks from the school. When I left lab for the day, snow had already coated the streets. I changed my back inner tube and started the slushy way home. When a train decided to cross Brook Rd, I stopped to snap a picture of the adventurous evening. [Yes, that is a 'horse crossing' sign in the background--who knew there would be a stable across from the metal recycling center in the city!]

An evening stroll down Wentbridge Rd on what could have been Richmond's blizzard of the season.

In the bleak midwinter, frosty wind made moan,
Earth stood hard as iron, water like a stone;
Snow had fallen, snow on snow, snow on snow,
In the bleak midwinter, long ago.

The dental school is only several blocks from the capital building, yet I rarely  make the intent to visit. Joining several lobbyist groups makes me realize that "we the people" are the government and are welcome and necessary in those walls.

...So there's plenty going on to keep things interesting. Asking a professor to comment on the statistic that says dentistry is the profession with the highest suicide rate, he said it's important to keep changing and moving--to keep things from getting stale...I might be on the right track.

First semester of dental school winds down

At the start of November, the street in my neighborhood boasted vibrant fall colors....now the trees stand bare.

The sun sets into the Appomattox River as we await initiation into the dental service fraternity, Delta Sigma Delta.

November has flown by with several weeks of intermittent exams and clinical competencies and in anticipation for Thanksgiving break. At the start of the month, I enjoyed taking a weekend road trip with one of my classmates, her sister and their three dogs and cat to Leola/Lancaster, PA. During a dental class Thanksgiving potluck and at an initiation for the dental service fraternity, Delta Sigma Delta, I continued to get to know some of my classmates a bit better. All in all, I think I am feeling very much at home in Richmond and at the dental school...so much so that it felt funny to visit my parents during the holiday break. I don’t quite return ‘home’ when I visit them because they had recently moved into a new house; nonetheless, I can still recall my childhood norms when I am there. Adapting to different norms in Richmond, I’ve wondered if my experience is similar to that of the Israelites returning from exile in Babylon to ‘their forefathers’ land.’ The song below prompted these musings:

By the waters of Babylon

Where we sat down

And there we wept

When we remembered Zion

For the wicked carried us away, captivity

Required of us a song.

How can we sing our holy song

In a strange land?

So let the words our my mouth

And the meditations of my heart

Be acceptable unto you,

O God.

Text: Jamaican traditional

Music: Jamaican traditional

(Song cited from : Sing the Journey—Hymnal: a Worship Book Supplement 1. 2005)

After I had first heard the song and tried to repeat it mindlessly, I found myself replacing ‘meditations’ in the last stanza with ‘hesitations.’ Coincidence or not, it seems that both meditations and hesitations are a necessary part of exile, both of which should be held to a certain standard.

Beyond the bare corn fields faithfully stands the slope of Massanutten Mountain, a small part of the Shenandoah Valley.

It's a bit hard to visualize the mountains beyond all the infrastructure around my parents' neighborhood,  but the sunrise is spectacular, nonetheless.

As the whole world seems to have done during the past several weeks, I’ve begun to think about Christmas. In this activity, I encountered the below song and thought it related nicely to the above discussion about thoughts, hesitations and exile.

Firstborn of Mary, provocative preacher, itinerant teacher, outsider’s choice;

Jesus inspires and disarms and confuses whomever he chooses to hear his voice!

Text: John L. Bell

Music: John L. Bell

(Song cited from : Sing the Story—Hymnal: a Worship Book Supplement 2. 2007)

...Challenging, isn’t it? As I continue to explore my surroundings (location and people) and think about how they affect me, I hope to extend some hospitality both to those around me and myself:

Hospitality

I asked Love to help me
greet the stranger in myself.
I knew how to open my door to the world
and greet everyone out there as friend
but I didn’t have any kind of welcome
for the impoverished one within.
She was the weakness I couldn’t acknowledge.
She was the pain I didn’t allow.
She was the leper I’d tried to cast out the city,
the one who cried at night in lonely places.
I thought that if I let her in
she’d cause me no end of trouble, and I was afraid.

But Love helped me to prepare a feast.
We set the table, Love and I,
and then I did it,
I invited my stranger.
‘Answer the door,’ said Love.
‘You have nothing to fear.’

She came in slowly.

I put my arms around her
and embraced her in her rags
and we wept together for years of separation.
I sat my stranger at the head of the table,
gave her the best of food and wine
and, claiming her as my own,
began to introduce her to my friends.
‘But who shall I say she is?’
I whispered to Love.
‘I can’t call her a stranger now.’
Love smiled and said, ‘Don’t you know?
She is the Christ.’

Joy Cowley
Aotearoa New Zealand

We saw our first patient this month (for periodontal probings) and above was our last dental anatomy carving competency. The blue wax is my attempt to recreate a mandibular molar per the acrylic model.

As the remaining two weeks of the semester wind down, I look forward to revisiting San Luis, Mexico. I had gone with a church youth group two years ago to organize a Christmas program for children in the neighborhood. My childhood home church continues to sponsor the church-building and children’s activities in the area, but I hope to make an early trip (before the Christmas program) with some toothbrushes and paste : ) The local pastor and I will visit several churches in the area to hold oral health workshops for children and adolescents (though I hope parents will also tune in). I am excited to rejuvenate my Peruvian charla (lesson) on oral health and hope that I am able to explore possibilities for future oral health projects, perhaps partnering with local dentists.