Morelia Balcony

Three years ago I started school for my Master of Public Health. I love public health people and the problems they are inspired to work on. I love the curriculum, I wanted to take ALL the classes. I needed to find an internship and I feel like I know a ton of people and I talked to so many but nothing was coming together. Also, it was COVID, so all the existing internship programs were closed. I talked to Monika Fisher Massey about possibly working at the Welcome Health Free clinic on access to dental care. I talked to Hershey Garner to see if there were possibilities with public health at the city. He mentioned Dr. Sharkey and I reached out to her on LinkedIn. Sharon Guthrie told me to check out the Boston Mountain Rural Authority. I have a notebook full of possibilities and rabbit holes that I went down but nothing panned out. During all of that time, I spent a lot of time on the sidelines of my son’s soccer games with friends Celia and Salvador, watching our kids play soccer and talking about life. At some point they said that Salvador’s uncle, Victor, was a urogynecologist, and his wife Julia was a retired head of teaching in the largest women’s hospital in the state of Michoacán and they were offering for me to go there and do my internship. At first it was just in passing. But when somebody says something like that to me, I’m like really?  Are you sure? Okay this would be amazing. How do we make it happen?

A little more background. I love women’s health. Love, love, love, love, love it. I had all of my children at home with a midwife (a dear friend to me still to this day). I was obsessed with information about birth, reproductive processes, hospital interventions, norms, medical culture, gynecological violence, statistics around the world related to cesarean section rates, infant mortality rates, maternal mortality rates and cultures surrounding birth. More recently, our laws in the United States have changed to limit women’s access to care and I feel passionate about helping increase women’s access to care if at all possible. But I currently work at a mostly men’s hospital. Granted, as the rest of the country has limited women’s access to care, the VA has actually expanded women’s access to care which is freaking amazing and I’m so proud of them for that.

So, the possibility of shifting my career to women’s health issues and also global health was a very exciting idea for me.

In June of 2020 I was moved into the department of Primary Care and told the chief of the department at our first meeting that I would need to take 5 weeks off to finish my degree requirements and she told me, “you won’t be able to participate in the committees you have been on, you can’t choose your team, and you won’t get the leave you want. I understand if you have to leave the VA to finish your school.” So I asked via email periodically after that, spoke to my managers about the problem, told them my concerns and they were supportive, but they could not accommodate my leave without the blessing of the chief. In August of 2021 I finally went over her head and explained my problem to her boss who was amazingly supportive and very cognizant of the complexities of the situation. Spring of 2022 University of Alabama released international travel restrictions due to COVID and I again asked for leave because now all my course work was done and the only thing remaining was my internship. My managers said, let us know what we can do to help. The chief again said no. But again her boss said, “of course we support you.” Next thing you know, my leave is approved and this thing is finally coming to fruition.

But. There were so many unknowns. Victor and Julia speak limited English and whenever I asked for information I received very short responses, so I wasn’t exactly sure what I was getting myself into. Also, I needed my preceptor, Victor, to log in to the University of Alabama website, register to be my preceptor, approve my proposal, etcetera, etcetera. Well, that wasn’t happening. The school of public health in Alabama has been incredibly accommodating of this. They said, maybe he can sign and return an email in Spanish that gives his approval. So we did that and I had one full week of some serious stress as I watched the deadline go by and still had not received his response. On August 30, I received his approval–after the deadline. This put in place a cascade of appeals. I had to appeal for late registration, appeal for study abroad (the computer also didn’t recognize me as a student, so the my teachers had to file the application on my behalf), and appeal to graduate in December (I was really scared about that one). After all of that, I paid my $1,800 dollars to the school for the opportunity to do all of this in their name, and was ready to jump into the unknown.

My friends Celia and Salvador are amazing humans whom I love dearly and this whole internship was based on faith and trust in them. But I didn’t have any details about what would happen, where I would stay, where I would work, or any of the things that an OCD person would lose their mind over if they didn’t know. In August of 2022 I was able to get Julia’s What’s App number and solidify dates with her. I was to wear a white lab coat and cool clothes as it is warm there. She said I would be able to stay with them in their home and that they would pick me up from the airport when I arrived. That was the sum total of my information.

Any one of these elements could have terminated this experience, my leave approval, my school deadlines, not knowing what I was getting myself into or not trusting the process. Who knew if Victor and Julia were seriously considering bringing a foreigner with limited language skills into their home for 5 weeks. That was a HUGE ask. Maybe they were just speaking off the cuff. There were a ton of moving parts to coordinate.

Finally though, all elements were in place, tickets purchased, internship proposal approved, study abroad approved, graduation approved, leave approved, dates confirmed! Hay caramba! Viva Mexico! Vamonos!

Another Balcony View in Morelia

Balcony view in Morelia