Not Your Typical Summer Vacation
BY KARIN JEGALIAN
BLOOD FILLED THE OPEN BELLY OF THE
YOUNG MAN ON THE OPERATING TABLE. HIS SPLEEN, SWOLLEN BY MALARIA,
HAD RUPTURED. HE WAS BLEEDING HEAVILY IN THE MIDDLE OF THE NIGHT,
BUT THE BLOOD BANK IN THE 300-BED HOSPITAL AT THE BASE OF MOUNT
KILIMANJARO HAD NO BLOOD FOR HIM. Glen Crawford,
still a medical student at Stanford, was spending part of his last
school year in Tanzania earning infectious disease credits when
he was awakened that night and summoned to the hospital, where he
found the operating room was already teeming with doctors. With
no blood for a transfusion and the young man before them in danger
of dying, the doctors resorted to extreme measures: They called
for a funnel and a ladle. Minutes later Crawford was using the cafeteria
utensils, dipped in alcohol and dried, to help scoop the blood pooled
in the man's abdomen back into his veins though an IV tube. It wasn't
a perfect solution. Clots in the blood caught in the man's lungs
in subsequent days, and he suffered some shortness of breath, but
he survived.
Fourteen years later, Glen Crawford (class of '85),
an orthopedist, and his wife, Sue Abkowitz-Crawford (also class
of '85), an internist, work most of the time in a hospital and in
private practice in a small coastal New England town, where they
live in a house on 15 acres of woodland with their three children.
But since their medical school days together at Stanford, every
few years they take a break from their American
middle-class lives and go on trips to Africa and Asia to volunteer.
They worked together at the base of Mount Kilimanjaro, and later
on various islands in Indonesia, in the remote Himalayan country
of Bhutan, in a former black township in South Africa and in Vietnam.
On all but their first trip, Sue and Glen have been accompanied
by their children, now ages 11, 8 and 1, on trips ranging in length
from 6 weeks to 3 months.
They say they are partly motivated by philanthropy,
but also see the trips as adventures, as vacations and as a way
to become submerged in other cultures. Besides all that, Sue says,
"It's interesting medical work. You come back from these trips refreshed,
thinking 'Yeah, this is why I went into medicine.' "
"I wind up doing a lot of complicated things," adds
Glen. "If I see a patient here and I don't think I can give the
best care, I can always refer the patient to someone else. But there,
if I don't do it, it just doesn't get done. You feel like you can
accomplish a lot, and people are so appreciative."
The couple met while in college at Harvard, attended
Stanford School of Medicine from 1981 to 1985, returned to Boston
for their residencies and eventually joined private practices in
Newburyport, Mass. They plan their trips with the help of two organizations,
Health Volunteers Overseas and Orthopedics Oversees, which send
them files of information about countries where volunteer slots
are available. Orthopedics Overseas was established in the late
1960s, when orthopedists from the United States and Australia established
a teaching center in Indonesia. The Indonesian center has trained
at least 150 orthopedists in the last 30 years; now the program
has spread into other countries and draws volunteers from around
the world. Health Volunteers Overseas organizes volunteering opportunities
for several other specialties.
For their first trip after completing their residencies,
Sue and Glen put their belongings in storage and left for Indonesia.
This time they were going as a family, with Emily who was three
and a half, and Neil, who turned one the day they set out. In fact,
Neil took his first steps weeks later, clambering up the stairs
at the largest Buddhist temple in the world.
"A lot of people don't understand why we would want
to bring our kids to these 'God-forsaken' places," Sue says in a
tone of mock horror, "all these third-world places that are full
of germs, and expose them to all sorts of diseases. ... But it's
been an adventure and it's been fun." And fortunately, the family
mostly has been spared from illness. Neil did get dengue fever,
a mosquito-borne viral infection, once, and both he and Emily have
been stung by jellyfish, but armed with their shots and bitter malaria
pills, the family has stayed largely healthy. Even Sue, who worked
in a 300-bed tuberculosis hospital in Bhutan, where "people were
coughing blood everywhere," is pleased and surprised that she hasn't
yet tested positive for TB.
Traveling with children actually has opened doors,
Sue says. Baby Matthew, for example, was a hit on their last trip,
to Vietnam. Then a chubby, bald 8-month-old, he attracted throngs
of people delighted with the "Little Buddha." Women would scoop
him up and carry him away to show him off to their families. Meanwhile,
Emily and Neil have been able to attend school in South Africa and
Vietnam. And they enjoy a certain celebrity when they return to
school in Massachusetts. Emily, for in stance,
wrote a well-received column for the school newspaper describing
the heat and the unusual things she had eaten while in Hanoi.
"I like the experience of going and learning about
different things that I had no clue existed," Emily says, though
she concedes that she eventually misses electricity and TV. She
and Neil also start missing friends, school -- and pizza. But they
proudly relate how their father put a cast on a prince in Bhutan
and how the family sat close to the president of Kenya at his birthday
celebration.
The Crawfords' photo albums showcase pictures of
immense goiters and tumors and display the resourceful ways Glen
has set bones, but the albums also show a family on vacation, the
children standing beside termite mounds taller than themselves and
flashing by on ostriches they're riding. The photos show whales,
elephants and crocodiles in the wild, rhinoceroses holding up roads,
warthogs blocking bridges. Emily and Neil eagerly remember the wares
at open-air markets and visiting the world's deepest gold mine while
in South Africa. Glen and Sue point out that Bhutan is closed to
conventional tourists.
The children are pleased to report that they have
eaten impala and zebra. In Vietnam, "the best eating place," Emily
says, they ate sea slug, eel and jellyfish, and, in a village outside
Hanoi, the family shared a memorable seven-course meal made from
a single cobra. The cobra was killed in front of them, but its heart,
beating through the whole meal, remained before them on a plate.
To close the meal, Glen ate it. Elsewhere, Neil says confidentially,
"My dad almost ordered pig uterus, and another thing on the menu
was ox balls."
In case anyone fears that the Crawford children are
missing out on more typical American family trips, rest assured
that they have gone to Disney World for more than one long weekend.
On most of their trips, Glen and Sue have toted trunks
of medical supplies that they donate to the hospitals where they
work. They started doing so after having to reuse latex gloves and
IV tubes at the Kilimanjaro Christian Medical Center. The couple
has observed a wide range of medical systems, ranging from the money-conscious
system in Indonesia, where patients' families have to pay in advance
for equipment used in surgeries, to the egalitarian distribution
of care in Bhutan, where a committee headed by the king decides
which patients may travel to India for surgeries that cannot be
performed in Bhutan. The hospital where they worked in South Africa
was exceptionally well-equipped, but hospitals in Vietnam were so
crowded that some patients lay on the floor next to others' beds.
A recurring source of frustration for Glen and Sue
has been facing patients they cannot help but who would have been
easily saved in the United States. Heart-valve damage, as a consequence
of rheumatic fever, for example, can be easily corrected with valve
replacement surgery, but in Bhutan, Tanzania and Vietnam, the same
problem is often fatal.
When the children start going to high school, the
family's biennial trips may prove impracticable, but Glen and Sue
sometimes think about going for longer intervals later on, after
the children are grown and they have retired. For now, volunteering
is just one facet of a fulfilling life, says Sue. SMD
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