It is hard for me to grasp that it has been 22 months since we moved to Botswana. It’s so weird how it sometimes feels like we just got here yesterday while simultaneously feeling like we have lived here for years. Time is a funny thing. Just like the mind. How we decide to interpret and assign meaning to the world around us is endlessly fascinating to me. The same events can have such vastly different effects on the same person, simply because of what feelings they decide to label it with. I still don’t know in the end how our time in Botswana will get stored in my brain. My feelings are a dichotomy of love and hate. I’ve been through hell and seen some of the worst aspects of humanity here while at the same time experienced so much beauty and kindness. How do I sort all that out? Best not to. I think in life we get so wrapped up in labeling things and trying to decide whether things are good/bad/ugly/pretty/happy/sad. My life here in Botswana just is. It is an experience full of a vast range of highs and lows and everything in between. And that is exactly what I wanted. I want to see and do and feel and learn about everything and that doesn’t just mean the “good.”

Most people wonder why I don’t spend much time writing about my work here. In general, I have always preferred to keep work life separate from my personal life. This has gotten much harder to do here because my life is basically all consumed by my work. I am so exhausted from living it everyday that I don’t have any more mental energy to try and explain the unexplainable to others. And when I do try to describe what my work here is like, people so readily jump to label it with their own judgments and assumptions. I don’t like bringing this type of criticism down on Botswana from outsiders who really don’t understand the full picture. Even people who spend a few months working here are still naive to so many of the realities of Botswana. I also feel very strongly about protecting the privacy of my patients. And when all else fails, if I can’t think of anything good to say, I always prefer to say nothing at all.

So when I do have free time, I practice my favorite defense mechanism – sublimation. I pour my stress, anxiety, heartbreak and anger into what I love most – building adventures and mapping out the best way to discover everything this amazing world holds within it. I spend my mental energy on learning about new places to explore – their unique art, history and culture. I prefer to share positive, beautiful images with others in the hopes of inspiring them to get out and explore something new, whether it be in their backyard or thousands of miles away.

But there is a conundrum this habit of mine creates – the assumption that because I am not constantly dwelling on work means that I am not working. I am personally responsible for caring for all skin disease in Botswana’s entire public health system. Because of this massive responsibility, I am always working whether it be at the hospital, on weeknights, weekends, while on holiday – my phone is always on and I am taking consults 24 hours a day while working on an endless array of other teaching, research or program development projects. I meticulously plan my time so that I can attempt to fit in as many fun activities while still being able to meet all my work responsibilities. I started this practice in med school and came near to perfecting it in residency – which lead to a lot of backlash from people constantly asking “do you even work”…. ““are you even in residency” …. “all you do is go on vacation”…..”are you even a doctor.” So much negativity from others for just trying to be balanced and attempting to live my best life. I find it hilarious that I am now working harder than I ever have in my life but still people continue to automatically assume I am just here on vacation. But I take it as a compliment toward my ability to find some balance and sublimate negative emotions into projections of a beautiful life well lived. If social media accurately reflected what my eyes and my mind experienced everyday — it would be incredibly traumatizing for all! But I often wonder….is this what people want? Seems like our society now craves and feeds off the dramatic, tragic and negative more than the positive.

I firmly believe the line from Hamlet – “There is nothing good or bad but thinking makes it so.”  You cannot ignore reality and one must always be honest with themselves…. however there are always chances to chose positivity over other emotions, there are always chances to support others instead of resenting them, there are always chances to focus on what makes you happy instead of what makes you frustrated and most importantly there are always things to be grateful for no matter what your circumstance. I am no expert at this, it is a daily struggle but there is no greater gift you can give to your own happiness than gratitude. And no greater gift you can give to others than positivity and encouragement.

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