Readjusting After Medical Separation

There’s a long version and a short version of what happened.

Short story: I was medically separated from the Peace Corps on January 4, 2019 after being evacuated on December 23, 2018. I was shipped out of the country just before the government shutdown started. PC’s theory was, and it seems plausible, that the impending government shutdown would impede my departure if we waited until the official required separation date. Only 3 people in the USA knew I was coming home which allowed for surprise reunions with some of my favorite people.

Long Story:

On November 19, I was walking to meet some fellow volunteers at a restaurant, and tripped and fell on some rocks lining the sidewalks. I stumbled, almost regained my balance, but couldn’t and resigned myself to falling. I fell. It hurt. I didn’t rip my jeans so I thought everything would be OK… a bruise, but nothing major.

My leg the night of the injury… See the lump on the left side… That’s the problems spot

I was wrong. So very wrong.

I managed to make it to the restaurant, but I could feel my leg swelling rapidly. Another volunteer was headed back to our hotel so he and I walked back together. I cleaned the wound the best I could with the materials I had, and talked to one of my friends and told her to come check on me in the morning because I was concerned that I might not be able to walk.

The next morning I could walk, but my leg was definitely swollen. I sent a quick text to the PCMO who was scheduled to be as IST later that morning anyway. It read something like ‘I fell last night and have some significant swelling in my left leg. I can bear weight, but walking in painful.’ NBD.

Later that day, the PCMO thought that I should have x-rays even though she didn’t think anything was broken.

And she was right… Nothing was broken, but I had a ‘soft-tissue injury’. I was put on ‘conservative therapy’ ie leg immobilization and bed rest for a few days. The prognosis: I’d be back to normal within a few days.

The truth was I never left med hold until I was leaving the country. I never expected a ‘bruise’ to be a injury Peace Corps’ couldn’t handle. I never expected to be medically separated for a bruise. A few days turned into a week and a week turned into three weeks. After three weeks, still having difficulty ambulating, I had to push the PCMO to order a MRI on my leg. I finally got the MRI on December 17, had a consultation with an orthopedist on December 18, and began physical therapy on December 19. All of this happened after I insisted on consultation with the other PCMO. And then the decision was made to send me back to the US on December 22 after only 3 PT sessions. I’m not sure if the PCMO took umbridge with someone questioning her medical decisions or what, but despite making progress in PT, it was decided that Peace Corps’ could no longer treat my injury in country.

I figured I’d have to get used to American English, flush toilets, driving, and winter, among other things. I’ve heard about how much harder ‘reverse culture shock’ is from regular culture shock. The the readjustment to fast-pace American life is a much more difficult transition than the transition to rural ‘African’ life. But I was prepared for that. As far as American life goes, my pace is much slower than the average American. I live in rural South Carolina and while it’s not quite the same as rural Rwanda, there are a lot of similarities. What I was not prepared for was dealing with medical separation during a ‘partial’ government shutdown; I was sent out of the country where I was receiving adequate treatment to a country [my own] where I’m unable to receive medical treatment because of a pissing contest between the two major parties of the American government.

The government is shut-down—just like meeting with my community health workers–there’s no one there to do business
with

You see, medical evacuation and separation is fiercely different than a typical COS, or even an ET. Most PCVs have weeks or months to wrap up projects, pack, and say goodbye. I had two hours. Most end their service with world travel. I ended mine with uncertainty. Most PCVs get to prepare for life in the States again, looking for jobs and finding a place to live. I was on a plane 36 hours after they determined I would be leaving for good.

Minimal improvement after almost a month

I had no idea the emotional toll of all this. I was prepared to serve as a health volunteer to the best of my ability for the entire 27 months. Despite the difficulties [Newsflash: Peace Corps service is hard]. Despite the hardship. [It‘s not the spotty electricity or the non-potable water; its the overwhelming loneliness that will get you.] And despite any other difficulties that may have popped up.

Malaria Camp!

Rather than simply dealing with life back in the States, I have had to deal with being torn away from my job, my home, [not]mycat, and my friends, then be sent back to friends and family who just can’t understand it all. Because you can’t understand it unless you’ve been through it.

Day one back in America: I get to hang out with my 5 week old niece

I’m still readjusting. Every. Single. Day. Some days I still feel homesickness for my life in Rwanda. Not every day, but more days than not. My guess is the longer I am here [in America], the less I’ll miss Rwanda.

I know my life has been fundamentally changed through my experience with the Peace Corps. I know some things will never be as they were before I left. I have changed. But in some ways, I am still transitioning back. It’s taken longer than I ever thought it would.

My best friend and companion in Rwanda–Octavia

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