Bishop Pass, Juba, Boise?....

This morning Heleen was occupied, so Tom and Chonge and I went off for a hike. Again, we drove up towards the mountains, but took a turn-off to a different dead-end trailhead, this one at South Lake (at 9600’). Heleen was a strong hiker, with pace that was similar if a little more rapid than my own; Tom was noticeably faster, and it took more effort to keep up, as we climbed the rising trail….

The path, a quite popular hike, goes up to Bishop Pass, but we didn’t have time to reach that destination. Tom had a meeting down in town at noon. So we made a loop, turning off and climbing east to Mary Louise Lake, a small, narrow tarn at the foot of a talus field of a looming peak…. We continued upwards, one rocky bench at a time, past Bull Lake, then the Chocolate Lakes, beyond the official trails at this point, picking out faint paths, weaving through bouldery terrain, amongst small pines. We reached the high point of our climb, up over 11,000’, after scrambling up a steep slope to a grassy saddle. From the saddle we could have continued up, above tree line, to the top of Chocolate Mountain, but Tom determined that we did not have time. Which was fine with me.

We dropped down to another lake, Ruwau, and eventually came back to the Bishop Pass Trail and started down….

Now that we were descending rather than climbing, I had the breath to talk more, and I began asking Tom questions about his work in south Sudan….

But before I describe some of what he told me, I should tell a little more about him…. First, we had some geographic commonalities. His parents grew up in Minnesota (his mother in St. Paul), and that’s where he was born. But when he was quite young the family moved to the D.C. area, after his father got a job working for Senator Eugene McCarthy. Tom had subsequently  grown up in Alexandria, Virginia.

Before going off to college he walked the length of the Appalachian Trail; later he bicycled across the continent, on a five-week ride . After college he joined the Peace Corps and lived in the Philippines, helping establish fish farms. After two years, he came back to Virginia and went to medical school. He completed his residency in family medicine in Ventura, then went to work for the Indian Health Service, on the Toiyabe Indian Reservation near Bishop. That was when he and Heleen bought the house in town….

He had remained interested in overseas work, and he eventually took a three-month course in tropical medicine, then applied for a CDC fellowship, in international health. But his interview was a “disaster.” Plus, these fellowships were quite competitive, and he didn’t have the usual public health or infectious disease credentials. “I was just a country family doc,” he told me. But then 9/11 happened.

Suddenly, Congress became interested in “epidemic intelligence,” and they appropriated a few million more dollars for the CDC, and Tom got a call and was asked if he was still interested…. Yes, but the catch was he was offered a position in Iowa—which wasn’t the sort of place Tom saw himself working…. But he took it. And it turned out, unexpectedly, that he soon got a chance to go to Sudan as an information officer for a short project (polio eradication, I think), then again for a second project…. And that experience eventually landed him another, longer term position for the CDC in South Sudan. He moved to the town of Juba and began work on organizing HIV testing and monitoring programs.

The work proved more than a little challenging…. A civil war cease fire had just been signed, the countryside was ravaged, there was no medical infrastructure, and Tom and his people had to negotiate substantial cultural barriers to even talking about sexual habits….

Tom’s efforts were divided between establishing a civil program and one within the military. He spoke mostly about the latter, which was the more successful. He worked closely with the SPLA (Sudan People’s Liberation Army), with a general who was eventually amenable to an HIV testing program. He was assigned an excellent liaison from the SPLA, and he brought in representatives from the Ugandan and Kenyan and US militaries, individuals who were working on similar programs. Apparently the Ugandans were especially influential: if they could do it, the Sudanese figured, we can too.

After three years, Tom took a different job. Heleen was working in Juba too, for the WHO (under the auspices of the UN), and the US authorities wouldn’t let her live in the US compound with him, or allow him to live in the separate UN compound with her. Generally, the US security people in Juba said no to much of what Tom wanted to do, whether traveling to outlying towns or going on mountain bike rides outside Juba (he and some friends went ahead with the latter). They moved to Nairobi, where he administered another program, mostly managing funding for Sudanese projects, and, as he said, pissing off enough of the bureaucrats that they were happy to see him go after two years.

After five years in Africa, he and Heleen had returned to Bishop. “If I was going to ever do clinical medicine again, I thought it better be soon,” he said. So he took the job at the hospital. Apparently his sort of career is not so common, the mix of public health and clinical work…. While he seemed happy and content with life in Bishop, it seemed to me that eventually he would work overseas again….

Later in the afternoon back at the house, Heleen pulled out a long article Tom had written for the Washington Post, in 1992. He was a medical student at the time and had just returned from seven weeks in Uganda, which was then in the worst throes of the AIDS epidemic. In the article, he described in heartbreaking detail home visits with sick people, listening to their stories and trying to help though they were mostly beyond help. He said to me, “Yes, it was a profoundly affecting experience.”

On the hike back down, we had begun to pass backpackers coming up, and Tom would stop and chat each time, and offer trail info or advice. At a fork two boys, about thirteen, asked the way to Long Lake, and we pointed them to the left. Further along we came to another three boys, then a group of six, the leader a pudgy kid who when asked how he was doing said, without breaking stride or making eye contact, “Terrible!” They all carried massive packs, with sleeping bags or tents hanging too low off the bottom. We’d passed a dozen kids, strung out along the trail, before we came to an adult who stopped us and asked about the boys. He was angry and looked it. “They’re supposed to wait!” he exploded. “They better be waiting!” They were not waiting. And why should they; I wouldn’t have.

In the afternoon, back at the house (where the temperature was in the upper 90s), I helped Heleen roll out and screw down a sort of awning, on top of the wood structure (word for this?) over the back deck. She was on the roof, I worked from a ladder, and Tom made pizza dough inside in the kitchen. I was happy to be doing something useful and helpful, giving after so much receiving….

Tom made three pizzas, and a salad, and their friends Stacy and Jen came over for dinner, with their dog, JoJo, Chonge’s lady friend. They live nearby, in a big garage they’ve converted to a house, on twenty acres of sage just outside Starlite. Stacy is a doctor too; he and Tom were in the same residency program. Jen runs a local environmental group, and she was off the next day to Vermont for a writer’s workshop.

They said that there was much joking at the hospital about Heleen taking in a patient, that maybe this would become a regular practice…. Maybe not, but I was happy for my good fortune. I liked these people, liked talking with them and staying at their house, getting to know them and their friends…. But I knew too I couldn’t stay much longer, as much as I would’ve liked to, and even though  they didn’t seem eager to be rid of me…. Still, these two days had been an opportunity to pause, to figure out what to do next, and soon I had to act….

I’d had a couple hours alone in the afternoon, and I’d considered how to proceed….I could return to the trail, and I seriously weighed that possibility—from the nearby North Lake trailhead it was twenty miles to the PCT and my first food drop at the Muir Trail Ranch. But the chest pain persisted…. And I sort of wanted to go back to Boise, though that really doesn’t make sense. These mountains are spectacular, and I’m right here…. But in Boise I could stay at Grandpa’s and visit with him, and rest and write, and send for some different gear, and work on lightening my pack….

I don’t want to leave Bishop, but I sort of do, and so I will.