Right before coming to London, I spent time volunteering in León, Nicaragua, as previously blogged. I mentioned to Evan after we arrived in London that I found it easier to find street photography subjects in León because the city is so colorful and lively. In The City, our neighborhood of London, it is often very bland in color. There are a lot of concrete buildings and a ton  of people dressed in suits. I began looking around for inspiration and trying to think of interesting projects to work on while here. Since I spent last year doing a photo a day project with strict themes, such as colors, and since I began to notice red and blue popping out in this concrete world, I decided to make that one of my projects. I have a vision of designing a book where the cover is smaller versions of the photos on the inside featuring red and blue in a pattern to make up the underground sign on the cover. I don’t know if this book will ever be printed, but following are the examples I have found so far. Some of them are obvious, like the buses and the telephone booths, but many are simply a woman’s red hair, a man’s red sock or a man’s blue suit in front of a red door. I have begun seeing things in red and blue all over the city and I enjoy the mix of subjects. It is a simple theme, but I think sometime restrictions make you look harder. Here is a sample of what I have found so far.  

This post is long overdue as I have now been in London for nearly two months, but I I want to reflect on my first impressions of London. Below is the Tower of London, which is two blocks from our apartment. I still find it somewhat surreal to walk past it every day. The right third of the photo is a piece of the London Wall still standing and of course crossing in front of the castle is a very common site in London- the red, double-decker bus. This is one of the first photos I snapped here and it sums up one of my first impressions, being that this city has many juxtapositions of new and old. The city is so much older than cities in the US and you can see that history everywhere you look.

I have been in old cities before, but what really makes London interesting to me is that it is not a static city. Many old monuments are preserved, but new construction is going on constantly. We live in The City, which is the financial center of London. We are surrounded by bizarre looking new buildings that have taken on amusing nicknames, in true British fashion, like the Walkie Talkie, the Gherkin and the Cheese Grater. These three buildings can be seen in the cityscape behind The Tower of London.

This one is actually called The Shard- it is not a nickname, but it does look like a shard of glass. It is currently the tallest building in London.

When we first arrived and were recovering from jet-lag, setting up our new apartment and adjusting to our new life, I watched the Harry Potter movies. They’re British, after all, and the British love Harry Potter. Many scenes from movies and television shows can be recognized in London. An early scene in the first movie was filmed right by our flat in Leadenhall Market.

And a scene in The Half Blood Prince was filmed on the Millennium Bridge. This used to be called the Wobbly Bridge, because it actually was unsteady, so it was rebuilt to embody that wobbly feeling.

We’ve enjoyed British humor, from our new friends to shop keepers to local television to street advertising.

When I first moved here, one of my favorite things to do was just wander around and get lost to see what I would discover. I have always wanted to live in a big city and be surrounded by the vibe offered in big cities, from the art to the graffiti and skate parks to the musicians and specialty food shops.

Of course, as cliché as these images are, it is really something to stand in front of the iconic buildings and structures in London, and they invariably form a strong first impression  to every newcomer. Here are a few shots of the Elizabeth Tower (which everyone calls Big Ben, but that is the name for the bell inside it), Parliament, The Eye, Tower Bridge (crossing the Thames River, where I often ran when I first arrived), the inside of Shakespeare’s Globe Theater (where we saw a lovely play in the open air called Last Days of Troy) and for good measure another photo of the Tower of London.

On our first weekend, we went to Borough Market. It is a wonderful food market near us that I have fallen in love with. I want to do a more in-depth post on just this market later, but here is a teaser of how beautiful and delicious it is. Another wonderful early impression was how wonderful the food is in this city, and I am not just talking about the Indian food. To everyone who warned us of how bad the food is here, y’all are crazy and out of date! London has become one of the food capitals of the world, enriched by all the different nationalities found here. We rarely have a bad meal. We’ve enjoyed Indian, Italian, French, English, Afghan, Lebanese, Chinese, Thai, Japanese and even some American, to name a few.

Another first impression is how colorful the city is in summer. I always thought of London as rather concrete, but in fact there are beautiful flowers, including a lot of lavender, and gardens and parks wherever you look.

We went to Kensington Gardens, one of the Royal Parks, our first weekend. It was a beautiful day, and everyone was out enjoying the sunshine. Kids were playing, lovers were cuddling and families and friends of all nationalities were playing games or having picnics. We brought a baguette, some wine, cheese and olives from Borough Market with us. We also brought Evan’s guitar. It is still one of the more memorable afternoons I have had here.

I also noticed several photographers working in the park. It further inspired me to seek out doing some portraits in this beautiful city.

My first impressions of this city would not be complete without mentioning football, by which I of course mean soccer. The world cup was happening in our first weeks here and everyone was excited, even after England lost. I was impressed by how attentive everyone was watching the games. One of our fond memories was watching the Holland-Croatian game in a Lebanese restaurant with the owner. It was almost more fun watching with people of different nationalities who were all rooting for teams they had no relation to. We really got into watching the games.

The city really is very diverse. There are people here from all corners of the globe. I must say, it feels like much more of a melting pot than America. Here a family gathers to smoke hookah at the park.

We did venture outside of The City and central London in our first weeks, thanks to our friends Heather, Michael and Nick. They showed us around their neighborhood, Islington, which is much more residential and has a completely different vibe. They had Evan, my friend Sarah who was visiting and myself over for a delicious dinner of lamb burgers and some of Heather’s famous side dishes. I love their garden and the stray cat, who has been lovingly called Toothless, after the dragon in How to Train Your Dragon. It is wonderful to be in the same city as one of my best girlfriends and we are lucky to have a built in network here. It was also nice to explore the city with Sarah, pictured below, in our first weeks.

There is so much more to say about this magnificent city. It continues to grow on me as I discover new neighborhoods, meet new people and learn more about the culture here. This is merely a glimpse into my first impressions of London. For now I will say goodnight and close with some shots of the city at night.

I have been living in London since May 30, and so far it has been a whirlwind of experiences. Today was like any other day, I woke up, ate breakfast, went for a run, picked up my husband’s suit from the dry cleaners, showered, started laundry, and oh yea, watched the Tour de France 2 blocks from our apartment in London. I grabbed a spot in front a couple hours before the race was predicted to pass.

Before the race there was a small parade. It was not like the New Orleans parades I am used to by any means, but I did catch a box of tea from Yorkshire, which was perfect for me. I can do more with that than rubber bracelets and key chains. According to Evan’s coworker, it is a good tea. As part of the race went through Yorkshire this year too, the tea was one of the sponsors.

It was a great place to people watch as I waited for the cyclists. In normal London fashion, the weather was completely unpredictable and people went from wearing sunglasses and t-shirts to rain jackets and sweaters. My poor husband and his coworker, who joined me on their lunch hour, got soaked in their suits. Nonetheless, everyone waited patiently, even the police and construction workers lined up on the top of buildings to watch.

At one point we finally thought the race had started, but it was clearly a rogue cyclist, not someone who was part of the race.

Finally, the first racers appeared from around the bend.

They were very quickly followed by the masses. They were so quick that you’d miss half of it by blinking.

Right after that first herd there were two cyclists who seemed to be chatting with one another as they rode. Is it just me, or do they look more like they are buddies on an afternoon ride than racers in the Tour de France?

Other than a few stragglers, who were maybe a minute behind, the whole thing was over in about 40 seconds.

There is something magical about watching a historic sporting event in a crowd of people from all of the world with The Tower of London as the backdrop. I have taken many photos since I have been out here, and now that I have finished my Nicaragua posts, I can begin posting my adventures in Europe. I wanted to start with the Tour de France so I could be timely for once. It is late here, so I think I will turn in, but look for more on London soon. I think I will have a cup of that Yorkshire tea in the morning. Life is good.

BE WARNED: THIS POST DEALS WITH SURGERY AND, AS SUCH, CONTAINS SOME IMAGES THAT MAY BE CONSIDERED GRAPHIC.

Volunteering in Nicaragua helped remind me why I got into the medical field in the first place. Here, we were not dealing with red tape, paperwork, hierarchies or egos. We all worked together, alongside local staff and volunteers, helping as many people as we could. There was close interaction with the patients, and without the normal headaches of work at home, the doctors enjoyed concentrating on their craft and I enjoyed learning from the surgeons and bonding with the patients and their families. We had more time to actually help people hands-on. In our short week, Dr. Sketchler and Dr. Millet and the rest of our team were able to complete 39 knee replacements for people who would never have had access to this treatment.

I’ll start this post with a few photos from around the hospital. A banner on the hospital and signs posted inside read “Bienvenidos NOMMS,” or “Welcome NOMMS (New Orleans Medical Mission).”

Though there was limited air conditioning in surgical theaters and supply rooms, the hospital was generally cooled naturally. As a result, it was not uncommon to see pigeons in the waiting room.

Motorcycle accidents are all too common in León. This man broke bones in both of his hands and his leg and has a long recovery ahead of him.

Occasionally, small children would be waiting to undergo surgery in the rooms adjacent to ours. Even at such a young age, they waited stoic; we never heard them cry.

As was the case last year in Ecuador, our first day consisted primarily of the nurses and other volunteers making preparations for the week’s surgeries while the surgeons and suppliers evaluated potential candidates from the masses of hopefuls who had arrived. Patient candidates lined up with their X-rays ready for the doctors to review.  Surprising to us was how many came with their X-rays loaded on iPads and iPhones.

Every subsequent day followed the same routine. First, we would start our day with a traditional Nicaraguan breakfast of beans, rice and eggs before setting out on foot to the hospital. Once at the hospital, we set to work preparing the rooms for surgery while the surgeons did rounds on their patients. Below is a photo of one of our suppliers with a bunch of the surgical instruments and following is an overall shot of a surgery.  Featured is the group’s official photographer, Dan Milham. I was happy to play a dual role. I truly love volunteering with this group, because I am able to channel two of my passions and expertise. Due to a lack of the same kind of privacy laws we have in the US, we were able to take photos inside the hospital.

This photo of me is courtesy of Dan Milham.

Following are some of the moments I captured during surgeries, starting with scrubbing in.

Here are a few of the wonderful volunteers I had the pleasure of working alongside in surgery. I know some of the relationships I formed on this trip, with locals and fellow volunteers, will last for years to come. It is not often that one week can provide for such a rich experience, but volunteering in another culture is so much more than just traveling through- you are immersed into their world.

Amy is holding some hardened bone cement in the shape of a star. While we waited for the cement to dry and tested to see if it had hardened enough, we would have some fun forming small bits into various shapes; I made a cat once.

Here are a few shots of me assisting Dr. Millet in surgery.

Beverly, our surgical tech, was very helpful and patient with us all. We could not have done this without her.

Junior was one one of the local volunteers who helped us translate. These were the first surgeries he had ever seen.

Dr. Sketchler and Dr. Millet both did a wonderful job teaching the local residents their technique. Hopefully these residents will be better equipped to provide knee replacements for this population between our visits. Of course, part of the problem is expense. As it is not considered a necessary surgery, most people who want the surgery need to buy the hardware themselves, which is ridiculously expensive even for Americans. It is impossible for most Nicaraguans.

Dr. Sketchler’s son, who is pre-med, was also on the trip. He mostly volunteered at the eye clinic, but got to scrub in on a few surgeries. It was touching to see him learning from his father.

After surgery, it was time to close the knee up and clean the instruments for the next case. The instruments had to be washed and then sent for sterilization. We worked hard to fit in as many surgeries as we could.

The patients were visited by Leslie and Jerome, our physical therapy team, the day after their surgery. A couple of the local volunteers worked hard alongside them learning the ropes of physical therapy.

Here, Dr. Sketchler makes rounds on his patients from the previous day and reviewing before and after X-rays.

Some patients required special consideration, such as this blind patient.  His circumstances made the teaching process all the more challenging for our physical therapists, but they, and the local volunteers who worked alongside them, were no less determined.

In spite of our best efforts, we still had to rely heavily on the patients’ families.  Unlike in the US, these patients do not receive much if any follow-up care, so it’s up to the family members to learn from us how to aid in rehabilitation. The Nicaraguan culture in general is very focused on family, which worked in our favor. The families were always present and they were vital in the recovery process. For many, the first small step is simply fanning the patients to keep them cool in the hot hospital.  With so many patients packed into the recovery rooms, overheating was a real risk.

This gentleman did overheat and fainted on the unit. Leslie was there to help.  It was clear that the nurses on that unit are overworked and underpaid, because none of them helped. This was the only negative experience I had with the local staff.

The patients were very strong- managing to walk and do their rehabilitation exercises with only anti-inflamatories, no narcotics, to aid in pain management. They were grateful just to have received the surgery, which was refreshing to see. The whole experience was so rewarding for me. I hope we have added to the quality of life of these 39 people and their families.

Working in these conditions makes for strong bonds; I had a hard time saying goodbye.

The path we took to and from the hospital led us by a wall someone had thoughtfully graffiti’d in our honor with the words “grasias enfermaras y doctores.” I will never forget this experience.