#7: Cesareans, Coffee Withdrawal, and Chronic Overthinking

I watched my first surgery this week—a cesarean section—and it stopped me in a way I didn’t expect.

From the first incision to the baby’s birth took only a few minutes. The baby was born at 9:46 a.m., and the entire operation was finished in about forty-five minutes. What caught me off guard wasn’t the speed, but the force. The physical effort required to open the body—to move through fat, muscle, and uterus—was far more intense than I had imagined. If you haven’t seen a surgery, can you imagine how much force it takes to rip muscles apart to access the body within? And the sound it would make?

The suturing came next, layer by layer, an attempt to carefully repair the woman’s abdomen. I thought I would find it fascinating. Instead, I found myself slowly draining. The room was hot and sealed, with no windows and no air conditioning. Blood and amniotic fluid covered the floor. By the end, the smell was overwhelming, and I was deeply relieved when it was over.

What unsettled me most wasn’t the gore—it was my reaction to it. I was exhausted. I should have asked more questions. I should have stayed to help clean up. Instead, I felt completely spent.

That afternoon, I had promised Liam Luke I’d play soccer with him. Instead, I spent eight hours on my bed. I felt terrible about it, but I also knew how I got there. I’ve been waking up at 5:30 a.m. every day and eating dinner around 9:00 p.m. I am trying to juggle learning Runyoro with MCAT prep AND hospital work...and resting nowhere in between.

A part of me hates that the surgery affected me so deeply. Shouldn’t this be what I want? If I want to be a doctor, shouldn’t I love all of it? The doubts came quickly: what if I’m not cut out for this? What if I’m not good enough?

Physically, I’ve been crashing too. I’ve developed a cough, probably from exhaustion. I’m behind on homework, constantly tired, and stuck in a cycle of feeling like I’m failing at everything. When I’m at the hospital, I feel guilty for not studying. When I study, I feel guilty for not being at the hospital. Today, I finally retreated to my room and stayed there for hours, feeling unprofessional and overwhelmed by all the people I should be checking on.

Doreen is eight years old and is being treated for typhoid and malaria +3, the most serious form of malaria. Precious is one and a half years old and was admitted yesterday as an emergency patient in respiratory distress with malaria +1. I should also be checking in with the mother who delivered her baby this morning—seeing how she’s healing and how the newborn is doing. 

What makes this confusion harder is that just days ago, I felt completely certain I was where I belonged. Yesterday, I was the first person to receive Precious as an emergency patient when he arrived in severe respiratory distress. His breathing rate was dangerously high (76 resp/min), and he needed blood and IV medications immediately. The staff worked tirelessly to stabilize him, struggling to find IV access and eventually starting a transfusion that visibly improved his condition. This morning, he was alert, responsive, and speaking. He gets to go home tomorrow.

The day before that, I traveled to Hoima with Hillary [Henry], which turned into its own kind of adventure. On a very practical level, the biggest success of the trip was finally being able to withdraw cash from an ATM so I could repay Hillary for covering my driver to the hospital. But beyond that, the day was incredibly enlightening.

We went to the main market, visited his mother’s house twice, stopped at various local vendors to buy construction materials and pillows, and passed by Hillian Clinic—one of Hillary’s expansion projects. He’s in the process of starting a second hospital in Hoima, the town where he grew up, and seeing that vision take physical shape made the trip feel especially meaningful.

Hillary is something of a celebrity in this region. Everywhere we went, someone seemed to know him. People called him doctor, waved him over, and asked him to come buy from them. He was kind and attentive to everyone he met. We stopped for lunch at an Ugandan chicken shop, Yo Kuku. I found it fascinating to follow his path through Hoima and see how deeply connected he is to his community.

What stayed with me most was visiting his mother’s house. Seeing it—especially bookending the day with visits there—made me think deeply about how different his childhood was from my own, even before considering the decade he wrongfully spent in a juvenile prison. His nieces and nephews were running around, completely absorbed in play, using objects that many American children would consider only for adults or consider trash.

I watched two of his nephews carefully pull every last bit of meat from a goat’s head. They were focused, patient, and clearly enjoying themselves. I couldn’t imagine any of my younger family members doing that.

One of his nieces was playing with a tire, rolling it through the dirt. I took a photo of her as a chicken wandered by, and she looked completely at peace. Later, two other children were playing a game with broken pages from an old cardboard children’s book, running around and trying to hit each other with the pages, laughing the entire time. They were having so much fun.

Watching them made me realize how narrow my definition of the word toy has been. I admired their creativity and resilience—their ability to play joyfully without having what we usually think of as toys. Most children in America have at least 50 items designed to occupy them, and seeing these kids play so freely made that abundance feel excessive. Children will play as children, no matter what you give them.

That reflection has extended to technology as well. Watching Luke scroll through AI slop on a phone for hours made me uneasy. I explained how algorithms tailor content to individual users, and when we looked at his feed, it was almost entirely AI-generated material. He was fully convinced that Greek mythological creatures were real and still living in our oceans. There’s a difference between imagination and misinformation, and I worry about how early and how deeply those lines blur. But maybe that’s just a rant for another time.

I think part of why I haven’t been writing is that I felt like I should only post if I had something cohesive and insightful to say. But the truth is, I don’t. I don’t know much yet. I’m just picking up the pieces and trying to be as helpful as I can. I’m not discovering grand truths or arriving at clean conclusions. I’m just settling in—learning a language, trying to keep up with my studies, and figuring out how to be useful without destroying myself in the process.

I think I need to set clearer time limits for myself and intentionally build in rest so that something like this doesn’t happen again. Resting is not something I’m good at. I’m not sure I’ve ever known how to do it, or how to feel content while resting. I usually fall asleep fighting all the things left undone. Even small, ordinary needs start to feel like negotiations when everything else feels unfinished.

Also, I miss coffee. I have good coffee but I don’t have access to hot water where I live in the mornings. I could, but I just need to buy some things next time we are in Hoima.

One cup of half-dissolved instant coffee a day is not cutting it, and I’m pretty sure caffeine withdrawal deserves its own entry.