Indigo Awakening; A Doctor’s Memoir for Forging an Authentic Life in a Turbulent World, Janine Talty: Author Guest Post

Dr. Janine Talty, today a successful osteopathic physician, as a child found herself bewildered by a world full of challenges that she could not understand. She felt isolated, unable to cope with the regular life issues that other children managed easily. She could not comprehend math or spelling-yet she could see energies that others could not see, and had levels of awareness than no-one around her possessed. She exhibited unusual artistic and healing talent. She spontaneously remembered and drew pictures from “old memories” of places her family had never visited. Only as she grew into adulthood, painfully learning to cope with her challenges, did she realize she was an “indigo,” one of a generation of people with unusual talents and abilities, yet who rarely fit neatly into societal roles. This book is the inspiring story of how she overcomes these challenges, finds her voice and identity, and discovers a channel for her healing abilities as an osteopathic physician. – FROM AMAZON.COM

Indigo Awakening is available in paperback AND Kindle format.

AUTHOR GUEST POST…Indigo Physician Field Notes: Janine Talty, D.O., M.P.H.
Journal entry; May 16^th, 2005; Havana and the Cuban country side

The day started for me at 6:30 AM with a 45-minute swim in a far to short pool on the 9^th floor of our hotel. I had to rush through my shower and breakfast in which to be present for a lecture given by a retired general surgeon Dr. Jose` de J. Portilla Garcia, who now works for the Ministry of Health within the Cuban government. He was sensitive to deliver the well-crafted power point presentation lecture in English, which made it convenient for me and the other four individuals in our group of 29 who did not speak Spanish. He described the overall organization of the Cuban health system showing an organizational flow chart focusing on the bottom rung, the Family Practice primary care community clinics. One physician and one nurse, both of who live on the premises, staff these clinics. Above the primary care clinics in the organizational chart are what are called Polyclinics. These were described as multispecialty clinics that have the capability to provide a higher level of care that cannot be handled at the neighborhood primary care settings. These clinics employ up to 100 physicians of multiple specialties provide urgent care as well as inpatient services. To hear him speak they could rival the Mayo or Cleveland Clinics in the US.

He went on to show how the Cuban (still considered third-world) system was superior to most “developing” countries and almost equal to the US when comparing infant mortality rates even though billions of dollars less are spent each year. The Infant mortality rate is the “barometer” in Public Health to show the over-all effectiveness of the health care system and is used to compare cities, states and countries. The grafts that were shown and sometimes brushed over and speed through left many of us with public health backgrounds with many questions. Not wanting to be confrontational we just listed quietly.

The next two hours was spent exchanging money, United States dollars for Convertible Cuban Pesos. We finally loaded the bus and headed west to see the real Cuba, our destination was the town of Vinales to have lunch in a very unique and special location on the way and to visit a Polyclinic. As we traveled our tour guides pointed out the local history, landmarks and cultural points of interest always from a very moderate and seemingly unbiased point of view. However, the story that we continued to be presented was the same…all their needs are being met, there is nothing that is needed that cannot be obtained and all of their systems and equipment are working and functional. According to our guide life was good! Outside the windows of our luxurious climate controlled Mercedes bus we had a glimpse of life outside the crumbling city of Havana. The countryside was marked by various different species of palms, sugar cane fields, tobacco, corn, and row crops. Each farm had either and emaciated oxen, a cow, or a horse usually tied by the neck to a tree or rock forging for unseen green blades. All shared a distinctive forlorn depressed look in their eyes, completely void of spirit and will. In part most likely due to an overload of intestinal parasites no doubt.

We arrived at our lunch designation around 4:00 PM to the most unusual spot. It looked like a scene from Jurassic Park. The windy road curved its way through a desperate valley closed in by vertical cliffs that seemed to hang over the road at times making visible stalactite caves in the cliffs. We dined in thatched huts and were entertained by a local band playing traditional Cuban music. We were served cabbage salad, with sliced cucumbers, onions and tomatoes, pork, chicken, Cuban rice with sausage and a potato-like root that had its origin in Africa brought to Cuba with the slave trade. It was starchier, but sweeter than a traditional South American potato. Once finished we tipped our hosts and loaded the bus for our late arrival to the community Polyclinic. The clinic closed at 5:00 PM, it was approximately 5:30 PM when we arrived.

In the bus we all had many opportunities to have long chats with our fellow Medical Humanitarians. Earlier in the day I had the chance to get to know one of Salud’s board members who joined their financially sinking ship in 1996 and who has been instrumental in its unbelievable recovery and now regionally recognized success. I had considered Edison Jensen aloof and quiet. He is a man of small stature who seemed uninterested in small talk. Actually, I had previously had known very little about him except for his very interesting background of being an adopted Latin child into a Anglo Wasp family raised far from any element of his native culture including never being exposed or having learned the Spanish language. I learned so much more about him on this trip. He holds a seat on three very powerful local Board of Directors, the other two to protect the one. Besides being on the Salud Para La Gente Board of Directors, he is on the Dominican Hospital Board and on their credentialing committee as well as the Pajaro Health Trust, which decides the fait of Watsonville Community Hospital. This allows him to protect Salud’s interest for access to Federal, State and local moneys, influence and market share. He is “bull doggishly” protective of community health for farm workers, Arcadio Viveros (the CEO of Salud) and all that Salud stands for. As I sat next to him, I began to get the sense of how truly large his heart was, contained within his petite chest. It was then that I realized how badly I had misjudged this man. He felt like kin to me, like-minded and intuitively driven – a man whose perception was sharp and intentions pure.

We finally arrived in the rural community, the bus stopping perpendicular to the building of interest. We filed out of the bus and were once again met with the heavy sultry humid tropical air and the “in-your-face” reminder of the profound poverty that is Cuba. The street was bordered by falling down tenement apartments made more colorful not just by the washed away plaster partially painted exteriors, but also because of the multicolored clothes hanging on the lines that adorned every porch and out of most open windows. It looked like a National United Nations banner convention. On the sidewalk were two loose piglets grazing happily on the drying lawn grass that separated the street from the sidewalk. Pork is the preferred meat of the locals, and it is common to see pigs staked out on people’s front lawns and in their yards, evidently in preparation for additions to next year’s meat rations.

We made our way down the tree lined side street toward the entrance to the clinic that had obviously already closed as there were few people coming or going. As we ascended the five stairs into the main entrance we were met with an uncomfortable greeting of a child’s defining crying. As we walked in, the voice was emanating from a small boy about two years old being wheeled out of a room to our left by his assumed father pushing him in a blue stroller.

Our group consisted of several community health center administrators, their wives, husbands or adult children, two attorneys, and four physicians. As we stood in the buildings foyer hearing more about how perfect the Cuban health system was the discussion was finally opened up for questions. All made continually difficult to hear over the incessant high-pitched unceasing crying in the background. I stood there listening to the discourse feeling more like a guest than a true participant; again I kept my questions to myself. Suddenly I felt a tap on my left shoulder. I spun to make eye contact with Edison Jensen who was holding a two-view radiograph of an elbow. He asked,  “could you take a look at this for me?” We quietly slipped out, back to the clinics open entrance doors. I had not really noticed, but the crying was no longer audible. However, I then became aware of a woman quietly sitting near the open door trying to hide her tears with her hands hiding her face. I walked outside where I could better evaluate the film and started my assessment. It was of a child’s humerus; growth plates still open, ulna and radius. I spent a good amount of time looking for a subtle fracture or the classic “sail,” sign that shows bleeding within the joint. Both were absent, but then I noticed something strange about the relationship between the ulna and the trochlia of the humerus. The olecranon was sitting inferior and anterior to its expected position. As this realization came to me I felt my heart begin to pound in my chest. My heart knew the diagnosis before my mind did. This elbow was dislocated, and I was going to be the likely candidate in the group to reduce it. The other three physicians in our group included two internists and one pediatrician. I then took notice of the people standing around me. Present were Luis, the other bilingual attorney, Edison and the crying woman. At that point it felt like I began acting automatically. I began to take what little history I could with Luis translating. Turning to the crying woman I asked, “How did he fall?” Looking directly at her she motioned and spoke at the same time, she bent one arm and with an upward motion of the other struck her palm directly on the olecranon process. A motion that would have driven the ulna anteriorly in the trochlear groove. This mechanism confirmed what I saw on the x-ray. I then asked, “who is this, and where is this child now?” Still not knowing it was the wailing child that to many of us was a disruption. The father had been told once the radiographs were obtained that they would have to travel 25 kilometers to another town to be treated. There was no one at this polyclinic that could help. Not owning a car, the father had already wheeled him down the street toward our parked bus in order to try to find some mode of transportation. I motioned to bring him back. I wanted to see this arm. In short order the crying became louder and from around the hedge that lined the sidewalk, appeared this father with his young son rocking in his seat, crying holding the stroller safety rail with his right hand and cradling his left lifeless arm in his lap. As I made eye contact I could feel his excruciating pain as big tears rolled down his well-soaked cheeks. As we connected I felt myself move into a mode of communication that I have used so naturally with animals. I consciously opened up my forth Chakra (the heart) to him and invited him to do the same – he obliged. I communicated to him that I was there to help and for him to relax, it would all be over soon. I knew he understood, because when I approached him his crying sputtered, it was as if he offered me his injured arm without hesitation. With my left hand I firmly grasped and stabilized his humerus. With my right hand I griped his 90-degree bent radius and ulna and distracted his forearm directly inferiorly disengaging the joint. The boy did not offer any resistance. Not one muscle twitch to pull away not even in the face of momentarily increased pain. As I distracted inferiorly my attention and gaze was focused on the elbow and so was his. I then began to move the olecranon posteriorly while I slowly moved it into extension, holding the humerus forward. As I worked it into full extension, distraction and posterior translation I felt and heard a reassuring “pop” regaining the remaining fully extended range. I could not hold back and excited “Ya!” and a big smile. He then looked up at me with eyes moving from fear and pain to relief and gratitude. I then ranged the elbow repeatedly through its full range of motion, making sure that internal and external range of motion was also preserved. All was restored when I released my firm grip. At that point I noticed he had stopped crying, something he had not done for the past four hours since the fall.

At that point it felt as though I was emerging from a trance. I had been completely unaware of anything or anyone around me. I began to notice the presence of many people standing near by. The parents both had big smiles as our group was now gathering. I am not really sure what happened in the moments following my completion of this duty. From the moment the radiograph was handed to me, to the time the reduction was completed must not have exceeded 5 – 7 minutes. For me however, time was completely irrelevant. It felt like some external force that provided me with the keen eye and perception to assess the problem, confirm the history and treat the child had somehow guided me. It was yet another example of tapping into knowledge that I have never learned directly, at least consciously. This was an example of perfection coming together. A gathering of a million synchronicities that added up to being able to change the lives of this one Cuban family.

As our group gathered the story began to be told, the family had begun to leave the clinic making their way back toward the bus. Our mostly Spanish-speaking group wanted to see this child and called them back. Again the father wheeled him back up the street and around the hedge, but this time he was not crying and neither was his mother. This time he was using his left hand to stabilize himself on the stroller rail and his right held a cracker that someone had already shared with him from our bus. I began hearing comments around me that included part of the story ending with my name and “hero.” That felt immediately inaccurate. I knew in my heart that I had been commissioned for this duty and only played a small part of the technician.  Someone else was the true hero. It was the individual who did not automatically tune out the crying but heard it was a wail of pain and not fussiness. It was the one who realized there was a problem that could not be solved here, and the solution for this family was almost as impossible, given the barriers to transportation. It was the person who assessed which individual in this group of American trained physicians would be the most likely to help. It was the person who had a keen ability to see on the soul level and intuit much more information than that which was being presented on the surface. At that point however, he had no idea he was tapping the shoulder of a like-minded, like-visual, like-guided kin. Edison and I had that conversation on the two-hour bus ride back to Havana.

Janine Talty, D.O., M.P.H.
Indigo Awakening; A Doctor’s Memoir for Forging an Authentic Life in a Turbulent World