Global Health Forum - Cyoa

Page 1: You are a bright, young medical student about to embark upon an international elective in the impoverished country of Elbonia. Boy are you eager to get out into that world and not only learn, but grow as a person! You puff your chest with pride thinking of all that good you may one day do. Your bags are packed, your farewells have been long and tearful, and you have a shiny new digital camera to evidence your heroism. But first, you have to decide on a program. Weird, that you’re all ready to go but you haven’t made even the most rudimentary of preparations yet. “Whatever,” you think to yourself cheerfully. “I will be guided by my Spirit Animal.” You summon Roscoe, your Spirit Mongoose, who materializes in an explosion of fur and fangs. Roscoe presents you with three options: Earl’s Hospital for Healing located in the incredibly cheap, recently reinhabited West Elbonia. St. Felix the Adventurer’s Clinic at the base of Mt. Whiffenswiff, Elbonia’s famously tall mountain. Elbonia City Hospital Center located in the heart of downtown Elbonia City, which many people commonly call the New York of the Third World. 1.) 2.) 3.)

You decide to go with “Earl’s Hospital for Healing.” You decide to go with “St. Felix the Adventurer’s Clinic” You decide to go with “Elbonia City Hospital”

-p. 2 -p. 3 -p. 4

Page 2: Roscoe shakes his head in pity before emitting a mating giggle and disappearing in yet another puff of fang and fur. Or was it fur and fang? You never can tell with Roscoe. It seems that you could have chosen more wisely, brave medical student, for Earl’s Hospital for Healing is pretty much a death trap. The doctors would be more commonly referred to as “shaman” in polite society, their tools are terribly outdated by even the bronze age, and you will have to wear a bearskin the entire time ‘lest the people of West Elbonia mistake you for a ghost and attack you. (This is a surprisingly common problem in West Elbonia.) 1.) Page 3:

Elbonia Ho!

-p. 5

“Ah, St. Felix the Adventurer’s Clinic,” Roscoe intones in a rich baritone. He speaks in the sort of complex timber that normally only comes from smoking four packs a day. Roscoe, however, is simply lucky. “An excellent choice.” Medical student, you are a man’s medical student. At St. Felix’s you will find interesting cases, a complex variety of people ranging from local Elbonians to touring mountain climbers, and that most sought-after of international medical experiences: exciting safety. People fly in from far and wide to climb Mt. Whiffenswiff, break some of their favorite bones, and happily allow the foreign surgeons to hack away at their bones and ligaments. This will be a most interesting place to work. 1.)

Up, up, and away!

-p. 5

Page 4: Roscoe snickers a little to himself before spitting in your face and evaporating. It seems that your Spirit Animal is still a little miffed from when you called him the “Damned and Ugly Cat of the Apocalypse” that one time, because the only people who call Elbonia City the New York of the Third World are people who have never been to New York and who fail to understand that the term Third World does not mean a third heavenly body. Elbonia City is actually a safe, little village whose moniker was attached either in irony or drunken irony. The people there desperately need more medical attention and supplies than they are provided. You might actually do some good there and truly discover a lot about native Elbonian culture. Not that you had any idea you were making this decision. Really, you should stop being so personal with your insults and actually do some research before hand in the future. Then maybe you’ll be able to make informed decisions. 1.)

Off on a jet plane…

-p. 5

Page 5: After touching down in the adjacent country of Mixzikhstan, you find that the only way to enter Elbonia is by way of a gruff, monosyllabic boatman who reminds you a lot of Sylvester Stallone. You attempt to ask him about his uncanny resemblance, but you only get grunts and growls in return. You begin to think that you may have failed to properly assess the situation: this may very well be a large ape that you’re talking to. Upon coming ashore in Elbonia, the boatman looks you in the eyes and says a full sentence: “You shouldn’t have come here.” He says it real ominous, with the monotonous voice of fact. Thinking he wants a tip, you give him some money and

happily stumble on to your destination. When you arrive you realize that the program offers you both a clinical and a more organizational experience. What to choose, what to choose? 1.) 2.)

Clinical Experience Organizational Experience

-p. 6 -p. 7

Page 6: You think to yourself, “What am I? An MPH student?! Of course I’m going into the clinic. We can leave bureaucratic control to insurance companies that clearly have better intentions than I do.” Failing to observe your own dry sarcasm, you proceed happily to the hospital where men and women sit in a waiting room and look at you suspiciously. Most of them wear the traditional bearskin covering of their forefathers, though some have opted for a more sleek business bearskin. You begin to think that perhaps you are standing out a wee bit with your Ipod and New Balance shoes. Whatever. You hum ABBA (Dancing Queen) to yourself as you look at the doors before you. In a cunningly simple arrangement there are two doors labeled “Surgery” and “Internal Medicine.” Perspiring and breathing heavily, you mop your brow in anxiety. Part of the reason you came to Elbonia was to avoid decisions like these. 1.) 2.)

Enter the door marked “Surgery.” Enter the door marked “Internal Medicine.”

-p. 8 -p. 9

Page 7: Oh. Yeah. Administrative stuff. Studies. Improving organizations. That’s why you’re taking next year off to get that MPH degree. Bracing yourself for the hard-knock world of spreadsheets and accounting, business plans and models, you kind of realize that you have no idea how hospitals are run. Or what you would even do with your future degree. I guess that’s why you’re here, then! You enter the administrator’s door and he stares down at you from a traditional four feet high chair marking him as an important Elbonian figure. You mouth the letters W-T-F as the administrator glares at you from up high. He clearly has no idea who you are. You try to explain why you’re there and what a good worker you are, but the administrator won’t have any of it. He’s up to his bearskin in work and babysitting you through your internship is not on his job description. He motions towards a messy pile of papers composed of the ongoing projects here.

You begin to shuffle through them hopelessly when you spy an open patient room with a patient sitting nervously in the corner. 1.) 2.)

Running things is hard. Go talk to that patient. No, damnit. I’m going to find a project if it kills me.

-p. 9 -p. 10

Page 8: You push aside the “Surgery” doors and embrace your future. Standing tall in the rather sterile environment you sniff the air and come away with the faint hint of money. You are a Columbia medical student, proud inheritor of the College of Surgeons and Surgeons. No. Wait. That’s not right. You’re pretty certain there was something with a “p” in there. Penis and Surgeons? You shrug your shoulders and change your Ipod to your “Cutter” Mix. Humming Avril Lavigne’s “Complicated,” you scrub in with the ferocity of an angsty teenage girl. Swollen with rage at life’s complexities and an unmerited smug sense of superiority, you enter the OR. By the lame leg of Hephaestus, the surgeons are repairing a torn ACL! You rush up and jostle the nurses a little. They mutter curses that are not derived from Greek mythology. The surgeon greets you with a nod and starts yabbering on about the wonders of the human knee. You agree with him. Yes. Totally. Without that joint, what would we do? No, we certainly could not walk without a knee. It is indeed miraculous how much I under appreciate my knee. Hell, I would dare say the knee is like the elbow of the leg. Ha ha! No, no sir. I just made that up. Right now. Yes, I’m sure your golfing joke is better, though. No, no, we shouldn’t hear it now; all the laughter may wake the patient from his anesthesia. Congratulations, dear medical student! Your brown-nosing has endeared you to this surgeon. His eyes glisten as he glances at you. He swears that you remind him of himself when he was young. He’s so drunk on nostalgia that he offers you the scalpel. You’ve seen this procedure before. 1.) 2.) Page 9:

Why not? See one, do one, teach one and all that nonsense. Are you kidding me? I’m a student.

-p. 11 -p. 12

Ah, patient interaction! This is what you went to medical school for: the thrill of communication, truly getting to know a person, becoming more than just a tool in his or her life—a professional, beloved confidant. You look at the patient. Holy Cow! What is that? Is that his face? No, wait…that’s a tattoo. Is it? You really, really want to reach out and touch it. Would that be professional? Is it pulsating? How could a tattoo pulsate? The patient clears his throat and looks at you expectantly. He wants to know if you’re the doctor. You look like a doctor. You ready your response. 1.) 2.)

“Why yes. I am the doctor. Your doctor.” “No, sorry I’m just a medical student.”

-p. 13 -p. 14

Page 10: You are at your wit’s end. What are these projects? Operation Dumbo Drop? Ghost Repellant? The Great De-Fangery? What does that even mean? Looking through this craziness you happen across some files tracking the local pharmacy. It’s poorly run and clearly corrupt. Drugs supposedly arrive but never make it to the patients. You rub your palms into your forehead in thought. You might actually be able to do something about this. In any case, you understand the problem: drug-thieves. Your immediate impulse is, unsurprisingly, to don a cape and fight crime á la Batman. “No,” you wisely tell yourself. “That day hasn’t come. Yet.” You decide instead to pragmatically address the situation. Drugs need to go to the patients. The pharmacy cannot be trusted. What to do, what to do? 1.) 2.)

You decide, “Hey, I’ll store the drugs myself!” You decide, “I need to work with the pharmacy and locals.”

-p. 15 -p. 16

Page 11: Grabbing the scalpel, you feel its power coursing through you. Surely, this must be what God feels like when He holds a scalpel. Remembering what you had seen in Milstein Hospital, you bring the scalpel gently into place. With the care of Leonardo da Vinci you make your first incision.

Holy. Hell. There is blood. Everywhere. “What happened?” shouts the attending as he crashes down from his nostalgia-inducedhigh. “What did you do?!” You don’t know! You don’t know! It seems that you may be more of a Pollock than a da Vinci. In any case, this patient is bleeding out. You think back to the anatomy of the leg and wonder what you could have nicked. There are, like, three pertinent arteries in the leg. None of them should have been where you were. Should they? What could cause this? Your anatomy professor appears in your mind’s eye. You look to this glowing image of him for help. What happened here? Your anatomy professor suggests situs inversus. You pretty much hate your anatomy professor. In any case, the patient bleeds out and dies. Tragic, right? You’re pretty choked up about this. People are screaming at you. Doctors are pushing you around. Why’d they even let you have that scalpel? Why did you take it? Things don’t look good for you. You’re thrown into the Hospital Administrator’s office face first. Dusting yourself off, you stand up and prepare yourself. 1.)

Goodbye, Elbonia.

- p. 17

Page 12: You shake your head, “No,” and return your attention to the surgery in process. Yeah, that would’ve been really cool, but you have no idea how malpractice insurance works in Elbonia. Thinking on it, you’re unsure what legal system is employed in Elbonia. Is mob rule internationally recognized? Something funny is going on with the surgery. You notice that every few minutes the surgeon lightly punches the patient straight in the abdomen. You screw up your face, trying to think if that’s the expected standard of care for a torn ACL. Maybe? Explanations and graphs race through your mind involving things like intra-abdominal pressures, blood flow, the valsalva maneuver, and the cellular response to trauma. In the end, though, you come to a single conclusion. This is bullshit.

You’re about to comment on the repeated blows to the patient, when a nagging doubt lodges itself in your brain. Like the bewildered Dorothy and her pet dog, you are a long way from Kansas. 1.) 2.)

Ask the surgeon what he’s doing. Let sleeping Toto’s lie.

-p. 18 -p. 19

Page 13: This is exactly the pick-me-up you needed. Yeah, you’ve misused the patient’s trust, but you feel fan-freaking-tastic. Dr. You. Mr. Dr. You. Dr. Mr. Dr. You, thank you very much. “Oh, silly foreign person,” you think, “you have just made my day.” You begin the patient interview in earnest, but all this guy cares about is what it’s like to be a doctor in America. He wants to know if you know Cher or Madonna or the B-52’s. What decade of American pop is Elbonia stuck in? Grabbing the patient’s shoulder you sit down and look him in the eye. You explain, 1.) 2.)

“America is awesome. And yes, I do know the B-52’s.” “What America is like isn’t important. This is about you.”

-p. 20 -p. 21

Page 14: Fat with moral imperatives, you correct the patient. You are simply a student, but you can provide some help. The patient doesn’t seem to register what you said and persists with his doctor-nonsense. You’re pretty sure you’ve fulfilled your duties here, and if the patient doesn’t want to listen to it: fine. Be that way. You start talking with the patient and somehow the wily man twists the topic back onto you. He seems a little America-crazy. What’s it like? Why are you here? But more importantly, do you know Patrick Dempsey? You sigh to yourself, thinking this long day will only get longer. 1.) 2.)

“Oddly enough, I do know Patrick Dempsey.” “Just…let’s just bring this back to your visit here today, okay?”

Page 15:

-p. 20 -p. 21

“Sustainability,” you declare to no one in particular, “is over-rated.” You lightly skip into action, redirecting all the drug supplies to you and the little room in which you sleep. Soon, you’re up to your eyeballs in anti-biotics and narcotics. You are literally tripping on morphine. (You have never been a particularly tidy child.) While you remain in Elbonia, everything runs smoothly. The drugs are dispensed on time and to the proper recipient. Yes, every now and then the Pharmacy Manager glares daggers at you and draws his index finger across his throat while keeping eye contact with you, but that could mean anything. This is another country after all. One day, however, the Hospital Administrator approaches you and asks what your plans are for the pharmacy after you leave. “After I leave?” you stammer. You hadn’t thought about that. Making the entire pharmaceutical dependent on your virtuous character had seemed a foolproof solution. The Administrator sighs and supposes that they’ll just have to go back to the old pharmacy situation. The Administrator looks at you judgingly, asking you to step up. 1.)

Fuck. That.

-p. 22

Page 16: Ah yes. Working within the infrastructure that’s already set-up. You go and meet with the Pharmacy Manager. His bearskin looks ratty and smells oddly, but you can’t be sure that that isn’t a style or something. He wears lots of jewelry and you begin anew the life-long debate you’ve had with yourself regarding men’s jewelry. “Why? Why do they do it? I mean, isn’t jewelry a distinctly feminine concept? Is it a deeply held conviction rebelling against social norms, or is it a cry for attention playing upon the culturally-established “weirdness” of his choice? Or maybe it’s an Elbonian thing? But none of the other men I’ve seen here have worn jewelry. The rings are certainly shiny, though.” You only come out of your reverie after the Pharmacy Manager’s third, forced cough. Forcing your eyes away from his brilliantly shimmering diamond ring, you explain the situation and ask the Pharmacy Manager to go over the transportation of the pharmaceuticals. The Manager understands the problem, says it’s been a problem for years. You just can’t trust the employees (good help being hard to find and all that). You suggest maybe adding a lock to the store room and that the Pharmacy Manager should handle each new shipment personally. No one likes getting assigned more work, and the Pharmacy Manager is no exception. For a moment, you fear that he may strike

you, but then he agrees amiably and punches you in the shoulder. He likes your initiative and the cut of your jib. You joke that it is indeed a fine day for sailing. The Manager most certainly does not laugh. He has never been to the ocean or seen a sailboat. Awkward. In any case, you come back several days later and check the inventory as written and the actual supplies. While the book keeping is now immaculate, it doesn’t match the actual pharmaceutical stores at all. Curse you, Pharmacy Manager! “There’s just something about a man’s jewelry,” you think to yourself. 1.) 2.)

You know what? Whatever. You tried your best. No, this cannot stand!

-p. 22 -p. 23

Page 17: The Hospital Administrator is very disappointed in you. The program can’t have your kind of lolly-gagging and bafoonery and piggly-wiggly. No sir, it cannot. You’re an American student, so there isn’t really anything they can do to you other than kick you out. The next thing you know, you’re packing up and fording that river to the airport once more. The same stoic boatman guides you to Mixzikhstan. As you get off the boat (which is—really—more of a canoe), he tells you, “You shouldn’t have come here.” Perhaps that’s just how he says good bye? In any case, here ends your adventure, young medical student. This wasn’t the most glorious end, but you know what? You’ve learned a lot. And when people ask you about your experience abroad you now exactly how you’ll respond. With lies. Filthy, filthy lies. THE END Page 18: The surgeon happily informs you that it’s a custom peculiar to Elbonia. It hasn’t been shown to affect patient outcomes in the slightest, but it makes the patients and their families feel better.

You have the distinct feeling that you’re being toyed with. You can’t tell if it’s the shiteating grin you can barely perceive underneath the surgeon’s mask or the slightly stifled laughter coming from behind you, but this is far from professional. Almost imperceptibly, someone whispers, “Pansy.” Flustered, you don’t know what to do. You feel everyone’s eyes on you. Judging you. Thinking you’re a loser. Insignificant. So you lightly punch the patient in the abdomen. Your judgment under pressure is not the reason you went into medicine. Everyone in the OR bursts out into laughter. You storm out of the operating room and fume for a little bit. Your ego has been bruised and your sense of justice outraged. This, this cannot stand! They will be sorry that they poked fun at you! They may also be sorry that they hurt an innocent patient. Oh, your outrage! You’re so angry you could just break into a dance number! Pirouettes and stag-jumps race through your mind. Why isn’t there more space? You have a perfect routine for expressing yourself (post-modern form with just the hint of krumping), but no space. Blast it all! Instead, you guess you’ll just have to report those miscreants’ impropriety. 1.) 2.)

Stick it to them, speak with the family. Hit them where it hurts, speak with the Administrator.

-p. 24 -p. 25

Page 19: The blows continue throughout the surgery. Towards the end, the surgeon glances at you after each strike as if expecting you to respond. He seems somehow disappointed when you never challenge his right to abuse his patient. After the surgery, you reflect on how much you enjoyed just letting everything slide back there. The sweet release of apathy wraps its tendrils around you and suddenly nothing seems to have importance. You make a spontaneous vow to never again vote in an election. Why get worked up about any of that stuff? Why are you even doing any of this? You’re not directly reporting to anyone. You’re…you’re practically on vacation. Why not? Why not just go to the beach? Elbonia has lovely beaches.

1.)

Surf’s up.

-p. 22

Page 20: You regale the patient with stories of The City, your minor celebrity interactions, and your obsession with Krispy Kreme. The patient eats it up. You can see the longing in his eyes: you’ve got a convert to the American middle-class lifestyle right here. As you stop your lecture, you see him come back down from his flights of fancy. He looks around the room as if it had suddenly dimmed and twists his face in disgust. Blinking, the patient stands up and thanks you for your time. He begins to leave. You ask him what brought him here and tell him the interview’s only just begun. He doesn’t seem to hear you. 1.) 2.)

Let him leave. You can’t force him to speak with you. No, no, no. He’s here to see a doctor. Sit him back down.

-p. 26 -p. 27

Page 21: The patient seems a little taken back. He clearly thinks you’re a holier-than-thou American whose knowledge couldn’t possibly be passed on to the patient. “Oh no,” his eyes scream. “Keep me in the dark, continue to use my country for your own capitalist purposes, but don’t share anything with me. I hope you get dysentery and die. Like in Oregon Trail.” You may be reading a little much into his look. You may also be adding in your own childhood memories of playing Oregon Trail, naming party members after all the kids who picked on you, and then driving the wagon at such a furious, unsustainable pace that they all died terrible, lonely deaths. You don’t regret those games at all. I mean, you should—what’s wrong with you?—but you don’t. The interview haltingly proceeds and you pray for his physician to enter the room so that you may step back and observe. 1.)

The doorknob begins to twist.

-p. 27

Page 22: You’ve had about enough of all of this. Medicine’s forever, and youth is short.

You skip out on the hospital, rent a car, and race to the nearest beach resort. As the wind whips through your hair, you have momentary doubts about leaving it all behind. But when you’re on the beach, sipping your iced-tea, and leafing through one of those nifty Choose-Your-Own-Adventure stories, you know you made the right decision. As you exchange significant glances with the brunette toweling herself dry, you tell yourself that even virtue needs a little vice now and then. (If you know what you mean. Eh? Eh?) Forget the hospital. Who’re they going to tell anyway? And who would even believe them? The sun begins to lower and the sky lights up with Christmas reds and greens. The air, thick with salt, wraps you up tight. It’s a holiday, man. It’s your holiday. THE END. Page 23: You march into the Hospital Administrator’s office and present your evidence. “Something is rotten in the state of Denmark!” you declare. Your theatrics not withstanding, the Administrator is on the phone and can’t really talk right now. You should give him five minutes or something. Shoo, shoo! Exiting the room, you can’t believe you wasted that line. What are you going to say now? You fret and fret as you pace outside the Administrator’s office. Argh! Your brain is uselessly full of medical facts! Hearing the Administrator hang-up his phone, you burst in with a, “Yippee-ki-yay, motherf…” The phrase dies an awkward death as you realize that quoting Die Hard was inappropriate on so very many levels. You attempt to regain some semblance of respectability by adopting a slightly British accent. (This, however, was a terrible choice. Elbonia had been a British colony and still feels generally displeased with the Brits.) You recount the problem with the pharmacy and your failed attempts to handle the situation on your own. The Administrator nods knowingly and assigns you full authority over the Pharmacy in order to work this thing out. You try to explain that you were looking for help, but the Administrator simply insists that the sign of good leadership is excellent delegation. And he is a master delegator.

“Fine!” you say. “I’ll handle this on my own.” You sit down and think on it, but you can only come up with two possible choices. You feel like you’re running out of energy, like you’re a writer who’s just coming up short on plausible possibilities. 1.) 2.)

Institute a Christian-values Program to teach that theft is sin. Divert finances to preventative programs.

-p. 28 -p. 29

Page 24: There’s no way this could be a bad idea. With your chest puffed up and proud, you enter the waiting room and inform the family that something has gone tragically wrong in the operating room. They immediately break into sobs. How? Why? It was just the knee. How could that even happen? Your bad. You explain that you simply meant the surgeon seemed to be touching their son inappropriately. More sobs and bewildered questions. Sheesh, these people sure know how to misinterpret your every word. No, no. You explain that the surgeon seemed to be lightly striking your son as a prank against you, and—frankly—that is not cool. Comparatively, this is not that big a deal, so the family seems relieved. You stress how this was a plot to ostracize you, but they don’t really seem to care about that. They do, however, care about the lawsuit you’ve basically handed to them. It turns out that Elbonia’s legal system is alive and well after all! The family marches you straight into the Administrator’s office where they begin shouting, pointing, and drooling at the prospect of their future settlement. The Administrator settles them down and redirects them to the legal department. Quickly, he shuts the door and shoots you the icy-cold-look-of-death-that-your-momused-to-give-you-if-you-acted-up-just-one-more-time-buster. He has got to get rid of you and fast, before the family realizes you’re the only witness they have. 1.)

Oopsie-doodle.

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-p. 17

The Hospital Administrator laughs for a fairly unsettling amount of time after you recount the perverse prank that the surgeon was pulling on you. (You wonder why Elbonians think that’s a good joke, but decide to remain stoically upset rather than ask.) He assures you that he understands the severity of what was happening and that that sort of patient mistreatment is not accepted around here. He’ll get right on it. The surgeon will be spoken to. You were kind of hoping for a bit more, but maybe you over reacted. You thank the Administrator for his support and assure him that you’re still having an excellent time despite this hiccup. It seems that your international experience will be all right, dear medical student. Except for that sound of gunfire coming from outside. 1.)

Wait. Gunfire?

-p. 30

Page 26: Unbeknownst to you, that patient returns home to his pregnant wife and his three children. He looks at them as pale imitations of the radiant life that he could have had. Over there. In America. Over the course of days and weeks, the patient starts drinking more, getting in fights at work and at home. His wife no longer knows him. This creature that their father has become terrifies the children. On the worse nights, they sleep at their aunt’s house. All the while, the patient is haunted by the specter of Americana that you had shown him: the B-52’s and McDreamy’s flowing hair. He takes to pretending that he is American. Muttering to himself, he carries on conversations with pretend neighbors about their pretend lawns and the pretend weather. “Yeah, I try the best I can, but this organic fertilizer just isn’t working,” he repeats over and over again. Crudely, he scrawls “North Face” on his clothing. Finally, his wife leaves him and his brother admits him to an insane asylum. There he lives out the rest of his days in agony, dreaming of an American-Elbonia that will never be. You, however, know none of this. You simply continue to show the same disregard for your position and time that you showed your patient until one day… 1.)

…You stop caring at all.

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-p. 22

With the real doctor in the room, you fall back into your usual state of passivity. You observe their rapport but the doctor insists on explaining everything to you. You tell her that it’s fine, that you don’t need to know all the fine details right now. Instead, she should focus on the patient. But, whether she’s simply bored with the case or eager to teach, she keeps turning back to you. The patient appears slightly aggravated that this is taking so long, but the doctor pays his frustration no mind. The patient was just there for a check-up, and soon enough he’s on his way out. It’s been a rough first day, but also a fulfilling one. You’re sure that your time in Elbonia will offer you many opportunities. The doctor invites you to sit down and have a cup of coffee with her. You start discussing medicine, science, television, and the political unrest in Elbonia. Political unrest? The doctor is shocked you signed up for the elective without doing any research. The nation’s hanging by a thread. You stare into your coffee, lost in caffeine fumes. You could swear that the ground was shaking, but it’s probably just your nerves. Wait. The ground is shaking. Next thing you know, the doctor drags you under the table and you hear the dull explosions of mortar shells in the background. 1.)

Well, shit.

-p. 30

Page 28: You knew those sleep-away camps you attended as a child would pay off! If there’s one thing certain to endear you to the local people as well as right any wrong-doing, it’s to judgmentally tell them their morality and culture are fundamentally wrong. You plan out a three day retreat by the base of the nearby mountain. You’ll start from the bottom and lead the pharmacy staff up the trail, all the while spreading the Good Word. As sleeplessness and exhaustion sets in, their minds will shift into a malleable mashedpotato consistency, which you will then make into a bowl to contain the Gravy of the Lord. Soon as all the arrangements are made, you set your plan in motion. Some problems arise. First of all, you are in much worse shape than all of these people. You slow the whole trip down to an insultingly ponderous speed.

Secondly, you do not know the trail as well as everyone else, so you’re not so much leading as shouting out sermons from the back of the group. And thirdly, they have already heard about Christianity. (Some of their best friends are Christians.) They’ve simply chosen instead to believe in their forefather’s god, the Flying Spaghetti Monster. Really, it’s pretty insulting that you had assumed the theft was arising from immorality and not necessity. Speaking of necessity: these guys need you to stop snooping around. Like, really need you to stop snooping around. You wonder why they chose to bring up this topic at the mountain’s summit in a closed semi-circle shape that forces you up against the cliff’s precipice. The Pharmacy Manager approaches you and thanks you for all your hard work, but unfortunately you won’t be needed around here anymore. He says how it’s tragic that you—in your exhaustion and confusion—left the group and fell to your death. You, having done neither of those things and do not see what he’s getting at. When he pushes you off the edge, on the other hand, things start to come together for you. THE END Page 29: Why are you even employing this many people at the pharmacy? It seems that over the years the Pharmacy Manager has been demanding more and more employees even though the years where it was just him had apparently worked fine. And why do you even order the quantity of drugs you order? If it weren’t getting stolen left and right, you could provide medical supplies for a small army. You decide instead that you’ll simply fire all the excess employees and limit the amount of pharmaceuticals ordered each week. With the fine, magisterial hand of an executive, your word becomes ballpoint-pen law. Feeling quite proud of yourself, you sit back in comfort. There. No muss, no fuss. Someone else will handle the downsizing and you can get back to being a student. Phew! Unfortunately for you, though, it seems that the medical supplies actually were going to a small army. A small army that just now is beginning to attack the town. Blissfully unaware of the shouts from outside, you drift into sleep before springing awake as someone pulls you to your feet. 1.)

Sadly, this is not a dream.

-p. 30

Page 30: The Pharmacy Manager enters the room wearing a military uniform and smoking a giant cigar. That rat-fink! You had never trusted him and wish you could tell him so. But now…now he’s in charge. And carrying a big gun. As leader of an insurgent army, the Manager has begun his battle with the government of Elbonia here at the hospital. He’s raised his colors and laid claim to the whole province. You’re shoved into a room and locked inside. As the tears course down your cheeks, you wonder why you did it? Why you went abroad in the first place? What have you accomplished? How could Roscoe lead you so far astray? Pounding your fists against the floor at the unfairness of life, you cry out at the Universe that has spurned you. “Why?! Why me?!” There isn’t any reason in particular it had to be you, so the Universe decides to stay mum about the whole situation. Just your luck, I guess. Suddenly, you hear strangled screams and the dull thud of skin against concrete from outside your room. The door bursts open and there stands the boatman, sweaty and rather unappealing. His clothes are torn, his face a mask of rage, and he’s simply covered in mud. He spits on the ground (it’s more blood than saliva) and reaches out a hand. You’re overcome by both relief and fear. This may not necessarily be a step in the right direction. “I’m John Rambo, and I’m here to save you.” THE END