As the day approaches for my departure, I find myself contemplating what I face in this remote part of the world (we're talking rural Burundi here).

I have been doing this pediatrician thing for over twenty-five years, yet I still wonder how my skills and my expertise will translate to a medical, as well as a geographical setting that will be completely unfamiliar to me. Let's face it: I have never treated malnutrition, nor malaria, nor disseminated tuberculosis, nor even, in the last twenty years, bacterial meningitis (the latter, thanks to vaccines--yes, all of you vaccine naysayers, vaccines are one of the great advances in modern medicine in the last century).

Nor have I treated the host of parasitic diseases that I will see. However, even though the diseases will often be unfamiliar to me, the patients who have those diseases will not. What I mean by that is that, whatever their diseases are, these patients are still children. And that's what I do: take care of children. So, yes, I have enormous anxiety about what I am about to do, but I also have hope and confidence that I may be able to contribute to the overall health and welfare of these Burundian children. I know that I am not going to save the world by going to Burundi. But, perhaps, just perhaps, I can make a small, maybe even infinitesimal difference for these obscenely poor and medically underserved children.

Many people have said that this will be a life-changing experience. I doubt that at 61, and soon to be 62 years of age, I'm capable of much change. I imagine that I will be the same obsessive-compulsive, Bichon-loving/spoiling, Yankee fanatic, daughter-devoted, mechanically incompetent, eccentric human being that, for better and worse, I have always been. So I may not change, but what I do imagine is that my perspective on that life may change. And I will warn you that there is an excellent chance that I will be even more intolerant (at least about certain things, like vaccines) when I come back than before I left.

Signing off for now. Peter