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Notice of site merge:  since much of the content tends to run parallel – from medical tourism to medical information about medical conditions and treatment options – I am merging Cartagena Surgery content with Latin American surgery.

This will also include some of my more personal posts on photography, student life during various internships and other posts that give readers a better sense of the person behind the posts.  I debated for several months before initiating the large-scale move – (hundreds of posts), and it will take time to organize and arrange all of the new additions.  Hopefully, the addition of the posts is welcome to all of my long-term followers  – who can now find information on medical conditions  (aortic stenosis) and the doctors (cardiac surgeons) to treat it at the same place.

So if you are a fan or subscriber to Cartagena Surgery – please take a moment to head over to http://latinamericansurgery.com/ to sign up to continue to receive my posts.


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We’re here – in Panama City, Panama starting what I hope turns out to be the latest installment in the Hidden Gem medical guide series..  (wow – #4 – can y’all believe it?!!)

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In the meantime, as I interview surgeons, take notes, photographs and continue my research – I’ve made some changes to the Cartagena Surgery trio of websites..

To streamline and consolidate the medical tourism information – I’ve transferred quite a few of my posts about the Mexicali book over to the sister site – which has been renamed “Latin American Surgery” in honor of the expanding list of destinations that the series has begun to cover.  Bogotá Surgery just didn’t seem entirely accurate now that there are Hidden Gem guides to multiple destinations.

I’ll still be coming by the Cartagena site – to give some of my more informal impressions, and related stories about my adventures as well as our usual discussions on medicine and health.  After all – Cartagena Surgery and its readers have become like old friends; you know the ones who don’t laugh when you kick your shoes off and have a great big hole in the toe of your dress sock.. (and they don’t think any less of you for it either..)

I like to think that my readers here don’t mind my little side trips into photography, funky restaurants, haunted houses or the myriad of touristy things I venture into whether I am “on-location” or just preparing for the next trip.

I also like to think (and hope) that readers don’t mind my ‘down home’ discussions on medicine and health since I think that’s what is often missing in our healthcare conversations.. Just real honest, straight talk..   (even if sometimes I do get a bit up on my soapbox about some of the things that are frustrating about healthcare..)

So – I’ll still be here – to talk about the sweltering heat of the rainy season in Panama City, post my continuing photography efforts, and all the other things that go on down here.. I just hope you’ll still be reading.

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Readers –

My current assignment in Texas is coming to an end – so the blog content will be shifting back; less photography and more medical news.  I’d like to thank all my loyal readers for staying with me as I indulged my creative side for the last few months, and drifted away from our original foci.

But I hope, that for your part – it hasn’t all been eye-rolling, deep sighing, shoulder shrugging ‘tolerance’.  I hope that you have enjoyed the chance to connect on a more personal and less formal level.

That’s how I feel when I read other bloggers pages about photography, travel, sewing, art or any of the other interests that define me outside of nursing and health care.  I hope that you get that same sense of familiarity, of enjoyment when each of my blogs is posted.

If I can recreate that same, “I wonder what she has today?” anticipation that I feel when reading the Mexfiles, seeing the latest creations at the Renegade Seamstress or vicariously enjoying the tasty travels of Bunny and Pork  Belly; well, that’s success in its own right.

My blog certainly isn’t up to the caliber as the others I’ve enjoyed – but I think if I can get each of my subset of readers (photography fans and medical / health readers) to remain interested and engaged, even when I stray off topic..

with fellow Nurse practitioners in Texas

with fellow Nurse practitioners in Texas

These last few months, since returning from Colombia have been fun.  Figuring out photography and trying to get past point-and-shoot has been frustrating, frustrating, jaw clenching, foot stamping frustrating at times..

But – it’s good photography practice for my future writings, and it’s also a bit less strenuous.  Writing and posting research based articles (with relevant citations) can be a bit onerous after a long day in the hospital.. Tired eyes tend to make for more spelling errors..  I could just post less often when on assignment, I suppose..

Yet – I am always hesitant to leave the blog for too long because it has come to be a place for me to indulge my ‘nerdy’ side with a friendly audience.

The blog lets me address and talk about the issues in medicine and patient care, explore relevant medical discoveries and emerging research as well as passing on some of the information (and patient education) that I have gained as part of my years of taking care of people.  It lets me talk about all the nerd stuff that people at work don’t really sit around and talk about –

Like everyone else, they talk about families, finances, home life. Taking kids to soccer, going to church, socializing with friends, landscaping the lawn..   All good things, great community and friendly folks.. But it doesn’t fill that ‘Dora the Explorer’ inside me; or the inner Florence Nightingale.

It also doesn’t mesh with my family; the vagabond roving band of travelers that we are, so it is sometimes hard to relate.  I mean, right now, I live in a hotel, my ‘home base’ is a storage shed in another state – where we stop in and swap out clothes.. My husband and I are sometimes working in different states (or countries) for weeks or months at a time – so we aren’t the best candidates to join leagues or make long-term commitments.  All of it sounds wonderful but it sometimes makes us feel like outsiders looking in.

So I come here to wordpress; to enjoy Serapa, Nicephore’s diary, and the return of Miss Christina and all the other people I will never meet – but sure enjoying knowing about a little corner of their lives..  I hope it is the same for all of you.

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Photography by K. Eckland 2013

Bridge crossing the Red River from Shreveport to Bossier City

On a recent trip to Shreveport, we headed downtown to indulge in two of my favorite hobbies; photography and looking at architecture..

While much of downtown Shreveport is like downtown segments of many cities across the United States, with some run-down areas; there are several lovely buildings from by-gone areas.

Downtown Shreveport (and other images of Shreveport)

The Strand

Most notably among these buildings is the Strand theater.  Originally built in 1925, (according to a local press clipping from the time), the Strand was originally conceived almost 18 years earlier.  It cost one million dollars to complete and opened its doors to the public for its first performance on July 3, 1925.  The first show at the Strand was “The Chocolate Soldier,” a comedic operetta first written in 1860, and popularized on Broadway in 1909.

Despite it’s illustrious opening, by the 1970’s the Strand had closed and fallen into disrepair.  It wasn’t until 1984 that the Strand re-opened, after several years of painstaking and meticulous restoration.

While we were wandering downtown and taking pictures – we noticed that the marquee was advertising a show that evening – for a Queen tribute band, “One Night of Queen”.  Who could pass that up??  so off we went..

A Night of Queen with Gary Mullen

Low light, and constantly changing light conditions, using my long lens (200mm), no flash, subjects with rapid movement.. Some of the pictures are terrible – but it sure was fun!  As you can see – the photos are a riot of color and noise, but it was great practice while rocking out to some great music..

Thank you to everyone at the Strand for allowing us to take pictures.  (They usually restrict photography, but immediately before the show, several ushers stated that photography would be permitted.)

The Riverwalk –

The River Boardwalk is a modern creation, devised to attract tourists to the areas surrounding the waterfront casinos.  On one side of the river lies a park and trails, along with a small string of businesses (that were almost all closed when we strolled by) and on the other side of the river, a huge shopping complex (and more casinos.)

We strolled down to the River Boardwalk after walking around downtown.  While most of it is pretty typical and kind of generic looking, I did enjoy some of the art designed to highlight Shreveport and its history.

panel from the past - tools and instruments from early Shreveport

panel from the past – tools and instruments from early Shreveport

The panel above is my favorite – in a string of decorated panels on the underside of the Neon Bridge.  There is a performance stage, several preserved handprints as well as a lonely little Mexican restaurant.  (All the other storefronts were vacant.)

More Shreveport: 

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While I always fall in love with the big things; bridges, skyscrapers and massive landscapes – along with their rich details, there is so much more to Shreveport.

While looking for more information about Shreveport architecture, I found another great photography blog called Southern Lagniappe.  If you want to better know Shreveport, and architecture, this is a good place to start.

Now, if you love home architecture, especially the ‘Painted Ladies’ – Gerald Massey has written a nice article about some of the Victorian homes in the city. (As the proud owner of my own historic home, in my native Virginia, these homes always make me just a tad wistful.)

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Since I had a few days off, we decided to take a road trip.  My assignment here is almost complete, so we are trying to squeeze in as many adventures and outings as possible before we leave for our next location.

Since I am a little camera-crazy – we usually plan trips that give me the opportunity to practice a little photography.  It’s funny how I can always manage to cram in a bit of ‘homework’ where ever we are – I guess that is what makes photography such an addictive hobby.

As many of my readers know, I never meant to do more than the usual touristy snaps – but necessity forced me to become more and more adept, to illustrate my writing, and visually document my  interviews and observations.  As I’ve progressed from project to project – my writing style has evolved, my detailing has become more precise – and I’ve refined my picture-taking.

In the most recent months, as I begin researching the next project, I’ve started practicing by trying to expand my range, beyond the casual snapshot – to fast-motion, low-light and a variety of other conditions.

So we headed off to Shreveport, for some new scenery and more practice.

Low-light, No flash with a tripod 

captioned, postcard style

captioned, postcard style

I have always lacked confidence in my photo-taking, so I’ve resisted using a tripod for a long time (and missed a lot of great photos because if it).  But, I finally had to face it; it’s just impossible to keep still enough during the SLOW shutter speeds necessary to capture low-light situations..

Even so – the photo still has a lot of noise, or fuzziness..

During our trip, we attended a concert at the Strand theater..  Surprisingly, both the theater staff, and the performers explicitly lifted the usual rules to permit photography – which was just fantastic, even if only to get photos of the restored theater.. But it was even nicer that the performers invited us to take pictures.

(More about the beautiful and historic Strand theater in my next post.)

The freehand photos from the concert stage demonstrate this lack of definition (and noise) even more acutely.

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If you don’t take a lot of photos, than this post is probably boring beyond belief – but you also don’t know the frustration of seeing an image in your mind’s eye, and then struggling to capture that image with your lens.

But then too – comes that satisfaction when the shutter clicks and the image is immortalized – in your mind, and on file, forever.  (or at least until I crash the hard drive.)

With the help of several friends, amateur and professional photographers – I’ve learned a lot, in my efforts to move the image from my eye to the camera.  I’m not always successful, but I seem to be getting better and better..  But there are other issues in photography.

For me, that struggle is two-fold; it’s both accuracy and providing perspective. Accuracy seems like an oxymoron for photography – but it’s not.  The next photo is a good example of what I mean..

a country lane?

a country lane?

Accuracy in photography to me means depicting a person, place or circumstances as honestly and straightforwardly as possible.  Now, in a movie, I recently watched – “The Best Exotic Marigold Hotel“, a group of English citizens decided to retire to a residential hotel in India based on a brochure, and the photos of the hotel in the brochure..

this 'romantic' backdrop for my lovely model is actually the corner of a somewhat dirty, beat-up parking lot in downtown Sherveport.

this ‘romantic’ backdrop for my lovely model is actually the corner of a somewhat dirty, beat-up parking lot in downtown Shreveport.

(I bet you can see where this is going.)  Of course, when they arrive in India – the group quickly finds out life in India (and their hotel) isn’t quite as cute, contained and photographic as the brochure led them to believe.

This isn't a great photo - but it does show the size and scale of some great art.  A mural, 14 stories tall, that is so detailed you can visualize the fabric of her dress..  (Note the size of the reference man walking on the sidewalk).

This isn’t a great photo – but it does show the size and scale of some great art.  This mural, 14 stories tall, is so detailed you can visualize the fabric of her dress.. (Note the size of the reference man walking on the sidewalk). It’s not crazy to want to be able to accurate capture that image just as it is.

With my style and type of writing, equally accurate photography is essential.

I also want to give perspective – whether that perspective is from peeking over the shoulder of a surgeon hard at work, the view from outside the operating room theater or even just the view from down the street.. (or even from really, really far away..)

washing a fire truck

washing a fire truck

That doesn’t mean that I don’t enjoy the sweet, or romantic photos – like these pictures from the sidelines of a recent parade.   (I was across the street – quite a distance away – but just watching from behind a camera – really did seem to tell a story.)


another photo from the same St. Patrick’s Day parade

little Eviel Knievel jumping his bike while waiting for the parade

little Evel Knievel jumping his bike while waiting for the parade

I’ll post some more photos of Shreveport in my next post..

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You may have guessed from some of my posts – and my eternal fascination at some of modern metropolis lifestyles that I am, at heart, a small town girl.

Of course, that just makes the big cities all the more wonderful and wonderous to me.  All of the essentials of big city life that are a big yawn for long-term residents still seem a bit magical to me.   I really do feel a bit like Dorothy at the gates to the Emerald City.

I don't think we are in Kansas anymore...

I don’t think we are in Kansas anymore…

I guess, even with all of my travelling, the rural redneck remains..

Never has this been more obvious than during my current stay in Texas..  Despite living in the shadow of the mega-freeways, I remain fascinated, and awed by their sheer size and scope.  The challenge has been trying to bring this to life with my camera..  I’ve tried on multiple occasions, and on every road trip since we’ve been here – but the results have been well, rather uninspiring..

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How can something that is so captivating to me, (yet so pedestrian to the  local citizenry) be so difficult to capture?

But I have included a gallery of my most recent attempts – in a mix of color and black and white..  The photos below come from the Cottonwood Trail.

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The Cottonwood (Creek) Trail

Just a few days ago – we wandered off our usual trail for our walk.. We took the path, that is (literally) less travelled – and headed down the Cottonwood Trail.   (I wouldn’t recommend it for solo journeys – we didn’t pass a single other person for much of the walk – in some pretty desolate areas.. Then, as we passed through some sketchy areas; there were large groups of homeless men gathered at the side of the trail.)

The desolation, the sense of aloneness is overwhelming, and bewildering since the trail winds thorough the heart of the maze of freeways that make up the cosmopolitan city.  Yet – alone we were on trails the snaked beneath the very freeways that rumbled and trembled above us, reducing the sky to just a sliver of blue.  At times, the roar of traffic was so loud as to be deafening, with the bombardment of noise coming from all directions – ricocheting off the acres of concrete, in the valleys beneath the elevated roadways.

on the path underneath the freeways of Dallas

on the path underneath the freeways of Dallas

Maps of Trails in Dallas

Much of the trail (along with much of Dallas) is under construction, so we took a couple of detours during our outing – including a trip past Mount Calvary Cemetery.

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View from Above Dallas

View from Above Dallas

Now if you’ve ever seen the old 1980’s television series, Dallas, then you’ve seen the gleaming glass highrise buildings that characterize the city of Dallas – and much of big-city Texas..

A lot has changed in the more than thirty years since this show was originally aired (in fact – there is now a sequel series).

The freeway segment of the intro is a good example – since it has now expanded to Jetson-like proportions, with ongoing construction making it one of the largest freeway systems in North America. Some of the decks are over six stories high..  Compare the scene from the video with the photo here, for example.

The freeway hovers above much of the city - a modern day 'Jetsons' skyscape

The freeway hovers above much of the city – a modern-day ‘Jetsons’ skyscape

The city itself has exploded in growth – and has one of the fastest growing (and healthiest) economies in the United States; now boasting the label of ninth-largest city in the USA, third-largest city in Texas.

(How big are the economies of US cities?)  Bigger than that of many countries according to this Huffington Post Report.

The baby sister to the mammoth city of Houston has a population of 1.2 million in the city proper.

If you are interested in the history of the buildings downtown, and more information on the architecture – there is a great website here by local Dallas architect, John Roberts.

Downtown Dallas also contains some of the most infamous sites in American history; the Texas School Book Depository and the Grassy Knoll..

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