September 25, 2015. I was on a bus bound for the capital, San José, having just left my post in San Vito (Costa Rica Stories #3). My two years as a JICA overseas volunteer were finally drawing to a close.
In two years I had seen more than 300 patients. I built braces by hand, traveled up to a mountain village, and explained prognoses over and over in my halting Spanish. This is the last thing I saw at the end of those days.
"Twenty-Eight Days Left in Costa Rica"
The end of a posting doesn't arrive all at once. It creeps up on you.
In May 2015, as my work entered its final stretch, I wrote something like this: "Maybe this is about as far as I'll get. For someone like me, I've done pretty well" — a soft, easy thought that drifted through my head. But the environment I was in wouldn't let me coast. Right to the end, it kept pushing me along, and I was grateful for it. That was the period when I felt most keenly how much the environment you place yourself in matters.
By late August, I had started counting down. "Twenty-eight days left in Costa Rica." Since I'd be starting solo life again back in Niigata, I was mentally tallying the appliances I'd need. One thing that had changed in me over these two years: I now wanted a coffee maker at home. Half my suitcase filled up with sweets and coffee beans from various Central American countries — to carry, along with coffee and sickly-sweet snacks, to all the people in Japan who had looked out for me.
The Last Patient
As my departure neared, in September, the treatment of one stroke patient reached its final session.
Some Costa Rican doctors are excellent; the opposite is just as thoroughgoing. So I didn't fully trust the medical reports, and more often than not I was asked to see a patient precisely because the cause was "unknown." This patient and their family, too, had been left without a clear roadmap after a severe hemiplegia from a stroke: what course things would take, and what to do at each stage.
I had them film videos of their home exercises and their assistive equipment, then gave advice on the exercise therapy, a forecast of the road ahead, and an explanation of "what needs to happen now." Compared with the first session, there were more smiles. At the end, they were reluctant to see me go, and sent me off with an embrace.
I often had to explain, in my clumsy Spanish, the very things other health workers had avoided explaining, and I had my share of unpleasant moments. Even so, when someone is glad in the end like this, I can think: "I'm glad I became a physiotherapist." My Costa Rican friends called me an altruist (Altruista). I have my selfish side too, but when it comes to my work, that's who I want to be.
Leaving My Post — the Final Report, and a Sinus Infection
On September 25, I left my post and reached the capital. The final report meeting, the farewell party — there was so much I wanted to write down.
Except that, for about a week, my right cheek had been aching. A sinus infection. At the clinic they took an X-ray, which confirmed it, and prescribed me some medicine. Not the most dignified way to cap off a posting — an aching sinus — but that, too, was part of my two years in Costa Rica. All I needed now was enough time to buy souvenirs at a leisurely pace.
La casa de rehabilitación — Two Years, Summed Up
Before leaving, I wrote a piece in Spanish looking back on my work.
What I mostly saw were orthopedic conditions — lower back pain, scoliosis, shoulder pain — but I handled everything from pediatric to neurological cases. I saw more than 250 patients, but I couldn't see any single one of them often. Once or twice a month was the limit, so the effects of treatment tended not to last. There was also a ceiling on how many people I could see in a day. That was the honest outline of what a single physiotherapist in a rural area could do.
Even so, in that place I kept calling "the clinic (Casa de rehabilitación)," I did everything I could. I've written in detail about what the work of physiotherapy itself looked like in "Working as a Physiotherapist in Costa Rica (Costa Rica Stories #16)."
Coming Home — "Fue una experiencia maravillosa"
On October 1, 2015, I flew home.
Landing at Narita, the first thing I ate was — of all things — lemon ramen (for those coming home, I'd recommend the plain soy sauce or salt). And to my Costa Rican friends, I left this message:
Hola, amig@s. Ya pasaron 2 años rápidamente. Ahora estoy en mi tierra. Estoy extrañando a ustedes... Muchísimas gracias por su cooperación, su paciencia y su amabilidad en Costa Rica. Fue una experiencia maravillosa. En el futuro voy a volver a CR.
(Hey, everyone. Two years went by so fast. I'm in my own country now. I already miss you all... Thank you so much for your cooperation, your patience, and your kindness in Costa Rica. It was a wonderful experience. Someday, I'll come back to CR.)
What Costa Rica Left Behind
Back in Niigata, I fitted winter tires for the snow country and started hospital work in November. Every day, in my room, I brewed Costa Rican coffee. ¡Muuuuuy rico! The dental work I'd had done in Costa Rica was praised by my dentist in Japan as "solidly done" (though I did have the silver filling redone in Japan — sorry, Costa Rica).
That November, someone told me my photo had appeared in the commemorative magazine for the 50th anniversary of the JICA overseas volunteer program in Costa Rica. All that directing of the camera work had paid off.
My two years were over. But I had promised: "I'll come back." I wouldn't keep that promise for another ten years — continued in "Returning to Costa Rica After 10 Years (Costa Rica Stories #20)."
Two years went by in a blink. And yet the promise I made on my way out — "I'll come back" — was the one thing that didn't fade, even ten years later.