Monday, June 30, 2008

Welcome to Puerto Rico! Side effects may include abdominal bleeding, anemia, black stool, nausea, vomiting, shortness of breath, constipation, etc.

Taking photos while driving is almost as dangerous as drug marketing!

Oh say can you breathe, by the dawn's indoor/outdoor allergy reliever...

As I approached the bridge from the airport on my first day in Puerto Rico, I saw in the distance flags flapping proudly in the wind. I passed the American flag, a powerful foreshadowing of the strong American influence I would experience in the next 2 months, felt the wind in my hair as I passed the Puerto Rican flag, a symbol of pride for so many, both in the US and the island, and then WTF??!?! A NOVARTIS FLAG?!

That’s right, friends, Novartis. As in the gigantic pharmaceutical company that produces some of our favorite prescription meds, like Gleevec. As in the gigantic pharmaceutical company that sued India after they tried to make cheap versions of cancer, HIV, AIDS, and diabetes medicines for a country that was in dire need. I mean geez, India! Novartis needs money to buy us doctors lunches and pretty pens and clipboards! Who do you think you are?! If you really want to be totally disgusted by Novartis and a few other drug companies, read this article about “cheerleader” drugs reps, but make sure you do it on an empty stomach. And if you’re still up for more, google the term “Novartis and FDA warning letters” and see what you come up with. Here’s another fun story that I originally heard on NPR about a Novartis employee that was fired after reporting safety violations during clinical trials. And what does ex-Pepsi executive turned Novartis pharmaceutical business CEO Thomas Ebeling think about his new job? Well, he thinks selling cola isn't all that different from selling pharmaceuticals. Barf.

Oh and by the way, sorry if this bothers you, Novartis, but maybe you should get your goddamn flags off of Puerto Rico’s bridges, your goddamn bribery out of my profession, and your goddamn psychological manipulation off my patients’ TV screens and then I’ll get off your case.

Anyway, how upsetting?! And it wasn’t just Novartis, but as I saw the first flag and felt my stomach turn, I put my head down.

“You fly drug company flags next to your country’s flag?” I asked my driver.

“Of course. We have a lot of drug companies here,” she answered. I sighed. This was going to be a long 2 months.

How important are pharmaceuticals to Puerto Rico's economy?

According to the Pharmaceutical Industry Association of Puerto Rico website, the pharmaceutical industry accounts for 30,000 direct (and allegedly 100,000 indirect) jobs on the island and a mighty 26% of Puerto Rico's employment in manufacturing. That's a lot of manufacturing. The website goes on to say that the average wage for production workers is among the highest salaries paid in Puerto Rico, and that the pharmaceutical industry accounts for a whopping 24% of Puerto Rico's gross domestic product. The Puerto Rico Industrial Development Company notes that there are more than 60 pharmaceutical plants on the island, and that in 2003, Puerto Rico was the world's largest international shipper of drugs, with 24.5% of total shipments. 16 of the top 20 drugs sold in the United States are from Puerto Rico. Most of the big pharma boys have some kind of representation in Puerto Rico, and for the most part they are spread around the island, although there are none in San Juan proper (there are a few in Carolina though, maybe I ought to pay them a visit).

Phew, that's a lot of facts.

So why, exactly, do so many drug companies operate out of Puerto Rico?

Maybe they just think that Puerto Ricans are a hardworking people deserving of steady jobs. OR MAYBE there's some ECONOMIC INCENTIVES to moving your big business down to this tiny island?

Let's have a look:

1. First, let's review PIAPR's own description of the incentives of operating out of Puerto Rico. Looks like we're chock full of income tax caps, especially for "pioneer industries" (huh?), something called "super-deductions," accelerated depreciation on building costs, a whole boatload of exemptions, payroll incentives and special deductions, etc.

Basically, because of the weirdness of Puerto Rico's commonwealth status, companies in Puerto Rico get all the good stuff from operating "in the United States," but they also get the tax benefits and incentives of being a "foreign company." Sneaky drug companies!

2. The workers! Here's a real shocker, Puerto Rico has one of the lowest minimum wages in the United States. Even Guam's is higher. True, those in the pharmaceutical industry probably aren't making minimum wage, but they aren't making as much as if the company were operating out of Connecticut. The Puerto Rico Industrial Development Company proudly claims on it's website that "wage rates are typically 20% to 30% lower than those on the mainland for the same position." How totally fair! I mean, what a bargain for a bilingual workforce that trails only Japan for the fewest number of work days lost due to labor disputes and that is also well educated (Puerto Rico is currently 9th in the U.S. in terms of engineering degrees awarded).

To recap, the drug companies get an intelligent, bilingual, and hard working workforce who rarely complains, and they get to pay them significantly less.

3. Puerto Rico has been trying to make it very easy for big companies to come down here, allowing for some of the previously mentioned tax incentives and also ensuring adequate technology and communications capabilities.

Summary: Puerto Rico is pretty desparate to improve the economic situation on the island, so they are opening the doors for big corporations. Meanwhile it's hasta la vista, Mom and Pop's lechón stand and Buenos días, Burger King, if you catch my drift.
Not to mention that with the economic slowdown, a few plants have closed down, leaving Puerto Rican families and towns in complete destruction due to their economic dependence on these foreign companies.

4. Puerto Rico's prime location and accessibility by boat or plane makes it an ideal place for shipping drugs worldwide.

No argument here, Puerto Rico is in a pretty sweet spot!


Okay, so it should be very clear to you that I have serious, deep-seeded, some might argue pathological issues with drug companies, which may make this entry seem pretty biased. And I'm okay with that, because it's my blog and I get to be as biased as I want! :P

But in all seriousness, I recognize that bringing jobs to Puerto Rico is an important endeavor, and I am certain that there are many families on the island that benefit greatly from their presence. But I don't think it is fair to exploit Puerto Rico's political situation and especially their workers, who deserve the same respect given to any mainland worker. For all of the things that Puerto Rico gives to them, they ought to be giving back to Puerto Rico. Why don't you save all the money you waste on the ridiculous plastic junk you hand out to doctors and open up some safe parks and playgrounds for Puerto Rican kids? Just a thought.

And Puerto Ricans, get those flags off of your bridges. You have a beautiful culture and a rich heritage, let's display that instead.

Buenas noches.

Social Factors and Obesity in Puerto Rican Women

Since I am no longer doing this particular research project, I thought I would post the background/introduction part of my old proposal to show part of what interested me in Puerto Rico in the first place. A large part of my project will still involve preventive care, obesity, and women's health, don't worry. But those of you in the health care field might find some of the information interesting, especially if you have Puerto Rican patients. What you might also find interesting is the evidence that socioeconomic status more strongly affects women's obesity rates than men's. Might have some implications for public health preventative care measures, that's all I'm saying.
For those of you who think this stuff is boring/are just looking for travel blog info, just skip this entry! (Yes, friends and family, I am saying you don't have to read it, I won't phone quiz you like I usually do!)

Title

Social Factors and Obesity in Puerto Rican Women
Renee Robinson, MS1

Background and Goals:

Recent focus on health disparities among various ethnic and cultural minority groups in the United States has sparked interest in understanding the socioeconomic determinants of good health. Obesity, an important risk factor for cancer, diabetes, cardiovascular diseases, and other chronic medical problems, has become a growing epidemic in the United States and in other developed countries. Among Hispanic minority groups, the fast-growing Puerto Rican population, with 3.8 million people living on the island itself and an additional 3.4 million in the mainland United States,1,2 has drawn attention recently for its steadily rising rates of obesity, with the governor of Puerto Rico recently calling the childhood obesity problem a “state of emergency” on the island.3. A study of U.S. Hispanic populations indicates that 40.7% of Puerto Ricans are classified as overweight (BMI in excess of 85th percentile of US reference standards) and an additional 15.0% classified as obese (BMI in excess of 95th percent).4 Puerto Ricans living on the mainland have a similar obesity prevalence as island Puerto Ricans (21% versus 22%, respectively), but island Puerto Ricans have significantly lower access to primary preventive health care, placing them at greater risk for complications of chronic obesity.5 One of the most important chronic conditions associated with obesity is type 2 diabetes. A study in 1999 indicated that 9.6% of island Puerto Ricans suffer from type 2 diabetes, higher than the U.S. national average.12 Residents of Puerto Rico are 1.8 times more likely to develop type 2 diabetes than U.S. non-Hispanic whites,9 and the diabetes in elder Puerto Rican populations living in the mainland is generally more poorly controlled than the diabetes of non-Hispanic whites.10 Obesity’s role in coronary heart disease is also especially important in Latin American populations, including Puerto Rico. One study investigated worldwide risk factors for coronary heart disease, including abnormal lipid levels, smoking, hypertension, diabetes, abdominal obesity, psychosocial stress, lack of physical activity, and diet, and found that the population attributable risk for abdominal obesity is more important for Latin American populations than for other populations.11

Much of the research assessing cardiovascular and chronic disease risk in Puerto Ricans has centered on men and children. A large study known as the Puerto Rico Heart Health Program (PRHHP) followed almost 10,000 men with the objective of investigating “morbidity and mortality from CHD [coronary heart disease] in Puerto Rican urban and rural men.” 6 No such large scale investigation of Puerto Rican women has been undertaken to date. Additionally, studies of the childhood obesity epidemic rarely include information about maternal obesity. This is a significant oversight given that women in Puerto Rico tend to be the primary caregivers and that parental obesity is directly related to child obesity. In a small study of 53 Puerto Rican children in Hartford, Connecticut, increased maternal body mass index (BMI) was associated with increased obesity levels in children, suggesting that, due to a shared environment, targeting risk factors for maternal obesity may have an impact on childhood obesity as well.7 This association has also been shown in a study on Mexican Americans, with obese mothers being twice as likely to have an overweight or at-risk-for-overweight child compared with normal-weight mothers.8

There are several important reasons to investigate predictive factors of obesity in Puerto Rican women. First, there are gender discrepancies in obesity-related disease status, notably type 2 diabetes, between Puerto Rican men and women. A 1999 study in Puerto Rico found that rates of diabetes were highest among women, older individuals, the unemployed, and individuals with high blood pressure, high cholesterol, and high BMI. The same study found that after age 65, the only significant characteristic associated with diabetes was the female sex.12 Studies also show an inverse relationship between BMI and pre-menopausal breast cancer risk for Hispanic women, including Puerto Ricans, living in the United States.13 Second, it appears that socioeconomic factors, such as income and educational level, play a very important role in obesity risk in Puerto Rican women, offering a potential basis for the implementation of socially appropriate preventive health programs. Among various populations in the mainland United States, it has been shown that while men are about as likely to be obese in any socioeconomic group, women of lower socioeconomic status are fifty percent more likely to be obese than those of a higher economic status.14 Another study shows that socioeconomic factors, especially lower levels of education, are associated with metabolic syndrome in a diverse population of women in the United States, but does not show the same association for men.15 Metabolic syndrome is a group of risk factors including abdominal obesity, dyslipidemia, high blood pressure, resistance to insulin, and proinflammatory and prothrombotic states that increases risk for type 2 diabetes.16 The San Antonio Heart study found that among Mexican Americans, there is a higher prevalence of diabetes among women of a low socioeconomic status, but again, this relationship did not hold true for men.17

While obesity prevalence rates and health disparities have been documented for Puerto Rican women, there have been few studies on the socioeconomic and cultural factors underlying obesity risk. The few studies that have tackled the predictive factors illness have focused primarily on Puerto Rican populations living in the mainland United States. A study of Puerto Rican women in a Connecticut population showed that obesity is correlated with higher levels of acculturation and lower socioeconomic status. It also found that women who do not own a car consume less meat, eggs, and fish, and that smokers are more likely to have an unhealthy pattern of food intake than nonsmokers.18 Another study also found acculturation to be a significant factor in obesity among Puerto Rican women living in the United States, with women who speak more English or who have lived in the mainland United States for a longer period being more likely to be obese than women who speak primarily Spanish or who had just recently moved to he mainland.19 A study of nutritional intake of Puerto Rican women living in both Puerto Rico and in the South Bronx indicate that these women tend to over-consume protein, sugar, and carbonated beverages, and that factors influencing a woman’s food acquisition included nutrition education programs, availability of foods and the food preference of children in the household.20

1. U.S. Census Bureau. Census 2000 Data for Puerto Rico. April 1, 2000. Retrieved April 1, 2008 from http://www.census.gov/census2000/states/pr.html

2. U.S. Census Bureau. We the people: Hispanics in the United States: Census 2000 special reports. April 1, 2000. Retrieved April 1, 2008 from http://www.census.gov/prod/2004pubs/censr-18.pdf

3. Big trouble in little Puerto Rico: Obese kids. Associated Press. Retrieved March 31, 2008 from http://www.msnbc.msn.com/id/18768818/

4. Pawson I, Martorell R, Mendoza F. Prevalence of overweight and obesity in US Hispanic populations. Am J Clin Nutr. 1991; 53: 1522S-1528S.

5. Ho G, Qian H, Kim M, Melnik T, Tucker K, Jimenez-Velazquez I, Kaplan R, Lee-Rey E, Stein D, Rivera W, Rohan T. Health disparities between island and mainland Puerto Ricans. Rev Panam Salud Publica. 2006; 19: 331-339.

6. Puerto Rico Heart Health Program (PRHHP). National heart, lung, and bloodinstitute. Retrieved April 1, 2008 from http://www.nhlbi.nih.gov/resources/deca/descriptions/prhhp.htm

7. Tanasescu M, Ferris A, Himmelgreen D, Rodriguez N, Perez-Escamilla R. Biobehavioral factors associated with obesity in Puerto Rican children. The Journal of Nutrition. 2000; 130: 1734-1742.

8. Hernández-Valero MA, Wilkinson AV, Forman MR, Etzel CJ, Cao Y, Bárcenas CH, Strom SS, Spitz MR, Bondy ML. Maternal BMI and country of birth as indicators of childhood obesity in children of Mexican origin. Obesity. 2007; 15: 2512-2519.

9. National diabetes statistics. National Diabetes Information Clearinghouse. Retrieved March 30, 2008 from http://diabetes.niddk.nih.gov/dm/pubs/statistics/

10. Tucker KL, Bermudez OI, Castaneda C. Type 2 diabetes is prevalent and poorly controlled among Hispanic elders of Caribbean origin. American Journal of Public Health. 2000; 90: 1288-1293.

11. Lanas F, Avezum A, Bautista LE, Diaz R, Luna M, Islam S, Yusuf S; INTERHEART investigators in Latin America. Risk factors for acute myocardial infarction in Latin America: the INTERHEART Latin American study. Circulation. 2007; 115: 1067-1074.

12. Pérez-Cardona C, Pérez-Perdomo R. Prevalence and associated factors of diabetes mellitus in Puerto Rican adults: behavioral risk factor surveillance system, 1999. P R Health Sci J. 2001; 20: 147-155.

13. Slattery ML, Sweeney C, Edwards S, Herrick J, Baumgartner K, Wolff R, Murtaugh M, Baumgartner R, Giuliano A, Byers T. Body size, weight change, fat distribution and breast cancer risk in Hispanic and non-Hispanic white women. Breast Cancer Res Treat. 2007; 102: 85-101.

14. HHS. Healthy People 2010, 2nd ed. Understanding and improving health and objectives for improving health. 2 vol. Washington (DC): GPO; 2000. p. 19-12.

15. Loucks E, Rehkopf D, Thurston R, Kawachi I. Socioeconomic Disparities in Metabolic Syndrome Differ by Gender: Evidence from NHANES III. Annals of Epidemiology. 2007; 17: 19-26.

16. Kahn R, Buse J, Ferrannini E, Stern M. The metabolic syndrome: Time for a critical appraisal: Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2005; 28: 2289-2304.

17. Hazuda HP, Haffner, SM, Stern, MP, Eifler CW. Effects of acculturation and socioeconomic status on obesity and diabetes in Mexican Americans: The San Antonio Heart Study. Am J Epidemiol 1988;128:1289–1301.

18. Fitzgerald N, Himmelgreen D, Damio G, Segura-Perez S, Peng Y, Perez-Escamilla R. Acculturation, socioeconomic status, obesity and lifestyle factors among low-income Puerto Rican women in Connecticut, U.S., 1998-1999. Rev Panam Salud Publica. 2006; 19: 306-313.

19. Himmelgreen DA, Perez-Escamilla R, Martinez D, Bretnall A, Eells B, Peng Y, Bermudez A. The longer you stay, the bigger you get: Length of time and language use in the U.S. are associated with obesity in Puerto Rican women. American Journal of Physical Anthropology. 2004; 125: 90-96.

20. Sanjur D, Immink M, Colon M, Bentz L, Burgos M, Alicea-Santana S. Trends and differentials in dietary patterns and nutrient intake among migrant Puerto Rican families. Arch Latinoam Nutr. 1986; 36: 625-641.

Sunday, June 29, 2008

Casinos in San Juan

I really can't think of anything I care less about in this world than gambling and casinos, but I am noticing that if you like casinos or just the fancy pants feel of blackjack tables and high rollers, San Juan is a pretty good choice for a vacation destination. Are you listening, parents? Visit your daughter, she's desperate!!
These blurry photos were taken inside El San Juan Resort and Casino, which has to be one of the coolest places I have ever been. You should really appreciate these because I got yelled at twice for having my camera out. Anyway, if you are coming to San Juan with some money to burn, you will probably want to stay either on Ashford Ave in Condado or Isla Verde in Carolina. There is also one casino in Old San Juan, but Old San Juan doesn't seem to be the place where the serious gambling happens. My experience at the El San Juan Resort Casino in Isla Verde was brief but pretty amazing. Sometimes when I walk down the Isla Verde strip at night, I think to myself, "This place is kinda dead tonight," but turns out, anybody who is anybody is inside of El San Juan, gambling, sipping drinks at some of their very upscale bars, or listening to live music. I felt like I walked into a different world because it was so beautiful and elegant inside. Quite a change from chasing iguanas out of your hotel room with a beach towel (don't ask).

So since I am such a thorough (albeit scatterbrained) blogger, I have decided to provide you with what I believe to be a pretty complete list of the casinos in/around San Juan, Puerto Rico. All of them are attached to a hotel of some sort, and I have categorized them both by location and by an arbitrary scale I will call "the fancy pants scale." This is my own personal scale that I am using to rate the level of fancy pants-ness of each casino, and takes into account data from personal experience, word-of-mouth, pictures on websites, and an inverse statistical calculation of my possibility of ever affording to stay at its hotel. So I think it's pretty accurate. But I would love to hear any feedback from those who have more first hand gambling experience!

Click on the hotel name to visit its website!

Scale legend:
*Not so fancy pants
**A little fancy pants
***Super fancy pants

Old San Juan
Sheraton Old San Juan Hotel**

Ashford Avenue, Condado
Condado Plaza Hotel and Casino***
Radisson Ambassador Plaza Hotel and Casino*
San Juan Marriot Resort and Stellaris Casino**

Isla Verde, Carolina
Best Western San Juan Airport Hotel and Casino*
Intercontinental San Juan Resort Spa and Casino**
El San Juan Hotel and Casino***
Ritz-Carlton San Juan Spa and Casino**
Embassy Suites Hotel and Casino**

Happy Gambling! Don't forget to know when to hold 'em and when to fold 'em!

Friday, June 27, 2008

Renee's Salsa Lessons

video video

On the debate over whether emic or etic approaches to anthropological investigation reign supreme:

You want to sit back, passively observe and study a culture as an outsider, and then write a book about it? Fine. Knock yourself out.
You want to really know Puerto Rican culture? Well, for heaven's sake, get yourself to Puerto Rico, throw on some chanclas, and dance salsa with your neighbors.

By the way, Renee's salsa lessons are free, every Friday. Pre-req: Don't be afraid of looking silly. This is easier if you are a 4 year old. Or if you are 24 but never really grew up.

Buenas noches, mis amigos, que descansen.

Thursday, June 26, 2008

Toro Salao in Old San Juan

367 Calle Tatua
Old San Juan, Puerto Rico
http://www.oofrestaurants.com/
(then click on "restaurants" and "toro salao." This website only worked for me with Internet Explorer)

I didn't bring a camera with me to Old San Juan on this particular day, which is a damn shame because Toro Salao was great! I really hesitated to go, because Toro Salao is one of a conglomerate of restaurants owned by Oof! Restaurants, and I really prefer restaurants that stand on their own, especially if they're family owned. But, I will admit, I keep hearing great things about the series of Oof! restaurants, all of which are unique in design and concept, and include some of tourist's and local's favorite dining and drinking hot spots, such as Koco, Aguaviva, The Parrot Club, Dragonfly and Dragonfly Too, and The Raven Room.

Toro Salao means "salted bull," in Puerto Rican Spanish, and highlights the Puerto Rican tendency to cut words ending in -ado down to simply -ao, a linguistic pattern that takes some getting used to for someone accustomed to Mexican Spanish. The concept of Toro Salao, according to Oof!'s wesbite, is that it pays homage to Puerto Rico's Spanish heritage. Their specialties include sangria and tapas, which are mostly Spanish-Puerto Rican fusion style tapas, such as Spanish Serrano Ham Croquettes with a Guava Glaze. I really enjoyed their grilled flatbread tapas as well. Their entrees are similarly fancy, and include a few traditional Puerto Rican recipes, such as arroz con gandules (rice with pigeon peas) and Puerto Rican morcilla (blood sausage) with Cauliflower Cream, a few Spanish dishes, like Paella and Seared Octopus with Sun Dried Tomato Vinaigrette, and a few fusions, like Seared Pork Loin with Cranberry Chutney & Coriander Mojo or Skirt Steak with Chimichurri Salsa & Smashed Breadfruit. I only had tapas, all of which were excellently executed, and sangria, which was amazing. I tried to write down in my notepad what ingredients they were putting in the sangria, but apparently I must have had a little too much, because all I've got are scribbles. That must be their secret, keep the patrons drunk so they can't steal your secret recipe!

The atmosphere of Toro Salao was perfect. Inside is cool and romantic, with dark colors and Spanish bullfighting pictures on the walls. Outside you can sit at the patio and watch all of the people walk by. Toro Salao is in a prime location! Additionally, the bilingual staff is fun, friendly, and attentive, and you really can't ask for anything more. The bartender told me that this place really picks up at night, making it a great option for a night out as well. Really, no complaints about the food or the atmosphere. Highly recommended!

Overall, my opinion of Toro Salao is as follows:
1. GREAT Sangria!
2. The waitstaff and bartenders have way too much fun working. I almost asked if they were hiring. But, this only adds to the wonderful service.
3. A tiny bit pricey, but worth it.
4. Not far from the cruise ship docks, I would think this would be a great place to stop after getting off the cruise. You could sit outside on the patio, order a pitcher of white sangria and a few tapas, and plan out the rest of your day in Old San Juan.

I recommend visiting the Oof! Restaurants website and checking out all of their restaurants before planning your trip to San Juan. Even though I hate to admit it, word is that they are some of the best on the island. And based on my trip to Toro Salao, this seems to be the case. Happy eating!

La Noche de San Juan Bautista

I have been a little busy this week, but the good news is that I am getting very good at administering geriatric screening exams in Spanish! Woot! Plus a Puerto Rican family from the South Bronx just moved in next to me, and the mom has decided to adopt me as "huh daut-uh," which means she has been force feeding me homemade Puerto Rican food. I have a difficult life, I know.

Anyway, I thought I would write a little about La Noche de San Juan Bautista, or the night of Saint John the Baptist. In case you couldn't guess, Saint John, or San Juan in Spanish, is the patron saint of San Juan, Puerto Rico. June 24th is his official birthday. According to legend, the night before his birth, all of the waters are blessed with special powers, like warding of evil stuff, healing, etc. Get it, like in baptism? So on this night, Puerto Ricans (a LOT of them) gather on the beach and at midnight, fall backwards 3 times into the water to bring fortune and health and all that goodness for the upcoming year. Or they might fall 7, there seems to be some debate about how many times you're supposed to do it.

If you are planning a trip to Puerto Rico during La Noche de San Juan, there are a few things you should know. One, if you are in a beach side hotel, there's a good chance you won't sleep that night, especially if you're in a "nice" hotel with a "quiet" air conditioner (mine sounds like a jet engine). People arrive at the beach early in the day to start the activities, and the beach becomes PACKED with people and bonfires. Second, apparently it is not safe to go all by your lone self, as the hotel front desk and my Bronx mother threatened to lock me in my room when I tried to go alone. Safety seems to be a minor issue this night, and there are cops everywhere, at least in Isla Verde. In fact, at my hotel some very drunk celebrators broke into an office and stole some computers and the wireless router, leaving me without internet for a day. :(

A plus though, is that the week surrounding La Noche de San Juan usually has small festivals and events leading up to this special day. Plus, La Noche de San Juan is a great experience and a way to get to know Puerto Ricans and their culture.

One of the interesting things that I noticed about this holiday is that it coincides with Midsummer's Day, which is the longest day/shortest night of the year, and also known as the summer solstice. This is an interesting example of the way that Christian "missionaries" adapted pre-existing pagan holidays and traditional celebrations to seduce the natives into Christianity. Another example is Christmas, which just so happens to coincide with the winter solstice. Here's an article with some more interesting parallels between Christianity and Paganism.
And here's another.

Here is a very good website (in Spanish) about La Noche de San Juan, which contains much more information about its history and its connection to the solstice. And here is a link to a Youtube video, which is actually a commerical for Ace (a store brand in Puerto Rico), but it shows a Puerto Rican man who is living abroad, apparently in a place where it snows in June, and he is heading to the water on the cold night, even though everyone thinks he's crazy. It's kind of cute. Unfortunately I still have not learned how to insert Youtube videos into my blog. I'm like a baby blogger! Wah!!

Sunday, June 22, 2008

Puerto Rican Fruit of the Week: Feijoa

Puerto Rico has such a wide variety of produce that I thought I would share it with you weekly! Plus I need a break from Health Issues in the Latino Community, which is a fantastic and highly recommended book, but less fun than blogging.

Feijoas, also known as Pineapple Guavas or Guavasteens, are about the size and shape of an egg. It is traditionally eaten like a kiwi,by cutting it in half and scooping out the flesh with a spoon. The flesh has an interesting, sort of gritty texture, and Wikipedia thinks it is a good ingredient for skin exfoliants.

The most interesting thing about feijoas are their smell. The smell is captivating and very distinct. My first thought was licorice, then maybe a little pineapple, then back to licorice. I couldn't put my finger on this enticing scent, but after doing some research, it turns out that the chemical methyl benzoate most closely approximates the feijoa's unique smell, and so this chemical is a popular additive in perfumes and other smelly stuff. Even more interesting, methyl benzoate is often used to train drug sniffing dogs because cocaine hydrochloride decomposes first to methyl alcohol and benzole acid, and then ultimately to methyl benzoate! No wonder feijoas are so addicting!! (10 points if you can write out the chemical formula for above chemical reaction)

So my thoughts on feijoas are as follows:

1. Cute and yummy snack

2. Would make an AWESOME addition to a fruit smoothie or a fruit salad. Their very unique scent and flavor, and NOT to quote Rachel Ray (barf), would be "the thing that makes people go hmmm...What is that?"
(For the record, if anything Rachel Ray makes causes you to go 'hmmm...,' it's NUTMEG! HAHA Rachel Ray! I ruined your secret ingredient!)

3. Mixologists and fancy pants chefs of the world hear this: There needs to be a feijoa martini, immediately. Find a way to import this highly perishable fruit, puree the flesh, and serve it up with some feijoa vodka in a chilled glass and I promise you I will be paying you a visit. Feijoa was meant to be a drink. I wouldn't mind if it was in some kind of desert either, maybe like a tropical fruit crepe or a panna cotta with feijoa sauce. Mmmmm....

Okay, now that I have made myself sufficiently hungry, it's off to bed to rest for my early morning Zumba class! Go out and try some feijoas!

Mayoketchup: THE Puerto Rican condiment


Scott and I used to work at a boarding school, and the kids there went through a phase where they would mix together mayonnaise, ketchup, sometimes a little hot sauce or mustard, and use it as a dipping sauce for their French fries. They called it "Fat Sauce," and after the school nurse noticed an increase in the children's waistlines, the school promptly banned Fat Sauce and all of its variations.

Little did we know, these children weren't seeking attention, they were displaying culinary ingenuity and appreciation of cultural gastronomy! Good job, kids!

My first experience with Mayoketchup was at restaurant called Fuentes (I think) in Puerto Nuevo. I went there with my hotel friend, Carlos, and we ordered tostones. He asked me if I wanted some mayoketchup. I will eat almost anything put in front of me, especially if it is a cultural food, so I said, "Of course!" and dunked my fried plantain into the light orange dip in front of me. As it approached my lips, the familiar smell sparked hellish memories of my 9 months working at said boarding school, and I proclaimed. "Oh my god, this is Fat Sauce." Carlos seemed totally confused, and replied, "Oh, uh, here we call it mayoketchup." Of course you do!

Mayo and I have a difficult history, namely that its smell alone is often enough to give me the heaves. But I am here to experience all that is Puerto Rican culture has to offer, and somehow mixing it with ketchup takes the edge off. Some people have told me that mayoketchup is also used as a salad dressing, but I don't know if I'm up to that yet. Interestingly, Wilo Benet, Puerto Rico's celebrity chef (I am so obsessed with celeb chefs), has included a recipe for mayoketchup in his book Puerto Rico True Flavors, which I highly recommend for anyone looking for great Puerto Rican recipes and drooly pictures. And if Wilo Benet makes it, it's legitimate in my mind.

For those of you who aren't lucky enough to find Mayoketchup at your local Walgreens, don't fret! You can make your own! Just follow these step by step instructions:

MAYOKETCHUP RECIPE

1. In a bowl, mix 1 part ketchup to 2 parts mayonnaise.
2. Add garlic salt or powder to taste and mix well.
3. Dip fried foods into mayoketchup and enjoy.
4. Think about what you've done.

And on that note, I'm off for a run. Even writing about Mayoketchup makes me fatter.

Thursday, June 19, 2008

Amadeus Cafe in Old San Juan

106 Calle San Sebastian
San Juan, PR 00901

I ate today!

ATMOSPHERE:
Amadeus is in a bright yellow building across the street from Plaza de San Jose. The restaurant is chic and modern, with a large bar, plenty of tables, an English/Spanish menu, and funky art lining the walls. It seems like a place where the cool kids probably hang out in the evening, although I went by myself for lunch, which means I was not a cool kid, at least not today.

FOOD:
First of all, they have a pretty decent bar. Interestingly, on the bar is a teeny alter with candles and a saint statue, presumably to protect the drunks during their debauchery. I had a mojito, and it was fabulous. I am sort of picky about my mojitos, specifically the ratio of sweet:lime:mint:rum, which is an art to master, if you ask me. Amadeus was spot on, although the $8 price tag meant I only got to enjoy one. I wasn't super hungry, since it was about a thousand degrees today, so I just got two appetizers, the yautía fritters and the Amadeus ceviche. Yautía, known in some other cultures as malanga, is a tuber that is sort of like a potato, but a little sweeter and starchier. Yautía is also an important ingredient in the Puerto Rican alcapurria, a mixture of ground plantains and yautía that is filled with either crab or meat and then deep fried. I had one of those today too...mmm... But anyway the fritters from Amadeus were served with a tomato chutney and were just okay, at best. The ceviche, pictured above, looked quite fancy but was just a pretty standard ceviche, and served a little warmer than it should have been. I mean, I ate it. I just won't rave about it.

Many of the online reviews of Amadeus say better things, and perhaps it is much more of a nighttime spot. I was the only diner in the establishment when I went, and since I only tried two things, I am giving the benefit of the doubt and saying that the food is probably much better a little later. It was about middle of the road price-wise. The fritters were $6, the ceviche $12, and the mojito $8, and $30 is a little more than I like to spend on lunch. The rest of the menu was sort of an American-Caribbean-Modern fusion, with options like upscale pizzas and burgers, dumplings with guava sauce, arrowroot fritters, pork scaloppine with sweet and sour sauce, buffalo wings, plantain mousse with shrimp, chicken breast with sun-dried tomatoes, Cajun grilled mahi mahi, goat cheese raviolis, and other eclectic options.

SERVICE:
The service was great. The two girls at the bar (where I sat) were very nice, and asked me if I would prefer speaking English or Spanish (I said Spanish). I asked them all about yautía and they asked me a little about myself. The food came out quickly, although I was the only one there.

WOULD I GO BACK?
Umm...not sure yet. I think I could do better. Not bad though.

Wednesday, June 18, 2008

Updates On My Appetite, Vibrating Veins, & Why Jesus Screws Up The Geriatric Depression Scale

This picture was the best of a photo shoot I took while salsa dancing in my hotel room this morning. I know, I'm lonely and pathetic. In it you can see my burnt face, my unmade bed, and my sweet white coat! Today was my first day in the clinic. It was a pretty perfect summary of how I feel about Puerto Rico so far. First of all, the clinic was in a MALL. So far I have been thoroughly dismayed by the Americanization of Puerto Rico. Of course I had expected it, but literally, it's more Americanized than Waterbury. I have never seen so many Burger Kings, Walgreens, and Subways concentrated in one area. I'm thinking it's because I have only spent time in the San Juan metropolitan area so far. Second of all, the first person I meet in the clinic is DRUG REP. For those of you who don't know how I feel about drug reps, perhaps I will upload my essay I wrote for the Brigham and Women's "Why Drug Marketing is Evil and Destroying the Very Fabric of Our Moral Conscience" essay contest. That may not have been the exact name of the contest. He brought Chili's (yes, baby back ribs Chili's) for everyone, but of course I refused to eat it, pleading an upset stomach. I actually wasn't that hungry anyway, despite my intense exercise routine this morning. After 6 hours, the doctor actually demanded that I go get something to eat, because she couldn't understand why I hadn't eaten anything all day. So I got this:
Hell yes, Puerto Rican food! Clockwise from the top is pastelón, which is like a sweet plantain and ground beef casserole, arroz y gandules, which is rice and pigeon peas, and some kind of delicious shredded chicken stew with potatoes and carrots. I WILL learn how to make these things. Sadly, my appetite still isn't back, so this meal is sitting in my fridge right now.

Anyway back to the clinic. I got to see a vibrating fistula. I had never even heard of this before, so I'll write a little bit about it. Basically, when someone is in kidney failure and needs to go on dialysis, doctors need direct access to their blood. Common methods of gaining access are through arteriovenous shunts or central venous access. But sometimes, a doctor decides to do something really cool and creates a fistula, which (in this context) is a direct connection between an artery and a vein. Eventually, the vein gets really big because of the high arterial pressure (looks like a snake under the patient's skin), and even more cool, the turbulence causes the fistula to literally vibrate. It was probably the weirdest thing I've ever felt, almost like little shocks going through my fingers. This guys humungo vein means a few things for him. First, his veins are easy to access and less likely to be damaged from all of the needle poking. Second, he has less of a risk of infection and clotting than he would have with either a central line or or shunt, meaning better outlook. Third, he will have pretty permanent access to his blood for hemodialysis, as opposed to the other options. Fourth, he gets to freak everyone out with his buzzing arm.

Okay, Jesus. Let me not go into a whole religious issue right here, let me just comment that it seems to me that sometimes Jesus and pals interfere with medicine. Like when 14 year olds die because they won't accept blood transfusions or when we trail behind the world in promising stem cell research because people claim to value frozen embryos as much as living children. Let me ask you this- if you could only save one thing from a burning building, a tray with 50 embryos or one 7 year old, which one would you choose? What about 50 embryos or your neighbor who's got mild Parkinson's? Not trying to be an instigator, but for Pete's sake, at least give yourselves some credibility and come up with an argument that makes sense.

Anyway, today I went with a medical assistant to give a Mini-Mental Status Exam and Geriatric Depression Inventory to an older woman. The mini-mental was the mini-mental, in my opinion a terrible screening exam that should be abolished. It's completely arbitrary and you could probably get a much better assessment by just talking to the patient and their family, especially for things like Alzheimer's. I suppose the clock drawing can be useful, but if you're suspecting a stroke, I would hope you would be digging a little deeper than the mini-mental. Plus, today I would have failed it, since I didn't know the date, the pueblo I was in, what floor we were on, or how to count back by 7s from 100. I'm sure someone will come out with a research study in the next 10 years proclaiming its uselessness. Obviously, I hate mini-mental. But what really got to me was the Depression Inventory. This woman cried during the entire depression screening, and if just thinking about your mood brings you to tears, you're probably not a ray of sunshine on most days. So why did this lady pass the screening and walk out of the clinic without medication or therapy? JESUS! Because she answered each question, I believe, the way that she thought she should, based on her piety. For example, despite the fact that she spoke for 10 minutes about how much she worried and couldn't sleep as a result, she responded to the "Do you frequently worry about the future?" question with, "One can't worry, because one needs to turn themselves over to the mercy or our Señor Jesucristo." She really said that. And to "Are you in good spirits most of the time?" Well DUH! She's filled with the HOLY SPIRIT! Of course those are good spirits! Nevermind she cries herself to sleep every night and has heart palpitations worrying about her husband's health! And it's totally healthy that she has isolated herself from all her friends and family so she can lock herself in her room for hours reciting the rosary! Those aren't signs of depression, just of one devout lady who is blazing her glory path straight to the pearly gates! She's fine!
Get real.

People, I implore you, if you're feeling blue, please answer depression inventories honestly, not the way that you think you should. You aren't saying Jesus is failing you if you get the mental health care you need and deserve. Doesn't he want you to be happy?
And doctors, please don't assume that just because someone is deeply involved in religious endeavors that they are happy. Because after all, believing that your life will finally be better in heaven is essentially the same as saying that your life will be better when you're dead.

Sorry that rant was so charged. Here's something to cool you off:

Quote of the day: "I just did something bad. I dipped American cheese into Tostito's Southwest Ranch Dip." -Scott

I’m Bringing Hungry Back

You know how when you are baking something in the oven, and you foolishly open the door and stick your face in to see if it’s done? Well, opening my room door in Puerto Rico is sort of like that, except instead of smelling banana bread, I smell either 1) the beach, 2) exhaust fumes, or 3) garbage. Now don’t get me long, I enjoy sweltering humid heat as much as the next masochist, but one thing has really been upsetting me about it- I am NOT HUNGRY. Seriously, I have been averaging about 1 meal a day, and I have been forcing myself just for the experience of eating, not because I’ve been hungry. Today, in a final act of desperation, I decided to do something to bring my appetite back. I will highlight with my morning phone conversations with one of my best friends, Brandon:

R: Sorry I missed your call, Bee, but GUESS where I was?
B: At the beach?
R: Nope!
B: At a restaurant?
R: Nope!
B: At a gay bar?
R: Bee, it’s 9:30 in the morning.
B: I seriously can’t think of any other place you would be. (Brandon knows me well.)
R: AT THE GYM!
B: WHAT?!

That’s right, ladies and gents, Renee joined a gym in Puerto Rico. Now some people might think, “Omg, someone joined a gym just so they could make themselves hungry so they could go stuff their faces??” Those people have obviously never met me. Although there is some perks, besides working up my appetite. I’ve been meaning to get back into shape, and this place offers fun Zumba classes, so I can get a little salsa movement in while I work out. I’ll let you know how it goes.
~ The new buff Renee

Tuesday, June 17, 2008

UCONN Could Use Some Palm Trees

I mean, really, look how much better med school looks with sun and palm trees. Today was my first day of school! Well, not so much school as meeting with the University of Puerto Rico contacts and talking about what I will be doing for the summer. I don't think I mentioned that I am no longer doing the research project that I had originally intended. Now I am doing a sort of cultural/medical immersion to learn more about Puerto Ricans so that hopefully I can 1) be a better physician for Puerto Ricans (and other latinos) back in the states, 2) help teach other students and doctors about Puerto Rican patients, and 3) improve my Spanish. America Facundo, one of my advisors, who may just be the nicest woman I have ever met in my life, summarizes it best by saying that I am "learning to become an advocate for Puerto Rican patients in the US," and I really like the ring of that.

So basically this morning I met with the 3 women that I will be working with the most. They all seem incredibly nice and excited to work with me. America is currently working on an "Humanities in Medicine" project, trying to integrate as much humanities curriculum as possible into the incoming medical students. She is really intelligent, and we talked a lot about the heterogeneity and diversity among Puerto Ricans, as well as the social classes and issues regarding immigration. She thinks I may be able to take a class on Women's Reproductive Health in July. Another woman, Delia, is in charge of preceptor assignments, so she's going to hook me up with preceptors in different parts of San Juan so I can see how health care is distributed in urban and rural areas. Dra. Jimenez is going to me my main doctor preceptor, and she is a geriatrician. I also met another woman who is running a program called The Hispanic Health Professional Training in Cancer Prevention and Control in Puerto Rico, and this program just started so she said I can feel free to come to any of the seminars or workshops, which are mostly on public health issues relating to cancer. Tomorrow I am going to a seminar called "Cancer Information Service as a Public Health Tool," and then in the afternoon I am going to shadow Dra. Jimenez.

Also today, the incoming 1st year students were having their orientation, and luckily enough, I got to take a tour of the facilities. El centro medico is absolutely overwhelmingly gigantic, and I have no idea how I will find my way around. Not to mention that San Juan public transportation is not so user-friendly, and takes me about an hour to get to the hospital. But, asi es la vida. Another good thing is that today I made a new friend who is a first year medical student, so hopefully I will have someone else to hang out with. Now I have to go shower because I smell like bus. By the way, I have been so confused by this because in Mexico, bus was camión, but here in Puerto Rico, they are called guaguas. Guagua is my new favorite Puerto Rican word, it's muy chévere.

Monday, June 16, 2008

Oh and one more thing...

This is a 5 minute walk from my door, on a sunny day.
And on a "less sunny" day...

¡Por fin!

FINALLY!
Today I actually unpacked, after 3 nights in Puerto Rico. And it feels awesome. I picked the apartment style room that was not directly off of the pool because I wanted to have a little privacy. This part of The Coqui Inn has a lot of Puerto Rican families, and they often have little fiestas outside during the day while the kids are in the pool. Which is spectacular, because hopefully I will get to hang out and chat with them. But, if the party goes late in the night, my room is set back enough where I won't hear anything. Here is a picture from behind my little gated hideaway, which Carlos (my hotel friend that brought me for pollo con arroz y habichuelas yesterday, my first Puerto Rican meal), said that I can lock if I want.

My room is great. It's very roomy, have a fridge and a double burner, a/c, TV, internet and everything. And I am right next to the hotel's kitchen, which is currently not in use because it is down season but I advised Carlos that I will be stealing from/using it. I think I am going to be happy here. :)

Sunday, June 15, 2008

New Friends and New Prospects

Happy Father's Day, Dad!

So things in Puerto Rico are looking on the up and up. This morning I talked with the Coqui Inn, and it turns out I can get a little apartment here for $700 a month, with everything included. Really can't argue with that. Plus it has a pool, and did I mention that it is a 4 minute walk to the beach?

I went to see the woman across the way who has a beautiful house with 4 apartments. She thought I should go with the hotel deal, since she couldn't offer me an apartment for less than 2500 for 2 months. She was a really nice lady, and we talked for a while, and she said she would invite me to go out in her convertible and boat and would show me how to make criollo food next week, which is so exciting. The guy at the front desk seems to think she was hitting on me, and while he may have reason to think that, I'm cool with hitting up the beach top-down convertible style. Plus she already knows I have a boyfriend and that he is coming in July (can't wait!)

Speaking of criollo food, I am FINALLY going out for some real Puerto Rican food tonight with my new friends from the hotel. I will certainly report on it later!

By the way, this morning I took a mini-trip to the docks of Old San Juan, and here is a photo from that. The reason I'm making a weird face is that there was a guy standing behind the photographer asking me if it hurt when I fell from heaven, and I think I was in shock that people actually still use that line.

Saturday, June 14, 2008

The Nikko Chinese/Sushi Restaurant

The Nikko Chinese/Sushi Restaurant
1165 Marginal Villamar
Isla Verde, Carolina, Puerto Rico
00979
(787) 268-3043

So far in Puerto Rico I have had lunchables and sushi. Good job, Renee, for diving right into Puerto Rican culture!

Also, typing the address made me realize that I am not actually in San Juan now, which means this blog is a lie and therefore useless.

Anyway, after an extremely stressful 24 hours in Puerto Rico, there was no way that I was going far for dinner, which led me to The Nikko, since the Chinese and Sushi restaurant is built right into my hotel (The Coqui Inn) and was literally 16 steps from my room.

ATMOSPHERE:
The restaurant is very elegantly decorated in traditional Japanese style. The cloth napkins are elegantly origami-folded, which screams, "We aren't a quick sushi bar lunch place! We're fancy!!" There are decent sized alcohol and sushi bars. I had dinner at about 5:30 on a Saturday night, and there was not a single other person in the entire restaurant, though there were a lot of tables. I'm not sure if it was just an off day or what, but if this is how this place operates, I have no idea how they can stay in business. Oh wait, yes I do, they charge more for sushi than any sushi restaurant I have ever been to! Is it worth it?

FOOD:
Nope, it isn't worth it. The best way I can describe the food is: Meh. I have had many better and a few worse sushi experiences, although my tasting ability was no doubt marred by the fact that I had seen beforehand how expensive their food was. $3.00 for MISO SOUP? That has to be some sort of crime. Not to mention that I saw the lady bringing frozen and freeze-wrapped "sushi" to the chef. A regular Chinese food sized portion of Chicken and Broccoli is a hefty $12.50 and fried rice, yes, pork fried rice, is $8.00. Anyway, I got some seaweed salad, which tasted like most other seaweed salads I have had. The eel roll and spicy tuna roll, which I picked to try and stay on some sort of budget, were totally unremarkable. I didn't even get that "Mmmm...sushi..." Homer Simpson-like feeling that I usually get (you sushi-lovers know what I am talking about). That's really all I have to say about it. Oh and then I had some lychee for desert, which consisted of 5 canned lychees on ice with toothpicks. The ice tasted like hotel tap water. Overall: Meh, Meh, Meh.

SERVICE:
The woman who served me was actually very sweet. I asked her if she spoke both Spanish and English, and she said she spoke "leetle bit Spanish." She also asked me if I was here on business, since I was eating dinner all by my lone self. I feel bad to give the restaurant such a bad rating, because she seemed like such a nice lady, with her little daughter was asleep in the back of the store, and I don't want to see them do poorly, but all's fair in love and restaurant reviews. Also, I'm sure that their business won't be affected by this blog, since it's mainly my parents and friends reading it. I'm a loser!

SHOULD YOU GO?
Honestly, no.

Minor Setbacks and My First Puerto Rican Meal


"But that looks like a homemade mango daiquiri in a frat house cup and some lunchables..."

Well, it is. Turns out, they have lunchables in Puerto Rico, and that was my first meal here. Actually, I suppose you could count the Subway veggie delite as my very first, but I was too shocked and horrified to enjoy it. Let me give you a rundown of the past, very traumatic, 24 hours in San Juan, Puerto Rico.

I was supposed to rent a house in Rio Piedras Heights, a gated community near the University of Puerto Rico. Although quite late, a lovely woman named Ruth, a friend of the homeowners, picked me up from the airport and even gave me a quick tour around the university grounds, which are beautiful. As we drove past the Rio Piedras Heights gates, I looked with excitement at the stunning homes of the neighborhood- it was obvious that these were some of the more financially fortunate families in San Juan. Then we pulled up to my house. It was...okay...I guess...from the outside, some overgrown plants but nothing major. A very old man, the home's supposed "caretaker" was waiting inside, mop in hand. The mop was a prop (and I'm a poet and didn't know it!) because the house was a complete disaster. It had the look of a condemned property, right down to the chains and padlocks, which were the only "lock" that the house even had (totally creepy). I'll spare you all of the details of what I, from now on, shall call, "the 12 hours from hell," but suffice it to say it contained cockroaches, mice droppings, stray cats, lizards, coquí frogs, lots of dirt, a TON of rust and mildew, and me pooping in a plastic bag. Things that it did NOT contain include hot water, lights, a working toilet, relief from sweltering heat, or, thanks to a taxi strike, a way to get myself the hell out of there. Gracias, taxistas.

Cut to morning time and after awakening and, in daylight, finally seeing my room and the 4 dead cockroaches on the floor (apparently they couldn't stand the heat either), it was sianora, Rio Piedras. While I was sobbing hysterically on the phone, Scott found me the cheapest hotel he could online, called The Coqui Inn in Isla Verde. For some reason, I actually really really like this hotel. It is literally a 5 minute walk over a bridge to one of the most beautiful beaches in Puerto Rico, is within walking distance to lots of bars and shops, and at $69 a night for students, is a great deal. Plus I have 2 beds, a large fridge, a stove, a TV, a great air conditioner, and most importantly, FREE Wi-Fi!!! Is it sad that I feel dead without internet access? I suppose. Anyway, there is also a cool atmosphere to this hotel. The people are very nice (the guy at the front desk offered me a room with a full kitchen after I showed him my lunchables), and there are beautiful murals painted on the outside walls (see pics on website). Apparently this hotel actually used to be 3 separate hotels, so there are 3 pools and the entire hotel spans a whole block. The rooms, at least in this part of the hotel, are sort of maze-like, which is nice because it gives it a more private feeling than your traditional hotel. I am actually planning on proposing to the owners a deal to see if I might stay here for the entire 2 months for some sort of discount. I feel like they have so many rooms, having someone stay for 2 months merits a pretty deep discount, especially since it's off-season time. The hotel also, somewhat randomly, features a Chinese/Sushi restaurant built right inside of it, which, being a hot 16 steps from my room, I shall review in the next post. Perhaps in a few days I will post a full review of The Coquí Inn as well.

Anyway, although I generally don't believe in fate, I often find that my gut steers me in the right direction. For some reason, I was drawn to a local business today where I met a very sweet older gentleman who was from Isla Verde, and knew many people in his church that rented apartments in the area. This man, for the record, has totally renewed my faith in people. He called several of his friends and set up appointments for me to go see a few apartments that are literally on the same block as the Coquí. Actually, the one I am going to see tomorrow is directly across the street from the Coquí, and includes 3 bedrooms, water, electricity, TV, cable, fridge, stove, etc. I am also seeing another one on Tuesday, so hopefully by Wednesday I will figure out what the hell I am doing for the next 2 months. I told this man that I wanted to buy him a present for helping me so much, and he said, "No! No! You just stop by sometimes and say hello to me, that's all I want!" How nice is that?

So, for now, even though I don't actually know where I will be 3 days from now, I am completely calm and cool in a comfortable hotel room, sin gatos y cucarachas, and truly looking forward to my 2 months in Puerto Rico.

Except now I can't hear the coquís...