09 March 2012

For tincture of time, there's no copay.

If you follow this blog, you know I’ve been missing for a bit. I am thankful to my buddy, Betty Ulrich, who penned the last entry, and I couldn’t agree more with her description of medical facilities we see in various parts of the world and how fortunate we are to have U.S. medical care.

So where have I been? Well, I went home for a few weeks to see my family, and then I attended a medical conference before returning to Karachi. Since then, I’ve been in somewhat of a funk! Is that word still used, or am I dating myself?

This is a very common problem in the Foreign Service (FS). We call it “culture shock,” but I think the name is a bit misleading. There is a period of time, usually three to six months after transfer to a new post, when an individual feels somewhat disconnected to the new environment, perhaps longs for the city and friends he or she has left behind and experiences anxiety or doldrums. Clinically, people show up on my doorstep complaining of insomnia, gastric disturbances, lethargy or nervousness. Symptoms are nearly always nonspecific, and a treatment of benign neglect is all that is warranted. I advise a person to eat well, exercise, get a good night’s sleep, do something that interests them in off hours and, usually, that is all it takes. “Tincture of time,” we call it.

No one is immune, no matter how many times the moving process is experienced. Early in my FS career, I was sure I would reach a point when culture shock didn’t occur. I was wrong. It has manifested itself in very different ways, depending on the circumstances, but it has always happened.

When I left Ghana, I really missed the friendships I had created and the many local people I had grown to love. When I left Guinea, I pined for the islands offshore that were such a wonderful place of respite. When I left Afghanistan, I had a haunting feeling of things left undone. When I left Pakistan (the first time), I was plagued by concern for the colleagues that remained.

This time, I think the hardest thing is being away from my children and grandchildren, and this only became an issue with this latest visit home. My grandson Cade, the little guy who used to describe his grandmother as living in a box, because he most frequently saw me on the computer screen via Skype, has the part of Michael in the community theater’s presentation of Peter Pan. I won’t be there, and I’m still deciding if that is acceptable to my vision of who a Nana should be.

When I knew I wouldn’t have the mindset to blog for a while, I wrote to Jim Mattson, editor of Reflections on Nursing Leadership, the magazine for which I write this blog. I told him I was suffering from jet lag, a cold and a bad attitude, and we both agreed the first two would resolve quickly, but the last malady could present a problem. I think the cure is near.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.


  1. Thanks for sharing this! As a long-time follower (but first-time commenter), I'm glad to see you back.

  2. Hi Judie -
    Just found your blog again and am so taken by your description above. It is wonderfully written and I wonder if this culture shock doesnt happen at the end of a post as well. Hope all is looking up in your corner of the world. Cheers, Stacy

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  4. Hi Judie,
    I found your blog when searching for information on Foreign Service Health Specialists. I am a nurse practitioner currently working on contract jobs in the US and traveling as much as I can. The Foreign Service has long been my dream job and I am looking forward to reading your archives and gleaning some information on living and working in some of the locales where we have a presence. The FS is currently taking applications again and I am working hard on mine. Keep up the good work!