Honduras Day 6 - Last day of clinic and final reflections

Our final day of clinic today. Found out that yesterday we saw 349 patients, and today we don't have the final count yet, but somewhere around 250 so a total of 1200ish patients for the 4 days of clinic. It was a very busy 4 days, and I definitely learned a lot -- realized a lot that I did know and a lot that I didn't. Things I need to study more, things I can improve on, and skills that need fine tuning. But most importantly for me, I got even more excited about residency and realizing all that I can learn over the next three years and how much more effective I will be in the future with my patients around the world. In comparing my abilities to treat patients now to them in the past, I've definitely learned a lot in the four years of medical school. I'm also even more excited that Dr. Pilch recruited me into the field of emergency medicine. I'm seeing more and more how the the skills and knowledge base an emergency medicine physician has is perfect for this type of work around the world. The few patients that we had with more emergent treatment needs (nothing terribly crazy) I even felt comfortable with treating them, and for a seasoned ER doc, it was a piece of cake. Knowing that anything that shows up in clinic, no matter how nuts, as long as we have the supplies we can do something. Even with limited supplies, we were able to treat some patients that really needed it. So from that standpoint overall, I'm happy with how everything went.

I told the kids this evening that I hope more than anything they maintain the heart for people that they demonstrated this week. Medical school was hard, and the idea of residency terrifies me, but being able to work with people around the world and show them love is the reason I can continue to push through. Well, that and Jesus. It's clear that he continues to give me strength to push through the physical and mental limitations that I have and do the work that I need to do in the moments that I need to. This week was tough with the daily migraines, diarrhea (that plagued a lot of the group actually), motion sickness with the crazy bus rides and feeling nauseated often, and overall just feeling like crap. But in the midst of that I felt like I had the strength I needed to work in a stuffy little humid clinic room for 7-8 hours a day, and I had the mental capacity to think clearly enough to provide good patient care. I'm immensely thankful to Dr. Pilch for having me on the trip, for teaching me, and for even keeping me in medical school with her support. When you read this, thank you so much.

As I work with different organizations around the world I've seen good and bad, things that I want to incorporate into my organization and things that I definitely want to steer clear from. I definitely never want to lose the heart. The very name of the organization, Make A Change International, provides a very clear instruction for what I want us to be able to through our work. On our website I write about how the song by Michael Jackson inspired the name, and like the song talks about, it all starts with looking at the man in the mirror and making a change there first. I hope that as I progress through my career I never lose sight of that, and that I'm always willing to change for the better in order to provide the best service I can to others. I know that the people surrounding me -- friends, family, board members, etc. -- will always hold me to that, so I feel a sense of comfort in that.

Second, I never want the success of the organization to supersede the care that we provide to patients. My goal is to provide long-term, sustainable health care that is of high quality to underserved communities all over the world, and have an actual impact in the communities we work in by us taking action and seeking change -- and that has to be the highest goal. If we ever start to be more concerned with the "success" of the organization in itself, I ask any of you to call me out on that.

Third, I never want organization and things running according to plan to be something that tops serving others. If the schedule, plan, wake-up or drive home time changes, if we have to stay later than desired to serve that one more patient, then I want to do that. Within reason clearly as we cannot obviously work 24/7, but I've seen where flexibility is lacking and how it can affect service.

Fourth, I want people to have fun. I want the volunteers to have fun, I want the patients to have fun, I want the locals serving us to have fun. Health care shouldn't be a drag, it shouldn't be overly difficult, it shouldn't be mentally draining on everyone (physically maybe). Everyone should do this because they enjoy it and the service work itself should be a lot of fun.

Fifth, I want people to respect each other. I want them to know their limitations, know when to ask for help, admit their mistakes, and call people out for making mistakes when they need to. But through that, they need to be respectful. There were a couple times on this trip where it was done right and it was done wrong. The nursing director came to me one of the days and there was a misunderstanding in something I had said to her that she wanted to clarify and give me some constructive feedback. I was grateful. What came across in the moment with a difficult patient was not at all what I meant, and it was a simple misunderstanding that could have made for a difficult week. I was glad that she pointed it out and we were able to clarify things, and discuss a better way to communicate through difficult patients. The rest of the week, our interactions were splendid. There were times with other staff and some of the other groups at the hotel where our interactions were not so great, terribly disrespectful, and people were not receptive to discussing it properly. Dissension in any group will tear it apart and make it an awful experience.

Those are just a few of the things I take away from this week and I know that it was all positive as far as how it will affect the further development of Make A Change moving forward.

A couple entertaining and interesting patients from today now. We had one boy with a pretty good cellulitis in his foot, so that was a good teaching point for the kids as they had never seen it. We had a little girl who had some an interesting yellow-brown discoloration in her eyes....not quite scleral icterus, but maybe. We sent her to the hospital to get checked out as we weren't 100% sure. I had one patient who presented with his right hand as a stump, so I asked him what happened. He replied, "someone cut it off." I asked, "someone? as in like a doctor? or just....someone?" He said, "someone. I don't know his name or who he was. I was walking to work 50 years ago and he came up behind me and chopped off my hand." The translator was laughing pretty hard when he translated this because the guy was so stoic during his story. We all kinda started laughing too. Not that his story was funny, but he was so nonchalant about the whole thing....we were like, um wow? He was like, meh. Wasn't causing him pain, so that was a plus. I had another patient ask me if I had a pill that would, "keep women away." Yeah, I don't think they have that yet. Another kid had some cafe-au-lait spots on his neck concerning for neurofibromatosis, so we sent him to the hospital as well. Actually had a kid with a fever today who had a pretty bad URI, so started on antibiotics for that. First and only person I saw with an actual fever. Otherwise, just a lot of normal pathology that I've written about.

Well that's it for this trip. Thanks so much for reading. Always feel free to post in the comments or send me an e-mail at aaron@makeachangeinternational.org with suggestions, input, questions, etc. Your support is what makes the ability for us to change the world possible, so I pray that it remains. Consider supporting us financially moving forward as well if you don't already, there are a lot of students and health care professionals who could really use it in order to be able to go on trips like this and impact lives. My hope is always to change at least one life.....in this case we impacted about 1200, so that's pretty awesome.

Here are a few more pictures from today:

Honduras Day 5

Day 3 in the clinic, and to my surprise we will be having another day of clinic tomorrow, which I am completely fine with. I was informed initially there would be the 3 days, and I guess that's what they normally do, but I suppose due to the fact that we have a larger group than usual, a 4th day it is. We were in a new community today, at a school, which had nicer bathrooms anyway (as in actual toilets) -- and that was a huge plus considering several in the group started to get diarrhea. Anyway, drove about an hour and a half to the new community, on some interesting roads, and our bus driver is a bit crazy, but really what can you expect from being in Honduras? Keeps things interesting.

Our clinic today was pretty crazy. I guess the community in which we were set up didn't really come to see us because so many from another community showed up. They had walked about 2 hours to get there, so the decision was made to have us see them today and the local community tomorrow.  I don't have the "final count" yet, but I heard about 350 patients went through triage before they started to shut it down. So needless to say, it was crazy busy. A lot of families came in with 5-6 kids, so it was tough to see a lot of them all at once.

Interesting cases today:
- we had a colles fracture (broken radius and ulna), which we sent to the hospital for x-ray and fixing considering it was 2 weeks old.
- lady post tumor removal from abdomen about a year prior presented with symptoms concerning for cancer, so sent her to hospital.
- lady with a very very large ganglion cyst, which was a good teaching point for the kids.
- another pseudomonas otitis externa infection in ear.

Nothing super crazy, which was just fine with us. No crazy hypertensives, dangerously high blood sugars, or anything like that, just a seemingly vast amount of patients which kept us really busy. We'll see if our last day tomorrow presents with anything nuts.

It's been pretty interesting to see how this organization does things, and I think it's a pretty good example of an organization that has grown to the point where they are more concerned with the organization, having things "organized" well, hitting their numbers, etc. and forgetting about the reason they should be doing this -- which is the people. Some of the college kids were pretty upset the other day when we finished early in the day and they were shutting down the clinic, and a family of 4 were standing outside the gate asking to be seen. They were told "maybe," and were made to wait a while because they "showed up late," and they wanted to "make them sweat." The kids were upset because they didn't understand why we couldn't treat a group of patients who were begging to be seen, when two doctors were willing to see them, and there was nothing going on. It's an interesting perspective that I've seen in other organizations, and I don't entirely understand it. I just think it's kind of sad. This evening there was a bit of a fiasco where we were supposed to have a meeting at 7:30 in our pharmacy, and when the kids showed up, another group of students were meeting in there and told them they had to leave because by standing there they were being disturbing. This didn't lead to a pleasant interaction with our leaders. I've been really impressed with our group of pre-health students, who have been working harder and longer hours than the other two groups here, and then getting treated pretty poorly by the other groups and their leaders, and they've stuck it out and keep working hard. Today was another example of how things are really poorly planned through an organization that thinks they have everything planned perfectly. The compound is plenty big enough to handle the number of people, if things were actually organized well. Things just really aren't. Anyway, my take away from all of this is the what to do's and what not to do's for a mission organization. The kids asked me to please never lose the heart in what I do as the reason behind my travels. I was impressed with that. And I'm glad they recognize it. I imagine that many of these people never thought they would "lose the heart," though maybe some of them joined into the stage beyond already. But it's interesting to see. There are definitely some good things I've seen here though, and I'm impressed with that they have a data informatics aspect and they analyze all their paperwork. I'm trying to get ahold of the analysis to see how they do it, and that could potentially be really helpful. That'll be my rant for the day. In short, again, eat the meat and spit out the bones, there just happen to be a lot of bones here. If any of the premeds ever read this, great job, really proud of you guys and the heart for the people that you've shown.

That's all for today. I'm glad we've at least gotten the chance to see a good amount of patients, give them good medical care, and love them through everything going on. The kids have been fantastic, and as usual, just being able to give them 5 minutes makes a huge difference in their life. Dr. Pilch has been fantastic, and is simultaneously seeing a ton of patients and helping me when I have questions, and teaching the students. I've learned a lot from her and have learned a lot from teaching the premeds as well. In the midst of all the craziness I'm just glad to be able to push through the noise and still do what I do for the reason that I do it. Maybe I can cast a stone into this water and make a ripple.....I can try, and if not in the organization, maybe within the community. If nothing else, we've hopefully impacted at least one life for the better.

Thanks for reading! Go Hawks!









(Clearly they are drinking too much coke...)

Honduras Day 4

Today was our last day in clinic in this community, and we saw another 317 patients. A total of 640 patients in 2 days. Not bad at all. I know global brigades wasn't quite expecting us to see that many at all, and I'll attribute a lot of it to Dr. Pilch because she is amazing. She's super quick and efficient, and in addition to seeing her patients, she can quickly shout out advice or answers to questions I have so I can effectively treat my patients. The girls that have helped me translate are doing fantastic. I've picked up a little more Spanish, but medical Spanish is tough, and these girls have been rockstars. I've still had a few questions on some rashes I've seen, but have been pretty right in most of my diagnoses, it's nice to have Dr. Pilch to confirm or teach something new. A few times I needed some dosing questions addressed. Being an ER doc, she can answer those in stride with no problem, lending to us seeing a bunch of patients.

Our lady with the broken arm showed up today first thing in the morning. She's I believe 77, if I'm remembering right, and pretty much just this frail little old lady who was probably semi-terrified about the idea of us yanking her arm around into place. We gave her a shot of some NSAIDs prior to starting, and then gave her a Norco 5 that I had with me. We then gave some local into the area. I then grabbed her arm, supinated the forearm and yanked as hard as I could distally to reset the broken humerus. The pain meds did wonders, but it still was obviously not a pleasant experience for her. We got it as set as we could, and then put our makeshift splint on her to hold it into place. This was about the point we realized the Norco took full effect.....she was pretty loopy ha. She's probably never had anything quite like that, so it definitely hit her well. We didn't have any to prescribe so I gave her two more pills to take home with her. It went rather well and I feel confident it will heal better now.

We also had a guy come in with some knee pain and there was an effusion around the joint space. Dr. Pilch said I should drain it if I wanted to, which of course I said yes. The patient said, "do what you think is best." So we prepped him, injected some local into the joint, and tried to drain some fluid with an 18 gauge needle. Sadly there was minimal drainage of fluid, but we did get a good amount of Lidocaine into his knee, so that'll make him feel better anyway. His brother was with him and afterwards I asked him if he had pain in his knee (which was specified on his chart), to which he said, "ummm, oh no, I'm good." Ha, probably after watching his brother he decided his knee was just fine :)

I think all the college kids enjoyed getting to see some procedural stuff, and helping out with everything too. Needed people to run and snag stuff, help us prep, etc. and they got to get some hands on with all that, which as a pre-medical student, getting to be involved in any of that I remember is great. It was nice to be able to teach them some stuff along the way as well, in addition to learning from Dr. Pilch through the experiences.

Otherwise the pathology was fairly similar to yesterday's group of patients. We had a few with really high blood pressure, but they weren't as symptomatic as the patient yesterday, so were able to treat a little differently. A lot of the kids are there with headaches, which is pretty much just from dehydration. I started asking all the moms, "do your kids drink coca cola?" And they all said, "yes." And then I would say, "STOP DRINKING COKE!" (and make sure they translated it for me ha). The one girl translating kept laughing because I was asking every mom about it. But these kids will drink coke alllllll day long and no water, and they are severely dehydrated and getting headaches and muscle cramps as a result. Then the moms want medication for the headache, but all they need is water.....and no coca cola. Sorry. I love a good cold coke, but not in 1000 degree weather every day.

Tomorrow we will head to a different community, which I'm not sure if they've ever done medical work there or not. They normally do 3 days in one community, but I guess this one was new and they didn't quite have enough patients yet or something like that. Even with seeing 640 patients we finished early today.

Oh, we did have my one asthmatic girl come back and she was pretty bad. Not moving air at all. I had given her a steroid taper, but she didn't take it because it made her feel nauseated.....so yeah, she got much worse. Today we found a nebulizer and gave her a treatment and a steroid shot, and told the family that she really really needs to take the meds. I feel bad for these families because they don't fully understand the severity of these conditions, but they also don't have access to getting care if something really bad happens with an asthma attack (among other conditions). But, glad we were able to help her today.

Anyway, tomorrow we will head to a different community and just have the one day of clinic. It's about an hour and a half away, and we'll see if the pathology differs much. Looking forward to it.

The one guy was calling me "Dr. Honey" because "I've got all the sweets." I keep pulling out snacks, candy, cookies, etc. Yesterday we made s'mores with Reese's peanut butter, and they saw all the other snacks I brought in my suitcase so they're excited. Today he walked in to the pharmacy and said "Estoy caliente!" Which basically means, "I'm sexy!" To say "I'm hot" you say "hace calor," so all the Hondurans had a good laugh and we are calling him "caliente" now ha.

Hopefully you're staying cooler than we are! Thanks for reading. Trying to post a bit shorter on this trip so y'all can read it more easily. I'm going to post a few pictures at the bottom here of the injections we did today, so check those out! Thanks a bunch!

Honduras Day 3 - Clinic

Today was our first day working in the clinic. I forgot to mention the region that we are working in, which is pretty much as far south as you can get, just about on the border of Nicaragua. Because of that, there are a lot of guarded checkpoints along the road and several armed guards who accompany us everywhere we go. So, check that out on a map if you are interested. Back to the clinic.

We arrived about 7:45am and got set up to start seeing patients around 8:15am. Dr. Pilch and I set up at different tables in the back of the room, nearby enough so I could ask her questions about patients as they arose. I had two college students with me, one that was fluent/nearly fluent in Spanish to help translate, and one to scribe and hand out Albendazole (de-worming medication that all patients receive). The patients came streaming in from triage pretty quickly, and the line quickly grew around the building. The students filled out the triage sheets with the vitals and chief complaint, and we were able to focus on figuring out the problem and formulating a treatment plan for the patients. Usually they were mothers with their 2, 3, or 4 children that came to the table, and you tried to go through a pretty full physical exam while addressing their complaints.

Most patients present with complaints about headaches, which are due to dehydration mostly.....some have migraine type headaches, but most are because they don't really drink a lot of water, they drink a ton of coca cola. One guy tried to assure me that he drinks 17 bottles of water while working in the fields all day and that his cramping and muscle aches had nothing to do with dehydration. On one girls prescription I wrote "MAS AGUA!" to which all of the students had a good laugh when it rolled into the pharmacy. She was very clearly dehydrated, and her mother was trying to assure me otherwise.

There are a lot of pterygiums as well, which I just recommend googling, but all we can do for them her is hand out sunglasses to help prevent them from worsening, or from getting them at all if they didn't already. Thanks to my parents for donating a bunch of sunglasses to bring down, especially because they are safety glasses, which for a bunch of the guys are really helpful.

Most of it is primary care type stuff, and we try to manage blood pressures (as long as we can give them a 3 month supply and know someone is coming back), refill medications that were filled 3 months ago, try to control blood sugars, and so forth. A lot of the kids have ear infections, upper respiratory infections, etc. and we give Amoxillicin. We did have one woman come in with a blood pressure of 240/128, and luckily we had some IV blood pressure medications. I placed an 18 gauge needle in her hand and started pushing the meds right away, to which I seem to have earned some respect from the nurse because she was surprised I got an 18 gauge into a hand so quickly. Thank you Africa for all that practice! We monitored her for a couple hours until it was relatively safe and told her to come back tomorrow to recheck how things were.

Another kid had "swimmer's ear," or otitis externa, with a really bad pseudomonas infection. It has a very distinct smell, to which we made all the students in the vicinity come and smell it. Pretty easy to diagnose, and glad we the meds to treat it.

We saw patients up until around 12:30 I think, took a short break for lunch, and resumed fairly quickly. I think we saw patients until around 4:30pm then. A total we saw 327 patients for the day, which was pretty good. 3 of us doctors saw them for primary care, 1 saw the gyne patients, and 2 dentists did extractions/cavities/etc. I think about all of the patients came through us first, so it was a lot.

It was good to start practicing medicine "on my own," though I had Dr. Pilch close by. But in general being able to diagnose and treat was a good feeling. Some of the skin conditions that I'm not as familiar with or certain medication dosing questions I still ran by her to clarify. I'm still learning a lot and teaching the students along the way makes me really think about things too. Thank God for having apps that work on the phone too without internet, because I can still consult it for certain dosing questions and diagnosing a few things that have slipped my mind over the last 4 years. But honestly, that's half of medicine, just knowing how to use resources, recognizing things and being able to figure out what it is. So today was a smashing success. Looking forward to tomorrow and I feel a bit more confident going into it, so that's a plus. I think it'll help me feel confident going into residency too, just from the standpoint of it won't be my "first" time prescribing medications. It's awesome working with Dr. Pilch in this capacity too. She has been my mentor for years, but now working alongside her, it's a good feeling. She's a great teacher and also pushes me. A few times I asked a question and she just said, "up to you." So that was good.

Our lady with the broken arm was not picked up today by the way, so they are going to get her first thing in the morning. We will be reducing the fracture and setting the arm, and I expect it will be a humerus experience (pun intended hahahahaha). I'll let you know tomorrow how it goes.

Having a team meeting tonight to discuss the day, but seems like everything went well. Dr. Erica (pharmacist) did a fabulous job and didn't have any complaints, so it's great to have a pharmacist who can handle things and keep everything running smoothly. Overall everyone is pretty pleasant to work with, and no complaints. It's good to see how they run things and I'll "take the meat and spit out the bones," as I do in every situation.

Thanks again for reading. Definitely consider supporting us in a future trip, and also consider sharing this post and our website with a few friends! We can use all the support we can get and I definitely know these people would appreciate it. Thanks everyone!

www.makeachangeinternational.org

Honduras Day 2 - visiting the community

Day 2 has come and is about gone here as we are pretty much just chilling for the rest of the night. The Global Brigades trips are very regimented, but not the most effective with their use of time and resources in my opinion. We shall see what the next couple days of clinics are like, though from what Dr. Pilch has told me, we won't be pushing ourselves as much as we would otherwise. It's definitely a different pace than I'm used to, and a VERY different pace than the Congo. But it's good to see how they run things and get a feel for a different type of trip. Considering these are all college students and some of them this is their first trip out of the country, it's probably a good pace.



We ate breakfast at 6:30 and headed out to the community where we will be working, which took about an hour and a half to drive there. We then split into two groups and walked around different parts talking with various families, seeing their houses, where they get water or use the bathroom, etc. In a lot of ways it's pretty similar to a remote village in Africa, and I was just discussing with some of the kids here as they asked to compare it to Africa, that it's the same in that there are very poor and very wealthy, with no in between. And you see that pretty evidently. You have the people who do business and fly back and forth to the States, and those that can barely afford to feed their families. Tomorrow will be better for comparing as I'll see patients in the clinic.

We did see one patient today, an elderly woman about 77 years old (we think), who had fallen and injured her arm about 10 days ago. Dr. Pilch and I went into see her and found that she had broken her distal humerus. Not having anyway to really image her (I need to get a portable ultrasound machine....) we tried to reduce it, but it was too painful for her. We are having her brought to the clinic tomorrow and will reduce and splint it then. We have some pain medication that we can give her and inject some lidocaine into the area and regionally numb her up. Then I'll try to reduce the fracture as best I can and we will put her in a splint that we made today out of cardboard, duct-tape, and gauze (see picture....worked out pretty well). If you can believe it, I had two slings sitting in my bag prior to leaving and said, "I won't need these," and took them out.....dang it, really wish I had those. I'll have to just make one now too.



We came back and started working on separating the medications and supplies that we will have for the next few days of clinic. The pharmacist, Dr. Erica, and her assistant, Catalina, are fantastic. They really know their stuff and everything that they have in stock, what dosages, and the first line treatments for the diseases that they use in Honduras. Dr. Pilch and I were pleasantly surprised. We have a good amount and will be able to treat most things we will see here, or make due with what we have when needed. The college kids counted out various medications like Aspirin into 3 month supplies that we can use to quickly hand out at the pharmacy. The pharmacist also said that for kids all we have to do is tell her what medication we want and she will calculate the dosage based on their weight for us. That will definitely speed things up. Considering the 3 of us are planning to see 300 patients between the hours of 9:30-4pm (max time I think there), it's gonna be pretty fast paced. I'm excited and a bit nervous, but I'm sure after the first bit of time I'll warm up to it and do just fine. I'll have two students with me shadowing as well, so it's a bit of a weird feeling. Not too long ago that I was in their position.

We are just chilling out for the remainder of the night and getting ready for tomorrow, so that's about it. Food as always is pretty great - tostadas for lunch and the fruit (papaya, mango, pineapple) is absolutely fantastic.  We did make some s'mores tonight as well....I brought everything needed, included a lighter and some sticks, so I roasted marshmallows over the lighter. Everyone had a good kick out of it and I told them "I come prepared."

I'll post some pictures from around the community when I'm back. I need to figure out a way to transfer them from my camera to my iPad easier so I can post them while on these trips....not that the internet could really handle it anyway though. Thanks for reading as always! Stay cool!

Honduras Day 1

Pleasant surprise this evening as we actually have internet, so I get the chance to blog a little bit for you all. The compound is much nicer than most places we've stayed as it's actually a hotel. There's a giant pool, which is probably filled with some nasty stuff considering all the college kids that have been jumping into it, and I'm sharing a room with 3 of the senior guys, but I get the giant full size bed, and the room is air conditioned.....so yeah, the place is nicer than most places I've stayed overseas.

The flight went well this morning. We arrived at the airport at 3:30am and got all 35 of us checked in. We flew to Miami and then quickly headed over to the other gate to head off to Honduras. I'm not 100% sure where we are quite yet, so I'll need to update you on the specifics of the area and such. So stay tuned. I know we drove about 2ish hours to get to the hotel and then we drive about an hour and 45 minutes to get to the community where we'll be working. I just don't know much about the layout of Honduras yet, but I will in the next few days. Having internet will help a lot.

Dr. Pilch, a doctor of nursing, and myself are the three doctors on the trip, though there are two Honduran doctors joining as well. Dr. Pilch, me and one of the Honduran docs will be running the clinic, the doctor of nursing, Noel, will be doing a lot with the triage and glucose screenings for various patients, and the other Honduran doctor will be running the gyne clinic.

Basically today we just had some debriefing sessions and talked about the plans for the week. Tomorrow we will be heading out into the community to give the kids a chance to see the population they are working with, and then we will come back and sort the medications and get ready for the clinic Wednesday through Friday. Saturday will be a debrief and some sort of community activity, and Sunday we head home. Short trip, but they expect us to see about 300 patients a day, so it will be a busy clinic. Hopefully I'm up to the task....but Dr. Pilch will be nearby to help me when I have questions, so I'm not too worried.

They fed us pretty well -- typical food you would expect here: rice, beans, chicken, veggies, some traditional soup, fruit. I"m sure most meals will be the same.

Going to try to keep these blog posts shorter than the Africa one, so that's all for now. Going to go chill with the group and rest up for the night. Thanks for reading.