American Airlines. Flight 931. From the north side of America to the south. Still the same continent- i think to myself -hushing any hesitation that slowly creeps into the back of my mind while spanish speaking patrons surround me in weathered leather chairs.

Granted, I´ve been there before. Recently even; yet, when i try and squeak out a gracias or buenos dias I soon realize the linguistic rust that will need to be brushed off before i feel overly comfortable on the equator. I say my goodbyes to deep-fried golden arches and roasted mermaid’s coffee. At the gate, the last seconds in my homeland slip and drip away like drops of rain racing down the oval window next to me. Belt fastened, Skymall scoured, take-off awaits.

Habitually, I find that the best way to deal with my impending stress is to snooze it away…

Sleep, although soothing, comes about as easily as a metallic cart pushed down a path far-too-narrow for its own good. Each time the edges bump another set of exposed legs- I turn to make sure the clanking isn´t a rivet reluctant to do it´s job- i wake up suddenly, then dose off again. My neck kinks and cramped knee-caps suddenly become noticeable. Pain, however, is all relative. I feel lucky that mine is coming from the mix of a 21st century flight´s economy class, and a body economically blessed to the extent of excessive growth.

Looking over the wing I’d believe we were submerged in a sub if it weren’t for the hum of engines and air conditioning. Floating, flying through a sea of never-ending white. Enclosed by double thick windows and safety belts the impending trip to Ecuador is as unwritten as the emergency procedure cards are unread. In this ocean of blank clouds, I begin to drown in the possibilities of medical brigades and struggled translations; as altitude increases, my frames of reference shrink.

When the flight attendant comes down the aisle, he serves up options and pre-packaged consistency. As if the gift of flight wasn´t enough; we´ve banished the wright brothers dreams to the dungeon wishing upon ever further stars to furnish our flying with televisions, first class cuisine, and individually catered drinks- dulling the fact that gravity may some day win this battle we´ve waged. Our persistence, our resilience, though, is breath taking. It’s beautiful. It’s exhilarating. For me, it’s much more than an opportunity to help those undeniably in need. It’s a chance to take my own dreams in public service and medicine, throw them to the side, and redefine what I consider well-being- redefine what I know of global health.

Cars turn to ants marching single file to shopping malls. Houses – like legos- litter a smoothly shrinking horizon. Fields unfold checkerboard patterns that solidify the departure, diminishing to nothing more than a blur of green, amber, and gold against the   shoreline. Meanwhile, the reality of the journey I’m embarking on begins to sink in like the slow popping of ear drums- new boundaries reached. State lines crossed, give way to foreign borders; fields of grain turn to boats and blue.

From Denver, to Miami, to Quito.

In one short day I traded purple mountain tops for andean adventures. What this really entails- I’m about to find out.

Over the scratching speaker I catch the captain declaring: “Bienvenidos a Quito”…