I came here at a turning point. I had just graduated college. I was in that in-between space before PA school, and I was looking for something that felt meaningful to do with the time in front of me. I found the MVC program and fell in love with the idea of it—the mission, the community, the service, the chance to do something that actually mattered during what could have just been a waiting period. But what I found when I actually got here was so much better than anything I had read about.

I want to be honest, though. I came here not really knowing what I was fully signing up for. I knew it was going to be hard. I knew I was going to be far from home, and I knew I was going to be pushed in ways I could not fully anticipate. I had my EMT background, which gave me some footing going in, but there is a difference between knowing something is going to challenge you and actually living inside that challenge every single day. Nothing could have fully prepared me for what these six months have actually been.

I am serving in the Emergency Room at St. Joseph Mercy Hospital in Georgetown, Guyana. On day two of work, I was left alone at the triage station, responsible for taking vitals, recording chief complaints, and deciding whether patients needed to be redirected or wait for the ER doctor. I was terrified. I remember standing there thinking everyone around me was going to find out very quickly that I was still figuring it out. The learning curve was steep and immediate, and there was no easing into it. This was just my life now, and I had to rise to it.

And slowly, week by week, I did. I learned how to do IVs and injections. I learned how to read and interpret doctors’ orders. I learned how to take blood, administer treatment, handle billing, and carry a patient through their entire visit—from the moment they walked in to the moment they left. I started doing solo ECGs and actually feeling proud walking away from them. Now, over six months in, I am functioning as the only nurse some patients ever see. I triage them, execute their full care plan, and send them on their way. I am someone patients rely on completely, and honestly that still feels surreal when I stop and think about where I started.

What I did not expect was how much the work would go beyond the medical tasks. One of the moments that has stayed with me most was a conversation I had with the ER doctor during a quiet shift. He had found an article I wrote about violence against women, and it opened up a real conversation about domestic violence in Guyana and how it shows up in our hospital every single day. The rates here are devastating, and the support systems for women are incredibly limited. What we can offer in the ER is compassionate care—making women feel safe and seen for however long they are with us. That conversation shifted something in me and reminded me that showing up fully for the person in front of you is at the heart of everything this program is about. That is the Mercy mission in action, and I feel it most on the hardest days.

Stepping outside my comfort zone here has not just been about medical work, though. It has been part of my life here. Moving to a country I had never been to, learning to live simply in ways I had never experienced before, hand-washing my clothes, filling my own water jugs, adjusting to a heat that still catches me off guard, cooking with completely new ingredients, and navigating a new city and culture entirely from scratch. None of it was easy at the beginning. We even all got typhoid fever, which was genuinely one of the harder moments of the year and not something I saw coming. But even that taught me something about pushing through the unexpected and showing up again the next day anyway. This experience has a way of doing that to you.

Somewhere in the middle of all that difficulty, something shifted. Georgetown started to feel familiar. The hospital started to feel like mine. The people around me started to feel like home. My market lady calls me “baby” and pulls me in for a hug before I leave every week. My coworkers bring me local food to try, surprised me with food on my birthday, and have become some of my closest friends here. I have a routine I genuinely love, friendships that have changed me, and a deep connection to this city and this community that I did not expect to find so fully.

Something else I did not expect was how much this year would give me back to myself in quieter ways, too. At home, life moves fast and I was always on to the next thing, but here I have actually had time to slow down. I have been reading more than I have in years, journaling every single day, baking, making friendship bracelets, watercoloring, and just doing the things that fill me up that I never seemed to make time for before. There is something really grounding about a life that has space in it. I did not realize how much I had been missing that until I found it here, and it has made me think a lot about how I want to carry that intentionality home with me when this is all over.

Part of what has made this year feel so complete is getting to share pieces of it with people I love from home. My little sister, Eliza, came to visit and we spent five nights in the remote South Rupununi savannah at a ranch where we rode horses, herded cattle, and were more off the grid than either of us had ever been. Then my parents came, and we had what I can only describe as the most incredible trip of my life. We flew in a tiny prop plane to Kaieteur Falls, the world’s largest single-drop waterfall. We stayed in an eco-lodge deep in the Amazon rainforest on the Essequibo River. We walked a canopy trail through the treetops, watched a Victoria amazonica bloom in real time from a boat on the river at night with rum in our hands, saw giant otters and capybaras and rare birds, and camped under the stars in the middle of nowhere. Getting to be that present and that remote with three of my favorite people—watching them fall in love with this place that has become so deeply important to me—felt like everything. They got to see me in my element here in a way that I think I needed as much as they did. It made everything I have built this year feel even more real.

I chose to come here because I wanted to be brave enough to show up somewhere completely unknown and figure it out. And what I found was so much more than a gap year. What I did not expect was how much I would learn beyond the medical skills, and that growth alone has been enormous. What these six months have really taught me is how to show up for people, how to build a life somewhere unfamiliar, how to find community in unexpected places, and how to keep going on the days when everything feels hard. Those are lessons I am going to carry into PA school and beyond.

And honestly, the most exciting part is that I am not done yet. I still have months left here, and I know I have so much more to learn—from the work, from the patients, from this community, and from this place. The Mercy mission is not something that stays in Guyana when I leave, but rather something I am taking home with me and continuing to grow into. I came here at a transition point in my life, looking for something meaningful to fill the space. What I found was something that is going to shape everything that comes next.

Lydia Stein: Georgetown, South America