Surviving paradise 365 days a year

People talk about cashing in everything and moving on to the place of their dreams. Sure, people talk about it, but how many are really willing to make it happen? How many are ready to pull up stakes and recreate their lives thousands of miles away from everything they have known for decades?

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by Anne Nugent Guignon, RDH, MPH

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The moment Judy Shimamoto, RDH, realized she wasn't responsible to anyone but herself and there were no compelling reasons to stay in St. Louis, it became obvious that it was time to trade her skills for a personal adventure and new experiences. She became a woman on a mission — a woman who was going to do something different with her life. The search was on, and here is her story.

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Judy Shimamoto relaxes in the Kwajalein Lagoon after work each day.
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A couple of years ago, Judy told me she had applied for a clinical dental hygiene position in the Marshall Islands, a little piece of paradise smack-dab in the middle of the Pacific Ocean. I thought, "OK, we'll see what happens."

While this may seem like an unusual thing to do, I actually understand this type of mentality. At age 70, my mother — who was still working full time — said, "I think I'll retire and move to Paris." She didn't mean Tennessee or Texas. She meant the City of Lights. She put her things in storage, leased her house in Virginia, and set off for the Left Bank. After living in Paris full time for seven years, my mom now splits her time between her grandchildren in the United States and her second apartment in the fifth arrondissemont. So, I am a champion of women who want to move on after their family responsibilities change.

What prompted Judy to make her move? Her children were grown. Was it wanderlust? A desire to travel? A midlife crisis? Hormones, accompanied by a desire to wear fewer clothes?

"The answer to all of these questions is probably 'yes.' Although wearing fewer clothes is an added benefit, it was never a goal," Judy said. "I started looking for an overseas position when I realized I had reached a different stage of my life. I suppose that could be seen as a midlife crisis, but midlife crossroads might be a more accurate term for that time, if 50 is midlife."

Trying to find the core reason for the move, I asked Judy if she had ever imagined doing something like this.

"Never," she said. "I married young and didn't travel as some young people do before they start families. Sometimes people travel after retirement, but I knew that I would not be able to afford much traveling once I retire. So this is a perfect solution to my wanting to see other parts of the world."

Judy's proposed move to the middle of the Pacific was fascinating. She kept me informed about her progress via email. She wrote me about her interviews and the physical exam requirements. All of a sudden, she put her home of 28 years and all of its contents up for sale. The move was on. Just like my mom, she really pulled up stakes and moved across the planet.

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Shimamoto's one-room abode
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It intrigued me to see another 50-plus-year-old woman say "aloha" to all that she had known. Judy left St. Louis, the only community in which she had ever lived. Why did Judy do this, and how is she faring three years after starting her life over on a small tropical island in the middle of the Pacific Ocean? Her answers were an email and international date line away.

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Down deep with granddaughter Lauren
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A long-distance interview is so easy with the Internet. I sent Judy loads of questions, and early on a Monday afternoon, her answers and photos started arriving in my computer inbox. It was already 6:30 a.m. Tuesday in the Marshall Islands. What an amazing world. We felt connected. She was getting ready to ride three minutes to work on her bike while I was counting spring raindrops on the windowpane and writing her story.

Judy didn't have a lot of concrete expectations about her move, other than she would be practicing dental hygiene and living dormitory style in one room. In July 2001, she moved to the Kwajalein Atoll in the Marshall Islands. For those of you who don't remember your grade school geography that well, an atoll is a coral reef surrounding a lagoon. The Kwajalein Atoll is home to an Army installation that does missile testing and is made up of 98 small islands encircling the world's largest lagoon. Judy, along with some 2,000 residents, lives on the largest island, approximately two miles wide and half a mile long. Most residents are contract workers or military families.

She, another hygienist, and a dentist provide dental care in a modern office for contract workers and their families. This is where similarities to her life in St. Louis end.

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Shimamoto enjoys taking pottery classes.
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"My workday is much the same as in any dental office in the United States. However, I ride a bike to work, eat in a mess hall, live in a one-room BQ, and the weather is always warm," Judy said. "I rarely feel that sense of urgency that is so constant in the states. I don't own a car — no one does. Personal motorized vehicles are not allowed on this tiny island. So I don't deal with car payments, insurance, maintenance, or traffic. I don't even know what a gallon of gas costs. Because the commute between my room and the clinic is three minutes by bike, I have time after a full day at work to enjoy something else, such as snorkeling before sunset if I choose. I am reminded of a line from the musical 'Porgy and Bess:' Summertime U and the livin' is easy."

Judy misses her two sons and 15-year-old granddaughter, Lauren. Even though they talk weekly and stay in touch by email, she's still not there to share their everyday experiences. This has made her aware of the trade-offs people make in life. Since she is halfway around the world, she didn't attend her granddaughter's school play or see the dress she wore to her first dance. But Lauren took scuba lessons when she came to visit last summer, so they were able to go diving together.

"How cool it that? I got to scuba dive with my granddaughter," Judy said. "That was the highlight of my summer and an experience we could not have shared in Missouri. And for the time being, that is a trade-off I'm willing to make."

There is always something to do on the island, Judy said. Because it is a military installation, there is a community-activities department that provides sporting activities and entertainment for everyone. Judy and other singles enjoy the casual, communal eating. The beach is a natural gathering place. There are plenty of opportunities to snorkel, swim, scuba dive, take a boat out just for the ride, or to look for dolphins.

Judy is also learning about the culture of the Pacific Islanders, the Marshallese. Since she's been on the island, Judy has taken classes in international cooking, astronomy, computing, and Marshallese culture and language. Now she's learning to make pottery and knows it will be a lifelong hobby. Another of her favorite activities is watching sunsets over the lagoon or watching the night sky. From Judy's perspective, one of the most relaxing activities is watching the sea roll into the shore. To Judy, it's like a mental message — or does she mean mental massage?

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Air Marshall Islands
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Judy had to pare down her life for living in one room. She created two separate living environments from one square space. A Japanese shoji screen and high-topped desk create a bedroom of sorts. Her bookcase is filled with an essential hat collection, which helps protect her fair skin from the tropical sun. Most of the hats came from friends before Judy moved to the island. While she tries to protect herself by using SPF 50 sunblock, she covers up in direct sunlight. Despite her efforts, Judy's battle with the sun's harmful rays is never-ending.

"I have a farmer's tan on my neck and arms and a Birkenstock tan on my feet. But the funniest looking tan is one on my hands. Because I ride a bike everywhere, the back of my hands are tan, but not my fingers because they are curled around and under the handlebar grips," Judy said.

Now, for some of the assorted non-essential, but intriguing questions one must ask a person who has chosen to live on a tropical island in the middle of the Pacific:

What do you crave that is not on the island? Fresh-picked, right-off-the-vine tomatoes.

How long does it take you to get regular mail? Up to six weeks!

Do your buddies send you care packages? Sometimes. Especially my friend, Mariann Cappadoro, RDH, who has sent whatever I have asked for and more.

Since it is a military facility, is there a PX? No, there are two stores. One sells food, the other merchandise. Both the food and merchandise are less expensive than it should be, considering the cost of getting it here.

What is the most amazing thing you see when you return to the United States? People on cell phones, anywhere and everywhere; a constant sense of urgency; traffic; and the smell of exhaust in the air. (An interesting commentary coming from one with roots in the heart of the Midwest. Has island living clarified her thoughts?)

The hardest thing for Judy to accept about being on the island is the lack of dental care available to the Marshallese people. Those who don't live on her island are not eligible for care in the clinic where she works. When Judy first arrived, Jan Budo, RDH, the other hygienist in the clinic, discussed the possibility of doing something for the 13,000 residents of a neighboring island. There is only one dentist, and care often is limited to extractions. After examining the overwhelming need, they decided education would be their best contribution.

Judy knows education is only part of the solution, but it can still be rewarding. In the spring, she gave a presentation on diabetes and oral health for 75 diabetic Marshallese at the hospital. In gratitude, the attendees thanked Judy, doctors, and nurses who care for them by singing native songs and presenting her with a handmade shell necklace.

When asked if she ever gets sick of the sand, sea, and tropical breezes, Judy comments that other people on the island tell her she'll miss snow after a while. So far, that hasn't happened. Even though Judy knows her current environment is one that many people would choose for a vacation, island fever can be a real threat. She takes every opportunity to travel. She has managed trips to New Zealand and the ADHA Annual Sessions in Los Angeles and New York City. Her current travel plans include Bali and the RDH Under One Roof conference in Norfolk, Va., in August.

There are 29 atolls with a total of more than 1,200 islets and five islands that make up the Marshall Islands. Judy has spent some time island hopping — a real adventure compared to the typical tourist island hop you might think of. A flight on Air Marshall Islands to another island is an adventure in itself. The airline fleet consists of two small planes that land on dirt runways and only hold a few passengers who are forced to squeeze in between the cargo and life rafts. Native Marshallese often bring squawking chickens and homemade brew aboard. Pilots are known to change flight plans because of darkness. Judy also took a trip to Pohnpei — a volcanic island — because she needed the vertical geography. Terrain in Pohnpei was a welcome contrast to the Marshall Islands, which are flat coral reefs.

Judy was active with the Greater St. Louis Dental Hygienists' Association and misses that type of professional connection. She says professional colleagues are invaluable and that we need to stay connected to others with similar interests and problems. She reads every dental hygiene magazine that is published and also participates in the RDH Yahoo email group.

Once a year she goes off island for continuing education and reconnects with her dental hygiene friends. She has mixed feelings about not being in Missouri to help with this year's legislative struggles. For one who has served her local dental hygiene association for many years, Judy is candid about being so far away.

"On one hand, I feel guilty about not being there to help," she said. "On the other, I'm glad I haven't had to deal with it."

What words of wisdom would Judy give a fellow professional looking for a position abroad?

"Exhaust all possibilities," she said. "When I started, the Internet was not what it is now. I wrote to dental societies around the world looking for a place that needed hygienists and one that would be willing to accept my Missouri license, answered ads listed in our professional journals, and sent applications to agencies that fill medical/dental positions."

Fortunately, Judy's dental hygiene friends knew she was looking. Lisa Shropshire, RDH, saw an ad in the St. Louis Post Dispatch. She called Judy immediately. "I never expected to find an overseas position in my local newspaper," Judy said.

How does someone find a position such as Judy's?

"These days, the Internet is the all-knowing, great and powerful Oz," she says. "There are many job search companies. Sometimes, there are overseas dental hygiene positions advertised on their sites: www.dental workers.com, www.dentaljobs.net, www.escapeartist.com, and www.Medhunters.com are a few. Military Web sites will sometimes list an overseas civilian position. Applicants can even submit a resume and ask the site to send new listings to them."

It took five years from the time Judy started her search until she set foot on the island. Her suggestion is to act immediately if you find a position that interests you. Even though Judy had seen the ad for the Marshall Islands position many months earlier, she did not sign her contract until the February before her departure, four months later.

The hygienist Judy replaced gave the company nearly a year to find a replacement, but then asked for an extension. It worked in Judy's favor. She had plenty of time to sell her house and work out other details that cropped up.

Her perspective on life and how she views the world has changed during her time away from the mainland.

"I wish I could say that travel is broadening and making me a better or wiser person," she said. "However, I must admit that I've become more egocentric. Now, that may have happened anyway. I no longer need to think of others first, so I get to think about what I want. And I'm taking full advantage of the opportunity."

When questioned about whether there was anything she would do differently, Judy said maybe she would have taken this adventure sooner. Bold moves such as this often overwhelm people with regrets, but not Judy.

As a friend, I just had to ask, "Are you ever coming back?"

"Eventually I will leave, but I have just signed another two-year contract," Judy said. "This has been a wonderful experience, and I'm not ready to give it up yet. In fact, it has been so good that when I leave, I may try to recreate the experience somewhere else."

Judy's recent fantasies include living in Italy and traveling about Europe. What could be wrong with that?

My final question was one I just couldn't resist: "Have you ever thought about hosting a CE course in your own backyard?

"Are you offering?" she said. "Let's talk."

I couldn't help but chuckle at her quick wit and succinct reply. The wheels started moving. What do you think? RDH Under One Roof in the tropics? Better alert the meeting planners at PennWell and get stocked up on sunblock.

Anne Nugent Guignon, RDH, MPH, is an international speaker, has published numerous articles, and authored several textbook chapters. Her popular programs include ergonomics, patient comfort, burnout, and advanced diagnostics and therapeutics. Recipient of the 2004 Mentor of the Year Award, Guignon is an ADHA member and has practiced clinical dental hygiene in Houston, Texas, since 1971. You may reach her at anne@ergosonics.com or (713) 974-4540 and her Web site is www.ergosonics.com.

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