In the summer of 1999 Kate was hand-picked to participate in a National Geographic expedition whose mission was to determine whether it was possible to successfully navigate all 550 miles of the Ethiopian Blue Nile.

It was the morning of another day on the river, but it wasn't going smoothly. As we pushed off, I was caught outside the raft. The river bottom sloped away so steeply underfoot that I was quickly pulled into the water. The raft nosed into the swift downstream current. Clinging to the rope, heart pounding, I screamed for help, but through the chaos of pouring rain and people shouting from the riverbank, no one could hear me. I realized it was possible to feel more secluded than the Blue Nile already was.

And then thoughts of Nile crocodiles overshadowed such contemplation.

Zelalem, an Ethiopian member of our expedition, finally heard me and helped me to safety. I had been rinsed (but in no way washed) by the thick, brown, rainy season waters of the Blue Nile. It didn't matter. We were filthy anyway, from three weeks camping alongside the river, and six days of trekking before that. Fortunately, fashion was our last concern. The real question was whether it was possible to successfully navigate all 940 km (550 miles) of Ethiopian Blue Nile from its source to the Sudan border.

The lure of adventure dangled over me last June. I was content at home in Lowell, when the phone rang. Out of the blue came an invitation to fill in as trip medic for a physician who had just cancelled. Because of the extreme hazards, the team was being hand-picked. Sponsored partly by the National Geographic Society, the team included three of their journalists: a writer, a photographer, and a videographer. There would be three professional, world-class oarsmen to manage the rafts, and two Ethiopians to translate and provide logistical assistance. In addition, we would have donkey drivers for the trek, and armed guards from the Ethiopian militia on parts of the river. It would be my job to bring the group through in one piece.

This particular journey had never been done from start to finish. No one had even attempted it in 30-odd years. On the few prior expeditions we knew about, someone had usually died due to crocodiles, drowning, or angry native people. I was being invited to join a rigorous expedition in the heart of a developing nation.

As a two-time graduate of the National Outdoor Leadership School, a former mountain rescue team member, an experienced, certified paramedic, and someone who had traveled in developing countries, they liked my credentials. Still, I'm a regular person a routine life — family, pets, job, mortgage, household to manage. But you get to thinking. A raging torrent halfway around the world, living literally for the moment, with no planner, no pager, and no plumbing. To live for five weeks beyond the end of the road, outdoors. To do something no one else had ever done! The final decision rested with my family. When I pitched it to my husband and daughter, bless them, the support was immediate and wholehearted: "Oh, you have to do this!" That's how we are at our house.

The potential for calamity was huge and relentless. Even a "simple" sprained ankle could have been disastrous out there. Or a snake bite, or a near-drowning. Although my medical director authorized me to "supersize" my paramedic scope of practice to include administering oral antibiotics and suturing/stapling capability, I was very limited. My first aid kit, which seemed so satisfactory leasing home, soon felt utterly inadequate, especially after the messy Betadine leaked the second day. Without X-rays or other diagnostic tools, I could usually only pro\ide temporary relief with an over-the-counter analgesic or antacid.

"lzo!" I'd say to the men. "Izosh!" if she were female. "Be strong! Have courage! "

My work as trip medic re-inflated skills honed years ago, but unused in recent years. Many times, I'd quietly bolster myself by uttering, "lzosh!" under my breath. The 60 km of trekking paralleled the Blue Nile on a narrow trail never before traversed by foreigners' feet. Once, I found myself mid-thigh in racing tributary waters that were quickly rising from the afternoon rains. It took courage to enter and strength to cross. When four of our group were washed off their feet, the trip medic was anxiously praying for open airways and intact bones. They managed to escape, exhausted but unharmed, before reaching some nasty downstream rapids. One of the grateful Ethiopians made an offering of bread to the river.

Although I gave medical care and advice to my team frequently, my skills were in greater demand by the villagers. I was sometimes swamped once people discovered there was a "doctor" nearby. Both highlander Ethiopians (on the six-day trek and first six river days) and tribal Ethiopians (on the final 12 river days) presented me with medical challenges. The only time I didn't have regular "clinic" hours was in the infamous Black Gorge, where for six days we saw no sign of humans at all.

Even in the Ethiopian highlands, the presence of "ferenj" (foreigners) caused great excitement. Among us were citizens of Canada, Australia, and the United States, including Alaska. Two of us were blonde, and several had blue eyes. There were three women. We ranged in age from 21 to 65 years old. Our messages were sometimes confusing: Two men had long hair, and the women sometimes wore pants. But the diversity of the group itself was a refreshing contrast to my daily life in West Michigan. And because we were the very first white people ever to come to the people of the rural Blue Nile watershed, I began to appreciate diversity on a deeper level.

"Abay Wenz" (meaning Grandfather River, the villagers’ name for the Blue Nile) is a holy body of water. Aside from a few dugout canoes for crossing the river, there was lio other river traffic. No one called ahead to notify them that we were coming. But instead of reaching for their guns, spears bows or arrows as we feared they might, they reached out to us with impressive open-mindedness and curiosity.

We were met with enthusiasm, handshakes, and direct eye contact. "This is history!" they'd say. "Salaam! Salaam!" Hello! We were often invited to villages for coffee, a tour, music, or maybe to chew some fresh-cut sorghum. Over and over, I found myself sitting with people who held their black arms to my white ones in disbelief. They inspected my soft palms, my blue eyes. They marveled at our body hair, especially on the men's chests. When the time seemed right, I removed my Grand River Pony Club baseball cap, and offered to let them touch my shoulder-length, brown hair. For people with no body hair and extremely short head hair, it was shocking to learn that my hair grows waist-long, as I explained non-verbally, and that I choose to cut it.

More often now, time will be measured from the date of our visit in many of the places we stopped. The woman in labor who I examined (hours from delivery) may well tell her child of being born "when the ferenj came." The village chief who asked me to come to his dying father might remember that sad time, too, by my efforts to comfort the patient and his family.

Overall, villagers were impressively strong and well. But there was no Lamaze, and no hospice, either. And there is a lot of chronic disease in Ethiopia, including hepatitis. What could I do for someone with such debilitating and likely fatal illnesses? I certainly could not refer them to their HMO for placement on a transplant list. Everyone wanted to know if we had medicine for malaria. What an uncontrollable scourge! I'm grateful to be back in Michigan where mosquitoes are basically just a nuisance.

I will always wonder about one little boy named Abush, who walked a long way to find us. He'd been attacked by dogs while trying to enter a village to beg for food several days earlier. About 10 years old, Abush was an orphan, completely on his own. He had badly infected cuts, but his fiery spirit inspired the entire group.

We accomplished our mission. But as I pass the Grand River, en route now from one everyday errand to another, I consider that the bigger discovery was realizing there is a world beyond well-entrenched routine. It is worth a look.