To the LW, don't waste time and money on Med school. You will end up more unhappy and frustrated than you are now. You seem to think that there will be a perfect way of serving the world out there. There isn't.

You don't say if you are on leave from the institution you left. If you are, I'd go back and regroup and rethink. What do your children want? What does your husband want? What if you could find a way to help people in your old community? What if you stopped and looked at the world you left and what it needs?

You strike me as an idealist. Well, guess what, Daniel Ortega was and IS an idealist (and that's the problem - idealists are extremists). Perhaps a little more pragmatism would serve you well.

Take some time. Don't take on more debt. By all means get out of Nicaragua, but don't take on another pet country without realizing that their mores may not agree with yours.

You have so much. I think you want to give. But you have people right around you who need some consideration as well: your family.

Unless a Nicaraugan coconut hits you hard on the head and reduces you to a simpering mongoloid, you're never going to be happy (and even then you'll only be happy when your belly is full and you don't have a wet diaper). Americans in particular are inflicted with this condition, which seems to cause them to think that not only CAN they be happy, but the universe OWES it to them. All you have to do is go live among brown earth-tilling peasants or go to medical school or have a baby or buy a bigger house or have a baby with your lesbian partner or finish your novel or get a new / improved husband / boyfriend / girlfriend / pet / car / MP3 player ... etc etc etc. Forget it. It's not going to happen. If it were possible to be happy, someone a lot smarter than you or me who lived a long time ago would have figured it out and we'd all be doing it.

Our species is hard-wired for endless striving. I don't care what that "toxic" American culture that you've carried right with you into the Third World that turned out not to be so picturesque tells you: there is no path to happiness. You can spend the next decades of your life fruitlessly attempting to defy this truth, or you can accept it, and do what's best. I didn't say what's right, I said what's best. You're going to have to figure that out on your own.

And for Christ's sake, honey, if you can't handle a few blackouts and some semi-hostile stares, get you and your family the hell out of the Third World NOW. It's not going to get any better any time soon.

A-freakin'-men. I can't tell you how many girlfriends I've had who've given me the same party line that boils down to "Among these people I am so useful and admired, and feel so good about myself."

OR

"Among these people where I have brought my mighty whiteness I am not loved for it, even though I so love their blighted brown-ness and want to help them because of it."

Of course, when I was teaching in the ghetto, among a panalopy of colors I was not experiencing the real world because I was choosing to stay in the US, and earning a living so I could buy an I-pod and a nicer car. For shame.

I got some news for you. All those brown (and other) earth-tilling people would be overjoyed for a chance to be poisoned by the toxic blend of capitalism and middle-class opportunity affording this woman. Screw tilling the freakin' soil!

So figure out what you want to do, LW. You didn't like teaching. Fine. You didn't like living in Nicaragua. Perfectly plausible. You like working with pregnant women, and are satisfied when you're needed. Teaching in an area where there was no struggle wasn't satisfying. Having enough money, and also being surrounded by people who had enough money was frustrating to you. You wanted to be somewhere where you had more, and could be benevolent, and also appreciated for your benevolence (which everyone seems to think goes hand in hand, but lo, it sure doesn't. Not by a long shot.)

So rather than running your family into huge debt and turmoil with medical school figure out how to invest what you have wisely, figure out if your husband is going to work, and perhaps find a teaching position at a school for pregnant teens and at-risk kids (I did that once. Those kids were hilarious. I had to sub for their gym teacher. Try teaching gym to a buncha pregnant girls. We sat under a tree and discussed birth control and how to prevent future teen pregnancies. Then we made daisy chains. No lie. It was a delightful afternoon.) Perhaps volunteer at a free clinic in a neighborhood with people who are down and out, but not tilling the soil. They may not love your benevolence either. But you'll still get to go home to somewhere with clean floors and regular power.

Create a program for impoverished single mothers to have better access to care. Create a charter school for pregnant teens. With your background you'd be ideal for this. Find your place among health care workers while still utilizing the skill set you have. Maybe learn a new skill set. Turn your philanthropy to people who will demonstrate appreciation by holding charity functions. No one who chooses to attend a charity function glares at the host. And someone always donates usually decent wine. Much nicer than Nicaragua.

My first year as a high school teacher (in a regular school, not a high-risk program, or night school) 15% of my students were parents, or were in the process of becoming parents. One girl went into labor in my classroom. You'll find where your skill set fits if you want to.

Good luck