A Cross Necklace

Being a Christian refugee in this part of the world is a dangerous affair.

Unlike in America, where counting oneself a Christian is increasingly perceived as a designation that affords privilege, sometimes to an unfair degree (I have my doubts on that one), there is no question that the opposite is true in much of the Middle East.

It is easy to see that militant Islamists are actively focused on the eradication of Christianity in at least “Muslim” lands, if not the whole world. This is true to some degree in the refugee camps as well.

Even still, many of the refugees we worked with this week are either committed Christians, or are actively exploring the faith.

The stories of how these people came to their decisions for Christianity vary widely, but most are eye-opening. Few in the Middle East can come to Christ as easily and risk-free as nearly every American can if they wish. Apostasy from Islam is often regarded as an offense punishable by death.

One man I saw this week was openly wearing a prominent silver and gold cross around his neck. I didn’t notice it at first, but as I was listening to his heart with my stethoscope the bright golden object swinging in front of me was suddenly hard to miss.

crossRealizing I wasn’t in America, where crosses are so ubiquitous they’ve become a little trite to me, I exclaimed, “You’re wearing a cross!”

“Yes,” he nodded.

I pondered the implications of wearing that specific symbol in the Islamic world. A cross is better described as cross-hairs for a man like him. Yet he wore the symbol proudly, unapologetically. Should our roles be reversed, would I have the same courage?

“You are a Christian then.” I said, continuing in my new role of Dr. Redundant.

“Yes.” He nodded again, smiling.

Through my translator, I learned that a few months ago in Iran he was awoken in the night by the figure of a man calling him to follow Christ. He said he was convinced that the man speaking to him was Jesus, the Son of God. He knew almost nothing of the Christian faith, as he was raised a Muslim.

Still, upon waking the next day, my patient committed himself for following Christ. He felt he had to do this. It was an inner compulsion; he had been called to a new faith, a new life, no matter the cost to him.

But it was indeed a ‘costly’ decision. Read anything about the Islamic regime of Iran (I recommend the the wonderful autobiography Persepolis as a cursory intro if interested), and you will know that the government of Iran is itself a religious organization. Along with typical functions of any secular government, like providing running water, working roads, electricity and health care (which in many instances, the Iranian government does quite well), it also enforces a highly conservative interpretation of Shia Islam.

How do they enforce such a thing, you ask? How do you get a nation of 77.5 million people to follow extremely strict religious rules? How can you enforce an entire nation to put every woman in robes and headcoverings, to allow no music, no dancing and to enforce frequent observance of Islamic practices like 5x daily prayer?

With “religious police” of course!

As a kid from the suburbs of America, following a Christian faith I was always free to reject, it took some reading and imagination for me to even comprehend such a notion.

It was only in 1979 that the Iranian Revolution took place. Prior to that, Iran probably looked much more like America than it does today. But in ’78-’79, things changed dramatically, as that was the year of the Iranian Revolution. It was then that the Pahlavi dynasty, led by Mohammed Reza Shah Pahlavi was overthrown by the Islamic Republic.

revolution
Supporters of the Revolution. Didn’t Turn Out Like Many Expected.

The Republic was initially a political movement, comprised of a collection of leftist thinkers, activist students and numerous Islamic movements. It was led by a powerful Islamic leader named Ruhollah Khomeini, a scholar, author, politician and political revolutionary.

After the Shah was forced from power, to the surprise of nobody, Khomeini was designated as the Supreme Leader of Iran. However, TO the surprise of many, Khomeini was given final authority on both political and religious matters.

The irony of this transformation is hard to miss. Criticism of the Shah centered around how difficult it was for the commoner to be heard. The Shah’s rulership was a dynastic monarchy, with power passing from father to child generation after generation. This meant that nobody could rise from, say, a community organizer and member of a minority comprising 13% of a nation’s population, like Barack Obama, to the highest position of power in the land (Huzzah! Huzzah! Democracy!).

Yet the solution to this problem that emerged in Iran was the Islamic Republic, which consolidated both political and religious power in one man. The power of the rulers of Iran was, effectively, broadened as a result of the revolution. The “little people” never got their say. And, I suspect, many of those who supported the Revolution experienced colossal disappointment. Power just went from one ruling class to another. To this day, a Khomeini rules Iran.

Some version of the above rushed through my mind as I stared at the cross hanging from my patient’s neck. An Iranian, 4 months in Greece, wearing a bright silver and gold cross. Wow.

As it turns out, the father of this man was a member of this religious police force. This patient had chosen to convert from Islam to Christianity as the son of a man who is tasked with enforcing and promulgating Islam in the country. More irony.

Imagine the shame on their family for such an act! Aside from endangering himself, my patient was possibly even endangering his own father (and mother).

Many immigrants come to Europe because they think it is rich, with jobs and money flowing like wine at a wedding party. Increasingly, they are finding that Europe is no utopia. Millions are unemployed. Millions are poor. Upward mobility is rare.

But one reality of Europe is that it does remain a place where you can follow a religion in nearly any any way you choose, to include no religion at all. Say what you will about the EU, but it remains a place of tremendous religious freedom, rivaled perhaps by only the U.S.

So it is understandable that this man left Iran. But it is still amazing that he was willing to do it. He left with nothing. No family, no friends. He slunk away in the night, alone. As the son of an important man, his life had no doubt been comfortable and safe. He upended all of that.

port
Pireaus Port. Lucky you if you have a tent.

My patient arrived at the Pireaus Port of Athens after crossing the Agean Sea from Turkey. He arrived nearly destitute, having given most of his money to a trafficker to get him to Greece. I think he slept on the concrete sidewalk the first night.

The next morning, he says he prayed that the God of his new faith would spare him, and shortly thereafter was approached by members of a Christian church in Athens who offered him a bottle of water. It was through this church that I met him.

ellenikoGreek authorities soon placed this man in the Elliniko refugee camp, where he made no secret of his faith, sharing it with any around him who would listen. Not long after his arrival, a riot broke out in the camp with Muslims targeting Christians.

The violence carried on for quite some time, as Greek police made no move to stop it, one even pointing out that if some of the refugees died, “there will be fewer of them for us to deal with.” My patient was beaten severely in the melee.

It is inhumane, of course, for anyone to think as these police did. But their attitude is understandable nonetheless. Would you wade into the middle of that mess?

Somewhere in this story, my patient picked up his cross. I don’t know if it was in Iran or somewhere in Athens. But he wears it daily. It is not merely jewelry to him, given at some Christmas party. It wasn’t bought from one of the ubiquitous Christian Book Stores in America, with every possible permutation of “cross trinkets” available for sale. It was bought for a price; worn for a higher one.

This isn’t necessarily a Christian story, although as a Christian I find it inspiring. But from this anyone can recognize the deep human desire to worship in freedom. This man’s life story is a reminder that people are willing to die for the right to think and act honestly in relation to their understanding of the divine.

The cross symbolizes the reality of this man’s beliefs, even if that symbol marks him for suffering or even death. Would that all Christendom be so committed. Would that all who cherish freedom be so as well.

Headed Back to Athens

 

The Acropolis in Athens, Greece.
Athens, looking pretty. A rarity, IMHO.

For the second time in less than a year, I’m on my way back to Athens. This will be a short trip with virtually no team. My colleague organizing things in Athens has stated that she “feels sorry” for me, as the number of people signed up for the clinic appears to be quite large.

From what I can tell, the situation in Greece has only gotten worse since I was last there. Many borders and routes into Europe have closed, and migrants are being turned away at far greater numbers than they were last year. But by “turned away,” I’m not describing from Greece itself. Nope. Thousands continue to arrive on the shores of Greece every day. I’m talking about further into Europe. So, the migrant population continues to swell in Greece, especially Athens. Although authorities have begun shipping back some migrants (numbering in the hundreds) in the past few days, this is a small small number.

I say I’m bringing ‘no team’ this time, but in reality this isn’t accurate. Aside from what sounds like a great number of willing helpers in Athens, I also will bring my 14 and 16 year old daughters with me this time. I don’t know what sort of role they will be able to play in the work we do this time. It could be simply watching the children of the patients while they’re waiting the doc.

migrantsHopefully, they can learn a bit about medical care in a refugee and/or underserved situation. As their lives are largely consumed with cheerleading, skinny jeans, teen-lit, French horn, Cello, soccer and boyfriends (ex…EX boyfriends), this might be quite an eye-opening experience for them. I hope so.

My biggest concern is that we will successfully collect accurate data on the patients we see. Last time we did a fair job, under the circumstances, but in my spare time I’m STILL working through the XL spreadsheet and trying to come up with data summaries that will be of some use to the wider medical world.

This time, I hope to have time to ask better questions, and to formalize how we input the data. It is well known among those who do medical research that 80% of the study is done before the study begins. Developing a means to collect data, to college USEFUL data, and to do it in a way that is searchable and accessible at a later date is difficult. It is especially difficult when at that later date, you are dealing with hundreds, maybe thousands of data points.

I’ve had enough training in this element of the medical world to feel a gnawing sense of anxiety as I approach the issue. My medical school heavily emphasizes epidemiology and biostatistics, and I was part-way through an Master’s in Public Health degree until I ran out of money. So I have a sense for how easy it is to do this stuff badly. But I wish I had a collaborator or better skills to know I could do it well.

Still, I’ve had some help from a colleague at work who maintains a quizzical affection for XL (I can’t judge, I was once in a steady relationship with Photoshop), and he has helped me clean up our data from October. And I have a much better sense for what I need to do this time around.

14_athens_imgIt should be mentioned that most relief agencies don’t actually do any of this, even the good agencies who actually help people (lots of them are there for the photo-op and little else, it seems). I received some generous help from a professor at the London School for Hygiene and Tropical Medicine prior to my last trip, and he noted only a small number of agencies who provide care AND do good, statistical research on the populations they serve.

So, it makes sense that I’m somewhat on my own here. It’s not easy to focus on research and practical care at the same time, as one is more empathy-driven, the other much more analytical and “cold.”

Example: if someone comes in coughing up blood, you can either turn and enter “hemoptysis” into your spreadsheet (and then get the heck out of there because…ew), or you can throw on some gloves, hopefully a mask, get them on a bed and start working them up for any of the many many possible reasons for that symptom (most of those reasons being prit-TEE bad).

So, we will see how this goes. We leave tomorrow (Sunday) afternoon.

 

Galatsi

On day 3 we left our makeshift clinic in the 2nd Evangelical Church of Athens to work in one of the main refugee “camps” in town. But it isn’t a campground. It’s one of the main stadia used in the 2004 Olympics, located in the Galatsi suburb of Athens.

The story of how this stadium came to be used for refugees is emblematic of the refugee crisis in generally. The stadium has been shuttered for years, no lights, no electricity. But with thousands of people suddenly camping in parks all over Athens, the people of the city were understandably upset. Furthermore, anti-immigration groups were organizing and preparing potentially-violent opposition to the influx.

So the Minister of Immigration apparently decreed that refugees would be moved to the Olympic Stadium. Only then was the mayor of Galatsi notified of the dictate, while also being told that he was, in fact, in charge of the stadium.

wpid-wp-1444681246447.jpeg
Queuing up for lunch. The food I saw was a step up from David Copperfield-esque porrige, but not by much.

On balance, it’s a good plan. There is lots of room there, the people and tents are out of the parks and off the sidewalks. The Greek Army (I think) has been tasked with feeding the refugees 3x per day, an endeavor equal to any reasonably-trained Army. It also protects Greek political leaders from human rights criticisms, since the people are being cared for while not upending entire neighborhoods.

There is both massive influx and efflux of people from the stadium every day. Nobody intends to stay for long; the Greek government does not plan on operating the facility indefinitely either.

We were given an emergency medical license under which I could function as a de facto Greek doctor on days when I worked at any of the camps. We were asked, really more like begged, to work at the Galatsi camp because over 1000 people were there, with hundreds requesting a doctor.

Here are some observations from that day:

  • 5
    Lots of people, all trying to help. Not a lot of organization.

    We worked out of a small room, filled with donated medicines, even some supplies. It was better-appointed than I expected. It was cramped, sweaty and regularly filled with people for myriad reasons. A hazy notion of ‘organization’ came and went throughout the day.

  • We infuriated the Greek doctor, a pulmonologist, who is overseeing the medical room in the camp. We had been “begged” by the ministry of immigration to come work that day. She was never notified. So our presence was a surprise to her. She wasn’t, however, working. Nobody was. She showed up, yelled at us about attending a strategy meeting in a few days, hung around for a bit, then left.
  • The Greek Government is doing better with this crisis than reported. There
    greecemap
    Areas around Greece where people are helping with the refugee crisis either directly or by collecting donations, etc. Click this pic for an interactive map.

    were police on the campus (until later in the afternoon, when they apparently lost interest and wandered away). There were GIANT piles of clothes in the “clothes section,” and everyone had food at mealtimes. The camping areas were dry and were clean if the refugees cleaned up after themselves (some did, some didn’t). But the same Greek Government has relied heavily on individual donors, NGO’s and privately-funded clinics like ours’ to make this some sort of controlled chaos.

  • Before we started, I watched a T.V. reporter van pull up next to a nice black car, out of which stepped some guy in a suit. The camera started rolling as the guy stood next to a reporter-looking person. There was a quick interview, then some panning shots of the facility. Then the guy got back in his car and drove away. I found out later this was some politician getting time on T.V. “working” at the camp. This is happening on the local Greek news, with dignitaries, including local doctors, posing as helpers in this crisis.
  • The majority of refugees in the camps and on the streets are from Afghanistan and Iran, not Syria. In general, the Syrians have more money and are staying in rented apartments. Usually, those apartments are being sub-let (for a substantial profit) by other refugees. It’s a dog-eat-dog environment.
  • 4
    Quite a few meds. No smokable opium. No opium t all, in fact.

    I saw a patient with back pain who was smoking opium for pain control. He said he didn’t want narcotics for his pain, but also said nothing else worked for him. As our clinic absolutely has no narcotics of any kind, we offered him some non-narc alternatives. He left, unhappy, then returned later, forcing his way through the scrum outside to “complain” about our “service.” Apparently narc-addiction and the behavior it engenders knows no social or ethnic boundaries.

  • Our clinic lead, the Persian woman who organizes these clinics (a refugee herself 15 years ago), wisely did NOT allow advertising when we started our clinic day. Just by word of mouth alone, we were nearly overwhelmed with a shouting, occasionally-pushy mass of people that formed outside our “clinic” shortly after we opened for business. HUGE credit to a great team in front of me to help control and direct the traffic outside.
  • The Mayor of Galatsi, and manager of the camp, is not a happy man. The Greeks dislike him because he’s helping refugees invade their country. The refugees don’t like him because he oversees a camp perpetually under-resourced. The political class over runs him, taking their own photo-ops and garnering the credit for the work being done there. When I met him in the camp, he half-shook my hand, then tersely told me to “get to work.” Can’t blame him.

I was worried to work here for a host of reasons, but I’m glad I went. I wish we could spend more time in the camps. Getting patients to our clinic at the church was a big challenge. No problem here.

Medical Case

image

A 44 year old man came to our clinic today with a description of chest pain, mostly on the left side. He says it’s been ongoing for about 4 months.

He arrived in Athens about two weeks ago, with plans to head to Germany in another week. He was seen last week at a Doctors of the World clinic in town for the same problem.

He says they gave him the above EKG, told him he was having a heart attack, and sent him out the door with 10 pills of Prilosec and instructions to go to “the hospital.”

Due to money restrictions, lack of transportation, minimal confidence in, and maximal confusion from, his interaction with his Greek-speaking doctor, he did not go to the hospital. He instead came to our clinic 4 days later, worried he was dying from a heart attack.

How would you handle this?

Lentils or Needles, Your Choice

church
The Church (not abandoned, as I first thought) were our clinic is located.

We saw around 15 patients on our first day. If I this was a video game (maybe all of life is?), by the end of the day my strength bars would have been around 2/5.

Today we have nearly 30 people on the schedule, plus a smattering of missionaries who seem to filter in with loooong lists of medical questions.

The missionaries are amazing. Most consider themselves to be “married” to the mission field, and are here by themselves, living on donations. And not just for a week. For years.

If you’re looking for “underserved” medical communities, no matter your own personal faith persuasion, here’s one. Most Christian missionaries donated their health and bodies to their work long ago. They see a doctor when they can (read: every 5 years on average), but it’s never a regular thing for them.

One question from a missionary yesterday, “We’re so excited. We’ve been given permission to use an old elementary school from the Greek government. People have been defecating and doing drugs in there for the past 5 years. All we have to do is clean it out, and it’s ours! Do I need Hep B vaccination? I think I had one of those shots. What about that HiB thing? Oh, and what about tetanus. Can’t remember when I last did one of those. And should I wear gloves? Maybe a face mask?”

Afghan migrants arrives on the shores of the Greek island of Lesbos after crossing the Aegean sea from Turkey on a inflatable dinghy, Thursday, Sept. 24, 2015. More than 260,000 asylum-seekers have arrived in Greece so far this year, most reaching the country's eastern islands on flimsy rafts or boats from the nearby Turkish coast.(AP Photo/Petros Giannakouris)
Afghan migrants arrives on the shores of the Greek island of Lesbos after crossing the Aegean sea from Turkey on a inflatable dinghy, Thursday, Sept. 24, 2015. More than 260,000 asylum-seekers have arrived in Greece so far this year, most reaching the country’s eastern islands on flimsy rafts or boats from the nearby Turkish coast.(AP Photo/Petros Giannakouris)

Another story: 12 year old girl with dizzyness. She left with her parents from Afghanastan over 6 months ago, running from the Taliban. The family took a number of cars overland from there to Tehran for around 20 hours. They then hiked from Tehran to somewhere in Turkey for days, eventually finding their way to a huge refugee camp there.

Then the family found a smuggler who, for most of their remaining money, agreed to put them in an inflatable raft for a trip to the island of Lesbos, which is officially “Greece,” and would allow them to begin the process of obtaining refugee status.

They were required to get from the refugee camp to the coast on their own. Upon finding the launch site a few days later, according to the mother, they found that the raft was about 8 feet long, and she counted nearly 30 people in it.

They were turned back by the Turkish coast guard 5 times before they succeeded. Each time they were turned away, they were “towed” back to the Turkish coast, which effectively half-sunk their raft because the front end kept getting pulled under the water. Although some had life vests, many did not, and nobody knew how to swim, so the affair was terrifying.

This young patient started her period 8 months ago. She has had to learn how to be hygenic in refugee camp conditions. She can’t understand why she feels so weak and tired all the time. I asked her how and what she eats.

“We got cookies on the road from Tehran to Turkey. They were good.”

“Do you eat the food in the camps.”

“Ew. It’s always bean soup, and they never cook the beans.”

I smile and look at the mother, she is looking at me, rolling her eyes. “Lentils, usually,” She says through my translator Sahar (and Superwoman). “But I can’t get her to eat anything. She’s my pickiest kid.”

Here I am, a billion miles from my homeland, from any Caucasian, from my life, and this mother is dealing with a UNIVERSAL problem of parenthood.

“I have the same problem in my house,” I say smiling. The mom laughs.

I then look at the daughter, “You are probably dizzy because you are losing lots of blood every month. It makes people feel weak, tired, cold and dizzy. The best way to take care of it is to eat. Cookies are not food.”

I look at the mom, smiling again, but shrewdly. “But I don’t know for sure if this is the problem. I need a,” (imagine the audio slowing down here for emphasis), “BLOOOOD TESST.”

The girl’s eyes widen. “Uh huh,” I confirm. “With a NEEEDLE.”

Cute, 12-year old crestfallen face. “So I’ll make you a deal,” I continue. “Lentils or needles, your choice.” Mom laughs again, getting it.

The daughter, I hope, got it too. The mother and I were able to make light of this, but it could get serious. The girl’s arms at the biceps are thinner than my wrists.

There are more stories from only this first day. To depict them is like trying to pour the entire Mediterranean Sea into a rain drop. It just can’t be done.

This world, these sorrows, these tragedies…they can only be know by walking, even for a moment, with those that are living them.

Tomorrow We Leave

We leave for the refugee clinic in Athens tomorrow.

I intended to blog the step-by-step story for how we arrived at this point. But THAT didn’t happen.

Here are some specifics:

wpid-wp-1443899443776.jpeg-We intend to see approximately 30 patients per day for a week, working half-days on Monday and Friday. I suspect we’ll end up seeing many more than this.
-We will be working in an abandoned church in downtown Athens. We’re staying in a Youth Hostel a short distance away.
-We have access to labs, Xray (maybe?) and some medications but I’m not sure which ones.
-I’ll be using an antique oto/opthalmoscope manufactured by the Riester Company, which was based in, you guessed it, Germany.
-We plan to see Afghan, Iranian, Iraqi and Syrian refugees. There could be many others.
-On the last day we will likely go into a refugee tent camp and set up our medical clinic there.
-Donations continue to roll in, to date over $6000.
-I’m not without a sense of concern. It isn’t lost on me that Americans aren’t the most popular people in the world today, especially in the lands where these people are coming from. On this, the night before our departure, I’m keenly aware of all that I leave behind, and all I hope to see again soon.

Your thoughts and prayers are most appreciated.

Athens, October 2015

Athens has long been a crossroads for refugees trying to make their way from the Middle East into Europe. So when I traveled there with my church pastor, David, this past February to explore the possibility of starting up a medical clinic, we had no idea what kind of summer was approaching.

At the time, it was clear that activity in Syria/Iraq (ISIS territory spans both) was worsening, so we predicted an influx of migrants seeking refugee status in the EU. We knew the numbers this summer would jump. But we didn’t predict anything to the level of what we’re seeing today.

Be advised that anything you read below this blog is from the days when my blog was largely a chronicle of my time in family medicine residency in Olympia, WA. Some of the posts are fun, some whimsical, some serious, some maybe a little helpful.

After residency I moved to Germany and live here still. I’m a practicing family medicine doctor and have long planned on working in international and relief settings. This is the primary reason for moving away from friends and family, and my decision has positioned me well to help with the current crises in Europe.

Can I, and this little clinic we’re building, do much to address these massive problems? Hardly. I understand that. But if lots of people do lots of little things, it can equal one big thing over time. So I’m starting with this little thing.

As such, from this blog forward, I’ll mostly be talking about the work we’re doing in Athens and the topics that relate to that work. Namely, cross-cultural medicine and global public health. If you care about these things, you may enjoy following along as I navigate through this project.

The media element of this project is just getting started, and it’s been awhile since I flexed my creaky “blingers” (that’d be blog-fingers). So bear with me.

However, already I’ve been met with scenarios for our clinic that I hope to present to you, SW101 nation, for input and ideas. This isn’t an easy challenge, with lots of questions that have no easy answers. So approaching this as a community is, I think, a much better way forward than going it totally alone.

So, if you’re willing to jump in with me, thank you, and welcome!

Lenk

switzerland

I recently returned from a church Men’s Retreat in the resort town of Lenk, Switzerland. This was MY kind of ‘retreat.’ The majority of our two days was spent on the ski slopes, not talking about God and theology and right and wrong.

 

I’ve been a Christian since I was 8, so the pastoral lectures and Bible verses never feel especially new to me.

I routinely enjoy the music, and in our case a great band led those times in the evenings, but I was happy to attend a retreat that was mostly just a cheap ski vacation. I met some cool guys, got a little better on a snowboard, and stood in absolute awe at some of the most beautiful scenery I have ever known.

 

I don’t worship God very well through study, or through listening to lectures from pastors. Lectures, ever, haven’t worked well with my brain. Ask any teacher of mine all the way back to 1st grade and you’ll probably get some version of the same mildly exasperated half-smile, and a reply along the lines of, “he really, really TRIED to give a crap.”

 

Adelboden-Lenk

But when I’m in the shadow of the Swiss Alps, with 1,000 year old glaciers clinging to jagged sawtooth ridges in a 300-degree ring all around me, I pay attention. Somehow, breathing in crystal-pure air, with rolling forests and organic dairy farms dotting the countryside in every direction far below me, I have no problem thinking about God and wondering how I couldn’t possibly be closer to His almighty Spirit for that moment.

So, it was a spiritual time for me, but with very little preaching or Bible-studying. Perfect.

 

I was also struck by the unity and beauty of the towns we passed through on our way to Lenk. Switzerland has been highly resistant to change over the years, from what little I’ve read of the country. It is fairly hard to immigrate there, and once you ARE there, good luck building consensus around any particular idea or religious creed that departs from the time-honored ways of the Swiss. Du willst ein Minaret? Das wird nie passieren!

Deutsch: Chalet in Pöschenried, Gemeinde Lenk,...
These, dotting the countryside as far as you can see. Plus snow when it’s winter.

 

 

In Switzerland, you know you are in Switzerland. Especially in the countryside. The buildings are stirringly beautiful, most made of a light-colored wood sometimes set on dazzling white painted rock or concrete bases. The barns looks related to the houses. Everything is clean, ordered, pristine.

This unity isn’t by accident. But it takes enormous force of will to maintain a cultural identity in an increasingly pluralistic and mobile society. To do so inevitably becomes political, with increasingly volatile arguments on either side.

My homeland, America, has never really had a unity of culture and history to this degree. We’re a nation of very few subjugated natives, and very very many immigrants. To walk through my country – or any large American city – is to walk around the world.

Both have their merits (except for our treatment of the natives). But there’s something so deeply peaceful about meandering through a place that knows itself so well. A place that is OLD, and has not forgotten the value of of old things. King Solomon was rewarded by God with power and money because when God offered to give Solomon anything he wanted, the young man asked for wisdom. Any place that honors age, honors wisdom, and God seems to have blessed the Swiss accordingly.

I’m not saying Switzerland is paradise or utopia. There are problems. But they’re getting lots of things right. Here, walking is revered over driving. Food is valued for quality and purity rather than quick access or cost.The country has some of the best health care access in the world, with 3.6 doctors and 10.7 nurses per 1000 people. Life expectancy is around 73 years old. Obesity is less than 8% (it’s almost 50% in the U.S.), and it is estimated that 100% of the population has access to clean drinking water and sanitation facilities.

As a Caucasian from the American suburbs, with no knowledge of my heritage further back than my grandparents, this place holds an impossible appeal for me. I don’t know my family history, whether a story of thieves or kings. My nation’s history doesn’t even span 300 years.

As our retreat drew to a close, I knew I could never truly be a part of a place like Lenk, Switzerland. I could only marvel and yearn, watching that priceless world slip past my car window, as we hurried home.

 

Officer Basic Training – Day 1 (or, The Subjugation of Befuddlement)

I have left my family in Germany and successfully arrived in tepid San Antonio, TX for 28 days of training to become an officer in the U.S. Army Medical Corps (pronounced ‘core’ not ‘corpse,’ though both work pretty well).

On my flight over here, I called some in-charge guy from Oh-Hare airport in Chicago to ask him where to go when I arrived last night because I was a day early.
 
***note to friends and family who know anything about me…I showed up EARLY for something I regard as totally stupid.  Note that. Somewhere.  Just get it down for posterity somehwere.  Not just on-time.  Early.  Me.***
 
A guy actually picked up his phone when I called and told me to go to building #596, which is an Army hotel on Ft. Sam Houston. 
 
“Nice,”  I think.  “I’ll be staying there for a month.”  I take a cab from the airport to the hotel.  The cab driver drives away.  I walk up to the counter, am asked for a copy of my orders, then am told that my room is at the Holiday Inn next to the airport.
 
“I was just at the airport.”
 
“Yep.”
 
“I just paid a cab guy to get me out here.”
 
“Yep.”
 
“Thank you, so much, ma’am, for your help.  Can I have my orders back?  And, could you call me a cab…maybe even THAT GUY driving away over there who just dropped me off?”
 
She calls a cab, but not that guy.  It will be a half-hour, she says, until a cab can get here. 
 
Hmmm.  K.
 
Then, feeling Army-saavy, I ask her to COPY the copy of my orders she asked me for, and make me a few extra, AND SHE DOES!  
 
We’ve been told to come here, inexplicably, with 10 copies of the orders telling us to come here.  The need for a billion copies of paper orders is one of the many stipulations that totally befuddles me.  I am actively in the process of subjugating all sense of confusion, befuddlement, and mystification, with mixed results. 
 
But with respect to my orders, I’m making it my personal goal to leave this course with MORE copies of my orders than I arrived with.  If I get back home with more than 10 copies of my orders…I’m taking my wife to dinner or something.
 
Anyway, it’s a nice hotel, and I have to keep reminding myself that I am NOT here for the usual blah-blah conference.  For example, our day starts tomorrow at oh-430…well before the “free” breakfast I’m entitled to.  And some of the classes we’re supposed to take start at 6pm or later.  So, it ain’t a cardiology meeting in Oahu.
 
I’m in SanAntonio, in August, in a heat-wave that is about to break historic records.  So yes, it is butt-hot outside.  And I’m the kind of person who thinks PERFECT weather is overcast, rainy and 65 degrees F.  Seriously.
 
But it turns out that the heat actually doesn’t bother me, so far.  Mostly just feel like I’m back in Beer Sheva, Israel where I went to medical school.  I haven’t been running around in it yet, but so far it hasn’t really phased me.  It’s hot.  Like med school.  Who cares.
 
I met a guy at breakfast this morning who is also in the class.  Cool.  Older.  Knows stuff, like what he “makes” per day and that it’s good to bring a roll of toilet paper when we go “to the field.” 
 
As he sits there describing Army stuff, I wonder what my problem is with details and why I’m so averse to them.  He’s talking about tax-deductions for military pay or something and I’m thinking…”Kyle Orton, he’s really the guy who needs to play for Denver this year”…and…”At some point, this guy is gonna tell me how to get out of deployment AND monthly drilling and when he does, boy, I’ll be RIGHT HERE ready to pay attention…but he just said ‘requisition’ so no need to tune in yet.”
 
His name’s “Ray” and I’m extremely proud of myself that I remembered it.  I came up with “First-day Ray” and now it’s in my head forever. 
 
Ray assures me that since we’re off-post, I won’t be given a roommate.  That was an “on-post” stipulation because it was a barracks environment.  The hotel lady yesterday told me otherwise, saying that I would be getting a roommate and I had not choice in the matter and would not be allowed to pay extra for my own room. 
 
So, the jury’s out on “Ray.”  If my single room survives today…he wins.  Stud.  Fount of knowledge.  I’ll actually like him at that point.  And he won’t be placed in my category of people who talk like they know stuff but who I ignore for your own safety.
 
Having my own room is pretty cool.  I can sit here, for example, completely naked and type my little blog.  I’m NOT, actually.  It’s just that I COULD if I wanted to…which is the whole point. 
 
It’s the Manhattan Effect…the desire of millions of people to live in Manhattan so they can be near museums, shows, galleries and restaruants and theaters even though they won’t patronize even 5% of what’s available to them for the entirety of time they actually there.  It’s just that the CAN go if they want to.
 
‘s called freedom, and I’m rather partial to it. 
 
So, my own room is nice in that way.  Doesn’t sound like I’ll be in it much, though.  Class starts at 430 in the morning, and the last class starts at 7pm.  So it doesn’t really matter who’s in here.
 
And I suppose I won’t type naked anyway. I’m afraid that as the hard drive warms up, a film of sweat will form between the laptop and the actual “lap”, as it were, and the machine will short itself out in an explosion of wicked-blue electricity bolts right into an area that really should have been covered out of respect for my readers, for God’s sake, if not for my own sense of Fallen-Man shame.
 
I do have a sense of pleasant anticipation as the day gets started.  I’m like any average boy who grew up crawling around fields and forests “fighting” Nazi’s and aliens and dragons.  Already I was “ordered” to buy a pocket knife, which definitively makes this better than your average medical seminar. 
 
So as I enter day 1, I can say that if over the next 28 days there’s firing of weapons – of any kind – any choppers, night-vision goggles, topo maps, compasses, smoke, explosions, crawling on elbows and knees, face paint, knives, matches, tents, or at least 11 copies of my orders…this little month away from my family might just be worth it. 

XBox – A Medical Necessity

“Dr. SW101,” Says the curly-haired assistant, “will you sign this memo.”

I don’t look up.  As usual, I don’t read the memo, reaching for the closest pen and signing as fast as possible.  I look up at him, smiling cheerfully.  “What’d I just authorize?”

This is a photo of my Xbox
Image via Wikipedia

 

“Oh, you just told General Forth that the unit has medical need for 6 additional XBoxes.”

I pause, wondering why I’m so morally opposed to all paperwork that I can’t bring myself to even look at paperwork unless I absolutely have to.

“Xbox,”  I say, brows furrowing.  “Do you get ’em at the pharmacy?”

“No!”  He says, cloyingly earnest.  “You’re SO funny, Dr. SW101.  You should write a blog!”

“I do.”  I say, feeling sardonic, looking dour.  I reach for Volume I of Harrison’s Internal Medicine.  I lick a thumb and start flipping through the thousand-page tome.  “Hmmmm, Xbox.  Nope.  Nothing here.”

Assistant waits dutifully, no doubt inwardly rolling his eyes while clutching his well-typed letterheaded memo, with my signature still drying at the bottom.

“OH!  Right.  I’m only in Volume I.  Stupid me.  I should be in Volume II, where the X’s are.”  I pause.  “Just a minute,” I say, reaching for the second book.  A few minutes of earnest searching, “Nooh.  Darn.  I just don’t see anything talking about how XBox is an accepted therapy for anything.  Not even my favorite disease of all time – mitochondrial infectitis.”

“You’re kidding, right?”  He says, now looking worried.  “We can get the Red Cross to buy XBoxes for the unit if you say they’re medically warranted.”

“So, my patients – most of whom have seizure disorders, PTSD and post-combat anxiety – can sit around all day blowing each other up and staring at flickering lights?  Maybe I should prescribe a Rave too, so we can add drugs to the strobe lights.  Or would they be used for the Xbox version of Myst or something?”

Regions of the brain affected by PTSD and stress.
Bzzzt. What I need is some rapidly blinking lights and simulated death right now.

 

Assistant gets all serious, fearing the loss of his beloved memo.  He starts reading some of the Pulitzer Prize material, “Gaming has become a central element to the Soldier’s past time.  When they return from war zones, the lifelike quality of the Xbox combat games approximate the environment they just left.  For many, this represents a “return” to their former lives, thus producing a sense of calm and reassurance.”

“I said that?!”  I exclaim, eyes wide.  “What kind of crap-pile hash was I smokin’ when I wrote that letter?”

“Oh, huh.  Um.  Well, if you didn’t notice…I wrote it.”  Says the assistant, looking dejected.

Short of tearing the letter out of his hands, and no doubt derailing an already fast-moving train with lots of passengers, I know I’m on the hook.

“Ok.  You win.  Xboxes all around!  On me.”

Relief, profusion, gagging urgency and more of that I-want-to-help-soldiers-but-won’t-listen-to-reason earnestness.  “Oh, THANK you!  Man, you have no idea what this will mean to the guys.”

“Can we just agree that you got me to sign yet another of those goofy Army things where you’re not really asking for medical opinion but if I sign the memo about 25 people will have busy stuff to do and somebody somewhere will get something to further the impression that they’re entitled to things that the average American pays for?”

“Um.  Sure.”

“Can we further agree that Xbox is not an accepted medical therapy for anything?

“Yep.”  Confidence growing…clearly the doctor is too weak to actually stop any administrative freight trains now.

“Fine.  You have your memo.”

He turns to leave.  Then turns back, “Oh, and about that memo for the massage chairs…”

But I don’t hear him.  I’ve crawled under my desk, looking for the Lost Thumbtack.  I don’t “find” the thing until I hear my door open and close.  Carefully I look up….he’s standing there, hand on the doorknob.  He’s smiling, one of those serious smiles that makes perfectly clear that nobody’s fooling anybody.  “Find your thumbtack?”

I sigh.  The sound is tired in my ears.  “Yes.  But I just tossed another one down there to go look for later.”  He doesn’t say anything.  “Yeah, the massage chairs.  Bring me the memo.  Until then, take this script-” I scribble onto a piece of paper.

He crossed the room and takes the script from my hand, smiling.

Massage Chair
1, bid.  Do not swallow.