Reader Q, Probable Farewell

Q – I just discovered your blog and have had fun reading it, however, it seems that you have stopped blogging?

A – It’s true. I burned out a little. Well, that’s a simplification. Moving here (to Germany), emerging from survival mode from medical training and settling into a normal life opened up all kinds of new emotions in me that I didn’t anticipate. The most important of these was a distinct realization that I wanted to deepen and widen my relationship with my wife.

So instead of pounding out these blog posts, I’ve been cooking dinner once a week (“Daddy Dinners”) and spending the majority of my nights watching some show or other with my wife by my side as I run my fingers slowly through her hair.

I’m gradually putting together a new blog – “Lover, Daddy, Doctor” – that picks up where SW101 leaves off. But it reflects my new focus in life.  I’d anticipate some humor, occasionally more intensity, less medicine.  I’d even expect the occasional Bible verse to accompany an irrepressible proclivity to pepper my writing with a well-placed swear word (Hey, I’ve come a long way…plus I’ve long bet that God nods to honesty before Christian decorum).

To survive in medical training, you HAVE to make survival and success your number one priority. I would have sworn this wasn’t true for me, but it was. Failure anywhere along the training path is a conscription to a lifetime of insurmountable debt, even poverty. Now that I’ve survived, my genuine priorities have emerged. I love to write, so it’s natural that I would blog about this new direction in my life. But I’m not sure. This is personal. More personal than just the experiences of being a doctor trainee. Maybe the story of one guy’s quest to be a better man is better left to be pondered quietly in the heart.

So, I’m mulling my next “move”. Maybe I’ll just pick up where I left off and start up SW101 again (thanks, everyone of you who wrote in to ask where all the good times went). Maybe I’ll finally finish my book.

Ultimately, I just can’t tell you where I’m going because I myself don’t know.  I DO know that I’ve successfully grilled tuna fillets, invented a mango/pear/mint salad that everyone loved, and I can broil Portabello mushrooms all by myself.  I learned the difference between Goat Cheese and Feta Cheese.  I know where the measuring cups are in the kitchen.  I can tell you every character in Lost (and the top 4 theories about what the freaking show even means).

But what I REALLY know is that my wife looks at me with eyes I haven’t seen for 13 years.  And this stirs my soul in ways that make most of the rest of my life comfortably superfluous.  This blog got caught up in that eternal vortex…

When I know anything more than this, you will too.

SW101

“All that I am, all that I ever was, is there in your perfect eyes…they’re all I can see.”  -Chasing Cars, by Snow Patrol

Reader Q: My Med School

bgucloseI get lots of questions about my med school.  For those few not in The Know, I attended the Medical School for International Health.  The school is located in Israel, in the ancient town of Beer Sheva (you can find it in the Bible, dude…can you say something like THAT about Maple Acres, Kansas?).  The institution is Ben Gurion University.

The program focuses on providing medicine in an international context; particularly to the 3rd world.  The school is a collaboration project between BGU and Columbia University, so blokes like me have a reasonable shot of doing residencies in the U.S. after graduation (got my 1st choice in residency program).  

Anyway, emails come in from all over the world asking me about my experience there and soliciting my advice about going.  This latest query was so expansive and had such good questions, I figured that if I was going to go to the trouble of replying to it, I might as well post it as a blog so everyone could check it out:

My name is Bryan and I am an accepted MSIH student from Provo, UT headed to Israel in July.  Here are a few questions for you:  

What did your spouse and kids do while in Israel for the 3 years?  

They found all kinds of things to do.  Getting settled in Israel is quite a job compared to the U.S.  Everything is slower to accomplish, from records to mail to shopping, things just take lots of time.

That said, my wife and I had 2 children while in Israel, so that kept her busy in ways that older kids wouldn’t.  She also took a Hebrew class that provided lots of social interaction, friends and experiences in the culture.

Additionally, you will have WAAAY more time that you might expect.  The first year, you don’t even take an exam of any kind for 5 months.  Not one.  You just go to class.  Or don’t.  Depends on your learning style.  Then, when exam time does roll around, you are home studying most of the day.  I don’t know if that’s how it is at other med schools, but that’s the way we roll in the IS.

So, you won’t be gone as much as you probably envision.  And, the family will have more to do that you might think.

BGU from a distance:  Lots of dirt and dust...then, suddenly, CITY
BGU from a distance: Lots of dirt and dust...then, suddenly, CITY

Did your kids attend school at all?

Mine didn’t, but they easily could have.  I started the program with just one 2 year old girl, but we had 2 more by the time we left (like I said…you do have, *ahem* free time).  The oldest would have done fine in their preschools, called Gan (pronounced GONE, means garden).  

I would recommend it, especially if your kids want to learn Hebrew.  Like most European countries, education is a huge emphasis, so they’ll want your kid there EVERY day, all day.  Even preschool.  This was the hang-up for us.  Something M/W/F might have worked, but my wife wasn’t ready to ship our 3 year old off for full-time school, so we skipped it.

Did your kids and your spouse learn the language?

 

See comments above about wife.  Kids didn’t learn it (although for some reason, we ALL still regularly say ‘agvanot’, which means tomatoes).  I wish they had been a bit older, becuase then I would have insisted on school for them.

Did you have any Hebrew before MSIH, or did you buy a program like Rosetta Stone to get you started?

I had none, and sucked at it all the way through.  Figured out how to buy food pretty quick, though.  I bought a tape-series that supposedly was used by State Department people, but never even opened the box.  

The school provided a pretty good immersion class, but really you need to take the same Hebrew class that my wife took at night to actually learn the language.  The Israeli people (unlike many lame ethnocentric Americans like me) know English almost universally in addition to their native Hebrew.  So, they would rather work on their English with you than let you work on your Hebrew with them.  All of your classes are in English.  You actually don’t get as much exposure to the language as you might think.

Furthermore, on the wards, I’d say Hebrew is only spoken by about 60% of the patients.  Beer Sheva has to be one of the most nationally-diverse cities on the planet.  Walk down a typical medical ward, and you may hear anything from the Big Three:  Hebrew, Arabic and Russian, to many “lesser” languages of the area like English, Spanish, Bulgarian, Yiddish, Romanian, French and others.  Although Jewish in heritage, the people who immigrate to Israel come from nearly every country in the world.  Their primary language usually isn’t Hebrew.

If you truly want to learn the language – and the best reason to is so that you understand the ward doctors during your 3rd year – my recommendation is to go to Israel 2 months early and take a true immersion course.  This is how they do it for the new immigrants.  You live in a house with other immigrants and they DRILL the language into you.  You’ll have it forever after that.

Did you buy a car?

 

We did.  It was very expensive and a bad idea.  Getting all the paperwork for it took 3 solid days of sitting in offices all over the town of Beer Sheva.  Gas is spendy.  Insurance and licensing is more than in the states.  

We should have just used cabs instead.  They crawl all over the city all the time.  You never wait for them, and a trip anywhere in town is only 15 shekels, which is about 3 dollars. We calculated that we could take 60 one-way cab rides a month for the monthly cost of the car.  

Years out, I still talk to the guy on the left a few times a month.  He's starting a fellowship in pulmonary/critical care next month at Henry Ford in Detroit.
Years out, I still talk to the guy on the left a few times a month. He's starting a fellowship in pulmonary/critical care next month at Henry Ford in Detroit.

Right about that time, I got into a minor wreck;  we parked the car after that because we didn’t want to spend the money to fix it.  I watched with interest as teenagers slowly dismantled the thing on a semi-nightly basis over the ensuing months.  I ended up with a twisted metal creature that can only loosely be described as a “machine”.  They took everything.

“Oh well,”  my friend Brian consoled me one day.  “Just be happy that you probably made some high school kid’s senior year 10 times funnier as they systematically ripped your car apart every night.”

Do many students buy cars while there?

Nope.  Just the dumber ones.

How else can you get to the more remote sites like Masada, Dead Sea, Elat and the like? 

Rent cars.  Fairly easy.  Fairly cheap.  Pool with friends if you aren’t going with the fam.  We saw EVERYTHING in Israel in nice Skodas or Seats (see-aht) with power windows and A/C and no worries about breaking down.

You can also take the train, which is efficient and fun…except when its crowded and you’re crammed between 6 sweaty IDF soldiers with automatic rifles, some of which are pointed at you and your kids. 

Where did you do your residency and what specialty did you choose?

Olympia, WA.  Family medicine.  I felt then, and still feel, that my specialty is absolutely the best preparation for medical mission work.  

I have not once regretted my specialty choice or the residency program I chose.

Did you know of any MSIH grads applying to the handful of International Health Residency Programs?

None of my class applied, but this largely had to do with location, not competitiveness.  We wouldn’t have had a problem getting into those programs, in general.  U of Rochester had a good connection with our school and a few of our grads went there.  Their Intl Health cirriculum is fantastic (or was a few years ago when I was looking at them).

Is there any personal advice you think would be beneficial to me; advice that might not be included in the admissions packet?

Be flexible, don’t whine like an American.  Don’t expect anyone to care about you or your little worries.  Be a traveler.  Be observant and end your sentences with question marks rather that declarative periods at a ratio of at least 2:1.  

ipconflictRecognize that there is no answer to the Israel-Palestinian conflict.  Accept that you have no right to have any opinion on the issue until you can say honestly that you have deep friendships with BOTH an Israeli and a Palestinian.  Until then, try as hard as you can to shut up learn.

Travel, travel, travel as much as you possibly can.  Drive the country from end-to-end at least twice.  Stay at a Kibbutz or Moshav.  Swim in the waters of Gan Hashlosha and the Med.  Absolutely see the Golan Heights in the spring when curtains of flowing green grass are punctured by brilliant red Israeli poppies.  Try as many foods as you can and never turn down invitations to Shabbat, Passover, Rosh Hashanna or Succoth. 

Spend lots of time in Jerusalem – especially the Arab Quarter of the Old City – and try to hang out in the Armenian Tavern for dinner at least once.  See the Wall and the Dome on the same day.

The Golan
The Golan

Jump on chances to go to Europe, especially the eastern countries.  See Turkey, Jordan and at least the Sinai of Egypt.  Get certified in SCUBA in 3 days on the Gulf of Aquaba (look up a guy named Hamdi in Dahab if you are interested).  Consider your experience there a colossal failure if you miss out on many of these opportunities.

Pick up a cause that will build the school.  I started the literature and medicine class.  I think it’s a required class now, so if you hate it, you can thank me.  Pour part of your life into the school.  Put MSIH on the map in your own small (or big) way. 

Will every moment of your experience into the marrow of your soul; drink its precious nectar as if you never will again.  Because you won’t.

And pass your damn tests.