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. 

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

Graduated – No Crying

The last days of residency passed – perhaps with a bang, and certainly no whimpers – and I am now full into my first week as a real, live doctor.

Everything feels the same, but with more sleep.

My graduation ceremony occurred 4 days ago, on Saturday.  For as emotional as I felt that night, I managed to survive the entire ordeal without much blubbering.  This had largely to do with my particular approach to the ceremony itself, which involved a skateboard, a wacky helmet and some iffy poetry.

Since there are only 6 graduating residents from our program, each of us enjoys (or endures) a sizeable amount of limelight as we graduate.  It starts with a picture slide show of us from our earliest days up to the present.  Some of my shots were strange, if not embarrassing, as you might imagine.

We are then introduced – for an agonizingly long time – by a faculty member.  Here our history, foibles and dreams are put on display for all in attendance to see.  This part can also be rather painful too.

It was then my turn to speak.  We aren’t given time-limits on our speeches.  As mentioned, there’s only 6 of us, so I guess we have the berth and he right to ramble a bit if we want to.

I survived the process with almost zero public display of emotion.

I’m not sure why this was some sort of goal for me.  I’ve always been a lousy crier.  I’m good at complaining, whining, moaning and bellyaching, mind you.  Rather too good.  But my crying skills must have atrophied somewhere in my childhood.

If I were to guess, I suppose it happened when I was about 5 years old and my biological father had just punched his girlfriend in the face.  He then leered at me and asked, “You gonna cry about that like a little girl?” in a drunken haze.

“Nope.”  I said.  And I never have.  These days, I can only cry when Ariel gets her statue of Eric blown up by King Triton, or the Broncos trade their franchise quarterback to the Bears.

So, I have some issues.  Fine.  I’ll bet you do too.  Intellectually, I admire the Roger Federers of rhe world who can stand on the international stage with unabashed tears streaming down their cheeks when they lose (or even win, sometimes) their latest tennis match.  Emotionally, I want to smack them with their own tear-stained pink hankies, tell them to find their purse and go back to the parlour where life doesn’t hurt so much.

Anyway, I wasn’t going to cry.  Smash my thumb with a hammer…we’ll talk.  But for this?  No way.

So, my approach was to first ride my Sector 9 longboard skateboard up to the podium wearing a tin foil-wrapped, overly-festooned bike helmet.  Why such a rather dumb graduation display?  Why, especially, at a solemn ceremony for a new practitioner of the healing arts?

sector9Aside from the fact that medicine is frequently too pompous and full of itself, I figured that if I could keep it fun and light, I could keep my eyes dry.  Plus, I ride my longboard to work most days, and I religiously never wear a helmet of any kind, much to the dismay and consternation of virtually every person I meet on the hospital campus.  For 3 years I’ve put up with near-constant haranguing to wear a helmet.

Why don’t I wear a helmet?  Well, I just figure that anyone traveling less than a mile, at about a mile an hour, while less than 3 inches off the ground…should garner me the right to feel the wind in their hair.  Granted, there isn’t much wind at that speed…and I don’t have much hair.  But that’s my metaphorical argument, people, and I’m sticking to it.

I also think that Americans are too stupidly safe these days.  We think we have allergies to things that 6000 years of humanity had no problem with.  We pad every corner in our houses and put seatbelts on our T.V.’s just in case the wall trembles and pushes that deadly thing over on a kid.  We have warnings on things like plastic 5-gallon buckets and nylon shower curtains.  Frankly, the fact that my children will never ride barefoot in the back of a bouncing pick up truck, screaming like golden-haired eagles as the wind whips wildly into their eyes, brings me no end of sorrow.

I grew up burning leaves, shooting bottle-rockets out of my hand and hunting fish with a whittled stick.  I think life is risky, and living life is an exercise in managing that risk.  Knee-jerk safety measures without true analysis of risk leads to heard-mentality that rarely leads to anything but really really bad groupthink: racism, genocide, militant nationalism, day-glo, Milli Vanilli, toilet-seat-shaped pillows for airplane flights that everyone carries around airports but never actually use for more than 10 minutes, to name a few.

So, in truth, I don’t wear my helmet when longboarding because I’m determined to not become a Nazi.  Gotta admire a guy like that, right?

Anyway, I understand that most of you dear readers will find fault in my little tirade, and will probably want to admonish my opinion about helmets just like all of the faculty, nurses, staff and freaking maintenance workers I see.

But take heart!  You don’t need to worry!  I rode to the podium in a helmet for the first time.  Just to make everyone happy.  Just to acknowledge that I’ve finally heard the message.  I give up.  It’s time to be responsible and extra-duty safe.  I’m a doctor now.

‘Course, my helmet was covered in tin foil and had sticks extending from it in every direction with tinfoil balls on the end of the sticks…but it was a helmet.

Then I delivered a poem.  It was supposed to be a rap – with a thumping beat and maybe a couple of dancers and lights flashing/spinning with everyone on their feet, their hands in the air all hip-hoppin’ on the floor.

But I’m white.  I’m a doc.  I’m in a tie.

Forget it.  It’s a poem.  A really bad 1-2-3-2 rhyme sequence that rhythmically scans like ice cream might feel if you were dumb enough pick a pile of it out of a sandbox and eat it.  But, in honour of my creation and the initial inspiration for it, I allowed that I would not in fact be delivering a rap, OR a poem that night.  It would be an amalgam, a mixture…a PAP.

This is fitting, of course, since we were all gathered to celebrate my new status as a fully-trained family medicine doctor.

My Pap made my mom cry.  I think my Dad too.  Kinda my wife.  And most of the people I talked to afterward said it made them a bit misty.  My goofy, two-bit hyper-syllabic tossed salad?

Cool.  People cried.  I didn’t.  I was too busy looking goofy, or saying goofy things.

Dear old Dad would be proud.

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.