In the name of justice and of defense of others, I have found myself divulging back to the days of what seems like the 3rd grade when I would fight with and/or yell at kids for cutting in the lunch line, feeling desires to throw their lunch tray full of starchy food products in their faces, and going to persuasively tell the local baker that he will once again be giving my buddy bread in the morning because she must be fed. With a lot of attitude, removal of my earings, some swinging of my neck, flailing of my arms, and mobilization of my Latino cohorts with Cesar Chavez' "Si, se puede," justice was served as I lectured these four Cuban medical students/teenagers on their lack of respect for our time spent waiting in the line as they continued to cut in the lunch line every day. I had to restrain myself from grabbing hair and punching this super disrespectful Cuban gal in the neck, realizing that losing my scholarship over rice and beans is definitely not worth it. At one time in the past, I definitely would have felt at-will to put my fist into her wind-pipe, or better yet…now that I am a doctor…choking her out with my stethoscope. Time is not money for them, but I have Capitalist roots ingrained in me and sometimes time still is equal to money for me, even in a socialistic country. I am not sure what their rationale is, because of all people Cubans know how (or did) to form a line. They are best the line-makers ever, derived from the necessity to wait in line for hours for anything whether it be a fresh inventory of chicken or, basically, anything that has been unavailable because of the U.S. blockade against Cuba. In fact, you better watch out because if more than three or four Cubans are grouped together, a line might form because they have given the impression that there is something good to wait in-line for, but in reality they are simply standing on a sidewalk, grouped together. You could be waiting in for nothing. And as far as the bread-maker goes, who knows--there was a bakery full of bread, but he did not want to sell any to Heather that morning, but he will now.
Almost two months back in Cuba, and I am settling back in to the heartbeat of Cuban life. With the help of two Cuban men, two trips in a 1952 Plymouth, myself, Buddy/Heather, and mostly recently Fabiola who has just arrived with her giant bottle of Cazadores tequila after taking her board exam, are settled into our apartment in Central Habana. Life is grand in my new pad--running water and electricity 24 hours/day, a real flushing toilet, and a washer and a bum/moocher of an owner who has became a permanent fixture on the sofa in the living room and feels at liberty to eat our food. Do not worry--the motivation to continue receiving $120 (divided between the three of us) each month has persuaded him to leave his own home. Either he goes or the money goes with us. With a $120/month, I no longer have to flush the toilet with a bucket of water, nor do I have to wash my clothes on a washboard. I no longer have to deal with the parasitic/draining noise of teenagers/future doctors partying until 3 a.m. on a school night, like I had to do when I was in the 1st and 2nd grade at the ELAM campus. Heather and I have even managed to budget in having a señora cook for us during the week. (See, Mom!! Remember when I told you, as a little girl, that one day that I would have a cook?!) Most importantly, I have a space to call my very own. With my new living space/favorable study environment and having all the books I need (thanks to my caretakers/donors) I am ready to take on my first board exam (STEP 1).
I feel like I have made that grand move to the big kids playground—that same feeling I got when I transitioned from 3rd to 4th grade, where the kids were bigger and the playground dynamic was more independent. Oh wait…I get to walk off campus whenever I want to? I am treated like an adult?! Hospital Salvador Allende is the teaching hospital where I will be at for the next few years, gaining my clinical experience through my rotations. It has been a social science experiment getting to know the hospital dynamic in Cuba. Dealing with the stink-ass attitudes of the nurses, getting bossed around by the old ladies that clean the floor (how was I supposed to know that the floor was clean?). Learning that HIPAA is completely non-existent, and patient privacy is a privilege. But, I realize that sick patients are the same in any country. Being medically trained in Cuba, I realize how valuable my given senses are, especially in the physical exam. I mean, I actually have to touch patients and really, really know how to examine a patient. Gloves are not necessary and my stethoscope always touches skin. That is the Cuban way (or the U.S. way like 40 years ago)—relying on the physical exam to observe signs and symptoms that will lead to a diagnosis and not necessarily a reliance on labs and expensive, and often unnecessary, tests and procedures. And there is evidence that their way works. For instance, I am supposed to have time in the morgue every week to review pathology with fresh corpses, but there are never any bodies in the morgue. It is like Cubans never die (in accordance with their superior life-expectancy age)! I am responsible for two beds in the geriatrics ward. For now, most of the wards have converted to treating patients with Dengue fever. Sheez…every time a mosquito bites me I think I am going to contract Dengue. I embrace the doctor-patient relationship with my Cuban patients. They seem to have confidence in me, that I am their doctor/medical student. It is ingrained in the medical culture here that medical students must learn/poke and prod the patient to become well-trained physicians. Generally, most patients in the U.S. squirm and/or retreat when they see a medical student walk in the exam room. With some of the clinical situations I have faced recently, I have to admit that I basically faked my way through the situation with sound judgment and educated guessing. I suppose I did it well enough that I actually had two patients invite me to their house for dinner. And then there was this one patient who found out it was my birthday and sang Happy Birthday to me in English. The bitch-ass nurses, the other physicians, my patients, continue calling me "doctora," sometimes still catching me off-guard because I am like "who is that?" And thus, I continue on with study-filled/sleepless nights becoming the best "doctora" that I can be.
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