Devil on your shoulder

Between living in Haiti and Botswana over the past few years I keep finding instances in my life where I don’t give second thoughts to things I think most people would instantly question.  For example, one of my classmates from Chile calls himself Satan (not his given name, just what he calls himself now).  This is not a lie.  The first time I met Satan I had to double check I was hearing his name correctly but as soon as I found out I was hearing it correctly I accepted it without a second thought.  This was about a month ago.  Then on Friday I was contemplating my presence in medical school in Cuba and what exactly I have gotten myself into and then it hit me: I got to school with a guy who calls himself Satan.  I’m not nearly as surprised with his name as I am with the fact that I didn’t give it a second thought until a month later.  I just accepted it as it was.

In Satan’s defense, he is a really amicable fellow.  He just happens to love the genre of music called “death metal”.  Odd for a future doctor?  Perhaps, but thank God (no pun intended) that it is only music.  I’m sure he will make a good doctor, and I feel that fans of death metal deserve a doctor who understands their life just as lawyers and bankers have doctors that understand their lives.  After all, he will probably be really good at diagnosing, treating, and understanding injuries encountered in mosh pits at concerts. 

I guess situations like this are destiny for those of us who search out understanding of other people and their situations.  It seriously makes me wonder what other things in life I miss that other people would immediately see as odd.  On the other hand, it also helps me understand that things I think are odd, such as poverty in the midst of so much wealth, other people accept as part of the normalcy of life.  So in the end who is odd and who is normal?  My answer:  If a medical student named Satan can be normal pretty much anything can be.

Jornada Científica and Demographics

All students at the Latin American School of Medicine are highly advised to participate in the yearly Scientific Journal competition. This is a country wide competition open to all university students. Our advisors for our journal articles are our professors or other faculty members. These professors have fervor for what they do. Most of them are teaching from 8 to 12 class sessions every week, often times in multiple subjects. They themselves are required to publish written reviews or investigations every year. Then work with us on our stuff. And grade tests and papers. And on top of that manage their department. There is no secretary at the front desk of the department, in fact, there is no front desk. I’m about to get off track talking about how different the professor culture is in Cuba from the U.S. I need to get back to the journals, but I’m going to revisit this area soon, I promise.

So, the Scientific Journal. In reality it seems that most students do not participate. And those that do participate usually write at least 2 or 3 articles for different journals depending on time and research resources available. Research in Cuba is very different. Our library is scant on books, however it is easy enough to go to Havana and buy books if we need them. The most expensive book in the country is not going to cost more than 30 pesos…about $1.25. However, what Cuba does have is an extensive country wide electronic library. Books, journal articles, thesis, everything. All available for free PDF format download.

Library reading room with a view of the Straits of Florida

So for the articles I am writing I’ve been pouring over a lot stuff written in Cuba. And I have stumbled upon something most interesting. Cuban research, no matter what subject, rarely talks about demographics. There is no talk of upper income levels and the lowest standard deviation of income, there is no talk of black, white, asian, or other. Very little racial demographic data is to be found anywhere. As a social science major from a United States university this is downright bewildering. I mean, these are the first distinguishing marks we are told to use to differentiate our sample. And here I am in Cuba and no one really gives a flip about how many people were black that got sick and how many people were white. What the Cubans care about is that people got sick. Where are they from? What made them sick? How do they live? Sure there are great arguments about why we need to look at groups of people based on their skin color or historic ethnic origin because of genetic predispositions and culture. But most of these arguments are well suited for a half-assed type of medical treatment we have in the U.S. We normally treat people in groups, according to the most common demographic features so we can judge success based on the population rather than the individual. If you don’t buy this why do you think so many individuals fall through the cracks?

Computer lab. Holy of Holies for those of the WWW clan.

Then there is Cuba. Here, people are rarely treated medically as a group. When it comes to treatment, and hell, even prevention, it is an individual on individual basis. There is no room or reason for distinguishing black, white, poor, or rich in this system. Those details don’t matter when you have the will to treat every person as an individual. What matters to the Cubans is how many people they cured and how many they didn’t.

M-F at ELAM

I wake up between 5 or 6 am every morning (depending on what was undone when I went to sleep) and study and then get ready for the day as quickly as I can. Grab my bread, cheese, and warm milk (coffee if lucky!) from the cafeteria and head to class. If I find myself with enough time I will sit down and read an article or two out of the most recent edition of the Economist or a Cuban newspaper. The Orbe and the Juventud Rebelde have local and some international news and are about 8 pages each. No classifieds.

Then it is off to class. Got to be there by 8am with correct uniform (white bata and blue pants, they say black shoes but no one really enforces that). From 8 to about noon is class. Class interactive and small (9 students) so lunch time sneaks up quickly. Back to the cafeteria, hoping there is no line for my comedor (comedor 6). Usually there is not now that they rearranged which groups are eating in which comedor. Cuba is really good at handling large groups of people for anything (feeding, injecting, screening, teaching ect). Lunch could be a big piece of pork with plenty of fat; a couple of hot dogs, chicken, and, of course, the staples of rice and beans. Ice cream is usually served twice a week. Pretty much everyone cleans their plate, but if its pork day I try to search out my Muslim friends from Palestine and Guinea, as that means a lot more meat for me.

Then right back to class until around 4:30. These classes have more students, around 25. We are all in groups (I’m in group 27) and we have all of our classes with the same group. In my group are Brazilians, bunch of folks from the Solomon Islands, and a couple each from Tuvalu, Kiribati and Guyana. Since about two years ago the Latin American School of Medicine has really become a global school with representation from around 40 or 50 countries. After class I find an empty room (under a fan) and study until dinner. If I feel like braving the mob I can go stand in line for internet. Our school has a daily quota of internet use (something like 1024 MB) and it usually runs out around 5:30pm. This is why our weekly guaranteed internet time starts at midnight, when the daily quota rolls over. After studying or internet it’s back to the cafeteria for dinner. I usually get done with dinner around 6 or 6:30 depending on who I sit with and how good the conversation is. Usually I sit with a group of friends from Mexico or just with people I have not met yet and strike up a conversation.

In my room, the white lab coat is a bata, people study in their beds

I always have the goal of getting right back to my room and getting to work, but I usually end up falling asleep while waiting for our water to turn on so I can get a shower (we get water three times a day in our dorm, morning, noon, and night, for an hour each time). So I usually end up cracking the books and opening the laptop around 7:30 or 8…sometimes 9 if I get distracted by one of the 10 people I share a room with. I sit in my bed, open the shutters, and enjoy the caribbean breeze. We have a snack (break and cheese with yogurt or juice) served from 9pm to 11pm and that is another trip to the comedor. I always tell myself to sleep by 10pm but that never happens. Midnight is the norm. Sometimes roommates are loud and wake me up, but not often. Usually just too exhausted to be bothered and everyone respects each other more or less in room. That is a very brief rundown of my Mondays-Fridays at ELAM.

Galas and Congress

Every weekend at ELAM there are one or two galas. These galas are chances for different countries and regions of the world to highlight their culture, but basically boil down to a bunch of dancing routines that are (usually) executed really well. I often wonder: If everyone spent as much time working towards providing health care for the poor as they spend on dance practice if we couldn’t make progress in the former proceed a bit more quickly. I especially wonder this when walking back from using the internet at 4 a.m. and seeing exhausted students practicing all various forms of dances.

Considering most students at ELAM are from 18-19 years old the ritual of the gala has important social significance. Pre-med students are expected to do a lot of work for the gala because their school work is much less demanding. I suppose a lot of strong friendships and grudges are formed though preparing for the galas. Leaders assert themselves and some sort of social order develops out of the chaos of teenage hormones. Galas take place at the Polígono. The Polígono is the all purpose outdoor stage/study area/sports viewing stand facing the Straits of Florida, only about a football field away. Usually countries invite their diplomatic representatives to come on out to the show, and they usually show up. So there are chance to rub shoulders with pretty interesting visitors, especially since the galas get sort of boring after about an hour (they can last up to 3!) Attendance is not required.

The U.S. Gala went off a couple of weeks back. I included a picture above. The theme was the Wizard of Oz and the storyline reflected the four regions of America and the contributions of immigrants to each region. At the same time it talked about how America isn’t the immigrant’s paradise it is made out to be. Or something like that. I actually left an hour into the thing because I had work to do. But there was a large crowd because the first annual ELAM national congress was taking place.

Awesome homemade (caseros) banners are the norm in Cuba

The national congress was a first gathering of representatives from every ELAM affiliated medical school and hospital in Cuba. I don’t know exactly how many schools/hospitals there are, but there were about 350 students at our campus for the congress. Most of them were 3rd and 4th year students studying in ‘provenica’. Provencia is where students go after their 2nd year at ELAM to complete their last four years of med school attached to a proper working hospital. Because Cuba has something like 25 or 30 medical schools every hospital in the country is connected to at least one school. All Americans go to ‘provencia’ in La Havana, other countries get to write a letter of request to what province they want to study in. The students from provencia at the first national congress were great to talk to and get information from. If you want really solid, introspective info about ELAM I suggest asking a 3rd or 4th year student…but, of course, keep reading this blog

Me and ELAM

I go to medical school in Cuba.  This is not novel or unique outside of the fact that I am from America.  Cuba has a lot of doctors, a lot of medical schools (around 20 I think), and there are currently thousands of students from other countries studying medicine here.  I simply happen to be one of them.

I’ve been here for about two and a half months now.  I decided to start this blog because I think that information is usually a good thing.  And because I now live in Cuba I can share about my experiences here.  More specific reasons I am starting this blog include wanting to make people aware of the Latin American School of Medicine, to keep my friends and family updated on my happenings, and to stay connected to the world outside of Cuba.  I’ll probably talk about all of these reasons in future posts, but I think that is sufficient for now.

Let me tell you about my school.  Right now I’m sitting on the third floor of building 4, tower 2, looking out the window at the Straits of Florida.  I’m about a football field away from the water.  It is excellent, but the fear of hurricanes past is marked with the residue of tape on the windows.  On my floor we are about 26 students living in 3 rooms of, give or take, 10 students per room.  We share all of our space, and it works out well.  With most students here from Latina America I am surrounded by Spanish, except for some Brazilians (Portuguese) who live on the floor above and a few of my roommates who know English.  Being in Cuba, all of our classes are in Spanish.

The Cuban government provides us with everything we need to sustain and study.  Food, clothes, books, toiletries, even a stipend paid monthly.  Most services available on any college campus are available at the Latin American School of Medicine, they might just look very different.  For example, we don’t have a multimillion dollar stadium, but we do have multiple sporting courts of all kinds and the freedom, as students, to make our own teams, leagues, practice schedules, and even fields (as some Caribbean students recently built a cricket pitch). 

why build a stadium around this view?

There are a couple of convenience stores on campus and more than a few food shops were we can buy snacks for a very reasonable price between meals and classes.  Most student activities and student administration is run by the Student Junta, a group of a few elected students who manage our well being and respond to queries and concerns.  There are lots of student groups on campus representing all types of organizations.  To start a group you only need initiative.  It is one of the most open campuses I have ever been on when it comes to student led programs.

Classes are about the same size variations that can be found in U.S. medical schools, even though at this campus we have many, many more students than a typical U.S. medical school.  I particularly like how classroom space is used here.  During the day there are classes in all rooms, all the time, and during the night the rooms are open to the students to study.  The system here really minimizes wasted real estate (opposite my experience on U.S. campuses with lots of empty classrooms during the day).  There remains lots to be said about our curriculum and student live, two subjects I plan to make recurrent topics in this blog.

I hope that this introduction might spur some interest and answer some questions about where I am.  I’m going to try to address all of those who, what, where, why, and how questions with this blog while, hopefully, keeping in mind the reasons I started it.  As I make more experiences here I hope the posts become a bit more personal and slightly more opinionated.  The reader only needs to keep in mind that thousands of people go to school here and I’m just one of them.