This was an update Karl sent out from his time doing rotations in the UK.

I just found the tirade that I sent when I was getting settled in to St. Maarten. So, in the true spirit of “erring on the side of more information,” (or perhaps procrastination from studying), and also since I am living on another island, I figured I would send out something relatively similar…

Life here… is interesting.

Work at the hospital requires a lot of swallowed pride. I feel like people get sick of hearing “Oh, that’s what you call it here. We have a different name for that back home,” so you just end up acting like you don’t know what a lot of things are when really it’s just a different acronym or different word. I put it in the same category as being almost fluent in a language. You have a conversation with someone and you know all the words that have been said, but all of a sudden you’re not really sure you are talking about the same thing the other person is talking about. Eventually you realize that you translated a word literally and they were using it as slang which means something totally different, or maybe the word just has a different definition than what you have been used to. Surgeons aren’t called Dr. Jones they are called Mr. or Ms. Jones for historical reasons. Public schools here are private schools and local schools are public schools. You don’t ask for a urine sample; you ask for a bit of wee. Asking about urination will only get you looks of confusion until you ask how the waterworks are. Same goes for bowel movements and the back passage. You don’t stand in line for the register; you wait in the cue for the till. So you end up asking a lot of questions to just define words, and finally you understand what people are saying. I’m not entirely sure any of that makes sense, but it seems to be how a lot of my conversations go and they are even all in English. Sometimes it seems a little overwhelming that I want to practice medicine in a totally different language…

The culture in general is a whole other entity to itself. In general, I feel like even the “cold-hearted” people of New York are more outgoing to strangers than people here. That’s not to say once you get to know people they aren’t pleasant, and will go out of their way for you, but walking down the street just doesn’t give the warm and fuzzy vibe all the time. Nonetheless it’s great to have people that think outside the box (or the country as the case may be). I had a conversation with one British attending and he talked about how he thought the demise of the world would revolve around the state that Africa and the Middle East were left in primarily by the Belgians, the French, the Brits, the Brits, and the Brits. In another conversation with a resident we talked about how the US Congress just passed the bill to get out of Iraq and how Bush would veto it. I couldn’t help, but wonder how many people in the US would be able to come up with any piece of legislation that any other government in the world was currently working on.

Other than that, I am slowly getting in the habit of telling myself to look right-left-right before crossing streets rather than left-right-left. I bump into a few less people every week as I overcome my urge to veer right when they of course will veer left. I enjoy the time spent talking with patients about football, and the weather, and music and literature because even though patients are scheduled just like states, they aren’t rushed like they are in the states. We spent at least forty five minutes just talking to a patient after breaking the news she had cervical cancer. Because “there is no way to rush something like that” my attending told me.

But overall living in another country is such a different entity than traveling through one. Meeting people, seeing things, going places, doing things are all much easier when traveling through because tomorrow you will be somewhere else. But to do things on your own when living somewhere, when you will still be here tomorrow, requires such a greater degree of motivation. And so just like St. Maarten, I am sure some things will just take time to get used to and maybe by the end of my time here I won’t be ready to leave.
But despite everything people say about the food… it doesn’t begin to scratch the surface of how terrible it is. It’s a good thing they have a lot of Indian food here…

I miss you all already…