Your perspective on life comes from the cage you were held captive in

August 18, 2015 § 3 Comments

As I look back on the days weeks that have passed since my last post, I realize that I have no idea where to start, what to write or how to write it. I’ve written before that I like to write when I feel reflective, so that the thoughts simply flow through my fingers onto the keyboard. These thoughts usually come together as I write, but so much has happened now that I can’t seem to bring everything together. So much to share and so little energy to figure out how to share it!

We’re two weeks into our jobs at hjemmetjenesten and feeling absolutely exhausted. So far this month, we’ve only had one day off each and we only have one or two more before we leave for Budapest.

AllBianca

My work schedule

Our internship at the hospital ended on more of a sour note. Working in hjemmetjenesten is such a different experience and it really puts our time at the hospital into perspective. On the very last day one of the department heads asked Skjalg to share his thoughts on the internship. He said he’d learned a lot and that he felt he had a much better idea about how the department is run, but that he wished there had been more guidance and some sort of orientation in the beginning. “What? You weren’t called before you started?” the doctor had asked. As it turned out, students are normally contacted before the beginning of the internship and given a sort of introduction/orientation to get them started. The person responsible for this was on vacation at the time and the person acting in his/her stead was apparently not quite as organized. So, on our very last day, we learned that we’d fallen through the cracks. A bit discouraging to say the least..

On top of this, we had a heavy experience with one of the heads of the surgery department. As a part of our curriculum, we have to complete summer practices/internships within various departments. First was nursing, this year was internal medicine and next year is surgery. We want to secure a place for next summer as soon as possible, so we’d figured we would contact the surgery department during that last week.

We spent maybe an hour trying to find the right person to talk to. When we did, Skjalg went into the office where they were having their morning meeting and I stayed out in the hall. Skjalg was in there for maybe 15 min. I could hear that people were talking and doctors and nurses kept entering and leaving the room, but I had no idea what was going on. When Skjalg came out, his facial expression was a sort of amused shock, that kind of shock when something is so unbelievable that you laugh it off until the anger sets in. “That was everything that you never want a doctor to be,” he said. “I need to sit down and process this”.

We headed back to the office designated for medical students and plopped down on the couch in one of the small rooms there. Skjalg began describing the experience and his words sucked whatever happiness I’d had that morning right out of me. Afterwards, we sat there in silence for what felt like hours. Once we’d had some time to process, Skjalg asked me what I wanted to do. “The weak part of me wants to go home and just curl up in bed. But that’s not going to make this any better. The strong part of me wants to prove them wrong,” I said. Skjalg felt the same and we decided to go down to the emergency room like we’d planned. It ended up being really slow there, so we asked one of the nurses to teach us how to perform a peripheral venous cannulation and then we spent an hour or so practicing on each other before going home. At the next morning’s meeting, we saw that only one patient had come in that whole day, so we didn’t miss out on anything other than a few hours of awkwardly standing around.

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At this point, you’re probably curious about the details of the exchange between Skjalg and the head surgeon. That evening, Skjalg sat down to write out everything he could remember in an email to the hospital’s administration. He received replies from HR and the director within several hours, both offering their sincerest apologies and saying that our applications were very welcome. Here is Skjalg’s email:

Today I went to the surgery department and spoke with one of the department heads there about a surgery practice spot next year. The exchange went something like this:

S: Hei, jeg ville gjerne høre om mulighetene for å ordne seg hospitant plass neste sommer. (Hi, I was wondering about the possibility to apply for a position for my surgery practice next summer.)

D: Oja, nei det vil vi aller nødigst gi dere. Dere utenlands studenter kommer jo bare å skal ha signatur. (I see, well, we would rather not give you that. You foreign students only come here for the signature.)

S: Hva mener du med det? (What do you mean by that?)

D: Jo, det blir jo at vi bare signerer uten å vite hva dere har gjort, bare rot med dere. Også er det jo sånn at de norske studentene må gå først. det blir jo idiotisk om vi gir dere fortrinn forann de som går i Norge. (Well, what happens is that we sign something without knowing what you have done, just a bunch of nonsense with you. Also, Norwegian students should be considered first. It would be idiotic for us to take you ahead of those studying in Norway.)

S: Så det er umulig for oss for å få plass her? (So it’s not possible for us to get a spot here?)

D: Nei dere kan jo alltid søke. Men en annen ting er jo at det bare er tull at dere er like godt egnet som de norske studenter som avtjener turnusstilling. De har jo mye mer praksis og er derfor bedre egnet. Jeg tror nok at disse utenlands studiene forsvinner snart tror du ikke det? (You can always apply. But another thing is that it is nonsense that you are as equally suited as the Norwegian students doing internships. They have much more practical experience and are therefore better suited. I believe that these exchange programs are going to disappear soon, don’t you agree?)

S: Nei, det tror jeg i grunnen ikke. Ikke så lenge norske universitet ikke utdanner nok leger til å møte behovet. (No, I don’t think so. Not so long as Norwegian universities continue to educate less doctors than are needed.)

D: Vi har jo altfor mange av dere utenlandske studenter. Det er jo overflod av italienske leger som går arbeidsledige, selv om mange av dem er kvinner som bare vil være hjemme, Det er jo snakk om patrialsk samfunn der. (We’ve got too many of you foreign students. There’s an abundance of Italian doctors without jobs, even though many of them are women who just want to be home. We’re talking about a patriarchal society there.)

S: Nå tenker jeg at vi er da norske studenter som studerer i utlandet fortsatt. Vi skal alle inn i samme arbeidsmarkedet til slutt. (The way I see it is that we are Norwegian students studying abroad. In the end, we’re all going to enter the same work field.)

D: Det kan hende, men jeg liker ikke at alle som helst kan dra til utlandet å kjøpe seg et artium. Men det er heldivis ikke jeg som ansetter turnusleger, der er det mange som også har gått i utlandet. (That may be, but I don’t like that jut anyone can go abroad and buy themselves a degree. Luckily it’s not me who hires residents, many of them have studied abroad.)

S: Det syntes jeg var veldig diskrimenerende sagt, Det er da ikke sånn at det er bare skoletapere som velger å dra til utlandet å studere. Vi er mange som kunne kommet inn på studiet hjemme men valgte å reise til utlandet for å få en bredere erfaring samt og oppleve litt av verden mens vi studerer. (I find what you’re saying to be very discriminatory. It’s not the case that it’s only those who couldn’t get in here that go to study abroad. There are many of us that could have studied here but chose to study abroad in order to have a broader experience and experience a bit of the world while we study.)

D: Neida, det var kanskje satt litt på spissen, du er sikkert både en snill og flink student du. (Well, I was perhaps a little blunt, you’re surely a nice and clever student.)

S: Takk? (Thanks?)

D: Dere får bare sende meg en mail med søknad da. Så får vi se. (Just send me an email with your application. Then we’ll see.)

S: Ha det bra! (Goodbye!)

Jeg håper virkelig ikke at slike holdninger er utbredt i helse-norge, og at dette var unntaket ikke regelen. Uansett så var det var utrolig nedslående å få høre at man er mindreverdig fordi man valgte å studere i utlandet. Jeg er veldig stolt av utdanningen min, og mener at den er minst like bra som den jeg kunne fått hjemme. Samtidig er jeg fortsatt glad for at jeg valgte å dra til ungarn for å studere. Det er et flott studentliv som jeg ikke kunne hatt i Norge og jeg har blitt kjennt med folk fra hele verden. Ingen burde se ned på dem som har valgt anerledes enn dem selv. Vi har valgt en annen rute. Men destinasjonen er den samme. (I really hope that such attitudes are not prevalent in the health industry in Norway and that this was the exception, not the rule. Whatever it was, it was incredibly discouraging to hear that you are inferior because you chose to study abroad. I am very proud of my education, and believe that it is at least as good as the one I could have had at home. I am still glad that I chose to go to Hungary to study. I have an amazing student life there that I could not have had in Norway and I have made friends with people from all over the world. Nobody should look down on those who have chosen differently than themselves. We have chosen a different route, but the destination is the same.)

After reading this, it’s easy to see why we were so strongly affected in that moment. We’d felt a bit ignored during the internship, save for the handful of good teaching moments, and this was exactly the type of mindset that we’d hoped we wouldn’t encounter. We’re fully aware of the prejudices that come with studying abroad, but remain very proud of the education that we are receiving. There are always going to be people that have different experiences and thus different feelings, but both Skjalg and I – and the friends we hold in close company – feel our education is thorough and demanding and preparing us to be great doctors. Every school is different and I don’t feel it is fair to pass judgement on students based on what one thinks one knows about a student’s education. For example, Skjalg was talking with a fellow medical student at work (hjemmetjenesten) about anatomy finals. This student studies in one of the Scandinavian countries and said that for their anatomy final exam, they sat together as a group of about 10 students around a large table and discussed anatomy with the examiner for about 15 minutes. At the end, they all passed (no grades, only pass/fail). A bit different from our anatomy final, which lasted 5 hours and included 3 parts with 3 different examiners.

I’ve had moments like this before. It’s amazing the power that some words can carry and how thoughtless – and incorrect – people can be. There are two moments that I remember really well. I’ve written about both of them in “My Story” and can repeat them here:

When I was 17, fresh out of high school and working at CPK:

While the whole Navy thing was going on, I was working at a restaurant chain called California Pizza Kitchen. I moved up pretty quickly, beginning as a hostess, then a server, and then was a trainer within 3 months. I was learning a lot about life, how to support myself, how to be a leader and function in the “real world”. (I had worked all through high school, from the summer I turned 15, but it was an after school/weekend job.) During this time, I struggled with the actuality of not being in school. I felt like I was letting a lot of people down. Some counselors at my former high school had even told me that I was a bad reflection on them. It didn’t matter that I was working hard to get there, only that I wasn’t there already. Once I started sharing my plans with people, I got much more supportive feedback.

One of the most harsh moments was actually when a girl I had taken AP Biology with came with her family into the restaurant where I was working. They sat, of course, in my section. Everything started out fine, everyone was really friendly, until her dad arrived. She introduced me, saying that we had gone to school together, to which he replied,

“All that money and all that education – and you’re working here?”

Truthfully, I was so shocked that I don’t recall exactly what happened afterwards. I think I tried defending myself – to no avail – and leaving as soon as I could. I think the girl might have talked to her father so that when I came back, I received an apology. I was so hurt that someone could not only be so cruel, but also so entitled. Even if I had chosen that path, he was in no position to judge my decision to do so.

When I was 21, living in Los Angeles and had just made the decision to move to Norway and start over:

After getting off the phone, I headed to physics class, smiling the whole way. I was blissful during the first half of class until break, when a friend in the class, who’s husband was a doctor, told me something that I was not prepared to hear. She had been witness to my struggle during the semester and understood what I had gone through to get to even that point. When I told her the decision I had just made, she told me:

“What? That’s a horrible decision. That’s honestly the worst decision you could possibly make! You can’t do that. If you do that, you’ll never be a doctor. You’ll go over there, waste a bunch of time and never get to where you want to be.”

I can’t imagine anything more damaging to your self-esteem than when you’ve committed yourself to making a big decision in your life and the very first person you tell bats it down without hesitation. When talking to my mom later that night, I told her about what my friend had said and she told me something I will never forget, something that I remind myself of almost every day:

There are always going to be people who react to any deviation from the common path. They are going to cut you down, tell you that you’re not going to make it, that you are going to fail and regret your decision. They are going to tell you it’s wrong because they are scared. They are scared to think that there is another way to do it. That you know something that they don’t. They will question themselves and wonder why they didn’t think of it first. And the only thing that will comfort them is telling you that you are wrong.

It’s hard to not let these types of comments get to you. They usually come when you are in a state of transition and one of the quintessential aspects of that state is vulnerability. I feel vulnerable a lot – and I really mean a lot! New classes, new teachers, new exams, new patients, new diseases, new treatments, new challenges that come with living abroad, new summer practices to apply for, new hospitals to work in, new coworkers to meet.

I felt so nervous before our first day of our internal medicine practice and possibly even more nervous for my first day working in hjemmetjenesten. I think part of it has to do with everything being new – and therefore challenging – and part of it has to do with language. Having to speak Norwegian all day makes me feel quite limited. I’m able to speak to coworkers and patients just fine, but I still have yet to feel like myself in Norwegian. I notice that there are quite a lot of times I don’t say something that I would have said had we been speaking English. With English I’m so much more sharp and open. With Norwegian, I spend my energy translating what I’ve heard, thinking about my response, translating my response, adjusting my response to fit cultural standards and then modifying my accent to most closely resemble a Norwegian dialect. By the time I’ve done that, the conversation has moved on and my brain in focusing on something else, or 50 other things simultaneously, which it often likes to do. Hopefully it will be different once I’m here for more than 1-2 months of the year.

That said, I survived everything I was nervous about! The internship is done and over with and I’m feeling better about work with every shift. One thing that has been really helpful for me is having to meet and speak with so many new people. This summer, I think I’ve met at least 200 people – between the hospital, restaurant and hjemmetjenesten – which means 200 times practicing how to introduce myself. I’m less insecure about having a slight accent when I speak and no longer cringe when I completely butcher a sentence. It’s actually helped me show my personality a bit more and forced the Norwegian version of myself to toughen up a little bit.

Enough of a catch-up for now – I’ll be back!

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§ 3 Responses to Your perspective on life comes from the cage you were held captive in

  • Charkie says:

    Bravo to Skjalg for keeping his cool during that encounter, and to you both for relaying it so eloquently to the administration and readers.
    “We’re fully aware of the prejudices that come with studying abroad, but remain very proud of the education that we are receiving.” — YES. This summer has made it increasingly clear for me that medical education has universal commonalities, including the fact that it is not perfect anywhere.
    Each person brings his/her own dedication and world of experience to the field.

    • Buda B says:

      Thank you for saying that! And YES to your comment. Looking so forward to catching up with you in a few weeks time. I’m sure we’ll have plenty to talk about!

  • afiore says:

    It is as old as history and guilds – the need to know that what you have will be yours; the secret will not be told to foreigners; and no one will come from places beyond to take away or change what is yours. Some of the doctor’s concern came out when he mentioned Italian doctors coming into the Norwegian “medical market”. The Labour Party in the UK instituted socialized medicine and the NHS by allowing in numberless doctors from South-East Asia – the same group that are the backbone of the NHS today. It was the only way to break the entrenched habits of the British Medical Associations,who would have preferred to retain their stuffy old medical nobility; at the expense of medical services to the people. And the only way to quickly have the number of physicians needed to provide near free medical care to the people of the UK. Norway is not immune to the encroaching pressure of globalization: cultural and economic. It should not be surprising to get the kind of attitude the doctor had. He is fighting a losing battle. When it comes to your ability and your worth do not ever accept the opinion of anyone that is based on their subjective prejudices. Know your ability and your worth and never betray it for the unfounded opinion of others.

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