Greetings from Riga, Latvia ... A place of great change where the Soviet
system was well entrenched just about 10 years ago and where I am now in a private clinic teaching cataract surgery.
The goal of this trip was to train three docs in the modern cataract surgery techniques in a two and a half week week period of time. While extremely challenging, this seemed possible with the bright ophthalmologists that I got to work with. Of course, to enhance efficiency ... We brought an extra microscope along... And customs had taken a liking to it. It took us an entire day the following day to clear it with me sleeping intermittently in the car as we drove back and forth for various paperwork ... But with success!
OK, life is tough here ... I live on the beach of the Baltic Sea ... The birds are loud and enjoy bringing alive the dense fog over the sea in the morning. I have a dog to walk/run in the morning and evening. I live with one of the docs who was in the cataract program last year. She and her husband both know English quite well and are good teachers of some Latvian. He has four jobs and is always bringing some stories back with him. Yesterday he was in Estonia and tonight we will here about it.
We start work every day about 8:00 after a 45 minute drive into the city. We see postops, complete workups and discuss patients and usually start surgery close to 10am. I record the video of each surgery directly on to my little iBook and we review the surgery with all the docs immediately after surgery. I save a few choice clips if there is something good for future teaching and then delete the remainder ... And we go to work again. Surgeries have their challenge with the language differences ... My Latvian is much worse than anyone else's English, but I am enjoying learning a few choice words for impressive application. Usually there are 3-4 docs watching each surgery, and so there is usually someone who can translate something to a degree or another. However, yesterday, during some critical points, the Latvian doc said "I don't understand what you say!" Often you think that things are understood much more than they really are ... And sometimes they understand much more than you think they do! However, such moments make me want to make sure, and doubly sure, that certain points are understood for sure ... So there may be a lot of repetition after which there may be some gestalt facial expressions.
We've had some delightful patient experiences. Yesterday got a hand-woven flax item from a lady who declared she was "angry" that we gave her more wrinkles in her face! Flowers are a big item here, so have gotten some of them, too. Now I proudly smell the flowers on a desk that I have adopted whenever I get the chance. No, flowers aren't just for ladies! Yesterday was a particularly exciting day as one of the docs who has done about 10 cases now ... Is doing just beautiful surgery with chopping techniques and the whole works. It is just exciting to see. Another doc handled a particularly difficult case with a hard cataract with a condition called pseudoexfoliation ... I just have to remark "Skaiste" (not how it is spelled) which means "beautiful" in Latvian. I work with a group of friendly people who have come from a very difficult background. Just 10 years ago, they would go to the store not knowing if they could get meat or milk ... Usually having to rely on personal friends in the butcher shop to be able to get something. They never knew if they could entertain people with anything. I was told last night that they never had a need for a car because there was no shopping to do ... You couldn't buy anything anyhow. One of the docs had a brother who was arrested for no apparent reason and later "disappeared" ... Still with no known reason, but apparently to fulfill a quota system inflicted by the soviets. When one person was assigned his territory and a quota to fulfill ... He would give parking tickets or anything to create an infraction as people weren't always bad enough to warrant their disappearance. Such was the difficult time they were under. Ten years ago when the Soviets drove tanks into the city of Riga.... It was the folks that I work with every day who camped day and night in old downtown Riga as human shields to hopefully prevent any destruction ...Such will. Most of us have little appreciation of what all they have been through.
Despite the past ... These folk have a wonderful sense of life and its enjoyment. They probably think I'm very boring and need to learn more about life than just ophthalmology, and they are doing a very good job at teaching me. I've gotten much more culture here than I get at home, and I have to admit that I rather enjoy it. Somehow, I think our friendships will last for more than a few weeks.
arthur.giebel@pcli.com
