Exam and Questions

On my return from Italy last week, the flight from Rome was full, with physician, scientists, and vendors headed to Chicago for a very large annual radiology conference. This lead to plenty of polite chatter before and after the mid-flight naps. Coming back into the US requires going through both immigration and customs.  A two step process with less than welcoming lines, and a fair bit of confusion for the uninitiated traveler. It really makes the US look a bit unfriendly, compared to entering the EU.

I got put in a line that was not moving. Literally. I could see ahead a couple of people that the white haired immigration official was talking intently at a somewhat cowering middle aged man. From a distance he seemed to be scolding the man, took his photo, took his palm prints, and kept talking at the man. Naturally those of in this line going nowhere watched with irritation as everyone around us whizzed pass their immigration official.

Finally I got close. I could hear the lady ahead of me say that that she had been Italy as a cupcake consultant. Really, that's what I heard. My turn.

The white haired man asked where have you been?
Italy
For how long?
Two weeks.
Business of pleasure?
A little business and a lot of pleasure.
(he smiled, vaguely)
What to do you do?
I'm a professor.
What do you profess?

I burst out laughing. He grinned widely, with that "got ya" look. Then he said that teachers always explain what they teach, but professors always laugh.  I asked what was the best answer he had heard. He replied "as little as possible."  I nodded. He handed me my passport and I moved on.

But, the question dangles. What do I profess? It's one of those questions against which to measure a life and a life's work.  Like the "in this I believe" essays. So rarely do we pause and take stock of where we are and where we are headed.

Some time ago, I decided, after a considerable amount of trying on ideas, that I believe in curiosity. I like that I now have a new question to ponder, to nudge my self-awareness. 

Spring break, coffee break

Spring break week means quieter hallways, more closed faculty office doors, and less traffic. Some faculty actually take a break from being on campus, although few actually stop working. We still answer email, work on manuscripts and prepare for the next class. For me, spring break means nothing more than fewer students in the hallway and no faculty meetings. I just can't get into the spirit of not working in the middle of the semester. After all, I am paid to work spring break.

For a few students, spring break is a time to get ahead on RA hours in anticipation of a hellish finals week. For a few other students, spring break is a time to get involved and manifest the best of the Millennial Generation characteristics ~ service and social justice. I have two students who are on a trip to Haiti with a group led by a College of Medicine faculty. They are going to do a community assessment of needs. They are paying their own expenses and taking their enthusiasm for making a difference to a place in need of energy, commitment, and enthusiasm. They represent the best of the Millennial character.

Meanwhile, back in Chicago, I struggle to decipher the meaning of clinging to the coffee cup in the classroom. Somehow, a conversation veered to the topic of coffee in the classroom. A student was complaining about the ants that immediate surround her cup. I complained about the distraction of coffee drinking while teaching. Not long ago, I mildly chastised a faculty for taking coffee and food to each of his morning classes, arguing we are not servants or restaurants. (Maybe we ARE more like chefs than I want to admit.) Why does the collective we need to bring coffee wherever we go? Does it signify informality? Addiction? Insecurity? Non-respect? Individuality? Sleep deprivation?

I'd say that I need a coffee break, but, in daily life today, that no longer exists. Demarcations between work, play, break are  faded, like old white car lane lines. I have no crystal ball (only a 9 ball) to tell me the future. Thinking of the students taking their spring break to work in Haiti, I see a future that looks promising and positive, if not caffeinated.

Winding Down

I'm strating to think about the end, which is to say about grading final papers, giving good-bye presents and scheduling my taxi to the airport.

The six students here sit in two groups, one each at a round table. One table has the older nurses who work at a public specialty clinic, quietly absorbing and concentrating. The other table has the younger nurses working in acute care, wiggling and giggling and trying to speak English. The two groups being a small sample of the nurses in Chile. And both groups coming to terms with their assumptions about how to improve health and the role of the Ministry of Health in do so.

Each time I teach this course here, I struggle with this too. What is the "correct" balance between entrepreneurial health programs and social responsibility as administered through a government? I come from a country which has a history of favoring the private sector's initiative and business approach to achieving health for its citizens. But, where's the profit in helping the disadvantaged to gain equal footing or being compassionate with the dregs of the street who slap all outreached hands? Maybe because I just finished one of Anne Lamont's books, I'm feeling both more radicalized and spiritualized about health care systems.

Chile has a history of dictatorship which has left the boot print of oppression throughout its bureacracy. I saw this during my interviews with people in the Ministry. It was more like a bruise, still sore enough to limit mobility. There is a "system" in place for all citizens to receive health care, and the primary care clinics, called consultorios, are neatly placed throughout the contry. But where's the benefit of creating new options and programs when the resources are distributed centrally based on a plan that has no known origins?

Neither system is right and neither system is perfect. But I do see individuals in both systems who are stepping forward and into the murky waters of what is ethically and morally and socically needed.

Santiago Work

I've lived in Santiago Chile before, each time for about 5-6 weeks. Long enough to get comfortable, but not so long as to get bored. This year, I'll be here 5 weeks, again teaching the Program Planning and Evaluation  course to post-graduate and master's level nursing students. The course goes ultra quick, and thankfully they are really smart students who seem able to keep up with the pace.

The start was rocky. I was exhausted and still  in hyperdrive from the June crazies. That said, they were not exactly organized either. They were still drumming up students (so that it would be more than 4; we ended up with 6), wanting they syllabus reformatted to the UC requirements, the course webpage not accessible to half the students, and no plans for me to meet with other faculty. All of this took a week to mostly get sorted out.

I teach all day on Friday (9am-6pm, 1 hour for lunch) and 4 hours on Saturday. In Santiago, almost all of the small stores close by 2pm on Saturday for the weekend. It changes one's patten of living. The campus is about 30-45 minutes away on the Metro. Yes, I am a seasoned subway commuter here, including being squeezed into a train car during the evening rush. Not fun.

Lisette and I have been asked by the Minstry of Health to consult with them to develop a plan for how to improve the national disaster and emergency plan.  Lisette had been asked to do this because a former classmate of hers is now in the position in the MINSAL (as it is abbreviated here). So, we have been coordinating that consulting work as well. Lisette is moving to US at the end of June to start the PhD program at the SPH. So, she too is ultra busy getting ready for that major life change.

Our first meeting include a representative from WHO/OMS. The international scene is fascinating to me. How the WHO provides support, but not really. How the national health system is both centralized and decentralized. These differences come up in my working with the students in the course. The reliance on MINSAL, but not really.