Flash!!! And so went my Thursday and Friday... Happy Saturday All!

I last left you all the night before my first big day... and how did it go?  Very positive, and a great couple of meetings!  (Don't worry, all of these meetings really are going somewhere...)

First I had a short meeting with the academians at the TB hospital (Dr. Ustian is the head of the Chisinau branch, so to speak.)  I chatted with the two pulmonology fellows who I will be learning from and shadowing for the next 5 weeks or so.  We talked about the goals for my study in Moldova, I explained where I was in my schooling (which required an explanation of K-12, Undergraduate, Graduate and Professional schools... a somewhat different structure than the layout of Moldovan schooling - K-12 followed by 6 years of medical school,) and of course there was time to talk about wine.

Then I was off to meet Dr. Cebotarenco and Dr. Cetulean.  I cannot express how lucky I am to have made successful contact with these women.  As it turns out, Dr. Cetulean is basically the CEO-equivalent of the TB hospital in Chisinau, as well as the lead organizer for all things TB in the Republic of Moldova.  And I should not leave out that she is the consummate host.  Meanwhile, Dr. Cebotarenco speaks perfect English, and is one heck of a networker across borders (she heads CoRSUM.)  Their combined abilities and energies are quite an inspiration... and with people like this fighting on the frontlines against TB, I really fail to see how TB stands a chance.

My meeting with them involved lots of coffee, many chocolates and long conversation.  All in all, we conversed for about 2.5 hours.  And in the midst of it, I also had the opportunity to meet a group of Finns who have been instrumental in the rebuilding of the children's wing of the hospital, as well as establishing regular on-site schooling for them.  During farewells, the stocky gentleman and I grappled forearms as a "true Finnish handshake."  :^)

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Within our conversation I found out about two locations of interest to my study.  One, there is a special school in Chisinau to which children who were "contacts" of TB cases are sent while they are treated prophylactically.  Aside from separating them from other children in the city's schools, they also receive a special high-calorie diet to ensure their overall immune status remains high.  Secondly, there is a small town in Moldova which is dedicated to housing patients with XDR/MDR-TB.  Drs. Cebotarenco and Cetulean have already agreed that I should board there for a few days.  Obviously, I am excited to see/experience both facilities.

How about locations of non-medical interest, you say?  OK, I give in... well, each Sunday Dr. Cetulean's husband (a professor from the School of Music) plays the trumpet with a band in the center of the park I explored last Saturday (the park with the fountain... not the park of brides.)  She invited me to check it out this Sunday (which of course I will oblige!)  Also, aside from talk of wineries and caves... did you know that the capital of April Fools Day is Odessa, Ukraine?  Me either... but I am going to try to get over to check out the festival this spring and see if I can't get a little background info on this strangest-of-strange holidays.  Dr. Cebotarenco says it is quite a blast.

Thursday Night...

After returning home from the hospital, I was immediately out the door to get over to "The House of Romanian Language" for a two hour session with Alexei Acsa, my new Romanian instructor.  It went really well, although by the end of the lesson I was certainly ready for some sleep.  I think the lessons will really help hammer home what I learned this summer at Indiana University, and will leave me speaking Romanian in no time!

On to Friday...

The next morning, I returned to the hospital at 8 am to join up with Dr. Veaceslav Culev (he's one of the pulmonology fellows who is guiding my time at the hospital) and take part in case-presentations (which all staff are required to attend each morning.)  Together, they examine x-rays and discuss individual patient progress, as well as deaths... a fairly somber reminder of the danger of MDR-TB.

Next, we walked over to the patient reception... and no patients were waiting.  So we took a tour of the grounds:  one building is shared with a drug-rehab clinic and is shared by the TB hospital's administrative offices, the bronchoscopy clinic, and the laboratory (where cases of TB are confirmed and classified;) a second building houses the patient reception office as well as in-patients, with two floors for children (infants on one, and school-children on another,) one floor for MDR-TB patients, and another floor for "regular" TB patients; a third small building houses the kitchen; and, finally, a fourth small building serves as the morgue.

After the tour, we itemized my studies for the next two weeks.  Over that span I will be put through the same course of two-week clinical lessons that Moldovan med-students experience on a rotation in the winter.  Luckily, I was given an English translation of the 100-page manual on Tuberculosis.  After planning, it was back over to the reception area, where a new patient was being examined.  I will have to give this topic its own break-out post.  From there, it was back onto an autobuz (of which I am now a regular rider...) and home for the evening.

Well, now I am off to study (maybe I will find a coffee-shop of some sort) before I join Deano and Tricia tonight at 8:00 for our second official "Skyped U of M Game"... should be a fun game to watch, and of course the "noon" kick-off will be much easier for me to cope with this week.

Enjoy your Saturday!

Tomorrow is Officially a Big Day!

Well, with all the meetings leading to further meetings, I feel like tomorrow is the "real" start of my work here.  After sending a written copy of my proposal to Dr. Vilc following yesterday's meeting, she circled back to present it to Drs. Iavorschi and Ustian and they all decided that they could offer me help immediately.  So, tomorrow I will have my first day at the Municipal City TB Hospital!  I am going to guess that it will begin with an introduction to other members of the University teams... and maybe some rounding from there.  Who knows?  I'm just excited to get started.

I also will meet two of my advisors, Drs. Cetulean and Cebotarenco, for the first time tomorrow at 2:00pm (also at the Municipal City TB Hospital.)  Hopefully I will leave tomorrow with a better idea of my daily schedule going forward, because...

I have also tracked down a language tutor.  His name is Alexei Acsan, and he is quite the lively instructor!  After talking to him for a bit in Romanian, he told me that he would be able to take me to fluency within 3 months.  Our first lesson is tomorrow at 5:30pm... I'll keep you posted!  I'm off to iron a shirt :^)

Tuesday's Meeting

I had another meeting today, this one over at the "Institute of Physiopneumology."  I met with a ring of specialists who are very involved in academic pulmonary research and are also connected to the Municipal City TB Hospital in Chisinau (which is where my contact Dr. Cetulean is a doctor-in-chief.)  I was thrilled to be able to meet with both the present head of the department as well as the former head, Dr. Constantin Iavorschi MD, PhD, PhD and Dr. Aurelia Ustian, MD, PhD, respectively.  Dr. Valentina Vilc, MD, who is a physiopneumologist in the department, was a key to the meeting's success, as she spoke English extremely well and translated the conversations back and forth.  There was a fourth physician there, who is apparently the primary TB researcher in the department... I am quite disappointed in myself for not having written his name down, as he, along with Dr. Vilc, will probably be my two main contacts in the department once everything is squared away.


My main impressions:  all four doctors were very excited to have me here in Moldova, were quite open to my presence, and seemed pleased to offer their services.  While I have yet to see them in clinical/academic action, their comport was very professional (as expected) and left me very excited that Dr. Topor introduced us.  I am still in disbelief that the four of them would all take a half hour out of their day to talk with me... it reminds me not to take this special opportunity for granted.  I think I will be able to learn a lot from this group of specialists, and that has me very excited!  Now, I just have to wait for my special ID and diplomatic letter...



I did learn another lesson today, and it is one that is not easily fixed.  I have always considered my face-to-face communication skills to be a major strength; it is probably why I have never been partial to phones, e-mail, etc.  In today's meeting I found that without being able to communicate fluently, I lost a lot of my efficacy.  I really felt quite disarmed.  Even having someone present who is able to translate with near perfection does not make up for the loss of response to social cues, and reigning-in and unfurling of the tone of conversation.  I was not mentally prepared to be out of control of presenting my proposals.  I can only hope to gain new strengths while waiting for my new language to develop further... otherwise, it will be a long 279 days.  Lesson #813 from Brian's Guide to Living in Moldova:  find a language tutor!  ...I will be finding mine tomorrow.  :^)



On the lighter side, about half-way through our meeting I really felt like I should apologize that I wasn't able to speak their language.  The Moldovan response?  Without blinking, they apologized that they did not speak mine... Moldovan kindness can be quite astounding at times.


Until the next time!

My Moldovan-in-laws

Well, my Moldovan parent in-laws came over again... yes, I am now going to refer to the landlords Ana and Dmitrii as my Moldovan parent-in-laws.  The "in-law" part is a technicality that I am including because of our official residence documentation.  They really are a cute couple.  I hope I have not disparaged them too much in the name of humor, because they have certainly taken a keen interest in my well-being (for which I am grateful.)

I should take a moment to give a better description of them (if I had known I was going to write about them tonight, I'd have taken a picture with them... I'll remember to do that at some point.)

They are both very friendly.  Dmitrii is a bit quieter, but very hands on.  He does not just explain something, but will physically do it as an illustration and then watch to make sure that I am able to mimic it.  When I told them that I broke my first key (which was part of my explanation of seeing a lot of the town) they became very concerned.  Well, today Dmitrii showed up with a copy of ALL THREE keys (one of which is a major piece of steel... the "push-lock" I call it.  Another is a very "secret" key... his daughter referred to it as her dad's FBI key... I guess I am in the "circle of trust.")  He also brought a metal file... when explaining how I broke the key last Thursday, I showed him how the lock sticks just a bit and requires a push on the door.  Well, I'll be danged if he didn't start filing down the door!  Apparently the "push" is not an official part of turning the lock thrice.  :^) 

Ana is quite a bit more talkative.  She also wants me to be a bit more talkative (she was impressed that I was able to converse much better today... I'm on-again off-again with the language right now.)  But if I say something with the wrong pronunciation, conjugation or accent, she will correct me (she really does want me to be able to speak well.)  She is more of a mother hen... took a look around the place, checked a third time to make sure I understand how the gas in the kitchen works, let me know that the window blinds should be left shut (for security reasons... something about people being able to see whether the lights are on)... she even brought fresh pillowcases and a new tablecloth.  The other tablecloth was white and a bit summery, this one is yellow and will be better for the fall.  I think she takes great pride in this apartment, and she should.  As you have all seen, I am lucky to have a very nice apartment.

Anyway, just wanted you to know that although sometimes I feel like I am on "Meet the Parents" and laugh about it, the Tafis are very nice people and hopefully some of you who are reading this will one day get to meet the little couple that keeps me well!

First Day of Work

Hey all... I had my first day "on the job" today - sort-of.  After four days of exploration and adventures, it felt pretty good to put on some business clothes and get on to my research.  I met with Dr. Topor this afternoon at his office in the Anatomy and Surgery division of the Nicolae Testemitsanu State University of Medicine and Pharmacy.  After introducing ourselves and conversing for a few moments we got down to business.  He set up a meeting for me with both the current and previous Chair of the university's Tuberculosis Department, as well as a third physician from the department (who speaks English.)  Dr. Topor was a visiting Fulbright Scholar at the University of Louisville School of Medicine for the academic year of 2000.  While there, one of his faculty advisors told him that he didn't see why Dr. Topor should not be able to complete one or two publications while in the States... so, Dr. Topor returned the favor and told me that he saw no reason that I should not be able to complete one or two publications while in Moldova.  :^)

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After our meeting, Dr. Topor offered me lunch and we wound up at a cafe that is about three blocks from my apartment.  We met a gentleman by the name of Igor Fonari, who runs "Projects Abroad" in Chisinau.  This is very fortuitous, as I had researched into Projects Abroad last May in case anyone was interested in visiting Moldova and coming away with a more interactive/fulfilling experience.  Projects Abroad specializes in organizing volunteer-tourism in many different countries:  volunteering opportunities in the morning (orphanage, hospital, school, or even journalism/businesses) with housing accomodations and meals with a host family.  Pretty neat company, and the founder of the Moldovan branch is a very nice man; I would definitely recommend looking into it if you are at all interested.

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www.projects-abroad.co.uk/volunteer-destinations/moldova/

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But, back to lunch...

Today I tried a traditional Moldovan soup (sorry, the name escapes me... I'll find out at a later date), salată castravete (a cucumber salad, creamy with dill,) bifstroganov (one of my family's favorites, beef stroganoff,) and mămăligă (semi-firm balls of corn "grits-porridge"... best way I can describe it, served with homemade cheese and sour cream.)  It was all very good!

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Now I am home, and it is time to prep for the week.  Before tomorrow's meeting I need to re-read my materials from the World Health Organization (The Stop TB Strategy, and the briefing of Key Bottlenecks in M/XDR-TB control and patient care.)  I also need to contact Drs. Cebotarenco and Cetulean to set up meetings with them this week.  Then I am going to start working through the Moldovan medical journal (Curierul medical) Dr. Topor gave to me today; this should help both with my professional language development and understanding of the formatting used for its articles.  And finally, I think I will try to get in a bit of general language studies tonight as well... I will only become fluent if I work at it!

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I hope everyone back home has a great start to their day...  La revedere!

And with that...

I hope you all enjoy today's posts!  I'm only going to have time to Skype with Bailey tonight (she probably woke up around an hour ago... it's now 9:00 AM in Louisiana...) as I have just gotten off the phone with Artiom and we're meeting for a couple of bere.  His and Julia's luggage was delayed in Frankfurt (they just resolved that issue this afternoon) so I'm sure, along with my couple of adventures, we will have plenty to talk about. :^)

After that, I am going to get started on the presentation of my project to semi-prep for tomorrow's meeting with Dr. Topor.

I hope you are all in good health and spirits.  Pe mâine!

Saturday's Pictures

Two Blocks from my house:  Pharmacy and Bank (where I exchange currency)

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And across the street...

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Center of Family Medicine #11

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Three blocks from my house is the little market from which I bought oranges (the day of the "broken key")

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In the windows on the left, you can just make out some fruit.  That is where the fruit window is.  The windows on the right enclose a little patio cafe, and straight through the door, down a short hallway is a market counter.  This is the type of store which houses its merchandise behind a counter, you tell a clerk what you need, and he/she gets it for you.

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A school of commerce is on the next block...

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...and five blocks from my house...

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... The Supreme Court.

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Kitty-corner from the Supreme Court (or Catty-corner, for the New Orleanians) but sitting more at the junction of blocks 5&6...

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The Academy of Economic Studies

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On the block 6 is the electronics store where I found my speakers...

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And then we arrive at a self-serve grocery market:  the food is on shelves, you pick what you want, and take it up to a check-out counter (like we shop in the states.)  Fidesco is open 24 hours!  I'll be headed there right after I finish posting and skyping Bailey...

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On the same block is an open air cafe... one of these days, when my time is not consumed by some unplanned adventure, I am going to try the food...

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An old door on block 7 that looks like it hasn't been opened in a couple of decades...

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Just thought it looked cool... on with the tour!

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Street signs are either hung or painted on the sides/corners of buildings... here is a one which has been hung across from ye olde door.

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And after 7 blocks, we are now at the edge of the park which is lined by florists (picturesof florists posted under "Crisis in Chisinau.")  On two of the corners you will see these little kiosks and carts... they are at every major intersection.  The kiosks vend cellphone minutes (either "Orange" or "Moldcell") as well as candy, lighters, etc.  The carts sell beer, juice, water, etc.  Other carts and kiosks sell foods, or perfumes, or newspapers... (I found a French bakery stuffed inside a kiosk about twice as large as the kiosk in this picture.)
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...or cigarettes.

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There are also many, many pizza places; which I guess makes sense given that Moldova is renowned for its tomatoes (and grapes, apples, wine and dairy...)

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These are the signs you see indicating monetary exchanges...

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And we've finally made it to the corner of Metropolitul G. Banudescu Bodoni and Boulevardul Stefan Cel Mare Si Sfint

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A more formal street sign  :^)

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In the distance you can see what will later be described to me as "the place where the president goes when there are problems..."

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And across the street...

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... is another park:

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Above:  Check out that Oak Alley...

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(In the interest of Joe and Michelle's ongoing debate as to whether that is a "Space Walk" or a "Bouncy Room"... the man told me it is a "Balon" = Balloon.  There were quite a few of these in the park.)

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And after passing the cafes on the edge of the park, we have looped back onto Stefan Cel Mare; about 2 blocks down from G. Badunescu Bodoni

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Here I find a cinema...

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..with an open air cafe.

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mmmmm....

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After getting directions to #192 Stefan Cel Mare, I come to the "President's Offices"

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*****HIJACKED*****

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And now from here I am no longer on my own... if you haven't read the "Hijacked on Stefan Cel Mare" post, some of this won't make snese... but here goes.

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 A church...

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Mass...

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...and the park filled with brides...

(sorry, these pictures were all a bit rushed... but I wasn't exactly on my own time at this point.)

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Hey, I'm getting good at this... :^)

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Wow, your beautiful.  No, don't get up!  This Journalist would like to take more photos of you!

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I think the groom wanted to choke me... :^)

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 My buzzed up tour guide... the one and only... Marina!

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And, just in case you didn't believe that I was wearing a jersey, jeans and sneakers in that beautiful church during mass...

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Yours truly, not allowed to smile (Marina's orders...) looking as silly as my day had turned.

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Hope you enjoyed the tour... sorry I didn't get pictures on the trolley or autobuz; I was in a bit of shock at the time.  :^)