Democracy in action?

This past Sunday Ukraine participated in parliamentary elections. The elections, these and ones in the past seem to be frail led with fraud. The whole election campaign has raised many questions in my very confused un-political head, and these are some of the answers I got. Ukrainian politics are fraudulent, much like politics anywhere else. They are filled with corruption and this corruption apparently has gotten worse. The orange revolution, as it turns out happened not because corruption became evident but because it reached a certain level of ridiculousness. corruption became so open and wide-spread, elections so fraud that people got angry. Elections were recounted and overturned, but yushchenko who became president effed-up and failed to do anything useful, so he lost the next election to the very guy over whom the orange revolution happened in the first place. Since president yanukovich has been president, the country has reverted back to corrupt ways. The president and his posse suddenly own large chunks of historic land, this land is used to build mansions. The opposition is angrily and severely persecuted: as in the example of yuliya timoschenko who was tried and convicted for some bogus crime. People are dying for random reasons. The year the economic crisis devastated Europe and specifically eastern Europe, there were several new millionaires reported in Ukraine. How? It's unclear. But the president's entourage, his party and supporters benefit from large sums of money, investments, real estate, and most importantly, cover from doing things outside the law. So the election. The party of regions, president's party is the main contender, opposed by various democratic parties, collectively known as the opposition. No one seems to be voting for the party of regions. And yet, somehow, its votes are growing. Several widely known facts: regional centers, small towns and villages, collectively vote for the presidential party, while having a terribly high voter turn-out. How? The mayor or governor of the region acquires a bribe and essentially guarantees votes by ordering the villagers to vote for the presidential party. Things get fixed quickly in return for votes, as the local official suddenly has money to build some personal property. Before the elections buses appear on Kiev streets. These buses bring people for temporary residence in Kiev for elections. Meaning, you are allowed to vote in your current physical location, so the presidential party literally fills buses with random students, ships them to the city, after buying dorm space, these people are housed in local university dorms and here they get to vote for the presidential party to ensure the right person ends up in the congress seat. Retirees we're approached on the street and given food packages in return for votes; election representatives would show up at your house and offer to pay money in exchange for your vote. The military apparently votes for the presidential party, these are direct orders, which you cannot disobey. The higher ranking officers are required to vote for the presidential candidates and take a cincture of your "correct" vote with your phone, if you don't, you risk losing your job. Which is a commodity. The night of the elections, exit polls showed that party of the regions was ahead. Not a majority ahead, but ahead. Tere was no official report as to the voter turn-out, despite the constitutional law that requires an official report before midnight. The votes are still being counted... The morning after, the presidential party has a oajority, while the opposition parties are not gaining votes and if anything, some have lost votes from reported exit polls percentages. If you add up the totals, they now exceed 100%. Im not a math person, but I'm pretty sure thats impossible. There are pictures of large stacks of ballots dumped into voting baskets, votes unclear. Voting committees have left counting randomly, as they pleased, without clear explanation as to why. The parliament will be filled with majority candidates from the presidential party, that is to the question. But how much cheating will happen before final numbers are in remains to be determined.

monday stress

i had a stressful day. it all started with toilet paper. apparently the city hospital does not have toilet paper. there is a doctor bathroom, locked with a key that hangs out in the call room. bathroom is nice and clean, has a shower. but i walked in and desperately looked for toilet paper, nothing, not even a toilet paper hanger...so i walked out, bladder full. and since i continued to forget to bring disposable pack of tissues, i suffered all of last week, full bladder despite large quantities of consumed coffee. finally, this morning, i remembered, so i walked into a store to buy some tissues. i found an entire row of shelves, with wet tissues. imagine, something like 7 shelves all filled with wet-ones, different brands, different flavors, smells, strengths...all wet. i literally stared at the shelf for like 20min. maybe i missed it, maybe i'm not reading it right, maybe i'm just totally crazy... nothing. some lady comes by and starts carefully staring at the shelves. we are now staring together, looking. i walk around the corner, maybe there is a whole shelf-full of dry tissues just around the corner..nothing. i come back: "ummm...there are no dry ones" "i know!!" finally, she breaks down and asks someone about the dry tissues: apparently, they are in an entirely different store section, at least they exist. at work, i am allowed to place leeches. this is additionally stressful. the little mo-fo's are squirmy and wet. they are different to grab with ring forceps, i'm afraid i am going to squish them, i'm afraid they're going to escape. the little 'resident' behind me is encouraging, but is always whispering something about the gauze being not entirely over the entire cervical surface, fearing the little criters with climb inside the uterus. mind you, i'm operating in one glove only, without a light. little buggers do not want to attach, i cant tell what's head and what's tail. in the end, it worked. but i was not a fan of this procedure. then, the head attending created a neo vagina. the scrubbing procedure is very interesting: you scrub your hands, then, you are given 2 4x4s which you use to dry your hands. then, you are handed another 2 4x4's soaked in ethanol...for disinfection. then you are dressed. the robe doesnt tie in the front, just the back. every time you touch something in the sterile field, which is maybe not exactly the sterile field (like the steril-y draped portion of the leg), you are handed a gauze soaked in ethanol, for disinfection. needles are not counted, in fact, there is such thing as disposable needles, and vicryl is threaded as if sewing thread. sponges and laps are not counted. i asked the scrub tech if they are counted, no bt she knows how many she has...so they are counted?? the anesthesia machine is old...there is no blood pressure cuff, the anesthesia intern (resident? nurse? i'm not actually sure who she is) takes blood persssure by hand, intermittently. they use monopolar--these prehistoric coag forceps. the attending who is assisting by holding the vagina, or what is going to be the vagina, at some point, removes her sandals, and stands there barefoot, on a step. the patient has no foley, she is intermittently straight cathed, despite the fact that we are operating by the bladder and the urethra, with a high risk of getting in to the bladder or accidentally injuring the urethra. . the foley is inserted after surgery, when patient goes back to teh room. returning to the call room, all the attendings are watching the elections. but more on that later.

parties, gangnam...I mean, kiev style

i'm sitting on a stool in the kitchen, drinking 2.5 shot espresso cafe au lait, trying to figure out why i hurt. must be the dancing in heels part. yesterday, the day started with souvenirs. we stop for vienesse coffee on the main city street. two very cute old gentlemen at the table next to us are discussing modern use of foreign words in ukrainian language, in perfect literary ukrainian. i, in turn, decide to loudly complain about shitty translation used all over the place, including the menu items, in not-so-proper english. then, Andrew's Descent, one of the main crafts streets in Kiev. it is freezing, like really freezing and at some point i stop feeling my feet. then, i spent some time babysitting. there is a kids halloween party in the local mall. this mall is kind of amazing. there is a ice skating rink, roller blading rink, bowing, curling, movie theater, zoo, aqua park, arcade, ton of little eateries, and shops. my (favorite under the age of 15) niece is dressed as a monster high character. i dont know what monster high is, but she is a monster...except that she looks like a cat. whatever. i dont have a costume, although i suppose i could always just be an angry american tourist. this place is a cesspool of children, all dressed in costumes of various effort levels: some are super dressed, some are just sporting head garments. i am surrounded by screaming children. this is not ideal. Rita, (that's short for Margarita) is not a fan of the halloween party so we just walk aroud. first, we paint with sparkly sand. we make the little mermaid. her skin gets a sparkly yellow coating, Ariel becomes asian, which is not quite accurate. then, the girl who is helping children peel away layers, serially removes concentric circles from her eyeballs. Ariel gets grey retinas, blue pupils and yellow sclera. ariel is now asian and jaundiced. after we are done, we eat ice cream. then, i am dragged into the 'zoo'. this zoo contains snakes and lizard in giant glass cages. after entering this place i realize that i am not a fan of snakes and lizard. not at all, i'm mildly grossed out. we need to leave. on the way home, we get two kinds of candy and nuts....yes, i am a seven year old. later that night, we go out to a club. this is supposed to be a super swanky Kiev club. it's hard to get in, face control is tight, unless of course you have a VIP card, which Anna does. this VIP card not only gets you in but also gets you a drink dscount inside. there are four floors: first is a restaurant, 2nd is a club lounge, then dance floor, then loungy booth floor with a bar. the dj spins house music, oddly mixing it with both depeche mode, moby, and coldplay in addition to your general pop music. the dancers interchane frequently and change many outfits. tehre is a whole production on stage. if this doctoring thing doesnt work out, sadly, i could not be a ukrainian go-go dancer: i eat too much. we dance for a little, i get smacked by some blonde doing some crazy hair spins. therse are too many people on the dance floor. Some dude decides to dance with me. He can actually dance, as in he carries a tune and has some decent body movement, but it's interrupted by strange gestures, like fist pumps, making him sort of resemble Vinny... Maybe even PaulyD. upstairs in the lounge, dudes are crowd watching while smoking hookahs. these dudes are surrounded by various forms of women. there are dudes loitering by the stairs, waiting for i'm not sure what. dress code is actually pretty decent, no crazy outfits, nothing super fancy. i guess i sort of look like a fit in. the club is super smoky, everyone smokes, people light up without leaving the dance floor. at 5am we leave, the party is still going strong. i smell like an ashtray that smoked another ashtray. i think i've aged three years just from smoke exposure. i want to burn my clothes. it's still dark out. this is normally the time i get up for work and i feel old.

tale of two clinics

Welcome to private REI (that's reproductive endocrinology and infertility, ya'll) clinic "Oberig"! here things are organized. there is a receptionist, there is an appointment list, patients are seen according to their appointment times. for some reason i am required to place booties over my shoes, remove my coat. i meet the guy who runs the clinic. he talks about a mile a minute and exhibits minor ADHD tendencies. he works fast, clinic appointments are brief, in and out, everyone gets an US. upstairs, there is a small OR, recovery room and labs for genetics testing, fertilization, embryo transfers, cryo--whatever the hell you want. it's kinda awesome. back to the city hospital. every morning i make my way to work. i take the speed tram (cause it's impossible to fit into city buses) and walk (uphill) for about 10min, not bad. at the tram stop you have the options of exiting the tram and walking back to overhead pass to get to the other side, or you can walk forward and getting to the end of the platform, climb down to the tracks and walk along tracks until the fence ends (cause there is a fence that prevents people from, you know, walking on tracks and dying). i follow the crowd and climb onto tracks, you have to walk fast, or flatten yourself against the fence to dodge the oncoming trams. work by the way starts at 830am, luxury if you ask me. the interns (aka 'residents') are allowed to miss rounds, which are at 830 sharp. this is when the charge nurse reports to the head of the floor (ie head attending) how many admissions there are, who went home yesterday, how many people are currently in-house. after that, everyone catches up on charting, waiting for cases. this is, again, interrupted by patients coming in to ask questions about whatever it is they want, or random other outside patients who need to be seen. actual morning rounds are deferred until after patients have had their breakfast, this appears to be very important for patient care. i'm sort of used to watching women just hang out in lithotomy for a while, in a common room, with others in the room, this does not appear to be awkward for the patient. i change in a tiny closet, its handle falls off, so i frequently have a panicked feeling thinking i am now locked in a tiny closet because i cant get the door to open without a handle. then, i sit on the couch waiting for someone to tell me about an exciting procedure. people feed me coffee, and attempt to feed me snacks and other things. they ask many questions about the american medical system, sometimes i get very generalized questions like "so is everything better there?" to which i'm not sure how to respond, other than with 'yea sorta'. the OR equipment is a bit prehistoric, like the laparoscopy and hysteroscopy tools. there is only one screen, the fluid pressure for the hysteroscope is applied directly by squeezing the bag, as the fluid machine is 'under maintenance'. the drapes are flimsy and are not quite the OR drapes (but hey at least they exist). apparently, i caused quite a raucus by scaring the crap out of all the janitors with my Dansko's: they were shocked by my wearing such 'boots' into the OR. everyone else, you see, wears sandals, no socks. not sure how my OR Danskos are dirtier than people's feet..but whatever. speaking of exciting procedure. many women are undergoing leech therapy. it is used for fibroids, endometriosis, infertility. in essense, leeches are applied to the vaginal walls...to, you know do their thing, while the owner of said vaginal wall hangs out in lithotomy, facing the window. you get five total treatments in a series, one a day. for this you are hospitalized. usually, two leeches are applied at a time. they are kept in individual jars, and discarded into communal leech jar afterwards. it is strange, i have yet to see evidence for this. but it seems very popular as it is one of the reasons why people remain inpatient in the hospital. in terms of remaining inpatient, there appears to be an issue with the upcoming elections. apparently, since some people will remain in the hospital, there is a chance they might miss the sunday elections. so some officially designated electorate lady went around the ward signing people up to vote and collecting their IDs. if you have done this, you can now vote in the hospital, while inpatients...you however, may not be discharged home, if you need to be before sunday, before you lack your ID papers. if you happened to register to vote prior to presenting to the hospital. you immediately need to be discharged, regardless of what is happening to you medically, by sunday, so you can participate in the elections. i will talk about elections later.

First day at work

Since I've been idling in Ukraine, I finally found a clinic to hang out at. I show up to meet this lady who is supposed to set me up. I go to an ambulatory clinic, kind of like a general ambulatory clinic, where there is a separate women's health center. Because I am early I hang out in the lobby. The Ukrainian elections are in a week, so the clinic lobby will, on the day of elections, serve as a voting center. Wich means that the resume of all the representatives running (and these are representative elections) are hanging out in the hallways, for all to see. Resumes include not only their full education and current job profile but also full names of their. Spouses and children, along with their addresses and phone numbers--maybe I'm just jaded but man, that's like a perfect stalker opportunity: let me steal your children and rob your house, before I vote for you. Once I get to the actual clinic, there is a sitcoms check. There does not seem to be an appointment list, people sort of just show up and wait in line. Meanwhile, waiting patients continuously pop their heads into the room, while you're seeing someone else, asking some burning question and end up being seen without waiting. It's messy. In this clinic, it appears, there is nothing for me to do--this is ob clinic and I'm too infected with whatever to ever step foot around anything newborn--so I am send to meet some other dude. The address of the next clinic is the Romanian embassy....I hope this is not right. I find it anyways, in the back of the embassy. There is no indication of where things are, X-ray is next to gyn rooms, next to ortho clinic (?!?), but after asking a bunch of people I make my way to meet the dude. He pimps me about medical things and then leads me to the inpatient gyn floor, leaving me with the inpatient unit head. The inpatient unit is confusing. Patients are sort of just hanging out, in their own clothes, terry-cloth bathrobes, and house slippers (or worse yet flip flops). Most of them do not appear to be sick and as it turns out are there for things that I would send everyone for outpatient evals (like patients are admitted to undergo Ultrasounds).i end up sitting in something along the lines of the call room. Tere are multiple bales where attendings sit and scribble notes in patient charts, which are all paper and appear terrible disorganized (UA's are hand glued directly into it). There are no actual notes, just scribbles, and the process is constantly interrupted by patients walking in to ask questions, to get doctor's notes, and to review results--this is both inpatient and consult setting. Again, intermittently, this is interrupted to perform Minot procedures. The procedure room is this large room with one wall being all windows. There are three gyn chairs, all facing the window, and in one of them, in full lithotomy, is a patients...just kinda hanging out. There are about 7 people in the room, and I immediately check to make sure there are o building across from the windows...cause, to know, this is awkward. I lean against the window, while staring at this lady's cervix just hanging out, and look back. On the window sill are vaginal smears, just neat little rows of glass slides on pieces of paper of patients' names and diagnoses scribbled. I quickly lean away...this is mildly gross. I now saline why the chairs are facing the window--natural light because the only OR light on the stand only has like 3 bulbs in it. There are no drapes on the chairs, each patient walks in with her own towel to sit on, and after the procedures, they are asked to get onto a cart (board with handles in wheels, no brakes or rails) after they have independently climbed into and out of the chair (this is after general anesthesia). There is a sheet on the cart, but no second sheet for coverage, so patients Re wheeled away on their sides (because that is how they slum onto the carts) I frantically try to cover their butts with their Own terry cloth robes as janitors (yes janitors) wheel them away. As I walked home,navigating post-work-day traffic, I felt bad. Mostly, because most of what I saw was simply because of lack of resources. And every single terrified and confused tout I had seemed like an arrogant developed world snobbery. The physicians are good, they have to be working like this, with nothing. But it seems weird that is happening. I gotta g to bed, back to work tomorrow.

grave hunting

so we go to the cemetery. my great-grandmother, her sister and more recently my grandmother are buried in the cemetery on the outskirts of the city. searching through the old jewish section of the cemetery is always a trick. many of these graves have nott been visited in years, left and forgotten by the 'from loving children, grandchildren'. many of the progeny have immigrated long ago, many others have died themselves. some of the giant gray tombstones have inscriptions in Yiddish. those that are much much older dont have birth dates: people were too old to remember the day and month of birth, simply "died at age ___"; others have just the year for the year of death. most often, it's listed as "1941" with a modifier "tragically died during World War II". you have to wonder if these are empty stones, where souls and bodies of their owners are left somewhere in concentration camps or mass graves. it's eerie to be around this old part of the cemetery, odd to look at names and faces on tombstones, trying to figrue out how people are related to the loved ones buried next to them. my mom tells a funny story: some time in the 60s, my great-grandmother acquired this giant silk imported French scarf. her daughters begged her to divide it into three (it was that long), so that each daughter and she can half a smaller scarf. my great-grandmothers reply? absolutely not, you will bury me in it. the day she died, her sister, my great-grand-aunt Dora came and brought the scarf. she cut it in half and even though they died 8 years apart, each one was wearing her half. we go searching for old graves of relatives' relatives. long story. but this turns into a great adventure. this part of the cemetery is even more abandoned and old than the other. no one knows where graves are, the map at the entrance to the place is terribly inaccurate. the cemetery is divided into sections, but somehow there are 3 sections "18", and "17" is nowhere to be found. we are walking up and down rows, taking detours when rows become too overgrown and impassable. i am walking on a thick soft layer of fallen leaves, both most recent and those left over from winters before. bugs are everywhere, even though it's october. i am fighting grasses, climbing over bushes, ducking under branches. it is a jungle. i am somewhat disgusted and somewhat creeped out, hoping not to step on a concealed dead animal or worse not to fall into an uncovered abandoned grave. this is not fun, especially since we're looking for some tombstone with a jewish last name, essentially searching for a cohen in a sea of cohens (not really, but you get the point, and i defintiely found like 4 different people i wanted to claim as the right ones, just so we can stop looking). at some point, i lose everyone and panic. then, we come across some dude who is 'trying to help' by asking man questions withoutany answers. not sure what he is doing there, randomly, but there is a pair of pants hanging out about 10 feet away from this guy. "mother, is this man wearing pants?" he is. we finally find the one we're looking for and walk back to the car. i open the trunk to get the purses out (because they are hiding there while we're on the adventure), i shut the trunk close and the car pulls away. srt of not funny, i try to jog with it, but i have three purses (yes, my uncle wears a purse ("it's european")) and it's hard to keep pace. so i lose them. i am lost at the cemetery. fuck. thankfully, i chased the car long enough to be facing the main street, i head towards it. i finally realize that i have a cell phone, so i dial, hoping my uncle has his mobile in his jacket. he picks up: "hello?" "where did you go??" "who is this?" "umm... ALEX?" "who's Alice?" 'godamit, just check the back seat for me!" ...pause..."SHIT!" i'm ok. everyone made it out, but just to be fair. death, i guess, is not so funny.

The intro

Made it. It's almost 7am and the sun is slowly rising. You can hear the traffic below pick up. The speed tram has been running for a while. It's partially responsible for my awakeness. Part jet lagged part just used to early rising, I'm contemplating how quietly I can make myself that cut of coffee, without waking anyone up. The flight over was mainly uneventful. Seems like hours of sitting and waiting, to take off, to board, to land. Although... At the airport, trouble started at the check-in kiosk. Since when international check in is automated? I was amazed at the lack of actual human counters: just a few isolated security workers running around in frantic attempts to check everyone's passport. My passport wouldn't scan, after it finally did and my boarding pass was printed, there was a commotion. The pleasant security officer "helping" us (but really checkin us in as he is supposed to be doing on internstionsl flights), takes my boarding pass and goes "umm...we don't usually see this, but your boarding pass came out with quadruple S, which is a high security alert." QUADRUPLE!?!? what does that mean?! Well it appears I'll have to answer a few extra questions...wtf? We get to security line and the security sees the boarding pass and starts loudly yelling at someone over: quadruple S, security alert, I'll need some extra assistance! People. Are now. Staring. We are whisked to the front of the conveyor line, dismemeber, I mean, take off shoes and watches and liquid bags out of bags, and pass through the X-ray (which by the way is not made for short people, cause the two feet painted on the floor, where you're supposed to step are way too far apart for me to straddle) and are again pulled aside: "we need a female pat-down over here" can you yell that louder?!? Our bags are thoroughly searching for drug or explosive residue, we are thoroughly patted down (she did go down my cleavage line and I'm pretty sure cupped both butt cheeks) we are let go. So why did this happen? Not sure, the security guy explains, but if I want, I can go onto their website and start an investigation to let them know they have tagged me wrong because I'm not the person they're looking for. Is it because I don't have an IRB? Did the IRB alert the authorities? Crap. I sleep on the plane: constricted, cramped, noisy, sleeping pill-aided abridged sleep. I make friends with a guy coming back from US- Canada tour with this touring large band thing. Munich makes me happy. Not sure what it is that makes me into a creepy germophile that I am, but even the airport proximity to being here just fills me with joy. I speak German and this makes me realize I miss the language, in my overly filled Spanish-speaking-patient incompetent life, it's good to actually communicate. I get complemented on my perfect German by the convenience store guy ("you live here?" "no, not right now") and we board the last leg of the flight. My mother makes a drunk friend. This guy, who reeks of booze (it's ten am) and has questionable stains on his pants, brown but sort of not in the location where one can soil themselves or aim to directly vomit...I don't know maybe it's ketchup, proceeds to start a conversation with my mother while we're waiting to board. He tells her his life story about ex-wives and step children, all while strangers are staring at ths charade. My mother is actively ignoring him (and I'm just laughing). After he treatens to help her with her bag, she tells him to go away. Then he asks if he can sit with us... I had no idea my mom has this weird attraction of the drunk. We land and the customs line is a mess. There is an actual line, like the bell demarcation of the line, but it's hard to tell it's actual shape. There does not appear to be beginning or end, therefore, the whole place is a one big shapeless herd aiming towards several small cubicle like border patrol peopled holes. People are pushing me, some lady decides that if she stands so close behind she is actually holding my ass, it'll get her to the front of the line faster. After several minutes of aimless herd-like movement, we jump under some useless rope following a fellow lost American and get ahead. The border guy is nice, and I, for the first time recite the address of where I'm staying (thanks shannon for making me fill out paperwork and yes you're supposed to provide an address of stay) we're free. Welcome to Kiev!