the news

i have been watching a lot of morning news shows, or rather morning digest ala 'good morning america', mostly because my body decided it wants to be awake in both hemispheres. the channel one news magazine is slightly different from what you'd expect. it is more of a DYI meets martha stewart meets BBB. it features short little segments on how to organize your nuts adn bolts drawer; how to sew your own trendy coat. it has reporting on some poorly functional bureaucrat in a tiny village in siberia who is failing to respond to some grievances put forth by the tenants, it then offers crafty 'expert' advise (actually titled expert in whatever household goods, but likely just a chief janitor offering his opinion) on how to go about getting your complaints addressed. it teaches proper driving by showing a segment of some police camera recording traffic violators. the consumer reporter teaches you how to buy best quality cottage cheese and how to spot overpriced sausages (did you know that you can tell how thick a lemon's skin is by the stem attachment little button?! did you know that if you stuff your shoes wiht newspaper, you can keep your feet warm?) there is a daily horoscope, there is a new diet and trend part. all of this repeats about hourly, interrupted by actual news segment about every 10min. the actual news. did you know there is a war going on? the fighting in Eastern ukraine has not been on the news. people have forgotten about it. the fighting, however, continues. the separatist forces continue to assert their rule, the authority and sovereignty. the DNR and LNR (that's Donersk national republic and luhansk national republic) continue to exist and hold fort. the fighting has recently escalated, when the ukrainian forces began shelling, some of it along civilian areas, in order to secure the donetsk airport. then, a bus was blown up, evidently by artillery fire. listening to the russian news, all of this is coming from ukrainian national force, the army, which by using artillery and long-distance missiles, is harming civilian sites. remember, this is skewed and russian perspective. it is very possible that it is correct, however, it is skewed. it shows poor separatists as trying to preserve their little regions' independence in light of angry, violent, almost fascist ukrainian nationalists, who are just so evil they'd rather shell civilians than engage in open adn fair combat with the separatists. again, not sure whether this is correct. what is interesting though is that russia, which is known internationally to be backing separatist forces, not just with military force but also with man-power, is not saying anything, anything! along those lines. whatever fighting is going on between the separatist and ukrainian forces, whoever is at fault or responsible for civilian deaths, the blown up bus, there is zero mention of russian involvement. none. every conversation, though, throughout the city involves ukraine. people on the street are talking about the fighting, are talking about the two regions wanting their independence and evil ukraine not letting them have it. ukraine is blamed for being nationalist and fascist, for being responsible, solely responsible, for all the violence. russia's involvement is not mentioned. at all. the guy who drove me to the airport spent the whole time talking (more on taht later) adn of course we got to discuss ukraine. he supported the region's independence from ukraine adn i asked him if russia would ever just take them in. "oh no, we dont want them." so this becomes even more confusing to me: initially the whole separation came about as a result of the february uprising. people revolted against an oligarch, who coming from eastern ukraine supported russia adn russian ties, whereas the rest of the country, the people, wanted ties to the european union. this resulted in violence and the oligarch, the president, was overturned. but the anger resulted in some harsh sanctions against anything pro-russian, which unfortunately affecting the currently fighting regions. they felt slighted, oppressed even, and started fighting asserting their separation. this has been going on for a while, although the western media, or rather american media, has stopped caring or covering anything along ukrainian lines. and the fighting continues. ukrainian government has made serious concessions, basically taking back all the scary things that made the region want to separate in the first place, allowing them a certain degree of freedom for staying as part of the country. but i guess that's not enough. what's confusing, yes, sorry i'm getting to my point, is that if separatists want to be closer to russia and russia doesnt want them, what are they thinking?! it's like Minnesota declaring independence, all by itself. the tour-guide who took us around the kremlin, touched upon the fighting as well. her opinion was that eastern ukraine should belong to russia, because centuries ago catherine the great conquered it as part of her path down to crimea to defeat the turks. logical, yes, but also, by this particular logic, india should be returned to england because, you know, it once controlled it. or poland should just permanently become part of germany because it controlled it several times and mostly, conquered it on its way somewhere else. this logic i do not understand. in the mean time, fighting continues and i'll have to hunt for some news sources.

the culture of excess

is what my boss referred to as this musical dinner celebration thing he attended, while i was at the bolshoi. he prefaced it by pointing out that he does not mean it in a negative way. but this is kind of what i mean. following the lavish first night dinner, we arrived at the conference a little after 830. we were herded into the queen's office to drop off our coats. there was a line of people outside the door. as it turned out, it was her birthday and all these people were the clinic staff awaiting to wish her a happy birthday. the office was filled, overflowing, with flowers, all from colleagues. it felt like a flower shop, and you had to compete with space with beautiful baskets, arrangements, and bouquets. a ton of flowers, in the middle of january in moscow. the flowers migrated into the conference hall and now line the staircase down to the podium. the snack table made laid out for us while we're dropping off our coats? gets replenished daily. it is full of snacks, nuts, and chocolates; blinis, caviar, and fruit. although i'm pretty sure the fruit bouquet is not faring so well as i think i spotted a moldy strawberry. for lunch, we are herded into the tiny clinic cafeteria where simple mortals are fighting to quickly grab a pre-made and undoubtedly stale piece of bread with a slab of bologna on top and coffee in a plastic cup. we are served a 3 course meal, shitty, but three courses, complete with wine, appetizers in the form of head cheese and blinis with caviar. this morning, my boss tapped me on the shoulder on the bus and said "guess what they served for breakfast? a large bowl of caviar!" now, the thing is I dont think it's a purely caviar-centric obsession. I think it's just part of that thing where you treat your guests well adn show off by offering the best-est. so then i started thinking more about excess in russia, or in russian culture more specifically. watching 'boris godunov' the opera, i was amazed at the brilliant period costumes. i mean, shiny gold sparkle everywhere. joseph and the amazing technicolor coat has nothing on this. and the thing is it's likely true to life. this opulent shiny rich garb of the tsarist russia, the pelts of the boyars. peter built a new capital and a navy, on a whim, to compete with european capitals. he succeeded and people died, but who cares. st. petersburg adn the court culture it created was on par with the courts of europe, if not more, since russia continued to have serfdom well into the 19th century. but fine, maybe all of that can be chucked to monarchy and autocrat rule. maybe, like the kings of other european countries, it was just supposed to be. ok. let's move out of the monarchy, but even in the twentieth century, the soviet union just continued the trend, if not excelled in it. the powerful soviet empire, wiht happy fulfilled citizens portrayed on the world stage, who exceed at sports, the arts, adn such, come from socialist equality, where basic necessities, the daily things of life are hard to procure. i'm not talking about a full explosion of consumerism, i'm talking about recycling old clothes because you physically cannot find new ones in stores. today, the russian economy is tanking. my dollar is worth so much more than last time i was here. as we were driving to the conference this morning, one of the delegates pointed out that the city was eliminated. it is still dark at 8:30 and the city is truly lit up with christmas lights, lanterns and other such things. the conversation went along the lines of how in this economic crisis, moscow still can afford to light up the city. i suspect russia is not short on fuel, but still, the question remains, and the culture of excess continues.

conferencing

So the conference opened yesterday. The opening remarks, or rather ceremony, included a musical performance by the Spivakov camera orchestra. For those of you who dont know who they are, this a very big deal orchestra, they perform internationally, they sell out venues. They performed directly on the stage where the podium for the speakers was set up, in such a way that the partially present wind section was sitting behind the podium. The bolshoi soloist joined them for part of the performance. She sang several arias, she is gorgeous. and the whole spectacle was, well, kind of much. the conference attendees are clinicians, presumably, from all over Russia. the clinic staff are also participating, in sneak in adn out throughout the day in scrubs. since the conference is taking place in the clinic, well, the space of the medical center, there is activity going all around. mortal clinic workers going to work every morning, patients showing up for their appointments, patients who are hospitalized and are trying to walk to their doctor's office to ask a question, fully gowned in 'house-clothes' because, you know, they are in the hospital, complete with slippers, sometimes robes. now, there are no people in house shoes at the conference, but some of them are wearing shoe covers and white coats. why do you need to wear a white coat to a doctor conference i'm not sure. it seems that the russians are not very good at using their cell phones. let me rephrase that, they are perfectly capable of making phone calls, answering phone calls, texting, and taking pictures. they are, however, not familiar with the silence function of their cellular devices. the phones are going off all the time, which is annoying. what is more annoying is that people answer them. pick up, have full conversations, all the time. the important scientific presentations are constantly interrupted wiht "hello? who is this? i'm at a conference". damn right, you're at a conference, hang up!! there are side conversations, not in whisper but full volume. someone's alarm went off for a solid 5 minutes (alarm, not pager). i sat next to a lady who ate a cough drop q15min. individually wrapped, crinkly cough drops, every 15 min. crinkle crinkle crinkle. crinkle crinkle crinkle. the conference is simultaneously translated. in exchange for some valuable, like a passport or a shoe, you can pick up a transmitter at the entrance to the conference. what people dont realize is that simultaneous transmitters are like walkie-talkie: they emit radio waves, radio waves that sometimes cause interference. so you get a lot of cshhhh noise. cshhh crinkle crinkle. additionally, what people dont realize is that if you think you're simultaneous translator transmitter is too loud, it probably is. in which case, the best thing to do is to locate the volume control and turn it down a bit. because wearing it around your neck or putting it on the chair next to you means that everyone around you is listening to the translation as well. which is annoying when you dont need to be, like, if the presentation is in english. it's like trying to listen to a conversation with two conversations going on, plus whatever else side-talks are happening. coupled wiht the fact that the presenters are not native english speakers adn you're already trying to decipher the musical italian, which makes everything sound like a question, or a rolling "r" rumble of mumbly french, and i swear i feel like i'm losing my mind. everyone takes pictures of the screen of the power point slides. it is actually quite an amazing site: an entire conference full of phones, ipads, and ipad-like devices, rising in unison with every change of the slide, up into the air. everything is photographed: slides with graphs, important quoted studies, title shots, the 'thank you for your attention' slides. i swear i watched a woman take a picture of every single slide of every presentation for the entire day. what is she going to do with them? organize them? label them into folders? use them for clinical practice or her own presenting skills? who knows! the podium on stage is for those presiding over the plenary sessions. irrespective of the fact that presentations are going on, that people sitting on stage are in front of the whole conference, people keep walking back adn forth up onto the stage, asking questions, delivering messages, whispering things to the queen. queen's minions (she has minions, or more like secretaries and personal assistants) are sometimes summoned by the queen to come up and receive an order. the minions wear slim skirts and tight dresses, heels and tights. they are slender and have long hair. only 50% of the minions speak english. there is also a lot of yelling from the podium. yelling in the form of presiding, which at times is almost comical. presiding directed not just as the 'service' individuals like sound guy ("we need sound! i said quickly! who is responsible! you are not listening to me! now!"), but also at the delegates ("i implore you to cease all activity! stop moving or get out of here and don't come back! raise your hand if you heard me! did you hear me?"). i literally laughed out loud at some point when the conference was ordered to raise their hand and answer a question about something. mostly, because the conference complied. the day ended with broadcasted surgery. large screen, broadcasted from the OR, multiple ORs, surgery performed by the congress delegates world renown gyne surgeons. i hope my colleagues at least got to meet the patients before they were asleep. i wonder what the consent process was like. even though i am your doctor, someone else will operate on you. the risk of the procedure, in addition to the standard bleeding, infection, injury to pelvic and abdominal organs, and death, also includes exposing your internal organs to the world as well as being recognized by your internal organs. actually, that's irrelevant because the case presentations included the patient's names. NAMES! not their birth dates, or medical record numbers. names. HIPPAA would have a field day about this, what IRB approved this. wait, wait a minute, there is no irb. but who is writing the operative report, since the surgeon doesnt speak russian?!?

"Friendship is more important than science" or how to crash an international conference

So this conference. I believe I got invited accidentally. The former chair of my department, one of the esteemed and world renowned professors, happens to sit in our division, in the office across the hall from me. He happens to know this amazing woman, the queen of russian gynecology. I also happen to speak Russian. The combination of these things is what brought me here, on a whim, as an invitation from the queen, but really because of my boss. My presence at the conference, although entirely coincidental, is quite astonishing though. The conference has not started yet. but last night, as the prelude, but as a guest and escort of my boss', i was invited to pre-conference dinner for the esteemed speakers, which sort of left me feeling like a kid at the adult table, who is sent to bed early but wakes up and comes downstairs because of the noise, and is allowed to stay, quietly, to avoid a scene. So i guess we should start at the beginning. The hotel. It is old and historic. If you walk out the door, to the right is the Bolshoi, to the left is the Kremlin. The parking lot literally abuts its outside wall. In addition to many famous people staying here throughout the years, in 1918, immediately following the October revolution, the new Soviet government occupied the building when they moved to Moscow from St. Petersburg. During the Soviet era, this was an international hotel, a currency hotel, which meant that you can exchange foreign currency here, but more importantly, buy things with foreign currency and things that you would not buy anywhere else in the country. The halls of the hotel are tiny mazes of persian rugs and mirrored halls, giving it a feel of an old theater or concert hall rather than hotel. The rooms are tiny, like really tiny, but covered in this beautiful textured wallpaper. There are condoms in the minibar. The conference. This is the 38th international conference on gynecology. Last night, amidst many (many) toasts, the people present discussed meeting for the first time in 1991. That long ago. It has been held in Moscow since that first time, when it was commissioned by the party (the Soviet party for those who are not following). At the time, apparently, every representative of the regional (or district) Ob/GYN had to be present, in addition to many international delegates, and the idea was that forcing all these physicians to attend a conference would propagate knowledge and skill exchange. not sure how much it propagated as the Soviet Union collapsed later that year, but the conference, i guess, stuck. The food. The dinner at the hotel restaurant was organized specifically for us. large table is set in the back in this beautifully decorated dining room, complete with chandeliers and ceilings paintings ala old italian mansions. the room is small and there are a few other tables that are occupied but we definitely occupy the large portion of the restaurant. the table is set with ou d'orves (somebody spell it for me). the wine keeps flowing throughout the night, with waiters refilling half empty glasses. champaigne toasts, well-aged italian red. "would you like the beef or the cod as your entree" "oohh, neither, can you make something without meat or fish?" "no....well, we can maybe make truffle risotto" "that sounds fantastic!" the truffle risotto was tasty. definitely not risotto though, but mushroom barley, definitely definitely just barley. The people. Mind you, I am being paraded as my boss' protege for lack of a better word, meaning I am introduced to everyone, and the people I am introduced to are amazing. I get kisses from the queen (both cheeks). warm handshakes and curious looks from other speakers (because I clearly do no belong). you may have heard from the news of this guy who transplanted a uterus last year? yeah, met him last night, sat at the same table with him. his wife is flawless. the first frenchman was rude, the second one walks in and my boss goes: "Oh Jacques, meet Alex Golobof. She is..." "Oh mon cheri..(hugs and kisses (that's multiple) follow)..she is a...??" "...She is my fellow!" "Oh....well, she is beautiful." #nothis daughter. and by the way, this man happens to be the father of hysteroscopy. the world renown laparascopic surgeon is a short italian, who sits down and begins raving about 'his small little vineyard in Tuscany that just won 95 out of 100 points for this season's wine.' you know, NBG. and toast after toast, the dinner party speaks warmly and highly of each other, of their friendship and their professional respect. year after year, for twenty something years these people have been coming together for conferences and scientific meetings. they know each and each others' work. they address each other in multiple languages, they speak highly of each others' accomplishments. i'll just sit here quietly in the corner, then.