"Lost in Translation" by MSIH first year blogger Rebecca Siegel

A few days ago, when I was walking home for class, a man asked me for directions in Russian. I know that he was asking for directions, not because my Russian was sufficient to decipher his intention but because he was pointing to a tattered map. From what I could tell, he was looking to get to the post office, which was pretty much a straight.

I tried to communicate that it was straight ahead in every way I could. I attempted in Hebrew. I attempted in English. I made a line with my finger on his map. I mimed a person walking forward and finding a post office.

Nothing worked and with each attempt he looked progressively more frustrated. I also felt frustrated because I knew what he was going through and I was powerless to help. I too was a stranger in a strange place. I knew exactly what it was like to say the simplest thing over and over again and not see a look of understanding on the face of the person that I was talking to.

            To me, this is one of the greatest assets of going to medical school in a foreign country. The very fact that we know what it is like to struggle with being able to communicate and understand basic things is what is going to make us good doctors. Not understanding is hard.

            So here’s to my classmates who have known the true horror of taking a bite of a would-be-delicious breakfast parfait, only to find they had purchased sour cream and not yogurt at the grocery store.

My very resilient classmates who have double, triple and quadruple checked the bus map, only to find they were now farther from their destination then they started.

Together, we have learned intimately what it means to need help and lack the words to ask for it.

My peers and I represent a class of physicians who will understand that it is not the responsibility of a patient to communicate in ways a physician can understand. It is on the doctor to hear a patient’s explanation and figure it out.

"Clown College" by MSIH first year blogger Rebecca Siegel

           On Wednesday evening at 3:47, a typical first medical student rummages through her backpack, to prepare for her next class. She sits in the break room on the sixth floor of the internal medicine building at Soroka hospital. She takes out a biochemistry textbook and put it’s on the floor beside her backpack. She takes out some highlighters, flash cards, and a binder full of printed out slides from immunology lectures. She still hasn’t found what she is looking for. She pulls out a tutu and then continues to rummage until she finds a Santa hat.  “Finally”, she mumbles. It’s time for class. 

Welcome to medical clowning. Meet Dr. Amnon Raviv, the only self-proclaimed only personal in the world to have a PHD in medical clowning. He is a clown, a real-word superhero, and the instructor of this very special course. He is a human sigh-of-relief for people battling serious illnesses all of the country. On any given day he can be found in an oncology ward, belting out an upbeat western style song about colon cancer, or in the surgery wing, helping a 5-year-old boy make a list of what dreams he would like to have during surgery (before summoning in the anesthesiologist and reading the list of dream-demands aloud).

As we leave the class three hours later, I feel a little overwhelmed by how lucky we are to have Dr. Raviv. We are students of empathy and active listening. We are tutu clad care takers. And for three hours every week, we are allowed to reclaim some of the idealism that made us want to practice medicine in the first place.

       It’s time to practice. One student is the patient, one is the doctor and one is the clown. Dr. Raviv tells us that the patient is a small child who is getting a shot, but feels quite scared. The clown tries to make bird noises and funny faces in order to distract the child from the shot. Dr. Raviv stops the exercise.“ The child is afraid of the shot”, Raviv explains “and you’re not going to help by ignoring the shot.”   They try again, only this time the clown jokes about the shot. He pretends to give it to the nurse, to himself, even to the wall. “Better”, Dr. Raviv says. Slowly we are starting to understand. 

A Quarter Doctor and a Full Clown, by blogger of the month Jixi He

Yesterday was extremely busy but awesomely interesting and fun. I was wearing my white lab coat in the morning, normal street clothes in the afternoon, and then a full-blown clown costume. The day didn’t just end there; I also had my band rehearsal in the evening. My day went from 10am to 10pm.

In the morning, a few classmates and I had our first clinical rotation at the pediatrics ER department of the Soroka Hospital. This is part of our course “Clinical and Global Medicine” which is aimed to give us clinical exposure, and gain insights and inspirations as a physician. We met at the lobby where Winnie the Pooh, Spiderman and all the Disney Princesses gather, and put on our white coats. Feeling like a quarter of doctor, I followed our instructor into the building. The whole place looked very children friendly, with a Hollywood walk of fame touch to it. There is even a cinema on the floor to entertain our little patients. We were told that there are 12 classrooms throughout the hospital to provide children with whatever class they would normally get in a community, be it academic or extracurricular.

We interviewed a young patient’s mom to know more about her son’s disease, and how the family is coping with it. She was speaking Hebrew the whole time and I was listening intently, leaning almost to her nose, trying to extrapolate as much information as I could with my pathetic Hebrew. It worked! Somehow? I felt I was able to understand 30-40% of what she said, catching familiar words here and there, and interpreting her facial expression and body language. Normally I would say my Hebrew is only 15% good. In 2 years, hopefully I’ll be able to interview patients using simple sentences and not feel like a clown.

Speaking of clown…I know…awful transition…

Probably the most fun class I’ve ever taken and will ever be able to take in med school is “Medical Clowning”. It fulfills one of the four global health clusters requirement. We had many attractive choices for the clusters and I wanted to take all of them, but as soon as I saw the description for medical clowning I knew I had to take it. This class is full of excitement, surprises, embarrassment, and inspiration. Oh, have I mentioned, laughers?  Medical clowns not only work with pediatric patients but also with adult patients, especially in the oncology wards. Clowns provide the patients empathy, and a sense of control, in addition to the endless joy they provide. Happiness is the best medicine; this cannot be more true when it comes to medical clowning.

In my medical clowning class yesterday, we all had to dress in something that we thought would make us look like a clown. I never go to any Halloween parties because I don’t have any costumes. Dressed like a clown?? I had to scratch my head for a whole week before I came up with my clown idea: hey, the once in a life time chance to be the class clown, go big or go home eh?

Wearing a rainbow color fluffy wig with tiger ears and a tiara on top, purple sunglasses covering my normal glasses, tiger bowtie, pink toy guitar hanging from my neck, yellow black striped PJ, pink polka dots pants, and a pair of bear claw warm slippers, I showed up in my clowning class. We had to dance to the music in our clown characters and later tell the whole class who we are in our clown voice. I got used to improvisations and surprises in this class. All the activities we do in class helped us get out of our comfort zone, pay attention to people around us and not feel embarrassed. So when it was my turn, I shouted in my lowest possible voice:” Helloooo!! I am Princess Tiger Bear!! Rawwwrrrr!! I am good at playing guitar, and painting my own hair!! My name is Bumble Bee!!” I was pleasantly surprised to find out that it was slightly more comfortable to be myself, act funny, and get out of my inhibitions when I was in my clown costume. Our instructor told us that the essence of being a medical clown is to connect with patients, and help them build a fantasy world that they can temporarily escape to. So communication and authenticity is very important to a clown.

Well, this is my first time writing a blog. I never know how to end my writing. But I had a great day!  

                                                                                                          - blogger of the month, Jixi He