TROPIC TO TUNDRA
It was late at night on December 29, 1965, that I landed at Milwaukee Mitchell Airport. My arrival was delayed many hours and the resident physician who was there earlier to meet me had left. I followed the crowd to the baggage area; I was in a strange land of white giants! While everyone was waiting for their baggage, I stepped outside. A blast of intense cold air greeted me. I could see my own breath, and for the first time, snow - beautiful, fluffy flakes.
I was cold, excited and apprehensive. I had left the warmth of Quilon (Kollam), a coastal town in Kerala in South India and the cocooning comfort of a very loving family, a large extended family and many close friends.
Preparation and Journey
In preparation for the trip across the seas, I had a long wool overcoat tailored near my home town. The tailor, who hitherto had not even seen an overcoat, did a fine job just working with a photograph from an old Time magazine. Gloves, though, were a problem. The only ones available in town were white silk or linen ones used in the ceremonial dressing of a body before a Christian burial.
A large number of people came to see me off at the airport for my flight by a noisy propeller plane to Bombay (Mumbai). It was an emotional leave-taking, and it was also my first airplane flight. Later that night the Air India jumbo jet took off from Bombay. I had a total of $8.00 in my pocket, the maximum foreign exchange allowed to be taken out of India at that time. After breaks in Rome, Frankfurt and a number of hours in London, the transatlantic flight resumed. The wine list carried champagne, a familiar name from American novels, and I had to try it. The champagne did dull my separation anxiety.
Arrival and Reaching Destination
I collected my single piece of luggage, a brown-belted case, and pondered my next step. I found that I had $3 and change left. I dug out the telephone number of St. Michael Hospital where I was to join a rotating internship. The pay phone was like a jigsaw puzzle, a matter of fitting the right coins into little slots. I had no idea of the value of each coin I had.
After a challenging conversation with a skeptical hospital telephone operator, who was unsure if the call was truly from a young doc in distress, she connected me to Sister Illumina, the administrator of the hospital. Although she was awakened from sleep, the sister was very cordial and assured me that my cab fare will be left with the telephone operator at the front desk. I got a taxicab and on my 40 minute drive to the hospital, I marveled at the size of the vehicles, the lighted streets, the marked lanes, the speed in the express ways and the total absence of honking horns. It took 40 minutes to reach the hospital. The cabdriver helped me with my luggage. He was paid and I then got a key from the operator – a bespectacled lady with strange bluish silver hair- to my room in the house-staff quarters attached to the hospital. I listened as she gave me directions in a slow deliberate manner. I followed her directions, carried my luggage to my room on the 2nd floor. A very clean and neat small room with a draped large window, an attached half bath, a bed, chest of drawers, a chair and a desk with a table lamp, an alarm clock, an elegant white phone and an enormous directory. It was near midnight and I got ready for bed. Why are these nice sheets and blanket so tightly tucked in I wondered as I got in and fell asleep instantly- a dreamless knockout.
The First Day
I woke with a startle to the ring of the phone. It was the chief resident, Dr. Garcia, checking up on me. He said he will show me around and to be ready in half an hour. I was ready when he knocked. “ Dr. Baarkey, welcome”, said Garcia, a stocky Filipino with a ready smile. I politely declined his offer for coffee and followed him to the office of Dr. Frank Berridge, the Director of Medical Education. Dr. FB, was the only name in the hospital I was familiar with as he had written to me in India. His letters, including the offer letter for the internship program, were notable for their print-like type (IBM selectric), high quality thick paper and assertive signature; and now I was about to meet the man! Dr. FB, a Sean Connery look alike, shook my hand and welcomed me in a deep baritone voice. He was in scrubs, between surgeries, and was off leaving me again with Garcia. I picked up my name tag. Next stop was the newly remodeled Cardiology department. The doors magically opened (first time experiencing automatic doors) and he showed me the many new EKG machines; crisply uniformed technicians were busily going in and out of the area.. There was no cardiac catheterization suite. In screened areas, some patients were undergoing EKG tests and in a well appointed room an attending physician in a dark suit was busy writing down his interpretation in neat folders.
As it was lunch time, Garcia led me to the cafeteria. A few people ahead of us in a line were moving forward and then I saw the line up of food; totally mind-boggling in variety but mostly unfamiliar. Some I recall: A number of leafy items, an array of cut up fruits and jello, mashed potatoes, flat pieces of meat in a brown gravy, cut pieces of greasy sausages, different types of milk in personal sized cartons. I stayed away from the leafy items as they looked raw, picked up a small plate of green jello, a scoop of mashed potatoes, a serving of meat and gravy and the best part - chocolate milk. The mashed potatoes and gravy and meat were so bland that I could not eat them even after heavy sprinkles of pepper and salt. I loved the chocolate milk. When we were done we deposited our trays in a clean moving track.
Outside the cafeteria, in the corridor, was a vending machine and Garcia put in a few coins (35 cents, I believe), and as I watched in fascination and a pack of cigarettes dropped. He asked me which brand I smoked and although there was a wide assortment in colorful packs, not surprisingly, my brands ( 'Charminar' usually, 'Scissors' at times, and very rarely the costly 'Players' ) were not there. I opted for Camel. He bought me a pack as a welcoming gift and a thin folder of matches. He then led me to the doctors lounge that had comfortable chairs, sofas, low tables with ash trays, a coffee machine and a library of textbooks and medical journals. Garcia had to leave to assist in surgery and said he will send an intern within an hour to escort me around and back to the quarters. I settled in a comfortable chair. I opened my Camel pack, while appreciating the tactile sensation of the plastic covering and the soft yielding case; inside the tin foil were 20 (not the 10, that I was used to) neatly arranged cigarettes. I took one out, lit it and took a deep, satisfying drag. I picked up a JAMA and started reading a study on diabetes and dozed off.
With a touch on my shoulder and a “Hello”, Dr. Varela, greeted me. He had a round friendly face with a wide smile and an easy going manner. He sat down and inquired about my flight, my well being, and concerns. He was easy to talk to and I told him that I did not know at which department I will be working, with whom and what to expect. He told me that he will orient me ( there was no formal orientation to the hospital internship program) and also assured me that that I can count on him for help during in the initial period of adjustment. I felt a rapport with him and that started a strong friendship. I learned that there were 12 interns, all foreign medical graduates (FMGs as abbreviated then; later years evolved to IMGs). This was a surprise to me as I expected at least some US graduates. Of the 12, nine were from the Philippines and one each from Japan, Colombia and India. There were no Indian doctors in the hospital and no Indian community to Varela' s knowledge. He informed me that my first 2 month posting was in the Emergency Room (ER) and I will be starting at 6 PM on December 31st, night shift till 6 AM the next morning. He also cautioned me to expect a busy shift as it was New Year's eve with many parties and excessive alcohol use. How prescient he was!
I followed Varela to the ER. Similar to other areas of the hospital it was immaculately clean; it was a fairly slow time with only a couple of patients in the waiting area. He introduced me to the intake clerk and an orderly, a candy-striper (appropriately named for the student volunteer with a bright pink striped uniform), and a nurse with an LPN title on her tag (I did not know then there were different classes of nurses) in the front. Inside, the main room had several metal beds with wheels neatly partitioned by white curtains and each with large, bright overhead steel shaded lights. An intern who was working on a child's laceration raised his hand in recognition. The in-charge nurse, a middle aged woman in well starched white dress, stiff white cap, well coiffed hair, white hosiery and white shoes came forward and offered her hand as Dr Varela introduced me. Steely eyes under puffy lids fixed on me, in a hoarse voice (years of smoking I guessed) she said her name ending with RN. Instinctively I responded “ Pleased to meet you, sister! “. Promptly she replied “ Not sister, call me nurse”. It was amply clear that this was not a woman to trifle with!
As we walked through the corridor to the next stop, the laundry room, Dr. Varela was paged by the overhead voice system. I asked him about the pages that were going on fairly frequently. He explained that was the only system other than the phone in your room for nurses to get hold you; you then dial O and the operator would then connect you to the calling extension. Personal wearable pagers were either not available or the hospital had not adopted them. He further explained that if the first page is not answered in 5 minutes a 2nd page will follow and if not tended to the 3rd call will be with both your first name and last name in a lower more serious pitch. He also alerted me that “Code blue” meant cardiac arrest and “Dr. Mortimer” was a code that an autopsy was about to start in the autopsy room in pathology department. We went down an elevator to the basement to pick up white coats for me. While Varela attended to his page on the laundry room phone, the laundry room attendant (incidentally, one of the very few skinned persons I encountered), quickly sized me up and brought me 3 size 32 white short coats
Although there was a short cut through the parking lot to our quarters as it was very cold (in the single digit Fahrenheit), Varela led me through the corridors to the quarters and pointed out the shower stalls as we passed by them. He said he will be back after completing some hospital notes by dinner time. Back in my room I noticed that the bed was all made and the drapes were open. I lit a cigarette and looked out through the large window at the parking lot below- snow covering most of the ground and some on the car tops, signal lights on the street ahead of the parking lot, and cars silently moving by. Pedestrians were nowhere to be seen. Although it was just 4 PM, the sky was gray and the day was coming to a close. Eerie silence; no sunlight, no color. No voices of dear ones, no crows cawing, no stunning greens of coconut trees and bushes and no pleasing smell of jasmine flowers. The reality hit me; I am far away from home.
I sat down and wrote a long letter to my parents. The letter was all upbeat and I made sure that the blues welling inside me did not seep through. Afterwards, I proceeded to the shower area that had 3 shower stalls, each enclosed in translucent frosted glass. Attached to the wall was a long shelf with 6 compartments with room numbers of the interns residing on the 2nd floor. Inside mine, I found 3 thick towels- small, medium and large. The shower itself had a rotating handle on a metal base at one end indicating cold and the other hot to adjust the desired temperature (all new to me). The temperature adjustment was a little tricky and I had to jump out of the shower at first because the water was too hot but after I got it right it was just great.
While the refreshing effect of the shower was lingering, there was a knock at the door Varela, pleasant as always, invited me to his room to meet some of the other interns and there I was introduced to Drs Rufino, Millar, Carin and Nunag. They were all very friendly and warmly welcomed me. All but Nunag had the same type buzz- haircut and Rufino and Varela could pass for brothers. All but one were shorter than me- unexpected, considering my height of 5' 4”, but strangely reassuring. The other interns, I was told, included a husband and wife in separate rooms in different floors, who were masquerading as singles to save money ( lodging and food ). This was a well kept secret from the nun in charge of the house-staff quarters and all were complicit in arranging and guarding for conjugal visits for the pair. The Japanese and Colombian interns were married and were living outside the campus. There was a lot of easy and fun conversation- about their day, the nurses, the food, home news etc. Occasionally when excited they would slip into Tagalog but promptly would revert to English. Their accent was nice but I had to tune in - v turned to b, f to p, a to aah. I am sure they had as much tuning to do with my accent as well. As we were conversing, Varela lowered a cardboard box tied to a string through an open window sill and then closed the window. Ten minutes later, it was pulled in and we now had ice-cold Schlitz beer to enjoy. Simple but ingenious !
After about an hour the party broke up; some were going to the hospital for their dinner, a couple of them opted to go down to the basement refrigerator for snacks. I joined the latter group. The basement had 3 areas: a TV room, a larger area with a table tennis table, and a small kitchen that also had a refrigerator. I picked up a small carton of milk, some cookies and a banana ( spotless skin with a Chiquita blue pasty). After our snacks we parted. Back now in room, I brushed my teeth and changed to my favored kili, rather than to my new set of pajamas, turned off the light and got into bed and pulled up the sheet and blanket. The events of the day ran through my mind in succession, followed by a mix of anxiety and excitement for what awaits me tomorrow. I prayed in silence and fell asleep.