At the learning center of Kazakhstan National Medical University

I generally follow "my" San Francisco Giants from about from March through April and Mid -August to whenever the season ends. As a kid I have fond memories of my dad listening to the game on his transistor radio (about the size of "War and Peace" in hardback) and if memory serves he even snuck it into church on a Sunday afternoon to listen on the ear phone as the Giants played the hated Dodgers. My mom blew a major gasket which of course made it even more worth it to him. So over the years I have casually followed the Giants from a distance, sometimes great distance. I knew they were in the wild card game then lost touch as I am 13 time zones away from the left coast. So what follows is an editied narrative to my family about the last day of the World Series.

Students in the entryway of the hall

"Here's how it went down over here in A'town. I awoke and knew the last game was on so tuned into TuneIn and listened as long as I could before Ieaving for the university. As it is about a 45min walk and I wanted to continue listening I thought, "OK I can do this", and loaded TuneIn onto my piece of shit phone. (It's a Samsung, by way of who knows where, so the outside says "Samsung" but the inside says "bugger off!")

Download to POS phone: check

Listen to game via Internet on walk over: check. Me saying to myself, "Man this is so cool. Me, in Almaty, listening to the freakin' World Series being played last night in the morning!"

Now just the day before I gave a group of women medical students a monstrous dressing down as they were in the back of the class gossiping, giggling, and playing with their cell phones, like it was bloody high school. You might say I lost it. Bear with me here, the point will become evident. I informed them that while they were adults, what they were doing was considered rude in my country. So they could stay, or leave, but please stop talking (shut up already!)  and please turn off the (effing!) phones. You get the gist. I think they figured they could do so as I was the guest and what did I care? Suffice it to say, I cared, a lot. But I digress.

same

So in I walk on the morning of the last game to an empty class room but for two students of the same group from yesterday. It's now the bottom of the 9th, no outs, MB on the hill throwing heat, scary good. I SO wanted to listen as I was thinking myself so very clever to have downloaded TuneIn and then signed into the university WiFi, in Russian no less!  I had unplugged my ear phones before entering but had left the phone and at very low volume so I could check. But I didn't want to get busted by the very same students I had just given hell to the day before. 

So, and I'm not ashamed to admit this, I stated that since there were only two students in the class let's just start in half an hour! Brilliant no?! I caught the last out, well not me, The Panda did. I silently raised my arms in celebration, and in walked a student. He asked what I was doing. I told him that my team had just won the World Series of Baseball! He high fived me and then walked past with a look of "dude its not the World Cup, chill."

Screw it, WE WON!!!"

Lately I have been working at the University with a group of students who are in their sixth course (the last year before internship). We have been discussing common cardiac arrhythmias, acute coronary syndrome, heart murmurs and the like. Students here get very little real time experience with humans so they are reduced to using manikins. This is not unlike other schools in the US where student learning is truncated due to lack of exposure to or patient unwillingness to be the subject of a learning experience. I'm old enough (and my kids would say crusty) to recall that I would simply walk in and take a history and physical after introducing myself and most patients were glad for the time. Like I tell my students, it like playing piano. You can't get proficient unless you practice. But for practice there is now a huge industry that tries to mimic human encounters with manikins. I'm talking manikins for rectal, pelvic, pediatric, thoracic, ear, and eye exams. Never mind that you can't find gloves, speculae, otoscopes and certainly not ophthalmoscopes in an exam room.

Not sure why but many want their picture with me

So as part of the week we spent some time watching presentations on heart sounds from the University of Miami. The speech was fast and of course meant for US audiences and it was done by the driest Casper Milquetoast'iest professor I have ever heard so even I was bored.

Jeez I look much older than I feel

Next we met "Harvey", half the man(ikin) he used to be. One can dial in forty different murmurs, feel pulses, and the like. It was a mess. Few got it, so the next day I downloaded a bunch of murmurs (clever, no?) took them to the class room and went over them one at a time with case based presentations. Much more effective. Next (Friday) we discussed and listened to breath sounds at their request. We listened on each other, they were introduced to Dr. Mike's distaste for the word "normal", and in general it was a great learning experience.

"He's dead Jim"

Finally, we have a close friend living in the same town as where two of our kids attended college. She is one of those amazing people you can trust to listen to your kids complaints of how they have a Neanderthal for a father and how "my (insert gender)friend is..." and know that the truly important stuff will get to us. She is tall and beautiful. We met in the OB dressing room at residency when I was trying to swipe some scubs after a tough delivery. Yesterday I got on a bus and there she was. Or someone who had to be her clone. Then it occurred to me that we have always known her by a contraction of her name that is properly a common Russian appellation. Her father was a Russian sea captain no less, and she looks like she could be from the CIS. So no, it wasn't her but it was freaky-amazing.