The Bear Inn

So it’s about 10:30 PM here in Oxford, and I was feeling a bit down about today because I got into town a little late. A lot of the things I wanted to go to had closed already, so I went for a walk and tour around Magdalen College, which was absolutely beautiful. However, what’s important for this short post (are blogs allowed to have these?) is what happened after leaving Magdalen.

I first had to find a place that had wifi ~and~ a good dinner, which oddly isn’t that hard to find in Oxford. I went to this place called All-In-One, an interestingly hip food and cocktail joint that had its fair share of young folk countered with a few very elderly couples. Surely these are the signs of a good restaurant. I had a little video meeting to set up for a video call next week, then after closing my computer, I thoroughly enjoyed a pad Thai with this incredible rice cake.

After this, though, I was looking for things to do and one of my friends (she goes by Snow White (we’ll talk about that later)) suggested a few bars. I ended up (innocently) taking none of her suggestions and instead ventured over to this place called Bear Inn. I did what I normally do at restaurants when I travel alone, and read. However, doing what’s commonplace here in the UK and Europe, but surely not in the U.S., I sat down at the same table as this man reading a newspaper. (I did the American thing and asked if I could sit there, albeit completely unnecessary. (Four-day)-old habits die hard.)

The book I was reading was the only book I brought overseas, solely because I believed it to be worth the weight (it’s a pretty big book). The book is called Death Without Weeping: The Violence of Everyday Life in Brazil. I see it almost as this mecca of my mind that I need to make before or while I start my program. Nancy Scheper-Hughes speaks volumes to the intersection of health and politics, health and the human condition, and to be able to learn some of these mindsets via the culture of Northeastern Brazil is all the better. I’ll save a post for that later, though.

What’s important was the page I ended up turning mid-read (this isn’t meant to be offensive, rather informational, explaining where Brazilians feel the “nervousness” of hunger):

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To have this open in a bar was merely peculiar, and the man sitting across from me commented, “What’s that you’re reading?” Keep in mind that we had been sitting at the same table for a little while already, about an hour or so. He had already asked me once to keep an eye on his jacket while he went outside for a smoke.

Well, this short little question sparked a conversation, and we started talking about why I was there, why he was there, his family, and other topics. This man, Martin, lives in Paris (but he’s an Englishman), and his daughter had a fellowship to go study policy and women’s studies at a London university (I cannot remember where). Martin himself is a sculptor, where he “misuses materials to create new ideas” (paraphrased) – I thought this was a beautiful way of looking at art, and truly is a mindset that inspires amazing art. You might come to learn that I’m an incredible fan of modern art.

Some world politics and geopolitical concepts/philosophy (mostly him speaking) made its way into the conversation, as well as the interesting tidbit that the pub we were at is the oldest pub in Oxford and originally they had bears from the nearby fight at that site. He said, perhaps, that if you dig far enough, you could find remains of the old ring where the bears fought, and maybe even some bear remains… Also adorning the walls of the pub were cases upon cases of ties from old Oxford club members within each college – I’ll have to do some more research on this one for sure.

Martin and I exchanged contact info and I now might have a place to stay in Paris if I decide to go soon! I will be going to Paris, I just have to decide when. Perhaps when I have a little French under my belt, as I’ll be dabbling in beginner French from UCL soon! With that, I need to go to sleep to get up early and seize the rest of my short time at Oxford. Stay tuned for some more updates on my travels in southern England!

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Rodzina

I was feeling quite good about the progress I was making on my dissertation and medical school apps, so in true Andrea-logic, I decided it would be a good idea to add another dose of adventure. Herein began my grand idea to plan a 12 day trip to one of my favorite spots in the world: Poland.

 

Between junior and senior year, I had the wonderful opportunity to study Polish language, history, and literature in Krakow. If you think Disney World has a touch of magic, then Tinker Bell must have dumped a whole bag of her dust on Krakow. Unlike many of it’s neighbors, Krakow was not bombed during WW2. Thus, the history is astonishingly well-preserved. Plus, the 14th century Wawel castle even includes a good dragon story. Win, win, win.

 

Despite these wonders that Krakow offers, northern Poland (Gdansk and surrounding areas) holds a larger part of my heart. It is from this region that my great-grandparents voyaged to the US with their two children (my Grandma Elizabeth Berkemeier’s oldest siblings) and whatever other material goods they could fit in their laundry-sized basket. There were no internet forums that provided insider details about the ‘American Dream’ or skype to call your family when you safely arrived. Just one way tickets and host of prayers.

 

Although the blood ties to Poland objectively grow more dilute with each passing generation, as I profess in my dissertation, my understanding of family… and parenting… and even life itself go beyond a DNA based-definition.

 

Z Bogiem i do zabaczenia,
Andrea xx

 

 

A small photo essay to share highlights of this visit:

 

 

 

The Netherlands – Presenting preliminary research findings!

Back in March, I pursued an opportunity to present findings from my research at a symposium in the Netherlands that coming August. As with most of my adventures, I planned to add some pleasure to this business trip.

Pleasure:

I have a fair amount of stamps from the Netherlands in my passport (thank you Delta / KLM transfers) but this was the first time I left the airport. I spent most of my time in Amsterdam and Utrecht, but I also skipped over to Den Haag for a solid 40 hours. See captions below for a quick overview:

Business:

I’ve struggled with putting pen to paper on this topic for quite some time because, in short, the story is complicated. For the sake of a blog post, I figured the best way to succinctly share is to publish a short response I submitted for a secondary medical school application.

Discuss a time when you stepped out of your comfort zone. What were the challenges? What did you learn?

In August, I had my first opportunity to travel to the Netherlands. International travel always presents challenges, but this trip in particular pushed me out of my comfort zone: I was attending the International Symposium for Young Adults with von Hippel-Lindau (VHL) as both a patient and a professional, presenting my dissertation research on reproductive counseling for young VHL-positive people.

During introductions, we were encouraged to share our current “VHL challenge”; I met people like T who had traveled 30+ hours by train, because his current post-operative instructions barred him from flying. I was moved by my peers’ courageous stories, simultaneously feeling blessed and self-conscious of NOT having the token scar along the nape of my neck indicative of brain surgery. I was shaken from these inner reflections when K shared her concerns that VHL would be incompatible with having children. Trying to offer help, the symposium coordinator singled me out as a “subject matter expert”. I flushed.

I enjoy public speaking, but presenting as both a patient and researcher quickened my heart rate. I was confident in my research, but the topic of reproduction is nevertheless sensitive. My presentation increased the awkward gap between the participants and me until I finished an interactive presentation with a silenced audience. Later that evening, participants began to approach me individually, sometimes with a reflective statement, technical questions, philosophical musings, or a quiz about my personal views. More commonly, however, they greeted me with positive encouragement: we are really appreciative to hear this from a VHL-positive person like you who not only knows her stuff but truly GETS it. As a physician, balancing authoritative knowledge with empathetic care will be a persistent challenge, but I know the more I practice navigating this awkward tension, the better I will be able to serve my patients.

A slide from the presentation before mine. This supports one of the findings of my research: adoption is a

A slide from the presentation before mine. This supports one of the findings of my research: adoption is a “forgotten” option.

Irish Solstices

It seems crazy to think that it has been more than 6 months since I was last in Ireland. Since I never actually got my December post up, I figured this was a good opportunity to add some bits from those 5 days in Dublin with the fantastic hostess, Katie!

Strong first impressions remain:

  • Ireland in December is cold. Really cold. Although Dublin and London are fairly close, Dublin is MUCH more damp. Add a bit of winter wind and wowza. Come June, the frigid air was gone, but I was quite comfortable in jeans and a fleece. I survived December with a fleece and my dress jacket (which was more than enough in London), but I could have benefited from a wool sweater or two. The tool of survival: hot water bottles. (As they say in Ireland, ‘Tanks a million,’ Katie!!)
Freezing on the pier at Dun Laoghaire

Freezing on the pier at Dun Laoghaire

  • Since Ireland uses the euro, I thought things would be a smidge less expensive than London. When it comes to food, this is certainly NOT the case.  I don’t profess to have a great understanding of economics, but presumably this is because of importing costs. Porridge was a staple for breakfast (and lunch a few times, too) which made it possible to indulge in a full Irish breakfast.
  • Confession: I remember when I first moved here I kept getting geographically related politics (ie: Great Britain, United Kingdom, England, Ireland / Northern Ireland, Scottish Independence) very mixed up. Traveling and speaking with locals definitely provides new perspective. If you ever have a chance to travel to Dublin, I highly recommend making the Kilmainham Gaol one of your first stops in the city.
  • Biking (or “cycling” as they say) is very common in Dublin. The CocaCola Dublinbikes rental share works quite nice—5 euro for 3 days. The complication in the story, however, comes when you remember Irish Winter Solstice sunlight hours: fluorescent safety gear is near mandatory if you care to ride for more than your lunch hours. During rush hour, this form of transit is elevated to the “extreme” level during rush hour when you start weaving between moving vehicles. (Deep breaths, everyone, deep breaths!) When the traffic is slower, however, it makes for quick transit and a great way to see the lil city.
  • The coast is where it’s at. In December, this meant taking a short train from Dublin to Dun Laoghaire, and in June we visited the west coast. (Keep reading!)
  • Dublin is home to both Jameson & Guinness which seems fitting considering the active pub culture in Ireland. Having toured both the distillery (December) and the brewery factory (June), I can recommend both. Flying Ryanair limits one’s ability of bringing many souvenirs back, but my brother Franz received a teeny bottle of Writer’s Tears, an Irish Whiskey that I first spotted on Katie’s shelf.

For the June visit, I was joined by my friend Zoe, and together we stretched our wings a bit further. We took pit stops in Enis & Gallway…

…But the highlight of our three day jaunt across the island was our coastal walk from the Cliffs of Moher up to Doolin.

From what we could tell, most tourists just make it to the visitor’s center, marvel at the cliffs, and call it a day. On an overcast day, as are a number of days in Ireland, I can understand the desire to make this a short visit. We, however, scored a gloriously clear day and feasted our eyes not only on the “main attraction” (the Cliffs) but also the Aran Islands which are just off the coast. As I expressed previously and will continue to re-state, there is something very awe-inspiring about experiencing natural wonders.

Here’s to a summer of making even more of these memories!

Andrea

Featured Image: 4pm December sunset at Dun Laoghaire

Three cheers for Spring!

If I was paid a nickel for every blog post that I intend to make, well… I would have a lot of nickels by now. But alas, life catches up, and I seem to have far more words floating in my head than I can manage to fit on paper in 24 hours each day. Here’s a tribute to the highlights of Spring 2015!

 

Stonehenge on the Equinox

Cici and Andrea Stonehenge

 

In case you missed that post, check it out here.

Isle of Man

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See Ben’s post here for more pictures & the rest of the story.

 

Lake District

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And see his post here about the “walking” (British word for hiking) in Lake District.

 

Adventures in Scotland

from Glasgow to Edinburgh with Gretchen & Joan

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Theatre bingeing

My love of theatre and the performing arts was treated quite well when I lived in A2, and it has only grown since moving to London. I was probably averaging about 1 show every 6 weeks… until I introduced Gretch & Joan to the West End. After a thrilling night with front row seats to Memphis, we decided that the 2nd of their two day visit to London should be spent going to a matinee (Billy Elliot) and an evening performance (Agatha Christie’s Mousetrap).  Gotta make the most of those London minutes!!

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As a student, I have the pleasure of tapping into the crazy-cheap student tickets with my last my last 6 shows ranging from £0 to£5 each. Just as golfing in Jackson, MI can be cheaper than going to the movie theater, scoring student tickets for the West End can be less expensive than meeting up at the pub. The more that I indulge however, the less I am able to shut my mind off and enjoy the show.   (Well… let’s be real. I don’t think I was ever the type to just shut my mind off.) I described part of this when I spoke of Matilda.  And I think it has become even more noticeable as I indulge. Consider, for example, the Curious Incident of the Dog in the Night. (The Spark Notes summary is here if you haven’t seen the show or read the book.) While the 12 year old girls sitting next to me were trying to solve the mystery during intermission and gushing over how “Christopher is so good at Maths*!!” after the final curtain call, my mind had drifted down some other paths.

 

  • How do we as a society treat people who fall outside of “normal”? From an early age, we learn to be tolerant of people that are different from us. This earns us the badge of being civil. What is the difference between being tolerant and being kind?
  • What responsibilities do parents have to their children? Do these responsibilities depend on the child’s individual needs and talents? I was particularly interested in the contrast between Christopher’s mother and father. The father stayed with him the whole time, but there were some obvious parent / child clashes made more frustrating by misunderstanding Christopher’s autism. The mother—overwhelmed by having an autistic child—copes by having an affair and moving away with the new man, but continues to express her never-ending love for Christopher through letters.

[*Brits say Maths instead of Math. This still hasn’t stopped bringing a smile to my face. 🙂 ]

If I ever become bored, I think I shall develop a lecture series about Social Science, Health, and Medicine in the West End.

 

…And reliving the excitement of seeing London for the first time through the eyes of visitors

Featured Image: from the Columbia Road Flower Market

Afternoon Tea (and then some)

My cousin Cecilia (Cici) and I were born just 4 days apart, and since 1992 we’ve managed to have a number of good adventures together. The last adventure included one of her college roommates, Hailey, as they took on London like champs. I mentioned that Matilda, Westminster Cathedral, and Cadogan Hall in my previous post; here are a few more of the highlights from their visit.

Afternoon tea the Vauxhall Tea House Theatre:

Definitely gave me memories of living in Martha Cook, the University of Michigan residence hall that enjoys Wednesday sit down dinners, Friday afternoon teas, and a number of other lovely traditions. 🙂  This tea, a pretty good representation of traditional British tea, featured black (vanilla) tea with brown sugar cubes and full cream with a 3 tiered cake stand:

– Bottom = finger sandwiches (tuna and coronation chicken)

– Middle = scones + on-site made  strawberry preserves + clotted cream (almost butter, but by calling it ‘cream’ you put on 25x more than would be acceptable for butter)

– Top = dessert. Sometimes little cakes, but this time we feasted on vanilla bean ice-cream and brownies that I’d gamble to say were even better than Zingerman’s.

We enjoyed this so much that Cecilia and I recreated the experience back at my flat on her last full day here. That version even featured a meat pie from Borough market. 🙂

 

Stonehenge / Old Sarum / Salisbury Cathedral

Since Cecilia was able to visit for a full week, we were able to explore London together and take a side trip. So many options to choose from! We settled on Stonehenge with our decision influenced by the fact that this was the Equinox. I had read about some pagan rituals that were supposed to occur at sunrise, but the logistics became exponentially more complicated and expensive when planning outside of regular public transportation hours. Instead, we enjoyed a morning train ride to Salisbury, and then caught the bus to arrive at Stonehenge just before noon.

This worked out quite well because we not only enjoyed the beautiful spring sunshine but also a dance performance (?) by a group of people in costumes. I agree with Cici’s guess: perhaps these were the pagans that overslept.

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After Stonehenge, we enjoyed walking around Old Sarum and then picnicing in the city of Salisbury before heading to Evensong at the Salisbury Cathedral.

Family

I also had the delightful surprise of receiving a message from one of our Polish cousins– he (L) and his girlfriend (M) were in London for the weekend! L had previously lived in London for a few weeks while taking English classes, but insisted that I should be the tour guide. No pressure haha.  This provided an excellent opportunity to try out some of ‘London’s best’ restaurants that I had been reading about, AND take a ride in a black cab. Another tick on the London bucketlist. 🙂

Our first choice was a tapas bar, but it didn’t take reservations and when we arrived (as to be expected on a Saturday night in London) it was literally overflowing with people. But sticking with good SWE event planning stragies, I had made a reservation (the last reservation at that time!) for a table at a well-reviewed restaurant called Antico down the street. Wowza was the food delicious! I feasted on a octopus / shallots / rocket greens (arugala) salad for my primo, a halibut steak (massive!) for my secundo, and a torte for dessert. The only downside was that (being a Saturday) they booked two rounds of guests, so as soon as our desserts were served the waitress began encouraging us to leave. Fine. Time for a walk across Tower Bridge, particularly beautiful at night. 🙂  My cousin is an architect, which made it even more interesting admiring London’s nighttime cityscape.

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These moments go so quickly! Seems like yesterday that I was moving in, but alas final exam papers are soon approaching. The more adventures that I take, the more and more convinced I become that life is better when shared. Thanks so much for indulging me with a visit, Cecilia!

Major photo credits to Cici. 🙂  I snapped a few of these, but again– twice as nice when shared! xx

Roma, Italia

Last week I had the incredible opportunity to participate in a medical ethics conference hosted by University of Notre Dame Center for Ethics and Culture at their Rome campus. As you may recall, this is the second year that I have been able to attend this medical ethics conference.  I had a bit of deja vu returning to the conference that helped fuel my desire to study bioethics, and more broadly, healthcare from the perspective of the humanities. To be fair though, this had a much different feel since we were just a block away from the Colosseum. 😉

I was impressed with how far I have progressed in my understanding of medical ethics in a year’s time.  Don’t misunderstand this as me thinking I’ve got it all figured out. Far from it! But I much better understood the language of this field and have become a bit more comfortable making bioethical arguments.  I guess my studying is paying off. 😉

I could write a book about what I have taken away from the conference discussions and then fill a few other volumes about tasting delicious Italian food… (click for enlargements + captions)

 

 

…strolling through beautiful museums, piazzas, and villas…

 

…standing in awe as a pilgrim in Rome (and Vatican City)…

 

…but I might have to drop out of my master’s program in order to make time for that. Instead, I present to you a snapshot at the intersection: is spirituality relevant to healthcare, medicine, and the understanding of bioethics?

This sends me back a few weeks ago when I was invited to speak to KCL’s Life Society about palliative care. From their website:

“We exist because universities are important spaces for the exploration of ideas and opinions, and it is important that the Pro-Life voice is heard on campus. Our message is a positive one, it is not about shaming or blaming, it is about discovering the beauty of human life, and protecting it.”

To be honest with you, I was pretty freaked out: why are you asking me?  How am I qualified to speak? To which the student in Life Society replied rather straightfowardly: You study bioethics right?  And you’re going into medicine? Seems like you would have a better idea about the topic than any of us!

It is amazing how much you can learn when you have to ‘teach’. I didn’t just want to speak on my own authority since, despite her encouragement, I honestly didn’t think I had much authority at all. In search of good reference material, I consulted a voice for whom I have profound respect, Ed Pellegrino, whose name I was introduced to little better than a year ago and whose literature continues to be a source of guidance in my study of bioethics.

Though I wouldn’t do justice to ‘summing up’ Pellegrino’s philosophy in a blog post, a central aspect is that:

Cure may be futile, but care is never futile.

The optimal end of healing is the good of the whole person– physical, emotional, and spiritual. The physician, manifestly, is no expert in every dimension. He or she, however, should be alert to the patient’s needs in each sphere, do what is within his or her capabilities and work with others in the health care team to come as close as clinical reality permits to meeting the several levels contained in the idea of the good of the patient. [1]

Considering the fact that a patient’s physical condition often provides the trigger to visit a doctor, it follows naturally that doctors have a reputation of focusing on the physical aspects health. Sometimes they are so focused though, that the patients’ emotional and spiritual needs are forsaken.  Although this applies to all aspects of medicine, I think it is particularly relevant to healthcare at the end-of-life which provided a good framework for my talk with the Life Society. It was also helpful for the conference last week where the keynote lecture was about international perspectives on the euthanasia debate… AND this week’s topic in my Case Studies module: “Ethics at the end of life– the biopolitics of dying.”

This post would get out of control if I tried to summarize all of the points relevant to this topic, so instead I’ll leave you with some important questions that I’ve been mulling over:

  • Does care change when cure is futile? Should it change? How so?
  • Aquinas’ Doctrine of Double Effect is often cited as a reason to prohibit euthanasia. Is there really a difference between [a] giving medication to a person that is intended to give them comfort but has a foreseeable outcome of shortening his life and [b] giving medication that has the intended effect of shortening his life? If there is a difference, how should this inform our ethics and legality of end of life care?
  • Conversations about emotional components of health (and even more frequently, spiritual components of health) are often omitted from clinical encounters. How does this effect patients’ care?  Should physicians be responsible for providing this care? If yes, in what capacity? If no, who (which member of the health care team) would better be able to provide this care?

Until next time,

A

[1] If you have access to a university library or other collection of journal articles, I highly recommend reading this full article! –> Pellegrino, E. (2001). The Internal Morality of Clinical Medicine: A Paradigm for the Ethics of the Helping and Healing Professions. The Journal of Medicine and Philosophy, 26(6), pp.559-579.

Featured image: St Peter’s by night