Wednesday, January 30, 2013

ONE MORE TIME PORTUGAL

PORTUGAL AND YOUNG MEDICAL STUDENTS' UNDERSTANDING OF MEDICAL EDUCATION 

I am back to Portugal, my third time visiting o Porto as the locals call it. I love this town; with her twin sister Gaia and the Rio do Doru in-between, they are a miniature replication of Istanbul, which lies with her Asian and European halves, similar to Gaia and o Porto, on both sides of Bosphorus. This is my first time in o Porto in the winter time, though. It doesn't surprise me that it is raining constantly, how else she could be this green in the heat of the summer, but my hosts are profusely apologetical for the weather; typical for the wonderful people of o Porto, kind, polite, elegant, warm, and caring, wanting to make their guests as comfortable as one possibly can. I feel so much at home, almost more at home in this town than anywhere else in the world, surrounded with its good people. That is why I will be extremely surprised when Zeynep, the wonderful receptionist in Lisbon, who will help me get on the plane back to Istanbul tells me "Portugal is wonderful if it weren't for its people". I then recall Teresa telling me how different Lisbonites are from the people of o Porto. Who knows maybe Portuguese of Lisbon are different than those of o Porto.



Beautiful o Porto across from Gaia along Rio do Doru at night

I had another first experience in Portugal this time. Due to scheduling conflicts, instead of flying from Lisbon to o Porto, I had to take the fast Alfa train. Once I figured out the system and got onto my train, I so appreciated the experience. It was almost better than flying. My dear friend Teresa had reserved a "comfort" seat for me, equivalent to business class on a plane. It was indeed comfortable with music, and newspaper and drink service. I had a seat across from a gentleman was on the way to o Porto with a shared table in-between. I thought, it would be an opportunity to chat with a  local. But no, he had no eye contact with me, deliberately looking down or to the sides. After a few attempts to catch his eye, I decided, "just as in Turkey, it may be culturally inappropriate for well educated men to look at women and well educated and well mannered women to attempt to chat with stranger men", so I gave up and focused on my computer just as he did. During my last evening in o Porto, when the guests including myself were having dinner with Teresa and her husband, a gentleman at the restaurant approached our table and chatted briefly with Antonio, Teresa's husband again without casting an eye or acknowledging us, women I asked them whether this was what I assumed it was. They laughed so hard; especially Teresa was a scene to enjoy while she was telling me in a very animated way "Quite on the contrary, they look at you as if to pierce you and some, look at you from head to toe and all around." That was quite a demonstration of how she rolled her eyes as if she was turning me around to see even my back. Is that what is lying in even intellectual men of Portugal, who love to throw their jackets over their shoulders (without wearing) and stroll.


Portuguese men carry their coats this way when they are in a casual mood or with a casual group

At the end of my 3 hour 45 minute trip, Teresa's "driver" meets me at the entrance gate to "Campanha" pronounced as kaempaenyeah, which sounds like French, feels very musical to me. Jose Manuel is a short, slender, bright faced young man. Maria, Teresa's secretary describes him as in his 40s, but he looks like he is in his early 30s to me, always with a smile on his face, I will find out. His English is as good as my colleague Agostino's, pretty good! He acknowledges me with a warm smile; he must have studied well, the picture of me Maria had told me she was going to show him. With that warm smile, I know that must be who would be waiting for me. He pronounces my name beautifully as most Spanish-speaking people do. He is very helpful as all of o Porto people are. We have a pleasant chat on the way to my hotel, Casa do Medico, which is in the center of the recreational campus of the Medical School of the University of Porto. He tells me he is married to one of the secretaries, Amelia, who also works for Teresa. They have two daughters, one is 20 and works at a shop, "she is a shop-girl" he will describe her with a smile on his face, almost apologetical that she hasn't gone further in her education. The other is 13 and in school.  He tells me Teresa is at a TV station to promote the third child abuse conference she and her team have been organizing in o Porto, in which I will also be presenting tomorrow. I admire her so much, she is organizing at least 2-3 conferences a year in addition to several local/regional courses, in addition to all the clinical work she has to do, in addition to heading one of three branches of the National Institute of Legal Medicine in the country. Some of my friends call me 'force of nature', they haven't met Teresa, who is constantly thundering among Europe, South America, and Africa.



The incredible female leader of Portugal pushing for a very humane approach in her country to manage child abuse and neglect

As humble and chatty as I am with drivers, receptionists at hotels, secretaries of colleagues that I work with, seeing the expression on their faces, full of respect, a measured distance, the shy smiles; I wonder what kind of an impression we academics make on these lovely people's minds, who might not have been as fortunate as we have been with the resources that brought us to where we are now. I have seen over the years that my humility and friendliness can cover some of the distance between them and I in my attempts to communicate with them, but not fully. This, impossible-to-eliminate distance is based on biases that societal norms impose on them, I believe. Social psychology, perhaps should be the next thing I should study. As we chat warmly, I can't help but thinking of these biases, barriers almost remnants of perceived untouchabilities, subtle cast systems crippling our societies. I can't help thinking of gated communities of the USA, membership clubs and facilities, even the club locker room at the gym at my university, all geared toward a subtle segregation, which then lead to these impossible-to-cross barriers and biases.

My hotel room is simple but clean and comfortable. Portugal is going through such hard times, economically, I would be perfectly OK to stay with Teresa and her family, but she wants to treat me properly. Tiago, Teresa's older son, who just graduated from Medical School and, to my surprise, his girlfriend Isabel pick me up from the hotel to take me to their home for dinner. It is past 8 pm, this is the European style, dinner can wait until 8-9 pm. Isabel, I find out is also a medical student, and is she a beauty, my goodness, over the evening I will discover, inside and out. She has a real royal beauty, looks like one of the princesses with royal blood out of a Micalengelo painting. I tell Tiago "It looks like you have found the most beautiful girl in town." They both chuckle with pleasure, a bit of shyness on Isabel's face. I ask them how they met. Tiago interviewed Isabel when he was doing his master's thesis, which is part of medical education in Portugal, thus every physician graduates with a master's degree as well. When it came to defending his thesis, Isabel contacted him and asked him if she could come listen to his defense. I ask her "Did you have him in mind romantically then?" with a loving mischievous smile. She smiles back with a shy but innocently mischievous look in her eyes and nods her head. I crack up, they follow, how sweet. After all, as Teresa reiterates during the dinner, women are always the one, who leads the way to relationships, but doing it subtly since to make the man feel he has the lead is the talent we all need, that's what the society dictates on all of us, doesn't it? 

I can't help but think of the book that I am reading lately "Women don't ask". This is a book that was assigned to a group of women faculty, who volunteered to join a group our medical school decided to sponsor to help us women faculty learn our rights better and learn to ask for things we need professionally. As feminist as the authors clearly are, they resolve in the end that, as much as we should be more assertive to ask for what we need, we should still do it in a way we should not come across as assertive as men are expected and tolerated to do. Because.... our socialization dictates that. What a dilemma, not that I have a problem with that, I don't like extreme assertiveness bordering arrogance in either sex, but when will men learn to be mroe sensitive, more elegant and respectful when it comes to negotiating? I must say, we are still more lucky than generations of the last century, but still, we have a long ways to go to bring men and women onto the same platform.


Linda and Sara do a very good job in this book in explaining why men and women have totally different negotiation styles from home to work


Isabel is extremely humble, though, as if she is not aware of her beauty, her elegance and talents. Tiago just took his residency entrance exam, but is not expecting a very high score. He is interested in psychiatry, though, and is expecting he will be able to get into a program in o Porto since not many people are interested in psychiatry. He tells me he studied for the exam for only 6 months, I am astonished with the preceding "only". Isabel, on the other hand has started studying for it 4 months ago and she will take her exam next November! To top it all, they tell me, there are people who study much more and for longer than Isabel, too. Wow, quite similar to the Turkish system. But the equivalency of this in the USA is the three-tier USMLE tests. Medicine is tough all over the world, I guess.

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