Where there is no Rite Aid.

It is a source of unmitigated shame that I’ve lived in Geneva for over a year now, and my French remains minimal to execrable. I can offer a bouquet of excuses for this atrocity (I speak English at work, I can mostly understand it now at least, the accent is so different from Spanish, it’s impossible to deal with multiple self improvement tasks at once), but really it stems from the fact that the moment I open my mouth to stammer something in French, your average Genevoise responds in perfect English.




I don’t understand how it is that they can switch between a multitude of languages without a flicker of hesitation, yet seem congenitally incapable of understanding me when I say “deux.” Deux, des, de, d’: to my ear they all sound essentially the same. Doo. Duh. De. Day. No matter how long I spend shrieking into the Rosetta Stone, both the computer monitor and your average francophone stare at me with a complete lack of comprehension when I try to pronounce my address: 2 Quai…. My parents required me to learn my address at age four for safety’s sake in the U.S.

I’m just winging it here.




The one place where my French is generally well understood, besides Senegal, is the pharmacy. The thrill of being able to communicate for myself, just like a real grown up, has led to my volunteering to be the pharmacy translator for a whole host of expats and interns at the WHO.

I’ve developed a whole dialect that is a mélange of French, Doctor, and spirited mime. It’s very effective.

This routine had its beginnings as a medical student on holiday in Hanoi.
Four medical students headed to Vietnam for one last long holiday before intern year. Alas, one of us didn’t have a levonorgestrel intrauterine device, and thus still had periods. To the pharmacy for the necessary supplies. Of course, we couldn’t just walk in and grab what was needed from the shelves. We had to ask the non-English or Spanish speaking pharmacist for this. Unfortunately, Lonely Planet does not include the word for tampon in its “Conversation and Essentials” section for Vietnam.

We broke into teams to maximize our chances of success. Two of us engaged in a vigorous game of Pictionary, that was remarkable more for its hilarity than effectiveness. The pharmacist was initially bewildered, than disturbed, by the odd stick figures that ensued. I paired with another to shout out as many synonyms as we could think of for tampons in as many languages as possible (Tampons, pads, Kotex, tampax, toallas, towel, diaper, menstrual, menses, period, bleeding, …). One of us finally happened upon Kotex, pronounced with a Pepe le Peu accent. The American rendition of Kotex had resulted in naught, but when re-delivered with a ridiculous accent, voila!

However, this is not Hanoi. This is not Senegal, where anti-malarial prophylaxis will be handed across the pharmacy counter to every tourist, regardless of what they think they have asked for. This isn’t Rome, where a smile and blonde hair will net schedule two medications along with your Zofran. It’s definitely not Costa Rica where the contents of the Physician’s Desk Reference are available to be tucked into your handbag along with your tube of Retin A.







This is Switzerland; there are rules about rules. There is an index for the rules. Rules are embraced here. These are people who enjoy reading instruction manuals. People even follow cross walk signs!

None the less, on my second day here, I managed to walk into a pharmacy, get the medicines I needed and a discount. All without speaking real French or having health insurance.
For any of you, who might find yourself in an international pharmacy, with an urgent need, I share the secrets for my success.

Start with this:
Je suis medicin.
I’m a doctor.

Non tisane. Je ne veux pas d une tisane. Piulule sil vous plait.
No, not a tea. I don’t want a tea. I want a pill please.

This is important: the voice must contain a hint of disdain at the paltry offer, without offending. They believe this is strong medicine. You want the real stuff. Remember to smile with your eyes while still maintaining a furrowed brow and a note of desperation in your voice.

A gaggle of pharmacists will now convene, and chatter in their high pitched native tongue. Pay them no mind.

With an air of authority, confidently inform them of the generic name and dosage of the medicines you require. Cést necesaire! Obligatoire!

Repeat, “Je suis medecin.”

This is where the mime comes in. Whatever they have now said, likely is a question about why you need the medicine. What’s wrong? They are concerned about you.

Lean forward, and with a confidential air, discreetly wave a hand vaguely in the direction of your chest, abdomen and pelvis. Let the hand begin fluttering around the xyphoid process, pass a few circles over your abdomen, press the hand into the general area of the bladder, then let your hand fall limply to your side. Maintain an expression of generalized distress with an undercurrent of embarrassment. I have found that this adequately conveys the symptoms of everything from gastroenteritis, to a bladder infection, to contraception.

Repeat, “Je suis medecin.”Et voila!

Where your husband?

The humid air enveloped us the moment we made our way off the plane and down the shaky metal steps to the tarmac in Dakar. It was nearly 9 pm, but the December heat persisted, and was a shock after the winter chill in Geneva. I took off my oversized coat, and hurried to join the hordes waiting for customs.

The queue stretched on and on, forward progress was rare; it was almost as bad as Washington Dulles. When I finally got to the front of the line, I realized why the line moved so slowly. First they fingerprinted me. Then they took a photo of me. Then they photographed my passport. Then the official, a lanky man in a mint green uniform, began with his questions.

“Where your husband?” he enquired sternly.

As I tried to come up with an evasive answer, I overhead the woman at the other counter responding to the same question.

“I’m not married,” I replied. I suspected I knew where this was going, but regardless, lying to a man who is holding all of your identification seemed like a bad idea.

He broke into a grin, revealing evenly spaced white teeth. “Good. You marry me.” The official Senegalese entry stamp hovered over my passport as he waited for my response expectantly.

“I’ll have to ask my mother first,” I politely demurred. As I waited by the baggage carousel, I briefly pondered who on Earth was accepting the marriage proposals of the customs agents. This strategy was clearly working for some of them, or they wouldn’t all be doing it. Right? Maybe they could have three separate lines instead of just two: Senegalese passports, All other passports, Seeking husband.



Malarone, the medication recommended to prevent contracting malaria, results in some extremely bizarre dreams. It’s a little bit like the sleep you might snatch if you’re lucky on call; fitful sleep haunted by things you need to remember or do. The odd hallucinations and desire to explore Dakar conspired to get me out of bed earlier than normal. Throwing open the curtains to our room, I got a glimpse of sandy beaches, palm trees, and a gigantic tent that was being erected on the lawn for our conference.






Île de Gorée, is a small island off Cape Vert Peninsula, about 30 minutes from Dakar by ferry. It’s one of the few entries in Lonely Planet under “Things to Do” in Dakar, and with our one free day, we decided that this should be our destination. No cars are allowed on the island, and about 1,000 people live there now. It’s been declared a UNESCO world heritage site, and carefully maintained, in part to serve as a memorial to the atrocities of the slave trade.



The road to the harbor wound along the ocean and outskirts of Dakar. Sandy beaches were populated with kids playing soccer, palm trees, and fitness fanatics. Senegal is the only developing country I’ve been to where I’ve seen so many people working out. Men in track suits jogged along the beach. A weight bench was set up under a palm tree. An improvised circuit with push-ups, jumping over two five-gallon buckets, and sprints. Within the city, narrow, congested streets were lined by yet more palm trees. Elaborate mosques were interspersed with crumbling apartment buildings.


At the ferry launch a guide quickly attached himself to us, and began chattering in French about his life on the island, his two wives, and the history of the island.
The ferry steamed away from Dakar, through a busy harbor lined with rusting freighters and small colorful fishing boats bobbing on the waves. Beer cans and plastic bags floated along the foam capped waves. Pulling into the harbor of Île de Gorée, I was reminded of Cuba. Colorful houses contrast with a brilliantly blue sky and the white sand of the beach. Colorful bougainvillea and hibiscus flowers lined narrow cobblestone streets where small kids played soccer and goats ambled. The gnarled baobab tree, a Senegalese symbol was everywhere. Our guide explained that the sap was “Senegalese Viagra.” We quickly backed away from the tree.


Maison des esclaves, serves as a memorial to the millions of Africans who were kidnapped and sold during the trans Atlantic slave trade. I caught about half of what the guide said, but seeing the cramped, subterranean cells where people were held for months, was enough to get a glimpse of the nightmare. The misery of the confined cages where captives were held contrasted painfully with the beauty of the island, and the house where the captors lived, right above their human cargo.



Over lunch, a few of our guide’s friends wandered up to the beachfront stand where we’d ordered cold beer and yassa poulet. A spirited debate broke out between the group as which of them would marry my friend, and which would marry moi. Neither of us was included in the discussion of course. Our various attributes were discussed enthusiastically. I vaguely appreciated the only-in-Africa experience of the conversation, but was beginning to feel like prime rib prominently displayed at the butcher shop. My friend and I drank beer, and waited for an opportunity to interject.
Finally, the matter was settled amongst the three of them; a jaundiced leprechaun offered me the honor of being his third wife.

I thanked him for the honor, but regretfully informed him that I planned to be the première femme et seulement (first and only wife). However, I continued, “Je vais prendre deux maris.”(But I will take two husbands).

Oh no! They replied. This is not possible! It is only for men to have many wives. Not for women.

“Pour quoi?”said Moi.
The response: Clearly a woman cannot have more than one husband. If she becomes pregnant, how would they know who the father was? The men shook their heads gravely.

I grinned. This was almost too easy. “Pas de problemes,”said Moi, as innocently as possible.
(No problem!)

“Je vais avoir deux maris- un mari africain et un mari europene. Le pere cést evident!”
(I will take two husbands- an African and a European. The father will be obvious.)
The table erupted in laughter.

Beneath the Tuscan sun

“Never take a trip with anyone you don’t love.”

I recalled Hemingway’s sage advice too late: we had already sped thru the Mont Blanc tunnel and begun an erratic descent into Italy. A bouchon of immense proportions had stalled our passage thru Mont Blanc for hours. Along with hundreds of other cars looking to escape Switzerland for the holiday weekend, we’d been stuck. Properly impacted. The hellion at the wheel was making up for her lack of driving experience with reckless abandon and expressive expletives.

With a surgeon’s detachment, I assessed the situation. Russian at the wheel, winding highway, multiple cell phones, tangential speech, Italian drivers honking impatiently when we slowed to 85 mph, the Russian’s ego preventing transfer to the right lane, and most disturbingly plans responding to external stimuli. My prognosis? No c’est bon.

I was calmly philosophical about our imminent demise in a fiery collision of steel and asphalt because I was in Italy. Italy exerts a mildly euphoric effect on me; I can explain it no more than I can deny it. Even the bad parts of Italy are simply wonderful, and as we raced towards our certain death, a part of me still took in the beauty of the mountains, the romance of the occasional castle silhouetted against the setting sun, and the complete rightness of having a highway sign labeled simply by a coffee mug.




An inadvertent swerve by our Baltic driver took us off the paved comfort of the highway briefly onto rougher terrain. My jaw rattled fiercely, and the romantic visions I had, fled my beleaguered skull. I grasped the safety handle on the top of the rental car firmly, and exchanged a meaningful glance with mon cher amie, H.P.

H.P was the common link between myself and the deranged Russian, and I wondered how long it would be before we would have sufficient privacy to discuss the inescapable fact that the Russian was clearly insane. I always feel need to give name to the obvious. It’s a deep seated character flaw, and wholly ineradicable.

It had started innocently enough. A road trip over Spring Break. Europe affords its workers more days off for Easter than I had dreamed existed. All of Geneva takes the opportunity to escape. We planned ours accordingly. We’d drive to Tuscany and do what we liked, when we liked. A leisurely pace with Italian wine and fashion was the order.



A last minute phone call from a friend who had fallen out of touch resulted in an addition to our party. Enter the Russian, who was chauffeuring us to our imminent demise.

“It’s all just so fucking retarded!” Another litany of curses erupted from the Russian, and I wondered, not for the last time, how our road trip had been so efficiently hijacked. It was the eighth hour of a planned four day holiday. This latest outburst had been prompted either by a text from one of her cell phones or perhaps being passed by a Porsche at well over 100 mph. It was unclear. Cursing, she had two cells in her right hand, while her left hand gripped the wheel in a frenzied vengeance. This was a graduate student in mathematics from Belarus. The ink on her driver’s license was weeks old. What hope did she have of competing with native born Italians in sports cars on their highways? None, none at all. She was insane, and we were all going to die. The facts were inescapable.

It would have been helpful, at this point, as a participant in this journey, if I had been aware of the cast of characters who were pulling the puppet strings in the background. Although I was not afforded that courtesy, I see no reason to perpetuate the insult upon you, Dear Reader.

As we learned upon the highway, the Russian had cancelled our hotel plans for the trip. She had a benefactor, here after known as Wealthy Banker, who owned a villa in Tuscany. Wealthy Banker appeared to be some sort of benevolent genie in the human guise of an elderly Indian man. In between her curses and swerving, we attempted to ascertain how she knew this man and what the deal was with the villa. Fearful of provoking her, and disturbing her tenuous hold upon the steering wheel, I used the same voice and style of questioning I use with psychotic patients. This elicited a similarly useless word salad of information.



Despite having programmed our GPS to the hotel address in Milano, a mere three hours before, we found ourselves arriving instead at an apartment building in Milano. Enter Italians 1 and 2. Italian 1 was a genial banker in his late 40s with an expansive smile and paunch. Italian 2 was a wizened Venetian, who sold women’s shoes. He had an extensive array of colorful silk scarves that followed each other in quick succession over the coming days; each more elaborately knotted than its predecessor. The Italians were to accompany us to the villa in Tuscany, where we could stay for free.

The final characters of note? The Russian’s three cell phones. As H.P and I gradually divined, each to keep in touch with a different man.
But I digress. Let’s now return to the Italian motorway.

At the first glimpse of a highway exit, H.P and I both simultaneously shrieked an urgent plea to stop and use the facilities. A curse, a swerve and two near misses later, our chauffer had negotiated her way to the parking lot.

I gaped in awe at the many splendored Italian truck stop, while H.P quietly commandeered the keys to the rental. This was no AM/PM, with depressed florescent lights casting dim shadows on withered 99 cent hot dogs, speared on electric spits, doomed to rotate next to the nachos and Big Gulps for all eternity. Ambient track lighting. Fresh paninis. Local olive oil. Wine and beer for sale. Espresso: strong, piping hot, freshly prepared from a gleaming, chrome laden marvel of Italian design. I may have swooned.

As I said, I am pretty sure I could undergo a root canal in Italy, sans anesthesia, and still enjoy the experience. With H.P now at the wheel, and two Italians in tow, we negotiated windy gravel roads twisting through beautiful vineyards, and rustic villages with crumbling stone walls. The Italians trailed us patiently for about five minutes, before they passed us in a blur of carbon fiber and exhaust. A sedate and safe four hours later, we arrived at the villa.




At the bottom of a steep and long driveway, there spread before us, was our home for the weekend. Wisteria twisted around a trellis that climbed the stone walls of the house. The sun was setting behind hills verdant with grapes. A swimming pool was nestled into a flower garden, and surrounded by an expansive deck. Farther away, by one of the adjacent guest cottages, a frog hopped off the wishing well, and disappeared into the lily pond with a small splash. Italians 1 and 2 had already arrived, and were sipping camparis by the pool as the last streaks of daylight disappeared from the sky. The house staff had assembled in front of the main building to greet us.

The house staff had assembled in front of the main building to greet us. For the first, but not the last time that week, I was to wonder what movie set I had walked into. Our luggage was efficiently whisked away, camparis were pressed into our hands, and the chef cleared the five course menu she had in mind for our delicate palates (we answered, Si, Si!).

The remarkable meal she had prepared, and the bottles of local wine, helped stem the awkwardness of sitting with an assorted group of strangers. Did I mention that the Wealthy Banker’s cousin, her mother, and two children were also at the villa? I didn’t learn that fact until dinner time either. Small talk ensued.

After dinner, the family members disappeared into one of the many houses affiliated with the villa. Italian 1 and the Russian drifted out onto the patio, where the occasional arch comment and soprano giggle would waft into the parlor. In the parlor, H.P, Italian 2 and I confronted each other over a bottle of limoncello. After the first round, Italian 2 began to confide in us. His girlfriend of many years had recently relocated to the United States for work, and he was far from happy about this state of affairs. He’d recently visited her in the small, backwater village she’d moved to, and he was far from impressed.

“Portland!” He sniffed disdainfully, slopping more limoncello into our waiting glasses. “What is this Portland? There are no clubs there, no music, no dance. We go to a club, and my English, not so good, but it was no club! It close at 2 am! And there, the men, how you say, oh… what is the opposite of rigid?”
I choked on my limoncello. Italian 2 poured his third, and adjusted his neck scarf. H.P waited with bated breath.

“No, it is I mean to say, the men, they are not so thick, but they wait on the walls and the girls, they all dance like this…(insert small Italian man jumping on chair and doing a booty dance).. like how you say…oh I don’t know…(insert visual of small Italian man doing pelvic thrust and winking lasciviously) but the clothes they wear are sport clothes! This is for hiking, not for club!”

To our amusement, and his appreciation, this theme was developed well into the first bottle of grappa. Sometime later, after Italian 2 had explained why his mother’s tiramisu was better than anyone else’s, asked us if we knew biscotti, and related his opinion on U.S traffic laws, the time had come to retire.

Italian 2 made his goodnights, and departed for the pool house. Italian 1 ushered us to our wing, up a winding set of stairs. On the second floor, we entered a spacious room, with a huge king bed covered in a lace duvet with delicately embroidered pillows artfully tossed about. Tasteful art adorned the walls. Through another door, an ensuite bathroom with Jacuzzi tub awaited. The Russian’s suitcase had been placed in front of the wardrobe. Wow.

I couldn’t wait to see my room!

We stopped at the next door along the hallway, and with a theatrical gesture, Italian 1 bade us all to enter. A narrow pine bed with a patchwork quilt waited. Bookshelves lined the walls. Two shuttered windows were tightly fastened. H.P and my luggage waited for us in the corner. The door shut behind us as Italian 1 and the Russian exited.

Our eyes met.
“WTF, BFF?”I queried.
“lmfao.”H.P wearily replied.
After rapid ablutions, we climbed into our bed to exchange whispers about whether we were having a shared hallucination, or if this was really happening, and the Russian had a psychotic break. Her behavior was completely at odds with how HP had known her to be in college. A coy giggle from the room next door interrupted our quiet debate. A series of suggestive thumps ensued.

“Hold me, I’m scared!”H.P whispered her tone thick with disbelief, tinged with disgust. I rolled my eyes, and distributed a travel essential: ear plugs.
Ten hours of sleep and waking to a gorgeous view of Tuscany rapidly restored any equanimity that had been lost overnight due to inadvertent spooning and allegations of blanket thievery.





The three of us had planned to spend the first day in Florence, where we had tickets to the Uffizi Gallery, and we’d planned to explore the Duomo, Campanile, and of course the Prada outlet. Over breakfast, H.P and I attempted to convene with the Russian and figure out when she wanted to leave. This proved to be astonishingly difficult. It was as if we had been rendered mute overnight. Although the Russian and Number 1 sat mere centimeters away from us, no acknowledgment, verbal or physical was made to our comments. Instead Number 1 dithered on about a party that night in the south of Italy that he wanted to take “us” to. The Russian listened with rapt attention. Italian 2 glumly sipped his espresso and caressed his orange checked silk scarf. H.P and I confirmed with each other that we could in fact, hear the other one speaking. I pointed out that the maid could also hear our requests for coffee. With the integrity of our vocal cords verified, we mutually agreed again, that nope, it definitely wasn’t us.

This didn’t go on for too long before the synergy of our combined impatience and decisiveness resulted in us pushing back from the breakfast table, and announcing that we were headed to Florence. An expert negotiator, H.P had cleverly maintained control of the car keys.

Florence is worthy of all the superlatives that it has been lavished with over the years. The stunning duomo, the meandering cobblestone streets, the gorgeous architecture, the charming Ponte Vecchio, the beautiful leather goods… Trying to describe Florence is akin to attempting to relate a dream to someone else. It’s etched indelibly in your memory, but when you try to describe it, you just sound like a trite, incoherent ass.






We happily ate gelato, browsed art and handbags, gawked at David, and scaled all 467 stairs to the top of the bell tower. Catching our breath at the top, we gazed out over the orange roof tops and pondered how we could get jobs in Italy.
The next few days passed in a blur of pasta, wine, runs in the vineyard, photography, and generally being ignored by the Russian and Italian 1. Italian 2 vacillated between periods of conviviality and morose reflection, where he’d stare absently into his limoncello and adjust his neck scarf thoughtfully. At these moments I surmised, Portland weighed heavily on his mind.

And so the vacation passed.



Up until the moment we headed up the driveway, H.P at the wheel, I was convinced the Russian would be staying in Tuscany. We needed to leave by noon, or there was no way we would get her to the Geneva airport on time. We had well passed the point when both H.P and I would be thrilled to see the last of her. Regardless, HP felt obliged to get her to the airport, whereas I was ok with just waving goodbye. HP is much nicer than moi. In a pre breakfast tactical discussion, we cornered the Russian in the sun room, and informed her of the need to be on the road by 11am, sharp. She smilingly agreed, and together we trooped to the breakfast table.

However:
At 10:30, she laughingly discussed lunch plans with the chef and Italian 1.
H.P and I mentioned our need to be on the road. The chef heard.
At 10:45, she requested an omelette and waffles to be made.
H.P and I pushed our long empty plates away on the table.
At 10:50, she playfully discussed a trip to San Vicente with Number 1.
H.P and I left to get our bags and made our farewells. Everyone except the Russian and Italian 1 heard them.

At 11:00, our luggage and our charming selves were loaded in the car. The Russian was not. H.P gave the engine a warning rev, and prepared to turn the car to head up the nearly vertical gravel driveway and head back to Switzerland.
To our surprise, the Russian climbed into the back seat, one of her text phones already attached to her ear.

The rental car, a humble import, bucked and reared, as gravel spun from beneath its tires. Our ascent was erratic, and I tried to refrain from clutching the sides of my seat. H.P was bent over the wheel, intent on controlling the car as we scaled the driveway at a snail’s pace. Our sigh of relief at the top of the cliff was brief- a red light was spotted on the dashboard, and the foul smell of something-that-shouldn’t-be-burning burning was unmistakable.

We pulled over. The Russian continued yammering on the phone. The red light contained an odd symbol that neither of us had ever before seen on a dashboard. It vaguely resembled a nuclear mushroom cloud. HP and I quickly began problem solving. Turn off the car, turn it back on. Let the car rest for a bit, maybe it’s overheated. Call the rental company and ask them the significance of the mystery symbol (wait, maybe we aren’t supposed to be in Italy with the car, and of course the Swiss advice will be to wait for a mechanic- I hurriedly hung up). I looked under the car for leaking fluids, and futilely looked under the hood for evidence of a nuclear explosion. HP searched the car manual for the definition of the cryptic Defcon 5 symbol that had popped up on our dashboard.

The Russian switched phones to make another call from the backseat.
I was staring in vain under the hood, when a triumphant yell from HP caught my attention.

She had found the mysterious symbol in our book! The answer was at hand. Unfortunately it was written in German. The only German we know between the two of us is sufficient to order beer, coffee and request no mustard on any foodstuffs. To Google Translate then! I prayed my ancient, WHO issued, blackberry would summon the energy to find a signal out here in the Tuscan wilds and load the page in the next two hours. The loading bar crept across the page at an agonizingly slow pace. HP and I stared fiercely at the miniature screen, willing it to keep loading. In the backseat, unconcerned, the Russian opened a bottle of wine, and sent a text from her second phone, the first one still pressed to her ear.

Finally! The page loaded! We bumped heads in our eagerness to read the diagnosis of our car, and learn our fate:
“Symbol engaged with beta saturated brake.”

Our eyes met with mingled relief and shame.
HP released the parking brake, and we sped home.

The IUD Crusade

“Belgium would like to acknowledge the comment made by Malaysia, and moves to second for the record.”

“The chair recognizes Belgium, and the record shall reflect Belgium’s endorsement of Malaysia’s comment. The chair recognizes the vice chair. Vice chair?”
“The Vice Chair would like to remind country participants to please state for the record if this is a comment, question or a point of personal privilege.”

“So noted.”

I yawned, and glanced at my empty coffee cup longingly. I am well aware that working for the United Nations sounds terrifically glamorous and important. It is. About 5% of the time. The remaining time is spent desk bound, filing forms in triplicate and attending meetings that are so mind numbingly dull, neurons snooze and synapses stagger to a halt.

The flood of acronyms and bureaucratic procedure have a way of making even the most interesting of topics profoundly dull and positively indecipherable. I was pretty sure we were talking about gender and human rights, but New Zealand was reading his speech in the most mono of monotones, and the ear revolted at listening for longer than five seconds.

A gentle snore erupted from Swaziland in the row ahead of me. Ghana was busily engaged in constructing an elaborate chain of paperclips. Now if only Kurgistan was gchatting Uzbekistan while Georgia played Farmville, this would be exactly like my MPH classes at Berkeley.

I was briefly diverted by imagining how it would be to conduct my life in UN speak.
“Oregon would like to recognize New York. New York, for the record: is this a question, comment or point of personal privilege?”

“New York requests tabling of dinner plans and motions that New York, Oregon and Australia have another round.”

I snickered.





Thirty six hours previously I’d been sipping an ice cold Corona, listening to Sweet Child of Mine, and enjoying the best enchiladas I’d had since the Mission District.
I was in Amman, Jordan on a mission for the World Health Organization, Iraq.

Three weeks ago, after eighteen months of bureaucratic and political delays, the Iraqi Ministry of Health's formal request to WHO for a reproductive health training finally got processed. The Iraqi health system, along with a lot of the country's infrastructure, has been decimated by years of war and strife.


By the time the paperwork got processed, we had less than a month to prepare for a "training of trainers" workshop. Iraqi physicians would come to Amman for a week long conference organized and led by yours truly, one other American obgyn and a well meaning epidemiologist. The Iraqis wanted an update in every contraceptive method available as well as clinical training (IUD and implant insertion, sterilization, counseling techniques).

I sent out pleading emails to obgyn friends for any and all grand rounds they'd given on contraception, and quickly started putting together our curriculum.
This was my first time doing this indepth of a training, and my first trip to the Middle east. I wasn't at all sure what to expect.

What was the current state of reproductive health in Iraq? What kind of contraceptive methods were available? Who was coming to the conference (doctors, midwives, nurses, family practice doctors or obgyns?)? Could I mention abortion? And most importantly, what on earth should I wear?




For security reasons, the conference was going to be held in Jordan. This was super exciting! Jordan, for those who haven't seen Indiana Jones, is where Petra, the lost city is. Archaeology, was right up there on the list of things I wanted to be when I grew up, somewhere after Gynecologist and Secret Agent, but well before Astronaut.

I immediately bought a Lonely Planet and downloaded the Lost Crusade. After my trip to Ethiopia for work, I'd learned my lesson. Schedule a couple vacay days around the trip or you'll never leave the hotel. I was not flying all the way to Jordan without seeing Petra, the Dead Sea, and hopefully Wadi Rum. In true obgyn fashion, I just planned to stay awake for a couple days to fit it all in.





Petra needs to be added to your To Do list. Stat.
An entire city carved into rose red cliffs preserved for centuries. I'm a gynecologist, not a geologist, so I can't bore you with too many facts about Petra. Our guide provided a range of info from historical details on lost civilizations to how to train a camel, but I was too busy staring, mouth agape, to take much of it in.

I did learn that telling a woman she resembles a camel is a Bedouin compliment.

Waves of red, black, green and white, undulated through the face of the cliffs that lined our path as we hiked into the city. The shapes were no less amazing; both the man made buildings that had been carved into the rock, enduring for centuries, but also the smooth surfaces that had been shaped by wind, flash floods and aeons of harsh sun.

Ater a quick shower and lunch, we clambered back into the Jeep, and headed south to Wadi Rum. An hour and a half south, and we were in a different world entirely. I felt as if I'd stepped into a Ray Bradbury short story. Intensely blue skies contrasted with fiery red sand to the horizon. Cliffs molded by wind and sun provided shade for occasional clusters of camels. The landscape was Martian.

We drove to a camp site and watched the sun set. I clambered to the top of one of the dunes, and as I watched the fading light I was really glad I decided to go to medical school.

Later, sitting by the fire, I was romantically entertaining thoughts of spending a while in the desert. I'd wander around red sand dunes, write, take photos, drink turkish coffee and think meaningful thoughts. Then a scorpion the size of Detroit lazily ambled past my foot, and I quickly realized the Bedouin lifestyle is not for moi.



We woke at dawn to have a brief stop at the Dead Sea (yes, you really do float) before arriving in Amman in just enough time to clean the mud from between our toes, throw on frumpy, professional attire, and meet with Ministry of Health representatives from Jordan and Iraq.

Forty physicians would arrive for the start of the conference tomorrow. In our organizational meeting we reviewed the conference agenda and got answers to some of the questions we'd been trying to figure out.

The doctors were all obgyns working in both the public and private sector. All but two were women.



Contraceptive supplies are highly limited in Iraq, especially in the public sector, which is where health care is provided for free, or minimal cost. What they have to offer women depends on the month. Some months they have depo provera (a long acting injectable form of birth control) and copper intrauterine devices. Most months they have one type of pill and male condoms they can offer women.

To have your tubes tied, government permission is needed. A woman must have had a minimum of FIVE children and be at least FORTY years old before she can request permission from the state to be sterilized. It goes without saying that she needs her husband's permission for a tubal ligation or any other form of contraception.

The average woman in Iraq gives birth to five children. Decisions about family planning are typically made before a woman arrives at the doctor's office. A woman's value is highly dependent on the number of children, and sons, that she has. Input on whether she uses contraception, and what kind, is based on the guidance of her inlaws, mother, and religious leaders.

Given the lack of access to basic medicines, and religious restrictions, the public health focus is on delaying marriage and promoting breastfeeding (to try and encourage birth spacing, or time between pregnancies).

Vasectomy is practically unheard of in Iraq where usage of male condoms is less than 2%. In a related note, a brief hooray for the enlightened men of the United Kingdom, New Zealand, and Iran who have the highest rates globally of both vasectomy and condom use. Yay.

Newer methods of sterilization (hysteroscopic) are unavailable. Implants (like Implanon) not available. The levonorgestrel IUD, (the Cadillac of Contraception), is available, but only in the private sector for the staggering sum of 20$. This is beaucoup expensive for Iraq, but having paid 800$ for mine, I was kind of underwhelmed. I was however, aghast to learn that a woman can only have one if she has a concurrent medical condition (hyperplasia, annovulatory bleeding etc).




For the next four days I barely left the Hotel Kempinski.
The Iraqi contingent arrived full of enthusiasm, questions and information about life in Iraq. The other ob and I gave lecture after lecture and were bombarded with questions. It was inspiring, fascinating and absolutely exhausting.

I learned that it is 60 degrees CELSIUS (140 Fahrenheit) in Baghdad in the summer. I hadn't realized that the temp scale went that high. Did I mention they have rolling blackouts and that AC is non existent?

This was the first trip out of Iraq for most of the group, even though Amman is only a few hours away by car or plane.

The majority of the doctors wore headscarves and loose clothing that covered them from their neck to their toes. The outfits were colorful, matched and were accessorized with heavy gold bracelets, rings and knock off Vuitton handbags.

Medical school text books in Iraq list the mechanism of action of an IUD as causing an abortion. It's not how the IUD works of course, but this limits the acceptability of one of the few effective methods of contraception available.

Animated conversations in bursts of Arabic and English punctuated our lectures. The physicians were passionate about improving the health and lives of women and families in Iraq. They talked about the importance of delaying marriage for teenage girls, because once married, it was imperative that a woman (or girl) have children to establish her worth to her new in-laws. They spoke respectfully about the difficulty of caring for women when the majority of their decisions were made for them, by their husband, families or religious communities.

I worry about getting sued as an Ob-Gyn. Most of us will in the US, on average, seven times in a career. It's the litigious culture we live in, and it breeds defensive medicine and many complaints.

I wondered why so many of the Iraqi doctors seemed risk averse and highly conservative. It came across as paternalistic and a little condescending, but I knew from our group conversations about consent and counselling (not to mention the personal sacrifices these doctors were making to provide care) that they cared deeply about promoting women's health.

On the last day, one of the doctors, pulled me aside during the training I was leading in how to insert an IUD. She again asked me if I was sure that an IUD didnt cause an abortion. For the umpteenth time I reassured her it did not.

She then confided that in her community, any bad medical outcome, whether the fault of the doctor or not, was settled not by a lawsuit, but by retribution. An unexplained stillbirth or death of a patient, even if no one was at fault? The doctors feared for their lives, and those of their families.

"It's the law of the jungle," she earnestly related. Jesus. I doubt I was able to conceal my shock, because she continued to explain. "It's just since the war. There is no law." My admiration for these physicians, and the work they do, under the most demanding of situations increased exponentially.

The Rapture That Wasn't

News of the expected "Rapture" on May 21, 2011 at 6 pm, wasn't big news in Europe. As best I could discern from the French headlines, the Swiss were more concerned about an altercation in Libya, a global financial crisis, and of course, the Royal Wedding.

Fortunately Facebook and a supply of American visitors alerted me to the fact that a homeless man in California with a colorful psychiatric history, had prophesied that we would all meet our judgment on this date, at this time.

I philosophically took the news with a casual shrug and another glass of wine. I was pleased to note that the Rapture had thoughtfully been scheduled to occur on my flight home from vacation, and not my outward bound flight. If I was going to burn in hellfire for all of eternity, at least my last week of life would be spent in Amsterdam.

Time sped by. For the record, Amsterdam was an absolutely brilliant place to spend a week, even if you aren't going to be immolated at the end of it.

The final day of vacation, and the alleged Rapture, came all too soon. I dragged myself and my burgeoning suitcases to Schiphol, and joined the Easy Jet cattle queue waiting to board the flight back to Geneve. As I stood with the rest of the unwashed masses, I idly pondered my chances of avoiding hell should the Rapture arrive.

Being a naturally cheerful person, I decided to ignore my long record of sins and instead look for hints of my eternal fate in the surrounding environment. It's not the most scientific approach, it's true, but why spend the last hour of my life depressed?

Gates for Easy Jet flights are always in the most barren of terminals. Schiphol was no exception. I scanned the area. Scarred linoleum floors. An aggressively intimate security screen. A pervasive odor. A total absence of amenities, including no coffee. This wasnt looking good. I sighed, and glanced around for an empty chair. I briefly met the eye of a handsome boy also waiting to board. He smiled at me.

Thirty three minutes later, the apathetic stewardess opened the gate, and a tide of travelers rushed the plane. Easy Jet doesnt assign seats, so it's survival of the fittest. I smugly launched myself into an ideal window seat and settled in. The plane rapidly filled up. A tall German folded his frame with a sigh of relief into the aisle seat of my row. The middle seat waited.

It's nearly impossible for me to stay awake on a plane. I'm not sure why, but the second I board, my eyes close, my head bobs, and I happily fall into a restful slumber until it's time to deplane. I was awakened however, when a passenger plopped into the middle seat. I cracked my eye open. Handsome Boy had just sat down next to me.

Interesting.

I always like to start planning my next trip as soon as the previous one ends, so my guidebook to Jordan was open on my lap. H.B noted the title and commented: "How funny, my father is from Jordan- I grew up there."

For the next five minutes the Rapture was really looking up. In addition to providing useful Jordan info, H.B was also a UN translator, and spoke five languages, including French. This has rapidly become a very, very attractive quality in a man.

Then it took a turn.

While telling me about his recent decision to quit working for the UN, I realized I was having a flashback to my medical student days when I rotated on psychiatry. Attractive hazel eyes, pupils slightly dilated, making eye contact for an uncomfortably long time. I pressed into the wall of the plane, and began to deeply regret eschewing the aisle seat.

In the next few minutes, H.B proceeded to relate that he's separated from his wife, but that they still have to pretend to be married for another ten years, so that she can get EU citizenship and not be shipped back to the Middle East. I nodded appropriately, maintained an impassive face, while internally I wondered if it was the blonde hair or the American accent that makes me seem stupid?

Honey, if you're "separated" from your wife, but no one, including your family knows it, then you're married. I promptly lost any remaining shred of interest in HB, despite his cute curly hair, height and ability to speak French. I'm moderately maniacal about monogamy and intensely intolerant of infidelity.

Thirty seconds later, I was able to feel self-righteous about being judgy.

H.B began relating all of the drugs he'd used in Amsterdam. Few things are more boring than listening to a complete stranger recount their hallucinogenic highs while locked into an uncomfortably small airplane seat. Without coffee. It has the same appeal of listening to your dentist expound upon their latest dream while giving you a root canal. Without anesthetic.

"Oh really, then the carrot you were eating grew legs and ran around the table singing Jefferson Airplane? OMG, that's soooo wierd...."

Yes, I understand the experience was profound, vivid, and resulted in transcendtal experiences of profound love for all mankind. It's called being high. No one is gonna award you the Nobel Peace Prize for your drug trip. I looked surreptitiously at my cell phone. Had the Rapture come and gone? Was I already in hell?

Then he offered me some ecstasy that he had left over in his pocket, and mentioned that he maintains a separate apartment from his wife. Now I see where we're going with the drug trip story.

I politely demured.

H.B suddenly remembered his manners. Heavens, we've shared so much together already, and he doesnt know my name! I give him my first name, for once thankful that I have an absurdly common name.

H.B:" My name is Osama."

Again the doctor training came in useful in maintaining a straight face.

I am well aware as an obstetrician of the unfortunate monikers parents are prone to saddle their helpless progeny with. I've known a perfectly adorable Atila, an apologetic Adolf (he went by his middle name) and heard tell of a shy Stalin. A name is just a name, and a more mature person than I would have just accepted this with a polite nod, well aware that 35 years ago at his birth, his parents couldnt have possibly forecast Osama bin Laden's nefarious actions. A kinder person than I would have dwelled on how bad it would suck to be named after a notorious terrorist.

Alas, being me, I suppressed a giggle, and started imagining all of the ways in which this was absolutely hilarious.

"Mom, this is my boyfriend Osama."
"Osama! How many times do I have to tell you? Put the seat down!"
"I'm sorry Osama, it's me, not you."

Variations of this game entertained me the rest of the flight, disembarking, and at baggage claim, where I finally managed to ditch Osama.

Sundays in Geneva

I yawned and smiled contentedly. The warmth of the sun was a pleasant weight on my eyelids.

“My god! Check that out!” H.P exclaimed sotto voce.

I peeked an eye open and glanced across the park. Eaux Vive is in and of itself comment worthy: an expanse of green lawn extends from a restored mansion, sweeps down a gentle hill, reaches the absurdly blue waters of Lac de Geneve. Perfectly arranged tulips, daffodils and assorted fauna are crisply maintained in beds throughout the park. Vibrant cherry blossoms are silhouetted by the azure sky.

Sorry to wax all poetic. Geneva has been swathed in the same shade of gray for the last five months, so all the color has made me slightly more delirious than usual.
Apparently, I was not the only one.

Was H.P commenting on the vigorous games of bad minton occurring throughout the park? I haven’t seen a set since the 1980’s but apparently it’s undergoing a revival. Even without nets. No, that was not a likely cause of the amused note of alarm in H.P’s voice.

Maybe the two girls sunning themselves directly below us caught her attention? They were slathering themselves in tanning oil. As I watched, one nonchalantly reached into her off the shoulder top, pulled out one breast, copiously oiled it, then its twin, before returning them (mostly) to her blouse. Her friend had set up a foil reflector to capitalize on the sun’s rays. I was momentarily distracted by the fact that they were lying with their heads at the bottom of the incline.

“That has to be uncomfortable,” I muttered.
H.P followed the direction of my gaze and agreed, “Yeah, and it’s going to be a heck of a burn. But no, check out three o’clock.”

Oh dear god. A mountain of a man, as pallid as the snow capped Alps, was spread eagled on the lawn, with nothing more than a very small, nude colored Speedo. At least that is what I told myself before hastily averting my eyes. Nude colored Speedo. Definitely. Very small, nude colored Speedo.

“I think I can smell the melanoma from here!” I remarked.
“I just don’t understand the European fondness for Speedos,” my friend remarked as she slathered a piece of baguette with cheese. She gazed at it for a moment, before remarking wistfully: “I miss bagels.”

“You’d think we could find them somewhere,” I mused. “I wonder if we could make them?”

“By my apartment in New York, we have the best bagel shop. All my favorite flavors, made fresh daily…”

I interrupted with a giggle. “Once upon a time in a far away land…”

HP obligingly continued. “There was a magical kingdom! Full of stores, people, and restaurants, most of which were even open on Sunday!”

With mock disbelief, I interjected, “No, surely the stores weren’t open on Sunday! Next thing you’ll be telling me this magical kingdom’s grocery stores stayed open past 6 p.m!”

Laughingly, HP continued. “Oh yes, my child. Stores were open late every night, and restaurants were full of diverse and delicious foods, including bagels!”

Trying for a note of childlike wonderment, “Bagels?! Really? Was this only on a special day of the year?”

“Oh no. Bagels could be bought any day of the week!”

“But how could that possibly be?! Wouldn’t people need an assigned time to eat bagels? Just like with laundry? Otherwise it would be complete chaos! People would eat bagels whenever they liked!” My voice resonated with mock horror.

HP snorted. “Oh no my dear, they ate bagels AND did laundry whenever they pleased!”

Aghast, I retorted, “Good lord! The sheer insanity! No weekly assigned times rotating on a fixed schedule to designate appropriate times to use the washing machine! Next thing you’ll be telling me they could take showers after 11 p.m!”

“Yes, yes they could! In this magical kingdom, the hot water was available 24 hours a day! Even on Sundays…”

It’s been about eight months now, and of the many things to get used to in Geneva, the hardest has been trying to figure out, and make sense of, the many rules. Regulations are legion here. I’ve tried to give up the quest for logic in many of the decrees; it’s simply not to be found. The stores will close before most of us get off of work, laundry can be done only at the assigned time, and if you try to take a shower after 11 pm or 5 am, be prepared: it’s going to be icy cold.

The biggest adjustment was Sundays. I can’t remember any weekends from this fall, they passed in a nauseating blur of studying for the oral board exam. By the time I resurfaced after my fateful day in Dallas, it was winter, and Geneva resembled a ghost town on the weekends. Buried in damp, monochromatic grey, anyone who wasn’t skiing was taking advantage of plane tickets to almost anywhere else. In retrospect, the fact that the highlights of Geneva were mentioned as the incredibly tacky flower clock, the underwhelming Jet d’eau, and its proximity to other European destinations, should have prepared me for the weekend wastelands.

Sundays were simply strange. Nothing is possible on a Sunday. Stores are closed. Recycling is forbidden. Laundry hours are nonexistent. Use of washing machines, be they for clothes or dishes, curtailed. Electricity was at least still available, and public transport would make a half hearted appearance, but everything else? Nope.

I vacillated in my response to this. At first, I tried to think how nice this was, that EVERYONE had the day off on Sunday, and that pretty much everything except for religious services and couch surfing was forbidden. Then I got kind of annoyed and abandoned my brief attempt at Pollyanna-hood. There are only so many hours in the weeks to get assorted errands taken care of, none of which the Swiss make simple, be it laundry, bill paying, grocery shopping, or gawd forbid, a hair cut. I learned that women only got the vote in the 1970s in Switzerland, and that most policies are passed assuming a hausfrau is available at home to run the dishwasher on alternating Mondays between 9 and 11 a.m.

It’s enough to raise your blood pressure, especially if you think you can accomplish anything, be it a quick trip to the bank or grocery store in an efficient fashion.

After 8 months though, I’ve begun to embrace laziness myself. Eight hours of sleep a night, 40 hour work weeks, and 2 days off a week? I can’t remember the last time I had this schedule, and it’s phenomenal the change it makes in my outlook. The sun shining is another excuse to put it off till next week.

As long as the sun keeps shining, you’ll find me smiling, slathered in SPF 50, lying in the park, ignoring all of the many things I should be doing instead. When in Geneva after all...

Mind the Gap

I should have known better. The thing is I’d convinced myself, that there was something special between us. I thought that years of shared history, common values and habits meant that we had something unique. True, I don’t always understand what you’re saying, but still. Sniff. Clearly I was wrong! It’s you, not me. Cuba never treats me this way, North Vietnam was nothing but polite. Formal, agonizingly meticulous, and painfully slow, but gracious.

So why the heck do I always get thoroughly grilled in UK customs? I have a U.S passport, a Swiss “legitimacy card,” and a diplomatic passport to substantiate that I am who I say I am and that I’ve never been convicted.

Mind you, I submit to full body scans (including retinas), standard video and photo recording, I disrobe nearly completely and patiently wait for the people in front of me going through security who somehow missed the signs every three feet about NO LIQUIDS MORE THAN 3 OUNCES and yet are still trying to convince the security guard that their oversized bottle of Aqua Net qualifies as a medical necessity.

Well, “patiently” is perhaps a gross exaggeration in the interests of dramatic effect (Lady, it’s NOT aerosolized insulin or breast milk, and as a doctor, it is my medical opinion that you shut your pie hole and move it along), but nonetheless I cheerfully submit to a variety of intrusive procedures because that is what we all signed up for. Security is important. I get it.

I don’t quite understand how what is happening at the United Kingdom’s border is making the skies any friendlier however.

My first two trips to England, I thought maybe the custom official was having a bad day, but this last trip confirmed my suspicion that it’s systematic.

After enduring the Easy Jet cattle stampede off the plane, I waited in the “All other Passports” line, landing card filled out in neat block letters, assorted identifications in hand. Finally, it was my turn.

I promptly walked over to the counter where the dour faced man waited. The straw colored wisps of his hair that remained were clinging frantically to the smooth surface of his egg shaped pate at awkward angles. The front row of his teeth overlapped each other and protruded forward over his lip inquisitively. He’d be a great mascot for the Oregon State Beavers.

I smiled, and slid my papers across the countertop to him.
“Look at the camera!” he barked. I nodded and blinked as a rapid fire series of digital pictures were taken. I caught a glimpse on the computer screen. Good lord; the pictures are about as flattering as those taken by speed cameras. I looked like a half wit with a good hair day.

“Why are you in England?”
“I’m here to visit a friend, she just had a baby.”
“How long are you staying for? Where does your friend live? How do you know her? How long have you known her?”
“I’m here for four days, they live on X Road, and we went to high school together.”
“High school? In the United States? Why is she living here? What does she do? What does her husband do?”

I wasn’t entirely sure what this had to do with national security, but I explained nonetheless. I even more or less managed to describe what my friend’s thesis was on. I was confused. Is this some sort of interrogatory tactic where he would pester me with a range of random social questions, then would sneak one in about terrorist activities? I was envisioning the scene from Austin Powers, where he asked the spy the same question three times, before he finally revealed all.

Oh my god.
The customs official let loose with a racking cough and exposed me to a full view of incisors one through forty two, soft and hard palate. Was that a fungus growing on his teeth? Is that even possible? Maybe I shouldn’t drink the water here. Maybe his mom took doxycycline while she was pregnant with him?

He interrupted these medical musings to ask if my friend had delivered a boy or a girl. Hmm. Maybe their technique is more sophisticated than Dr. Evil! I glanced around. Were video cameras and heart rate monitors measuring pupil dilation, tachycardia and body language to identify liars and thus potential terrorists?

He stopped me after I gave the baby’s gender, birth weight, length and APGARS. Dang, I was really looking forward to taking him through a c-section, but seriously, my ride was waiting, and if we chatted much longer he was going to need to buy me a drink.

“Why do you live in Switzerland? How long have you lived there? What do you do for work?”

I hesitated. I don’t mind the body scans and property searches, but it just never seems like a good idea to tell the truth to authority figures. Possibly this is the result of hiding from Officer Mann on his stealthy Schwinn during my misspent youth, or more likely it’s from having a lot of friends who are lawyers. Nonetheless, I was already half way concerned I was going to get pulled into solitary for a prolonged chat with British customs. I eschewed a more creative response and stuck with the truth.

“I moved to Switzerland six months ago for a job. I’m a doctor with the World Health Organization.”

“What kind of nursing do you do?”

“None. I’m a surgeon.” I delivered this last line with a minor challenge issued by my shoulders and a firm glance into his pale, ferret shaped eyes.
Stamp, stamp.

“Welcome to England.”

Postcards from Ethiopia

My first thought on boarding the flight to Ethiopia and finding my seat was: “Wow, Lufthansa rocks!” Captain style, plush seat, leg room to spare, and a smiling stewardess offering a freshly fluffed pillow.

I immediately started playing with the remote control for my seat. Legs out, back straight; back down, legs straight; or completely prone. I pondered the possibilities as a bearded dignitary waited patiently in the aisle. Holding up the line was a young white kid, with haphazard dreadlocks to his waist and a Bob Marley t-shirt on. I couldn’t tell if he was trying to ask the waitress a question, or if he was possibly choking on a hairball from his dredlock. Doctor senses alerted, I watched him with narrowed eyes, waiting for the diagnosis to declare itself, as I mentally reviewed the Heimlich remover and how to do a tracheotomy with a Bic pen. Seconds later, in a broad Midwest accent, he disappointedly said, “No, no, I don’t speak German. That’s Amheric! Don’t you understand Amheric?” The stewardesses blinked in surprise. They hadn’t recognized his variation of their native tongue, but they smiled politely and ushered him to his seat. As one of them returned with a glass of freshly chilled champagne, I suddenly realized I was in the Promised Land: Business Class.

Seven hours and thirty eight minutes later, I yawned contentedly, stretched with a smile, and disembarked the plane. My traveling companion stared at me with equal parts disgust and envy. “You were asleep before the plane even took off, and you slept the whole time! How do you do that?!” It’s just my special gift. I simply can’t stay awake on plane rides. Oh, and I win raffles with an unusually high frequency.

The international air terminal in Addis Ababa is a cavernous room, half heartedly illuminated by flickering florescent lights. Our pale blue diplomatic passports got us waved to the front of a line where a bored official branded them. “Welcome to Ethiopia, have nice stay,” she spoke through her yawn. I was pretty sure I wasn’t going to be one of those mainly white people who go to Africa for a few days, and come home with corn rows, indigenous clothing, and speaking in reverent tones of having had a life changing experience. None the less, my heart bounded with excitement. I was in Africa! A whole new continent!

“Three minutes!” the young woman in the official vest had proclaimed. We’d walked right past the metal detector and “Immigration Suggestion” desk, sent our bags through an unmanned X-ray machine, and exited the main terminal. Our hotel had promised a “Speedy Shuttle” as part of their guest services, and we were greeted by a smiling clerk in a mint green uniform, as we entered the seething masses of humanity outside the terminal. I guess the business travelers are that easy to pick out. She carefully checked our names off a list, and assured us that the driver would pick us up in three minutes.

We politely smiled, and I inwardly placed bets as to how long three minutes would turn out to be. Thirty minutes? Probably. Three hours? God, I hoped not. I was still charmed by the specificity of the time promised. Not a few minutes, not five minutes, or a little while, but three minutes. Thirty minutes later, the clerk leaned over the counter and reassured, “Three minutes he say! I talk him on cell phone.” She carefully reapplied lipstick, banged out a text message on her cell phone and began to shed her uniform. Was she abandoning us to our wait alone? Many choruses of “three minutes” later, her cell phone chirped. Visibly relieved, she ushered us out the door, down a winding cement ramp, and into a parking jungle.

Cars, animals, people and luggage were strewn about haphazardly. Wending our way through the dark obstacle course, we finally came upon a van with the “Jupiter Hotel: Two hotels, one concept” motto emblazoned on its side. The driver stubbed out his cigarette and threw our suitcases in the back. The clerk hopped into the passenger seat.

“How far is the hotel?” my traveling companion asked. “Oh, it’s three minutes!” called the driver, as we sped out into the darkened street, narrowly missing a goat taking a piss on the center lane. About three minutes later, another chirp from the cell phone had us swerving, braking and turning around to go back to the terminal.
“We very close, get more passengers now.” The clerk explained. “Take three minutes.”

The charm of this promise was starting to wear off. Forty minutes later, the van was packed full, and we again set off into the night. The social worker sandwiched in between the driver and the clerk visibly tensed as we careened out of the parking lot. Again. We arrived without further adventure to our hotel, but then we passed it. To drop the clerk off first. Smiling, she wished us goodnight, and said “Hotel very close. You be there three minutes.”

And finally, two and a half hours after we arrived in Addis, we made the 5 kilometer journey to our hotel. The smiling doorman, grabbed our bags, and undid the rope so that we could walk to the side of the metal detector. The security guard, rifle in hand, affably nodded. “Welcome to Addis!”



I groaned and hit snooze. Besides the jet lag, I’d spent the last seven hours turning and coughing, trying to fall asleep in a room permeated by the stench of tobacco and penetrated by the pounding of Ethiopian techno. The driving bass line was punctuated with amelodic wailing. When I did sleep, it was to dream of cats in labor, locked in a drum. I blame the soundtrack. The music died down for a few hours, but then at 430 the day’s rhythm began. Lumbering diesel trucks shifting into low gear. Workmen calling greetings to each other as they waited for transport. A surly rooster. Women arranging displays of produce on blankets by the roadside. That damn music again.

As I swung my feet to the side of the bed, and staggered into the day, my eyes burned from the haze of smoke that clung to the curtains, carpet and blankets in the room. I wandered to the room’s window to get my first look at Addis Ababa in the sunlight. The windows were caked with dust, so I pushed on the rusty catch until the window swung open into the daylight. Facing me, across the crumbling road, was a row of one room stores shaped by cement blocks and covered with slats of painted wood. A shoeshine boy took swipes at kamikaze flies as he waited for customers. Clustered behind the store, amidst concrete rubble, multiple burn piles and assorted rubbish heaps, dwellings sprang from the earth. A slab of corrugated metal propped against a wedge of splintered wood, carefully covered with a plastic tarp.


As the caffeine hit my bloodstream, my enthusiasm picked up. Today we were meeting with teams from reproductive health clinics throughout Ethiopia. In Africa, maternal mortality is still at insane rates. Throughout most of Africa, 1 in 30 women dies in childbirth. In Afghanistan, being pregnant is even more perilous, about 1 in 12 women. That’s a stat that deserves a pause. What’s cause for baby showers, baby moons, and “pushing presents” in the United States kills an awful lot of women in Africa. With unplanned pregnancies accounting for about half of all pregnancies in the U.S (and half of these ending in abortion), it’s not surprising that in Africa the situation is even more dire. Fewer resources of every kind whether it’s contraception or a health care provider. Restrictive laws. The doctors we were meeting with were giving us feedback on our new guidelines to help reduce unsafe abortion globally. In Ethiopia, there is no scarcity of patients.

How would I describe the moon that night? A razor sharp crescent, fierce yellow beams enveloping glittering stars. The darkness of the sky wrapped around us, despite the brilliant constellations. No street lights, porch lights or neon signs. The rare beam of light from a passing car briefly illuminated the path. I carefully placed each foot, feeling each stone, pot hole and assorted menace through the sole of my foot as I made my way. I wondered again, silently, at the wisdom of walking to the "Abyssinian Cultural Center," where we were to meet our group for a traditional Ethiopian dinner. My supervisor had assured me blithely that "it would be fine", but the hotel security guard had looked doubtful, and I felt like soon I would be starring in an episode of Law and Order. The streets were quiet.

Down an unmarked alley we finally saw the bright lights of the restaurant. A goat tethered outside the front door bleated angrily. Sorry, little guy. No ngiri or beer for you! The restaurant was packed. Rows and rows of tables faced a stage where dancers whirled, movements so fast colors and limbs difficult to discern. Waitresses in bright coral dresses swarmed past us, trays of beer, coffee and assorted beverages held high above their heads.

This was clearly a popular tourist destination. After six months in Europe and at the UN, I have gotten pretty good at profiling foreigners. The table in suits, with shovel-shaped jaws, still sporting name tags I identified as oil businessman. The tables with ill fitting cotton dresses and unattractive, yet comfortable footwear, were obviously aid workers.

“Obama!!!!!” The cry startled me as I hopped out of our Jeep, and I blinked in the bright Ethiopian sun as I glanced around. Was the U.S President also in Addis Ababa? Jet lag is almost as effective as being post call for knocking points off of the IQ. I caught the eye of a gaggle of teenagers waiting near the Family Guidance Association of Ethiopia’s clinic and was rewarded with gap-toothed smiles and another chorus of Oooooo-bama! Oh. They meant us. A small girl with almond eyes, elaborate braids, and a striped Hello Kitty shirt stared in fascination as one of the teenagers loped across the courtyard to make our acquaintance.


“Hello! Hello, hello!” he exclaimed, as he reached out to shake each of our hands. “You know Obama, yes? He good man, yes?”
We all nodded and smiled, offered a bouquet of assents. Our agreement caused a smile that threatened to split his face in half, and he jabbed his thumb to his chest for emphasis. “Yeeee-SSssh!” he nodded vigorously, “Bush he bad man.” This got him high fives.

Variations of this conversation were repeated over and over during the dusty days I spent in Addis. Obama pride is huge in Africa, his Kenyan heritage makes him a native son.

Patients formed a queue that extended from the clinic's front door, along the front of the white washed building, along the side, and to a courtyard in the back where folding chairs and umbrellas would shield their wait from the hot Ethiopian sun. A woman clad in leopard print leggings with a long tunic and turquoise heels jabbered into her cell phone. The little girl with almond eyes ran to hug the leg of a woman clad from head to toe in layers of white muslin, her bright eyes followed our steps through the yard.


One of the nurses we had met the day before enthusiastically burst out of the clinic to greet us. "Hello, hello!" We smiled and greeted her, kissed cheeks. Her energy and pride was infectious, words poured from her, as she showed us each room. In between faltering descriptions in English to us, she called greetings in Amheric to the waiting patients. The little girl with almond eyes had followed us in. She stood in the narrow hallway where patients were lined up waiting. The nurse clicked her tongue, uttered a few words and patted her on the head. Four rooms, three nurses, two doctors: two hundred patients a day. One day. Five to twenty rape victims. A day. Five to ten safe abortions. Five to fifteen complications from unsafe abortions. HIV care. Prenatal care. Vasectomies. Tubal sterilizations under local. The operating room had stained lace curtains, a metal stretcher, and pots holding antiseptic and steel instruments.

"Integrated care," the nurse carefully enunciated each syllable of the catchphrase. She then smiled and said simply, "Whatever she may need, we do."

Carnitas

I still remember being a little girl and listening to my mother tell us about when she lived in Japan as a young woman. She lived outside of Kyoto and taught English. I can remember the gold detailing of the kimono she had carefully saved, and grainy photographs of my mother posed by pagodas with solemn school children, but I can’t remember exactly the reason for her transoceanic move.

Was it to train for her black belt in karate in a proper dojo? An opportunity to figure out if she really wanted to teach school as her profession? Was she annoyed that after several years my eventual father hadn’t yet proposed? Could it have been an escape from the stinky hippies that had San Francisco in a death grip of patchouli and body odor in the ‘60s? Knowing my mother, I am guessing she doesn’t remember the exact reason herself, but the fact that it was an adventure was enough.
Tracing the elaborate calligraphy covering the album with my finger, I asked her a question. Interrupted mid-reverie, she looked at me blankly for a moment before responding airily: “Did I speak Japanese? No, but I bought a book and figured I’d learn on the boat ride there. Did I tell you I met the princess of Korea on the voyage over?”

I guess, years later, it’s not all together surprising that I didn’t give much thought to moving to Switzerland. I mean, for god’s sake, it’s just Europe, it’s hardly Timbuktu. Sure, I’d miss friends and family, but what with Skype, email, text messaging, Facebook, and a vow from my sister-in-law to stick my charming nephew in front of Google video chat on a regular basis, why not?

Do I speak French? No, I figured I would learn that on the plane ride over.
Six months into being an expatriate, I’ve thought of several things about the United States that it didn’t occur to me that I would miss until I ended up living in Geneva. Having a clothes dryer. Being able to go to the grocery stores, movies, or anywhere, really, on a Sunday. Being there for friends in trouble. Pandora. Being able to tell off irritating men on the bus, and be understood. Netflix. My nephew’s third birthday party. Mexican food: spicy, delicious, rrrrrrriquísima Mexican food.
Switzerland is so white bread, they don’t actually carry black beans here, just garbanzo frijoles . Their idea of a salsa picante is my idea of ketchup. En serio, mon ami.

It took months, but I did eventually get tired of fondue, and my solution to bland Swiss cuisine was to actually dust off my domestic skills (and to slather everything in copious amounts of hot sauce that my little sister kindly mailed me). This may shock many who knew me during residency when my culinary prowess extended largely to opening a bottle of wine and ordering takeout, but there was an earlier point in time when I attended cooking school in Thailand, perfected tiramisu recipes, and regularly threw elaborate dinner parties.

Finding decent Mexican food in Europe is no easy feat, but hey, with Obama as our president, I feel like anything is possible (still). I started my quest for the Holy Culinary Grail by asking long-time residents (no one is an actual native here) where I could go for good Mexican food. Ha! I laugh, now, at my naiveté. The fact that the best Mexican restaurant in Geneva has a French name (Le Chat Rouge) should tell you all you need to know. But, if an Obgyn residency taught me anything, it’s how to cope with adversity.

I used Google translate to find the French names of the ingredients needed to make carnitas according to the recipe I plannedgto sort-of-follow from Epicurious.com.
Remember what I said about black beans?
Well, that apparently holds true for cilantro, tomatillos, and tortillas. In all fairness, the local supermarket does offer El Paso-brand refried beans for a mere 5$ a can, but this had become an issue of conscience. Sí, se puede!

A trip to Bristol to visit long time friends and their adorable new baby fueled my efforts. Z, an expatriate and excellent cook, sympathized with my suffering. She pulled out recipe books and then innocently remarked that a new Mexican restaurant had opened in the Uni district: “Mission Burritos.” We were there next day at opening. To my amusement, they had directions for nervous British customers about how to eat a burrito. Wow, that’s just sad. Mission Burritos promised “Food from Mexico via San Francisco to the UK.” I’m not entirely sure their marketing campaign would pass a lie detector test, but at least their spicy salsa momentarily made my eyes water. Momentarily.

Bolstered by Z’s cookbooks and words of encouragement, I headed home to Geneva, determined to have a decent carnitas burrito on the Continent.
Now, in the interests of full disclosure, I should confess that I have always had a chef school trained brother available for an instant text, telephone, or in person consultation as the situation required. I like to pretend he enjoys my charmingly ignorant questions at random moments: “What exactly is searing anyways? Will anyone die if it’s not 160 degrees? What’s a substitute for coriander?” It’s his brotherly prerogative to grumble and lord it over me; it’s my sisterly privilege to ignore his annoyance.

No amount of shared DNA, however, would make a one a.m text message with a pork-related question charming. This time I was on my own.
I did my due diligence. Google research turned up an online Mexican grocer capable of delivering to Switzerland. I inadvertently bought 20 pounds of canned tomatillos. Bleepin’ metric system.

My office mate explained that the particular cut of pork needed for carnitas was not readily available in Switzerland, but that the Indonesian community, desiring the same cut for their satay, substituted epaule du porc.
The butcher must have been hard of hearing, because I had to repeat my request five times, before he finally understood me. “Je voudre acheter deux kilograms des epaule du porc.” I was aflame with embarrassment, holding up a long line, but I finally just pointed and held up two fingers. Desperate times call for desperate measures, and in true Rodriguez form I decided to not just make carnitas, salsa verde, and my own refried beans but to throw a dinner party. I’ve always favored the cannonball approach.

At this point, word of my quest had spread, and the dinner party had begun to resemble a scavenger hunt. S. tracked down a bottle of tequila remarkable for not only its potency, but also the sombrero shaped lid it jauntily wore. Plantains were secured by another guest. Cilantro turned up in a French grocery store, just across the border from Switzerland.

And finally, there on aisle four, on a dusty shelf down in the bottom of the “Ethnic Aisle” the pièce de résistance - canned black beans. I half expected a beam of light to emanate from the heavens, illuminating the treasured haricot noir while a chorus of angels sang, but alas, the transaction was more prosaic than that.
So how did the meal turn out? If you drown anything in enough salsa verde and wash it down with tequila sporting a sombrero, it tastes pretty darn fine.