Friday, January 17, 2014

Labor and Delivery: One Man's Trials and Travails

Fourteen and a half years ago I was in the hospital in Logan with my wife.  We were anxiously awaiting the arrival of our first child.  As I watched, and provided what support I could, I was amazed at the entire process and what a woman goes through to become a mother.  My appreciation for my wife and my own mother grew by leaps and bounds that day.  

A few short days later I got myself into hot water at our church meeting.  It was a fast and testimony meeting where we have the opportunity to stand and share our feelings, beliefs, and thoughts with the other members.  Having just gone through an incredibly emotional and spiritual experience, I felt compelled to share some of my feelings.  I stood at the podium and talked about my gratitude for my wife for what she had just done.  My last words were, "After seeing what she went through, I am so grateful to be a man."

It was an attempt to show my gratitude for what she had done and to highlight my own weakness in facing such a physical trial.  Unfortunately, I managed to offend a number of the sisters in the ward.  A number of them made their way to the podium, and while glaring at me, told me how wonderful it is to be a woman.  I don't think they understood what I was trying to say.

Either way, and this is meant to be humorous in my own serious way, it is important to share the trials and travails that the husbands and fathers suffer through during the labor and delivery process.  I'll try not to avoid any mention of our suffering that occurs during the pregnancy...that may be too much suffering in one post.

Mothers spend a lot of time sharing labor and delivery stories.  They relish the experience, even if it does frighten soon to be new mothers and young male bachelors.  It is my hope that my experiences will not scare any soon to be fathers.  You can be prepared and weather the storms that will come.

Please note that the couch for the spouse is to close to the bed to allow for any meaningful rest.

First Time: A Rookie's Story
The Beef & Cheddar That Wasn't, Until Later
As we entered the hospital for the birth of our first child, I was unbelievably anxious.  For weeks I had been anxious for this child to be born.  I was excited to be a father.  (And I was excited to quit my job at the cheese factory.)  At the end of her pregnancy my wife was suffering from a serious rash and a few other things.  The doctor mercifully decided to induce labor.

With all of the attention on my wife and my high level of excitement, I had forgotten to eat all day.  By five o'clock that evening I was starving, not literally, but rather strongly in a figurative way.  Luckily, my parents and sisters were at the hospital.  They ran to grab me a Beef & Cheddar from Arbie's.  They delivered it to me in the room and my wife kindly gave me permission to eat it quickly.  As I sat with the bag in my hands, the nurse came in to check on my wife's progress.  Just as I begin to unwrap the warm, delicious smelling sandwich, the nurse said loudly, "It's time.  Get the doctor in her now.  The baby is coming!"

For a split second, my excitement for the birth of our first baby and my deep physiological need for nourishment battled for my attention.  Coming to my senses, I wrapped up the sandwich and put it back into the bag.

Throughout the delivery process my wife was amazing.  We were blessed with a beautiful baby girl with a shock of dark hair on her head.  She was beautiful!  I split my time between telling my wife that she had done a great job and admiring the baby as the nurses cleaned her and checked her vitals.  At some point, the nurses took our daughter out of the room.  Thinking that most of the important work had been done, I decided to go back after my sandwich.  

I was wrong.  The process was not complete.  Picking up the bag with the sandwich, the doctor looked at me and said, "You'll want to see this."

He turned with the placenta in his hands and placed it in a large metal bowl.  My raging appetite quivered and then died.  It was another couple of hours before the hunger returned and I managed to choke down the now cold and stale sandwich.

Stay the Night With Me--Or, the Graduation I Don't Remember
Our first child was brought into the world at an exciting time in our lives.  Not only were we starting out as new parents, it was also the day before my college graduation.  Grandparents held their new granddaughter and rejoiced.  By the end of the night my tired wife fell into exhaustion.  Thinking of my graduation the next day, I begin to think of how to tell my wife good night so I could go home to get some much needed sleep.  

Before I could say anything, my wife reached up and took my hand.  Looking at me with her tired, beautiful eyes she said, "Will you stay the night here with me?"

Looking at the small, hard couch that would be my bed for the night if I stayed, I had to fight the urge to tell my wife that I would prefer to go home.  Somewhat reluctantly, I agreed.  It was a rough night.  Not only was the couch uncomfortable, but the nurses kept coming in to check on my wife and the baby.  Nobody checked on me, yet I survived the night anyway with little to no sleep.

At around six in the morning I stumbled out making my way back to my apartment so I could shower and get ready for my graduation.  After my shower, I woke my parents and sisters up so they could join me at my graduation later.  Once I was on campus I met up with my best friend.  We walked with other graduates from the College of Business to the Spectrum for ceremony.  I was feeling fine, excited for the moment, right up until I sat in my chair.  I have no idea who spoke or what they said.  One of my classmates kept elbowing me in the side each time I slumped over.  One time she leaned over to ask me, with some humor, to quit snoring.  If it hadn't been for her, I never would have known when to walk across the stage to receive my diploma.

Doctor Eye Candy
I have to tell one story about some suffering that occurred during our second pregnancy.  We were stationed at Vance AFB in Enid, Oklahoma at the time.  As my wife searched for a local doctor, one came very highly recommended.

At our first appointment it was immediately obvious why he had such a stellar reputation among the mothers.  He was pure eye candy in the likeness of a Calvin Klein model.  Now this was probably her toughest pregnancy out of all six.  She was miserable and the heat in Oklahoma made it worse.  Yet each time she had an appointment she would get excited.  While I never felt seriously threatened, I did make sure I wore my Battle Dress Uniform to each appointment with the sleeves rolled up.  (I may have even spent a little more time working on my biceps than usual.)

The Worst Night (Maybe Not Ever, But It Was Bad)
With our third pregnancy, my wife was measuring very large as we approached the last week.  Once again, for the third time, the doctor decided to induce labor.  This time her doctor, instead of being a version of McDreamy, looked to be about as old as Methusaleh.  Anyway, for some reason he asked us to come to the hospital later in the day for the induction.  

Based on previous experiences, I figured it would all be over by early to late evening.  We finished packing her bag and left for the hospital.  Since it was a warm day in June, I left the house wearing shorts and a t-shirt.  I figured that once the baby was born and my wife was somewhat recovered, I would go home to pick up my mother-in-law and two daughters to bring them back to the hospital to meet their new brother.

Things didn't go as the doctor planned.  He tried a different type of induction method that just wouldn't get things started.  Finally, late that night he decided to hold off on actively pushing labor until the morning.  Even though she wasn't in full, active labor at that time, it could go by itself at any moment.  So, once again I faced the prospects of a night in a labor and delivery room.

It was worse this time.  She was hot and so they kept the room frigid.  I was in shorts and a t-shirt remember and going home to change at that point didn't seem prudent.  As I shivered on the small, lumpy couch, the nurse brought me a thin sheet from a warming cabinet.  It was heaven, briefly.  Eventually the heat dissipated and I was left to suffer.  

A number of times I was able to relax enough, despite the cold, to begin to fall asleep.  Each time, just as I would start to slip away, the nurse would come in to check on my wife.  Now, I understood the need to check on her, but a little more consideration and quiet would have been appreciated by me.  Heck, even a little attention thrown my way would have been appreciated.  

"Would you like some hot chocolate?"

"Would you like some hot soup?"

"Would you like a real blanket?"

"Sir, are you still alive?"

Any one of those questions would have made me feel like a valued person.  All I received from the staff was silence.  Now, the few times when my wife asked me for ice chips or something else, I was happy to get up and help.  Despite my desperate and destitute situation, I was wise.  I did not speak out loud about my discomfort to anyone that night.  Well, I might have mentioned to my wife once or twice that I was a bit cold.  

While the next day was rough for me, it was undoubtedly rougher for my wife.  It was her first time making a go at it without an epidural.  (Men, this is a big conversation topic.  Make sure you know enough to nod and agree with your wife's opinion on the matter.)  
As my wife and I experienced three more labor and deliveries, we learned to handle the pain, stress, and exhaustion.  It helped that the deliveries began to happen more quickly with each child.  For the last two she instructed doctors and nurses on what she wanted and how it was going to be.  They listened.  (On the last one I had to help the doctor get suited up because the rest of the labor and delivery team weren't there for the start of the festivities.)

Throughout my years as a husband, father, and birth coach, I understood that the needs and sufferings of the husband are often neglected.  Often, as I have come across expecting husbands, I make it a point to warn them.  I give the a quick run down of things to expect, things to take, things to do, and when to speak and when to be quiet.  In response to my warnings, many people laugh and some expecting moms and some experienced moms get a look of annoyance in their eyes.  I understand that they and the new babies are the stars of this show, but the forgotten ones have needs as well.

So, here are some of my...

Lessons Learned
What to Bring
- First, whatever your wife tells you to bring.
- Layers of clothing to include long sleeve shirt(s) and pants.  You can go to the hospital in shorts and a t-shirt, but make sure you have something else to put on.  A word of caution, you might not be given enough time or privacy to change.
- Snacks.  Bring the snacks you like but make sure they aren't the type that might annoy your very agitated wife.  She may not want you chewing on something that is crunchy or chewy.  She may not appreciate certain odors.
- Entertainment.  Tread lightly here, very lightly.  It's okay to bring a book or some type of electronic device.  Only pull them out when your wife approves their use.
- Cash.  Bring small bills and coins for quick runs to the vending machines.  If you have time to run to the cafeteria, take advantage of it but be prepared in case you can't.

How to Select a Doctor
- Let your wife select the doctor but try to steer her away from former Calvin Klein models.
- Also, try to steer her toward doctors who go to the quality hospitals.  (Definition of a quality hospital is below.)
- Always agree with your wife's opinion of the doctor (except for when she talks about how handsome he is).

How to Select a Quality Hospital
-  A quality hospital has three things: good food in the cafeteria, good food that brought to the rooms, and great amenities (snacks and drinks) that are available for both you and your wife.
- Take the tours of the labor and delivery wings of the hospital.  Ask questions about the amenities available to the husband.  Can you get drinks and snacks from the amenities room?  If the answer is no, then observe how closely it is watched.  Are meals for you, in the room, included in the service?  Who is their cable or satellite tv provider?
- Eat a meal at their cafeteria.  Some hospitals have had amazing food.  

Try to guide your wife to pick the doctor that goes to the good hospital, but realize you can only say so much.  Anything you do say should be couched in terms of how it benefits her, so look for those things so you can maintain your integrity.

Getting It Right (Mostly)
As we entered the hospital for our sixth labor and delivery, my wife was excited.  This was going to be her first time without pitocin.  I expected things to go quickly and wasn't too worried about my comfort.  Before my wife changed into her hospital garb she reached into her overstuffed bag and pulled out a surprise for me.  It was a homemade blanket that folded into a pillow.  Stuffed inside the blanket was book, some Twizzlers, some Pringles, and a few other of my favorite snacks.  My eyes, as they did when she handed me the blanket, are tearing up while I write this.  We were truly prepared.

My wife's labor progressed rapidly this time.  The doctor and I had to set the bed up and get her dressed without the assistance of the labor and delivery team.  They were still wrapping up another one in a nearby room.  A backup nurse was called in to help.  

Now, an important aside.  This last doctor was her first female OB/GYN to deliver one our babies.  She was a lot of fun to meet with throughout the pregnancy because she runs a lot of marathons and other races.  Several times she and I swapped stories about various races in our pasts and futures.  

In the delivery room, the contractions started to come on more frequently and powerfully.  I stood holding my wife's hand so she could squeeze it hard during the contractions.  Due to my wife's experience and strength, there wasn't much coaching from the doctor or the nurse.  To fill the silence the doctor started to talk about my upcoming race that was taking place the next week.  She told the nurse about it.  The nurse then proceeded to ask me questions.  I love to talk about running and races, especially to someone who really wants to know.  Under the circumstances, however, I knew I was walking on thin ice.  I tried to keep my answers informative, yet brief so that I didn't annoy my wife.  I even made a concerted effort to quit talking during the contractions.  But the nurse kept asking questions.

In the middle of one my informative, yet brief answers, my wife crushes my hand and says, "Shut up!  Just shut up about the race!"

Never forget, no matter how cool you are or your stories are, you are not the star of this particular show.

Wednesday, January 15, 2014

Foreign Medicine: Remembrance and Recovery

At the end of an intensive year and a half of study at the Naval Postgraduate School, I submitted the final draft of my master's thesis.  It is titled The Demise of Russian Health Capital: The Continuity of Ineffective Government Policy.  My professors and thesis advisor were excited for the topic.  Compared to topics covered by the other military officers seeking degrees in National Security Affairs, it was a decidedly un-military type of topic.  At the time I wasn't sure what drove my interest, but looking back I think it was an attempt to understand some of my past experiences with the Russian health care system.  The stories below will serve as a belated prologue to my master's thesis.

The Questionable Transportation of Medical Supplies 
At the end of my two month stay at the Missionary Training Center in Provo, I was excited to pack my luggage for my departure to Russia.  While we were wrapping up our packing we were asked to head to one of the administrative offices.  Upon arrival we met with a good brother and were given multiple bags of syringes and vaccines for us to take over in our luggage to the mission home.  These would be used as booster shots for the missionaries.  We were instructed to pack them in our bags to prevent them from being stolen by the Russian customs inspectors who commonly plundered items sent through the mail.

As we prepared to go back to our rooms with the bags of supplies, I stopped and asked a simple question, "Are the customs people at the airport in Russia going to have any problems with us transporting this stuff?  Should we have any paperwork with us?"

The good brother suddenly looked uncomfortable.  Looking down, he said, "Well, we're not sure.  We hope that they won't check or if they do, that they won't care."

Back in our rooms I hoped to get the other missionaries to put all of the supplies into their luggage.  Unfortunately they were not able to fit it all and I was forced to take a large bag of syringes.  If I had been aware then of what it would be like to go through passport control and customs, I likely would have refused to take the package.  It was an especially touchy time because the Russian government had recently started blaming the West, and America specifically, for carrying HIV into the country. 

(For a general story of my arrival in Russia please read the blog at this link: "Welcome to Russia!  Welcome to Siberia!")

When I finally made it through passport control and customs I found my luggage.  Some of my clothing had been pulled out.  Sitting on top was the large bag of syringes.  No questions were asked of me or of the other missionaries who had brought the syringes and vaccine.

Not In My Country, Comrade!
In the late 80s and early 90s HIV was spreading quickly in Russia.  All foreigners were suspected of being carriers.  Any who resided in Russia for any period of time were subjected to random blood tests.  We were given detailed instructions, in case we were selected for testing, to make sure that a the syringe used was new and taken from a sealed package.  Initially, I was shocked to even consider the idea that they recycled syringes.

I was only selected once for a random blood test, while living in my first apartment.  A knock came on the door early in the morning.  A uniformed officer was there.  He asked to see our passports and then invited us to follow him to a local clinic to have our blood drawn.  As we walked through the snow I started to run through my mind how I would ask for a clean syringe.  Having only been in the country for a couple of weeks, my vocabulary was severely lacking.  My only hope was that my companion, who had been in the country for just over three months, would have sufficient skill with the language to keep us safe.  I envisioned two scenarios.  In one they didn't have clean, fresh needles and syringes.  After arguing we would be held down while a nurse pulled a needle out of a sink full of water and other needles, attached it to the syringe, and then it being plunged into my vein to extract my blood while leaving behind pathogens and viruses from others.  In the other scenario, my companion utilized his budding, yet proficient, Russian skills and some cash to convince the nurse to reach into her hidden stash of safe needles.  Then we were arrested for bribing a medical official.

Neither scenario played out.  As we entered the medical facility, we were taken into an exam room where a nurse was waiting for us.  On the table were two brand new needles and syringes still in their sealed wrapper.  The relief was so great that I believe that was the first time I enjoyed giving any amount of blood.

The Novosibirsk Regional Hospital: "Hello, Nurse!"
After two months in Russia I started to experience significant stomach and digestive issues.  The pain would come and go, but it could be quite intense.  At some point my mission president put me in touch with an American doctor the Church had assigned to Moscow.  We spoke over the phone a few times.  I shared my symptoms and he asked me questions.  Without the ability to run tests he was unable to diagnose my problem accurately.  (He did, however, contribute to an incident that scared me badly at the time.  He asked if I had seen any blood in my stool and told me what to expect.  Up to that point I had never really looked.  A day or two later I ate a beet salad and some borscht.  I had never in my life eaten so many beets at once.  Well, the next day, while in the bathroom, I was convinced that I blood in my stool.  Luckily, my companion at the time, who had been in Russia for almost two years, calmly reminded me that I had just eaten a lot of beets and that this was normal.)

The doctor suggested that I visit a local clinic or hospital for testing.  He also instructed me to write down any medications that I was given so I could tell him.  Our mission president gave us permission to travel to the Novosibirsk Regional Hospital just outside of the city.  The director of the hospital had been trained in Germany and our mission president, who served his mission in Germany, had befriended him.  My companion had quietly been suffering from his own ailment so it was a good opportunity for both of us to visit the doctor.

We boarded the bus early one winter morning.  The bus ride took about an hour.  Upon arrival we made our way to the office of the director where we described our symptoms.  He brought in two assistants and gave them instructions regarding which tests needed to be done.  Unfortunately, he split us up.  I was terrified.  While I was beginning to understand more of what was being said, I still wasn't confident or very skilled in my ability to communicate in Russian.  No matter.  We were rushed off in separate ways.

The hallways of the hospital, especially on the main floor, were packed with people waiting in line to be seen.  I heard two people talking about how they had been there for two days waiting to speak with someone.  As guests of the director we were taken to the front of every line.

Approaching my first stop I tried to ask my escort what was about to happen.  I don't remember if I understood or not, but as soon as I stepped into the room I saw a large ultrasound machine.  The previous patient had just finished dressing behind a white curtain and quickly exited.  My escort explained my situation and what tests needed to be completed and then left.  Suddenly I realized that I was alone with two young, female nurses who were very attractive.

As my heart rate begin to rise and I considered running out the door.  One of them smiled at me and said in Russian, "Please take your clothes off."

I responded in my best Russian, "May I take off just my shirt."

She stared at me for a few, uncomfortable seconds before she answered, "Well, okay. Take your shirt off."

After I removed my shirt I lay on the exam table.  One of the nurses sat next to me while the other sat at the desk with my paperwork.  The one next to me squeezed some of the ultrasound gel into her hands.  She rubbed the gel around in her hands to warm it up and then began to rub it onto my abdomen, smiling at me the whole time.

As she was doing this, her partner at the desk asked, "What do you think of Russian women?"

Trying to answer while looking away, I said, "I'm a missionary.  I don't think about that."

Her reply, "Yes, you do.  You're thinking about them right now."

Both of them laughed.

Finally, they got started with the actual procedure.  One moved the instrument around on my abdomen and read off the measurements while the other wrote it down.  Once they were finished they continued to tease me, asking me if all American men were so shy.  I put my shirt back on as quickly as possible and stepped out into the hallway to find my escort.

From there I went for an EKG which was uneventful.  Once the EKG was finished I met up again with my companion.  He went with me for my final test of the day.  They were going to draw a bit of blood for some tests.  I was told it would just be a finger prick.  We entered a lab ahead of a long line of people waiting to be seen.  I only remember a few things about the lab and the experience.  The nurse was wearing one of those cool, old-style nurse hats.  She had me walk over to a large metallic sink where she cleaned my hand with water and then some antiseptic.  She then pulled out a small cylinder made out of what looked to be paper or cardboard.  It was about two inches long and maybe an eighth of an inch in diameter.  She snapped it in half and revealed in the casing a small razor blade with an angle on it.  The light glinted off of the edge of the razor.  Immediately I realized she was going to jab that into my finger to produce some blood.  My knees buckled a little before I recovered.  I struggled to find the words to ask why they couldn't use a small needle.  As I was struggling to speak and stay conscious, she jabbed the razor blade into the tip of my index finger.  Needless to say it produced sufficient blood for the tests.

Following our tests, we met again with the director who told us we would be contacted again soon regarding the results.  He also informed us that another of our missionaries was being seen in the hospital that day for some treatment.  We asked if we could stop by to see him before we left.  We were escorted to another treatment room, a large hall with curtained off areas.

We were somewhat aware of this elder's medical issue.  He had developed a visible and painful rash on his neck.  This wasn't his first trip to the hospital to receive treatment.  Walking into the room we saw his companion sitting on a chair.  He smiled as soon as he saw us.

He said, "Elder Hurlburt (names have been changed to protect the victims) is behind that curtain over there.  Go look at him.  But do not laugh!  The nurse will get very angry if you laugh at him."

Intrigued we made our way over to the curtained off cubicle and looked inside.  I was not prepared for what I saw.  What appeared to be an alien creature looked up at me.  He had two long bronze or copper tubes going up into his nasal cavities.  The tubes came out and each was capped off by a large metallic ball of the same color.  A curly cable was attached to each ball and went back into a large electrical machine that was thrumming at a regular rhythm.  The tubes and balls seemed to be held in place by some type of Ace bandage that had been wrapped around his head several times.  His eyes were barely visible and his shock of dark curly hair was forced out of the top of the bandages.

My first thought was that they had turned him into a Tuscan raider from the planet Tatooine.

Trying not to laugh and remain quiet we asked him what the machine was supposed to do for his rash.

"They are shooting ultraviolet rays into my sinuses in hopes that it will kill the infection that is causing the skin rash."

Standing there listening the thrum of the machine and looking at his misshapen head, I lost control and started to laugh out loud.  Immediately a rather large, middle-aged nurse was next to me.  I'm not sure exactly what she said, but from the tone of her voice it was clear that I was being asked to leave.

A week or two later this same elder had been checked into the hospital for care.  We stopped by to see him when we came back for the results of our tests.  He had been there for a few days and his face was covered in stubble, not usual for a missionary.  As we were visiting in his room he told us that one day a nurse or a doctor had come in to give him an injection.  Expecting the injection in his arm or backside, he was shocked when the person injected the needle directly into his neck and pushed the plunger down.  His skin immediately felt as if it were on fire and the feeling spread.  Once he had recovered sufficiently from the shock he asked the name of the medicine and wrote it down so he could give it to the Church doctor in Moscow.  Then he asked what the medicine was supposed to do.  The answer basically was:

"Oh, we don't know in your case.  Usually we use it for something else entirely, but we wanted to see what it would do for your rash."

Eventually he recovered.  My test results all came back negative, with no obvious problems.  The next step was for them to perform an endoscopy and a colonoscopy.  Due to the invasive nature of those procedures we decided to hold off for a week or two.  Luckily by then I was feeling surprisingly better.

One more quick story about treatment at that hospital.  One of our senior missionaries had developed a painful boil.  The mission president took him and his wife to the hospital for treatment.  As they were waiting in the room, the mission president stepped out briefly.  When he went back into to room the elder was lying unconscious on the exam table.  According to his wife a nurse had come in and given him an injection that put him out immediately and completely, all for a skin boil.

Miscellaneous Hospitals
While I never returned to that hospital or went to any other for treatment, I did have reason to stop by a couple of others.

One day my companion, who was new and didn't speak much Russian, were out looking for a pool we could rent for an upcoming baptism.  We decided to visit a hospital to ask if theirs would be available.  Along the way, my companion realized he needed to use the bathroom and the feeling got stronger as we walked.  By the time we reached the hospital he had an almost overwhelming need to take a leak.  It's important to understand that in Russia, especially at that time, there weren't many public restrooms.  The few public restrooms usually were in parks and cost a few hundred rubles for access and a short length of toilet paper. 

As we entered the hospital, he begged me to ask them if he could use one of their bathrooms.  The lady with whom we spoke was not friendly and did not want to speak to us.  I asked her immediately if my friend could use one of their bathrooms.  She refused and said that none were available.  I told him that they didn't have anything but that as soon as I asked her about the pool we would go find something.  He looked like he was going to cry.

I explained our need for a pool and asked with whom we needed to speak to in order to find out if it was for rent.  She said we couldn't speak with anyone about it because it wasn't for rent.  She was the receptionist at the door.  I was sure if I could get past her I could find someone who would be willing to work with us.  But, I couldn't get her to budge.

Turning to leave, I saw the panic in my companion's eyes.  He grabbed me by the arm, and squeezing said, "Please ask if I can use their bathroom again!"

So, I turned and begged.  The lady started to say no again, and then she smiled.

"I do have a room he can use.  Please follow me."

We walked down a hallway and she showed us the door to a room.

"He can go in there and then you must leave."

With that she walked away.  I looked up at the door.  The sign said "Enema Room".  (For an explanation of how I recognized that word, please see this previous blog post: Incongruities.)  I wasn't sure what that meant exactly so I opened the door and saw a tiled wall with water running down it.  It became clear that enemas were administered in an adjoining room with a separate entrance.  The patients would receive their enema and then rush into this room to complete the process against the tiled wall.

Not wanting to scare him, I decided not to tell him about the purpose of the room.  I said, "Go in there and pee as fast as you can."  I was weak and waited in the hallway.

Unfortunately it was in January and very cold.  It must have taken him some time to work through the layers of clothing.  Suddenly, I heard a scream from inside the room.  It was followed by another scream.  He came running out, holding his coat.

"Do you know what I just saw?  A woman came running in wearing a hospital gown and she...!"  

I won't share his description, but he saw it all.

As you can guess, these experiences likely contributed to my desire to study the foundations of Russian health care.  I have one or two other personal stories, but nobody wants to read about me looking into a room full of dead bodies, bodies with surgical instruments still stuck inside of them.

Friday, January 3, 2014

Tracting Down Memory Lane: A Tale of Russian Surprises

Typical Russian Nine-Story Apartment

Soviet era apartment buildings play a significant role in Russian life and culture.  One of my favorite Russian movies is The Irony of Fate: Or, Enjoy Your Bath.  The beginning credits of the movie show the unstoppable progress of Soviet glory through a humorous cartoon as the same types of apartment buildings are massed produced and spread across the world.  The narrator then explains how big and large cities became the same by adopting not just the same buildings but the same street names.   From there we begin to watch the story of a man who gets drunk with his friends in the banya early in the day on New Year's Eve.  The group rushes from the banya to the airport so one of their friends can catch a flight from Moscow to Leningrad (St. Petersburg).  Upon arrival at the airport they continue to drink until it is time to board the plane.  Unfortunately, they forget who is supposed to fly to Leningrad.  A drunken debate ensues and the wrong man, our hero, is put on the plane by his friends.  He arrives in Leningrad and stumbles into a cab.  He gives his apartment address to his driver who takes him to the same street and apartment number in Leningrad.  The man makes his way up the elevator to the apartment door that matches his in Moscow.  He enters his key into the door and the door opens.  He enters the apartment, falls asleep and when the beautiful, female tenant of the Leningrad apartment arrives home a series of romantic adventures begin.  

As a missionary in Russia, tracting through these apartments, going from door to door, was often an adventure.  Sometimes it was funny, sometimes it was scary, and sometimes it was just strange.  Here are a few of my experiences for your enjoyment.

Ding Dong, Is the Elder Dead?
Russia in the mid-90s was an exciting place.  It was in the middle of an unexpected and, for many, unfathomable transition away from the Soviet state to...well, something else.  The uncertainty of the times, along with the general methods of construction, resulted in many apartment buildings that were poor quality or unfinished in some small, but annoying ways.  A common problem we encountered in the newer neighborhoods were electrical wiring that was never completed, particularly doorbells.  Often all we would find for the doorbell were two live wires sticking out. 

Now, without a doorbell you would think that the next best option would be to knock on the door.  While a seemingly simple solution, knocking proved to be ineffective in most cases.  The reason being that Russians, for security purposes, usually had two doors to their apartments and the outer door was invariably made of metal with anywhere from two to four deadbolts.  Knocking on those metal doors only created a loud noise in the hallway that didn't always penetrate through the inner door into the apartment.

So, one day, rather than be discouraged by the lack of a doorbell, I touched the two wires by the casings and pushed them together, producing a nice buzzing sound in the apartment.  I continued to use this method when necessary throughout my mission without incident.  Sometimes the tenants were surprised to find that their doorbell worked.  Others obviously had friends who used the same method. 

My second to last companion, however, was a Russian from St. Petersburg.  We came across an apartment with several missing doorbells.  I proceeded to use my tried and true method.  After watching me for awhile he finally said, "I wouldn't do that.  I doubt it's safe."  I of course discounted his counsel and informed him that I had been using the method for over a year and a half without incident.  

Shortly after that conversation I was assigned to train a brand new missionary from Idaho, my last companion before I returned home.  As a trainer I made it a point to teach him everything I knew, including the doorbell trick.  At one point he asked if it was safe.  I told him about the unnecessary warning from my Russian companion but that I had never had an incident.  I encouraged him to do what it took to contact those dwelling in the apartment.  

It happened that very day.  This trusting, brand new missionary, reached up and pushed two wires together.  There was a bright, blinding light and a loud noise.  I blinked my eyes several times trying to regain my vision.  Slowly things came back into focus.  I looked for my companion but he wasn't where he had been standing.  With my ears ringing I heard some moaning from the floor and looked down to where he lay. 

He looked up at me, and with an accusatory tone in his voice he said, "I don't think that's safe."  

A Bonus Door-Bell Story
One day we were tracting and I came across a door-bell that wouldn't go in.  It had been painted over and was stuck.  I gave it one more good push and in it went.  Unfortunately, it didn't come out again resulting in a continuous loud shrieking ring.  Our initial instinct was to flee but we were frozen in place.  Before we could make a break for it an old lady opened the door.  I expected her to yell at us for being idiots.  Instead she looked pleasantly surprised and said, "That doorbell hasn't worked in years!"  

Then she asked, "Can you make it stop?"

We did everything we could think of with our resources at hand.  I tried to pry it back out with my key but it wouldn't budge.  As we were trying to fix it the neighbors on her floor heard the incessant ringing and came out to see what was happening.  I could hear their conversations as they watched.

"The idiot Americans pushed the button and got it stuck."

"What did they expect would happen?"

Finally, I got enough nerve to ask for a screwdriver from the neighbors.  One of them, mumbling his opinion of us under his breath, retreated into his apartment and brought us a couple of screwdrivers.  In order to fix it we had to remove the doorbell completely, which was dangerous because there was no way to turn off the electricity.  We managed to take the doorbell part, stop the ringing, clean the old paint off of the button, and put it all back together again in working order.  The lady was extremely happy that we had pushed her doorbell in and been forced to fix it.  Now her friends could ring the doorbell when the came for a visit instead of pounding, hoping she would hear them.  

We're the Police!
In Russia, people don't like to open their doors to strangers.  Instead, when you ring the doorbell, they'll open the inner door and yell at you through the door to find out who you are and what you want.  We would yell back our replies to try to get them to open the doors.  If you didn't succeed, you would step to the next door on that floor or go down to the next floor.

As a brand new missionary with less than a month in the country, my trainer had me doing the speaking at the door.  I rang the door bell and a lady yelled, "Who are you?"

In my best accent, I yelled back, "We are the missionaries."

"What?  Who are you?"

"The missionaries!  May we speak with you?"

It was an unfortunate combination of factors.  I wasn't confident enough yet to elaborate regarding our identity.  She was hard of hearing, especially through a metal door.  And, I had a poor accent and couldn't speak clearly.  The word for missionary and police in Russian are very similar.  This is what she heard:

"We are the police."

"The police.  May we speak with you?"

The door flew open and she started to cry.  She yelled at her son, who came to the door.  It probably didn't help that we were in suits and ties which likely seemed even more ominous than the normal uniformed police.  She grabbed her son by the ear and twisted.

She screamed at him, "What did you do this time you idiot?  They're going to take you away again!  They won't let you out this time."

The son, who was mid to late twenties, protested his innocence to both her and us.  He was getting close to tears.  

My trainer was doing his best to interrupt this sad scene to set them straight.  Finally he reached through the door and grabbed the lady gently by the arm and said, "We are missionaries, not the police."

Both of them immediately went silent and stared at us.  

"Missionaries?  Not police?"


She grabbed her son and hugged him closely, then turned to us with a high degree of anger visible in her eyes.

"You two are idiots!  Leave now!"

The Delayed Answer
The configuration of standard Russian apartments is difficult to describe, but I'll give it a shot.  Each apartment building will have multiple entries with each entry exclusive to that part of the building.  As you go in each entry, or podyezd, you have access to the stairs and the elevator (which may or may not work).  On each floor you will usually have access to four apartments with two apartment doors facing the stairs and the other two perpendicular at each side.  As a result the doors on each floor are close, particularly the sets that are perpendicular to one another.  A column of apartments, with four on each floor, is only accessible from the one podyezd.  So, when you tract you must go in and up one podyezd, ring doorbells as you descend, and then go the next podyezd and start over again.  

A Russian Podyezd (Entrance)
With the doors so close to one another we would often run into the problem of the delayed answer.  This would occur when you ring one doorbell, don't get an answer and move onto the next door only to have the tenant at the previous door come to the door once you're already engaged in a conversation.

Here is my all-time favorite delayed answer story (although I do have one that is scarier).  It was sometime in the spring and the sun was just starting to go down.  The floor we were on wasn't too well lit and only a little sunlight was coming in through the small window by the doors.  We rang the doorbell on one of the doors and waited a few minutes with no response.  The next door was within arms reach from the first.  An older lady with an apron and a kitchen spoon opened the door.  Delicious smells drifted from her apartment.  

We began a very nice conversation when suddenly the previous door opened.  Turning I saw something I funny and disturbing.  A rather old man was standing there completely nude and wet with soap suds covering his body and most of his face.

He yelled, "What do you want?  Can't you see I'm in the middle of my bath?"

As I struggled with what to say, the neighbor lady suddenly came to life.

"Ivan Nicholaievich, what are you doing?  Have you gone crazy answering your door naked?  Get back in your room now!  Get back now!  Do you hear me?"

With that she went after him with the spoon, swinging it up and down and hitting him repeatedly on the head.  Stepping back a safe distance all we could do was watch.  Ivan Nicholaievich made it back into his apartment and his neighbor slammed his door shut.  Talking aloud about crazy people she walked back into her apartment without looking at us and shut the door.

I have always hoped she washed the spoon before finishing up dinner.