I’ve been in Lebanon for four weeks now and just finished my second week of medical school. The first two weeks were spent in my father’s village of Amioun where everyone is a distant cousin and you can’t walk down the street without being invited in for coffee. It was a good way to ease into Lebanon – familiar surroundings mixed with an abundance of familial support. Two weeks ago, I moved into my dorm at the American University of Beirut and began classes.
First the basics: My medical school class is made up of 87 students, all but three of whom were undergraduates at the AUB. The three of us who didn’t attend the AUB are all American citizens of Lebanese decent and, oddly enough, all came from Texas. The other students were all either Biology or Chemistry majors and are all fresh out of undergraduate. While ‘non-traditional’ students (i.e. those who worked and/or attended graduate school before coming to medical school) make up the majority of many US medical school classes, the idea is unheard of here. I am not only the oldest person in my class – I am a full eight years older than the next oldest person.
Medical school at the AUB is not organized into semesters. Rather, courses take between six and twelve weeks each and are arranged so that we are taking two or three courses at any given time. For the first twelve weeks, we are taking Anatomy, Embryology and Histology – purportedly thee of the hardest classes of first year.
The first lesson I learned was that med school classes are not designed to teach you but rather to tell you what you need to learn. The professors sit at the front of the class and flip through charts with just enough time to read the title of each one for two hours each morning. We then have anatomy lab until 1:30pm and are excused for the day – this is when the learning begins. Using any book we like (the professors have suggested lists), we sit in the library for the next six hours and read about the topics presented on the slides. Self-learning has never been a strength of mine, so this will take some getting used to. Moreover, I find myself questioning the value of class at all – if you aren’t going to teach, why not just publish a list of topics on the web along with the exam dates?
Following class, we migrate en mass to the anatomy lab where 87 of us crowd around four cadavers (11 on each side of each cadaver) and jockey for position in an effort to see what we’ve been reading about. The students here are very passionate in every sense of the word – the first seats to fill in the lecture hall are those in the front row, each question is met with a chorus of answers, and anatomy lab is like a mob of teenage girls at a Justin Timberlake concert. Most days, I participate just long enough to see the basics then retreat to a corner of the lab to study.
I am living on-campus in a dorm. The rooms are similar to those of any American university except that I can see the Mediterranean sea out my window and five times a day (beginning at 4:30am!), the Muslim call to prayer echoes out over Western Beirut. The university is beautiful, though outside its walls are a decidedly different scene. Beirut has a population three times that of Washington D.C. but occupies only half the area – it is crowded, polluted and above all, noisy. There are several aspects of Beirut which are very foreign to me. In no particular order:
- Here, taxi drivers honk at you to get you to notice them. If you are walking down the sidewalk and you don’t make eye contact with them, they assume you are looking for a cab on the sidewalk pavement and honk at you until you look up. I have taken to wearing earplugs on the street-side ear to keep from going deaf.
- Everyone is extremely friendly and refers to me instantly as ‘habibi’ (my darling). The street vendors here display a level of respect for their customers one would expect to find in a five star restaurant stateside.
- It is quite literally impossible for people to understand why someone would voluntarily leave the states to come live in Beirut. The looks when people find out that I gave up a slot at a US medical school to come here go beyond surprise into the realm of disbelief. It seems everyone who has the money to leave Lebanon does and those who don’t pray for the day when they can.
- The campus is home to hundreds of cats which have been here as long as anybody can remember and are fed and cared for by the university. Sit down on a bench and one is likely to jump into your lap and beg for attention.
- The relative cost of goods in Lebanon varies greatly depending on the commodity. Food is very cheap (one can easily eat for $5/day in Beirut) while cell phones are very expensive (about fifty cents per minute). Couple this with the fact that the middle class in Lebanon brings home less than $500/month and this becomes even more of an issue. Given this, an interesting culture has developed in which two people agree before hand what a ‘missed call’ will indicate (e.g. “when you are ready to meet in the library, “missed call” me and we’ll meet there ten minutes later).
- The idea of a student loan is all but unheard of here. The tuition of everyone here is paid for by their parents – those who can’t afford to go to school simply don’t. Thus, the majority of the campus’ population comes from the upper classes of Lebanon. When my classmates found out that I am funding my own education, they reacted with a mixture of shock and compassion – ironic since medical school here will cost me about a third of what it would have in the states.
- Taxi drivers don’t have meters and they don’t quote prices. When you arrive at your destination and you ask how much you owe them, they reply ‘mittle ma bidak’ (as you wish). If you quote a price lower than they were envisioning, they argue with you until you come to an agreement – at which point they typically do their best to make you feel guilty about it.
Overall, I am happy – enough. Two weeks into medical school, it is clear that it will easily be the hardest thing I have ever attempted. Most difficult for me is the process of selecting what to learn. It is physically impossible to memorize the human anatomy – between bones, muscles, nerves, arteries and veins, the body has tens of thousands of parts, most of which have proper nouns as names. Thus, the better part of my studying involves not memorization but rather deciding what I will memorize and organizing it so as to remember it. I have already earned a reputation for 'coming up with funny mnemonics for remembering anatomy’ (e.g. the nerves of the Brachial Plexus can be remembered by the phrase U R An M&M – Ulner, Radial, Axillary, Median and Musculocutaneous).
At the end of each day though, I go home to my dorm room and talk to Brooke who encourages me and tells me she is proud of me. She and my family have been more than supportive. If I make it through this, it will be because of them. For now, I am looking forward to the end of Ramadan for two reasons – my Muslim friends (who are fasting from sun-up to sun-down) will be less cranky and more importantly, my Brookie is coming to visit me!
More later – off to bed now.
...on the off-chance anyone is interested, I was looking at a neutrophil (a type of white blood cell):
