“Dier Dammen an dier Hären, wëllkomm zu Lëtzebuerg. Déi lokal Auerzeit ass 16:30 Auer.”
Ladies and gentlemen, welcome to Luxembourg. The local time is half past four in the afternoon.
The butterflies floating about my stomach throughout the rocky descent intensified as the plane sped down the landing strip, transitioned to a slow crawl, and then skidded to a halt at a jet bridge at the Luxembourg Airport. With a backpack weighing me down and two large suitcases – fortunately with wheels – rolling alongside me, I entered the Grand Duchy of Luxembourg for the first time to begin my year as a Fulbright Study/Research grantee. No family. No friends. No bank account. No cell phone. The most I had was broken French – enough to say, “Hi, how are you?”, not that useful to help me find my way to my new apartment 45 minutes outside of the capital city. Finally, after searching for a taxi for nearly half an hour in a non-native language, I found one eager for business. A short ride later and I made it “home,” stumbling into my new studio apartment. Exhausted but energized for what was to come over the following year. Now, having graduated from medical school and started residency over half a decade after returning to the United States, I believe the handful of lessons and skills I learned – rooted in the tradition of the Fulbright Program over its 75 years of existence – are invaluable assets for any health care professional seeking to deliver high-quality patient care in the setting of a complex health care delivery system.
First, after arriving in a new country with no cell phone and minimal – at best – local language skills, a mild set of panic may set in. What should I do if something happens to me? I don’t even know the emergency phone number to dial if needed (it turns out it is 1-1-2, not 9-1-1!). Even if I did know the appropriate phone number, are there still payphones I can use? However, once the initial panic subsided, I found myself taking a step back, assessing the situation, and allowing logic and a lifetime of problem-solving daily challenges to triumph. I was supposed to be here.
However, it was still the case that I did not know exactly where to go to hail a taxi, how to communicate effectively, nor where to exchange my U.S. dollars to euros. But I realized I could do this, and if I made a misstep, that was OK, as long as I learned and corrected it efficiently – or next time. The general feeling of uncertainty and the need to be comfortable in uncomfortable situations are core to medicine, including orthopaedic surgery, especially as a trainee. Despite substantial effort to prepare and be well versed in all that could be, I consistently find myself in situations of ambiguity that cause the same uneasiness I experienced upon landing in Luxembourg. In fact, many of my mentors share that this feeling does not disappear, only lessens in frequency over years of practice. Fortunately, having experienced this sense of insecurity – similar to imposter syndrome – in my life prior to medicine, I have gained an appreciation that this is acceptable. Indeed, the sense of urgency and uneasiness paired with an understanding that “I can do this” and do – in fact – have support can lead to optimal learning while also ensuring optimal patient care.
Second, a principal goal of The Fulbright Program is citizen diplomacy through an emphasis on cross-cultural, mutual understanding between those from the United States and those from other countries globally; indeed, this objective is fostered in daily experiences during the grant timeframe. The world is becoming ever more connected through the easier movement of persons and technological advancements, leading to a rich diversity of ideas being able to be shared easily within seconds. Within the United States and Luxembourg, where over half of the population at any one time is non-Luxembourgish, a melting pot of ideas can add value but can also be a source of substantial disagreement. Thus, to move any project or initiative forward – active listening and compromise in the setting of respectful, though sometimes heated, disagreement – was often required. This problem-solving approach is exactly what is needed to deliver ideal patient care. Many patients have complex medical and surgical histories, requiring the insight of multiple medical specialties, or medical “nationalities,” as well as engagement with administrative leaders. At times, the divergence of ideas may appear to be an impediment to progress – and in some cases, this may be true. However, in many settings, if we take a step back, truly listen to one another, and re-center our focus as a cohesive, multidisciplinary team on the goal at hand (i.e., delivering exceptional care to patients), we can drive forward positive progress that will benefit not only the current singular patient but future patients as well.
Lastly, having fun is core to any Fulbright awardee’s experience. Each day in Luxembourg, a new adventure began, and I found myself filled with genuine excitement and endless energy. What would I learn today? What would I see? Would I make another lifelong friend? Not only is practicing medicine a privilege, but – similar to living abroad on a Fulbright grant – it is also fun. The camaraderie amongst colleagues and enjoyment associated with reducing that complex fracture pattern or correctly diagnosing that “zebra” case makes an often stressful job …fun!
Practicing medicine is an honor, and I appreciate that it is not a career choice everyone can – or is able – to pursue. Likewise, I recognize that not everyone will have the opportunity to live abroad as a member of The Fulbright Program. Fortunately, it does not require a Fulbright grant to recognize the importance of and seek out opportunities to foster the lessons I nurtured while on my Fulbright grant (i.e., being comfortable in an uncomfortable setting, active listening and compromise in the setting of robust disagreement, and importance of having fun). Ultimately, as I continue to refine these skills, I believe incorporating them to the best of my ability as a trainee thus far has certainly paid dividends. I would urge other trainees to seek out opportunities to develop such skills and incorporate them into their daily routines routine as well.
David Bernstein is an orthopedic surgery resident.
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