The Making of an American Doctor
By: Matthew Trifan
Not long ago, I was on duty in the Emergency Department, sewing up a kid’s lacerated hand. He was ten years old and terrified. I had to make all kinds of promises to numb him up before starting. As I cajoled him, I had the strangest sense of déjà vu. I realized that I had lived through the same experience myself — as a young boy sitting in my kitchen with a torn up hand, having careened on roller-skates into a pile of rocks. Only the doctor had been my father, and he had coaxed and pleaded with me just like I was doing now. I remember the burn of the lidocaine, and then being mesmerized by my father’s deft weaving of knots. Now here I was: spinning the same knots, singing the same song, soon to be a doctor myself. Just like that, our lives had swung full circle. The torch had passed on.
I find myself thinking about my family a lot these days. And for good reason. My journey to becoming a physician really started with their own.
My parents’ story begins some fifty years ago in Romania, a beautiful country nestled in Eastern Europe’s Carpathian Mountains. In the 1950s, Romania was yet another country yoked to the Soviet empire, bearing the Communist flag. My mother was born a city girl in the capital of Bucharest. My father was raised in the smaller Transylvanian town of Brasov. As teenagers in the early seventies, they grew up with a love for all things American. They jammed out to black-market records in their rooms, from CCR, to Pink Floyd, to Jimi Hendrix and Fleetwood Mac. They wore “blue jeans” out in public. They indulged in the rare Pepsi-Vodka at the discotheque. Everything American was edgy, rich, and cool, and gently subversive to the Communists stiffs who ran the country.
What little they actually knew about American life came from books and movies smuggled into Romania. My parents learned about Western culture from films on the “black market.” These movies were bootlegged ¬ad nauseam and watched with neighbors and friends in living rooms at night. My mother loved the forbidden love saga of Natalie Wood and Warren Beatty in “Splendor in the Grass.” My father was particular to gangster movies and hardboiled crime noirs like “The French Connection.” The heroes did what they wanted and said what they wanted, wherever and whenever they wanted. “We couldn’t believe how bold they were,” my mother recounts. “We couldn’t get enough of it.”
It wasn’t until the end of the Seventies, when the deprivations of the Cold War began strangling the Romanian people, that the “American dream” became an escape plan. Suddenly there were food shortages, crackdowns on political dissent, and most obnoxiously, long waiting lines for everything. My mother would wait three hours in line to buy butter; my father did the same for toilet paper. It was no longer easy to laugh off “incompetent” government bureaucrats — not when you couldn’t put food on the table, or get petrol for your car, or find a steady job. More and more Romanians were spying on each other, acting as informants at home, in school, in churches, and even in hospitals. Daily interactions became hostile, suspicious, and dangerous. Some citizens tried to emigrate westward, but even this became difficult. Obtaining travel papers was an increasingly onerous process, taking months to years to complete. If someone was lucky enough to travel abroad, their family members might be forced to remain in Romania–-to reduce the risk of defection. The country was turning into a prison.
One Romanian had had quite enough of this. In the late 1950s, my grandfather, a surgeon, had made a careless toast at a dinner party — saluting the “Hungarian Revolution” against the Communists — and an informant had reported him to the police. Thus, my grandfather received a ten-year sentence as a “political dissenter” in a laboring gulag. This sentence often meant death from malnourishment, guard brutality, and disease. However, his medical knowledge proved to be an asset in prison. Because the nearest hospital was six hours away, the guards came to depend on him for his medical expertise.
My grandfather had been prisoner for about five years when the prison warden approached him one night in a state of panic. The warden’s wife had had a tubal pregnancy, which had ruptured. She was hemorrhaging blood and would not survive the journey to the hospital. “Do everything you can to save her life,” the warden begged him. Immediately, my grandfather pillaged the jail’s shoe-repair shop for cutting instruments and thread. He boiled the instruments to sterilize them. Then he operated on the warden’s wife. He stabilized her bleeding, and she was able to reach the hospital. In gratitude for saving her life, the prison warden commuted the remaining sentence. My grandfather emerged from the gulag in 1963 with a “clean slate” to practice medicine freely. He resumed his career as a surgeon. But he would never forgive the State for robbing him of his children’s earliest years. My father was seven years old when my grandfather finally came home.
Thus, in 1978 — fed up with being spied on, underpaid, and overworked — my grandfather obtained travel papers to America. He was the first of his family to leave Romania, albeit under the guise of returning soon. Upon arriving at a friend’s home in Ohio, however, he applied for political asylum. The US government reviewed his history and granted his request. There was a steep price for admission. Because of his poor English and lack of an American degree, he had to surrender his profession as a surgeon. He would finish his career as an OR technician in Ohio, relegated to fetching instruments and assisting surgeons from the sidelines. He took small comfort in his expertise, which won the respect of his colleagues, and more importantly, in his job, which meant he could host his family in America. Using a Romanian emigration law known as “family reunion,” his wife and daughter were able to join him in the United States.
Now there was only the issue of my father. In 1981, at age 25, my father was the last of his family left in Romania. He had his heart set on America, but leaving would not be easy for him. First and foremost, he was in love with my mother who had her own career — and her own family — in Romania. He met my mother during his mandatory service in the Romanian army after high school. She was the sister of his best friend in the army. One rainy Sunday afternoon, she had come to visit her sibling at the camp, and my father had trudged along to say hello. He was thunderstruck. At the time, she was dating another man, but that did not deter my father. He was dogged in his courtship, catching weekend trains to visit her and writing love novellas to mail her, dozens of pages at a time. Every night, after marches and drilling, he dreamed up a life of them together on ink-blotted pages.
In 1981, my parents were happily married and miserably broke. My father had finished medical school in Bucharest. Despite his budding career, he had his eyes set on America. The Romanian economy continued to crash, and my parents decided it was time to leave. Strings were pulled. Favors were called in. It was a long and expensive process, lasting a full year. Eventually they got their wish in the form of a travel passport via Italy. There was no time to waste. My parents packed lightly and gathered what little money they could. They were permitted two suitcases each and $50 per person for travel expenses.
My father was convinced they would be stopped by the secret police at the airport. “When your mother and I were walking to that plane, I expected a hand on my shoulder,” he said. “I was waiting to hear a friendly voice saying, Tovarăş (Comrade), where are you going so quickly?” Their sense of dread followed them into the plane, where they sat sweating in their seats. Ominous clouds darkened the skies. The plane sped down the runway and ascended in the midst of a terrible storm. “It was as if God himself was denying us passage out of hell,” my father said. Ferocious wind ripped at the plane. They held each other’s hands.
The dingy aircraft rattled its way to Albania, where it stopped for refueling. The passengers waited inside a dingy airport during the storm. Through a huge window, they could see a dozen giant tanks parked along the darkened runway. The mammoth turrets were pointed directly at them. They waited for hours in the airport with their hearts thundering.
The plane was refueled, and a few hours later my parents arrived in Rome. They bought Italian gelato from the nearest vendor and sat down on the sidewalk. They held hands. With the warm sun beating on their necks, they wept.
It would take nearly a month for the American embassy in Rome to grant them entry visas. In the interim, my parents, then ages 28 and 30, received $200 from my grandparents in America. The money allowed them to travel to the island of Capri off the gulf of Naples, and then to Florence. This was their impromptu honeymoon of sorts — their first true taste of love in the free world.
In the spring of 1984, my parents landed at JFK International Airport in New York City. They had made it to the Land of the Free — only to find a fresh set of hardships. They had less than a hundred dollars between them. Although my mother was fluent in English, my father spoke miserably little of it. My mother began work as a bank teller for Citibank for $800 per month. My father discovered that his eight years of medical training in Bucharest held no weight whatsoever in America. He would need to apply to residencies without a formal US medical degree — and with minimal English to boot! His applications were rejected by nearly thirty residencies in the region. On the phone, he was bluntly informed “We do not take foreign graduates.” He was dejected. No longer the bread-winner, he sat alone in the apartment most hours of the day, confronting the choices he had made.
He caught a break through a fellow Romanian in New York. My father was offered a “voluntary internship” at a New York hospital for a year, unsalaried, as a “trial” for residency. His English was rudimentary, meaning he would have to learn the language as he went along. And he did. He impressed his fellow residents and physicians with his acumen and astute physical exams. He could diagnose pneumonia almost exclusively from pulmonary percussion — at a time when his colleagues were mostly relying on radiograph imaging. He likewise dumbfounded an infectious disease specialist by diagnosing tuberculosis by stethoscope alone. Half a year later, my father was offered a residency position at the hospital. He had made it in America.
With a residency secured, my father and mother felt it was time to begin a family. My older brother was born in 1987. I was born in 1989, the year the Berlin Wall fell. It was also the year that the Communist regimes of Eastern Europe began toppling like dominos. On December 25th, 1989, the former Communist dictator of Romania, Nicolae Ceaușescu, and his wife Elena, were dragged before a kangaroo court and charged with genocide. My parents watched dumbfounded as the proceedings unfolded on television. The Ceaușescus were found guilty and sentenced to death by firing squad. They were taken behind the courthouse and lined against a wall — like so many of their victims before them — and shot to death. “Our whole lives they were untouchable,” my mother recounts. “Then, poof, just like that, they were gone.”
A new era was dawning in Romania — and in my parents’ lives too. In the early 1990s, our family moved to central Pennsylvania, into a house with a spacious yard in a quiet neighborhood. My father began working for the Veterans Hospital in Altoona — proudly serving veterans for the next twenty-five years. My mother devoted herself diligently to raising my brother and me as typical American kids. She drove my brother and me to school meetings and tennis matches and karate classes. She helped with sleepovers and birthday parties and prom suit shopping. Most importantly, she taught us the value of a dollar hard-earned, which she truly understood from her life.
Today, my brother is working happily as a hospitalist physician in Pittsburgh. My father is approaching retirement and looking forward to the most American of pastimes: golfing. My mother still travels yearly to Romania to reunite with old friends. Before passing away ten years ago, my grandfather was also able to return to the country of his birth — this time, as a free American citizen.
Now I am nearing the end of my own eight-year journey through college and medical school. Residency looms ahead. It will be a fresh start in a new city. I find myself standing on the precipice of an unknown future, just like my parents and grandparents before me. Their journey gives me strength.
So here I am, sewing up a young boy’s hand, feeling the pinch and the pull in my own, hearing my father’s voice in my head, echoing the past. My patient has calmed down. He watches me with trustful eyes. I draw each circle tightly closed, lending the wound a little more strength, before my needle travels on. The path forward is uncharted — but somehow, I know I’ll find my own way.
Michael Vitez, winner of the 1997 Pulitzer Prize for Explanatory Journalism at The Philadelphia Inquirer, is the director of narrative medicine at the Lewis Katz School of Medicine at Temple University. Michael.firstname.lastname@example.org