From nucleus - Winter 2018 - a day in the life
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Chris Downing describes life in Albania
What does a typical day look like? It might involve language practice, conversations with local doctors, or perhaps a lecture or training session. Last weekend, at a conference in Tirana with a colleague from Brighton, I demonstrated to Albanian doctors and students how to assess and treat trauma using ATLS principles. We then discussed local constraints that affect how those principles are put into practice. In two weeks' time, I'll be working alongside an Albanian Christian GP helping to train rural Albanian doctors to manage hypertension. Every day is different.
Why Emergency Medicine? My postgraduate career was somewhat atypical. After graduating from Leeds University as a doctor in 1995, I joined a Basic Surgical Training rotation and, by the grace of God, passed my MRCSEd on the nth attempt. Thereafter my wife and I 'ran away to sea', initially working as volunteers for a church in Sydney and later studying Theology and Mission at Wycliffe Hall in Oxford. I then started working for CMF as a staffworker while also doing locums in A&E. These locums led to a longer-term middle grade job and later to a registrar post on the deanery's training rotation. I passed FRCEM and finished my EM training in 2010 and started working as a Consultant in 2011. This path may have seemed rather chaotic to others, but I did try to make each decision 'reverently, responsibly, and after serious thought'. At the time I couldn't say definitively that the Lord was clearly guiding us to do so-and-so; it was more that we had thought carefully and prayed and the choice seemed both sensible and honouring to God.
Nevertheless, Emergency Medicine is a good match for me. I enjoy being a generalist, knowing quite-a-lot about most medical conditions rather than 'more and more about less and less'. That said, unlike my brave GP colleagues, I rely heavily on ready access to definitive investigations. I enjoy working in teams with something of a 'flat hierarchy', something that didn't always go down with my superiors when I was a surgical SHO. Finally the new rota system in Brighton, in which we self-roster in advance our clinical shifts, is a life-changer, giving me control of when I spend time on the 'shop floor' in A&E.
Why Albania? This was unexpected! My wife and I first visited as part of a CMF team in 2001, to help on a summer camp for Albanian medical students. We met aspiring doctors who had lived through darkness and now wanted to see light in their country, especially in their health system. I returned each year to lead further camps, and we were always greeted warmly and listened to respectfully and the students often seemed to benefit. I began to feel that in order truly to help Albanian doctors I needed not merely to dispense advice and encouragement from my foreign vantage point but to face similar struggles by living alongside them. Getting ready to move abroad was a long process. We didn't move until ten years after our first exploratory visit with an almost-two-year-old - but on the way we were provided with three further children, my EM training was completed, and a few health issues were resolved that couldn't have been provided for in Albania. So as we look back we clearly perceive God at work, healing and refining us while also providing us with the resources we would need.
What are the challenges and joys? Albanian is a difficult language. Although after four years here I now speak at 'conversational level', often I don't understand what is going on or cannot make myself sufficiently understood. Another challenge is the difficulty of trying to establish working relationships from outside the health system. I have focused on working in the state hospital, helping to train medical students and junior doctors, but all of this has been done as a volunteer. So any training I provide is an 'optional extra' for my target audience.
One of the joys of living here is seeing God at work in a country where it was forbidden to mention him 30 years ago. I am privileged to be developing deep, encouraging friendships with Albanian Christian professionals who want to honour God with their lives and see him at work in their marriages, their communities, and their places of work.
What advice would you give to students? I appreciated the advice we were given at last year's national conference: 'Make the glory of the risen Lord the number one priority in your life'. This is more or-less what Paul says in Romans 12:1-2. Unpacking this would take another article, but my executive summary would counsel wisdom with: