We’ve slept like rocks for two nights in a row now. We’re staying at the Grecotel Palace Athena, a small boutique hotel with modern, funky design. Evie sleeps in the pack n play provided by the hotel. We have a large balcony with a view of the square where we played with the pigeons yesterday.
This morning we set out on a mission for breakfast. We binge-watched travel shows on Netflix and YouTube to plan our trip. One spot that surfaced on every show was Stani. Known for their fresh dairy and honey breakfast/desserts (fine line here), there are two staples to try. The Greek yogurt with honey and nuts and the simple cream with honey top. We didn’t even make it to the loukoumades or baklava.
After breakfast, we walked to the metro station and rode it three stops on the red line to Acropolis Museum. The metro was easy to navigate, even with a stroller.
The Acropolis Museum opened in June 2009 and had won numerous well-deserved awards. As you enter, you walk atop a glass floor that lies above the ruins of the old city . There are circles within circles, rooms, fountains, walls, staircases. All of the functional elements reveal themselves if you look closely enough.
As you enter the Museum and walk up the steep ramp to the exhibits, you get to peek at various frescos and statues – an amuse-bouche to the main course.
There are three main floors to the museum, with the first floor housing a visiting exhibit, the second floor endless sculptures, and the third floor an experience in an of itself.
It’s interesting to think about how we view these ancient civilizations through the carvings they left behind. Why did they choose to carve what they did? they chose the story they left behind. Many of the fresco carvings depict romanticized versions of battle war or opulent feasts.
I was left wondering what wasn’t depicted. What was the boring day to day of life in Athens in 480 BC? We see only these romanticized scenes and snippets. Is what these artists did that much different than what we criticize people for doing today with social media? Showing only a glorified and glamorized version of ourselves?
As you reach the top floor of the museum, you suddenly realize you are inside a modern rendition of the Parthenon. There are 17 columns spanning the longest side of the museum, and in between each are carved marble blocks which were once part of the upper ceiling of the inner portion of the Parthenon. The pieces were excavated years after the ammunition explosion that destroyed much of the structure. Also from the top floor, huge glass windows allow for parallel viewing of the real deal.
I do have to give a nod to the museum for having my all-time favorite family changing room on the first floor of the museum. Complete with changing table, toys, kids table and hand sanitizer, it was everything you need right in one room. It was also nice that all three of us could go in together since changing a diaper on a two year old often requires four hands.
We opted to walk back towards our hotel rather than taking the metro just so we could see some new sights and grab a small snack along the way.
Every hour on the hour, there’s a changing of the guard at the palace. We decided to catch the guards and then head to the National Garden before sunset. They have a large playground with swings and slides, and entrance is free.
On our walk back from the National Garden, we stopped for dinner at Diporto, another hidden gem we discovered during our Netflix binge. There’s no sign and no menu. A true hole-in-the-wall place, you just walk down into a basement with paper-covered tables, wine barrels and not a word of English. You sit down and are served within 3 minutes, which is easy to do when there’s no choice of what to eat.
The only choice we made was to have “vino” with dinner or not. Not red vs white, just “vino.” We stuffed ourselves full for a mere €18.
And as the life of the toddler parent goes, we were warned by our little, “I need poop.” Diaper changes have been the rate limiter to a lot of things these past two years. Diporto for all its charm, didn’t have a restroom nevertheless a changing table. We settled up and headed back to our hotel. Tomorrow we’ve booked a food tour – as if we haven’t been eating enough already!
It turns out late January is an excellent time of year to visit Greece. Technically “off-season,” it’s still 60 degrees with sunny skies and greenery all around, just minus about 1/2 the tourists one usually encounters in peak season.
We flew Dulles–>Heathrow–>Athens with an itinerary we thought perfect for our almost 2 year old. An overnight transatlantic flight on British Airways followed by a shorter flight arriving early afternoon into Athens.
We’ve flown together as a family of three on at least 4 occasions in these two short years. Our daughter is usually a good flyer, but I still have PTSD from our trip last summer to Italy when she screamed for 6.5 hours straight. I’m happy to say she was a delight on the way here. Entertained by Peppa Pig and endless crackers, she hardly fussed a bit. What we didn’t expect however, was the call for help on the plane.
“If you are a Doctor of Medicine, please press your call bell.” I half thought I’d dreamt the overhead call. Just over halfway through our flight, my two co-travelers were both sleeping, and I’d just closed my eyes. I jabbed Amir. He awoke startled, pressed the button, and we waited. About 5 seconds. A calm but concerned flight attendant arrived and told us a man up front was having a medical event and they were attaching the defibrillator. What I had assumed was a simple syncope or low blood sugar event was clearly more serious.
“My wife and I are both emergency medicine doctors, we can go.” We decided that he would go, and I would stay to watch our daughter. After thirty minutes, a different flight attendant came to update me. “The man is 82. He stopped breathing. Your husband will be tired when he returns.”
I knew then what the outcome was. We were only 4.5 hours into our flight, still an hour away from the nearest airport where you can safely land a 747. The story of what happened in between is not mine to tell. We were required to stay in the plane for 2 hours after landing to give statements to police. As such, we missed our connecting flight to Athens. The British Airways crew were so apologetic, but we felt it a small price to pay to delay our holiday a few hours to have the opportunity to put our training to use. If only the outcome could have been different.
Amazingly we all were asleep by 10pm Athens time and slept all night and into the morning until 10am. We’d missed the delicious hotel breakfast of fresh coffee, yogurt and fruit, but we were well-rested and ready.
If you have a baby or a toddler, and don’t have a CitiMini stroller, you must be missing out on how easy getting around can be. We’ve taken this thing to California, the Bahamas, Italy and now Greece. It’s survived the pummel of airport baggage handlers across the globe and can even tackle the crooked sidewalks of The Fan District back home in Richmond. If you plan to travel with young kids, don’t be afraid to travel with a good stroller. Strollers and car seats are free to check.
Whenever we arrive in a new place, we like to walk around first to get a feel for the location, people, safety and maneuverability.
Athens has an insane amount of graffiti. Most cities attempt to take down graffiti as soon as it goes up. There’s a threshold you cross where once there’s a certain amount it’s accepted, just part of the area. It’s peculiar to see the juxtaposition of 2500+ year old ruins with this century’s modern art.
From down in center city near our hotel, we walked up towards the Acropolis. The incline wasn’t as severe as it seemed when looking up from below.
We stopped along the way to refuel and taste some local sweets. We enjoyed coffee and pastries hand-piped full of Nutella.
We stopped to say “hello” to a few of the numerous kitties who live just outside the Acropolis. They are quite friendly and appreciate the music of the street musicians.
We reached the top of the hill and the Acropolis. You can purchase a 5 site pass for $30 euro which lasts 5 days and gives you access to the major historic sites. We also opted to hire a guide to walk with us and narrate the history.
The views from here were amazing. You can see the whole city and even the Aegean Sea.
While our guide said the tour was 1 hour, at hour 2 our daughter was getting restless, and we still had more to see. We politely cut our tour short and carried on by ourselves.
The rest of the day was spent tasting local cocktails, exploring hidden side streets and fresh seafood.
One of the things I’ve most looked forward to since Steph and I toured all over the country interviewing at 20+ residency programs was the prospect of an “elective” month. Almost every program had a month carved out for residents to choose an area of (educational) interest and immerse themselves however they pleased. Finally, after three years of waiting, this year was my chance.
I researched for months and finally settled on traveling to London to work with and learn from the London Ambulance Service, one of the world’s premier prehospital agencies. Combined with the emergency physicians aboard the London Air Ambulance, they are doing some cutting edge stuff – including point of care ultrasound, field thoracotomies, REBOA and true prehospital critical care. Plus I’d have a chance to visit Grandma.
So, needless to say, I was bummed when the opportunity failed to materialize.
But as luck would have it, just a few days later I bumped into Dr. Ornato, the chairman of our department at VCU. I mentioned it to him, and without skipping a beat he asked, “Want to go to Singapore?”
Fun Fact #1: Singapore is a tiny island city-state, meaning the entire country is one big city (think Ancient Greece, but Asian). It has been at the center of the global economy for hundreds of years, from a refueling port for the British East India Company to what is now one of the largest shipping ports in the world, with up to 100,000 vessels traversing the Strait of Singapore yearly.
Now when I say Singapore is far away, consider this: the Earth is roughly 24,000 miles around and this was a 12,000 mile flight. If I’d have gone any further I’d have been on my way back home. (And did I mention I was in a middle seat? My knees, back and bladder were not amused. But I digress.) Roughly two days after setting off I landed as far from home as I’d ever been and will likely ever be (until I make it into orbit, that is).
My first impression both in the airport moving through customs and in the taxi on the way to the place where I’d be stay for the next ten days was pleasant surprise at just how clean, efficient and organized the whole place seemed to be. No pushing or even a raised voice, just well designed infrastructure ready to welcome visitors, students, investors and most importantly: me.
I decided to try AirBnb for the first time. I was traveling alone and found it to be much cheaper than hotels, so why not give it a shot. There was of course the possibility of being murdered in a stranger’s home, and every listing looked far too good to be true, but hell what’s life without a little risk of being drugged and dismembered in your sleep every now and then. So I settled on a condo in an upscale residential district which boasted four swimming pools, a hot tub, free wifi, private bedroom and bathroom, plus walking distance to two subway stations, restaurants, shopping, and a few of Singapore’s ubiquitous dining halls (more on that later), all for less than $60/night. See what I mean?! Must be too good to be true.
But it wasn’t! I found the apartment to be exceptionally comfortable and convenient, precisely as advertised. I met my hosts – an American/Chinese Harvard grad and a Moroccan/French banker – who didn’t seem like serial killers at all. Again, pleasantly surprised and more than a little relieved.
I arrived early and had slept for 16 hours all the way across the Pacific, so after getting settled I was ready to explore. I stepped outside to an instant reminder that the country lies just one degree north of the Equator – instant, drenching perspiration. Nevertheless, I spent the first two days exploring the tiny country on foot, sweating profusely.
Singapore is about half the size of London or Los Angeles with a population of just over five million. One of the most striking things about it was the diversity – a nation made up of Chinese, Indian, Malay, European and dozens of other nationalities living in near-complete harmony. That, combined with an effective, non-corrupt government, has attracted tremendous investment, and in just one generation the little city-state has blossomed to become a global center of commerce, ranking 7th in GDP per capita world-wide.
Fun Fact #2: After independence from Britain following WWII, Singapore briefly merged with its big brother to the north, Malaysia. But thanks to racial strife between the Malays and predominantly Chinese Singaporeans, the island was kicked out in 1965. Singapore has gone on to become an economic powerhouse and first world nation while Malaysia currently ranks 79th in GDP. Whoops!
After eating my way around downtown, having coffee with some very pampered cats and strolling around the stunning Gardens by the Bay and exceptionally impressive Art-Science museum it was time to do some actual work. I spent the first two clinical days at Singapore General Hospital, in the emergency department with Dr. Marcus Ong and his staff. Here’s an excerpt from my Facebook travel diary with my first impressions:
“Spent my first day at SGH today. It’s a remarkably similar place, facing many of the same issues we do in the US. Grumpy consultants, slow throughput, ED boarding, and misuse of emergency services. That said, they see almost zero violent trauma, drug seeking is nonexistent, and psychiatric care is managed outside of the ED. Overall, the care is excellent and very up to date, with all the latest technology readily available but used in a more cost effective way.”
I was impressed with the care but noticed it to be somewhat less aggressive than what we do in the US, with invasive procedures done emergently if necessary, but more often left to be sorted out upstairs. While they see very little violent trauma, I was fortunate to see how they managed a motorcycle accident victim – a wealthy British businessman with broken ribs and a collapsed lung. At VCU he would have had a team of 12 providers standing-by on arrival, been stripped of every stitch of clothing and irradiated from head to toe by our CT scanner. At SGH he cracked jokes for an hour while a nervous intern tried his best to place a chest tube.
Like everything else in the country, the healthcare system in Singapore is modern, effective and efficient (ranked most efficient in the world in 2014). Coverage is universal under the principle of no care being completely free which reduces wasteful over usage. Co-payments (typically 3-10% of the cost) and optional supplemental private insurance are paid from a compulsory personal savings account called MediSave. With the 3rd longest life expectancy worldwide Singaporeans spend just 1.6% of GDP on healthcare. For comparison, the US spends over 17% of its wealth on medical services yearly, and its citizens live just slightly shorter lives than the people of the Turks and Caicos islands at number 43 globally.
After my time in the hospital I spent a full day with the staff of the Unit for Prehospital Emergency Care (UPEC) which is led by Dr. Ong. Just a few years ago the government of Singapore sent experts around the world collecting best practices and poured tens of millions of dollars into the project, tasking UPEC with modernizing the EMS system. At the heart of that effort is the SCDF.
The Singapore Civil Defense Force is a quasi-military 4th branch of uniformed national service which includes both the fire department and ambulance service. Unlike the US, the two branches are almost entirely separate, with firefighters generally providing no medical care and responding only to fire incidents. One exception is the new “firebiker” program, with an EMT trained firefighter on a motorcycle able to respond quickly through traffic to cardiac arrest cases. The ambulance service, on the other hand, is well equipped and staffed by paramedics on every ambulance. A unique aspect of both branches is the inclusion of conscripts, young men completing their two years of national service. While most are drafted into the traditional military branches, others fill the ranks of the SCDF.
Fun Fact #3: There are two emergency numbers in Singapore. “9-9-5” is reserved for emergencies, with a government SCDF ambulance responding. “1-7-7-7” is available for non-emergencies, and staffed by unregulated private ambulance companies. Calling 9-9-5 for a non-emergency can result in a hefty fine.
I had a chance to spend time both aboard an SCDF ambulance and in their command center, where over 50 ambulances are dispatched to almost 1000 calls to 9-9-5 daily. Many unique challenges exist, ranging from the use of four primary national languages (English, Tamil, Malay, and Mandarin), to cultural and religious differences, not to mention a complex environment including dense urban centers and the surrounding swamps, jungle and sea. It was there I first heard the term “vertical response time,” the extra minutes which have to be factored in when lugging a stretcher and equipment to the 40th or 60th floor of an apartment or office building. To combat that particular challenge, the government has funded AEDs being placed in the lobby of every other housing complex as well as community hands-only CPR training, all organized by UPEC. The coordination of such an effort is a remarkable achievement.
Fun Fact #4: The government LOVES fines. Jaywalking? $20. Smoking in an elevator? Better have $1000 to spare. Even drinking water on the subway or spitting out chewing gum on the street will set you back $500. But most Singaporeans will admit the loss of a few simple freedoms is worth it and has led to a safe and orderly society, with essentially no crime.
As my time was coming to a close I had one last clinical opportunity, the one I was most looking forward to: race medical support for the Singapore Grand Prix. Now I’ve never followed Formula 1 racing, but if I learned one thing from the UCI Road World Championships in Richmond last year it’s that you don’t have to be a superfan to get excited when a big event comes to town. With an all-access pass, a chauffeured golf-cart, the scent of high octane gasoline and that distinct TIE-fighter whine of the engines I was soaking up an intoxicating atmosphere. The medical facilities were impressive, with the SCDF, dozens of volunteers from St. John’s Ambulance and the elite Disaster Assistance Rescue Team (DART) on standby. There were even fire-boats positioned to evacuate patients by sea if necessary, avoiding the inevitable gridlock of a city hosting a world-class event. Like everything else I came across during my time there, every detail was planned out and meticulously accounted for with robotic precision.
After the race, having completed my educational syllabus, I used my last day in the country to be a shameless tourist. The highlight was undoubtedly the stunning botanical gardens, a UNESCO World Heritage site. I spent most of the day strolling through various areas like the Evolution Garden, Healing Garden, Bonsai Garden and of course, the jaw-dropping National Orchid Garden. Next time you find yourself in the area, do yourself a favor and pay it a visit. You won’t be sorry.
Although it may seem I was in a veritable utopia, by the end of my time there I was ready to come home. Not only was I missing my wife, but in a weird way the predictability of the orderliness, combined with the brutal heat became somehow… monotonous. Full of new knowledge and tremendous respect for the work being done to develop Emergency Medicine in Singapore, I caught the last seat on a full flight home after saying goodbye to my new friends at UPEC, SGH and the SCDF. Did I mention Singaporeans love abbreviations?
But what about the food?! Up to this point I’ve purposely avoided mentioning it to prevent an irreversible segway into what I can only describe as the best, cheapest, most diverse cuisine I’ve ever come across. It was simply too good for words, with each meal better than the last. Singapore more than lived up to its reputation as an international foodie destination, so I can think of no better way to conclude than with a stream of epic food porn. Enjoy!
Tangier Island has always been a place of intrigue in my mind – a mythical island of less than 500 people, disconnected from daily life. When we were young, my sister took an overnight boat trip there with family friends. A hurricane led to a near stranding and peaked my interest in visiting. In medical school, we learned of Tangier Disease, a genetic disorder causing reduced levels of HDL (good cholesterol), named after the island’s inhabitants who have a rather shallow genetic pool.
So when Amir suggested a day trip, I Googled “tangier ferry” and discovered Tangier Rappahannock Cruises, a 2 hour ferry service that leaves from the coastal fishing town of Reedville, VA. I recommend selecting the same-day return trip, and skipping the suggested lunch at the Chesapeake House (more on that in a bit). Total cost round-trip for the two of us was just $57.24 including all taxes and fees. While you can just show up at the dock and buy tickets the same day, I recommend booking online to save yourself time and ensure your reservation.
We sat on the bow to get the best vantage point of blue skies and glassy seas. Osprey, fishing boats and crumbling barns float by, demanding the attention of your camera lens. I, as usual, captured them through the lens of my iPhone, Amir through his Canon DSLR.
Tangier soon turned from a distant mirage to a beautiful green world just ahead. The skyline was low, consisting mostly of simple two-story houses with a rare deviation in height for a church steeple and a water tower. As we entered the man-made channel lined with little white houses and docks, our ship’s captain revealed that Tangier is the world’s source for soft shell crabs. The crabbers live in these tiny white shacks – shacks that are filled with blue crabs, checked diligently on the hour in anticipation of the golden moment when the crab molts its shell. The crab is then scooped up and placed on ice or into a freezer and sold to restaurants for a feast later that day. It’s a practice as unique as the island itself.
We stepped off the boat and onto the dock, the end of which was lined with locals in golf carts offering 15 minute tours of the island, and friendly women with sun-aged skin offering coupons for the best lunch spots (there are only 7). We opted to skip the carts and create our own walking tour.
Instantly we were struck by the strange collision of worlds. Tangier is part what you would expect – fishermen, boats, flip flops and simple life at a slow pace – everything I love about Chesapeake Bay living. But it’s also part Cuba, part 3rd world country. For an isolated island, bringing goods in is expensive, so you see signs of old everywhere you turn. 1970s motorbikes, rusted chain link fences, refrigerators from 3 generations past. If you want new and shiny, this is not the place for you.
And while old often equates with charm, there’s something a bit off in Tangier. Like bringing things to the island, disposing of them is also a costly task. So, garbage is everywhere – broken down golf carts, bottomless boats, and 20 year old Pepsi cans littering the land and the water. It makes you cringe. It doesn’t fit. A proud people so dependent upon nature for their existence, so careless in protecting it.
For a half second my mind contemplated the missed opportunity – “What if they just picked up the trash?” “What if they had some eco-friendly activities?” I imaged the potential for increased tourism, and the subsequent revenue that could benefit this island and its people. And then I wondered, maybe this is deliberate.
We decided to try Fisherman’s Corner for lunch. We entered the brightly painted, simple square building to find a bustling room tightly packed with tables of both tourists and locals. The menu was typical Chesapeake Bay fare – she crab soup, crab dip, fried shrimp, crab cakes and soft shell crabs. Clearly we had to try the soft shells. The food was simple, home-cooked and a tad pricy, but delicious. My soft shell crab was sandwiched between two slices of white Wonder bread. While I was initially skeptical of my minimalist bun, when topped with the zesty tartar sauce, the flavors combined perfectly. We skipped dessert since we’d already cheated and devoured hand-dipped ice cream cones on our earlier walk.
We continued our ambulatory tour of the island, scoping out the picturesque little houses and the oddly placed graveyards in each front yard. Tangier is only 4 feet above sea level and losing 10-15 feet of land mass per year, so space is limited. A brief scan of graves reveals repeating names – Crockett, Pruett, Pruett, Crockett, Crockett. I begin to better understand the origins of Tangier Disease.
There are two churches, one fire station, one police officer and one school. On an island with 450 people, you make do. The sign outside the fire station explains that until very recently, every household was provided with a single leather bucket. When a fire broke out, the entire town would arrive and form a bucket brigade. I wondered what hurricane preparations took place today.
In just 3 short hours, we’d experienced 90% of what Tangier has to offer. We heard a dialect I can only describe best as Old English garble. We marveled at the eccentric locals like bird watchers spotting a never-before-seen species. Tangier is a dichotomy of beautiful and ugly, but special none-the-less.