New York July 2019 - A Different World

July 2020, Cork.

I wrote this piece about my trip to the MWIA Congress this time last year, and for some reason I never quite got around to publishing it. Reading it now, from within the eye of a pandemic, it is making me nostalgic for the times when we could travel freely and embrace strangers warmly. It is encouraging, though, to reflect on an organisation like the MWIA which has survived World War, political unrest, social upheaval and, no doubt, plenty of interpersonal strife, and yet it continues to support and encourage female physicians all around the globe.

-Sarah

“Thumb”.

“Thumb!”

“Ma’am, you need to put your thumb here”.

Presumably it is a cultural legacy that we will never truly lose, this innate fear and trepidation of interacting with US Immigration Services. I am sure the gentleman was probably quite pleasant and welcoming, but I stuttered and stammered my way through the process. Delighted when he asked me for the Purpose Of My Visit. “Work!” I said gleefully. Then I remember the countless times that my family members had had to lie through their teeth and insist that their journey was entirely for the purposes of Leisure and definitely, definitely, NOT to work. I reassured him that I would be home again to my respectable job and respectable house in just a few days, that I would not be encroaching on his country’s kindness for any longer than absolutely necessary. He inspected my pristine passport, untouched in the last eight years by the stamp that marks an expedition beyond the safe walls of our European Union. I tend to stick within the security blanket of the E111 zone, confident that if I were to suddenly need medical help, that I wouldn’t have to sell one of my children to be able to afford it.

Perhaps the allure of the USA is its bristly unkindness. You have to fight your way in, fight to stay alive and well while you’re there and scoot your butt out the door before someone scoots it for you with a deportation order and a machine gun.

But I was delighted to be elbowing my way in this time. I was going to New York City for the first time ever. I was on my way to attend the Centennial Congress of the Medical Women’s International Association (MWIA), which had held its first meeting in the same city in October 1919. Back then, 140 female doctors from 16 nations ate dinner together, and within a few days a Committee of Twelve was chosen by ballot and empowered to organise the Medical Women’s International Association. The purpose of the organisation was simple: “exchange ideas and unite efforts for the benefit of mankind”. This year, six new national women doctors’ associations were joining MWIA, and the Women in Medicine in Ireland Network was one of them.

I was very proud to be presented with a certificate of membership from Dr Shelley Ross, Secretary General of MWIA, but also overwhelmed with the breadth of knowledge and experience that I encountered over the four days of the Congress. The big-hitters of the #womeninmedicine crew were there - Dr Esther Choo, Dr Arghaven Salles, Dr Gigi Osler - as well as the incredible 85-year-old writer and activist Gloria Steinem. The real energy came from the collective wisdom of 1200 women from all parts of the world sharing their research and insights. At one session about the use of technology in medicine, an American physician spoke about a new concept for primary care which cuts costs by roughly a third and therefore allows GPs to break even instead of spiralling into debt, which is a new problem in the US. (The idea is basically a mobile doctor, who has no bricks-and-mortar surgery, and attends patients at their homes or in their workplace to treat acute problems and management of chronic one). The next speaker was a doctor from Mali, who described a project where community leaders in small villages were given a mobile phone which they used to text a central number each time a woman or a baby died in childbirth. This increased the recorded numbers of maternal mortality three-fold. On the one hand we were hearing the minutiae of profit margins and a few minutes later we are discussing the 162 babies who died in a small province in rural Africa. It was sobering stuff.

The wide cultural diversity of the congress was inspiring. The African delegates all wore traditional costumes in matching fabrics but each with an individual design twist. The Korean women wore stunning pastel kimonos. The Italian women had sharply tailored suits and high heels. The Northern Europeans wore Scholls.

Singalongs, poetry slams, storytelling, dramatisations, sand art - not a bland after-dinner speech in sight. The catering could be fairly described as “minimalist” and the wifi was non-existent, but otherwise the event was a great success.

New York is often described as a melting pot, where people from all over the world work and live together in one hot sticky city. However, it seemed to me that it was a little bit more like a vegetable steamer, with those metal divider thingies which separate the broccoli from the carrots. Each borough has a distinctive cultural feel and look, which is noticeably different from the next. Ascending the Subway stairs at a new station usually means entering a new world, a new vibe and identity. Chinatown, Little Italy, Brooklyn Heights, Greenwich; they all jostle shoulder to shoulder, but with very clear boundaries and borders. The buzz of the place is universal, though. Every footpath - sorry, sidewalk - seems to be vibrating with energy, the noise is constant, the shouting and laughing and beeping and hustling. We wandered into a packed bar in the early evening and sat down with our twelve-dollar beers in plastic cups. Suddenly the place emptied, and the barman moved through the room with a black plastic sack, chucking the paper plates and disposable forks into the trash. Happy hour was over. No fool pays the non-happy hour prices. Or recycles.

I was delighted to be served by some older people in restaurants, thinking to myself how lovely that there is no ageism here, everyone gets an opportunity to work. Slowly it dawned on me though - perhaps these octogenarians have no choice. If they don’t work, they have no money, no support, no lifeline.

The TV ads are an endless stream of direct-to-consumer pharmaceutical promotions, not for aspirin or candesartan or statins, but for ridiculously expensive and potentially dangerous meds all ending in “-imab”.

The place is FUBAR, but there is no doubt that it is a lot of demented fun.