stephjournal1

Starting residency represented the beginning of a new chapter in our lives! My german husband had nervously gone through several weeks of interviews and had been accepted in a hospital in Stuttgart. The first 18 months after medical school are affectionately termed A.I.P, or arzt im Praktikum...basically...internship year. During this time, they are paid 1/2 of the salary of a regular resident, and are expected to do twice the work! As an American living abroad, my own job opportunities were rather limited. I had a bachelor's degree, but because the first degree that students get in Germany is a Masters, this left me with few options. I was unable to even get a retail job because these required a two-year training program and certificate. My first job was a dishwasher at a mall. This was truly miserable, though I eventually did move up to a busboy. I eventually left this position and began working for McDonalds, feeling very much like I had somehow taken a major step backwards! I came home from work every night smelling like a grease factory. My husband and I were embarassed by this frightful turn of events, but we could not do without the salary. His income only covered our rent...to the pfennig! I searched for alternatives, but when I discovered that I was pregnant could no longer make a career change. In germany, the employer is required to pay for maternity leave and no one would hire me. If I left the job, I would lose those benefits and be unemployed.

Michael worked long hours. His day started at 7 am and often didn't end until after 8pm at night. Fortunately, the hospital had a night float program for call, so in that regard, I felt lucky! I still felt tired and resented the amount of time that he was away. He struggled that year to come to terms with the reality of being a physician. He was doing 18 months of Oncology and his intial enthusiasm for making a diference was quickly dampened by the repeated deaths of his youngest patients. His first patient to die was a young medical student who had self-diagnosed a lymphoma in her second year of medical school. He was adamant that they would find a way to save her life. One evening he came home from work and told me that she had left the hospital...that they had cured her. He wasn't himself anymore though. He was moody and distant and I felt that I didn't know him anymore. One night he came home and I had prepared a special dinner for him to cheer him up. He finally told me that it was true that the young woman had left the hospital, but that she had not left alive...and that he couldn't cope with it. His second patient to die was a 19 year old who found a lump in his testicle. It was diagnosed as a rare form of cancer and the young man passed away despite the most aggressive experimental therapies within 6 months. Thomas decided that he never wanted to work on an oncology ward again.

Our son was born towards the end of his 18 months, and we began making plans for the future. We decided that we wanted to move to the US, where I was from, to be closer to family and friends. He prepared for the USMLEI and applying in the UK for a residency position in Internal Medicine. He wanted the opportunity to practice in an English-speaking region before moving to the US.

The end of AIP came quickly, and we narrowed down the interview list. We flew to the UK and began the process. Most of the interviews were uneventful and we were still undecided as we drove our rental car to the pier in Stranrear, Scotland to catch a ferry to Northern Ireland. The trip itself turned out to be a major adventure in our lives. We miscalculated the time that it would take for us to drive from London to Stranrear. Many of the roads weren't paved or were in poor condition. They were narrow and winding and it was difficult to navigate. I had to drive throught the night while Thomas rested up for his 8am interview. The trucks were nearly blowing us off the road. While my husband and 6 month old slept soundly, I found myself praying silently for our safe arrival.

I was able to sleep for an hour on the docks before loading the car onto the ferry. The trip over was incredible, and we drove through the countryside to Portadown amazed by the scenery. The hospital in Craigavon was a lovely place and we felt at home in the community from the very beginning. After a night of discussions, my husband decided to accept the job offer on the spot. We prepared to return to Germany to collect our things.

That night though, the peace that had been in Northern Ireland for several months was put to the test. We had been in Belfast that afternoon and when we tried to return to Craigavon we were caught up in smoke and fire. Tank-like cars poured down the streets and it took us hours to get out. We had no idea what was happening, but later discovered that the docks would be difficult to get to because of the eruption of "troubles" on the streets of Belfast. We were amazed watching the news reports that we had been in the middle of it all that afternoon. I felt a nervous twinge, but contract in hand, we returned to Germany.