Travel Journal: Siena

Benvenuti!

italy1

As a former medieval powerhouse, Siena is the first stop on our tour of Tuscany. Once upon a time (in the 1200s) it was Florence’s rival city, but after the black plague killed off many of its citizens, Florence permanently became the superior city. Still, Siena is still a great place to experience medieval life.

The narrow streets of Siena:

siena

At the heart of the city is Il Campo, a plaza in the center of the city that spreads outward and forms an amphitheater of sorts. Both locals and tourists gather here all day long, and it really becomes packed in the afternoons and evenings.

ilcampo

The highlight of Il Campo is the Palio horse races of the summer, where the 17 neighborhoods of Siena are each represented by one horse and rider in a no-holds barred horse race. While we missed the race by one week, we did see the celebration honoring the winning neighborhood. Il Campo quickly filled up with people our first night there, and we took a seat to watch the craziness unfold.

Different groups and schools and clubs rode by on floats, and at one point a large group of little children monks (or something like that) marched by. They thought it’d be fun to throw hard candy at the spectators, and one landed at our table. To return the favor I thought it’d be fun to throw one back at them, but when I did it accidentally hit one of the mini-monks in the face, who then fell down. Oops. You know what they say: when in Rome…um, take out one of the Romans? (Then make sure to get the heck out of Rome.)

palio

In the final moment of randomness, someone ran by and threw a piece of dry ice into my water.

Tuscan Food

“Farm to table” dining, such a fad at home, is the de facto culture here. All food is local and fresh, and the cuisine is always seasonal. The region’s specialty is wild boar (cinghiale) as is thick spaghetti known as pici, which pair well with each other. Other local specialties include all sorts of cured meats (salumi) and white truffles; upscale restaurants will offer this delicacy by shaving it directly above your pasta. Pricey yet tasty!

foodmontage2

By the way, peoples, the pasta photos on the bottom right nearly cost me my life, reputation, and dignity. I wandered into a small pasta shop and started snapping away pics of their exotic pastas. Immediately an angry Italian old man grabbed me and dragged me to another part of the store with a sign that said “No Foto”. I apologized in a mix of English and Spanish (I don’t know, I just did) and started walking out. At the entrance to his shop, just before kicking me out, he loudly and passionately scolded me in Italian, complete with angry hand gestures and probably lots of profanity. My dad accidentally walked into this mess too, and after our 5-minute royal chew out session was over, we both walked away with our heads down in shame…but secretly laughing under our breaths.

Shopping

My dad, brother, and I walked into a shoe store and ended up buying shoes…the same one. All three of us.

shoes

(I’m the skinny hairy one.)

This puts that whole Swim Trunk Fiasco to shame.

Travel Journal: Florence

Welcome to Florence, the cradle of the Renaissance and the cultural capital of Italy. Compared to Siena it’s a much bigger and more bustling city…and much hotter. There’s not a day that passes that I don’t soak my shirt in sweat. And I thought Cuba was bad.

Italian Fashion

People at home routinely mock my impeccable fashion sense. One person in particular, let’s call him Mitul – because, well, that’s his real name – likes to give me grief about the length of my pants, calling them too short. What’s the point of awesome socks if people can’t see them?

Anyway, within my first few minutes of arriving in Florence I saw this dapper guy:

shortpants

When the town floods, this guy will never need to worry about wet pant legs. I’ll now return back home with renewed confidence, and who knows…I may even let my ankles go commando too.

Uffizi

The Uffizi Gallery is the jewel of Florence’s cultural crown, full of Renaissance art. It is a huge U-shaped gallery on two floors, and it takes several hours to go through it all. Michelangelo, Leonardo da Vinci, and Raphael all have their works displayed here. The artists, not the ninja turtles.

Unfortunately, my knowledge and appreciation for art is limited, but I’ve included some of the more interesting pieces and what I feel their names should be:

“Disco Fever”

discofever

“I Should Photoshop His Face”

uglybaby

“Importance of Checking for Diabetic Foot Ulcers”

footulcers

And finally this one:

notmadonna

Why this painting? It’s not particularly well known, but after 100 paintings it was a refreshing change of subject material. After all, there’s a limit to how many portraits of Madonna, child, or Madonna and child I can handle…

David

We saw the world’s most famous naked man today. The statue David was created by Michelangelo between 1501 and 1504, and represents the biblical hero (as in David and Goliath.) We went to the Galleria dell’Accademia to view it, but after yesterday’s tiring journey inside the Uffizi, we wanted to go straight to the good stuff. Bypassing all other statues, we looked only for these signs:

davidsign

When we finally reached it, it really was incredible:

david

Photos never truly reveal the size of this great statue, which is close to 14 feet high. It’s actually quite amazing to think that this was created from a single piece of marble…a mediocre quality one that Michelangelo didn’t even select himself. Most impressive is the anatomic detail (especially considering how it was formed by chipping away with a hammer and chisel), in particular the veins on the back of the hands and arms.

daviddetails

The Uffizi gallery? Meh. But this was absolutely worth it.

No to Mafia

Walking down the street in Florence, I came across this:

mafia

I figured I should support them. In general it’s good to adopt a No On Mafia policy.

Favorite Italian Meal

Italian food…I’m sick of it. Really, I just can’t take another spaghettini alla this or pomodoro alla that. While Italian cuisine is tasty, I much prefer flavors that are more powerful and pungent (i.e. the foods I bring to work for my lunches everyday.)

Our last night in Italy, all of us felt the same. Thanks to a quick search online, we were able to eat the best meal of our trip to Italy: chicken tikka masala.

Travel Journal: Hanoi

Chào mừng! (I hope that means “welcome” in Vietnamese.)

Continuing eastward on my journey, I am now in Vietnam after a very lengthy 12-hour flight. I plan to explore the country from north (Hanoi) to south (Ho Chi Minh City), with plane, train, and automobile…and the occasional boat. For you visual types:

vietnam_overview

But first, a brief rant…

Rant

Delta Airlines: you’re awful. After waking up at 4am to take a train from Florence to reach Milan for my flight to Vietnam, I couldn’t check in at the airport. An airport customer service rep looked up my account and noticed Delta inactivated all my flights for the remainder of my trip. That’s certainly a new one. She called Delta and was put on hold immediately. (Meanwhile, she asked me if I happened to knew of a better number to reach Delta at!) After 15 minutes on hold – an eternity, when minutes are being counted – she finally reached someone who sadly couldn’t help us. Not because my situation was unusually complicated but because Delta didn’t pass 5th grade geography. Our side of the conversation went as follows: “Hello I’m calling from Milan International Airport and…yes, Milan…Meeeeelan…no, it’s in Italy.”

Ultimately I did make it to Vietnam – with only minutes to spare – but not without newfound resentment for Delta. Anyway, once I was picked up at the airport by my driver I forgot all about my troubles.

mrsamir

Food

Vietnam is often considered the culinary capital of Southeast Asia, even though Thailand tends to receive the mainstream attention. Touring the country from top to bottom will therefore offer a sampling of the country’s regional cuisine and, in turn, their culture. I’ve long felt the best way to learn a culture is through food, and so I’m excited to try everything from street stalls to upscale restaurants.

Vietnamese food can be characterized as “fresh and light”, neither of which are terms typically used to describe Asian cuisine. Their dishes are filled with piles of fresh greens and other fruits and vegetables, and the streets are packed with women transporting greens on their back, selling them, or cooking them right there on the sidewalk.

streetveggies2

Don’t worry they have meat too, although the USDA would probably have a few questions about this setup.

meat

Here are some other food highlights.

Pho

Vietnam’s most well-known dish is pho, or noodle soup with thin slices of meat and handfuls of fresh greens. It’s pronounced “fuhh” – like “fun” without the n – and not “foe”. Great pho depends on great broth, which involves many hours of cooking. Walking down the street of Hanoi smelling the aroma of pho is very tantalizing.

Even though I generally prefer other Vietnamese dishes, I certainly don’t dislike pho so my first goal here was to get a bowl. I ended up at Pho 2000, a local chain. (Yes, goofy name but sit tight.)

Simple as it may appear, it was…pho-nomenal! I was afraid the clear broth meant it’d be devoid of flavor, but not at all. This wasn’t their first time doing this.

pho

Also it turns out that then-president Bill Clinton ate here in 2000. What the pho?!

(That too marked the first time an American president visited Vietnam since the war.)

clinton

That’s now three times I’ve followed Clinton: first for beer in the Czech Republic, then hot dogs in Iceland, and now this. Where will he lead me to next?

Street Food

If food is being sold on the street, chances are I’ll be standing in line for it. Lucky for me, Hanoi is known for being one of Asia’s great cities for street food.

“Restaurant” is a bit of a stretch for what these places are. They’re more like one-room shops where the food is being cooked in the corner or in front of the shop. In Vietnam they all have a propane or charcoal stove and seating is a table or tiny plastic stools. Most feature only one or two dishes that they have perfected and sell for ridiculously low prices. It’s a wonderful thing to walk in, take a seat, and soon have delicious food placed in front of you, all without saying a word.

My favorite in Hanoi was this place, which I ate at three times:

restaurant

They serve only bun cha, very flavorful grilled meat with rice vermicelli noodles and a mountain of fresh greens. I wasn’t familiar with this dish before this trip, but I am a loyal fan now.

buncha

That bowl in the upper right isn’t rice…it’s chopped up chilies and garlic, and you know I loaded up on it. Although I had fierce garlic breath – and a churning stomach – afterwards, it was well worth it.

By the way, their “menu” is simply this poster on the wall:

menu

The conversion rate is 1 USD to 20,000 dong, so bun cha is $3, beer $0.75, and water $0.50. Yes, beer is less than $1.

It’s Communist, but…

Vietnam’s political system is communist, and there’s no confusion there.

flags

(Any place you see the Vietnamese flag (star, on the right), you’ll see the old USSR hammer and sickle flag next to it.) Their economy, however, has realized the benefits of a free market and thus capitalism is thriving here. And everyone is out to make a quick buck.

Case in point: when I landed in Vietnam I saw a non-official taxi driver approach an unsuspecting tourist asking if he wanted a taxi. The rogue taxi driver flashed him a ID card with a phony logo of the city’s official taxi company, so the tourist believed him and hopped in his taxi – his plain unmarked van, that is. Then, instead of being charged approximately 150,000 dong, the poor sucker was charged 700,000 dong.

In case you can’t tell, that poor sucker was me.

Halong Bay

I took an overnight trip to Halong Bay, a beautiful bay with more than 2000 limestone islands popping out of the water. It’s a UNESCO World Heritage site, and with some others we hopped aboard this boat:

boat

One of the islands had a small temple at the very top that you can reach, but only after climbing up 430 steps. Normally that’s doable, but in this unbelievably hot and humid weather, it was grueling. Here’s a selfie from the top:

myhead

A fun — but damp — trip. Nothing ever fully dries on a boat. Come to think of it, I don’t think I’ve worn dry clothes for a month.

grouphalong

Travel Journal: Hue and Hoi An

Moving down to central Vietnam, I visited the cities of Hue and Hoi An. (By the way, I strongly recommend against anyone taking an overnight sleeper train in Southeast Asia. You won’t sleep a wink due to the constant stop-and-go, and people knock on your door every hour to sell you beer.)

Hue

Hue (pronounced “way”) was the former capital of Vietnam during its imperial years. The capital has since moved to Hanoi but Hue is still filled with palaces, pagodas, temples, and this citadel:

citadel

This large citadel also features that large flagpole…in fact, it’s the largest flagpole in Vietnam. Why are communist countries so obsessed with having huge flagpoles? That’s right, I’m looking at you North Korea.

We also visited the Thien Mu pagoda, the largest religious building in Vietnam. They enforce a strict dress code, including no showing of the knees. I would have worn my blue jeans but it’s so unbelievably hot here that I almost passed out from heat exhaustion when I tried them on for a few minutes as a test. Instead I bought these very lightweight pants that went just below my knees. Here I am, sporting them in front of the pagoda:

pagoda

Yes, they make me look irresistible. Please try to control yourselves.

This pagoda also houses the Austin vehicle that transported the monk to the site of his 1963 self-immolation in Saigon, in protest against the government’s regime. As soon as he stepped out of the car, he assumed the lotus position on the street, doused himself with gasoline, and lit himself on fire. He never moved or said anything, which led to the famous photograph. (Of note, his heart remained intact and did not burn.)

austin2

On a less morbid note, motorbikes are everywhere in Vietnam, and I mean everywhere. The country has approximately 90 million people and there are close to 40 million motorbikes…compared to only 2 million cars. The streets are congested with motorbikes, and every time you cross an intersection it’s like playing a game of chicken with 10 motorbikes driving straight at you. And they certainly cram as many things onto them as they can: children, animals, and even other motorbikes.

motorbikes

After street food, the other thing I can’t resist when I travel is getting on a motorbike. I did that this time too and got a nice tour of the city. Along the way I got a hands-on lesson how to make incense sticks and also saw an old American bomb that had been cut in half and turned into a boat.

motorbiketour

It’s too hot to talk anymore. I’m really not cut out for this weather. Luckily my hotel room has great air conditioning…and this beautiful view.

brickwindow

Hoi An

Hoi An is a beautiful and quaint city oftentimes described as “delightful” and I agree completely. It has interesting architecture and a river that lights up at night with thousands of lanterns. Here’s a panoramic shot that doesn’t do justice to the view.

panoramic

I spent four days here where I roamed their massive marketplace, bought a tailor-made suit, took a cooking class, found my favorite street food thus far in Vietnam (I may have eaten there three times), and went on a great bike ride through the city’s outskirts. On the bike ride I lucked out and was able to interact with some local farmers…who put me promptly to work:

watering

Another proudly showed off his water buffalo to me. He wanted me to stand on the animal to show how strong it was, indicating he was a successful farmer. I was a little afraid of this giant beast, but it turned out to be a gentle giant.

boof

If you have the opportunity to visit Vietnam, definitely do not skip Hoi An.

Introducing Nigeria

Time for another adventure, peoples. This year brings me to Nigeria and for the first time I will mix business with pleasure. I will be participating in the Nigerian Cardiovascular Symposium, a conference brought to my attention by a colleague, where the plan is to implant devices – both pacemakers and defibrillators – and also give several lectures.

Nigeria isn’t exactly the safest country at this time, and so the list of things that threaten me on this trip is a little longer than the usual my international escapades. Here’s a brief rundown:

Travellers diarrhea

Nothing new for international travel, but a recent discussion with one of our Infectious Diseases doctors frightened me into loading up on multiple antibiotics, just in case. Ain’t nobody got time for loose movements.

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Zika virus

I have no plans on getting pregnant there, so I’m probably safe with this one. Some microcephaly may actually improve the size of my head.

Terrorists

Boko Haram is no joke. Every time I forget about them, they surface again in the news in frightening ways. Luckily the part of Nigeria I will be in is quite far away from where they operate.

Nigerian email scammers

Prior to preparing for this trip, my only connection to Nigeria was that a few years ago I found out I was the recipient of a very large fortune due to the untimely death of one of their royalty. I kept in touch via email with a very polite Nigerian prince telling me how to cash in on this event. However, the next thing I knew I had lost $50,000 and had no fortune to show for it. Turns out it was all a scam … who knew.

In all seriousness, as I was applying for my visa, the list of required documents – as instructed by the Nigerian embassy, mind you – included the following:

  • Letter of invitation from the host
  • Hotel reservation confirmation
  • Evidence of funds to cover stay in Nigeria (letter from bank etc.)

Invitation letter: check. Hotel confirmation: check. Evidence of funds…wait, what? This sounded suspiciously similar to the hundred scamming emails I’d received in the past. I reluctantly sent them a screenshot of my bank account with appropriate parts blacked out, but I still had a very uneasy feeling. Luckily I have yet to receive a response along the lines of “I know this message will come to you as a surprise but I am a well known wealthy business man…”

nigerian-scam

See you all on the other side.

Travel Journal: Nigeria

Hello from Lagos!

Lagos is not only the largest city in Nigeria but all of Africa. I am here to participate in the Nigerian Cardiovascular Symposium, which involves implanting pacemakers for the first two days, followed by participating in the conference for the next two.

Vaccination and Corruption

Upon setting foot onto the airport in Lagos, I was greeted by a large sign announcing the country’s efforts to eliminate corruption. It stated “If you see it, text it!” meaning to text the government with details of the incident. Little did I know that soon I’d have a good one for them.

The first line I stood in didn’t make sense. There were no signs for passport control, customs, or security. As I approached the front I noticed all the Nigerian citizens were quickly passed through but foreign visitors like me had to stay behind at a podium. Apparently it was a line to confirm yellow fever vaccination. Since multiple sources informed me beforehand that this was not required for entry into the country, I did not get the vaccine.

I told this to the woman, who then gave me a sarcastic response and had me stand there as she kept waving others through. Only once everyone from our flight had passed, she closed all the doors to this hallway, shutting us in, and then told me “What can you do for me?” Excuse me? So she repeated, “How much can you spare?”

Ah hell no. I told her “I’m not paying anything” and there we stood, silent, in a deadlock for 15 minutes. She kept pretending to read her book while I kept staring into space. During this time I started looking through my yellow vaccination card and noticed an amusing surprise – I actually had been vaccinated for yellow fever back in 2013! I eagerly showed this to her and she turned it down, the excuse now that its stamp wasn’t in the right section of the card. These people are ridiculous.

At this point I lost it and demanded to see my friend I was traveling with. We were reunited and he laid into her in their native tongue, saying how we were there to teach the locals and perform medical procedures.  She finally conceded and let us pass, noticeably ashamed for what she did. What an introduction to the country.

Had I remembered that phone number for the government, I would have sent them a very strongly worded text.

Pacemakers for All

Perhaps not all, but for four.

The healthcare system in Nigeria is in near shambles. A few select hospitals have acceptable facilities, but the vast majority has close to no resources. There are limited medications in their pharmacies, and anything more hi-tech like ECGs or echocardiograms are a luxury; cath labs are a rarity, and electrophysiology procedures are essentially non-existent. The only time a pacemaker is implanted is when a cardiac surgeon makes himself available once a month or so.

Thanks to generous donations from Biotronik, as well as Medtronic, we had the pleasure of implanting several pacemakers and defibrillators in patients here. We loaded many huge duffel bags full of devices and equipment in the van and headed to the hospital an hour away.

loadingvan

The local cardiologists had a surprisingly difficult time finding patients who needed such devices – if patients felt well they didn’t think they required treatment for anything. Even if a patient had complete heart block but didn’t die from it, they’d be convinced they must be healthy.

With four patients and four EP’s, we each performed one case. The lab was surprisingly modern, although many supplies such as scrub soap, sutures, and even surgical drapes were still limited.

eplab

My patient was a middle-aged man who was overjoyed to be getting his device and very grateful that I would be implanting it … I was quite honored especially considering we had never met and I clearly looked like a foreigner.

intraop

The implant went smoothly and safely, and he remained very happy. Here I am with some of the team.

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This Nigerian Life

While I have seen some unusual sights (random men with machine guns walking along the highways) and eaten some unusual foods (snail stew, surprisingly tasty), it has been enjoyable here.

However, since kidnappings, car jacking, muggings, and burglaries are common in Lagos, security is extremely tight. Entry into the hotel grounds requires passing through a heavy gate where they inspect under the hood, look under the car, and check for any radioactive material around us. Inside the hotel there is a security guard on each floor 24 hours a day.

Almost Famous

While walking to dinner, one of the hotel staff approached me for and we had a short but interesting conversation:

 

Him: “Do you play ball?”

Me: “Depends. Which ball?”

Him: “Football”

Me: “American or soccer?”

Him: “Soccer”

Me: “No”

Him: “So American football?”

Me: “Um, definitely not.”

 

He then proceeded to tell me that I look like a well-known European soccer player, which was pretty flattering.

This topic actually became a recurring theme with multiple hotel staff. For example, the security guard on my floor told me on my first day here that I look like a famous soccer player (different from previous guy). And now every day when he wishes me good morning, he calls me that guy’s name. We both share a good laugh together, with me feigning that I know exactly who he’s talking about, and then I get on my way, still confused who he thinks I am. Every day … same thing.