Home.
So today I attended the meeting (see my work blog), reviewed a journal article and then hit the streets. I haven’t done much walking since I got here, and I thought it reasonable to get some exercise, so I figured that I would walk down the Malecon, to Havana Neuvo and the on to Havana Viejo. The Malecon is the seawall that borders the Florida Straight. It is very windy, and usually has waves washing up from the North, splashing over the Malecon and onto the highway. It is a popular spot to stroll, an excellent spot to sit with your girlfriend or w
ife (but not at the same time) and an interesting place to walk, since, if you are not careful, large waves can get you wet as you walk along. First, I headed west, to inspect by daylight the US Interest Section in Cuba (or which we spoke last night). It is impressive- both the building and the amount of time an energy that the the Cuban governement has but into “suppressing” its message. The “Jose Marti with Child” image is also powerful.
high rent district. There, is was the Havana I remembered. Old, overcrowded building in ill repair, with makeshift fixes holding them together. People carrying bags of rice home on their backs. Neighborhoods that needed work. Even in those places, however, there were spots of renovation and hope- a building under reparations, a new paint job. Something that gave you hope.
ing. Things looked pretty prosperous, near the National Theatre and the Capitol (pretty buiding). I turned East, toward Old Havana. A few images:
So on the workblog, you have already heard that this was the day of our talk, which went well, and generated lots of interest from the folks who heard it. Ironically, you may be reading this after I have returned home-turns out that the hotel is out of Wireless Cards and doesn’t know when they will get them in again. So, I will save things to the hard drive and upload them when I return.
checkpoint along the way. I sat on the bus with Valerie and struck up a conversation with a student from Virginia, an enthusiastic African-American woman who was really enjoying her experience so far in this environment. She told us that students really had little access to Havana; some trips, but most of their off campus activities were focused in a small town just west of campus. Their curriculum included a substantial bit of work in the social sciences- history, English, literature, political economy (a concept rarely mentioned in the US) and physical education (mandatory), and focuses on creating doctors with social engagement. That on top of the same s
ciences and skill based learning that we use. No wonder it takes 6 years. The campus is big and new- we were greeted by representative of each “delegation” in costume and flag, and ushered into an auditorium for video and speeches, with singing and dancing and a reception in the hall in which they display the gifts sent by the various family to the school in thanks for the free medical education. The underlying theme of all of their education is that the practice medicine is a social good, and that the practictioner is obliged to bring that “good” back to their roots, to the community from which they came. They claim a very high rate of success in placing doctors in underserved communities, although it is early and it will be interesting to see if the doctors stay “down on the farm” once they have seen the wonders of the city.
Great idea; I wish that we could have dispensed with protocol, and visited some classes and laboratories. In this time and place, however, that is not the way in which it is done.After the tour, I met up with a group of folks in the lobby to got out eating . We ended up in La Torre, a restaurant high atop a tower, French and expensive ($30 for dinner, the most I have paid yet), with spectacular views of the city and fort. Our guide was was Rob Huish, a Canadian, who has been studying the development of ELAM and has visiting Cuba 16 times in the last 7 years, for up to 5 months at a time. He told us the story of the US Interest Section Scroll, blasting FOX news at the people and blocked by 100 flagpoles, arock concert stage and the statue of Jose Marti saving the children in response to Elian, 
and the Miami 5, imprisoned for espionage because they were spying on anti-Castro groups on US soil (the spying was there- but the target was not the US government- is that espionage?), and even the building in which we were eating (built 30 stories high without the benefit of a crane and considered to be an ugly marvel of civil engineering, but formerly occupied by nests of vultures) . Great dinner, great conversation, great views (and a really nice Chilean shiraz).
Yesterday, I woke to the sound of the ocean (my window looks out at the Malecon and the Straits of Florida), and wrote for a long time- hence all of the posts yesterday. Today, we present- I stayed up late honing our talk into a 10 minute work of polished beauty, and then watched a bit of season 3 Buffy before going to sleep (vampire Willow is indeed awesome) Today’s post will be a bit shorter, as we present in 2 hours. But I wanted to get something out there.
implementing the vision of socially accountable medical schools was complex in our capitalist environment, and that we probably would have to move in baby steps in the US to achieve his vision. He also expressed dissatifaction with the COPC model in practice, and discussed his meeting long ago with the Karps (the folks who invented the idea). He has found it difficult to “stick to the method” of analysis that first proposed, and sees a role for the differing expertise of the MD and the MPH skill sets in caring for individuals and populations. Fun lunch. The oral presentations in the afternoon were interesting: I had trouble following the ones in Spanish, and the ones in English largely seemed to be works in progress, interesting work, but no real data presented to support it. Perhaps today will be more data driven (of course, our talk is more descriptive as well, so a least we will fit in well).
Bob and Linda were going to Chinatown for dinner, and, since I couldn’t locate Valerie, that seemed a reasonable thing to do. The idea came from 2 others they had met, Vaugn and Helen, from Miami and Washington, who were presenting some work on teaching Genetics-oriented family history. The ride to Chinatown was long and complicated, and the Chinatown here looks a lot different than what I envisioned- not at all like San Francisco or New York. Narrow streets, few lights, no signage. But the “Lotus Flower” restaurant lived up to its billing, serving Cantonese food with a Cuban flair. We had a nice sangria with dinner, and good conversation about the
upcoming inauguration before piling back the the Cab to go to Moro Castle at night for the 9 PM cannon firing, a tradition that goes back to Colonial times. The cannon called the people into the fort before the closing of the city walls, and also afforded an incredible view of the city at night. Well worth the visit.
We arrived and cleared customs with little fanfare. The drive in showed a fewer billboards and fewer old cars than I remember- I think that some of those cars from the 1950s are finally giving up the ghost despite the tender loving care that they have received over all of these years. Billboards have been replaced by murals- slogans and pictures painted onto the walls, extolling the revolution and all of its works, exhorting the people to work harder and conserve. The buildings on the outside of town are in disrepair; the quality and upkeep increased dramatically as we got closer to the center of the city. Our hotel is gorgeous; the Nacional is an old hotel, with lots of wood and a gorgeous back yard with a view of the Malecon. Not shabby at all. More to follow
So Sunday was arrival day. We got to the hotel at about 10:30 in the morning. I was sort of exhausted when I wrote the above, since I spent the night in Miami airport awaiting the 4 AM wake up call at the airport and hadn’t slept in 24 hours on arrival. My room was not yet available, so I registered for the conference, and sat out on the “backyard”, an enormous greensward with comfy chairs overlooking the ocean. Changed money: they had suggested that we bring Canadian Dollars or Euros as the Cuban government extracts an extra tax on the conversion of US Dollars to Convertible Pesos (the currency of the tourist), which in the Communist tradition, is different than the money of the locals. So, figuring in fees and stuff, 1 CUC is worth about $1.26 at present, the way I did it. Chatted with a couple from North Carolina who had found the secret to online access at 8 CUC / hr via the business office. I resolved to do that daily, and hopefully I will continue to do so. Wrote the above paragraph and then got tired and hungry, The folks from NC had been here doing research for the last 4 days, and they recommended a pizza place in Vedado, so off I went in pursuit of pizza.
Things appeared to be in better repair, to some extant, than they were last time I was here. I have yet to spot a wooden park bench. Coppellia (the ice cream place) still has a huge line of locals waiting in front of it. I am told that foreigners get to cut to the front of the line, which is probably enough “privilege” that I won’t do it. The architecture is still gorgeous, whether in ruin or newly repaired. Many of the homes are still divided into multiple apartments. Laundry still hangs on otherwise classy looking balconies. Old cars have now become the byword of Havana, and it was unusual to see a car with fewer than 6 riders- people here share rides. I haven’t spotted a “camel” bus yet, and the Metrobus fleet has a bunch of relatively modern looking “double” buses. People were out walking on Sunday afternoon. Nancy, an epidemiologist from NEOUCOM with who we shared a ride on the way in, noticed few children on the road on the 
way in; I found them all wandering around down the Malecon, laughing and playing clapping games and flirting (the 13 and 14 y/o kids in particular) and making fun of each other. Cubans seem to be very upbeat folk, at least on a Sunday afternoon when the sun is shining. Many pedicabs- all trying to get me to take a ride to a house somewhere where I could get “comida typica”, a typical Cuban meal. Apparently many Cubans have converted their homes into restaurants, as a way of augmenting income.
that I will write about the opening in the other blog, but there were a lot of people there, and we did have a lovely flute interlude by Nunca Gonzales Nunez, an audio clip of which may embedded here, if I can figure out how to do it. Afterward, we wandered to a Restaurant called El Conejito, which really did had a lot of rabbit on the menu. We ate with two intensivists from Pennsylvania, who were here because a friend from Swaziland invited them to come, (and then couldn’t make it themselves). I had a pork dish with ice cream for dessert , beer and Café Cubano, for about CUC 12 ($15), which was good but not great, and went home happy and sleep. Took lots of pictures today. Not sure how that will go tomorrow.
The flight to Orlando and then on Nassau was uneventful. In Nassau we began meeting the group that was to become our traveling companions. First was Alan Meyers and his wife Gail S. They are from Boston City Hospital and the Boston Visiting Nurse Association respectively. Alan has much experience in Nicaragua, Salvador and Guatemala, both as a health care worker and observer of health care systems. In addition to that he is a strong patient advocate within the Boston City Hospital system. Next, Tom Whitney and his wife Alison joined us. Tom is a pediatrician from Maine who set this all up. It turns out that he was a resident under Evan back in Rochester many years ago and knew a number of people that we also knew. The rest of the folks arrived in spurts. We had many interesting conversations regarding antecedents.Wonder how much it has changed? We will see. Still isn't easy to get there, I can tell you that. I will be trying to blog stuff relevant to mental health on the other blog, and more touristy stuff on this one. We will see how that works.
We then began the rather lengthy process of checking in so that we could board our Cubana airlines TU154. I was a little concerned because this a Soviet made plane, but I reassured by several people that the Cubans keep them in good condition. We walked out on the tarmac and I took several pictures of the plane. We then entered the plane. No assigned seating. No first class seating (Viva the Revolution!). The seats were soft to the point of being uncomfortable but the flight was, in general, not unpleasant. The beer was free as were the Canadian peanuts. We sat next to a Canadian from Toronto, Jim Sorenson. He works for the Delta Hotel Company, which is apparently Canada's largest privately owned hotel company. They run hotels in Canada, the Far East and Cuba. He has been involved in Cuban affairs for about four years and has been coming down here one to two times a month for the last year and a half since his firm opened the first of what are now five hotels and resort hotels on Cuba.
While waiting for this flight, I should mention that our tour guide, Vivian, recognized Stokely Carmichael, also known by a Islamic name at present, waiting in the airport lobby with his foot propped up. I asked her if to ask him if it would be okay if I took his picture and he agreed. His foot has what sounds like severe claudication and he was on his way to Cuba so that the Cuban doctors could help him with his problem. On the airplane, we heard of another man sitting one seat over from us who had retinitis pigmentosa and was going to Cuba for treatment of this condition. When I went over to take the former Mr. Carmichael's picture, I told him what an honor it was to meet him in person and that I was happy to see that there were still people for whom the dream had not died, even in these days of Gingrich. He replied that Mr. Gingrich was going to be, in the long run, making radical change much more possible by making conditions for real people in the United States much worse.
We landed at the airport and went through Customs and Immigration. Waiting for us at the airport was Rachel Cohen and a doctor from the Department of Public Health who helped to arrange the itinerary for our trip. We saw the itinerary which includes opportunities to visit the Children's Hospital, a facility for long-term care of children with leukemia from the Chernobel accident in the Ukraine, a visit to a school, and other real neat-looking activities. We then collected our luggage and went outside the airport to get on a bus to go to our hotel.
A few random impressions from the bus ride: First, the bus was made by Mercedes-Benz and was very comfortable to ride in. The driver did not seem to have a delayed windshield wiper setting and had to manually turn the wipers on and off. The road was a divided highway with two lanes. The lane closest to the edge was generally for a bicycle, motorcycle or occasionally a car. Whenever a bus came up on a car moving too slowly in the second lane, he would flash his lights and move on by him. The speed limit on the road was 90 kilometers/hour. The cars driven on the road were either new Toyotas, Mercedes-Benz or Japanese cars, or old cars held over from the revolution. We saw one vintage Dodge stalling repeatedly while attempting to execute a three point turn. This was in keeping with Mr. Sorenson's description of Cuba as a place that was frozen in 1959 and desper-ately needed fixing up. Apparently, the supply of automobiles is so limited that these vintage cars are driven "into the ground" under conditions in which we would not usually drive them. The bicyclists wore no helmets and often bicycled two a cycle in order to get through the streets. This was observed at approximately 8:30 or 9 o'clock at night on our ride to the hotel. We had been transferred into a new facility that is still in the process of being built. Our rooms are very nice although there isn't very much storage space. We were the last to get our keys and when we got down we went straight over to dinner at about quarter of ten. The restaurant, actually the hotel, was willing to make dinner for 18, even at a late hour. I had some sort of Royal Chicken with rice and beans. A good meal marred only by the fact that Julie couldn't get her meal for a long time.
A couple of other thoughts about the state of things in Cuba. On our drive to the airport, we passed three cars that were pulled over to the side of the road changing flats. While this may be chance on the part of the Cubans, it is also possible that repairing old equipment is becoming increasingly difficult within the Cuban system.
Anyway, we then quickly unpacked and went out to dinner. The food was good but the service was terrible. We reviewed the plans for tomorrow and talked until about midnight. The folks at the restaurant clearly had difficulty with organization of the menus as well as difficulty figuring out where our bills were. It ended up costing about $10. each for a very good dinner of chicken and rice.
I don't know if I mentioned earlier, but in addition to the many bicycles we saw heading home at 8 o'clock at night on the road, there were motorcycles with side cars as well as vintage automobiles. We saw three cars with flat tires and several cars pulled over the side of the road with their hoods up. In one instance, we were stopped beyond a Dodge that was about 40 years old and was trying to turn around on the street, and kept stalling as it moved through the three point turn. The infra-structure is clearly aging. The hotel is a new hotel, just finished being built, and much nicer than we thought it would be.
concert in Bad Tatzmanndorf today, that it was well received, and that Austria is a really pretty country. No pictures tonight- much to late. See you all soon.
So, on our last day, I decided to forgo the prepaid breakfast at the hotel and head over to Café Landtmann before leave for our next choral engagement at 10 AM. A short time to linger in a timeless café, but I realized that I had yet to do so on this trip. I’m typing this on the Underground, which is a very efficient way to get around Vienna. So efficient, in fact, that I am certain that I won’t finish before I get there. Still, kind of cool thing to do.
the one where Mozart premiered the Requiem, with an organist who is a published composer. But no pressure. We were to sing 5 pieces, two of which we had yet to perform, and the dress rehearsal, at 9 AM was rushed, and frankly worrisome. But when the service started, the priest was so warm and welcoming that we could hardly do a bad job. The organist borrowed my music and riffed on "Oh Lord What a Morning" for the opening, after which we sang it as well. (I was fine with that one off book) "Saints Bound for Heaven" went well and "Daniel" rocked in that space. But it was the Lauritsen that soared. "O Nata Lux" seems especially appropriate in a beautiful old church. The last piece, "O Sacrum Convivium", a modern work by a Texan composer, went well and I think that the merging of the threads of American spirituality in a sacred space of centuries duration worked really well. Andy seemed happier after the concert than before.
Loop"- 30 km around a section of the river and an island that has turned half of the Danube into a swimming lake. Everyone was at the beach- we ate at a cafe overlooking the beach, road through family cookout and nude sunbathers (the Austrians are a bit more liberal about these things) and got tired riding against the wind. In the evening, a group of us went to the Arbat (I think) restaurant, to far from our hotel for the best meal that I have had in Vienna. All in all, a satisfying day.
This tour is divided in half by the wonderful performance on the 4th of July. On Saturday, we bid farewell to the rest of the Robert Page Festival Singers while we waited to be transferred to Hotel Ananas- closer to town, but it would have been easier to stay in one place for our whole time in Vienna. After stepping into a nearby phone booth, we instantly transformed into the the Blackstone Valley Chorale, with an urgent rehearsal at the Universitat of Music- wonderful rehearsal space that included a piano that Andy wants to sneak home on the plane. Our goal was to prepare for a concert in Berndorf on Saturday night with a completely new repertoire, heavy on the spirituals and "new music" that characterize American choral music: “Hard Times”,”O Nata Lux”, “Roll Jordan Roll”, “Bach Again” and “Didn’t My Lord Deliver Daniel” alone, and “Locus Iste” and “My Lord, What a Morning” with an Austrian choir (Chorgemeinschaft Berndorf-Veitsau, a local group had coordinate activities for us) We did OK in the rehearsal, but we had forgotten some of the work we had done back in Whitinsville. Andy worked us hard, then we hopped on the bus, to visit
a few places before hotel check in.
between the classical and the pop world is less rigid than in the States. Our performance was good, not great. “Hard Times” we have down. “Roll Jordan” was exceptional, I thought, and “O Nata Lux” reverborated nicely within the dome. The joint pieces were worth waiting for- the song was rich and full, and made “Locus Iste” really fit into that time and place. There were lovely speeches of greeting and Fellowship, all and all adding up to an almost 2 hour program, with no intermission. The people were very happy with us- many joined us for the after show entertainment.
My instant reaction to last night's concert at Stephansdom was recording on the BVC blog last night- I was hoping for a more sober reflection by light of day. It seems that it takes longer than that for the glow to wear off- I slept soundly and woke still filled with the glow of having been part of a beautiful thing, so you all will have to bear with me. For the record, last night's performance was one for the ages. We rocked. But I digress...4th of July in Vienna began with no bang- I woke up at dawn, read for a bit, blogged some and ate a leisurely pace. Read the Declaration aloud to no one in particular, and prepared for a late departure into town. Everyone was clearly on edge about the impending 
It is a very weird thing, to be in Vienna twice within a 10 month period. Certainly not a bad thing, but it a little weird, in a good way. Technically, of course, I am currently outside of Vienna- but I digress.
rselves entering the large sprawling urban landmass that is Vienna.
the a little walking tour of the city.
ealand, and concerts are constantly being advertised. But we are definitely going to be a part of it.
at 3:30, come back here to change into performance garb, and then go back to the city. At least the internet is good.
n of World War II, and, white the State was providing them, homelessness was not a problem. I agree that they are eyesores, but then again, Budapest did not have folks sleeping on the streets in the bad old days. No cup is ever entirely empty. At the north end of Budapest, I entered a little towm square, that had not yet opened its shops and restaurants. The Budapest city limit is a small stream feeding the Danube. On the other side, I entered Hungarian vacationland.
is narrow, but takes you through the sort of primeval Danubian forest- dense vegetation that is used to being flooded regularly. The trail ended in the aforementioned bit of dirt biking that brought us into the town of Szentendre. I knew that I had arrived somewhere because there was a lot of traffic on the main road, and when I turned up to path, my way was blocked by a bunch of art students who set up their easels on the bike path. After the artists, I found this cute little medieval town with shops and cafes. I decided to stop for a bit, which turned into a two hour ramble.
reading this online- no hints) I also had a milkshake for lunch, and visited the Orthodox Church (Serbian Orthodox, but it sounded like Russian chant in there, and the signs were in Cyrillic). Sat in a café and read for a while, before I decided to head back to Budapest. Nice little town, and would be a good place from which to start a tour of that part of Hungary.
