Saturday, February 23, 2008

How did you end up in Saipan?

We all have it: the story we tell when someone asks, “How did you end up in Saipan?” I have a short version that goes something like this. “I always wanted to work internationally. I sent letters all over the world, ended up in Samoa, then a year later moved to Saipan.” It’s the version I tell when I meet someone. But I thought there would be some value in writing down the long version. The Saipan story is part of everyone’s Saipan experience, and it’s also part of my kids story of how they ended up in Saipan (actually, ended up being born and growing up in Saipan.)
I’m fascinated to hear the other stories out there, short, long or medium versions. So, I’m turning this into a game of tag. I’m tagging Angelo, Jeff, Boni, Bev, Brad and Bree to write about their Saipan stories. If you grew up here, what took you away, and why did you come back? If you just left, or are leaving, add that to the story too. Tag three more people to write their story of “How did you end up in Saipan?”
I’ve always wanted to work internationally. I grew up in a Bahá’í family, and there were two messages positive that infused my childhood. One was that the highest station for a human being was a life of service to others. The second was that it was a praiseworthy act to leave one’s homeland to serve in a place where one is really needed. The possibility of living internationally was something I grew up with. It was actually something I aspired to.
In the winter of 1992, as I was finishing my ophthalmology training, I was also in the midst of a huge personal crisis, wondering what would be the next step in my life. I prayed and meditated a lot, but I didn’t get very far. At the time, my sister, who is an attorney, was working at the Bahá’í World Centre in Haifa, in the Holy Land. So, I went there to pray and meditate some more, and also to have a chance to consult with some people who might have some insight to share with me.
My sister set up appointments for me to spend time with various individuals with experience all over the world. Many told me, “Oh, you must go to this place. The need is very great!” and depending on to whom I was talking, the place may have been Eastern Europe, Russia, anywhere in Africa, India, or South America. Finally, I landed at the desk of Don Rogers, a Canadian Artist who had been in Haifa for many years. He shared with me his own experience of being a struggling artists, and being told by his peers to stay in Canada and focus on his art, but he decided to let go of that paradigm, and managed to become an internationally acclaimed artist while still living where he wanted to live, and serving in the way he wanted to serve. When I asked him, “Where should I go then?” He said, “Send enquiries all over the planet. Give the Force some options to work with. (He actually said “Holy Spirit.”) You will be guided.” That gentle conversation in Don Rogers office at 4 Haparsim Street in Haifa turned my life.
I returned to Chicago, and began to send letters to NGO’s and Government Health Departments around the world – Africa, Asia, the Pacific, South America. But even though I was sending these letters, I was still hesitant. I wasn’t yet sure that leaving America would be my path, and so at the same time I continued to interview for the Retina Fellowships I had applied for earlier. My own residency program at Northwestern was holding a fellowship position for me, and needed me to let them know so they could pursue another candidate for the position if I didn’t want to take the spot. Time was running out.
I was starting to hear back from the hospitals around the world. Everywhere wrote back saying, “We’d love to have you. We cannot pay you a penny.” Thanks to my parents, I was lucky enough to get out of medical school without any debt, so I didn’t need a high paying job, but I did need to make some money. There were two places that could pay “subsistence” wages – a hospital in the Caribbean, and the LBJ Tropical Medical Center in Pago Pago, American Samoa. I found an ophthalmologist who had been visiting the hospital in the Caribbean every year for 20 years, and he didn’t recommend working there full-time. So, I was left with the job in Pago Pago. It was a bit familiar to me because seven years earlier, after my first year of medical school, I had spent a summer working in a dispensary on the outer island of Tau, and had spent a morning at LBJ.
But I still wasn’t sure if I should get further education or go to Samoa. It was winter, and I stood in a little bookstore under the El station in Chicago, opened a book, and on one page were the words, “Be bold and courageous. When you look back on your life you will regret the things you did not do more than the things you did.” That was it for me. I thought about those words and knew that I had to go overseas. I also realized that if I did a Retina Fellowship, I could get too specialized for the jobs available in developing countries, and I could also get stuck in America – stuck with a high-paying ego stroking job, a nice house, the white picket fence – the golden handcuffs. That night, I booked my ticket for Samoa. The next day, I let the fellowship programs know that I was withdrawing my applications.
I finished my training on June 30, and three weeks later I boarded a plane for Pago Pago. Tears welled up in my eyes as the plane left the ground. I knew it was big move. I was scared of the unknown. I didn’t known if I’d be coming back. “What am I doing?” I thought to myself.
The year in Samoa was phenomenal. There hadn’t been an ophthalmologist there in ten years, so I was incredibly busy, doing all kind of complex cases, and getting the kind of experience that people only dream about in their first jobs. It was also a year of discovery – I made some of the closest friends of my life there; I found my wife, Mara, there; and I found parts of myself and a new way of life there.
By the end of my year in Pago Pago my friends were leaving, some of the equipment was breaking down and there wasn’t a prospect of getting it fixed quickly. In the meantime, I had fallen in love with the Pacific and started to explore other possibilities – teaching at the medical school in Fiji, working in various health departments, etc.
Straub Hospital in Honolulu has a Pacific Island liaison office, and the liaison officer, Dr. Henry Preston, would travel throughout the Pacific touching base with various health departments. So he knew a thing or two about healthcare in the Pacific. When he stopped in Samoa, I asked him for advice on which countries or jurisdictions might be ready for an ophthalmologist. Many of the islands were, and are still, dealing with basic health care issues like immunization, and the resources are not available for more specialized areas like ophthalmology. Henry recommended I check out Saipan.
I had sent Saipan a letter in the initial round of inquiries a year earlier, but Saipan wasn’t ready at the time. This time, they were eager. So, in August of 1993, I took a month to travel to Saipan from Samoa, visiting hospitals and Bahá’í communities along the way in Fiji, Tuvalu, Kiribati, the Marshall Islands, Kosrae, and Pohnpei. It was a trip out of National Geographic.
I was initially hired by the CNMI government on a one month contract as a consultant – to treat patients, but to also look at ophthalmology needs in the CNMI. At that time, the place was flush with money, and the hospital had been bringing a couple of ophthalmologists here from San Diego, and paying them insane amounts ($500,000 for five weeks work – I saw the check with my own eyes). I offered to work full-time for half that amount, but of course, there were ceilings on government employees so that wasn’t a possibility, even though it made complete sense.
Anyway, my consulting contract was renewed a couple of times while the government worked to create a full-time position for an ophthalmologist, and within a few months I was hired as an employee of the Commonwealth Health Center with a usual salary.
I enjoyed my work there, and during those five years I built The Center for Eye Disease at CHC. It was fun. I published a couple of scientific papers, attended conferences at the CDC, and worked on public health issues. But, there was a limit in terms of how much I could improve things. The hospital couldn’t budget for the more advanced technologies I needed to raise the level of care, and each year there were worries as to whether or not funding would be available for my position.
By this time, Mara and I had decided to make Saipan home. (We had both left Samoa at the same time in August 1993, she heading off to Honolulu to start her Masters of Public Health, and me to Saipan. She moved to Saipan a few months later, in December and completed her MPH by traveling back and forth to UH. We got married here about a year after she arrived. That’s another very complicated, but happy story.) In making Saipan home, we realized that because of the funding issues it would be difficult to have a sense of security while working for the government. So we both quit our jobs (she was working as the epidemiologist for the Division of Mental Health at the time), and opened Marianas Eye Institute. That was ten years ago. And that’s the story of how we ended up where we are in Saipan.
I have a couple of other “Saipan stories” that I am asked about every month or so – “How did you come to open a school?” and “Four kids?!” Those stories are for another time.


Jeff said...

My monologue in the play deals with this subject, so you'll have to wait for the Play Buffet in two weeks.

The Saipan Blogger アンジェロ・ビラゴメズ said...

I kind of touched on this in a previous post. Should I get more specific?

The Saipan Blogger アンジェロ・ビラゴメズ said...

My short version is, "the planets lined up against me to bring me here and now I'm stuck."

Said tongue in cheek, of course.

Marianas Eye said...

Jeff, I look forward to it.

Angelo, I forgot about this post. Fill us in on the work stuff. What's the job that got you here, and what's the one now, the peeew thing?

Beverly said...

Thank you for sharing your story! It's always interesting to hear how everyone ended up here. I'm working on mine=)

Marianas Eye said...

I look forward to reading yours, Bev.

The Saipan Blogger アンジェロ・ビラゴメズ said...

I'm still thinking about this tag.

I'll be making a big announcement some time next week.

Might be a good time to answer your tag.

Marianas Eye said...

I don't like the sounds of this.