You're Going Where?! Travel & elective in the Czech Republic - Ed Fitzgerald

7/29/2019 You're Going Where?! Travel & elective in the Czech Republic - Ed Fitzgerald

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An impenetrable language,

very cold weather and a cui-sine largely based arounddumplings. As the train rat-

tled north towards the airport I satback in my seat and asked myself, notfor the first time, why on earth I had

ended up choosing winter in the CzechRepublic for my elective. Perhaps it

was a subconscious rebellion againstthe quarter of my year that thought

Australia would be an "adventure", as

only another westernised countryspeaking the same language can be.Or perhaps it was a rejection of the

sun-seeking brigade planning tospend eight weeks revising their tan-

lines on a beach in the Caribbean.Either way, these options had come tolook infinitely more attractive over the

past month as, day by day, I checkedthe weather for my destination and

found that once again it was a scorch-ing -16C. Sun-tan lotion would not berequired where I was heading.

With the medical-world as my oysterfor an elective destination, Liberec

(pronounced Lee-ver-ess) in the CzechRepublic had caught my attention for

two reasons. Firstly, students who'dbeen there before recounted bravetales of daring-do in the operating

theatres, with ample opportunities toperform a variety of surgical proce-dures themselves. This sounded like a

great opportunity to hone my practicalskills. Secondly, I'd always wanted to

explore Eastern Europe. Perhaps I'dread too many Ian Fleming spy nov-

els, but I'd always longed to venture

behind the former Iron Curtain.Liberec seemed like an ideal basefrom which to drink vodka-Martini

whilst recruiting beautiful doubleagents for MI6. Hmm...

My travel to Prague was uneventful,other than my travelling companion

loosing her passport and the flightbeing cancelled due to 1 mm of snowat Heathrow. Miss Moneypenny effi-

ciently re-booked. When I finallydeparted a week later, the in-flightentertainment was provided by a

group of skinheads on their way to astag-weekend and some "easty-beasty"

action. Their most memorable com-ment was actually very amusing,

though sadly they didn't even realise.An attractive blonde in the aisle oppo-

site was being lewdly chatted up afterdisclosing she was a masseur. Theirresponse to her description of a full

body massage: "Gluteus maximus -wasn't he in Gladiator?" Perfect. Sadly

their elaborate floorshow ended pre-maturely when the cabin staff indicat-ed they would have to start flapping

hard if they wanted to remain air-borne. Thankfully the flight continuedand I skilfully evaded the searchlights

and flak over Dresden to pilot us insmoothly at Ruzyne airport in the

You're Going

Where?!You're Going

Where?!Travel & elective in the Czech Republic

Edward Fitzgerald


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69Gazette

Czech capital, a very modern and

sophisticated affair that made many ofour own look distinctly impoverished.

Prague

Kafka described Prague as "the cutemother with her clutches who neverlets you go". I have my doubts about

"cute" being an acceptable word todescribe ones mother, metaphorical ornot. However, I do share the senti-

ment. The centre of the city remains ashining gem of largely untouched

architectural beauty, from cubism tocommunism, renaissance to revival-ism. I reflected that this probably had

much to do with the 170 litres of lagerper person per year rendering the

population unable to touch anything.This figure is a genuine fact and doesnot exclude children and tee-totalers.

Impressive stuff.

Star M_sto is the beautiful old-town

district, with a history lesson at everyturn. Dark cobbled roads take you off

the tourist routes and amongst narrowstreets that once housed the medievalmerchants who brought the city its'

fortunes. Karluv Most, the famousCharles Bridge, links Star M_sto

with Hrad_any district. Here, on a

hillside overlooking the spires below isthe splendour of Prague Castle and St.

Vitus' Cathedral.

The main shopping district is now

much the same as any other Europeancity, with Marks & Spencer jostling forspace between Next and Nike.

Everywhere I went it seemed thatanother film crew were using the pic-

turesque streets as a movie backdrop.This proved particularly unnerving

when I happened across a pseudo-

Reichstag building draped in swastikabanners and surrounded byWehrmacht troops. I was worried I

may have happened across a meetingof the Young Conservatives, but

thankfully a gun-totting actor put meat ease.

Everywhere I went it was also un-nerving to have dubious locals asking

to exchange currency. Luckily I waswise to the local scams. This latesttrick involved a criminal offering to

swap your pounds or dollars for Czechkoruna at a special rate. Regardless of

whether you accepted this offer, you

would then be approached by policeasking to see your passport andmoney. Only these wouldn't be police

and they'd "confiscate" your moneyand papers, never to be seen again.

Future visitors beware.

Walking through the scenic squares of

Prague over the weekend was surreal-ly reminiscent of Cornmarket Street,in that all the trinket shops were sell-

ing "Beckham 7" t-shirts and we were

totally surrounded by English and

American voices. It was clear to seethe popularity of the city with touristseven in the off-season. The English

were easy to pick out, with the chapsall wearing cord trousers and the

ladies bottom's blocking out the after-noon sun. The English stag-night par-ties were even easier to pick out, with

several gangs wandering arounddrunk in kilts and "Dave's not gettingmarried in the morning" t-shirts. It

made me proud to be British.

By the end of the weekend it was time

to move on. My MI6 cover was clearlyblown: all the touts and beggars were

addressing me in English. Did I reallylook like such a tourist?

Into the Sudetenland

I caught the coach to Liberec, a two-hour journey north of Prague. Be ittram, coach or train, the clean and

punctual public transport made meweep at the inadequacies of our ownservices. We headed north quickly,

with the snow becoming deeper andthe country side more rural. As

Liberec approached it appeared to bethe stereotypical image of an EasternEuropean industrial town. Yellow

smoke drifted upwards from tall redand white chimneys, with low smoghanging over the area. As I struggled

up the hill into town my view slowly


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changed. Snow laden clouds gave wayto winter sunshine and the

Communist buildings gave way togranite-sett roads with grand neo-ren-aissance houses and bustling shop-

ping streets. Liberec now looked a lotmore welcoming.

The town itself lies at the eastern end

of north Bohemia, at the junction ofthe German and Polish borders withthe Czech Republic. It occupies a dra-

matic position in the Nisa Valleybetween the Jizera Mountains to thenorth and the Je_t_d peak to the

south. First mentioned in 1352, thetown has an interesting history.During the 18th century it developed a

major textile industry and thisbrought the wealth of merchant build-

ings that still shape Liberec today. Atthat point the town ranked as one of

the most important in the Austro-Hungarian region but by the early1900's the town was in decline again,

badly affected by war. During this era

it was known by the German nameReichenberg, which it remained until

1945. The inhabitants were mainlySudeten Germans and KonradHenlein, leader of the Sudeten-

German Party, oversaw Liberec'sannex as part of the Reich and even a

visit by the Viennese house painter

himself.

Following the war the German popu-lation was expelled and the electionsof 1946 saw the start of the

Communist era. Outside of Prague,Liberec was almost the only Czechtown to see violence when the Red

Army rolled through on their way tothe capital in 1968, with nine inhabi-

tants shot in the town square. The fol-lowing two decades saw further eco-nomic decline, though thankfully

things have taken a turn for the bettersince 1989. With a population of

130,000 the town has become a popu-lar tourist destination for winter

sports and hopes to once againbecome the metropolis of northBohemia.

After a brief circuit around the centre

I walked up to the hospital to beginmy neurosurgical adventures. Liberec

is very compact, taking only a fewminutes to walk across the centre. Thehospital is conveniently located juston the edge of this. A sprawling com-

plex reminiscent of the RadcliffeInfirmary, the buildings all have a

utilitarian look to them. The neuro-surgery department is at the top of aten-story block in the middle of this,

with excellent views over the town.

On arrival I received the warmest of

welcomes from the staff. In contrast to

the slightly neglected feel to the build-ings, the neurosurgical department ispacked with new computers, highspeed internet, LCD displays and

video projectors. The influence of thecharismatic boss was clear to see. DrPetr Suchomel was delighted to see

me, immediately asking Do you wantto work, or do you want a holiday?

Naturally I replied the former. Thetimetable he outlined was 90% assist-ing in theatres, with major cranial and

spinal surgery every day. Next-doorwere the orthopaedic theatres, where I

was also welcome to join in the ham-mer-and-chisel fun.

Following this introduction my firstafternoon in the hospital didn't quitepan out as expected. The neurosurgi-

cal registrar had heard of myUniversity Wine Society shenanigansand shared my passion. Rather than

take me on a tour of the wards wespent the afternoon visiting local

Czech wine producers, ending up inthe local brewery. I certainly had no

complaints!

My accommodation was perfectlysandwiched between the hospital andtown centre, either of these being just

a minutes walk. Despite my initialtrepidation as I approached the aus-tere six-storey concrete block, my

room was better than that provided in

many Oxford Colleges. The buildingturned out to be a hospital staff hos-tel, with the interesting socialist dictatthat it should provide equal accommo-

dation for all hospital workers, be theycleaners or consultants. My monthhere cost just 30, less than a week at

Magdalen.

That night I ate in the hospital can-teen. Only canteen wasn't the right

word for it, resembling as it did some-

thing between a restaurant and a

German beer cellar. When the menuarrived the drinks list alone ran tothree pages, from Met et Chandonthrough tequila, port and whisky, nat-

urally finishing with XO Cognac and arespectable selection of cigars. I hadto slap myself to make sure I wasn't

dreaming. I still wasn't convinced, so Iasked one of the very attractive wait-

resses to slap me too. Unfortunatelythey charged extra for that service.Still, their rendition of the Cheeky

Girls "Touch My Bum" pop-hit wasfree of charge and well worth six

whole years of studying medicine justto reach that point.

The food menu was five pages longwith everything from Italian andAsian dishes to local Czech cuisine.

For the second time that day I nearlywept at the inadequacies of our owncountry. How could I ever visit the

John Radcliffe canteen again? For afew pounds I ate a fantastic meal and

I'm not someone who thinks thatAhmed's kebab van should get a

Michelin star. My Plzen beer arrivedin a 0.5L jug and cost 50 pence, asure-fire recipe for disaster. I couldsee this was going to be a lot of fun.

Nemocnice Liberec

Every morning started with a 7 amdepartmental meeting where you

could choose which operations towork on. The team would talk furious-ly fast in Czech, downing black coffee

and demolishing packets of Spartacigarettes. As one of the previous elec-

tive students had commented, thestunning Czech nurses wear an outra-geous uniform blatantly designed by a

bloke. It's far too small to be called a


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dress, in fact it's so comical that it washard not to stop and stare. The unisex

theatre changing rooms and showerstook a bit of getting used to in light ofthat.

Once in theatre the surgeons lack for

nothing, with all the latest equipmentfrom ultrasound aspirators to Zeiss

robotic microscopes. However, thereare also some contrasts, such as thehospital trolleys being based around

what seem to be rickshaw frames andold bicycle wheels.

Just like Oxford, the anaesthetists dotheir best to spoil the surgeon's fun.One patient had low potassium,

another too high potassium. The finalpatient had suspiciously normal

potassium. When we finally started Iwas invited to scrub-up and perform

the craniotomy with one of the juniorsurgeons. Confident or foolhardy,either way the surgical staff appearedto have a lot more faith in the rigours

of the Oxford medical education thanI did. After a brief struggle to recall

my undergraduate anatomy, I success-fully located the patient's head andcracked on.

For lunch the surgeons would pile intothe hospital canteen for a huge meal

with beers. Then everyone totteredback to the theatres for the afternoon

list. And so it continued. Over thecourse of the attachment I was able toassist with carotid endarterectomies,

spinal discectomies, metastatic malig-nancies, meninigiomas, pavlovas andanything else that came their way.

Throughout my stay there were always

one or two Czech medical studentsaround to visit the pub and banter

with. Interestingly the students and

staff were all much more laid backthan their English counterparts. This

confirmed a long standing suspicion -that somewhere in the Oxford inter-view process is a secret check-box

tutors must tick: Is this candidatehighly-strung? Yes? Well lets offerthem a place, they'll fit in well here...

Outside of the hospital there wasplenty to see. The very traditional

Museum of Northern Bohemia wasfounded in 1873 and houses one of the

most important collections in theRepublic. At first it appeared to be ataxidermists heaven, though it also

has a fascinating collection of decora-tive arts from medieval times to pres-ent day. As well as being a dramatic

building, the Viennese-style town the-

atre has a very active stage, hostingplays, opera and ballet. During my

stay I saw a stirring performance ofPuccini's Tosca for just 3. Paganini,Barber of Seville and Romeo & Juliet

were also scheduled.

The regional gallery is a real treasurewith a significant collection of 16th &

17th century Dutch still life (i.e. care-fully positioned dead things). More tomy taste, their holding also includes acontemporary collection from Czech

artists and a beautiful display ofFrench landscapes. The 20 pence

entrance fee even includes an elderlyCzech lady who'll shadow you all the

way round at a discreet distance to

ensure you don't get too close to theart work.

Finally, the cultural highpoint: Tesco

supermarkets have now reachednorthern Bohemia and should also becounted as one of the town's attrac-tions, judging from its popularity with

the locals. Wandering around thewell-stocked store you could be forgiv-en for thinking you were back in

England were it not for some subtledifferences. Firstly, everything is cov-

ered in cigarette advertising, an inter-esting moral position I'd like to raise

with their management back home.

Other less obvious differences includethe fresh fish stand being more of a

tank, from where you choose dinneras it swims around. The wine sectionalso has a distinctly monotonous

Moravian theme to it, although bottlesof vodka (industrial alcohol?) wereonly 2. But, for a little touch of

England, it was great to be able to buysome tea during my stay.

By the end of the month the weatherhad turned seriously cold. Being born

in Yorkshire, I thought I had a goodunderstanding of the term 'cold'.

Liberec taught me otherwise. The coldwas reaching bits of me that no othercold could reach, perhaps to beexpected with a low of -18C. The

town became an animal-rights pro-tester's worst nightmare. Cold weather

clothing meant one thing to the locals:fur, and lots of it.

Mluvte anglicky?

It was only here in Liberec that Iencountered any language difficulties.In Prague everyone spoke English. In

Liberec even the traditional Britishremedy of repeating what you saidmore loudly didn't help the locals

understand. Thankfully I'd learnt

some essential phrases, so my pigeon-Czech just about made me under-

stood. I shuddered to think how badmy pronunciation must have been -the English tongue just isn't designed

to make some of the sounds the Czechlanguage requires. GCSE German justabout got me through when the Czech

failed. However, as far as the written

language was concerned there waseven less hope. It's the only country

where _ize_ has a meaning other thanyou accidentally dropping something

on your keyboard. Thankfully thingswere different in the hospital, the bosshaving decreed that my visit was the

staffs' opportunity to improve theirEnglish language.

Golden opportunities

In conclusion, my final report to M

was that while I had failed to recruitany beautiful Czech agents for British

Intelligence, I had enjoyed the mostmemorable elective. If you are des-

tined to spend your career fiddlingwith prescriptions for hypertensionand faint at the merest mention of

sutures then this may not be the elec-tive for you. For someone with a sur-gical leaning, who doesn't want to fol-

low the sheep on elective or concen-trate on perfecting their tan, I cannot

recommend this placement highlyenough. Brilliant hospitality, fantastic

supervision, utter ease of organisa-tion, golden opportunities to operateand sheer affordability all conspire tomake this the best surgical elective

available.

My thanks must ultimately go toOndrej Choutka, an Oxford medicalstudent who first arranged this con-

tact with his hometown four yearsago. I do hope future students contin-

ue this unique link and enjoy thewarm welcome and high standing we

have now earned there.

If anyone would like further informa-tion on this elective please contact:

[email protected]

Or visit the Liberec & hospital web-sites: http://www.nemlib.cz

http://www.infolbc.cz/

Other useful Czech websites:

http://www.myczechrepublic.com http://www.locallingo.com

Edward Fitzgerald is a final yearmedical student at Magdalen College

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You're Going Where?! Travel & elective in the Czech Republic - Ed Fitzgerald