What are your current favorites?
Books: Haruki Murakami is spectacular! Kafka on the Shore is by far one of the most amazing novels I’ve read. Let’s see…I just finished reading Richard Brautigan, In Watermelon Sugar – Pretty odd, I’m into it. Another is The Araboolies of Liberty Street, I read it a lot as a kid; a very fine story.

Movies: Suicide Club, Harold and Maude, Clueless, Alice in Wonderland, Me You and Everyone We Know

Music: Bjork, Tujiko Noriko, Red House Painters, Electrelane...

What do you do in your spare time?
Estudio Espanol en el centro de la ciudad y hablo con mi gato en ingles! I also enjoy eating and then talking about what I ate. Brunch is my favorite pastime; I try to eat brunch at a different place every weekend. Maybe I have too much spare time.. I do like other things such as reading and spending time with good people.

What is your favorite place in the world and why?
So far in my travels, I’ve fell in love with 2 places: Tokyo, Japan and Guanajuato, Mexico; Both quite opposite from each other. I had a blast in Tokyo, really. What a great place to be, fascinating and life changing. Guanajuato is just a place that I’ve never felt happier. The whole vibe was energetic yet easygoing. It has a great nightlife too, some really interesting places to hang out and its gorgeous!

What is your favorite meal?
A HUGE burrito filled of cheese, veggie meat, refried beans, sour cream, and all the other essential burrito fillings. Yum. I also enjoy huge bowls of miso-ramen or udon noodles.

What is your favorite drink?
Ginger Beer

What is your favorite time of year?
That time of the year when Philadelphia starts to get warm and the whole city seems to change. Everything opens up and people go out and have more fun. And it’s the time I actually get on a bike.

Where are you from?
I was born in Chile, have a German and Chilean nationality and grew up in Spain.

What's your sign?
Scorpio.

How long have you been with AmeriSpan?
1 year and 3 months.

What are your current favorites?
Books: Travel Guides

Movies: Independent productions

Music: Rock

What do you do in your spare time?
Travel, museums, cinema, bars and restaurants with friends.

What is your favorite place in the world?
I don’t know all the places in the world yet, but I love Chile because of the diversity: desert, mountains, lakes, rivers, sea, ice and my family is there!

What is your favorite food?
Seafood.

What is your favorite drink?
Fresh fruit juices.

What is your favorite time of the year?
Spring.

If you were stranded on a desert island, what five things would you have to have and why?
A friend to share my experiences with
A lighter to make fire
A tent to protect myself from weather conditions
A map of the island
A cell phone if there was a network!

Where are you from?
Madrid, Spain.

What's your sign?
Scorpio.

How long have you been with AmeriSpan?
3 months.

What are your current favorites?
Books:"Amor en tiempos de colera"

Movies: The Island

Music: Spanish Music

What do you do in your spare time?
Listen to music, go to the gym...

What is your favorite place in the world?
Spain.

What is your favorite food?
Paella.

What is your favorite drink?
Sangria.

What is your favorite time of the year?
Summer.

If you were stranded on a desert island, what things would you have to have?
Soccer ball, books, lighter, my Spanish soccer t-shirt.

In fall of 2005 I found myself at the Narita Airport in Japan. Sometimes I wonder how it is that I got there. Well, I know how I “physically” got there. I got there by enduring a sixteen-hour plane ride where I seemed to be the only passenger who couldn’t fall asleep. I remember looking around and observing the old Japanese men gently snoring with their shoes off. I remember the group of teenagers to the right dressed in outrageous fashions with their headphones blasting pop music. I remember Ai, the girl who sat next to me and said that the kanji of her name meant indigo blue. She had just studied English in Texas and casually joked about how unhealthy American food was. I was lucky that I had met her for as soon as I got off the plane I was overwhelmed by the chaos of the airport. Yet, this chaos was different. Perhaps it is hard to explain but it was organized; organized chaos. There were so many people and so many different things going on yet the atmosphere appeared in order. I like to compare this chaos to a beehive or an ant colony where everything is working harmoniously together.

In no way do I mean to compare Japanese culture to the habitat of insects but it is this rhythm of life in metropolitan Tokyo that I believe makes it distinct from any other big city. I witnessed the same organized chaos in the districts of Shibuya, Shinjuku, Harajuku and Ginza. It was exciting to be immersed in the busy patterned movements of people. Half the time I thought that everything was staged, that I was in some movie and all those moving around me were just extras. Maybe I was in something similar to the Truman Show, that movie with Jim Carey where everything around him is staged and aired on national television, all while he has no idea. Alright, I realize that is a stretch but rest assured when you go to Tokyo, and you step off that plane you’ll feel like you are in another world and you may continue to feel that way right until you are about to leave.

I was fortunate to live in Tokyo for four months. I resided in a student apartment on what I believe was the “outskirts” of Tokyo in Jiyugaoka. This area is referred to as the “Bellaire” of Tokyo for all the fancy houses and cars that line the tiny streets. I never met any of my neighbors for the area was quiet and serene. I suppose the closest encounter I had with them was when I would spot them peeking through their window curtains. At first I found this quite odd. Why would they not reveal themselves or stand on their porch to greet me and the other students that lived there? I was later informed by my resident advisor, Kota, that we were being “too loud” as the residents were not used to people congregating on stoops to just hang out. The only sound I would hear, other than the voices of the students I lived with, was this loud, melancholy recording of a man singing about something. It belonged to what we referred to as the "yam man" who was an older man driving a rickety truck with crates filled of cooked yams by our apartment everyday. I forget the exact price they were but those yams were cheap and delicious.

I’m honestly not quite sure why I felt it important to write about the yams. It seems to be this constant memory I’ll never forget, similar to the produce stand near my house where some mystery neighbor or farmer would leave fresh produce out. The amazing thing about this was that next to the produce were prices and a small box for yen. I walked by this stand 3 or 4 times a day and found produce missing and the box full of yen just sitting there! You could never do something like that in the states. Japan definitely nourishes some unspoken honor system. Rarely does on hear about theft or other acts of crime. Someone once told me the most commonly stolen object in Japan is umbrellas.

I also feel that is important to mention my experience with Tokyoites and all other Japanese people who I’d encountered. At first I found my place within the city, or society, to be insignificant for there are far too many people that tread the sidewalks day in and day out. I felt like a number and not a name. I noticed that no one seemed to make eye contact or acknowledge that I was among them, or that I existed. This is a bit challenging for me to express. It’s not that I felt I should be given some special privilege or placed on a pedestal because I was a gaijin. It is that I found myself alone at first, deep in thought as to what I was doing in Tokyo. I don’t believe I have ever thought that much to myself before. I initially believed that many Japanese would know English and that I would hear it openly, flowing through the streets because of their fascination with American culture. Sure this might be the case for places like Roppongi, but elsewhere I was surrounded by conversation I couldn’t understand. Since I was taking courses in English at a University I paid little attention to learning Japanese, setting my Japanese homework aside to focus on bigger school projects and essays. And there I was walking the streets of Tokyo as a 20 year old, this big dream I had always had was now true. Something was just missing and at first I thought I was homesick, that I couldn’t handle being in a foreign country. After a few more weeks, I realized that these feelings I harbored were inaccurate, that I was merely misinterpreting those that surrounded me.

I had come to find, throughout my stay, that many of the Japanese people I met, or those that studied at the same school as me were just shy. Some were nervous about using their English and others felt it inappropriate to approach strangers for they are respectful of people’s privacy. Also, as the months wore on, I met several Japanese people, at school, while at cafes, at the grocery store, all of which were extremely friendly and helpful guides showing me their favorite spots. I have several stories of wonderful nights I spent in Tokyo which involve meeting Japanese people. Because this excerpt is getting quite long and if you’re still reading your eyes are most likely tired… I’ll mention just one:

Another American student and I decided to venture through Jiyugaoka one Saturday to see what cool places we could find. We stumbled across this tiny building with the sign “Jazz Café” outside. After climbing down several steps we entered a small room that consisted of a bar, the bartender (obviously), a goldfish, and a Japanese couple. A bit underwhelmed with the atmosphere and the fact we were expecting live jazz music, we headed for the exit. As soon as we turned around the couple started calling to us in Japanese and patted the seats next to them; they wanted us to stay. They immediately ordered us drinks from the bar and tried to converse with us in broken English. Since none of us understood each other’s native language, we spent most the night pantomiming and teaching each other “slang” phrases and words. They also enjoyed telling us what American movie stars we resembled. Apparently my friend was Kevin Bacon and I was Meg Ryan (we don’t look anything like them!) After a while the bartender joined in and there we were, the 5 of us, sitting in a small jazz cafe with no jazz on a Saturday night. All of a sudden the bartender jumped up from his seat and said something excitedly in Japanese. Kevin Bacon exchanged confused glances with me. The lights started to dim and a television is lowered slightly from the ceiling. And that’s when we hear the opening “Dun Dun..Dun dun dun da..” of Jon Bon Jovi’s song “It’s My Life” followed by Jon Bon Jovi strutting across the television screen (I apologize if that’s not the title as I am not a particular fan of him.) It was truly hilarious because Kevin Bacon and I came to the conclusion that the bartender assumed we were huge Bon Jovi fans because we were from America. Out of courtesy we sat there and watched the next couple of songs...

In sum, Tokyo was incredible; I’d even say it was life changing. I will never forget my time spent there and I eagerly a wait when I can go back. Because… where else would I be able to hang out with complete strangers, in a tiny jazz cafe with no jazz, pantomiming why I am there, being compared to an actress I look nothing like, all while grooving out to Mr. Jon Bon Jovi? Only in Japan, I promise.. :-)

Where are you from?
Born in Philadelphia, raised in southeastern PA, USA.

How long have you been with AmeriSpan?
7 months.

What are your current favorites?
Books: Moonlight on the Avenue of Faith by Gina B. Nahai
Movies: Terrible 80’s comedies pre-1990. (Pee Wee’s Big Adventure, Coneheads, etc.)
Music: Poppy and melodic indie electronic music, indie rock, funk/soul, some hip-hop, and old pop/classic rock.

What do you do in your spare time?
Go on bike rides, read, illustrate/design, sketch, travel, spend time with friends/family, go dancing.

What is your favorite place in the world and why?
My favorite cities that I’ve visited are San Francisco, Paris, Nice, Munich, and Stockholm, because they were clean, friendly, and have so much to offer a ‘white bread American’ interested in art and music.

What is your favorite food?
Indian vegetarian food.

What is your favorite drink?
Non-alcoholic: limeade
Alcoholic: any fruity cocktail

What is your favorite time of year?
Spring, summer, and Halloween.

If you were stranded on a deserted island, what five things would you have to have and why?
1. Company
2. Pens and paper for drawing.
3. Food and water, for survival
4. Internet access, for averting boredom
5. Music, for dancing

I wanted to study abroad because I had never been outside of the States and a semester in Spain cost the same as a semester in State College, PA. Seemed like a no-brainer. I knew it’d be fun, but I had NO idea what was really in store. I traveled with 3 of my closest college buddies and I thought I was the “Spanish expert” of the group because I had a couple semesters of college Spanish under my belt. I was in for a surprise when we showed up at the shuttle from the airport in Madrid to the Ave (the high speed train that would take us to Sevilla). I could form a sentence to ask where to go, but had no idea what the woman was saying when she replied in ultra-fast Spanish.

Lesson 1- there IS a degree of shock when you arrive in a place that doesn’t speak your language- embrace it, it’ll go away.

So we made it to Sevilla and found our way to our host family. It was a little difficult at first trying to get to know each other. The only one that spoke English was the 16 year old daughter and her English was about as good as my Spanish. We were anxious to explore so we hit the local tapas place and felt like we were on top of the world. We cheers’d over our first drink together and it was sweet!

School started, and we started to get into the Spanish way of life.

Lesson 2- SIESTA = AWESOME!

Every day at 2PM we’d come home for a big lunch with our host family, then crawl into bed and sleep for 2 hours. There wasn’t much choice, literally everything, and I mean everything shuts down from around 2-5 in the afternoon. No groceries, no bars, no movies, just naptime. It’s genius. Sometimes we’d spend the Siesta by the river where there was a vendor selling “Tinto de Verano” (kind of like Sangria). We’d pay 5 euros for a liter and bask in the glorious sun like kings. I can guarantee you our friends back at Penn State were not doing this in February!

There are too many stories to tell in one blog but I’d like to highlight the most memorable one:

One Saturday night, our homestay brother, Gabi, told us to get dressed up ‘cause he was taking us out for a night of REAL Sevilla. Don’t get me wrong, we partied Spanish style all semester (botellon, late-night discoteca, tapas, etc.) but this night would be different.
We showed up at this plush club hidden in this little cove by the water and everyone was decked out. All the females were wearing traditional Flamenco dresses and all the gentlemen were wearing suits. We got inside and there was an incredible band playing music I had never heard. It was local Flamenco music, and it was awesome. Everyone knew how to dance, and dance with style, Flamenco style. We each found ourselves a lady to teach us the moves, and we were right in the mix. I looked around from time to time and thought I was in a movie. Ridiculous. Absolutely a dream! All of a sudden at midnight the band stopped and all the lights went out in the club. Everyone moved towards one side of the room and a bunch of people lit candles. There was a statue of the Virgin Mary called El Rocio. Everyone sang this song in a loud, boisterous voice and then blew the candles out. The lights came back on, the band started up, and the crowd went nuts! I was shell-shocked. Were we just part of some religious ceremony on a Saturday night in the middle Sevilla? Yes! That certainly never happened in Central Pennsylvania. That night will go down, without a doubt, as one of the best nights of my life.

Lesson 3: A host family can take you places and show you things you have no chance of finding on your own. Take advantage of it!

By the end of my 15 weeks in Spain I was thinking and dreaming in Spanish. I was having deep conversations with Spanish women, in Spanish. Seriously? That woman at the airport shuttle should see me now! Please, please, please, please, if you’re reading this and are tossing around the idea of spending some time abroad- DO IT! And do it right. Get into the culture and take it all in. You’re about to change your life!

These are all words I used in postcards sent to family and friends on my visit to Hong Kong. This was my 1st adventure in Asia and it was a good choice. Without a guidebook, or even an itinerary, my friend and I didn’t know what to expect of Hong Kong. We only knew that we would be going to the Hong Kong Disneyworld, which had opened just weeks before our arrival. Upon landing, we grabbed the free tourist brochure in the airport and found more to do than we had time for.

From the minute you arrive, you can see that Hong Kong has an excellent transportation system, linking all the main islands. From the airport, it’s a matter of minutes before you arrive in the center of the most popular islands, Hong Kong Island and Kowloon. My friend and I also found a free shuttle bus to our hotel when we got off. There are links off the main subways lines to special attractions too. You can quickly arrive at the new Skyrail station to zip over to Lantau Island. There is even a special line for Hong Kong Disney. The windows and hand straps of the train are shaped like Mickey Mouse! And don’t forget to make time to take the special Peak Tram up to the top of Victoria Peak for a spectacular aerial view of Hong Kong.

The busy, chaotic, modern, and energized Hong Kong is visible almost everywhere, but can mostly be seen when shopping in one of the many markets around the islands. Kowloon Island is filled with markets, both day and night. The Temple Street Night Market is packed with sellers hawking traditional Asian crafts, while Nathan Road is bustling with flashy shops showcasing trendy items. And when in Kowloon at night, make sure to stop by Victoria Harbour. Stroll down the Avenue of Stars and find your favorite Asian celebrity on this walk-of-fame while you watch the Symphony of Lights show illuminates the high-rise buildings of Victoria Harbour. My friend and I liked the show so much we went back every night.

When my friend and I were tired of the lively city life, we headed out to Lantau Island. There you find the more relaxing, peaceful, and traditional Hong Kong. The Giant Buddha statue on Lantau is the most visible attraction there. Being the largest outdoor Buddha in the world, he can be seen from almost anywhere. It is also possible to venture up more than 250 steps to the top of the Buddha for a view of the calming Po Lin Monastery below. My friend and I followed a trail marked ‘Wisdom Path’ and found ourselves in a field contemplating the wood pillars in front of us, placed to form an infinity ring.

There are a lot of components that make modern day Hong Kong tick. These were my favorite discoveries on this diverse group of islands, where the modern connivances of the world meet traditional Asia.

Having spent 2 years living in Thailand, I feel cliché in referring to Thailand with the sometimes overused marketing phrase ‘The Land of Smiles;’ but truth be told, there is no better way to describe Thailand and its people.

So you may not speak the same language, (at least not yet!) but Thai people will tell you the answer to any question or help you find your way if lost. They will smile and laugh ‘farang’ meaning ‘foreigner,’ as you walk by. Don’t worry, they mean no disrespect and you did nothing to disrespect them. Your taxi driver will smile wide after going the wrong way and say ‘no problem.’

Another time to smile in Thailand is when there’s food around. It’s true; Thailand has some of the best dishes in the world. The blending of spices; revolving around combinations of sweet, sour, hot, and very hot, is what makes their food spectacular. Simple ingredients magically transform into flavorful and exotic bites. My favorite part was the freshness of Thai food. Dishes are always made for you right on the spot, with fresh vegetables probably picked earlier that morning. When in Thailand, I recommend you try the ‘som tom’ or spicy papaya salad mixed with tomatoes, peanuts, shrimp, and of course tons of Thai chilies. This northeastern dish is perfect when eaten with a handful of sticky rice. “Aroy mak!!” Say this to your Thai cook and you are sure to get a smile.

Big smiles are also received with mention of Thailand’s king and national hero, HM King Bhumibol Adulyadej, or Rama IX. Thai people adore him and the evidence can be seen everywhere. Posters and banners line the streets. Taxis are adorned with photos of the Royal Family. The Royal Anthem is played twice daily on the radio, before all public events, and at the movies. Since celebrating his 60th year on the throne in 2006 and his 80th birthday in 2007, their love for him has become even more evident. Every Monday, the day of his birth, Thai people wear yellow to show love, honor, and respect to their King. At my job, we wore yellow on Mondays and Fridays. We really loved the King.

The biggest smiles in Thailand can be found during April’s ‘Songkran’ Festival, the Thai New Year celebration. It’s a holiday to celebrate the passing of the old and the coming of the new. Celebrations can be described as nothing short of chaotic, spirited, religious, and mostly wet. Beyond the religious importance, Songkran is about water fights. Ask any Thai person and they will tell that Chiang Mai is the place to be to play Songkran. There, with the perfectly placed city moat, water is readily available. Adults and kids alike join forces to soak the town. Using water guns, buckets, coolers, trashcans, and anything that will hold water; everyone tosses water on passersby to help them ‘wash away their bad luck.’

Thailand and its people know the true meaning of the smile. They share theirs with everyone and on every occasion.

And now, the Winner of the 15th Birthday Contest is ...Karen Hatcher!

Our staff spent 3 days voting and finally came to the decision on Friday the 13th. Once again, Congratulations Karen. Your creativity and hard work surely paid off. Please enjoy your two free weeks of classes and make sure to tell us about your trip when you get back!

The day starts off early enough, at 8:00 a.m. as the competitors don their distinctive outfits- all white clothing, with a red handkerchief around their necks (called a panuelo) and a red sash around their waist (called a faja). Before beginning their dangerous route, all the runners gather to sing an ode to a statue of San Fermin, perhaps to grant them luck and safety.

Then, it’s time for the actual run, which begin with the firing of two rockets (cohetes), which announces first the release of the bulls, and then notification that the last bull has left the corral. And then it’s every man for himself! As the runners make their half mile way through Pampona’s cobbled streets, there are several factors to look out for. Though the initial rush of the bulls and agitated stragglers are of great concern, the biggest cause of injury in recent years has actually been caused by the crowd; In order to get the best views of the bulls and runners, the audience has created some fatal stampedes, leaving the Festival organizers to distribute multi-lingual guides with safety precautions.

The run concludes when the last of the bulls are herded into the Corralillos stadium. A third rocket is fired to signal the bulls have entered the stadium and a fourth, and final, rocket signifies the bulls have returned to their pens, and the end of the race.

Even if you are not in great physical shape, don’t agree with the run itself, or simply don’t want to risk your life, there are many other events to enjoy, including carnival rides, sangria tastings, and puppet shows. Pamplona during the San Fermin Festival is truly a once in a life time experience that everyone should enjoy.

I am finding that the most frustrating part of this experience so far is translating the information that I have learned in class out in the city. I find that when I am class I am able to understand a great deal of the Spanish that my teacher uses however when I actually go to a restaurant or a store sometimes I am not able to identify anything that the people are trying to say to me. I keep reminding myself the importance of being patient and that I have only been studying the language for a total of 9 days but I guess it is just part of personal pressure.

Yesterday I attended another of the school's dancing classes where we learned some group dances. The dance begins in a circle with everybody in pairs. However, through turns and different moves the women rotate around the circle between all of the men transferring partners. I have to say that my group's first couple of tries was pretty hilarious. I am assuming that some of the difficulty stems from the fact that in America these are not typical styles of dancing, except perhaps with square dancing. I haven't laughed that hard in a long time but it was really fun. It also helped to get to know other people in the class. Each song that we practice to, the salsa or the merengue, we have to change partners. While this provides additional practice it also makes it difficult to become accustomed to a specific person's dancing style. I thought I had rhythm, but I guess we'll have to wait and see...

Last evening I went with a group of students out to dinner and out on the town. It is interesting to observe the local nightlife including the differences in service and atmosphere. There is a lot more American music played that I first would have suspected. While sometimes it brings the comfort of home it also brings a shock to the senses when you step outside and remember that you are in a different country. Tomorrow I take another exam to test my skills and attempt to move to a higher level. Well, I guess that means that I must study!

Though many are familiar with the famous date (the fifth of May, for those who haven’t consulted their calendars), the actual history of this Mexican holiday often gets lost in translation.

Cinco de Mayo celebrates the first victory of the Mexican forces over the French, a large step towards the country’s independence. Though Mexico officially declared independence from Spain on September 15, 1810, it took eleven years for the Spaniards to exit the country and after that, Napoleon III attempted another takeover. On May 5, 1862, four thousand Mexican fighters overturned the eight thousand French troops at Puebla, Mexico, led by General Ignacio Zaragoza Seguin.

Today, Cinco de Mayo is celebrated throughout the Mexico and the United States. South of the border, the holiday is primarily a regional celebration limited to the state of Puebla, consisting of dancing, feasting, and lots of music. In the United States however, Cinco de Mayo has become a cultural phenomenon. Perhaps this is due to a large Hispanic population spread throughout the country, or perhaps it is just because of our love of parties. Regardless of your ethnic origin, bars and backyards throughout America welcome everyone to celebrate with a cerveza and burrito while enjoying authentic mariachi music. Other countries have embraced the celebration as well, such as Vancouver, Canada, which hosts a Cinco de Mayo sky diving event. The Cayman islands even have a mariachi air guitar contest!

Whatever your ancestry or location, everyone’s a little Mexican on Cinco de Mayo. Grab a sombrero, pour yourself a margarita, and enjoy!

Today was the day of the mystical La Tomatina in Bunol, Espana. Leading up to the event I was excited about the thought of getting in the middle of a giant food fight with 30,000 other people. The idea seemed pretty interesting to me and I couldn't help my curiosity. As the day came closer, I felt a little fear deep inside, haha. It seemed the idea of being in the middle of a giant food fight was starting to get to me.

About 75 students from my school boarded to charter buses and we headed for the pueblo of Buñol west of Valencia. The town has a population of 9,000, but on the day of the La Tomatina the population swells to 30,000 plus. When we arrived, the highway was already starting to back up from all of the people arriving for the fest. It seemed that many of the people coming were in Valencia or the area specifically for La Tomatina. The fight was to begin with a gunshot at 11:00AM and last for approximately an hour.

We made our way through the town to the city center with the several thousand other travelers in town for the fest. We heard the gunshot go off and the anticipation built even more. By the time we made it close to where the fight was taking place, we saw numerous folks covered in what was tomato paste by this time.

Although we missed the start we quickly received our welcome with the flying tomatoes. Approximately every 10 minutes a large truck loaded with tomatoes would make its way down the street dumping tomatoes. A few brave soles were on back throwing tomatoes out, but they made easy target practice for those in the crowd.

The neighbors of the fight join in as well, but from a more logical standpoint. Many watch from their terrazas of their apartments and houses above. When the time is right or they feel like it is a good time, they would dump water on the rowdy crowd below. At times, this was a blessing because the tomato paste and did a number on the eyes, haha. I am not sure who enjoyed the dumping of the water more - the neighbors above or the crowd below. The whole fight ended with the sound of the second and final gunshot.

I enjoyed the festival greatly and am glad I made the trip to Bunol. It will be a memory that I doubt I will forget anytime soon.

Statistics: 30,000 plus tomato loving travelers; 100,000 Kilos of Tomatoes and 1 much wiser traveler of Spain.

I am a fourth year medical student specializing in Family Medicine with Intermediate Spanish speaking ability. I was given the unforgettable opportunity to observe the socialized medical system in Costa Rica for two weeks and two days. This was made possible through the coordination and hard work of the school in .Heredia

I was given an introduction of the three parts of the Costa Rican public medical system "Caja Costarricense de Seguro Social" (CCSS) which is referred to as "La Caja" for short by Dra. Quiros. The system is like a ladder which treats patients and transfers them to the facility best able to beat their ailment The first rung of the ladder is the Ebais, the second is the Clinica, the third and top of the ladder is Hospital. Hospitals are separated into classes A through C based on their resources and equipment available to treat different ailments. Most class A hospitals are in San Jose, Costa Rica and are the most well equipped. In my short amount of time I was able to observe/assist all three rungs of the CCSS and two different classes of Hospitals.

For two days I shadowed Dra. Quiros, a Neonatologist and Pediatrician in San Jose Costa Rica. One day was spent in the Hospital Dr. R A Calderon Guardia, the other day was an overnight stay in San Juan de Dios. I was able to view the facilities and departments through a personal tour of the hospital and observed first hand the management of patients in the Neonatology unit while improving my Spanish and expanding my medical Spanish vocabulary with the patients of Dra. Quiros. I was able to observe a birth in the labor and delivery unit of Calderon Guardia and the immediate neonatal care of the baby. This was a rewarding and familiar experience and was a great introduction for the weeks to follow.

I spent the mornings of five days of first full week in the Bernardo Benavides Ebais with Dra. Cespedes and Dra. Santamaria. This was an opportunity to see the entry point of the CCSS in action. There were a steady flow of patients with many of the basic medical ailments and some with more grave states which were transferred to the Hospital for evaluation. I was able to listen to the patient/doctor dialogue closely and experience the similarities and differences in primary care between this sampling of the Hispanic population and those patients in the United States. I brought basic medical supplies and over-the-counter medications from the United States as donations to the Ebais which has the fewest resources of the three parts of the CCSS.

In the beginning of the first full week I also spent afternoons and evenings (until 6pm or 8pm) in 'San Vincent De Paul" Hospital in Heredia with Dr. Quiros (brother of Dra. Quiros) and Dra. Alfaro. I was given a personal tour of the facilities and was explained the differences in resources and equipment in comparison to a Class A hospital such as those in San Jose I visited the week before. Dr. Quiros is an Emergency Physician who was stationed in "La Capilla" during my week there. La Capilla is the chapel in the hospital where patients admitted to the Hospital through the Emergency Department are kept until they are found room in their corresponding unit in the hospital. I was able to follow the management of patients in a non-acute setting and perform an Ingreso (patient interview) in Spanish. I was able to observe/participate in the San Vincent De Paul Triage room with Dra. Alfaro, Emergency Department Director, for two nights at the end of the week. I was able to experience first-hand how patients are evaluated and channeled as either requiring medical care in the Hospital or the Clinica depending on the severity of their ailment With the assistance and the observation of Dra. Alfaro and Dr. Quriros I further improved my Medical Spanish vocabulary, and given the opportunity to witness the management of Dengue.

My second week was spent in the Heredia Clinica where I observed, examined, and interacted with patients with Dra. Mendez, an Internist at the Clinica, as my Medical Spanish has much improved at this point. I attended regularly scheduled Medical Forums with the internists and discovered that the grievances of patient noncompliance, and the hurdle of trying to encourage lifestyle changes are consistent with the grievances and obstacles of those physicians in the United States as well. I was able to grasp more of the nuances of patient/physician relationship with this second half of the experience as well as expand my understanding of the CCSS system and practice my Medical Spanish.

This experience has changed my perspective of the medical system in America. I can now clearly see the differences and begin to understand how a socialized medical system serves a community, This new understanding will help me serve my patients in the future and I hope to return to Costa Rica again as a physician to learn and serve some more. Thank you for this excellent opportunity!

We here at AmeriSpan would recommend it for a SALUD program participant or volunteer working in a medical field. Even if your program includes medical Spanish vocabulary, this can certainly come in handy and will encompass things that you may not have covered during your weeks of class. The words in the book are organized by medical specialty for easy reference. You can easily find vocabulary relating to areas such as cardiology, pediatrics and general medical terms. Even the most basic vocabulary may help in a pinch: words for a medical exam, body parts, symptoms and common conditions.

This book has been stirring up a lot of talk. Recently, the book has been featured in some worthwhile publications: In February it was featured in the Chicago Tribune. Two months ago, it was mentioned in The Washington Post.

Other editions of he book, including the travel edition, may be helpful for any of our participants. While nothing can replace what you will learn during an immersion program, having a background knowledge of the language and vocabulary you will need can take the pressure off of a beginning student or first time language traveler.