Archive for the ‘USA’ Category

Prof. Jean Decety in Amman and an interesting Lecture about the Neurobiological Mechanisms of Empathy and Caring for Others

I had the honor of attending a lecture by a French American Professor called Jean Decety from the University of Chicago. The lecture took place in the building of the Jordan Society of Scientific Research (JSSR) in Amman on Wednesday, 11/09/2013 (If you want to keep updated with the activities of the JSSR, here is a link to their facebook page). The title of the lecture of Prof. Decety was:

 الآليات العصبية الحيوية التي تشكل الأساس للتعاطف و الاهتمام بالآخرين لدى الإنسان 
Neurobiological Mechanisms of Empathy and Caring for Others

The topic of the lecture seemed strange to me. For minutes, I thought of not attending this lecture. Firstly, I could not imagine about what this lecture would be. Secondly, I did not know how important Prof. Decety is. Nonetheless, because I trusted my friend who recommended this lecture for me (Thank you Dr. Ali Alfar) and because I am interested in psychiatry my possible future specialty, then I googled the name of Prof. Decety. Quickly, I discovered that there is a detailed Wikipedia page about Prof. Decety. Can anyone have a detailed wikipedia page? I also found multiple articles mentioning him. Therefore, I decided quickly to attend because I thought that I would benefit something from this lecture no matter how boring the topic turned out to be.

A friend of mine and I decided to go to this lecture. My friend is also interested in psychiatry. We arrived a few minutes before the lecture started. Prof. Decety then arrived. From the first few minutes, I could deduce that he is a jolly person, funny, and to my relive, that I would not bored by the “weird” lecture that was to come.

The lecture started. A Dr. Rana Dajani introduced Prof. Decety. I understood that Dr. Dajani and Prof. Decety conducted are conducting researches together.

The lecture started with Prof. Decety talking a little bit about his family (From my short experience in attending conferences, this is something usual with western doctors). Prof. Decety explained briefly about the research center in which he works “The University of Chicago Social Cognitive Neuroscience Lab (SCNL).” Prof. Decety is the head of this center. This information really impressed me because Prof. Decety is French. He had his Bachelor degree, three master degrees, and PhD in France [1]. Nonetheless, Prof. Decety’s un-American origin did not prevent the University of Chicago from appointing him as a head of a research center as important as the SCNL. What matters are qualifications! This reminded me of multiple articles that spoke about how the USA attracts scientists from all over the world. Why would not it? Is not the story of Prof. Decety an excellent example why this occurs?

As the topic of the lecture became more and more clear to me, I started enjoying the multiple researches about which Prof. Decety spoke. I was impressed a lot with a sentence that Prof. Decety used to describe himself: “I am an Evolutionary Psychologist.” I have never heard about a branch of science with that name. However, it was not hard for me to expect what this branch of study is about: Explaining pychology in view of evolution! [Here is a wikipedia article about Evolutionary Psychology]! This is very amazing! I love evolution and I think it is very logical to use it to explain biology. It turned out that it can also explain “psychology”… Those atheistic infidels!

From the very first minutes of the lecture, Prof. Decety mentioned the “taboo” of evolution. An attending student raised his hand and asked a question that initially appeared to be related to the lecture’s topic. Nonetheless, because I come from this society, I knew from the beginning that it was a matter of the speaker wanting to prove that evolution is wrong. The questions did not stop and were more and more indirectly revolving about the correctness of Evolution. It is really a pity that many of the people around me still discuss whether evolution is correct or not! The world is way ahead of us. I do not think that this should be a topic of discussion anymore. The debate increased and another student joined. It was then consuming a lot of time that Dr. Dajani finally intervened and said (something like): “The discussion is now about Evolution and it will not end! Evolution is compatible with religion. Some think that it is not. Here at the society we will have a lecture that shows the compatibility of evolution with religion. Let us continue the lecture.” The lecture finally resumed!

Religious explanation are so wide!

Religious explanations are so wide! I really do not understand how accepting evolution contradicts the belief in God! // Source: religifake.com

Prof. Decety then explained about multiple studies. Of interest, Prof. Decety talked about the findings that the hormone oxytocin increased empathy. Prof. Decety then suggested jokingly, but also, almost seriously as of someone really concerned:

"Maybe we should spray the Middle East with Oxytocin?" Prof. Jean Decety, Head of the University of Chicago Social Cognitive Neuroscience Lab (SCNL)

“Some studies show that the hormone oxytocin increase empathy in human beings” Prof. Jean Decety, the University of Chicago.

I did not feel the time pass before the lecture ended. At his last slide, Prof. Decety had put the links of the facebook pages of his two lab: The SCNL and the Child Neuro Suite. He asked if we could like it (The link for the SCNL is here and the link to the Child Neuro Suite is here). Next, the audience asked some questions and Prof. Decety happily answered them.

Prof. Jean Decety, with active use of body language, answering the audience questions.

Prof. Jean Decety, with active use of body language, answering the audience questions.

Prof. Jean Decety, with active use of body language, answering the audience questions.

Next, I smiled a lot when I saw Prof. Decety holding a camera. What made me smile was that Prof. Decety was more interested to take photos more than the audience members who wanted to be photographed with him. When I saw the situation like this, I happily asked my friend [Thank you Dr. Fadi Walid Farah] to take a photo of me with Prof. Decety. Here I am now publishing it proudly (I hope that Prof. Decety does not mind that).

Jameel Hijazeen (Moa'bite) with Prof. Jean Decety, Amman, Jordan, 11/09/2013

[1] Jean Decety, Wikipedia, www.en.wikipedia.org/wiki/Jean_Decety

For Medical Students: Normal values for laboratory investigations, BP, and BMI (USMLE-friendly)

“We teach our students that they should not believe us… Do not believe your professors!” Dr. Kevin Hanretty, University of Glasgow, UK.

If some professors, somewhere, are teaching their students not to trust them, how come that you trust a colleague of yours? Therefore, the  source of the below information: Unless specified, most of the values are from “Step 1: Content Description & General Information 2012”, p. 22, www.usmle.org/pdfs/step-1/2012content_step1.pdf.  The remaining few are from “Reference Intervals for Laboratory Tests & Procedures”, ch.708, Nelson Textbook of Pediatrics, 19th ed, 2011.

*** To view and download a printer-friendly version, you can visit Google Docs at: https://docs.google.com/file/d/0B9fwLrrCPng0dTRyX1RzeFNjRlU/edit ***

Normal Values: Laboratory, BP, and BMI
Reference Range
Conventional Units SI Units
Serum Nonelectrolytes
Amylase, serum 25-125 U/L
Phosphatase (alkaline), serum (p-NPP at 30EC) 20-70 U/L
Alanine aminotransferase (ALT at 30EC) SGPT(serum glutamic-pyruvic transaminase) 8-20 U/L
Aspartate aminotransferase (AST at 30EC) SGOT(serum glutamic-oxaloacetic transaminase) 8-20 U/L
Bilirubin, serum (adult) Total // Direct 0.1-1.0 mg/dL // 0.0-0.3 mg/dL 2-17 µmol/L // 0-5 µmol/L
Lipoprotein levels – Adult Treatment Panel (ATP) III Classification of LDL, Total, and HDL Cholesterol (mg/dL):Cholesterol mmol/L (Total, LDL, and HDL) = mg/dL ÷ 38.6 // Triglyceride mmol/L = mg/dL ÷ 88.5 LDL Cholesterol (Primarytarget of therapy):

  • <100: Optimal
  • 100-129: Near optimal/above optimal
  • 130-159: Borderline high
  • 160-189: High
  • ≥190: Very high

Serum Triglycerides:

  • <150: Normal
  • 150-199: Borderline high
  • 200-499: High
  • ≥500: Very high
Total Cholesterol:

  • <200: Desirable\Recommen.
  • 200-239: Borderline high
  • ≥240: High

HDL Cholesterol:

  • <40: Low
  • ≥60: High
Creatine kinase, serum M: 25-90 U/L // F: 10-70 U/L
Creatinine, serum 0.6-1.2 mg/dL 53-106 µmol/L
Urea nitrogen, serum Cord blood: 21-40 // Premature (1 wk): 3-25 // Newborn: 3-12 // Infant or child: 5-18 // Thereafter: 7-18 mg/dL Thereafter: 2.5-6.4 mmol/L [BUN (mmol/L) = BUN (mg/d)/2.8]
Uric acid, serum 3.0-8.2 mg/dL 0.18-0.48 mmol/L
Glucose, serum Fasting: 70-99 mg/dL (USMLE: 110 mg/dL) (3.8-5.6) mmol/L2-h postprandial: < 120 mg/dL (6.6 mmol/L)
Categories of increased risk for diabetes (prediabetes): FPG: 100-125 mg/dL (5.6-6.9 mmol/L): IFG OR 2-h plasma glucose in the 75-g OGTT: 140-199 mg/dL (7.8-11.0 mmol/L): IGT OR A1C: 5.7-6.4%
Diabetes can be diagnosed with either one of the following four criteria:
(Source: Standards of Medical Care in Diabetes 2011, American Diabetes Association)  Glucose (mmol) = Glucose (mg/dL)/18
1. A1C ≥ 6.5%.The test should be performed in a laboratory using a method that is NGSP certified and standardized to the DCCT assay. *2. FPG ≥ 126 mg/dL (7.0 mmol/L).Fasting is defined as no caloric intake for at least 8 h.*3. 2-h plasma glucose ≥ 200 mg/dL (11.1 mmol/L) during an OGTT.The test should be performed as described by the World Health Organization, using a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water.*4. In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥ 200 mg/dL (11.1 mmol/L)*(*In the absence of unequivocal hyperglycemia, result should be confirmed by repeat testing.)
Lactate dehydrogenase, serum 45-90 U/L
Osmolality, serum 275-295 mOsmol/kg (Osmolality=  2x[Na] + [Glucose]/18 + [BUN]/2.8)
Iron 50-170 µg/dL 9-30 µmol/L
Ferritin, serum M: 15-200 ng/mL
F: 12-150 ng/mL
M: 15-200 µg/L 
F:
 12-150 µg/L
Serum proteins Total (recumbent) 6.0-7.8 g/dL 60-78 g/L
Albumin 3.5-5.5 g/dL 35-55 g/L
Globulin 2.3-3.5 g/dL 23-35 g/L
Immunoglobulins, serum IgAIgE
IgG
IgM
76-390 mg/dL0-380 IU/mL650-1500 mg/dL40-345 mg/dL 0.76-3.90 g/L0-380 kIU/L6.5-15 g/L0.4-3.45 g/L
Serum hormones
Cortisol, serum 0800 h: 5-23 µg/dL
1600 h: 3-15 µg/dL
2000 h: <50% of 0800 h
138-635 nmol/L
82-413 nmol/L
Fraction of 0800 h: <0.50
TSH, serum or plasma 0.5-5.0 µU/mL
Thyroidal iodine (123I) uptake 8%-30% of administered dose/24 h 0.08-0.30/24 h
Thyroxine (T4), serum 5-12 µg/dL 64-155 nmol/L
Triiodothyronine (T3), serum (RIA) 115-190 ng/dL 1.8-2.9 nmol/L
Triiodothyronine (T3) resin uptake 25%-35% 0.25-0.35
LH, serum/plasma
(Range in SI units: Same but in U/L)
M: 6-23 mIU/mL // F: follicular phase 5-30 mIU/mL // midcycle 75-150 mIU/mL // postmenopause 30-200 mIU/mL
PTH, serum, N-terminal 230-630 pg/mL (Pico=10-12 230-630 ng/L (Nano=10-9)
Prolactin, serum (hPRL) <20 ng/mL <20 µg/L
Estriol, total, serum (in pregnancy) 24-28 wks // 32-36 wks 30-170 ng/mL // 60-280 ng/mL 104-590 nmol/L // 208-970 nmol/L
28-32 wks // 36-40 wks 40-220 ng/mL // 80-350 ng/mL 140-760 nmol/L // 280-1210 nmol/L
FSH, serum/plasma
(Range in SI units: Same but in U/L)
M: 4-25 mIU/mL // F: premenopause 4-30 mIU/mL// midcycle peak 10-90 mIU/mL // postmenopause 40-250 mIU/mL
GH  – arginine stimulation
(Range in SI units: Same but in ug/L)
Fasting: <5 ng/mL // Provocative stimuli: >7 ng/mL
Serum Electrolytes
  1. 1.  Sodium (Na+)
  2. 2.  Potassium (K+)
  3. 3.  Chloride (Cl)
  4. 4.  Calcium, serum (Ca2+)
  5. 5.  Magnesium (Mg2+)
  6. 6.  Bicarbonate (HCO3)
  7. 7.  Phosphorus (inorganic), serum
136-145 mEq/L3.5-5.0 mEq/L95-105 mEq/L8.4-10.2 mg/dL1.5-2.0 mEq/L22-28 (25 ± 3) mEq/L3.0-4.5 mg/dL 136-145 mmol/L3.5-5.0 mmol/L95-105 mmol/L2.1-2.8 mmol/L0.75-1.0 mmol/L22-28 (25 ± 3)  mmol/L1.0-1.5 mmol/L
Arterial Blood Gases (ABGs) (room air)
pHPaCO2 PaO2 7.35-7.45 (7.40 ± 0.05)35-45 (40 ± 5) mm Hg75-105 mm Hg [H+] = 36-44 nmol/L4.7-5.9 kPa10.0-14.0 kPa
Hematological
Erythrocyte count M: 4.3-5.9 million/mm3F: 3.5-5.5 million/mm3 M: 4.3-5.9 x 1012/LF: 3.5-5.5 x 1012/L
ESR (Westergren method) (mm/hr) (Source: Medscape) NB: 0-2 // NB to puberty: 3-13  // M under 50: < 15 // F under 50: < 20 // M over 50: < 20 // F over 50: < 30
Hematocrit or PCV (Packed red cell volume) M: 41%-53%
F: 36%-46%
M: 0.41-0.53
F: 0.36-0.46
Hemoglobin, blood  0-30 days:15.0-24.0 g/dL1-23 mo: 10.5-14.0 g/dL
Until 18:11.5-16.1 (M) // 15.0 (F)…M:13.5-17.5 g/dLF: 12.0-16.0 g/dL
0-30 days:2.32-3.72 mmol/L1-23 mo:1.63-2.17 mmol/LUntil 18: 1.78-2.50 (M) // 2.32 (F)
M:2.09-2.71 mmol/LF: 1.86-2.48 mmol/L
Hemoglobin, plasma 1-4 mg/dL 0.16-0.62 mmol/L
Reticulocyte count 0.5%-1.5% of red cells 0.005-0.015
MCH 25.4-34.6 pg/cell 0.39-0.54 fmol/cell
MCHC 31%-36% Hb/cell 4.81-5.58 mmol Hb/L
MCV 80-100 µm3 80-100 fL (Femto  =10-15)
RDW_CV (Coefficient of Variation) 11.6-14.6% in adult
RDW_SD (Standard Deviation) 39-46 fL
Platelet count 150,000-400,000/mm3 150-400 x 109/L
Partial thromboplastin time (activated) 25-40 s
Prothrombin time 11-15 s
INR 1.0-1.1
Bleeding time (template) 2-7 minutes
Thrombin time <2s deviation from control
Leukocyte count and differential
Leukocyte count (WCC: White Cell Count) 4,500-11,000/mm3 4.5-11.0 x 109/L
  1. 1.    Segmented neutrophils
  2. 2.    Lymphocytes
  3. 3.    Monocytes
  4. 4.    Eosinophils
  5. 5.    Basophils
  6. 6.    Bands
54%-62%25%-33%3%-7%1%-3%0%-0.75%3%-5% 0.54-0.620.25-0.330.03-0.070.01-0.030-0.00750.03-0.05
Volume    Plasma M: 25-43 mL/kg
F: 28-45 mL/kg
M: 0.025-0.043 L/kg
F: 0.028-0.045 L/kg
   Red cell M:20-36 mL/kgF: 19-31 mL/kg M: 0.020-0.036 L/kg
F: 0.019-0.031 L/kg
Sweat
Chloride 0-35 mmol/L (ñ in CF, Ald defeciency, or pseudohypoaldosteronism)
Sodium 5-40 mmol/L
Urine
Oxalate 8-40 µg/mL 90-445 µmol/L
Proteins, total < 150 mg/24 h <0.15 g/24 h
Calcium 100-300 mg/24 h 2.5-7.5 mmol/24 h
Osmolality 50-1400 mOsmol/kg
Sodium, potassium, chloride, and uric acid Vary with intake/diet
Creatinine clearance M: 97-137 mL/min // F: 88-128 mL/min
Estriol, total (in pregnancy):

  • 30 wks
  • 35 wks
  • 40 wks
6-18 mg/24 h9-28 mg/24 h13-42 mg/24 h 21-62 µmol/24 h31-97 µmol/24 h45-146 µmol/24 h
17-Hydroxycorticosteroids M:3.0-10.0 mg/24 hF: 2.0-8.0 mg/24 h 8.2-27.6 µmol/24 h5.5-22.0 µmol/24 h
17-Ketosteroids, total M:8-20 mg/24 hF: 6-15 mg/24 h 28-70 µmol/24 h21-52 µmol/24 h
Urinary dipstick test (mg/dL) Trace: 10-20 // 1+: 30  // 2+: 100 // 3+: 300 // 4+: 1,000-2,000
CSF
Cell count 0-5 cells/mm3 0-5 x 106/L
Chloride 118-132 mEq/L 118-132 mmol/L
Gamma globulin 3-12% total proteins 0.03-0.12
Glucose 40-70 mg/dL 2.2-3.9 mmol/L
Proteins, total < 40 mg/dL < 0.40 g/L
Pressure 70-180 mm H2O
BP Classification (Source: Seventh report of the JNC, 2003, American Heart Association)
SBP (mm Hg) DBP (mm Hg)
Normal <120 and <80
Prehypertension 120–139 or 80–89
Stage 1 Hypertension 140–159 or 90–99
Stage 2  Hypertension ≥160 or ≥100
Body Mass Index (BMI)  (kg/m2(Source: WHO)
Underweight: <18.5 // Normal: 18.5-24.99 // Overweight: 25-29.99 // Obese: ≥ 30 (BMI =  Weight (kg) / Height(m)2)
  • 1 m3 = 103 dm3 = 106 cc = 10mm3 (One cubic meter = One thousand cubic decimeter = One million cubic cm =  One billion cubic mm = one billion uL)
  • 1 L = 1,000 cc = 1,000,000 mm3 = 1,000,000 uL // 1 uL = 1 mm3

 By: Hijazeen, JK. Any feedback? 

This image, provided by NASA, shows the first 360-degree color panorama taken on Mars by NASA’s Curiosity rover. NASA – Image of the Day – Gallery

NASA – Image of the Day – Gallery.

This image, provided by NASA, shows the first 360-degree color panorama taken on Mars by NASA’s Curiosity rover.

NASA - Image of the Day - Gallery

Elective course of clinical training in the USA: My horrible experience!

Elective Reqest- Jameel Khaleel Hijazeen - Mu'tah University*** This is a imaginary letter to a person who will enter my Blog and help me accomplish a dream of mine. Time is runnig out and this dream is most likely not going to be fulfilled… What is most important to me is that when other friends of mine have accomplished this dream, I will not be angry or feeling sorry, simply because I will have asked for help from all those whom I thought they could offer it! My blog is my last place to seek help! What I am requesting might be hard… yes… it is a DREAM! ***

Sir,

My name is Jameel Hijazeen. I am a 5th-year Medical student in Mu’tah University. In the period of June-August 2012, I am required by my faculty to do “two-months of clinical training in two of the major branches of medicine” (Please, to see the elective request, click on the resized image above).

Worldwide, the most advanced country in Medicine is undoubtedly the United States. What is more, if you are a doctor who is to be accepted for residency in the USA, one of the things that will tremendously support your CV is having “US experience”. Therefore, a dream of mine is to do my two months of clinical training in internal medicine in the form of an elective in the United States.

 

How did it all begin?

Starting from exactly 8 months ago, I started searching for how a Jordanian medical student from Mu’tah University can obtain such training.

Soon after my search started, I realized how expensive, complicated, and demanding is such a “dream” is. These are the main reasons:

1. Most universities\hospitals require expensive application fees and training fees. What is ‘interesting’ is that your application fees are ‘non-refundable’ even if you are not accepted.

2. Most universities\hospitals require having finished a USMLE step.

3. Most universities\hospitals require TOEFL (not required if you had finished a USMLE step or are recommended as a good English speaker)

4. Few universities\hospitals accept students from outside the US (Sometimes, an exception can be made if you are recommended).

5. Few universities\hospitals acknowledge Jordanian universities. Even fewer universities acknowledge Mu’tah University.

6. Applying for these universities\hospitals requires hours of papers filing, preparation, and sending.

 

What is the solution then?

I asked older students who know about this issue, all of them summarized the way in which someone can be accepted into two: Pure luck or having someone recommending you for acceptance. Till today, two students in my batch have already obtained an elective via the second way (one in the USA and another in France).  Via the first way, not a single students of the 5th year in Mu’tah University has obtained an acceptance; How surprised am I!.

For the above reasons, I did not contact any university\hospital. As a result, I was left with the second option.

image

Here is a list of the people I contacted:

# My faculty: No formal programs are available that are meant for sending faculty students to western countries. Nonetheless, certain efforts have been given. I deduced that because Dr. Omar Nafia Al-Ajarmeh, the vice dean, thankfully, contacted a certain University in the USA to accept some of Mu’tah students. In an email reply hanged on one of the boards in the faculty, a part of the response was, “Your university is not recognized by (certain accreditation committee)… Therefore, students from Mu’tah University cannot be accepted for electives in our university”.

# An uncle of mine: A thoracic surgeon in a western country since the 1980s. He had performed more than 4,500 operations. My uncle apologized and denied the presence of any friends of him in the US who could help. He advised me to seek help from my faculty doctors!

# Dr. Nabil S: An American-Jordanian doctor whom I met in a medical conference that was held in Amman. I took a list of the doctors who participated in that conference and showed them to another Uncle of mine to see if he knew anyone of them. For my huge surprise, he turned out to know the brother of this Dr. Nabil S. My uncle contacted his brother. Dr. Nabil, to my happiness, emailed me showing his readiness to help me. From the beginning, unfortunately, it was a hard road full of multiple obstacles!

The first obstacle that face me was that his hospital only accept students for obeserverships not for electives (It is enough to know that if you are an observer, you are never allowed to be in the hospital unless your sponsoring doctor is. What is more humiliating, you can never touch or simply talk to a patient). Reluctantly, I agreed. Do I have any other options so as to refuse this “great opportunity”?

Nevertheless, things got even worst. The doctor sent an acceptance for a two-month observership in family medicine; a branch which my faculty does not accept. So, I asked for the observership to be changed. Because I thought that I am going to remain under the supervision of the same doctor, I did not specifically talk about my wish to be accepted in the internal medicine department. As a result, I was accepted in the surgery department and at the same time, was told by an administrative in the hospital that I can only be accepted for one month… How worst can things be more than this? I emaild my complaints for two times… Dr. Nabil never responded!

# An American young Jordanian doctor: All my information about this doctor are from a blog that he has. Despite realizing how hard it is for a young doctor to recommend others for such a hard thing as an elective, and despite my little knowledge of him, I rudely contacted him. With a big heart, he showed readiness to help (as I expected). Unfortunately, the hospital where he works did not offer electives. At that point, I decided to bother him no more and so sent him no further requests. If my faculty, my relatives, and the friends of my relatives could not help, why would I bother a person that does not know anything about me to help?

The above is a list of the persons whom I contacted. I do not carry any bad feelings about them for not being able to help. On the contrary, whenever I talked to anyone about my elective, I felt ashamed because of my consuming their time and efforts!

 

Can you help me get accepted for a two-month

elective in internal medicine in the US?

image

You might consider it a small favor, but with this “small” favor, you are changing the life of a doctor-to-be forever!… It is like the “small step” of Neil Armstrong:

“That’s one small step for [a] man, one giant leap for mankind”[1]

Neil Armstrong, 2:56 UTC July 21, 1969.

 

 

[1] Source: “Neil Armstrong”, http://en.wikipedia.org/wiki/Neil_Armstrong, retrieved: 07.02.2012.

USMLE step 2 cs: New patient note

I am subscribed a newsletter by the ECFMG. Once subscribed to this mailing list, you get the most updated information regarding the USMLE. On december the 20th, 2011, I received an email from them annoucing “CHANGES TO THE STEP 2 CLINICAL SKILLS (CS) EXAMINATION”.

The next important question after asking what are the changes is “when are they going to take place”. “These changes will be introduced in Step 2 CS for examinations delivered beginning June 17, 2012.”

 

I like the new changes they are making to the patient note.

“In the new note, examinees will continue to be asked to document relevant history and physical examination findings and to list initial diagnostic studies to be ordered. Examinees will also be asked to create a reasoned, focused differential (maximum of three diagnoses) listed in order of likelihood and to indicate the evidence obtained from the history and physical examination that supports (or refutes) each potential diagnosis. The new patient note provides examinees with an opportunity to document their analysis of a patient’s possible diagnoses.”

Take a look at the new CS patient note:

image
image

 

For those who were not registered in the ECFMG mailing list, here is their full email:

 

The ECFMG(r) Reporter
An E-Newsletter for International Medical Graduates Pursuing Graduate Medical Education in the United States
Issue 180 – December 20, 2011
**********************************************
IN THIS ISSUE:
– CHANGES TO THE STEP 2 CLINICAL SKILLS (CS) EXAMINATION
**********************************************
CHANGES TO THE STEP 2 CLINICAL SKILLS (CS) EXAMINATION
One of the recommendations emerging from the Comprehensive Review of USMLE (CRU) process is that USMLE consider ways to further enhance the testing methods used in the Step 2 Clinical Skills (CS) examination. As previously announced in the 2012 Bulletin of Information, these enhancements are scheduled for implementation in mid-2012. These changes will be introduced in Step 2 CS for examinations delivered beginning June 17, 2012.
The reporting schedule for examinees testing from June 17, 2012 through November 3, 2012 will be 2-3 weeks longer than for examinees testing during other periods.
More information about the Step 2 CS score reporting dates for examinations delivered in 2012 is provided in the Step 2 CS Score Reporting Schedule at
http://www.ecfmg.org/news/2011/09/29/2011-schedule-and-2012-partial-schedule-for-reporting-step-2-cs-results/.
CHANGES TO THE ASSESSMENT OF COMMUNICATION AND INTERPERSONAL SKILLS (CIS)
The CIS subcomponent of Step 2 CS has been redesigned to assess a fuller range of competencies.  Background information about these changes is provided on pages 5-6 of the Fall 2010/Winter 2011 NBME Examiner at
http://www.nbme.org/PDF/Publications/Examiner-2010-Fall-Winter.pdf. The new approach divides communication skills into a series of functions. These functions have been further divided into sub-functions. Beginning June 17, 2012, the Communication and Interpersonal Skills (CIS) scale will focus on five functions:
1.      Fostering the relationship
2.      Gathering information
3.      Providing information
4.      Making decisions: basic
5.      Supporting emotions: basic
Several additional functions are still under development; these include making decisions: advanced; supporting emotions: advanced; and helping patients with behavior change. A list of the functions and sub-functions is available at
http://www.usmle.org/pdfs/step-2-cs/Assessment_of_Communication_Skills_Behavior_List.pdf.
CHANGES TO THE PATIENT NOTE
Also beginning June 17, 2012, a new patient note will be introduced. The patient note is completed by the Step 2 CS examinee after the encounter with the standardized patient. In the new note, examinees will continue to be asked to document relevant history and physical examination findings and to list initial diagnostic studies to be ordered. Examinees will also be asked to create a reasoned, focused differential (maximum of three diagnoses) listed in order of likelihood and to indicate the evidence obtained from the history and physical examination that supports (or refutes) each potential diagnosis. The new patient note provides examinees with an opportunity to document their analysis of a patient’s possible diagnoses. A sample of the new patient note is available for review at
http://www.usmle.org/pdfs/practice-materials/patient-note/new-cs-patient-note.pdf.
PRACTICE MATERIALS
Updated practice materials for Step 2 CS will be posted to the USMLE website in March 2012. These include the Step 2 CS Content Description and General Information Booklet, onsite orientation video, sample patient notes, and a simulation of the program for typing patient notes.
*********************************************
ABOUT THIS PUBLICATION
As an organization, ECFMG is committed to providing information on issues of importance to international medical graduates. We realize that many individuals would like updated information on developing issues related to ECFMG Certification and entry into graduate medical education in the United States. As a result, ECFMG has developed The ECFMG(r) Reporter to provide international medical graduates worldwide with timely, objective information on current topics of interest. It is our hope that this newsletter will allow physicians educated outside the United States and Canada to make informed choices on issues that shape their careers.
Previous issues of The ECFMG(r) Reporter are available on the ECFMG website. Subsequent issues will be posted to the ECFMG website as they are published. To access previous issues, visit the ECFMG website at
www.ecfmg.org/reporter/.
Interested individuals can join or leave The ECFMG(r) Reporter mailing list at any time. To join or leave, visit The ECFMG Reporter home page at
www.ecfmg.org/reporter/.
Please do not reply to this message. Messages received at this address will not receive responses.
We hope you find these updates helpful. Thank you for your interest in ECFMG.
Copyright (c) 2011 by the Educational Commission for Foreign Medical Graduates (ECFMG(r)). All rights reserved.

Have you ever eaten testicles?

*** Warning: This article is only for strong-hearted people 😉 ***

*** Another Warning: People from Jordan, can read this post without hesitation. They just understand! ***

Today, my Mother cooked us a very delicious Mansaf. Mansaf is a famous traditional dish in Jordan. Karak, my governorate, is famous for cooking this dish.

Today’s Mansaf was different; It didn’t only contain goat meat, but also, it contained a weird clyndrical-like piece of meat. This piece of meat was white-colored. It was lying there as if boasting as being the only one of its kind in our Mansaf.

“Is this a testicle?” I asked silently and slowly. In front of Mansaf, I don’t usually hesitate; There is always something to eat. Even if there is little amount of meat, the rice, BAGDONES, and syrup is delicious enough. Today, I hesitated.

“So this is what Dr. Hareega talked about…” I rememberd a very funny post by Dr. Fares Masanat- Hareega at www.hareega.blogspot.com. Dr. Masanat is a Jordanian physician working in the USA. That post was about him trying to buy “testicles” in the USA. I remeber he called this part of the goat’s body, “Beed”. Which means in Arabic, “Eggs!”….

[Wait! I now can describe the shape of this “weird clyndrical-like piece of meat.”… Yes! It is egg-shaped. This must be the cause why it is called “Beed” or “Eggs” in Arabic… Ah! Do you agree with me? I am not sure. I have just got this explanation in an Epiphany!]

“Yes, it is a testicle…” I heard. I was then sent into deep thinking, “Should I eat it or not?” After sternuous thinking, I said to myself, “If Dr. Hareega said that he loved them… I am sure it wouldn’t be a problem for me to try them!”

Next, encouraged by the opinion of Dr. Hareega, I grabbed this little lonely “egg-shaped” testicle. Then, I did it…

One bite… Second bite… A part of me told me to stop but another part wanted to find out what special taste it had… I continued eating. Finally, I reached a quick answer”:

“Lamb testicles, cooked with Mansaf, are roughly the same taste as the goat’s brain that is cooked with Mansaf!”

A small fraction of the testicle was left in my hand. In order to hide its weird taste, I ate it with a spoon of rice. The taste of the Mansaf rice was strong enough to hide its taste.

Will I eat testicles again? Soemtimes, people do things once in their whole life-time. This describes me today! Firstly and foremost, I tasted testicles because I wanted to know how they taste! Secondly, I wanted to know what special is about them that a Jordanian physician – Dr. Hareega- took the plunge of trying to buy testicles in the USA.

*. NB, I have just finished writing this post at my home where I don’t have an internet connection. This is why I am using the word “remeber” to talk about the post of Dr. Hareega.

# Update 30.08.2010:
See what reactions Dr. Hareega got here:
http://hareega.blogspot.com/2007/10/searching-for-testicle.html

English Village in Mu’tah University by Peace Corps Volunteers: Chris, Adam, Nataly, and Rachel. In addition to the coordination of Dr. Layla Omari

It is hard to disagree with the proverb that “you know the importance of something only when you lose it”.

 

I really enjoyed it… The most beautiful part, getting to now new people. I love Adam the most because he knows how to create and manage debates!

English Village in Mu’tah University by Peace Corps Volunteers: Chris, Adam, Nataly, and Rachel. In addition to the coordination of Dr. Layla Omari

It is hard to disagree with the proverb that “you know the importance of something only when you lose it”.

 

I really enjoyed it… The most beautiful part, getting to now new people. I love Adam the most because he knows how to create and manage debates!

Jackson Cha: Arrived, slept, then left Smakieh

Thursday afternoon, at about 3 o’clock, I and Jackson Cha arrived at Smakieh. I brought him from the South Bus Terminal in Amman.

Jackson slept at my house for 2 days. “I will never forget Somakkieh!” Said he at almost 7 o’clock this morning on the circle of Smakieh. He pronounced the name of my village in the weirdest pronunciation I’ve ever heard. It sounded funny!

At about 7:25, we both boarded Hamideh Villages-Amman bus. He chose a single seat. I talked to HH; a policeman who was wearing the national uniform of Jordanian traffic police. I told Hussam to “take care” of Jackson.

Next, I paid the bus fee of Jackson. It now costs 1.5 JD. Yesterday, Fuel prices were raised. Next, I came back to Smakieh. Jackson Cha was generous and courageous enough to not allow me to accompany him to Amman. I explained to him that I had a hard exam on Monday.

When I arrived home, I slept till 11 o’clock. I called Jackson seconds after the Alarm Clock went off. “I am sorry I didn’t call you.” He said immediately. “I arrived 2 hours ago!” Said he. I smiled. He then told me that he is copying the images he took in Smakieh on a DVD. He said that he is going to send me a copy in a mail message.

Will the DVD work after being sent using normal mail ? I hope so! I need those photos to describe not only the visit but many future posts about Smakieh, Traditions, Customs, etc.

All in all, it was a great experience I lived the previous two days. It showed me a hidden aspect of some of Smakieh people. How shy was i to discover some facts! I will talk about this in the future.

WordPress Tags: Jackson,Smakieh,afternoon,clock,South,Terminal,Amman,Somakkieh,Said,village,pronunciation,Hamideh,Hussam,policeman,Jordanian,traffic,Fuel,exam,Alarm,images,message,Traditions,Customs,aspect,Villages,photos

Playing a Christian Song in an ‘English Village’ in Mu’tah University, Insanity?

Chris is one of four American volunteers in a governmental American organization called ‘Peace Corps’. Today, Chris gave us the 4th lecture of the English Village course in Mu’tah University.

Since less than a year, Chris lives in Smakieh, my village. “We, volunteers, don’t choose where to live! Peace Corps just choose where we live!” Chris explained to a student in Qaser-University bus today’s evening.

Today’s lecture was about English songs. It was clearly that Chris had a hard job preparing this lesson for less than 30 students who attended his three-hour lesson. How many hours did he spend preparing the lyrics, downloading the songs from the internet then to his iPod, carrying large speakers to and fro the University, standing for 3 continuous hours explaining, discussing, and interacting with Jordanian students studying in Mu’tah University! If volunteers decided to ask for money in return for their lessons, what amount of money is enough to repay them their favors?

Chris asked us, students, what songs to play. He just enumerated the songs he prepared. Then he would wait for students to decide. After the first song or two he played, he started to talk about a song he had talking about ‘Christian Song’. “Oh God!” I thought to myself. Does he really understand what he is talking about? I discovered that it was only the beginning.

He described this song as “very emotional”. It is about a “conversation between God and his son, Jesus!” I didn’t know what to say or do! Doesn’t he know that he touched the most controversial issue between Christianity and Islam? The Quran talks specifically about the ‘infidels’ who claimed that ‘God had a son’. What? Why? How? I was baffled and my face flushed instead of Chris’.

Chris just continued. He didn’t seem to care. He talked as comfortable as if he was talking about the weather. I wanted to warn him. “You should stop! This is not a topic of discussion! Christians believe that Jesus is the ‘Son of God’ and Muslims…” How could I explain all of this to him in front of all students? Will I deliver my idea correctly? Should I enter in a discussion related to a forbidden subject as “Religion”? I sat silent waiting to see a student or another raising his voice to object to Chris. “How pity is Chris! He doesn’t know much about religions in the Middle East!” I felt sorry for Chris!

Students chose the third song and ignored the idea of hearing the “very emotional Christian song”. I felt relieved! But, for not too long!

We finished the third song. It was time to choose the next song.
Again, Chris began to explain what options we had. Again, I heard him mentioning “God and his Son”. “What is the matter with him?” I thought and thought! Again, the students voted to listen to another song. I was voting with them! I surely understood why they don’t want to understand such a song! Discussing religion is like discussing Sex or Politics. Nawaal Sa’dawee نوال السعداوي , an Egyptian feminist and writer, describe those horrible and unspeakable topics in the Arab World as “Forbidden Trinity”. Choose any other topic and talk about it!

Again, we finished this song. Chris wanted to start another. It was way long before lesson ends. Again and Again, Chris offers the Christian song, and we students, choose the one of the remaining 3 then 2 options.

20 minutes prior to the end of the class, Dr. Layla Omari, a doctor in the English department of the Faculty of Arts in Mu’tah University entered our class. Since the beginning of this course on Sunday, this is the first time the Supervisor doctor attended a lecture with us.

We finished the 5th or 6th song. We were left with two songs to choose from. The first song, you name it. The other one was about ‘loving one’s country’. A fuss occurred in the class, a female student behind me whispered to Dr. Layla. I was sitting between the two. I didn’t turn my head toward them. I didn’t want to appear spying on them. In the first place, why was she whispering? She wants the subject to be classified.

I overheard the following words… “Tell him… Religion…. Religion…” Then Chris just interrupted and all the students, including this one, stopped talking. Dr. Layla nodded like she understood what the girl talked about.

It was the time to choose the last Song to hear. It was almost 5 o’clock. Students had only two options. What do you think we chose? You guess it! I smiled at how Chris insisted on describing what the Christian song talked about. I have never seen him in the Church in Smakieh. Why Christianity was so important to him then?

After the lecture, I waited till all students left. I approached Chris and was beginning to explain to him this controversial issue between Christianity and Islam. “I know!” Quickly he answered. I was shocked. “Muslims doesn’t believe that Jesus is the Son of God!” I said nothing more. It turned out that he knows! Why did he talk about it then? Is this “Bravery” or “Misjudgment”? I thought for a moment until Chris expressed his opinion!

How courageous is to have a principle in life! What is more courageous is to defend this principle! The principle might be wrong! This might be the case as trying to play a Christian song in Mu’tah. But in the end, you are defending what you believe in no matter what Moabite or others think of!

“OK, Muslims don’t believe in this… Fine! If you listen to other’s opinions, this doesn’t mean that you are accepting them! Just listen to them”

What do you think? Is Chris’s principle correct? Should you listen to an idea or opinion you definitely believe is incorrect?

The Sound of Harmony Band of Boston is performing in Karak, Jordan

The above band is supposedly to perform in Karak this evening. I read an Ad in Alghad newspaper yesterday evening. This activity is one of the very first activities of the Jordan Vestival. They specified the date but not the time.

I searched in google news… I searched in Jordanian Newspapers websites but never found an answer. The best I could find was in Alrai newspaper. It only confirmed to me that the event will be held today’s evening in Marj, Karak. But when?

Today’s morning, before 8 o’clcok, No Ad was hanged on the north gate of Mu’tah university. Where can I find the timing? Please…

I will call a friend of mine (Mazen Kh) to inquire;  he lives in Marj. maybe he saw an Ad on his way to university.

If it turned out that I have no exam tomorrow, I will make sure to attend this event held by this American band.

Googling the name of this band gave me no clear results. Either the name is wrong, or, maybe the band is not very famous. Will a famous and very prestigous band agree to perform in a small place like Karak?

Since I put the name of this band as the title of my post, will this post appear in google search engine when a person want to get information about this mysterious band? Will my post be one of the top 10 results?

Lets wait and see… In the mean time, dear reader, if you arrived to my blog through google after searching for “The Sound of Harmony Band!” Can you publish this interesting information in the “comment” section below… Thanks!

Rachel Cleary: “This word is so bad that I haven’t proably said it in my life!”

What kind of word that my English teacher couldn’t have ‘probably’ said in her life? I and the students in the English village class in Mu’tah university were amazed at how intense, emotional, and almost agressive our English teacher, Miss Rachel Cleary became. But what was said that bothere her?

A student started a questoin, with a modest English, saying, “Negro!” The teacher didn’t give herself nor us a time to understand what the question is about. She just answered him very quickly and strongly. I couldn’t imagine how a smily, jolly, and joking person can become furious as she was. Women!

“This is the worst word in English language!” She stated confidently. Wow! I didn’t know that such a word is that bad. She continued only not to let anyperson have the chance to think of the innocence of this word against the charges against it. To prove her point of view, she only asked a question. She is smart to have asked such a question. When you put yourself in other’s places, you can understand what they feel. When teacher rachel asked that question, I could understand what she thought about this word. She asked:

“What is the most horrible Arabic word?”

She gave us little time to think. Later in my house, it took me minutes to think of an answer. She then said only to deliver her idea effectively and strongly, “Negro is like this most horrible Arabic word!” Wow! How could she come with such a comparison? Again, “Women”!

The most horrible Arabic word in my opinion could be “Infidel”. I hate this word because it is a sterotype against those not following a certain religion. As Negro is sterotyping against a human beingjust because of the color of his skin, an infidel sterotype against a human beings for freely choosing his religion!

English Village in Mu’tah University Started on Sunday

I met 2 Amreican volunteers till now. The man, named Adam, is a unique person. He is the kind of of teacher you will remeber till the end of your life.

I was surprised to know that there were Iraqi Kurdish students studying in Mu’tah university. Four are part of the English village.

Today, Chris is gonnna give us his first lecture. Will he be as shy as he is in public buses? Will he be as confident and funny as Adam is? Will he be as courageous as Rachel was in front of the angry doctor who wanted to get us out of the classroom? Will he control the lesson strongly as both Adam and Rachel did?

A guy told me that Rachel is married to a Tarawneh man. Really? If so, I wonder what personality doles this person have that he was able to make an American women, of different culture and different standard, to fill in love with him?!

Who is to be blamed more on poverty, governments or individuals? My opinion was that it depends on what country that individual lives in. If he is a hardworking person but lives in a country where there are no jobs, and if there are jobs, they generate low salaries, then the blame is not his but on his country. Don’t you think that my opinion is correct?

Obama in Mu’tah University

Now I am sitting in the deanship of students in Mu’tah university. It is 1:20. Although I had been sitting here since 10 o’clock, I still have many and many things to do on the internet.
What really made me stop surfing the internet is that Obama’a voice and image are seen in the deanship.
In body, Obama is now doing a speech in Egypt. JRTV is now live broadcasting the speech. Obama is still talking since more than 7 minutes.

The university is empty today because most of the students, including me, finished their final exams yesterday. Some students, however, are seen between now and then in the deanship.

5 students, including me, are now sitting on chairs inside the deanship. The don’t seem to care about the speech. One is playing with his mobile phone, a girl is just sitting down and starting at nothing, another is very busy with both his laptop and mobile phone.

What catches my eye is a man who is standing less than a meter away from the more than 35 inch LCD screen of the deanship. He is still standing. He doesn’t move. He is very attracted to the screen. “Islam is part of America…” I heard Obama saying. Well, this will surely have a positive effect. Won’t it?

The man is now sitting on a near bench. It seems that he wants to continue watching the speech.

Should this speech make a kind of ‘change’ that Obama want americans to ‘believe in!’.
In the begining of the speech, Obama explained that one speech can’t correct the situation.

Will I go back to hom at 2 o’clock? As long as I am allowed to keep sitting, I don’t think so!

10.09.2008 Chris, An American Volunteer Arriving at Smakieh in the House of Mukhles Torman Hijazeen (2nd day)

*. At 9 o’clock this evening, I went to Mukles Toman house. Yesterday, I arranged with the new guest of Smakieh, the American Chris, to visit my aunt. He wanted to install an internet connection at his house. I suggested that he share a connection with my cousin. Although I wasn’t sure of what I was talking about, I just wanted to socialize with this different human being. Today, however, I did my calculations again. Why should I force myself on him? Certainly, he will look down at me. Doesn’t a proverb say, “Easy come, easy go!” If Moabite gave his services quickly and without any considerations to his own needs, will this make Chris respect him? I don’t think so. What if you think that you have good English when compared to inhabitants of a desert village like Simakiyya? Chris is not searching for fluent English speakers. He is searching for someone who is not interested in improving or even learning English. This way, he will be improving his Arabic more effectively. Are you good at dealing with your fellow Jordanians? How could you deal with a person from a different culture? Do you have a lot of friends? You don’t have. How could you gain the friendship of a foreign person?

As a result, Moabite didn’t talk to Chris at all this evening. At the beginning of the 10 minutes visit to Mukhles house where Chris was invited to dinner, Moabite apologized to Chris because his cousin is in Amman (Daniele is bringing his wife from her family’s!). Next thing, he asked Chris how his first day of School was. “Students here are much different than of Irbid.” It was the only good sentence that he said that contained no compliments. Moabite acted like a smart ass and said, “These are the type of people Lawrence of Arabia lived with!” Wow! How informative are you Moabite. Do you know anything about this Lawrence except the Movie you watched? Do you know any worth-mentioning point about this obviously great man?! Why are you opening subjects you are not well-informed about? “Yes,” Chris answered. What could he answer other than this? Moabite then realized how he is raining this fresh visitor of not very accurate information. “Bedouins!” Chris cleverly deduced. Moabite was touched when he heard Chris’s answer. “How could he think of such a simple, concise, and 100% correct answer?”

After asking this question, Moabite sat silently. He talked not to anyone. Mukhles was talking to his sister-in-law, Umm Udai Torman. Mukhles wife was occasionally talking to Moabite. “What does your brother study? You study in Jordan University? How many years have you been studying?” Moabite was asked. The TV was turned on. It was a Syrian soap oprah. “A person doesn’t get bored with all of these shows!” Mukhles wife commented to Moabite. Moabite didn’t have an answer and only gave a smile. He ignored the TV and tried to figure out what important subject is preventing Mukhles from talking to Chris. It seemed that Mukhles was discussing something very important with Umm Udai. Moabite lost hope in Mukhles. “He won’t talk to Chris! It is non of my business. I am not talking to him.” Moabite thought, “I have many questions to ask, but I won’t to make any further damage to my image in front of Chris.” The situation continued this way for more minutes. There were about 6 children in the room. All of them were, as yesterday, looking at Chris. This time, however, TV shared attention with Chris. Children would look at the TV, then quickly look back to see how Chris is reacting to whatever is shown on the Channels. The situation continued this way. “Mukhles,” Muklhes wife grabbed her husband’s attention. “You have a guest!” He sounded like a mother banishing her son. “Talk to him!” Mukhles was very interested in his conversation that he didn’t even respond. He just continued speaking. Moabite kept silent. Chris tried to take interest in the TV. Chris tried to smile between now and then.

Finally, Chris said in broken Arabic words that he was tired. He left and Moabite followed him as a child follows his father. They walked together to Chris’s house. It was less than 50 meters away. Moabite, still, didn’t say a word. Chris commented how the sky is clear. It seemed that Chris was anxious because he didn’t correctly locate the hand of the house outside gate. “Nice to meet you!” Moabite said just before Chris was about to disappear behind a wall. Chris responded the same sentence. “You know something?” Moabite almost shouted to grab Chris’s attention because Chris almost arrived at the door of his house. Chris stopped and walked toward Moabite as if he waited Moabite to say something. “I don’t know you name yet!” Moabite commented. How ironic? Moabite had spoken with Chris for hours and hadn’t asked him about his name! “Chris!” Chris simply answered. “I…” Moabite muttered. Chris understood Moabite and answered after little hesitation, “Moabite!”.

Moabite continued walking toward the direction of the house of his aunt, he said at last, “Nice to meet you!” How irrelevant! Moabite didn’t know what to say! The same sentence was repeated from the yard of the house. Moabite went to the Layer’s house to check what happened with the potential buyer of their land in Ws. He didn’t find the layer. Later that evening, the Layer called them and told them that the buyer thought that the land is very tall in length. Moabite, courageously, called Hussien and told him that they only wanted to sell one piece of land. Hussien said that he only wanted to buy the two. “Put yourself in our place, will you sell the two pieces and put the money in bank?!” After hearing this great explanation, Hussien didn’t comment anymore. Moabite continued, “If you happened to want to buy the land, call us!” Next and lastly, “Thank you Abu Sa’ed!”.

10.09.2008 Chris, An American Volunteer Arriving at Smakieh in the House of M Hijazeen (2nd day)

*. At 9 o’clock this evening, I went to M Hijazeen house. Yesterday, I arranged with the new guest of Smakieh, the American Chris, to visit my aunt. He wanted to install an internet connection at his house. I suggested that he share a connection with my cousin. Although I wasn’t sure of what I was talking about, I just wanted to socialize with this different human being. Today, however, I did my calculations again. Why should I force myself on him? Certainly, he will look down at me. Doesn’t a proverb say, “Easy come, easy go!” If Moabite gave his services quickly and without any considerations to his own needs, will this make Chris respect him? I don’t think so. What if you think that you have good English when compared to inhabitants of a desert village like Simakiyya? Chris is not searching for fluent English speakers. He is searching for someone who is not interested in improving or even learning English. This way, he will be improving his Arabic more effectively. Are you good at dealing with your fellow Jordanians? How could you deal with a person from a different culture? Do you have a lot of friends? You don’t have. How could you gain the friendship of a foreign person?

As a result, Moabite didn’t talk to Chris at all this evening. At the beginning of the 10 minutes visit to M’s house where Chris was invited to dinner, Moabite apologized to Chris because his cousin is in Amman (my cousin is bringing his wife from her family’s!). Next thing, he asked Chris how his first day of School was. “Students here are much different than of Irbid.” It was the only good sentence that he said that contained no compliments. Moabite acted like a smart ass and said, “These are the type of people Lawrence of Arabia lived with!” Wow! How informative are you Moabite. Do you know anything about this Lawrence except the Movie you watched? Do you know any worth-mentioning point about this obviously great man?! Why are you opening subjects you are not well-informed about? “Yes,” Chris answered. What could he answer other than this? Moabite then realized how he is raining this fresh visitor of not very accurate information. “Bedouins!” Chris cleverly deduced. Moabite was touched when he heard Chris’s answer. “How could he think of such a simple, concise, and 100% correct answer?”

After asking this question, Moabite sat silently. He talked not to anyone. M was talking to his sister-in-law, Umm Ud. M wife was occasionally talking to Moabite. “What does your brother study? You study in Jordan University? How many years have you been studying?” Moabite was asked. The TV was turned on. It was a Syrian soap Oprah. “A person doesn’t get bored with all of these shows!” M’s wife commented to Moabite. Moabite didn’t have an answer and only gave a smile. He ignored the TV and tried to figure out what important subject is preventing M from talking to Chris. It seemed that M was discussing something very important with Umm Ud. Moabite lost hope in M. “He won’t talk to Chris! It is non of my business. I am not talking to him.” Moabite thought, “I have many questions to ask, but I won’t to make any further damage to my image in front of Chris.” The situation continued this way for more minutes. There were about 6 children in the room. All of them were, as yesterday, looking at Chris. This time, however, TV shared attention with Chris. Children would look at the TV, then quickly look back to see how Chris is reacting to whatever is shown on the Channels. The situation continued this way. “M,” M’s wife grabbed her husband’s attention. “You have a guest!” He sounded like a mother banishing her son. “Talk to him!” M was very interested in his conversation that he didn’t even respond. He just continued speaking. Moabite kept silent. Chris tried to take interest in the TV. Chris tried to smile between now and then.

Finally, Chris said in broken Arabic words that he was tired. He left and Moabite followed him as a child follows his father. They walked together to Chris’s house. It was less than 50 meters away. Moabite, still, didn’t say a word. Chris commented how the sky is clear. It seemed that Chris was anxious because he didn’t correctly locate the hand of the house outside gate. “Nice to meet you!” Moabite said just before Chris was about to disappear behind a wall. Chris responded the same sentence. “You know something?” Moabite almost shouted to grab Chris’s attention because Chris almost arrived at the door of his house. Chris stopped and walked toward Moabite as if he waited Moabite to say something. “I don’t know you name yet!” Moabite commented. How ironic? Moabite had spoken with Chris for hours and hadn’t asked him about his name! “Chris!” Chris simply answered. “I…” Moabite muttered. Chris understood Moabite and answered after little hesitation, “Moabite!”.

<

p>Moabite continued walking toward the direction of the house of his aunt, he said at last, “Nice to meet you!” How irrelevant! Moabite didn’t know what to say! The same sentence was repeated from the yard of the house. Moabite went to the Layer’s house to check what happened with the potential buyer of their land in Ws. He didn’t find the layer. Later that evening, the Layer called them and told them that the buyer thought that the land is very tall in length. Moabite, courageously, called Hussien and told him that they only wanted to sell one piece of land. Hussien said that he only wanted to buy the two. “Put yourself in our place, will you sell the two pieces and put the money in bank?!” After hearing this great explanation, Hussien didn’t comment anymore. Moabite continued, “If you happened to want to buy the land, call us!” Next and lastly, “Thank you Abu Sa’ed!”.

American Volunteer arriving at Smakieh

A few days ago, an American volunteer rented a house in Smakieh. It is the house of Sharea’ Hijazeen. His name is Chris. He will be both teaching English and learning Arabic at Hmood High School for boys– a governmental school. Yesterday night, I met him in the house of Mukles Torman Hijazeen.

Chris works with an organization called “Peace Corps”. “Peace Corps aims at eliminating the misconceptions that people have about the US” Chris said yesterday evening at the house of Mukhles Torman. What is more, helping promote understanding between the Middle East and the United States is but one side of the coin. “After 2 years,” Chris said. “I will be back in the US. There, I will be teaching my fellow American’s about the Middle East.”

Before coming to Smakieh, he spent two months in Irbid. He used to live at a host Muslim family. In order to understand more about Islam, Chris proudly and happily said how he fasted for five days. His next station was Smakieh. “I was astonished.” He describes his feelings when he found out some facts about this tiny southern Jordanian village. “In Irbid, I was taught how to live in a Muslim society.” He recalls. “I came to Smakieh and I found that it is an all-Christian village.” He regretted.

Mukhles Hijazeen and his wife, one of Chris’s closet neighbors, were very happy. Still, their happiness is nothing compared with that of their children. One of their two sons, Hamzeh, aged around 8 year-old, smiled as if he was sitting beside a king. Most of the time, the tiny hands of Hamzeh held the left hand of the embarrassed Chris. Hamzeh looked like a son clinging to the hand of his mother. You should have seen the embarrassment on Chris’s face when the little Hamzeh kept and kept holding his left hand. Moabite noticed a silent call of help in the eyes of Chris. Moabite, however, never allowed himself to intervene. Moabite thought that if there was anything wrong in the obvious huge compassion the child shows, then his parents are the ones who should react.

Moabite acted as a translator between Chris and this Hijazeen family. “I should make no conversation at all. This is why I was invited to drink a cup of tea, it was because they needed my knowledge of English.” Moabite told himself. Consequently, most of the time, Moabite was only doing translation. Occasionally, he looked at the faces of Muklish, his wife, and his 6 children. Based on previous experience, Moabite used to think that people, especially young children, stares at him when he speaks English. Wouldn’t you stare at a person who speaks a language you don’t know? But that night, not on any of the few occasions he looked at the family did he find anyone looking at his direction. All of the people present, young and adult, males and females were staring at Chris. All of the time, Chris was the center of attention like a singer on stage. “I am invisible!” Moabite thought cynically. Was Moabite upset because of being ignored? Not at all! He gets embarrassed whenever he is a center of attention. “Nice, I hope that no one is looking at me now, no one will be describing my English to Smakieh.” Moabite thought the way his society teaches. He hoped that no one would ‘envy’ him because of his English. How sad is that some people, in the 21 century, still believe in myths as envy!

Over a period of 60 minutes, Moabite and Chris drank 2 cups of tea with mint. The time passed quickly because there was always something to talk about. For example, how much does the organization pay Chris? Chris told them that he receives a salary of 170 JD. Every one present, except Chris and the little children, were amazed. How could it be that an American receives such a low salary? Egyptian workers receive higher salaries. Don’t they? Chris had to explain, for many times, what it means to volunteer. On the other side, more than 3 times, Mukhles and his wife made the translator, Moabite, translate to Chris stories about the Canadian family that used to live in that same house Chris is now living in. “In two years, they spent more than 100,000 JD. All paid by the organization.” Mukhles said amazed. His wife followed him to say how the Canadians toured not only whole Jordan, but also the whole Middle East. “Jerusalem, Syria, Sharm Sheikh…” She gave examples of places they visited. After huge emphasis on the salary issue, the conversation took a turn to discuss the Canadian Family. Both of the parents praised, Ken, the husband, a lot. They stated how nice he was, how he used to come and sit with them, and how different he was from his wife. Talking about his wife, Chris laughed about a description they gave of her character. They didn’t love her as they loved the husband.

In another instance, a hazardous subject was started; Politics. In short, political views of Chris will bring him publicity with a Middle Easter. He stated how horrible America’s foreign policy is. Later on, he described how America, not the American government, wants money from the whole world. In many occasions, he clearly stated the need for a change. In his opinion, laws in America only support the wealthy people (Somehow, I can’t remember this point exactly.) “You are voting for Obaman?” Moabite deduced easily. Chris didn’t object on Moabite’s comment. The conversation about politics ended when Mukhles wife whispered to him, almost stealthily, “Leave it!” Moabite laughed as he was the only one who noticed this warning. Muklhes looked at Moabite and said nothing. From that moment on, politics was history.

“I wash my clothes manually; I want to buy a washing machine.” Chris asked for advice. Mukhles showed him 2 types of washing machines. One of them was very plain that only rotated the clothes within it. It had no dryer. “You can get it as low as 50 JD” I translated after Mukhles. To my amazement, Chris said that this was expensive. He wanted to know if there were cheaper washing machines. Mukhles informed him the bad news. Later, Mukhles told Chris that he can take him to Karak city if he wanted to buy anything. I don’t believe that Mukhles will profit any money from Chris. Chris thinks that 50 JD for a washing machine is ‘expensive’. How could such a person afford hiring a car when he wants to travel? “I will pay his bus fee if we go to Karak castle together.” Moabite took sympathy at Chris because he thought of how an American can get used to living by such a very low income!