C:\user\bea\letters\usa2000.doc 2000-06-13 11:45 TRIP REPORT: WASHINGTON DC, NEW YORK CITY AND ALBANY, May 1-13, 2000 by Bea Kovacsovics, assisted by Torbjörn Ledin Dear Friends! It s time again for a short trip report. Recently we spent 13 days in the EASTERN Part of THE UNITED STATES. WASHINGTON DC. The whole thing started with that we attended the Meeting of the European Society of Head and Neck Radiology in WASHINGTON D C. I hear you exclaim here: Washington D C is the USA, how come that we were in the States? Our Society has joint meeting with the American organization in every third year. Every second such occasion is held in America, every second i Europe. This year was USA s turn. The American doctors must collect so called credit points which prove that they participated meetings and symposia and learned the newest methods - treatments in their speciality. Because of this the educational sessons dominated over THE JOINT MEETING OF THE HEAD AND NECK SOCIETIES this time."repetition is the mother of knowledge" - as the old Romans said. The symposium on clinical problem focused imaging gave me a new way to see the head and imaging. Despite of this I must confess that the scientific meeting on imaging of the ear was the most enjoyable for me. The American way to organize a congress is to collect all the participants into one huge hotel and arrange all the programs - both scientific and social -in the same building, preferably in over air conditioned rooms. I was for the first time in my life guest in a huge American hotel, which gave extra experience to the meeting. There was a funny thing: the breakfast was in included in the congress fee! As you know the American hotels seldom include the breakfast in the room prize, so the congress arranged the morning meal instead in the form of simple continental breakfast. When we saw the huge piles of muffins and other bakery products in the morning somebody asked - continental breakfast? But which continent? Another colleague answered - the American continent of course. Well, Washington D C is much more than a Hotel near to the ZOO. From this town governs the world richest nation - USA. It s interesting to discover how this city looks like. Washington D C belongs to the so called "planned towns", (like St Petersburg or Brasilia) those who did not develop slowly, step by step but the whole city was planned built during a short period. These towns are well organized ones, but a bit sterile. A scholar of the neoclassical and neorenessaince buildings would thrive in Washington.
The most of the sights interesting for the tourists are along the MALL the long park west of the Capitol or on the streets just north or south of the Mall. Only a few buildings like the Congress Library are on the Capitol s east side. The sights fall into four categories: 1. governmental buildings, 2. museums, 3. monuments 4. others. The surprisingly small, dimly lit rooms of the CAPITOL are in contrast with the majestetic outer appearance of the building. The NATIONAL ARCHIVES is a must for the visitor in Washington DC. There are the three founding documents of the USA - The Declaration of Independence, The Constitution and The Bill of Rights exhibited. (+ a copy of the Magna Charta!) A congress participant must select heavily from the 10 museums of the Smithonian Institute. The AIR AND SPACE MUSEUM is a must. Where else can you see the Lunar module of the Apollo program, the Gemini & Mercury space ships, new and old aeroplanes, exhibition about the carriers and many many more? The dinosaur skeletons in the NATURAL HISTORY MUSEUM are also interesting, not forgetting the submarine exhibition in the AMERICAN HISTORY MUSEUM. As I am geography fan we could not miss the Exploration Hall of the NATIONAL GEOGRAPHIC SOCIETY with the exhibition on the Antarctica in it. We even had a birds-eye view of Washington from the tower of the OLD POST OFFICE. One funny thing. We saw several statues of a man from the 2 nd half the 19 th century, named Garfield. Torbjorn never could stop laughing when he saw him. Garfield is a cat, isn t it???? What does Encarta Encyclopedia say? Garfield, James Abram (1831-1881), 20th president of the United States (1881). He held the office of president only four months before he was fatally shot by an assassin. He had served in the House of Representatives of the Congress of the United States for 17 years and had established a distinguished record there. He was only lightly touched by the corruption in government that marked the period after the Civil War ended in 1865. Garfield's assassination by a disappointed office seeker gave new impetus to demands for reform of the federal employment system, called the civil service. 1 After Washington it was time for the second scientific event of our trip - a visit in the ENT department of Albany s University Hospital. NEW YORK CITY Approximately halfway between Washington and Albany is NEW YORK CITY (NYC). There we had to stop. While Washington DC is the diplomatic capital of the USA, New York - as it s well known - is the "practical capital", the centre of commerce, trade, finance and culture. No one of us has ever been in the Big Apple, but we read and heard a lot about this city: the newest, the biggest, the greatest, the tallest. All of our friends were very impressed by New York. You can imagine our curiosity was on the top level when we arrived to NYC. 1 "Garfield, James Abram," Microsoft Encarta 98 Encyclopedia. 1993-1997 Microsoft Corporation. All rights reserved.
Buildings were surprisingly old in the capital of the newest, fanciest, biggest stuff. All the famous landmarks of the town were built in the 30-ies (Empire State Building, Chrysler Building, Rockefeller center), 50-ies (Guggenheim Museum, United Nations), 60-ies (Lincoln Center, Met Life Bldg) and 70-ies (World Trade Center). My problem with them was that these sights WERE modern when they were new. The style of the time they were built is too dominant and it was difficult for me to accept that New York is so fancy and great while the buildings are so old. The problem is that during the 2½ days we spent there we could not discover the soul of New York, the people and the mentality of the city, which can make a town great and fancy despite of the old buildings. It may sound controversial, but we were very lucky with the people in New York. A few years ago I met MARTHA, a teacher of literature in Albany s University. She grew up in NYC and frequently visits this town. We could stay with her in her apartment on Upper East Side, and see how a typical New Yorker's flat looks like. (Small rooms with a tiny kitchen and an air-conditioner. And a door-man in nearly every house.) She could suggest us nice spots for sightseeing and told us things that a tourist would otherwise not hear. Martha runs her great-great uncle s foundation which supports a lot of cultural and educational projects in NYC. It s very usual that rich people donate money to theatres, museums, cultural and educational organizations, as donations are tax deductible in America. We visited Martha in the TUCK FOUNDATIONS office in the CHANNON BUILDING on the 42 nd Avenue, just opposite to CHRYSLER BUILDING, in a famous area in Midtown). Could we have had a chance to see an office in a Manhattan skyscraper otherwise? Martha knew which play was worth to see and many many more. Martha introduced us to DENISE, the foundation s book-keeper. She is even more a New Yorker, (with her own words - a New York "mutant") as she lived in this town in practically all her life. After a dinner in a restaurant overlooking THE STATUE OF LIBERTY Denise drove us in a zig-zag manner around the Manhattan island and we could have a glimpse of a lot of parts of New York, which we could not have seen during our 2½ day stay. Of course Denise did not miss to drive us to Brooklyn showing us the Manhattan skyline by night. Without Martha and Denise we would know even less about the soul and mentality of New York. The New York book written by Pamela Thomas also has helped me to understand New York a bit better. We were less lucky with the weather. The stone jungle of Manhattan had to be discovered in a 33 o C heat wave. Manhattan is a small island, 20 km long and 4 km wide at the widest point. There all the wealth of New York concentrates. It occurs to me that the other parts of the town are only to serve Manhattan and provide homes for those who could not get a flat there. Imagine all the goods you see on the island must be transported there! Manhattan consists of a numerous "districts", and all of them has it s own history and character. To simplify: New York started as a small town on the southern tip of Manhattan and successively the city moved northwards. If I understood well this went on until the very beginning of the 20 th century, when the island became full. People live very tight in Manhattan, the physical distance between them is short and - according to what we read and discussed - they compensate for it by keeping long intellectual distance from each other. This leads to communication and relation problems. There are many lonely people in New York. The relation - or no
relation - is mirrored in the artistic life in New York. Martha took us to a dance-play "CONTACT " at the VIVAN BEAUMONT THEATRE in the LINCOLN CENTER. The difficulties of making contacts in New York was very expressive in the third - and last - part of the play, which is about New York in the 90-ies. I interpreted the play the most pessimistically: may be the people in New York (at least whom the play was about) has lost their capability to make human contacts for ever. (Martha and Denise showed the opposite of it!) Apart from learning about New York from the inside and analyse the relations in this huge town, we managed to see some parts of Manhattan. The areas in and around the southern part of CENTRAL PARK, including some of the famous museums there, parts of MIDTOWN, the very centre of New York and the SOUTHERN TIP OF MANHATTAN - where New York started. Our favourite was the STATEN ISLAND FERRY from where one has a very good view of Manhattan skyline, the STATUE OF LIBERTY and ELLIS ISLAND. I am sure we liked the ferry most as it was the coolest point in the Big Apple during our stay. Because it is impossible to discover New York in 2½ days small things gained importance: discovering the Vietnamese cuisine in street corner restaurant in a typical New York house: red bricks and fire ladders. We will not forget the Asian section of the PUBLIC LIBRARY. We found there a book about the fax numbers in China, 1998. It was not a too thick book According to Torbjorn they should have thrown the book out a long time ago. I was surprised that no newer edition of the Chinese fax numbers exists. Or just to sit in a restaurant on the Southern edge of Manhattan looking to the Statue of Liberty. I had a funny feeling in New York: it was quite natural to be there. But why? I think it has a lot to do with the American films. A great deal of them are shot in New York and already before a trip one saw the "Yellow river the New York way" (cabs) and famous skyscrapers several times on film. To take the subway is not new for me, I rode the Budapest metro for 25 years. (Of course there are differences between the two systems but the basic idea is the same.) I wrote a lot and quite philosophically what happened to us on our way from Washington DC to Albany Medical Center. Now it was time to take the train from New York to Albany, the Capital of New York State. The TRAIN STATIONS were organized surprisingly unpractical. The people were let onto the train platforms only approximately 10 minutes before it left the station. As a consequence of this, huge crowds pushed and pressed on the narrow corridors and stairs of the station. What happens if a passenger is handicapped or just simply old and walks slowly? Washington DC was organized better. Everybody could wait at the entrance of the platform of their train, but New York Pennsylvania station was chaotic. We met some other signs of inefficiency in America, the nation who could send man to the moon. For example visitors of the BUREAU OF ENGRAVING AND PRINTING IN WASHINGTON D C (the greenbacks are made here). You have to stand in line four times! Once to get the - free! - ticket. This place is exactly on the opposite side of the 250 m long building as the entrance. The second line, waiting for the tour guide is at the corner of the building. The third one is at the entrance and fourth, and last one, is on the corridor inside the building waiting to be guided around.
ALBANY The train ride from New York to Albany goes along the eastern BANK OF THE HUDSON RIVER. The valley is full of the manors of the financial aristocracy and memories from the time when the area was a Dutch colony and from the revolutionary war. The river is really impressive - no wonder that it inspired several American painters, who belong to the Hudson River School. It used to be an important passageway to the Midlands via the Mohawk River and the Eire canal. Where the Mohawk and Hudson rivers meet is ALBANY, THE CAPITAL OF NEW YORK STATE. The town is the seat of the second largest State government in the USA but at the same time Albany could keep its' charm as well. The town is centered around the EMPIRE STATE PLAZA surrounded by modern governmental buildings on three sides and the 100 year old CAPITOL on the fourth. All the modern buildings, with exception of the egg formed CONVENTION CENTER resemble faintly to the old Mexican temples. As John, Martha's husband, works in the Government we could visit his office, and he also showed us the Observation Desk on the top of the highest building with excellent view of Albany and its' surroundings, the CATSKILLS and ADIRONDACK MOUNTAINS. We saw the Capitol in a guided tour. It took 30 years and 25 million dollars to finish the building, a huge sum at that time. During the construction New York State became more and more important and rich, and it had to be mirrored in the size of the Capitol. The final result became a nice building in the historical style. (Some of you might be familiar with the Vigado, the concert hall in Budapest. It s also built in the historical style.) The NEW YORK STATE MUSEUM faces the Capitol from across the Plaza. The museum has some interesting exhibitions on the Adirondack mountains, the history of New York City and the Indians of the region. This museum, which we saw before we left Albany and the USA was a nice experience for us. Torbjörn took the chance to visit an american ENT clinic whilst being in Albany. The clinic at Albany Medical College is a full academic and clinical institution headed by Steven Parnes. The population in Albany is only around 100000 people, but many areas nearby are also in some way connected to the hospital, so I think the load of health care in the area takes care of around 3-500000 people. The clinic has seven or eight senior doctors on staff and, which Torbjorn found out after quite a while of discussions, in addition there are two residents in each year, i.e. a total of eight residents. Thus the clinic size is approximately like Linköping. There was a rather small sized outpatient clinic, and in the rooms the doctor was most often working alone and had to call for nurse assistance if needed. Minor procedures were conducted in the outpatient clinic, e.g. snoring operations using radio frequency heat transfer. Comparing the volume of in-patients with conditions back home in Linköping is difficult, as the patients dismissed within 24 hours (i.e. practically all of the more simple operations) are not counted. The number of beds occupied by real in-patients was around 5-10, and those may well be spread out over many different wards, where a vacant bed was available. Trauma cases were handled outside the ENT clinic as well. On top of this, doctors in private practice rent beds in the hospital for their surgical cases, and those are also not counted in the figures I was presented. In conclusion from the visit to the ENT clinic, I felt a little confused at the organization, and think that I have a very easy job to describe the situation in my clinic, with one single ward, a reliable number of in-patients and not so much of private practice in the town, thus being able to grasp the total ENT health care quite a lot easier than in the american system.
Among the many interesting sights in Albany, Martha and her son Josh showed us the SUNY (University of New York State) where Martha works, shopping malls and their neighbourhood. We even made an excursion to SARATOGA SPRINGS, the health spa, and former casino with some slight relation to the organized crime about a 100 years ago. I think the short walk on the main street was not really enough to discover the town, the springs' salty water and the baths. An old deserted hotel under renovation impressed us most. It looked like as a ghost from the 19th century. Also in Albany we had the chance to see how an American family lives. As we understood sport is very important for the men, and Martha s younger son, Alex was very active in all forms of athletics. We were offered the opportunity to play basketball in the garden after the excursion to Saratoga Springs. The TV and computer also played an important role both as a form of entertainment and a way to communicate with friends. Martha s family of 4 persons has three TV sets! We left USA on a Friday afternoon from NEWARK AIRPORT, near New York. After a successful trip it took me a lot of time "digest" our experiences, read the broschures and guide books and write about our "escapades" in the States. A few articles in the National Geographic Magazine about the Hudson river is not read yet, so hang on, some completion will possibly come.