Update from the Field: Emergency Medicine in Lebanon

Ryan Nichols '17
Ryan Nichols ’17

August 19, 2014: Ryan Nichols ’17

This summer I spent three weeks completing a shadowing rotation in the Emergency Department at the American University of Beirut Medical Center (AUBMC) in Beirut, Lebanon. As part of this rotation I shadowed an Emergency Medicine throughout his shifts in the ED, as well as participated in the lectures, case presentations, and clinical skills sessions included in the fourth year Emergency Medicine clerkship at the American University of Beirut School of Medicine. Having had the opportunity to work and study in Lebanon before I began down the path of a career in medicine, it was an exciting and meaningful experience to return to this country once again. I greatly enjoyed the chance to pair the interests I developed and pursued (specifically here, that of studying Arabic, the Middle East, and conflict resolution) before beginning medical school with an opportunity to learn more about medicine in such a setting.

Medically, I appreciated the chance to spend time observing and learning in a clinical setting, with a distinctive focus placed on developing a robust and well-supported differential diagnosis. The emphasis on the clinical aspects of medicine throughout this experience was a fitting complement to our first year of medical school curriculum and encouragement for the aspects to come. Socially, it was fascinating to watch the impact of domestic and regional conflict play out in the Emergency Department. From the common treatment of Iraqis seeking advanced medical care abroad because of fear and a faltering medical system at home to the way in which connection to Lebanese political figures could impact where one received medical treatment, social factors figured prominently in an understanding of who sought treatment in the AUBMC Emergency Department and the way in which it functioned.

In counterpoint to the many points of division in the country and the region, spending these three weeks in the ED during the month of Ramadan also proved to highlight points of connection and encouragement. Lebanon is home to many different faiths; indeed much of its history and character is due to the interplay of these different communities. With many medical students, residents, nurses, techs, and physicians fasting during the daylight hours because of their Islamic faith, their sense of community as well as the support given to them by non-Muslim members of the ED staff was very much apparent. An understanding of the difficulty of fasting during the summer months and an unwritten, supportive, reworking of responsibilities around sunset so that fasting members of the ED were free to break their fast at that time spoke loudly to the cohesion of the ED staff and their care for one another. While such small-scale growth of relationships do not erase divisions on a communal or societal level, they are what larger level attempts at reconciliation are built upon and in that sense are a source of hope and encouragement.

I thoroughly enjoyed this opportunity to further my understanding of medicine while coming to more fully understand the way in which the politics, faith, and conflict of the region play into the provision of medical care. Feeding both interests this summer leaves me excited to return Lebanon at another point in my medical career.

Location: Beirut, Lebanon
Length of Stay: 3 weeks
Name of Program: American University of Beirut Medical Center Department of Emergency Medicine

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