A DAY (OR TWO) IN THE LIFE OF AN AMERICAN LIVING IN RUSSIA

feb-23rdThis blog is a bit more personal than usual. For folks to understand life in Russia, however, I think some personal details are essential from time to time. There are some things about living in another country that you simply cannot prepare for. One main issue is being away from family and friends you love. I was reminded of this fact Thursday night (night here in Russia anyway). I made several phone calls back home. I called my brother because I had not talked to him in a couple of weeks and wanted to check on things. He is very busy because his business is going so well, and now, since we moved, he and his wife have been left with taking our mom to all her appointments, church, and events. She’s 86 and has lived by herself since dad died in 2014. She won’t hear of going to assisted living or “an old folks home” (her phrase). She’s healthy, but she doesn’t drive anymore. So my brother had a pile of work, but he had to take mom to the dentist. Then she needed groceries. Then she wanted to go out for supper. So I hung up feeling a bit guilty I’d left him with all that extra responsibility.

Then I called mom. I was going to suggest gently that maybe she could find other neighbors to help out. But she started telling me all about her life. She gets lonely. Her and dad were married over 65 years! She told me her neighbor had given her some pizza they had left over. Mom let it sit a couple of days in the fridge before eating it. She got food poisoning. So she had been up all night with diarrhea and vomiting. She said dad always took care of her when she would get sick. So, again, I had that terrible feeling. One light moment was after she said she was in such bad shape and was praying but still was sick. Then she said, “I know Baptists aren’t supposed to do this, but I was in such a mess that I called out to dad and said, ‘Clarence! Pray for me! Tell God I need some help!’” The thought of my “Baptist-to-the-bone” mother praying to the departed seemed strangely ironic and a bit funny to me–her now Eastern Orthodox son! I assured her there was absolutely nothing wrong with it. You’re just asking for intercession from them just like we ask our friends still living on earth to intercede for us.

Then I called my friend I taught with at North Greenville University for 13 years. We’ve known each other much longer than that. The university had a post on FB that it would announce the new president at 2:00 that afternoon. I called hoping to find some inside scoop. He didn’t know many details, but as he talked my mind went back to my days there. I’ve mentioned a couple of times in blogs I loved teaching there. I enjoyed my colleagues, my students, the courses I taught. The former president had been very good to my friend and me. I think he signed my friend and me to our contracts to teach there the same day. I know it was time for that president to leave, but as my friend talked on I realized how few people I knew there. Of the “old timers” still there, my friend is the only one with whom I can talk. There was much talk of the “new era” on the university’s web-site. I realized I no longer have connections to that place that was so much a part of my life.

After that I still had to call my oldest son. My second born son was having his gall bladder taken out that morning. I had talked to him the night before, and it was supposed to be laparoscopy, and they were not anticipating any problems. There is still anxiety when it is your child and especially when you live half way around the world! My older son told me he had received a text and apparently all was okay. But as we talked on and he told me about how things were going with him I felt that helplessness that comes from not being able to actually be with that person as you talk together. Nothing can take the place of actually being with a person when you talk about things. I went to bed with a very heavy and somewhat lonely heart that night.

Yesterday we got up and I saw we had a nice new blanket of snow. The sun was shining, which is an odd thing in northwest Russia in the winter. The weather was still well below freezing. That is perfect winter weather here. I hate it when it gets up to or just above freezing. The snow melts and mud and slush are everywhere. Andrei, a gentleman who had put in our internet when we moved in, came by. He is very involved in a church in a nearby village and collects toys, food, clothes, etc., for the poor. Oksana had seen on a Russian social network “vk.com” that he was taking up money for a family with four children who were about to have their power turned off. The wife is pregnant with the fifth child; the husband has a job but is poorly paid. Oksana called him and told him to come by and we could pay for it. I don’t say that to draw attention to us. I say that because there were times when we lived in America we went through some very hard financial times. We were the ones who needed help. We determined that if we ever got to the place where we could help others financially we would remember our times of distress. Even with a decent income you can still live under financial oppression in America with a mortgage, car payment, and credit card debts that seem to have become a part of life there. My income is much lower here, but we are now debt free and the cost of living is so much lower. Jesus said, “It is better to give than receive.” It really is! We are approaching Orthodox Lent. One main facet of Lent for Orthodox is to focus on helping the needy. We had prayed for that opportunity, and it came!

Then we went shopping. We had to walk almost from one end of Luga to the other. But the sun was bright, the air was cold and clean, and the snow was crunchy. It was just the two of us! We left Roman in charge of his little brother and sister. We could actually talk while we walked and carry on a full conversation without interruptions! (Every parent will understand the blessing that is!) My favorite part was, as always, the open market. We bought the last big dairy supply until after Lent. (Orthodox do not eat meat or dairy during the 7 weeks of Lent.) Chatting with the lady there who sells all this completely natural, organic, and local dairy is always pleasant. She always brightens up when she sees us, and we love chatting with her.

Then we came back and quickly got ready to go to Oksana’s parents. Thursday was “Defender of the Fatherland” day in Russia. It was originally started to honor those who fought in the Red Army against the Whites. Over time it really became a day to honor all “potential” defenders of the family and the Fatherland, which is any male. Even I got gifts! It is a great day for Oksana’s dad, since he is retired military. But he had worked Thursday so we celebrated on Friday. (The kids were out of school Thursday and Friday.) We got there, and Oksana’s mom had prepared a full table, of course. It was really pretty.

We began with her toasting her husband, but as she began bragging about how his commanding officers would always say what a great soldier he was, he waved her off. He said, “We aren’t together to talk about me. We are here to toast our wonderful Russian-American family being together!” Wow. He actually said our “Russian-American family” with pride! It was a great meal, and as we were concluding it they brought out some old pics from Oksana’s childhood. (Okay, full disclosure, I had a little trouble “concluding the meal” with conviction because Sveta brought out this big plate of homemade cream puffs she had prepared. “Just one more” went on many more times than it should have!) The pics were primarily of Oksana and awards she received back in grade school. Most of them had a picture of the stern looking Vladimir Lenin looking down with approval. They recognized her academic accomplishments as well as her citizenship as a good littleCommunist. I was not familiar with the injunction until last night, “Proletariats of all countries–Unite!”

The television was on, and the program was about a Russian who was an expert at finding and disarming old mines. I wasn’t paying much attention, but as the ladies were in the kitchen cleaning up, Ivan (my father-in-law) and I started paying more attention. The mine expert went to Angola on a big and important mission. Apparently there were still dangerous mines in the ocean near there. Somehow, as best as I could understand, he joined up with an American, and the two of them worked together to disable many of the mines. He said he could not have done it without having such great help. They became friends and would call his mother back in Russia. The American could only speak English, but he would assure “mama” that her son was safe and they were taking every precaution to remain safe. After the mission was over the American went to Russia to see his friend again and to take flowers to the mother with whom he had spoken by phone. It ended with the Russians and the American reaffirming their friendship. What a great and surprising program to see on a weekend devoted to remembering the Russian military. Ivan looked over at me as the program concluded. Neither of us said anything. But we didn’t have to. It was a powerful scene watching the Russian and the American embrace.

As I said in the opening to this blog, living away from family and friends is tough. The phone calls reminded me that living separated from your past is also painful—those people, that job, or that special place. I am fortunate that my family in America, while not glad to see us go, were supportive of us and continue to be. “Supportive” means more than just wishing us “good luck.” Supportive means they understand and accept the fact we are here. There is no resentment from them. That makes my guilt trips a little shorter! I am thankful for their support and understanding.

The events of that next day, however, reminded me that I also have some of my family here! I still get to see the my little ones play at “Babushka’s.” I see them growing in a country that is not filled with the animosity and division that seems to be choking America. I miss being able to impact the lives of students like I sensed when I was teaching in America. But “that was then, and this is now” has to be my attitude. The people here see me, know I’m American, and form impressions based on how I live here. They see the hypocrisy of Lindsey Graham and John McCain shouting to Ukrainian soldiers that they must “go on the offensive against the Russians in 2017,” then US politicians lecture the Russians on how they must honor the Minsk cease fire/peace agreement. So the Russians must honor, but American senators can go there to encourage and support war? They watch American politicians work with our media to blame Russia for just about anything and everything that happens that they do not like. The former U.N. Ambassador, Samantha Power, who was no friend of Russia, tweeted a message about the Russian Ambassador, Vitaly Churkin, who died suddenly recently. She called him a “diplomatic maestro and a deeply caring man who did all he could to bridge US-RUS relations.” She was ravaged by many Americans for her kind comments about her recently deceased former colleague. That is what Russians see on TV as “America.” At least in my “little world” I get to show them a different “face,” a different attitude. That is the impact I can and must have. We were laughing about me getting presents on Russia’s “Defender of the Fatherland,” but someone quipped that they had read my blog and felt I was defending the Fatherland. I greatly appreciated the compliment! I am not an ex-pat; I am a cultural refugee and see myself as an ambassador minus the political influence. It entails the heartache of missing some joys of family and friends back in the States. But this is my home now. I should live as faithfully as possible to the reasons God put us here.

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THE PRIEST (ПОП): RUSSIA & RECONCILLIATION

Last night my wife and I decided to watch a movie together. Not a small mission with three kids! We chose to watch “The Priest,” a Russian movie from 2009 (with English subtitles) that we downloaded from YouTube. The main character is the Russian Orthodox priest Alexander, and the setting is 1941 when the Nazis invaded the USSR. Father Alexander is the priest of a small town in Latvia at the opening of the movie. He is sent to a mission in the region of Pskov in Russia.

The Nazis successfully invade the region and take over the town. They allow Fr Alexander to restore the church that the Soviets had turned into a community center, where they played movies, held dances, etc. The relationship with the Nazis is ambiguous in that they let him conduct the Liturgy, minister to the members of the community and even be involved in some limited ministry to the POWs in the small concentration camp nearby. One particular poingnant moment in the movie is when the Nazis allow the prisoners to come to the Pascha (Easter) service and participate in the Procession of the Cross. The leader of the Nazis is Orthodox. On the other hand, the Nazis are cruel and one young teen girl is senselessly murdered in the very beginning of the movie. There are other acts of violence committed against the citizens by the mocking Nazis. Fr Alexander tries to work with them without compromising his faith. Ultimately the Soviets return in victory. Without giving away the ending, when the Soviet troops arrive it is “out of the frying pan and into the fire” for the believers.

As we watched the movie I found myself responding at a very emotional level. I looked over at Oksana, however, and she was silently sobbing—sometimes not silently. Her reaction was at a much more profound and visceral level than mine. As many of my readers know, Oksana was raised in a Communist home here in Luga, although her dad was stationed in East Germany for several years, and they lived in a Russian military community there. Her atheistic childhood was basically happy. Her memories are not of a cruel and heartless Communism. Her parents were and are very loving and happy people. They believed in the principles of Communism (some of which actually came from the Bible unbeknownst to most Russians) and sought to live them out as best they could. Oksana was a little Octobrist and then a Pioneer. Summers usually involved going to Pioneers’ Camps.

Luga was occupied by the Nazis. The “Seige of Lenningrad” was not too far from outside the city limits. I have mentioned before the old Orthodox Church here still bears the mark of the Nazi era. It also bears the scars of Stalinism. It was turned into a dance hall and then a theatre. Many have pointed out that the numbers of Stalin’s executions were inflated by most Western historians. Nevertheless, you won’t find many here who will vouch that he really was a good guy. The history of the Orthodox Church here records he had all the priests murdered. This is not the corrupted history of Westerners; it is the record of those Russians who lived here and saw what his henchmen did. Still, much of this was hidden from Oksana and her family until much later.

As I observed her tears I thought how difficult it is for an American to get inside the thinking of those who were born and raised in this country. Our history is not just incredibly shorter, it is also largely devoid of many of the horrors. We’ve had our wars, and we’ve had our hard times to be sure. But more Americans died during the War Between the States than in any other war we’ve had. In WWII about 450,000 American lives were lost. That seems a lot, and clearly a lot of people suffered. Russian lost about 27 million, not to mention the suffering, the shame, and the horror of the Nazi occupation and the atrocities that took place. There was no family in Russia that was not impacted by that war. When I first came to Russia some of the “grandmothers” in the Baptist church here tried to speak to me in German. Those of that generation who had not been deported to slavery there had experienced the daily presence of the Nazis. “Foreigner” to them meant “people who speak German” I guess. I wanted to laugh when they concluded that if I didn’t speak Russian, then surely I spoke German! But as I looked at their faces I realized I could not fathom what they had experienced. Since the Revolutionary War my country has never been occupied. Its citizens have never been deported to serve as slaves. We took the land and then later we, in fact, imported human beings from other countries to serve as slaves. So looking at the wrinkled faces of those old “babushki” made me painfully appreciative of their smiles. They accepted suffering as a part of life. The Russian people have been a многострадальный народ (a much-suffering people).

While Russians feel their history more deeply than many of us, they do not stay locked in it. Oksana is no longer a Communist. She enjoyed her life in America, and we enjoy the freedoms we have now in Russia. Both she and I converted to the Orthodox Christian faith. We laugh about idiosyncrasies in American culture and in Russian culture as well. We both have been shaped by the culture and history of the other.

That understanding would be our hope for the relationship of our countries. As an American who has lived in Russia almost four years now, I have to say I do not think there has been much of an atttempt at a political or social level overall to understand Russia, its culture, and its history. On the other hand, we formed some very close friendships while in America with folks who were interested, who did care, and who came to appreciate Oksana’s homeland. And I find many Russians interested in American language and culture. It seems a bit idealistic, but some of our American and Russian friends have given me hope. So as a non-objective observer, I would like to offer some suggestions on certain things any person—at any level—has to understand about Russia before forming judgments.

First, as I have mentioned above, we Americans must recognize that their history has been far more tormented than ours. This October (actually November by the new calendar) will mark the 100th anniversary of the fall of the Tsars and the beginning of 70 years of Communism. “Outsiders” like me need to remember the horrors that that era brought to Russia, but not to all Russians. As I said, Oksana had a happy childhood and a more loving family than many in America will ever know. She remembers many good people growing up who were loyal to their families, good providers, and good moral people. We must recognize both the horrible acts, as the ones portrayed in the movie, perpetrated by the government on religious persons as well as the strong moral stand of many who were not believers.

Second, Russia has endured the collapse of two governments in one century. The old Orthodox Tsars were toppled by the Communists. Then Communism collapsed under the weight of its own abuses and stagnation. America now is in a political and social whirlpool. I’ve never seen it this disjointed or divided. But it is good to remember our country has never had a coup; we’ve never been forced to completely reorient our loyalties. Russians have been through this twice since 1917. I believe and detest the fact that some American politicians resent the fact that Russia is, comparitively speaking, a much more stable country now. They seem determined to twist reality to convince the tax paying populace that Russia is just the way it used to be—and thus we really need to spend a lot of our money on weapons. Unlike what the Western media and some politicians suggest, there is some dissension here but people feel free to express their disagreements with the current administration. The truth, however, is most Russians realize that the disagreements with each other are miniscule compared to their past revolutions. They have a leader that, according to almost all polls (both Western and the ones taken here) approve of. That does not mean they approve of everything Mr. Putin does! They complain about things. At the same time many believe and appreciate that they have a leader who loves this country and has worked tirelessly to make it better. So even those who disagree with him are by and large civil. Americans must come “to the table” understanding that most Russians like the general direction in which their country is going. I don’t sense that same shared unity of vision from Americans about America. Nevertheless, we can’t resent Russia because it is not in turmoil like we are.

Third, Americans should investigate for themselves what is and is not true about Russia and its leaders. John McCain, Lindsey Graham, Bill O’Reilly have casually referred to Putin as a murderer. From their comments and their writings I see no evidence they have actually researched this charge. One has to go outside the pale of reading Western press releases to study the charges. I have thought of devoting one blog to this topic simply because it has become a part of the polemic of some American leaders. The trick is to keep repeating something enough times that you can slip it by the public as an accepted fact without really having to prove it. For example, when Boris Nemtsov was murdered (and Putin was assumed guilty by the West), Putin had an 86% approval rating. So he murdered Nemtsov because he was insecure of his political standing or future? Name one American politician who comes close to 85% approval. Trump was ecstatic over 55% this week. Putin took over when Boris Yeltsin appointed him as his successor. As Gleb Povlovsky said, “Yeltsin didn’t build a government; he led a revolution for ten years.” There were a lot of bad people in power. Some journalists and political operatives were murdered. Since Yeltsin appointed Putin I guess it became convenient for Westerners to pin the murders on him. The idea that no one here actually investigated these murders is simple ignorance.

Fourth, appreciate what could come of good relations between Russia and America. I confess feeling more than frustration that Donald Trump’s foreign politicy seems to lack a “center.” He fires Flynn, says Crimea should be returned to Ukraine, then insist in the following press conference that having good relations with Russia is a good thing. What I do like about what he has said is that there is potential for good if both countries unite in fighting ISIS and all forms of terrorism. I clearly remember the tension of the Cold War days. But there was a shared conviction ultimately that, in Ronald Reagan’s words, “a nuclear war cannot be won and must never be fought.” Terrorists do not care about the ramifications of their actions. If Russia and the United States can join together, then I think the terrorists will be on the run.

Finally, I would offer the Ronald Reagan model of leading the relations between the two countries. Now, I realize I have good American friends and good Russian friends who think that is a terrible suggestion. Reagan did refer to the USSR as “the evil empire,” after all. I contend, however, as with Jack Matlock and others, Reagan hated Communism. He thought it was awful. He didn’t hate the people living under it. Reagan chose Jack Matlock to be his lead diplomat in working with the Soviets. Matlock had studied the Russian language, culture, and politics all his adult life. He had immersed himself in it. He spoke “their language” in the fullest sense of that phrase. He appreciated their good points and separated political and personal differences. Then Reagan got to know Suzanne Massie—of “trust but verify” fame. She had studied the language and the culture since she was a child and had written a profound book called Land of the Firebird (which even someone with my extremely limited artistic abilities can enjoy). Her area was more the religious, artistic, and cultural aspects of Russia. She traveled to Russia whenever possible even in the Cold War era. Reagan, she said, would call her in for lunch from time to time and the conversation would often begin, “So tell me how the real Russians are doing?” He wanted to know what life was like for them—especially the religious ones. (Both Massie and Matlock were Democrats, by the way. They were chosen for their expertise not the potential political donations they would bring to the president.) Russians were not cogs in some political wheel or tools for some political game as far as Reagan was concerned. So he took the abuse he got from the right wing of his party and went to Russia to meet with Gorbachev. I was a child, but I remember Krushchev and the reaction of adults to his banging his shoe, claiming (supposedly) “we will bury you,” and the Cuban missile crisis. The animosity between the two countries, the nuclear proliferation and all of that were a part of life for us. I never thought I would see the end of it. If you had asked me (or most members of the CIA) in 1990 if the USSR would fall the next year the answer would have been, “No way!” But it did fall. The number of nuclear weapons was drastically reduced, and the world was safer.

Last Sunday we went to Liturgy at the downtown Orthodox Church. It was very uncomfortable, primarily because the church was packed! It was hot inside, and I couldn’t move! Everybody stood there for two hours with their big coats on! I reflected on that later, however, and again as I watched the movie. Back in those days of that occupation and what followed, one could be risking freedom or even one’s life by faithful worship. Now, Russia is—despite what you hear—a free country. Some worship; some don’t. Some like the President Putin and brag on him. Others don’t like him, and they let you know. Reagan reminds me that change is possible. Things, cultures, politics can be made better. I hope sooner rather than later.

MY “DOCTOR-WEEK” IN RUSSIA

This past week has been my “doctor week.” Last Monday I went to an ear, nose, and throat specialist; Wednesday I went to the physician who treats my neck/discs problems; and Thursday I went to a dermatologist; this morning I went to a surgeon to have a large mole removed. So I thought I’d give an update and a few more details on the medical care here in Russia.

The first difference I noted between the way we do things in America and here in Russia was the way “appointments” are made. All three physicians had been recommended by friends who gave us the doctors’ phone numbers. The dermatologist scheduled the appointment with the surgeon. Oksana called the doctors directly, and and told them the days we could come, and they told her when we should show up. They didn’t give exact appointment times but just told her when they start seeing patients. Now, since we go to the neck doctor each week, we set up a standard weekly time. With the others we showed up and essentially took a seat in line. When we arrived we asked, “Who is last?” That way you know when you are next. You do not sign in since you do not have a set time. That seems like it would lead to problems, but everyone understands the “system.” Frankly the wait was less time in both cases than it was most times I had an “appointment” with my doctor in America.

From the time I was a young man I have had ear trouble in that when the weather changes or just gets very humid or cold my ear canals clog up. In northwest Russia, since we are so close to the gulf of Finland, the weather is often quite humid and since we are so far north it is very cold. Of course, that means a lot of snow, but it also means I feel like I have cotton in my ear a lot. When I got to her office I realized the ENT was actually Svetlana, a lady I had taught when I filled in for another teacher at our school. Russian doctors frequently try to study as much English as possible since most of the medical information on the internet is in English. She treated my condition well with the same kind of “machine” my doctor in America used. She also asked about my overall health, any joint issues, etc. When I told her about my neck and TMJ she offered as much information as she could. Then we discussed a hearing test because I think maybe I don’t hear as well in my right ear. They’ll let me know when there is an opening. The treatment gave me immediate relief, but she graciously refused payment. When Oksana tried to pay her, she smiled and said, “You need to leave now.”

Then Wednesday I went back for my usual appointment with the doctor who treats my neck problems. As I mentioned last time, during my treatments I get to practice my Russian, and the doctor practices his English. This time, however, we mostly spoke in Russia. Since he speaks more slowly and distinctly for me I like talking with him. The treatments, which consist of massage as well as manipulation of the joints, last forty minutes. When I took my shirt off he saw I had a large, irritated mole on my back which is looking kind of bad. He went and got a different bandage (he didn’t like the one Oksana had put on it) and then insisted I go to a dermatologist and get him to look at it. After the treatment, I thanked him and paid the lady the $8.45 after he reminded me again to get the skin problem checked because the mole was so large. Oksana had her appointment with this same physician that afternoon, and he made sure we had made an appointment with the dermatologist. He also asked her questions about how I was handling Russia, how are my moods, if I am I doing fine emotionally during my time of adjustment in Russia. She assured him I am fine. (She may or may not have told the truth.)

The next day (Thursday) I went to the dermatologist, whom I had met when I had my physical for teaching at the school. He examined my back and said it does not look like anything that is malignant, but if I do not have it removed then it would continue to grow and get in the way and bleed. He said that normally they remove moles with a lazer, but given the size of this one it would have to be removed surgically. He called his friend who is a surgeon and scheduled me an appointment to have it removed Monday morning. Oksana was there so he was interested in chatting about America and how we saw some of the political changes going on. As with Svetlana, he would not take any money for his services. So I left with with a hearty hand shake and smile.

My appointment with the surgeon was this morning at 8:30. I have been to this facility before, and it is very nice, modern, and clean. We got there a little early but after a short wait he was ready for me. He looked my mole over and measured it. Then he took me back to his operating room. He asked Oksana to wait a few moments until everything was sanitized. He made sure I knew how to say, “That hurts!” in Russian. I assured him I know how to let people know I am hurting. He warned me the injections to numb the area usually hurt some, but they were not bad. What surprised me is how quickly they took effect, yet I could tell from his touch that the area an inch away was not “dead.” The surgery turned out to be a bit more complicated than any mole removal I’ve ever had. It took him over thirty minutes. He said the problem was it was also quite deep. He put in two layers of stiches. He used cat gut to sew inside the incision, and then a kind of metal surgical thread for the outer skin. He was very careful, and his nurse was at my side the whole time. Oksana watched him sew me up and said he put the stiches very close together, and there were a lot of stiches. I asked him how many, and he smiled and said, “I wasn’t counting, but it was three packs of surgical thread.” I was hoping to find out so I could brag and get a lot of sympathy, but that has not worked out for me so far!

The nurse went downstairs with us to explain what the doctor did to the folks who do the paperwork. That took a while, since Russians consider every little detail of paperwork of great importance. Given the current exchange rate the cost for both the surgery and for the test for my tissues to make sure there is no cancer was just under $70.00. The surgeon charged me $51.00 for his services and the rest was for the histological tests. I’ll have to pay $20.00 for two follow up visits including the one to remove the stiches.

Health care in Russia is a very different system than in the United States, and I cannot give an in-depth analysis of it because I don’t know all the different aspects of it. There are a few things I’ve learned, however. First, the socialism of Russia’s past and its current democratic system has left basically two “paths” of health care. There is the free, government supported health care. Citizens can choose to be treated in free clinics. Non-citizens like me or other Russians who prefer and can afford private care opt for what many think is the superior care you get for private care. Many of the physicians, however, just work different locations so I’m not sure private care is all that superior. It clearly is more convenient, however. You call the doctor, as we did, and show up and you get treated ASAP. But compared to America, the government is far less instrusive—or so it seems to me—and there really are no large health care companies involved. Thus, even in the private systems the costs are much lower than in the United States. I do not get the sense the doctors are under any pressure to see “X” number of patients to make a profit for a health care company or hospital system as sometimes happens in the US. They also want to take time to get to know you. And as a matter of courtesy two physicians did not want to take money from a “foreigner” who is adjusting to the rigorous winters of Russia.

I am somewhat baffled by the changes in health care in America, and I certainly am not qualified to offer expert analysis. I offer the following observations only as a “consumer” who tried to keep up with changes in health care from various news outlets and a few conversations with friends who work in the medical field. While it is not expert analysis, I can explain how the way I and my family were treated changed. I went to the same medical clinic for many years in our small town in South Carolina and saw the same doctor for almost all of my visits. He treated all members of my family. I had good affordable health insurance, so costs were reasonable both for medical treatment and for medicine, which we bought at a pharmacy that adjoined the medical clinic. I could not have been more pleased with medical treatment in America. It was excellent. Then a larger hospital system/health care company bought out the clinic a few years back. After that I had to take whatever doctor was available. I think the care I received was good, but there was a distinct changes from before in the way I was able to interact with the physicians. I rarely got to see the same doctor. There was no small talk; no asking about other members of the family and, frankly, very few questions about my overall health. They treated the immediate problem, and I was sent on my way. I finally changed doctors and upon his first evaluation he concluded that I had had an undiagnosed thyroid condition probably for years. I do not fault the doctors. I think the system created the pressure which led to poorer care. Further, with the health care changes and the government getting more involved under “Obamacare,” the financial strain on a family of five like ours was very intense and our care became, frankly, inadequate. The question when one of us got sick was, “Do we want to pay $150 for an office visit? Is it that bad?” The deductable was so high it did not help cover most expenses. Thus, it has been refreshing to be able to address some health concerns of our family in Russia without the undue financial stress. We remain confident we are receiving excellent care here. One of the odd things is that some friends and family have encouraged us to go to St. Petersburg or another big city for treatment like I received today. I can say for those who are considering moving here or spending time in Russia, medical care even in a small city like Luga is above what we expected and, to be honest, above what we received the last couple of years before we came here. On the other hand, there is still poverty in Russia and many people in Luga cannot afford the kind of care we receive. The average wage is still quite low so the perspective of some here would be different from ours. What I regard as extremely affordable care is, for some residents here, not within their financial reach.

In all of the appointments here the doctors all seemed very concerned about my overall health and wanted to discuss aspects of what could be causing the various problems. They all took quite a bit of time with me and wanted to get the “total picture.” Also, they all were concerned about how I, an American, am adjusting to life here in small town Russia—especially knowing I come from the very different climate in the southern part of the United States to live in northwest Russia. There was absolutely no “prejudice” or animosity shown toward me. Actually, it was quite the opposite. I was conscious while interacting with them, as with many of the people I deal with here in Luga, that I may be the only American they have ever met—probably the only one they’ve ever gotten to know personally. I want to let them know I have great respect for this town and its residents. I also sense that they really respect the fact I am living here. Another friend tells Oksana frequently how much he and others admire me for living here. It is nice to hear, but I really do not think I deserve any special admiration because my family and I chose to live here. I appreciate their respect, but I also appreciate their kindness and generosity towards me and my family.