Tuesday, March 31, 2015

The Visa Game

If you've ever lived for a prolonged time in a country that is not your own you probably know what a hassle it is to apply for a visa or residence permit. There is nothing worse than feeling helpless in a system that seems doomed for you to fail.

I can't say much about the U.S. immigration system as I'm lucky enough to hold a U.S. passport, but I am thankful most days to have that piece of cardboard. I say most days because there are days like today when I would kill for an EU passport. Life would be so much easier.

My first two years in Poland I went through the US embassy in Washington DC to apply for a student visa. I went in submitted my forms and three days later picked it up. No problem, easy peasy, simple.

My third year I didn't return back to the US so I was forced to apply for what is known as a temporary stay card as you can't apply for student visas inside of Poland (you also can't apply for temporary stay cards outside of Poland. Which makes no sense.) So I did what I was supposed to do, I applied within the 90 day period, I collected the letter from my school, proved that I had enough money in my bank account, got health insurance from ZUS, officially registered my residence with the town hall, was visited by the Police, and managed to navigate my way through the Polish immigration system (mostly in Polish, a miracle even then).

Generally speaking it was the nightmare you're probably imagining. But it was nothing compared to what some students have gone through to get their temporary stay cards. So I was happy to have conquered the system and in the end I was rewarded with a shiny new temporary stay card. Proof that I live in Poland.

Let's fast forward a year. The card expired when I was back in the US last fall. I was going to apply for a student visa in Washington, but my school never sent me a letter of enrollment to prove I was a student (after I repeatedly called and asked). I finally got an e-mail from them asking if I still needed it a week before I was supposed to return to Europe. Too late.

I got back in December but wasn't able to apply for my temporary stay card right away because unlike the student visa I also had to prove that I had funds to stay in Poland. Which I didn't as we don't get our loans until the end of January. So I had to wait. Which totally wasn't a problem. I had time.

Around the first of February I had everything I needed to apply for my visa. So I did. The next weekend I flew to Ireland again which "reset" my 90 days in Poland, but not in the rest of the shengen zone- something that wouldn't be a problem once I get my visa. (Oh and I have the 90 day rule recorded from the horses mouth. Because I couldn't find that law written anywhere.).

I waited and waited. No letter, no confirmation of my application. No nothing.

I went to the visa office. "It's no problem, don't worry" they said.

I visited them 5 times in the past 2 months and waited two hours in line or more each time. And every time they said the same thing.

Today I visited again and this is what I was told. "You aren't eligible for a visa because you're leaving in June."

I just want a visa! Is that too much to ask?!? 

If I get deported before I graduate, I'm not going to be a happy camper. 

Sunday, March 8, 2015

Tell the Truth

A few weeks ago I had a patient that kind of surprised me. 

I was in oncology and an older patient who had presented with neurological symptoms was diagnosed with lymphoma in the brain. If you know anything about this terrible disease, you also know that it's usually related to HIV/AIDS. But, upon taking the patients history the only disease she admitted to having was fifteen years ago when she was treated for syphilis. 

So as she lay in critical care the doctors performed the routine tests including normal blood work and an ELIZA for HIV/AIDS. Her CD4+ count was 3. She had AIDS. 

Two weeks later she was doing much better all things considered. But, still had not been told of her diagnosis. Some classmates and I asked the doctors why she hadn't been told yet and they told us that they were concerned for her mental well-being and her current health state. Both genuine concerns. We were under strict instructions NOT to mention the diagnosis in front of the patient.  

As we sat in the doctors lounge one day near the end of the rotation one of my classmates asked if she had been told. The doctor said that he was going to tell her today. But, he said something that made me think long and hard about this patient.

"I think she already knows. I think she was probably diagnosed when she was diagnosed with syphilis, or at some other point. Most people don't have a CD4+ count that low and not show some preliminary symptoms of some type." 

They took her to a private room to tell her the diagnosis later that day. 

She already knew she had AIDS.  The doctor was right. 

But, why had she not told them? What made her think that it wasn't important enough to share? Was it fear of the stigmatism that HIV has in Poland? Or was it genuine lack of knowledge about the disease itself? 

Universal precautions are always used, but knowing the diagnosis would have made it more important and would have led those who treated her to be just a bit more careful. Knowing the final diagnosis would have also meant that her current diagnosis of brain lymphoma would have been recognized and treated sooner, which would have been better for her. She could have been started on HAART sooner and had radiation sooner, she might have lied and wasted the chance to save her own life. 

No one cared that she had AIDS. The doctors were upset because they had been lied to. They were upset because, she might very well have died had they of not caught it. 

Please, never lie or fail to mention health conditions to your doctors. It might not seem important to you, but to your healthcare provider it might be the minor difference between medications used to treat you or the difference between knowing the diagnosis and not.

It's your life, doctors are just trying to help you save it. Don't lie to them.  

Photo Credits to: http://www.med.uc.edu/neurorad/webpage/gua.html