Moldovan man makes long health care journey
Monday, January 9, 2012
GREENFIELD, Mass. (AP) — It's a 400-mile commute Sergei Ivantchev makes twice a week to and from the Greenfield duplex that he and his wife have shared with their two daughters as well as his parents since 1998.
But the trip, to the Waterville, New Brunswick, Canada, hospital where the 47-year-old Greenfield transplant works as an anesthetist, is just a small part of the journey he's made since leaving his home country of Moldova.
Ivantchev had already successfully completed six years of medical school after college before he and his wife, Lucia who had chemistry training and worked in a perfume factory left the Moldovan capital, Chisinau, with their baby daughter. Their adventure, which included a hastily-arranged 1992 Cuban "vacation" on an Aeroflot flight and their defection from the former Soviet republic during a refueling stop in Gander, Newfoundland, is described in Ivantchev's new self-published memoir, "The Journey."
In the 98-page book, which is sold at World Eye Bookshop in Greenfield, Ivantchev recalls his first encounter with a map of Canada during a sixth-grade geography lesson.
"Wow", I said to myself, "This country has plenty of wheat, and probably they have never had to endure lack of bread on their tables." Here my thoughts flew back in time to my grandparents' and my mother's stories about their family not having enough bread because of Stalin's forcible collectivization of people, and their deportation to Siberia as enemies of the state. After a few more minutes I heard the teacher's light steps Should I tell him that I was almost ready or about the desire to go to Canada and see it with my own eyes? I didn't think it was a good idea, because we students were supposed to be the pioneers, the future of the youth communist party.
"We were told we should not bother with the westerners, where the capitalist system is standing with one foot on the edge and with the other foot stepping in the cleft." In the Gander Airport terminal, where Ivantchev and his family refused to re-board the plane, along with 75 other passengers, they explained through an interpreter that they were seeking religious and political refugee status.
Ivantchev, who had to bribe embassy officials in the Ukraine with cognac and cash to get the papers necessary to leave Moldova, had been warned by a co-worker at the 300-bed hospital in Chisinau, that the Moldovan medical degree he'd earned would not be recognized on this side of the Atlantic. And unfortunately for Ivantchev, his arrival in Canada coincided with a reduction of all postgraduate physician training.
"So I said, OK, I'll become a nurse," and enrolled for two years of nursing training at Algonquin College in Ottawa starting in 1995.
But first, he and his wife, granted Canadian refugee and "independent immigration" status, had to attend English classes in Newfoundland. He got a simple job delivering advertising fliers for a restaurant "No Name Pizza" which also turned into a job delivering pizzas, cutting vegetables and folding boxes, and he began an overnight newspaper delivery route for the St. John's Telegram.
In 1995, while in nursing school, he worked in a pizzeria owned by an Afghan immigrant who taught him to make dough. He also won one of roughly 50,000 chances to immigrate to the United States as part of the green card lottery.
He worked briefly in an Ottawa nursing home with quadriplegics.
But once his U.S. immigrant visa was approved, he began making arrangements to move to the United States. A truck-driving friend from Moldova who was already living in Pittsfield had even arranged for him to be offered a job driving trucks. But a worker in the U.S. consulate in Toronto had assured him, "Oh, you will do well in the U.S. as a physician."
After winning the green card lottery, Ivantchev had contacted another Moldovan friend who had immigrated to Greenfield six months earlier.
"Come to Greenfield You'll like it, I promise! It is very green," she said.
U.S. immigrant visa in hand, Ivantchev got a job in June 1997 as a registered nurse at Buckley Nursing Home and later as a nursing supervisor at Baystate Franklin Medical Center, working 3 to 11 p.m. Then he went to work from 2001 to 2004 at Valley Medical Group's Greenfield Health Center and pursued a two-year nurse practitioner program at the University of Massachusetts.
His wife, Lucia, meanwhile, had parlayed her training in Ottawa as a hair stylist at Arch Street Salon and began working as a hairdresser in Greenfield and also working as an English as a Second Language tutor in the Greenfield Public Schools, while helping raise their two daughters the second, Nicole, born in Greenfield.
After three years of working for Valley Medical Group, Ivantchev said he was faced with the requirement that he either buy into the group practice or leave.
"I couldn't do that because of my long-term goal to go back to residency," said Ivantchev, who had been preparing to take medical licensure examinations in both the United States and Canada.
The U.S. State Department offered Ivantchev a position as a nurse practitioner in its Foreign Service Health Program in its embassy in Moscow. The Russian speaking Greenfield resident, who would provide medical care alongside a physician for about 300 embassy workers, completed specialized training in Washington, D.C., and was issued a diplomatic passport. But 10 days before he was ready to leave, with his wife eager to see her relatives back in Moldova, he got what seemed like an even better offer: Dalhousie University in Halifax, Nova Scotia, had matched him for a spot in its family medicine residency.
If that two-year-long residency wasn't enough, Ivantchev also enrolled for 15 months of anesthesiology training at Queens University in Kingston, Ontario, which trains and certifies general practitioner anesthetists to practice in areas other than neurosurgery and cardiology, he said. That limited training, unlike the four-to-six year anesthesiologist training is not accepted in the United States, but it landed him three job offers in suburban Toronto and a position about five miles from the Houlton, Maine, border in Waterville, N.B. when the 70-bed Upper River Valley hospital opened there.
"The only inconvenience is a little bit of driving," said Ivantchev, who works there four days a week and is also on call one weekend a month. Otherwise, it's a six-hour drive that he said takes him straight up Interstate 95 through Maine, including a 110-mile stretch north of Bangor with a 75 mph speed limit. The job allows him to spend time with his family, although when he's home, he also works a couple of shifts a month in the emergency room of Fairview Hospital in Great Barrington.
The Ivantchevs are also deeply involved in the Moldovian Baptist Church of Greenfield, which Ivantchev said he's also happy to get back to when he returns here on weekends.
With another three years of residency at Baystate Medical Center in Springfield, he maintains, he could practice anesthesiology in this country. But he shakes his head at that notion.
"I don't want to do that. I have been a resident for too many years. I'm not young any more. By that time, I will be at least 50," said Ivantchev, who said he loves doing anesthesiology and plans to remain at the New Brunswick job and maybe find a closer alternative to the occasional Great Barrington job.
The "downside" to Ivantchev's multiyear drama, including over seven years of additional training, is in all of the time that he was away from his family in Greenfield.
"Professionally, I'm accomplished. I have probably more degrees than anyone else after my name RN, LNP, BS, MD," said Ivantchev, comparing himself to some of the long-distance truck drivers he knows who work away from their immigrant families for days at a time to help support them. "Family-wise, spiritually I's not at the level where I wish to be. Now (his daughters) are big they understand, but when they were younger, I was in all this training, and since 2005, I haven't been with them on a regular basis. Some weekends I've been on call. My wife did very well, managing."
In fact, Lucia Ivantchev has played a key role not only in parenting their daughters, but in helping Moldovan, Russian and Romanian students as an ESL tutor since 1998.
According to Mary Ellen Bricker, an English Language Learning teacher who works with Lucia Ivantchev, "She goes to parent-teacher conferences, tutors in classrooms, consults with teachers, encourages students, translates papers from school, calls parents when there are discipline problems, and more. The schools would be lost without her, as would the countless Moldovan, Russian, Ukrainian and other Eastern European families who have settled here."
Donna Gleason, associate principal at The Discovery School at Four Corners, said Ivantchev has helped bridge cultural differences for teachers, parents and students.
"She has spent 10 years working with individual families, teachers, and children, and she's enriched us all. She's one of those unsung heroes and she's really good at heightening the awareness of teachers."
Like himself, Ivantchev said, many immigrants he knows have careers they've left behind in search of "a better life, a better future for the kids" in a place where there is at least on the surface less corruption. Others settle for less prestigious work here rather than jump through the additional retraining hoops.
Unlike in his home country, he said, in the United States, "You don't need to know anybody, in terms of bribes. If you work, you will get it. If you can prove you're a worker, you're diligent, punctual in what you do, a man of your word, you will get it."
That's not to say it's easy, as Ivantchev's story shows. In Canada, he says, there are 1,000 foreign-trained physicians who have passed their examinations but are waiting to be accepted for residency programs.
"Those people, if they didn't do nursing or other jobs, they probably will work as clinical associates or other jobs in the lab. And I'm sure in the United States, there are people trained as physicians waiting for residency, because of family issues," he said, recalling the example of his brother and sister- in-law, whom he helped bring to Greenfield. His brother was a practicing dentist in Romania, where he went to dental school, but had to first attend the dental hygienist's program at Holyoke Community College and is now a student at the University of Pennsylvania. Meanwhile, his wife who was a physician in Romania looks after their children in Greenfield and works as a nurse-practitioner in Holyoke waiting to repeat a residency program. (She studied in the same UMass program that her brother-in-law, Ivantchev, did.) And Ivantchev's older daughter is a junior at UMass, where she's studying biology and considering pursuing a career as a physician's assistant.
"Victoria wasn't considering medicine," Ivantchev said. "At least I feel I made some kind of impact on her. I love medicine. I encouraged at least one of my kids to become a health care provider."
The couple's younger daughter, ninth-grader Nicole, "reminds me, You went through so many things, that teaches that if you work hard toward a goal, you can get it."