It was his first day at work as a nurse in a small town called Hastings, in Nebraska. When he had the professional who was going to train him in front of him, the first thing he did was give her a hug and a kiss on the cheek, in true Cuban style. “She stepped away from me, very serious, and I ended up in the health center’s director’s office and was reviewed for that “lack of respect”, that bordered on “sexual harassment”. Like a little kid that has been caught ditching school.” He laughs when he tells the story now, but he’ll never forget the fright he had at that moment.

According to Sandy Lopez, the cultural, professional, and geographic switch was a tremendous challenge of adaptation. From Camaguey to the US. From being a journalist (graduating from Oriente University in 2006, a professor and PhD in Communication Sciences to being a nursing student and nurse. From Spanish to English. All against the clock, as we say in the press. Learning everything all over again, from scratch, within an environment where skill and competitiveness are the basic tools you need to get ahead.

In 2016, he had decided to go and live in the United States. It was an “emotional impulse”. He had always wanted to study Medicine. In Cuba, he chose to study journalism and teaching in the end, because of his family situation; but that dream always stayed with him. When he reached US soil and knowing that nursing there has great financial incentives and social recognition, plus exceptional job offers, he didn’t think twice: the opportunity came like a “hole in one”.

So, he passed through every level of this profession: a nursing assistant, in a six-month course in which he did “very little more than what a family member would do in Cuba: be with the patient, take samples for analysis, check their temperature…” Then, he studied an associate degree, “which would be a higher technical degree in Cuba. You get it in two years. That’s how I got my license to be a nurse. The change is huge: in responsibility, in complexity, in wages… For example, if a patient has low potassium levels, you don’t even have to call a doctor, it’s your job to get it stable.”

He then completed a bachelor’s degree in Nursing Sciences, “which is becoming the equivalent of a specialist degree. If you are a registered nurse, you can do this in a year. Luckily, I was able to finish mine in just eight months, by getting ahead with some modules. I graduated with honors on June 20th 2020, in the middle of the pandemic,” he remembers.

“The challenge of being a migrant is always the hardest though. The best thing you can do is be very humble. You can’t go there thinking that you have this and that level of expertise. It’s a different country, with a different culture. I was shocked by the education systems here which, I would say, are less demanding than the ones we have in Cuba, in some aspects, as they prioritize work in the field, without so many assessments or technical presentations by the student. The professor’s role is colder and more distant. An advantage is that there are so many online education programs, which is the greatest benefit you can have so you can work and study at the same time,” he says about changing his way of studying.

“When you finish your nursing training, you must take a public test, which is very rigorous. You have to go over the entire profession: maternity, pediatrics, pharmacology, everything. The exam costs around 200 USD. You have to keep taking it until you pass it. It’s a questionnaire in English with 265 questions, and you need to get at least 75% of them right. It’s all done on the computer, with a camera in front of you as you’re responding. These exams are prepared by teams of experts who formulate hundreds of combinations of questions, so there is absolutely no way to cheat.”

Sandy had to gain composure over time, even in the way he talked and his behavior, speaking lower and avoiding excessive gesticulation. Not thinking in Spanish first to then say what he wants in English. The only option he had was to transform himself, it was a matter of survival.

He lived in Miami first, which helped him a great deal because he was close to Cuban idiosyncrasies. Then, he left for Nebraska, “a completely US city, where there is an environment, that I would call more guajiro or “peasant-like”, very traditional people, who have conservative, reserved attitudes.”

He has held many jobs: in hospitals, rehabilitation centers (similar to old people’s homes), in agencies (which involve going to patients’ homes), in oncology, mental health wards, clinics or surgery rooms.

At the beginning of our interview – in late 2020 – he was working in New Jersey, at the CareOne at the Highlands hospital. “I came here via a travel nurse company; these organizations pay a great income, hotels, stipend, transport… I came with a two-month contract and then I renewed it. Nurses were in high demand; many professionals had been infected with COVID-19, others had small children and were afraid of catching the virus… The contract I was offered was really beneficial in economic terms. However, I was walking into a biological war, there’s no doubt about it. Before stepping foot on the plane, I had never seen such an empty airport in the US. People were all wearing masks. Like in the movies. You thought to yourself: “I’m going to war, will I come back alive?”

His family in Cuba is always his greatest concern. He helps them out financially, but he can’t be next to them to help them navigate the thousands of everyday hardships. He is happy about one thing though: not infecting them when he comes home every day after treating dozens of SARS-CoV-2 positive patients.

In the beginning of his time working during the pandemic, his hands would sting because he was using so much alcohol and double gloves. Sweat, with so much PPE on, would cloud his vision, his glasses would steam up: it was hard to look at the computer, patients, medicines that he was administering…

“You end up dealing with death in a very calm way. It might seem heartless, but it’s not like that, it’s just that you slowly come to understand the process of life: you’re born, you grow, you die. It’s really tough, but that’s all there is, regardless of any affection you have towards patients. In a critical moment, a moment of emergency, you have to be impartial, focused, working with a lot of cold blood so you can help recover somebody in need. With COVID-19, you have to resuscitate sick people in cardiac arrest a lot.”

“I guess emergencies force you to live a brutal everyday routine…”

“Uf, just imagine: we finish with the code red of a patient and the alarm of another patient is already going off, and you have nurses running this way and that. You have to work around oxygen supplies and other parameters. I remember a young man who was only 32 years old and he died. These deaths are especially heart-rending. Their anxiety also increases because they are human beings who are not allowed to be in contact with their families because of their condition. So, you become the closest person they have. You come from home and they see you as a bridge with the outside world. They even ask you what day and time it is because the disease has them half-out of it.

But even amidst the chaos, Sandy hasn’t stopped laughing, traveling, listening to all kinds of music (an eternal passion), dancing, making plans and achieving them one step at a time. In less than five years on US soil, he has already bought a house and has freed himself from having to pay rent. He also watches a lot of TV series, he loves medical ones. Just like he loves comedy movies, a lot more if they are Spanish. He prefers not to talk about politics. “I keep it far away from my emotions. It’s a diabolic mechanism.” When he can connect to Cuban TV, he likes to see his old colleagues from the journalists’ association.

He moved back to Miami in July. It’s been a year now too that he began a Masters in Family Nurse Practitioner at the Ana G Mendez University, in the southern Florida campus. “It’s a kind of GP,” he explains. He jokes that he is better “protected” now, as he is working at Mercy Hospital, which is next to the Chapel of Our Lady of Charity.

“Any frustrations?”

“I believe that what you have to do is convert your desires not into frustration, but into goals. I would like to have my parents here with me now: to take care of them and protect them, like I’ve always done. The other things I’ve achieved with a great deal of sacrifice and dedication. I have always said that if I had another life, I would dedicate it to the medical sciences. I came here and began this other life. I have my friends, my partner, and I keep thinking that the main thing is what makes us human, beyond our professions. What more can you ask for?”

This article was translated into English from the original in Spanish.