Mariam & Jerry's excellent adventure

updated 8 November 2021

view from our kitchen

Mariam's 2 month sabbatical was triggered by Jerry's retirement and Stanford's closure of the Manoukian Medical office.  She will return to their Grant Rd location in November.

Mariam arrived to Armenia September 6 and Jerry arrived a week later.  Our itinerary as included Mariam's teaching of Armenian physicians, mainly primary care physicians in a number of settings.  She gave classes in Endocrinology (targeting primary care physicians) at the National Institute of Health in Armenia's capital, Yerevan, as well as in rural locations in Armenia's north.  She saw patients in consultation with the local physicians in a number of settings.


Armenia is a former Soviet country, population approx. 3 million, half of whom live in Yerevan.  The other half are spread throughout cities and villages in the "Marzes", roughly equivalent to counties in the US.  The economy is bolstered by tourism, high tech, farming and construction. 

Initial impressions of Armenia tip the balance in favor of charms:

Armenia's charms Armenia's challenges
Great food hard life for farmers
Friendly people prolific smoking
The wine! Beer!  Oghi! Good idea to boil the water
Exotic alphabet strange alphabet
Amazing beauty in Marzes Heavy traffic in Yerevan
Lot of new construction restroom fixtures lagging behind
Music, lots of it, and fabulous      inconsistent mask wearing and 4th wave of COVID 19
Taxis are plentiful and cheap

Remind drivers to replace cigarette with a mask.

There is a seat belt, somewhere.  May need to dig around for it.

     Share the road with countless other taxis

Did I mention amazing beauty?       Still need to solve waste management problem


3 main arms of the medical industry include the Ministry of Health, the National Institute of Health, and the Yerevan State Medical University.  Additional medical universities compete with YSMU, and there is a recognized glut of undertrained physicians and nurses.  Several of Mariam's students at the NIH had scarcely seen a patient during training or since graduation. 

 Our experience in the marzes was facilitated through 2 nonprofit organizations which have made major impact in Armenia over the past several decades since the devastating earthquake in 1988 and independence with the breakup of the USSR in 1991.  The Children of Armenia Fund (COAF) and the Fund for Armenian Relief (FAR) support many projects including medical education and medical clinics. 

Additionally, we were able to visit several schools as part of Education of Armenian Children through Sports (EACTS), a program spearheaded by Mariam and supported by the Armenian Healthcare Association of the Bay Area.

 We went to Gyumri, a city in NW Armenia that was heavily hit by the earthquake.  The city has made a strong recovery during the past 3 decades.  We visited several schools and noted gymnasiums in various states of decay.  One school renovated by the United Kingdom following the earthquake has a modernized gym but use is greatly limited by a nonfunctional heating system.  Medical clinics supported by COAF in the Gyumri area employ primary care physicians and nurses serving pediatric and adult clients.  Mariam gave endocrine consultation on approx. 30 patients in the village of Maralik (and Jerry saw 5 patients with general medical complaints).  Jerry also found his Kardia handheld EKG to be quite useful for several of the thyroid patients who complained of palpitations.  

We also noted an abundance of potatoes grown in the region and sold for 100 Armenian Dram per kilogram.  100 AMD is approximately 20 cents.  Mariam is researching the possibility of supporting a potato chip industry to serve the restaurants, bars and markets.  Such an industry has been studied with business plans created, but the majority of chips in the country are imported Lay's and Pringle's chips.  We oughta change that.

Visiting a clinic in Horom, outside Gyumri, we learned of a fortress on a nearby hill dating back between the bronze age and the Urartian kingdom approximately 3000 yrs ago.  The site is marked by "cyclopian" structure, huge boulders stacked on one another to build walls.  The name comes from the assumption that the rocks are so large that only a cyclops could have lifted them.  The ground is strewn with pieces of pottery, presumably dating back 3 millenia, as well as small pieces of obsidian.  Many of the obsidian pieces could have served as cutting tools.  Notably, there is not any obvious presence of obsidian in the soil as there is in other areas of Armenia.  However there is significant obsidian in nearby Maralik, and presumably these pieces were brought to Horom by the ancient inhabitants.   The site has been partially excavated, and may offer significant archaeologic riches if further studied.  (It is worth mentioning that Armenia has significant ancient sites including a cave with a 6000 year old shoe and wine operations from the same period.)




While in Yerevan, we filmed a few short videos about lifestyle medicine. 

Here is a link to a page where the YouTube links are listed


 A second foray into the marzes involved the FAR center in Berd, a small city in the Tavush Marz, not far from the border with Azerbaijan.  Mariam offered 2 afternoons of endocrinology classes to local physicians at the FAR center.  Jerry found an abundance of wild hops, raising the possibility of a farming option to provide income to local farmers as well as support Armenia's burgeoning beer industry. 

Mariam and Jerry spent a morning harvesting wine grapes outside a local village.  The Lalvari variety of white wine grapes is characteristic of Tavush's growing wine industry.  Many of the grapes will be sold as wine in Russia, while part of the harvest will be converted to brandy by the Ararat Brandy company.

A local lamb joined us for lunch.  Mariam's former classmate (and vineyard owner) poured us some of best homemade brandy on earth, from a plastic Coke bottle.


 Our third visit to the marzes was also with COAF.  We were hosted at the COAF SMART center in the village of Debet in the Lori marz. 

 This photo of the COAF SMART Center is pirated from, and links to, the COAF website.

COAF is worth supporting.

Fall colors were shifting into high gear and we saw a bit of snow on hilltops.  This center offers after-school training to local children including English, programming, music, agriculture, health and others.  Mariam saw approximately 20 patients in the nearby village of Vahagni.  Jerry, with his limited Armenian, saw 2.  We visited the Vahagni school, with its recently renovated gym.

Lori is some of the most stunning mountains and gorges.



The EACTS project was started in the aftermath of vicious attacks in the enclave of Nagorno Karabagh by Turkish and Azerbaijani forces using Israeli attack drones, cluster bombs, white phosphorus and ISIS mercenaries from Syria.   

It is our hope that through team sports, we can encourage physical development and communal mindset in the next generation.  I might add that group thinking would benefit Armenia in many ways, including such areas as traffic management, mask-wearing, avoidance of smoking indoors, and control of litter/pollution.  In effect, life ought to be a team sport.

 The British-supported gym in Gyumri is used only a few months out of the year, as the furnace is not properly connected to the ventilation ducting.  For the past 3 decades it has been dormant November through March when it is too cold, and during the summer months when school is closed.  We have made a decision for AHABA to finance the necessary duct repairs.  


 Back to our place in the Yerevan Physics Institute, we have our eyes on an old gym that previously housed an indoor tennis court.  Its floors are falling apart, most of the windows are broken.  It is a bit narrow for a basketball court.  Next to it are clay tennis courts and a soccer field.  If repaired, the gym could house team sports, science camps and other activities for the YerPhI and the adjacent community of Achapnyak.  



Around the corner from our apartment,

a former Head of State advises us (by example)

to quit while you're a head.


On 10/13 we took a day trip to Armavir Marz, southwest of Yerevan.  We visited several COAF schools, saw some great gyms, and Mariam saw several patients (under Jerry's supervision, what the hell, I am retired.)


We also saw a nearby hill in Nor Armavir which had the ruins of an old Urartian fortress (approx 3000 yrs old).  Like Horom, it was scarcely possible to take a step without treading on fragments of ancient pottery.  There weren't all the obsidian fragments that we saw in Horom, but there were a few.  The site is called Argishtikhinili and it is spectacular, in spite of the litter.  You can scroll down to October 24 where we organized a cleanup crew to get rid of some of the litter.


On the way home we stopped at a magnificent Yezidi temple. 


Ziarat Yazidi Temple in Armavir

(links to Wikipedia page)


It had some monuments and plaques calling attention to the genocide of Yazidis by ISIS in northern Iraq in 2014.  I'm glad that Armenia has some refuge to offer other genocide victims.  We still have a long way to go.  Humanity has a long way to go.


I made up a joke today.  Do you know why they call it a cattle *drive*?

Because it's tavar to walk!

Tavar is the Armenian word for "beef".  I thought it was pretty funny.  Mariam didn't.


OK.  Back in Yerevan.  Dinner with Mariam and Raffi, local entrepreneur and journalist.

Beer with Ambassador from Norway.  Lunch with colleagues from France.  Mariam had breakfast with the President.

We must be big shots!

Side trip to Mariam's Dad's summer home. We have an apricot orchard there, suffered some damage in a grass fire.

Guess I'll have to come back here next spring to see which branches are viable. 

There are ruins of an old church in the orchard next door.

This structure is about 200 meters from Robert's summer home in Karbi, Armenia It is filled in with sand and rubble, stones scattered nearby Inscriptions on some of the stones indicate that is likely an old church.  The inscriptions are Armenian capital letters, difficult to read because a different dialect was used (Grabar) and they didn't have spacing between words. The spiral "wheel of life" is a very common inscription on churches and - wait, that's a saw blade.

 Mariam was interviewed by journalist and rock star Lara Tcholakian from Civilnet.  They spoke about women's empowerment and  lessons learned from Mariam's parents and grandmother.  It was a gorgeous morning in the Physics Institute.  you can see the interview at


Rock Stars

A quick note about rock stars.

I love to be seen with them.

Like when I took a selfie with these gents in LA a while back.     =>

You'll recognize Rock Star Michael Manoukian.  

With the great Serj Tankian

Orthopedist Garen Koloyan performs miracles on birth defects as well as earthquake and war injuries. Dr Aram Ghazarian from Lyon, France.  Yeah, you should Google Aram Ghazarian. Composer John Hodian, creator of the Naghash Ensemble of Armenia.  Catch them when they are on tour.  

 I love it here.


October 20, Mariam took part in an Osteoporosis Symposium for over 200 participants.  There were 6 speakers including Mariam and our  (rock star) friend Dr John Bilezikian from Columbia University via Zoom call.  Mariam spoke about lifestyle in the prevention and management of osteoporosis.

Mariam forgot her phone at the conference hall.  Fortunately the Conference Chair, Dr Varta Babalyan,

found the phone and kept it for Mariam.  Even better, Varta was out to dinner when we got ahold of her.

It was a posh place on top of the city.  So we splurged on a fancy meal, dancing and show for about 60 bucks.

I couldn't load the video to our server, but here it is on YouTube


A word about COVID-19

We cannot sugarcoat this.  COVID-19 has hit this country as it has worldwide. The difference is that Armenia can't afford it.  There is a shortage of everything, including know-how.  There is a great deal of creativity when it comes to mask-wearing.  Too many of us are flaunting the rules. Mask use at the Osteoporosis Symposium was around 60%.   Vaccination rate is around 6%.  There are many reasons for this, including mistrust of Chinese and Russian products.

There is mistrust of vaccines in general.  One educated person who is so anti-vaccine that he forbids his (old enough and overweight enough) parents from getting vaccinated, describes mask mandates as government tyranny.  Yeah, we have a bit of that in the US too.  After speaking to him, it sunk in how  government overreach makes us drive on the right-hand side of the road, when there's a perfectly good left-hand side of the road that looks clear.  Huh.  

Meanwhile, we watched as an elderly woman with COVID was loaded onto an ambulance.  Neither she nor her family members wore masks.  The ambulance drivers wore surgical masks (not N-95).  

Full disclosure:  I caught some jazz at an underground club.  The music was great.  I wasn't wearing a mask, nor were the other 50 people.  I refuse to disclose my vaccination status.  Just kidding.  Of course I'm vaccinated.  Are you crazy?



Let's talk about music.

There is tons of it here.  We enjoyed performances by our friends Vahagn Hayrapetian, Artyom Manukyan and Arto Tuncboyaciyan.


old friends and new

Vahagn with Sash on drums Artyom & Friends      

We got to see the godfather of jazz, Levon Malkhasyan, or "Malkhas".    The Nova Folk Instruments Ensemble of the Naregatsi Art Institute played an impromptu show (leaving us breathless) to John Hodian after his presentation at Naregatsi.


This photo shows Malkhas playing effortlessly, in his jazz club

at around midnite, at roughly the speed of sound. 

Note how he is sitting sideways.

Here's a sample of how he sounded years ago: 

Earlier that evening, the Armenian State Jazz Orchestra, led by our friend Armen Hyusnunts, played a beautiful tribute to jazz legend Stepan Shakaryan who passed away in 2019.  Armen, whom I recall as standing motionless while his fingers fly over his saxophone, was in his own element with the jazz orchestra.  He danced while the band cooked, delivered messages from the heart to his Mentor.

Rock Star!



More photos! 

We want more photos!

All the other countries  

export inferior potassium

did i mention taking selfies with rock stars?


The Volga is the most 

 beautiful car ever produced  

                       bar none




Oct 23:

Dinner with Zareh and Armine, 

who introduced us to 

Aren and Stephani



who are excellent dancers

and changed their plans for ...

October 24

when they joined our cleanup crew

at Argishtikhinili.

Mariam lassoed a bus driver 

at the last minute

and he took us in his 12 seater

bus to the cleanup site


Argishtikhinili was a fortress that King Argishti (king of Urartu, a while back) built for himself in the 8th century BCE or so. Now it is partly excavated, but mainly used as a party site for locals. 

A dozen of us spent a few hours cleaning trash from the site with the blessing of the mayor and a few locals.  This site has ancient pottery fragments scattered all over the place.



Stone cylinder may have served as the base for a column

The cleanup crew at Argishtikhinili.  That's Mount Ararat in the back.  It's a little different than the view from our kitchen window (top of this blog).  That's because we are so far west of Yerevan that "Sis", the smaller of the two peaks, is now behind Masis, the larger peak shown here.





The Mayor of Armavir has a buddy, Davo, who tried to dig a tandur, a pit in the ground that's great for barbecuing.  Actually amazing for barbecuing, but I digress.  Davo ran into some Urartian artifacts that were pretty fascinating.

2 Urartian pots among the large store of treasures under Davo's house Closeup view of the detail on this 3000 year old pot. Mariam and Artur, the Nor Armavir mayor, next to a large karas that once was likely used for wine storage



Wine ought

No outing is really complete without a stop at a winery.  In this case, we went to Maran winery, near Zvartnots Airport.

Frunz is the winemaker and is our neighbor in our Yerevan apartment.  For those of you who remember Enoteca, that's Frunz's family.

After a tour of the winery, he invited us to this underground series of rooms where we got tastes of white, orange, pink and red wines.

Suffice it to say, drink Maran wines!

(we can get them in California)

Note 3 large karases, (just behind and to right of the table).  These are large clay pots used to make and store wine back in the day. 


Are these cool or what?

Mariam and lifelong buddy Ruz

Underground storage and tasting room


Still fired up for small scale brandy production in a nearby building