day four

Thursday = Tropical Diseases + Cardiology

So the American equivalent to the specialty of tropical diseases is epidemiology, which is something I've been interested in ever since I took microbiology at UNC with Professor McGonagall (i.e. Prof. Matthyssee from Har-varhd). Probably the hardest class I took in undergrad but probably one of best courses I could have taken (although some of my classmates who suffered through that course may disagree with me).  I was looking forward to today because epidemics are not too varied in the States (except H1N1 and the occasionally salmonella/E coli outbreak - but I'm no expert). Based on the climate and other conditions of Vietnam, I assumed that I would be presented with a different potpourri of illnesses. 

Today was also a day when I could practice my French. The only tropical diseases doc that spoke English didn't speak it fluently but was fluent in French since he went to medical school in Bordeaux, France.  France, along with Canada and the US, is a popular place where Vietnamese students travel to to further their studies.  The reason why my dad emigrated from Vietnam is because he was able to obtain a student visa in the mid 70's to do his university studies at the University of Montreal and stayed (Random but great story: when my dad first came to Canada, he came across bacon in the grocery store and thought it was deli meat so he ate raw bacon on sandwiches for a while until his brother caught and corrected him. Today, he proudly eats cooked bacon). However, the doc I worked with today said that he was "required by the government" to return to Vietnam to practice. Anyway, our conversation was pretty colorful - a mash up of Vietnamese, English, and French - lots of "Comment dit-on?," "How do you say...," and "Toi khong biet" flying around. 


Unfortunately (or fortunately) I've caught Ho Chi Minh on an off-season for epidemics so the whole department had a mere 6 patients on the day I visited.  The only case that remained significant to me was a case of Dengue fever - but this is probably because I hung out with the nursing students who were learning how to administer shots into someone's buttock. And the poor guy was the chosen patient whose buttocks were in plain view for about 12 young ladies, including myself.


Although this day could have been a bust due to the lack of patients, I actually had a really great 3-hour conversation with the French doc and the head of the department, who only spoke Vietnamese.  I first told them that if they were busy, they didn't need to stay with me but due to the lack of patients, they had a pretty free day and were glad to hang out with me (it was weird - it seems to me that American docs are way too busy to even enjoy a meal during the work day). The three of us were sitting in one of their break rooms and the head of the department was keen on making sure that I would get something out of my visit. It seemed like he thought I'd be reporting back to my school about my experiences in the hospital and wanted me to experience only positive things - an effort that I definitely appreciated.

So we chatted - mostly about general epidemiology in Vietnam (what's popular in the each season - and it was a lot) but also about differences b/c American and Vietnamese healthcare.  Perhaps they seem like dry topics, but it was actually really entertaining (especially with the trilingual/3-way translation) and I got a lot of insight in how some Vietnamese doctors may view American doctors.  They asked me about how the US handled the H1N1 outbreak and they were fascinated at the fact that some pharmacies were allowed to give the vaccines to the public and that there were organized drive-thru clinics that just gave you a shot as you sat in your driver's seat (true story). While they were asking me if I've heard of this and that disease, I surprisingly remembered a good bit of microbiology and I explained some of the things that I knew (transmission, mechanisms, symptoms). They said that they were impressed how much I knew for a first-year medical student (I was too) and talked about how they thought that they thought that American medical education is of higher quality than Vietnamese. Keep in mind that these was just one or two doc's opinion and not the general consensus. But the docs I have spoken too throughout this week find it frustrating that docs who get their degree in Vietnam can't practice in the US but American docs that visit Vietnam are regarded as welcomed experts.  In fact, one of the neurosurgeons I met the other day was planning on taking the USMLE Step 1 boards the same time as I am but there he is, already doing neurosurgery and I'm just standing there, not knowing what's going on. 


After the lunch break, I went to spend some time in the critical care room for the interventional cardio patients  - I wanted to document this particular moment because (!) this was the first moment I stuck a needle in a real, live person. And without causing any pain! First, I thought I was just supposed to watch a doc draw some blood to determine the blood gas content. After she finished with the first patient, she handed me a needle for the second patient. I just looked at her and asked, "For me?" She obviously saw the terror on my face because she said not to worry and that the needle size was small so it wouldn't cause too much pain.  I really didn't want to do it because I had no idea what to do and her English wasn't too clear so I couldn't even really understand what I was even supposed to do. But she told me I would have to do it eventually so I just took it. Good thing I was watching her closely during the first patient because I couldn't understand much of her spoken directions. Feel radial pulse, hold area with 2nd and 3rd finger, needle in (ahhhh), wiggle it around, blood! As soon as I saw blood enter the needle, I finally exhaled. After I finished, the poor old man who was my first target kindly said "Good job" to me in Vietnamese. I wanted to hug him.