Hello! I may have joked about needing fans last week in the heat, but we have moved past jokes. It is hot. Like too hot. Like July and August in Kansas hot, with very few places to catch an air-conditioned break. I have relied on naps and the kindness of the visiting physician and his family to share icy drinks to stay cool and ignore the oppressive 100+ degree days.
This week was the Thai New Year, Songkran, meaning that normal activities were suspended toward the end of the week. People in Thailand traditionally travel to their hometowns, where water fights and family gatherings reign supreme. The surgeon of our hospital took his family on vacation south to the beaches, so we had a different surgeon come with his family for the week.
This family has three little girls, and I must say they liven up our quiet neighborhood around the hospital! They run around in the heat, calling for “Auntie” (despite their mother’s best attempts to make them call me “Miss”) to come play. They opened their home to my roommate and I almost every day for treats and games. On Thursday they had a party for a birthday, and we had a large feast! Traditional Thai food is delicious, usually an assortment of grilled meats and “salads” which are sometimes too spicy for the American palates. My roommate and I baked a cake, and I have to say it turned out well considering our limitations.
The time off also left time for my American roommate and I to go crazy about the small gecko lizards living in our apartment. We had enough of them one day after one posted up in my bedroom. After chasing it out with a towel and bug spray I had to admit defeat there would be some somewhere, just not in my room. We have one that has taken permanent residence under the microwave…
Time does pass quickly. Having inpatient rounds and outpatient clinic makes the mornings fly. A full emergency department does the same. Empty hotter afternoons are a different story, especially now that all my roommates have left and I have the place to myself. I take refuge in my Spotify playlists and books. Another American arrives tomorrow.
Despite the holidays, there was still work to be done in the hospital. We round in the hospital as a team every morning. There has been a large outbreak of gastroenteritis, leading us to have several small children on the ward most days who are unable to maintain hydration with their vomiting and diarrhea. To make us Americans feel more at home, we also have an asthma exacerbation and newly recognized atrial fibrillation with heart failure.
Monday and Tuesday we were able to hold outpatient clinic, seeing some illnesses that we are less familiar with. It is a rarity to see chicken pox in the US these days, but I was still able to spot its beginnings on a three year old from across the room. There are more complicated cases seen by the staff physicians. A man with a large parotid tumor causing facial nerve paralysis came for a second opinion. We told him to go back to his first doctor! On Saturday I was able to have my own clinic, supervised 100% by the attending, but will have some returning this week! I’m starting to get used to the different medications and dosing, especially in pediatric cases.
Unfortunately the holiday also encourages lots of alcohol consumption and vehicle accidents. If you have been watching the global news, you may have seen this. We had multiple patients come in one afternoon. Thankfully while only 1 is seriously hurt, they are all largely well. The same can be said for the accidental gunshot who came in just hours before the motorcycle accident victims. Lots of trauma experience to be had!
These larger cases give the surgeons the opportunity to operate (and us Americans to seek refuge in the air conditioned operating room). Watching patients be operated on with a spinal seems miraculous, until you realize C-sections are performed this way every day at home. Regardless, watching surgeons operate in a low resource setting is amazing every time. Most baby deliveries have happened at night, but I was able to finally watch one! They have nurses who can handle uncomplicated deliveries, and they handle them very similarly to US deliveries.
I am so surprised by how similar some aspects of healthcare are to the situation in the States. The other American and I discussed how we see outpatients maybe (maybe!) twice and never again. I suppose I am used to this from student clinics, or just student rotations. Patients are lost to follow up. Access is an issue. Transportation is an issue. Cost is an issue. We are all so much more alike than we are different.