This day brought us a surprise - we lost four people Friday and Hien leaves Tuesday, but we got three new workers. The bad news - they didn't show up until their 14 hour train ride from Ho Chi Minh City ended and they made their way to the hospital. While we waited, we started off the day working with Dr. Bill on two tables - doing his paperwork and pointing him where to go, and he went simply from one case to another with no down time. It is not as fast going as two tables running simultaneously, but almost.
Up we got and headed for breakfast. We have found a corner at the hotel dining area with a long table that accommodated us all, and we sat and got some techie computer time while eating needed calories for the morning's work. The connection was not always great, but enough to check our email and read the news.
Frankie, Wendell and I left a bit early so we could take a detour and see a street market we drove by Saturday morning. We took a left where I believed the driver to have come out. Wendell and Frankie followed loyally, but I bet their eyes were rolling the farther we walked. Wendell got his photo of himself with a Sacramento newspaper in front of a buddhist monastary. We made a couple of turns, got pretty close to the hospital, but not quite there.
We passed a small table of school-age girls, sitting with their mother. They were all giggling to themselves and staring at us (I am getting used to this), and as we passed, one girl reached out with one finger and quickly touched me, like forbidden fruit or "tag - yer it". I'm sure it was to show her friends how brave she was, and they all laughed. I stopped and held my hand out to her, and she showed me very large eyes. She slowly reached out and she let me shake her hand, so tiny and very tentative like a butterfly. We made eye contact and I couldn't help but smile, and walked away. I could hear gasping and tittering behind me. Close Encounters of the Quang Ngai Kind, and I'm the alien.
We finally asked and got a direction to turn at the next street. We did that, but still nothing familiar. So we stopped at another spot - a young group at a table together outside a cafe ("Ca-phe`"). Lots of people sitting at sidewalk tables today. I asked where the hospital was, and they looked at me like I was a Martian. More alien complex coming my way. Wendell, thinking on his feet, pulled out his stethoscope and imitated a nurse. All four of the people simultaneously swung their arms east and pointed down the street. I guess they got the idea! Off we walked and made our way - finally - to the operating room, only about 10 minutes late. Dr. McClure was very calm about it, but we were all in a sweaty huff and ready for some air-conditioning and recovery time!
Nice surprise when we arrived - ANTS! They invited themselves into our storage and food room, and were trying to picnic in our food. Luckily most things were wrapped, and with a bit of clean up they made their way back outside. If that is the worst invasion we have, we will count ourselves lucky.
Soon after we started, one of the two operating lights (Frankie's pole) went dark. Presumably a new light bulb needed, but no way to find out except to dissemble the thing. It isn't until one begins to handle an apparatus close-up and in detail that the intricacies and innovation can be fully appreciated (sorry for the sarcasm). I presumed an outer glass casing came off to access the bulb, and began to try to unscrew the rusty screws. Only two of the three would budge, and then I noticed the whole glass casing would twist off. So I put the screws back, got the outer layer off, and by now our local "bio-med" guy had arrived and he replaced the bulb. Luckily that was all there was to it; problem solved. I think I threatened his job security though, so I will have to be more helpless next time.
A couple of people have mentioned how safe they feel here. I have to agree. I don't know what it is, but I had no qualms about walking anywhere. The town is fairly homogeneous in terms of neighborhoods, and these people are very family oriented. Except for the gaggles of guys we saw at restaurants now and then, smoking and talking, most people were with families or had children along. No one was really interested in us except when they were amused or inclined to give us a greeting.
Someone also commented on a photo I posted with a young father and child. Dr. McClure had mentioned earlier that it seemed so very family oriented here. The fathers were very involved, and the parents clearly dote on the children. I asked one of our co-workers if she had any children, and those around her laughed and said, "She's not married!" I guess that is the only time anyone has children; very different expectations. The government encourages having no more than two children, and most families seem to comply. The men did seem very gentle and it was difficult to envision any of them at war, but at the same time I could see how if their homeland or especially their families were threatened, that they could be very fierce.
This young child was done early in the morning, and I realized as I passed the recovery room a bit later that she was being held by a young man. This boy, at 17, was the responsible family member for his sister. His mother was sick at home, and although his aunt was with him, his sister could only be consoled by him and he was there to do just that. Many of these families are very poor, but they are rich with family bonds and the right priorities.
One of our helpful Vietnamese scrub techs had a moment of fame - her pants fell down. I have not heard so much giggling and squealing since slumber parties in 6th grade. Her friend came to the rescue, and made it right.
Our new crew members finally arrived. They came straight from the train station after 14 hours of train travel and jumped into the mix. This photo was taken of the two new anesthesia providers - nurse Khuong and Dr. Thinh. We were doing our best to pronounce their names, but there are so many nuances to the language that one can only hope to keep the mangling to a minimum. But I wahs starting to fehl at home whith the extrah lhetters.
These team members had some English skills, one of them even understandable. But we managed and I wrote lots of teaching points down so they could see the numbers and read the words. That seemed to work better.
I did have a complaint - they all had cell phones that rang all the time, and they answered no matter what they were in the middle of doing. This was the same in Africa and China. It was kind of annoying, and I certainly felt that what we were doing in the OR was more important than any call. But we tried to observe and see how things were done by the locals, as long as no patient was harmed or neglected. As much as they answer phones, they don't do paperwork. Different ways. Here is a photo of an all Vietnamese host team - scrub tech, surgeon, and nurse anesthesia.
Nurse Khuong...
Setting a good example - Dr. Bill helped with turn-over. He's a keeper!
There was sometimes confusion among patients who come to see us as to what procedures we could do. Some women came right out and asked for cosmetic procedures. A mother may bring in a child who has already had procedures, wanting a small tweak to make something look better. But usually what we offer is to improve function, and although the surgeons try to use the most aesthetic approach, function trumps appearance. We are doing quite a few nose-lip revisions for those who may have had a lip repair done in the past that pulled apart over the ensuing years, and these are in a sense more cosmetic, but do make a big difference in the lives of these young people.
Frankie is always the last one out - doors glued shut with an official paper, lights out, and a lonely dark walk down the operative suite corridor.
It has been a long day. This is about what time we arrived "late" this morning, and now the sun has been long down.
As I walked out, I noticed the many dark hospital corridors above us with the lights shining from the rooms and the shapes drifting along in front of them. Even the lobby was quite dark; often the hospitals use very few lights to save electricity. This is common in many of the places we visit. Electricity is a luxury, and is used sparingly; as is everything else. We have much to learn from our host countries.
I didn't go down to dinner, because I lay down in my room, my legs said, "Yes!" and I decided R+R would win over food. Monday was national Health Care Providers Day in Vietnam, and the hotel honored us with some flowers, of which Frankie sent me a photo. Nice touch!
Frankie is tired. She said her feet hurt, but then she realized her shoes were on the wrong feet...
But we forgive her - she is really a one-woman band!
http://www.youtube.com/watch?v=uXMuWi0dUBc
Enjoy.
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