The trek home

Mission accomplished, but then we had to relocate our condensed equipment and get the boxes and ourselves all safely home.

The boxes had been picked up Thursday night and kept over at a man's house ready to drive to Da Nang Friday. The bus for the team was set to come to the hotel early, so we had to manage breakfast and packing before about 7:15 a.m. Frankie and I finished getting the boxes ready for pick up at the hospital Thursday, so they were ready to be en route to Da Nang before we were. Here is a photo Frankie took of us at the hospital, punchy but job finished before the boxes got taken away. The photo almost looks as surreal as we felt. We had to get the boxes on a guerney and down to the truck where a couple of men loaded them into the back. That got us back to the hotel late for our party, but the packing had to be done.














The team was given a beautiful bouquet of flowers and a lovely piece of framed art. We had the picture wrapped and taped for the trip home, but the flowers had to stay, so we all must remember via this photo.
















The drive north was uneventful, except for a pit stop half way at an interesting spot with food, snacks, and gifts, as well as a roomy bathroom area. The stalls were very roomy too, because there was no toilet; only a hole in the ground. After riding in a car for hours, standing still enough and taking enough aim to both hit the hole and miss the shoes is more Olympics than I can take when sleep-deprived. We all did manage to pull it off (no pun intended), but after contemplating the lack of toilet paper and presence of long hose and nozzle in each stall, I had to leave before a mental image became too clear in my mind.

Da Nang airport is quite new and very beautiful, except for the brainless idiot who approved the installation of a Burger King in the middle of it.













The first time I was in Vietnam was in Saigon (now Ho Chi Minh City) back in 1974. It was interesting to look out over the tarmac at the new, modern fixtures superimposed over the old hangers from the war in the distance. Vietnam has come a long way since the days of the '60's and '70's, and some of us noticed how much better fed and kept these children seemed during this trip.












Something familiar to Vietnam - foreign faces. People have been living in Vietnam for over 1/2 million years, and it is one of the first cultures to practice agriculture. We saw hints of this via the many rice fields we passed during our drive to Da Nang. But with a history of several Chinese and other Asian dominations, as well as the French, Americans, and a multitude of missionaries, there has been no shortage of outsiders. For example, the Vietnamese people used to use Chinese characters for their alphabet, but that was replaced by Portuguese Christian missionaries to facilitate the teaching of faith (that is why we English-speakers can almost read the writing here). As I looked around the waiting room at the airport, all I saw was a sea of white faces traveling from Da Nang to Ho Chi Minh City (HCMC). One was a German man who strutted right up and cut in line with everyone politely queued and watching. No manners!













Once we got our boxes and bags checked through to HCMC, we boarded the flight ourselves and had an uneventful journey to our last stop before home. Our Da Nang flight was too late for us to catch the flight that day to SFO, so we overnighted in HCMC to wait for the next day's SFO flight. Back to a bus, boxes and bags on, long drive to a hotel, boxes and bags off. Can't we just beam the dang things home?

Wendell and Frankie wanted to head off shopping, so we all dropped our things in our rooms and took off for the large market in town. Big cities have many features that are the same, but Vietnam is just different. The wiring for example?










The motor scooters all random and chaotic?











And the largest open market of stalls and goods I've seen anywhere. Do people really need these things, really?















Wendell went off on his own errands. After a bit of roaming around the hot and sweaty market, Frankie and I decided to wander around outside and make our way to the Rex Hotel, where we had all agreed to meet for dinner.

This is a statue of Ho Chi Minh: a Marxist-Leninist Revolutionary, Prime Minister, and President in Vietnam's mid-twentieth century past. He was instrumental in the formation of the Democratic Republic of Vietnam in the North, and fought for an independent and unified Vietnam until his death in 1969. After its capture in 1975, which officially ended the war, Saigon was renamed to honor him. This statue sits in front of the City Hall.


















We made our way around to the opera house, which is a stunning building with beautiful, white, marble statues. The geckos think so too!















We finished up our loop by arriving at the top of the Rex Hotel, which was an outdoor covered bar with an amazing view of the city. This 5 star hotel is in District 1, the main downtown area. Supposedly this hotel is where the first American soldiers stayed in 1961 while their tents were being set up. They had their first Thanksgiving dinner on the rooftop, and then the hotel became famous for the daily press conferences about the war. The hotel was where the press conference announcing reunification of Vietnam was made in 1976. The rooftop bar was a popular hangout for military personnel and journalists.













Frankie and I were not sure when we were supposed to meet here for dinner, so we were there for about an hour before anyone showed up. We had a nice visit, and then in walked Bill and Wendell. Soon after came Drs. Hien, Tuong, and Nguon. Hien brought her adorable daughter for us to meet, who enchanted us all. We had a nice visit and a drink, the Vietnamese contingent headed for home, and the team went to dinner.

















The remaining five of us walked to the Lemon Grass restaurant, which is on the 14th floor of the Palace Saigon Hotel. It was a beautiful place to sit, and the core Resurge team finally got some good down-time together and a good meal. Thank you Dr. Bill!

The ladies had a good laugh in the bathroom with its tiny doors. We all piled out and walked home in what was a beautiful night - warm air, refreshing breeze, and finally fewer motorbikes on the road. We made it in good time, even including our stop to view the local wildlife. HCMC is truly a place that never sleeps.

Imploding an OR

All of us came to the hospital early our last day to do a few cases and wrap things up. On the way in, I noticed a few crowds of nurses out on the balconies, probably just starting their shifts. You can see how large the hospital is.















Everything was done at about noon and we began to tally, check-list, clean, toss, and disassemble all the parts. My two anesthesia colleagues were remarkable at helping, especially given that they had never done this before. Their abilities and their energies were an inspiration to me during both of my weeks in Quang Ngai. I feel I have made four incredible friends.

It baffles the mind to see the equipment balloon out of these many boxes, many of which are filled with "soft" supplies that we leave, and then to repack what is left at the end of the trip back into the Pelican boxes. We came with 28; we leave with 16. The biggest job was Frankie's, but we all chipped in where needed to get it all done.











































The lunch man arrived with our daily food, as he always does, making sure that we all got something to eat. The meals have been good and they brought great veggie meals for me.





Being the lightweight, I really have to choose which meals I am going to eat; usually two out of three a day. Any meals that were left, Phi took out to the families to have something to eat while they waited. She is an amazing charity of one!






I caught this photo of the local OR crew just after lunch. It seems to be everyone's habit to take a nice siesta after lunch, and we were left surrounded by a very empty recovery room and operating unit. The room next door was full of napping women, but the blinds had been pulled and I would have had to use a flash.













The afternoon after we packed was the first real daylight we had in Quang Ngai. Wendell, Frankie and I took a long walk looking for a street market we had seen last Saturday on our way out of town to Hoi An. We couldn't find it, but did make our way into a Buddhist Temple. A delightful young man showed us around, and gave us incense to show respect to the various shrines they had inside. It was one of those wonderful, unexpected, random and spontaneous moments in another culture that can make a trip so memorable.

After the temple, we made our way to a supermarket to buy a few items, and then made our final trek back to the hospital to get the boxes loaded. We borrowed a guerney to get the 16 boxes onto a truck for the journey to Da Nang, and while we were waiting, we saw a nurse carry out two tiny twin babies. The young father had an expression of both sheer delight and wary apprehension. It is a daunting moment that no parent every forgets, and Frankie caught it perfectly in this shot.













The twins each had a piece of tape on their foreheads to tell them apart. They were both so quiet, but very well-looking. This appearance of new babies at the operating doors had been happening all week, as there is a busy OB service here.

We took a taxi home, hot and tired, and got a drink to take up onto the 7th floor balcony. In the heat and humidity, we spent awhile looking out over a city we knew from up close, and finally got to see from a more overhead perspective. We could see the stunningly high mountains to the west, with the sun setting behind them. The ocean lies to the east, and except for the East-West flip, is a setting not unlike Southern California. It is an odd city for us though, full of motor scooters, thin small buildings, and funny top floor porches and gardens.

Next came the traditional party given by Resurge at the end of each trip to thank the hosts and local co-workers. We had this in our restaurant at the hotel and about thirty people showed up, including a couple of local officials. Everyone made speeches and then the drinks began to flow, especially for the locals. Vietnamese like to party!

Of course there was dancing, karaoke, group photos, and certificates. Most of our important players made it there, and we got to recognize them for their contribution to the effort we all made here. A job well done by all, and a party to show for it.

Intensive scare

The wireless here at the hotel is quite a piece of work. It comes and goes, gives us five options that may or may not take us to a connection, and when we call the desk to complain there is a fire drill of hustling clerks playing musical chairs, calling someone on the phone, smiling and explaining in Vietnamese, and suddenly there it is. Sometimes I see 4 out of 5 bars, but most of the time it is 1 or 2 and my computer is not happy. So the blog limps along...

Also at odds with the blog are some long days - Thursday night went until 10pm with a sick child, but more on that later...

I love our walk into the hospital, because we can peruse the city and see how the people function from day to day. We are getting pretty good at dodging motor bikes, which unlike some cities I know, do their best to gracefully dance their way around us without hopes of carnage. Sometimes we see signs that look funny to us, but I'm sure they sound and mean something totally different than we think.
















Our Vietnamese surgeon, Dr. Tuong, is our barefoot doctor. He slips off his blue plastic slippers and keeps his feet cool on the OR floor. Also shows a level of confidence that he won't get too much bleeding. His assistant had cute socks with on spot for the great toe and the rest of the sock for the four little toes. So many cute details when you look closely.


















One little two year old patient had a very gnarly cleft which involved both sides and left a central island of gum, lip, and bone. These are so strange to look at and condemn a child to a lifetime of inability to eat or speak correctly, as well as the cruelty that comes with being different. You can see the transformation here, and the look on the mother's face as she sees her child's repair for the first time. It is a moment we all treasure.

































Thursday was cataract day at the hospital, and I enjoyed seeing these two men sharing their post-operative bed. They were laughing and talking and having a good ol' time, and after I caught this photo, they gave me a big chuckle and a wave.













Our very capable Vietnamese anesthesiologist, Dr. Thinh, sitting on his sandals to have his lunch. What a great idea!





















We had one child keep bleeding after a palate, and he even had to come back to the operating room for a touch up. He kept oozing later, and just looked like he was working too hard to breath. We worked with him for awhile, and finally decided that going up to the dark ward with very little attention was not going to be safe. We had him transferred to the intensive care unit, and there he stayed for the night. But I have never seen anything like it in my life.

Twenty-eight or so patients, five nurses, and one doctor. The doctor was kind enough to give us a bit of a tour of his patients, which included enough critical and complicated medical problems to scare even the most seasoned of us. Many of them had a breathing tube in, but not to a ventilator. Only a lonely thread of plastic with oxygen made its way to hang into the end of the tube and give that vital boost to what looked like an otherwise dire situation. The bed with a lady's feet you see in the foreground, perpendicular to the others, was an older woman who was ashen and barely breathing. She had a can of Ensure at the head of the bed next to her, and was intubated with an endotracheal tube going to room air. I'm not sure if this is Hospice care, if she is waiting for a bed space, or being transferred to a room. Probably not, with an endotracheal tube, but no one is watching her, so why not?













Our dear intensivist to the rescue. Our little guy did very well under his care, and was fine by morning.