8:00 a.m.- Morning Conference
Usually, these presentations are given in Thai, with slides in English. I don't know why that's the norm, but at least it allows me to follow along.
9:00 a.m.- Coffee Break
Why are attendings so much cooler than residents? OF COURSE we had to stop and have coffee in his office. That is what the coffee machine is for! The other pediatricians and his secretary were there also and I was force fed chocolate, fried sweet bananas with sesame seeds, and fried potato puff street food by multiple different people.
 |
| We're here! |
This is Dr. Amom. He's a homeopathic doctor who is also trained in "Western" (allopathic) medicine. He volunteers his time and also provides herbs and other treatments free of cost at this government clinic. He also has a private practice during the week in the evenings.
Gout and kidney stones are common problems here, due to diet and dehydration. This patient had previously been treated for kidney stones and asked to be checked again. Sure, why not?
We were done with patients early, so Dr. Amom was asking me about alternative medicine in the US. He was appalled to learn that US medical insurance only covers traditional medicine, so you usually have to pay out of pocket if you want homeopathy. I also told him about my Thai massage yesterday and how a 60 minute massage in the US is about $120. He was like, "120 DOLLARS?" Then, the resident asked if massages weren't cheaper at the hospital. He was shocked to learn that hospitals in the US don't offer massages. WHAT IS THIS WORLD OF DYSFUNCTIONAL MEDICINE THAT THIS STUDENT LIVES IN!
12:15 p.m.- Dropped back off at University Hospital by Community Clinic doctor
12:15 p.m.-12:45 p.m.- Lunch
Hospital cafeteria score! I found this vegetarian place and I don't know what I ate, but it was gingery and spicy and yummy. I also knew that the food did not have pork, which cannot be said about multiple mystery meals that have been presented to me at various points so far. I will be a repeat customer here.
12:45 p.m.-1:30 p.m.- Hang out in International Student Lounge
I didn't have my next meeting until 1:30 p.m., and I'm not going to lie. I partially went to the International Medicine office because I didn't know how to get where I was supposed to be in the hospital. Plus, they have air conditioning and a "comfort room" with pillowy couches for international students to sit in.
I bought fruit from a vendor, which I ate in my air conditioned room "comfort room." The fruit on the left is Thai guava--sturdier and more like the texture of a pear, but still guava tasting. I don't know what the fruit on the right is called here, but it's "plumrose" in St. Vincent (the island where my parents are from). It's got a crisp texture, like a Fuji apple, but is delicately sweet (not tangy). They also put this sugar/salt/chili mixture on fruit and now I'm addicted and can't eat fruit any other way!
1:30 p.m.-3:00 p.m.- Palliative Care Conference
Palliative care is a more accepted concept here than in the US, thanks to "cam-ma" (spelling?), the Buddhist concept of fate or "what will be will be." The doctors provide home care for patients until the time of death and then bereavement visits for the family for at least an entire year after the child's passing. I learned lots of things about Thai culture from this meeting.
For example, it's fairly common for Thai fathers to leave, remarry, and start a new family if a child becomes chronically ill. The prevailing belief is that it is the woman's fault and the man has the right to start a new family with someone who will not have the genetics to bear chronically ill children. You can imagine that I asked about a hundred questions regarding this, and the attending just laughed and said, "In the US, it's very different, right? It's not OK for the man to do this." Umm...no, it is not OK. Here, the families are fine with it (the doctors were actually laughing while explaining this), and the community rallies around the mother and helps her financially. In the US, to say this would be frowned upon is an understatement. Also, depending on who you are, your wife may or may not genetically test your behind, take all your money and possessions, and then divorce you. I'm not saying what kind of woman would do this, but it's probably the doctor type writing a blog about international medicine from Thailand. Ahem.
The Thai also believe that if a child dies in the hospital, their spirit will get trapped there, and they won't be able to advance to the next life. It is very, very important to get a child home if they are dying. Obviously, this would make palliation a preferably option than doing some of the extreme, life-saving interventions that we do in the US. Also, parents may return to the hospital if their child dies there, trying to help the spirit get home. One of the doctors told me that the parents always ask her if she has dreamed of their child, because this provides some sort of insight into how they're doing in the after life. The doctor said that while she does believe in this type of Buddhism, she's thankfully only dreamed of her living patients.
This same doctor told me that the belief is that if you see a spirit, it is asking you for something and you have to "do something nice" for it. I was all, "What nice thing would you do for a spirit!" (I was finding this conversation fascinating) and was told that you give a gift to a monk and ask him to pray.
Thai Buddhism is very weird. It's got elements of Hinduism, animism, and even Catholicism wrapped up in it. The sacrifice (gift) to the monk sounded very Hindu, while asking him to pray for the dead spirit seemed very Catholic.
It also seemed like kind of a large emotional burden for doctors to bear doing this work, in addition to all of their usual tasks, but they don't have chaplains here. The doctors said sometimes they will call a monk to go visit patients with them, and they encourage parents to "do something nice" for their children. It's very important that the dying patient be thinking good thoughts when they die, so "doing something nice" and having the monk come and pray helps achieve this. (Thai Buddhism is very much thought and deed based, when trying to achieve happiness or peace.) Overall, though, the people are much more comfortable with death, and the doctors seem fine with doing the home visits. In two weeks, I will actually go with them to one.
(Or if you are the international medical student, who hates rounds and has an attending who wants you to "live life," time for home! WHAT?)
No comments:
Post a Comment