Strange

In addition to providing a culturally- contextual ear to chat to, my recent American visitors - Kim and Kate, and then Kristiana, an ER doc from Chicago, have made me think more concretely about here vs home and my time here. People from home often ask me what is different or strange here, and I often have trouble coming up with anything. My life here is radically different from my life in the US, but it’s normal for here, and some how my mind has quite effectively partitioned. I note things that you would never see, hear, or experience in the US, and I chuckle or think “what a shame” or think “I should take a picture”, but I rarely feel shocked or disturbed.

Example: Cats wandering the corridors of the hospital, sneaking under the chairs as I teach lecture in the resident room, or, once, a tiny kitten crouched in the middle of a wide wheelchair. In America, this would be incredibly rare, but it’s normal here, and while I recognize that there is a public health risk, I also like cats and know that they probably kill mice and roaches that would otherwise be infesting the hospital. (The week after Phi Mai, there was a constant stream of roaches from the nurses room at Setta. Someone must have left a lot of food in there, and the cats can’t get in. THAT did disgust me a little, along with just being impressive.)


Cat napping on a transport stretcher at Mahosot hospital - photo credit to Kim.

Example: a man I saw last week with an absent femoral pulse and blue, cold leg. He had been started on a heparin drip without any imaging, and the team was hoping to get an ultrasound that afternoon, but it was in no way perceived as a medical emergency the way it would have been in the US. Did I encourage my residents to talk to the ultrasound tech about what they were looking for and why, and get the scan ASAP? Yes. Did I freak out the way I might have at home? No.

Example: I see a man with a giant, peripherally calcified mass that appears to arise from his pleura and has completely displaced most of the left lower lobe of his lung. You do not see x-rays like this in America. Chronic cough gets an X-ray sooner than this. What is it? Tumor? Could be. . . Infection? Could be. . . but it’s something crazy either way. I’ll probably never know. I hope they find a way to biopsy, but I know that they probably won’t, and it doesn’t really bother me that I will likely never know what it was.


Incredible Lung mass CT - the x-ray is even more impressive.

However, at some point in the last 2 weeks I realized I have been here for 9 months, and have just over 5 months left of my stay. I’m no longer hovering around the halfway mark of my visit, I’m well into the second half. That does seem strange. It is crazy that I’ll be home in significantly less time that the time I’ve already been here. A small part of me is tempted to volunteer to stay on through the spring - we still haven’t found anyone to take over my job when I leave - but I know I need to get home and start preparing for the next stage in my life, and I also know I need the money I can make working at home. This volunteer job has been wonderful - I love my residents, the Lao staff doctors and teachers, teaching has been incredibly rewarding (see previous post), my schedule is much nicer than that of residency, and I am healthier than I’ve been in a long time physically. But it hasn’t been great for the metaphorical pocket book. I’m not accruing interest on my student loans, but I’m not paying them off. And I haven’t made any super close friends here, so I think it will be nice to get back to a familiar social circle as well.

But there’s so much I haven’t done. . . I haven’t learned nearly as much Lao language as I would like to, and have lost most of my motivation to do so. I still haven’t really been to Bangkok, which I’m not excited about, but I know is an experience I’m supposed to have while in SE Asia. I haven’t been to Muang Sing and Luang Nam Tha, Chang Mai, Siem Reip, back to Luang Prabang, or even to the Patu Xai and Korp Jai Der in Vientiane. I know that some of these things will probably not end up happening before I leave. I start feeling that bitter-sweet moving feeling, though my ticket home isn’t till December. I start to buying souvenirs for people at home. (People other than me - if you have a specific request, probably now is the time to get it in.) And I start to realize that I will really really miss many of the things about life here in Vientiane, and I think the transition home will be much harder than the transition here was.


Free Right Turn - something I thought was crazy when I got here, and have become totally adjusted to. If I don't get at ticket for turning right on a red within a year of coming home it will be a miracle.