Thursday, February 17, 2011

Amazing Day

The past couple days, I have been lucky to be able to attend the Oxford Tropica Network annual meeting. It is usually closed, but Paul did some finagling and local NGOs were allowed to send a representative. I don’t understand a lot of the research presented, but it is really cool to see how hard some really smart people are working on malaria, dengue, TB, and other diseases that disproportionately affect poor countries. Last night after a dinner for one of the Lao teachers, who has been promoted to the Ministry of Health, I was able to see them jamming together as well at their annual musical review. Scientists and musicians - a talented bunch of people.

This morning I went to the last session of the meeting, as I had a lunch meeting but not the truck, and no way to reliably get back from Setta in time. I’m glad I did (though I missed seeing the residents again this week) because it was again interesting. Talks on antibiotic resistance, new drugs for malaria etc were interesting. But the best was a talk on a neonatal unit in Thailand - basically a hut - but where good training in identifying at-risk babies and treating them quickly and correctly is saving many lives - of preterm and term infants - and all for 200$/month for the sickest. It was really interesting. I also really enjoyed the last talk - about giant crocodiles in a remote part of Papua New Guinea. Mostly because it reminded me of the book Dingley loaned me on crocks and how scary they are. Which made me miss the pub quiz.

Lunch was at our office, signing a “MOU” Memorandum of Understanding with an Australian / Chinese mining executive to pay for pediatric CME for the next 5 years. He told us about how they are helping the Lao government learn about sustainable, environmentally friendly mining practices - they took them to a reclaimed mine site in Indonesia that is now a stunning national park - and will visit Tasmania, which has some examples of bad mining practices and their long lasting effects. It was really nice to know that there are some companies that are trying to use sustainable, environmentally appropriate business practices, and even in a place like Laos where with some well placed bribes and pay-offs to the government, they could certainly get away with doing whatever they wanted and leaving the mess for the Lao people. As a child of the American West, it’s easy to assume no one has learned the lessons from our mine messes.

Then this evening I went with Yannick (our computer repair specialist), Dr. Leatherman, and some conference attendees to the Lao-Taipei soccer match. It started before we thought it did, and it was a long drive, so by the time we arrived it was half-time. (Or whatever we call that in soccer.) The second half was interesting - there were 8 or 9 pauses while players were carried off the field on stretchers - all of them to get up on their own power within a minute and most to cheerfully return to play - so it was all theatrics. The Brits we were with reported that the quality of play was not great, but it was still fun to watch. The crowd dynamics were much the same as an American sporting event - chanting go go go! counting when the players were down, and one crazy guy with a flag running up and down encouraging and leading cheering. After the 7 additional minutes added on to make up for the stretcher-related delays, the game was still tied, but Taipei won the previous night, so unfortunately Lao lost the series.

Dinner at La Terrace with Cindy (former IM coordinator) joining us late - one last camembert salad and pasta binge before I go off to the hinterlands - and tiramisu for desert, and then home to finish some e-mails and pack. Now, at 2 AM I will go to bed, for about 4 hours of sleep. At 6:30, we take a tuk tuk to the bus station, where we get a bus to Xieng Kuang to visit a pediatric grad there. 2 of my IM residents currently are from Xieng Kuang, so I’m interested to see it. Then I will go on alone to Sam Neua, where I will visit another former IM grad. I hope to also have time to see the Vieng Xay caves, where the Pathet Lao lived during the revolution.

Commence radio silence! (likely no safe internets where I am going, and I know you guys don’t want me spamming you after my passwords are stolen)

Monday, February 14, 2011

My Funny Valentine’s Day

I’m going to try blogging shorter snippets for a while and see how that goes.

Today I rounded at Setta for the first time in 9 or 10 days, because of scheduling conflicts in my or the resident’s schedules. It was nice to be back with them. When I arrived, of course we discussed Valentines day. There were some english logistics questions around exchanging gifts, and then of course whether I had plans to celebrate. When I told them I did not, the senior resident instructed the intern to take me out dancing “all night long” he blushed and very apologetically explained that he was on duty, so he would not be able to take me dancing. It was cute. (Actually, I had a full schedule this evening, but none of it was Valentines related.) Then we got on to the patient care, where I was able to help the residents thing through a musculoskeletal problem a bit more (thought they had a pretty good differential diagnosis, and they were on the right track of investigation for the most part.) The next patient, with an alarmingly high white blood cell count of 44 and anemia, I encouraged them to get a smear (morphology here) on, and the third they were again pretty much on the right track, with maybe a few small adjustments. Khamvay, the other 3rd year resident, is a short, shy woman who actually does decent patient presentations in English, but spends a great deal of time apologizing for not having perfect English. It is a real pleasure to work with her because she is so genuinely interested and learning and doing the best thing for her patients.

This afternoon, I was luck to be able to attend part of the Oxford Tropical Network annual conference, which is in Vientiane for the first time. The OTN is a network of labs doing research in tropical disease and supported in large part by the Welcome trust, and this is their annual global meeting to make sure everyone is up to date on the research and progress taking place elsewhere. My favorite session was the “Speed dating for scientists” - 16 2 minute talks (one power point slide/presenter) with 2 minutes for questions and 1 minute in between. You could tell we were all pretty type A, rule driven, people when one woman clicked on to a second slide. There was an audible gasp of disapproval from at least 3/4 of the audience. (Including me.) However, we uncomfortably sat through that slide and the third one that followed. Miraculously, this session ended up taking less than the scheduled time, though some presenters went over their allotted 2 minutes of explanation. The highlight was Cindy, a former HF IM coordinator who gave a great, brief but coherent talk about her Malaria research on the Thai-Burma border. She managed to explain why the research was important, how it was done, and what the results were, all coherently in such a short time. I hope I grow up to be like her. . .

After the meeting finished, we all headed over to the Lane Xane hotel where we had Lao food for dinner, and a Lao music show including a man who did an imitation of several birds and then a dying pig (including miming killing the pig), followed by skits/musical numbers by lab groups from Thailand, Vietnam, Cambodia, and Kenya. And then more Lao dancing. It was a good (if odd) way to spend Valentines Day; with a conference room full of people who have devoted their lives to tropical disease, though most of them could be earning more money or accumulating more prestige doing other types of research.

Sunday, February 13, 2011

Funny conversations from the past few weeks

When asked how their new english teachers were (two Australian medical students who volunteered)
Resident: Nayang has palpitations.
Libby: Oh really?
R: Yes, because the new English teachers are very beautiful. He has sinus tachycardia.
Next week: L: Nayang, do you have tachycardia again?
Nayang: No, I premedicated with propranolol.

After a second new english teacher:
L: How do you like your new english teacher?
R: She is big and strong, like a man (Makes body building pose with arms)
L: Please don’t tell her that. . .

Thai Doctor, explaining how the university has only one staff dermatologist: “We say that dermatologists are a mystery. We train them and then they disappear.”