A rather chilly weekend with Louise

Louise Sanderson (a friend from Singapore who I’ve known since birth) came to visit this weekend. She arrived on Thursday, and despite strict instructions from me that she should bring warm clothes as it is Hanoi’s winter, she appeared at arrivals wearing cropped trousers and crocs!! The weather in Hanoi has gone a little bit nuts, and it’s the coldest winter in about 20 years or something… Although I’m hesitant to admit it, I think it’s about the same temperature as it is in England right now (about 10 degrees)!! So Louise definately needed more than crocs and cut-offs. Fortunately, I had a fleece, north-face trousers and walking boots for her to borrow (lucky that eurasians all have little feet).

On Thursday night, we had a late dinner (Pho Xao Bo) and went to bed… Then on Friday, we donned our many layers of clothes and braved the artic streets! It was mostly a weekend of eating (need fuel to keep warm, plus I knew Louise would appreciate Hanoi’s culinary delights)! For breakfast, we of course had Pho Bo… we then took in some sights (the Sofitel Metropole, Hoan Kiem Lake, Gia Ngu Wet Market, the streets of the Old Quarter…) before feasting at Quan An Ngon for lunch… we then watched the Water Puppet show at Thanh Long… and then met up with a Ukrainian/American/Aussie guy (who I met at breakfast one morning) and his Brazilian doctor friend. We all went out for Cha Ca (you barbeque your own fish at the table, with lots of veggies and bun noodles), followed by some Bia Hoi on a street corner. Bia Hoi is fresh pilsner beer without any preservatives added. It goes off after a day or so, therefore the point is to sell it on very quickly (thus at very cheap prices). It’s the street corner drink of Hanoi, and you basically sit on low plastic stools drinking your bia hoi for dirt cheap prices (and I mean DIRT cheap). A glass of the stuff costs 2000 dong (which works out at 6 pence (UK), or 12 cents (US)). I actually really like Bia Hoi, it tastes fresher and lighter than normal beer. Plus (oddly), it has a delayed red-face reaction for me. I go red when I drink alcohol, usually within 5 minutes of my first sip of alcohol. However, Bia Hoi doesn’t make me red until about an hour after I start drinking it. Wierd huh?

Here’s a photo of us at the Bia Hoi place:

 

Normally, people stay out on the streets drinking Bia Hoi for ages (think how long £1 could last at 6p/drink). But on Friday night, after one Bia Hoi our hands were like ice… so we had to retreat to Mao’s Red Lounge (an indoor bar) for some warmth! It was a nice bar, and we stayed for a few hours having normal beers…

The next day, Louise and I went to a few museums (I was trying to come up with as many indoor activities as possible). The problem with a lot of the museums in Hanoi is that the English exhibit descriptions are quite brief. You have to go their being clued up on all the background history info in order to really understand the exhibits. We thought that the Museum of the Vietnamese Revolution might give us more insight into the Franco-Viet Minh War and the American War. But instead we just saw lots of photographs of people during the war, or chairs that Ho Chi Minh sat on when he signed key documents, or the microphone he used when he made key speeches… and we left none the wiser about the actual chain of events! (We did read up on it all later in the Lonely Planet… I began to feel quite ignorant for not knowing important facts about Vietnam’s history despite having been here since November!)

Anyway, we also made a trip out to West Lake (Ho Tay) to see a pagoda, and sit at Highlands Coffee (they have a cafe on a boat on West Lake). We considered hiring a goose/swan paddle boat to paddle around the lake, but there was a light spitty rain, and we were feeling lazy! So instead we spent ages at Foodshop 45, a great Indian restaurant overlooking the lake.

Our last stop of the day was at the Temple of Literature where we wandered around for a bit… That night, we had a cheap but tasty meal at a Bia Hoi street corner, along with a glass of Bia Hoi (I got Louise hooked!). We had an early night, because the next morning we were off to see Uncle Ho!

Uncle Ho (Ho Chi Minh) is embalmed (against his wishes… he specifically asked to be cremated and scattered at various spots around Vietnam), and you can go and pay your respects to his yellow, waxy body at the Ho Chi Minh Mausoleum. It’s an experience I would recommend to anyone visiting Hanoi. I went three years ago with Will, and it was just as fascinating the second time! There are lots of locals as well as tourists, it’s free entry, but you have to leave your camera’s in a left-luggage facility, and put your mobile phones into a clear plastic bag (that you have to carry in your right hand… very specific instructions!). You queue outside the imposing square marble mausoleum, guards alongside the queue shout instructions at you, for example ‘no hands in pockets’ ‘remove your hat’ ’shhh no laughing, no talking’… then you are ushered through the mausoleum, single file… you can’t stop walking, you have to keep perfect distance with the person in front… the gap should not widen. You spend about 30 seconds walking around Uncle Ho’s body (he’s inside a glass case, surrounded by 4 guards), and then you’re back outside and it’s all over!!

Anyway, other activities on Sunday included more Pho Bo, a trip to the temple on Hoan Kiem Lake (mostly because we wanted to see the Giant Turtle remains… it was a day for seeing embalmed things!). Hoan Kiem Lake has giant turtles in it (quite how they survive the pollution I don’t know). It’s name means Lake of the Restored Sword, because legend has it that a giant turtle came up and took a sword from King Le Loi, and took the sword to the bottom of the lake, where it still lies. I don’t know whether the whole sword thing happened or not, but the turtles definately exist. There have been several sightings over the years, and photographs too. Plus, at the temple, you can see the embalmed body of one of the giant beasts! Quite massive!

The last stop on Louise’s weekend trip was to Dong Xuan Market, and then a late lunch back at Quan An Ngon (I can’t tell you how many times I’ve eaten there!).

Today, I went to Hanoi Medical University to get all my paperwork signed… and then I had lots and lots of waxing! It’s so cheap! I went to a great salon near my hotel, and had the full works (half leg, bikini and underarm) for less than the price of an underarm wax in the UK. The lady doing the waxing was adorable… she would warn me before tearing the wax strips off ‘very hurt, very hurt!’… The salon was very posh looking (it wouldn’t look out of place on High Street Kensington), the floors were marble, with marble columns, lots of water features everywhere, soothing music, feng shui style rocks lining the stairs… I felt pampered!

Well… that’s all for now. Mum turns up on Wednesday… Tomorrow is my last day in the hospital. I’m meeting Dr Ha at 8am in the Operating Room. I’m sad that it’s all coming to an end, but this freakish cold-spell here in Hanoi is sure gonna make leaving easier!! Whereas England can’t handle hot weather, Hanoi can’t handle cold! My hotel room is freezing! At least I can convince myself that the amount of food I’m eating is because I need fuel to keep warm…

The emergency department, and lots of eating!

I’ve just returned from an evening in the Emergency Department. One of the Vietnamese medical students (Thuong) invited me to join them on their shift. They’re going to be there all night, but I decided against that!

It was quite a night… I was only there for a few hours, but I saw so many interesting cases. Literally every two minutes another motorbike trauma case gets wheeled into the ED. Tonight I saw a subdural haemorrage, extradural haemorrhage, three patients with legs shattered to pieces, acute appendicitis, a patient with a rigid abdomen (rock solid), a patient with frank haematuria (blood in urine), a patient with malaena (blood in stools from upper GI bleed), an elderly patient involved in a motorbike accident who suffered major head trauma and passed away (well actually she was sent home intubated with her family squeezing her bag and mask valve to enable her to pass away at home… here in Vietnam, I think people prefer it if their relatives can die at home).

Here is an X-ray of one of the crazy fractures (this guy’s leg was completely open with bone sticking out):

 

It was quite overwhelming how much was going on. There were lots of Vietnamese students there (many more than we have on-call in the UK). There weren’t many nurses, which meant that family members tended to do most of the nursing (fetching bowls for vomit, changing soiled sheets etc). I think I’ll describe it as organised chaos… it was hard to tell who was running things, so at times it was pure chaos, but I’m sure there was some sort of organisation behind it all. We didn’t really get to follow any patients through, because as soon as we saw one patient, the next ten would arrive! It was pretty full-on. Here is a photo of Tamara and me:

Anyway, apart from hospital stuff, I’ve also been doing lots of eating… I’ve introduced Tamara and Paula to Quan An Ngon (that’s the one I eat at with Annett, and also went to lots with the Swedish girls), and they’ve fallen in love with it! We went there for dinner last night, and again for lunch today! Here we all are (Paula, Tamara, Me, Thomas and Lawrence):

 

Two nights ago we all went out for dinner to a restaurant overlooking Hoan Kiem Lake. It was a bit touristy (there were musicians playing traditional Vietnamese music by the side of the table), but it had a really nice view… They also came around and gave us roses! Here’s a photo of us there:

 The only other thing I’ve been doing is shopping… I’m trying to get some gifts and sounvenirs sorted because my time in Hanoi is coming to an end. I can’t give away too much info about gifts… but after 2 months here in Hanoi, I think I’m quite clued up about where to get good presents. So don’t worry, you have nice gifts on the way! 

Tomorrow, I’m giving a powerpoint presentation at English Club about motorcycle helmets and cervical spine injuries… and then at 8pm, Louise Sanderson arrives from Singapore… she’s staying for the weekend, and I’m really looking forward to showing her around!

A bizarre nightclub, cool surgery, an acromegalic and some expats

Since my last post I’ve basically seen/done what the title says…

On Friday night I went out to a nightclub with Tuan (the doctor I met at Ba Vi hospital) and three of his friends. It was a really bizarre club… (I think Hanoi nightclubs have had some problems recently with drugs, so they have all had to become very strict or risk being shut down). When we arrived, it was still early, and pretty quiet. There were at least 70 waiters/waitresses milling around though, so the small club looked full despite having no customers there (bizarre thing number one). Despite being empty, the DJ was already playing some pretty loud, full-on music! I then looked around for the dancefloor and realised that there wasn’t one, (bizarre aspect number two). We were immediately ushered to a table, which was stacked with soft drinks, water, a fruit platter etc… Tuan then purchased a bottle of JD and 5-6 waitresses came over to pour our drinks and wait on us. I would take a sip, and the glass would immediately be topped up, it seemed like a crime if they allowed an ice-cube to melt without replacing it with a new one (bizarre thing number three). After a while, I got out my camera to take a photo of everyone, but two security men came running over and shouted at me ‘no photo, no photo’ (bizarre thing number four). The place started to get busier. Me and the other girls decided to dance. There was no dancefloor, but there was a big walkway between tables, so we went to dance there. The security men were over in no time shouting ‘no dance here, no dance here, only dance at table’ and ushered us back to our table (bizarre thing number five). What a bizarre evening!

The next day, I went into the hospital because Dr Ha was on-call. I didn’t stay for his whole shift, because I was going to a party that evening. But during my time at the hospital, we received a trauma patient who had severe head injuries (extradural haematoma), and cervical spine injuries (fractured C5, paralysed). Watching the surgery was pretty incredible. The electric drill was broken, so Dr Ha had to use a handheld drill to make the burr holes, and a piece of wire as a saw to open the skull. I’ve never seen anything like it! As for the c-spine, he cut away C5, removed the disc between C4-5 and C5-6, took a bone graft from the patient’s pelvis, moulded it into shape to replace C5, and then used a metal plate to fuse the bone-graft between C4-6. It was so sad to see what a state the patient was in, but really good learning for me. It’s hard writing about this in my blog, because I don’t want to make it sound as if I was happy to see someone with so many injuries, but at the same time, I was glad to see such interesting surgery. Does that make sense?

Anyway, that night, I shut out the horrible thought of what a motorbike accident can do to you, and got onto a Xe Om (motorbike taxi) to go to Annett’s housewarming party. Her house was lovely (it overlooks West Lake… where all the expats live), and I had a great time meeting her friends. One couple were teachers at the Hanoi International School. The International Schools around the world are quite incestuous, and within a few minutes we’d managed to find a common link (they knew Mr Towers, an IT teacher at UWC, because he had taught at the same school as them in the Bahama’s). I also met lots of Annett’s PriceWaterhouseCoopers expat colleagues, one of which was a Londoner who used to work at the Embankment office (which is where Will works). Such a small world… I had a really nice evening with all of them.

The only other thing I wanted to mention from my blog title was that today I saw a patient with Acromegaly!! This isn’t going to mean much to all you non-medics (thus all my blog readers)… but it’s seriously cool. It’s very rare, and I’ve never seen a patient with Acromegaly before. Basically, a tumour in the pituitary (in the brain) secretes growth hormone, which causes bone and soft tissue growth. In adults, their long bones are already fused, so they can’t grow in height, but their face, hands, feet all change shape. Spade-like hands, protruding jaw and forehead, big feet…

That’s all for now! I don’t have any photo’s to add… I haven’t been taking many photo’s I’m afraid. I’ll try to remember to take more photo’s. It’s just that I’m not really doing touristy things, so there isn’t much for me to photograph.

I’m really starting to feel at home here. I don’t have very long left though, which makes me feel sad. I’m very fond of Hanoi, and the longer I spend here, the more I like it. There are times when I’ve felt lonely or homesick, but I’ve always liked my own company, and when I’m out and about, Hanoi does a good job of keeping me company (and when I’m in my room, my good friends Meredith and Derek on Grey’s Anatomy ensure I never feel alone). Plus I’ve met so many great (non-TV series) people along the way too… I’m never going to forget my time out here.

Neurosurgery in Nam

Sorry I haven’t written for a while…

I started at Viet Duc hospital on Tuesday, and I’ve been quite busy. Although I can’t quite believe it, I’ve somehow ended up in the Neurosurgery department at Viet Duc! I was meant to be doing general surgery and emergency medicine, but the doctor (Dr Ha) that Hanoi Medical University contacted is actually a neurosurgeon! I’m not complaining though… I would never have though this is what I would be doing on my elective, but I’m really enjoying it. Plus, Dr Ha is great, and I’m getting proper teaching, so I’m staying put.

The reason I never thought this is what I would end up doing on elective is because I’ve always been more of a medic than a surgeon… People who know me at med school know that I enjoy a good old chit-chat with patients! I like talking about feelings and all that, whereas the future surgeons detest chit-chat and like to get on with the practical side of things. Out here in Hanoi, since I can’t chat with patients anyway because of language barriers, I may as well get some surgical experience in! 

The word neurosurgery makes it sound as if it’s all really complex, uber-complicated surgery… and some of it is (this morning I saw three patients in theatre having various different brain tumours being removed), but the bulk of their work seems to be head traumas from motorbike accidents. I’m certainly going to be able to talk about subdural and extradural haemorrhages after this, and I know how to make burr holes in the skull!

Anyway, I’m also going to shadow Dr Ha when he is on-call, so I’ll get to spend some time in the emergency department. It’s easy for me to go and see general cases in theatre too. Viet Duc hospital seems more slick than the O&G hospital, and it seems more geared up for foreign students. They take a lot of Australian students. In fact, there are two Aussie girls (Paula adnd Tamara) who started at the same time as me (but in a different department). We all met at English Club, which is held every Thursday for Vietnamese doctors and students to get together and chat in English (they loved having us at English Club).

I’m quite glad that I met the two Aussie girls because I was missing the company of Emma, Anna and Matilda (the Swedes). Paula and Tamara have been in Vietnam for the same amount of time as me, but they’ve been doing O&G in a hospital down south in HCMC. They only arrived in Hanoi on Monday, so it’ll be nice to show them all the great restaurants and shops that I’ve discovered in my time here. They’re actually moving into my hotel (they weren’t very happy with their current hotel, so I showed them mine… it’s hard not to like my hotel, the girls who work here are so friendly, and it feels so homely…)

Last night we went out to an Irish Pub for Quiz Night! I seem to be going to a fair few Irish Pubs (this one was also called Finnegans)! The quiz was run by an Irish guy (the owner perhaps?), who in true Irish fashion was pretty drunk by the time the quiz began. It was a really fun atmosphere though, and good hearty food too. We didn’t get off to good start with the quiz questions. The first round was titled Disasters… and we got 3.5/10… One question was name the only astronaut to die on a space mission… No clue! The second round was Who Said It, and we did even worse in that round! We only managed to identify two quotes, one was a Bushism, the other was a Homer Simpson quote! So the two that we got correct doesn’t say much about our intellectual capacities! We did not manage to identify the great words of Churchill, Mark Twain, Mahatma Gandhi, Che Guevara… We improved in the third round, which was (sadly) Sci-Fi! I’m not sure why we were so good at this round, it made us look like sad sci-fi nerds!! And the final round was a Bits & Bobs round, which was our best round, and we ended up coming third overall! It was a lot of fun…

Here’s a photo of us at the quiz: