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:

Back in Hanoi

I got back to Hanoi on Sunday… and then early on Monday morning I was picked up and taken to Ba Vi District Hospital (about 70km out of Hanoi). I had opted to spend a week out at Ba Vi hospital to see what healthcare provision was like outside of the main cities. A large proportion of the population in Vietnam live in rural villages, and I thought I should see how they receive healthcare in order to get an overall insight into Vietnamese healthcare.

I’m so glad I decided to go out there… The hospital was a real eye-opener! Almost no doctors spoke English though, so I was allocated to this Vietnamese lady who had done public health research in Sweden, and she acted as my personal translator. It was great! I spent some time in the Infectious Disease outpatients department, and she helped me to take histories from patients (mostly diarrhoea histories), and also helped me to ask the doctor questions about HIV, TB, malaria and other infectious diseases in the area. After that, I asked if I could spend some time in the Traditional Medicine department! It was so cool, they have a whole department devoted to acupuncture and herbal remedies!

To give you some background on the hospital… patients can come from as far as 40km away. It serves a rural/village population, and has numerous satellite community clinics to deal with minor problems. Healthcare isn’t free in Vietnam, but there is an insurance scheme that people sign up to, it’s about US$5 a year (but bear in mind that in rural areas, some people are earning less than US$20-30 per year). If you can’t pay for insurance, you receive a card which entitles you to subsidised healthcare, but you get seen in a different part of the hospital (an even grubbier part). This info is all from chatting to my translator, so it’s not properly researched or anything… but I think it should paint a general picture. 

The hospital has 150 beds. It was pretty basic… it only has one X-ray machine (no CT or anything)… here is the X-ray machine:

There was another doctor in Ba Vi who had done some research in Sweden, and the two English speaking doctors took me under their wing and made sure I had things to do in the evening. We went out for dinner and karaoke!! Karaoke was fun, and so were the dinners… the food served in the rural areas definately do not cater for western tastes! The first night, an entire Chicken was served up… it’s organs (heart, liver, kidneys, boiled blood) were on one plate… Here is it’s head, with some organs in the background:

Another thing that we did in Ba Vi was visit some of the villages, and take New Year money packets to poorer members of the community. This was an unbelievable experience for me, because it enabled me to glimpse into people’s lives and homes, and I saw things that I would never be able to see as a tourist. The villages were a myriad of little crumbling buildings and dirt paths amidst farms and fields… Here is one of the little old ladies that we visited:

I was really enjoying my time in Ba Vi, but at the same time, I felt quite bad because I was taking up a lot of people’s time, and I’m sure they had other things they could have been doing instead of translating for me! I felt that my trip out to Ba Vi was for my benefit rather than being of any benefit for the patients or the hospital. So when they told me that there was transport back to Hanoi on Wednesday, I thought it might be better for me to go back early.

It was quite cold out in Ba Vi… but when I got back to Hanoi on Wednesday, the weather was glorious!! Today, it’s hot hot hot!! Apparently it’ll go colder again by Sunday, but for now I’m loving it. Wednesday night, I watched tv all night! Thursday, I got into tourist mode and took the Lonely Planet walking route to see all the streets of the old quarter (all the streets are named according to what they sell… I walked down silk street, gravestone street, toy street, rope/string street, counterfeit money street, altar street, tin street, musical instrument street)… It was great. I went for lunch at this Cha Ca (Grilled Fish) restaurant. It was slightly embarrassing because they almost refused to serve me. They shouted out loudly ‘not for single person… must have two person… not one person for cha ca’!!! But I begged a bit (no dignity left by this point), and they allowed me to have cha ca for one!

After lunch, I wandered back to my favourite coffee shop overlooking Hoan Kiem lake, and enjoyed the sunshine! For dinner, I met up with Annett and her husband for dinner at Chim Sao. We had catfish, which was quite an experience! These little charred fish plonked on the plate, skin, head, fins, all burnt to a crisp… They were quite good, but there wasn’t much meat on them, just lots of tiny bones that kept stabbing my gums.

Today, I met up with my friend Shazzy (who I met through the new hanoian website). Today we decided to treat ourselves to a nice lunch at the swanky Sofitel Metropole hotel. It’s one of the old Asian colonial hotels, like Raffles in Singapore… It was built at the end of the 19th century, and is very French colonial. We ate at the poolside cafe, and felt very posh! The prices in the menu scared me a little… but it’s a treat right? I save my pennies with the Xe Om / taxi drivers so that I can indulge in poolside moments like that!! Here’s a photo of us:

So since getting back from New Zealand, I haven’t done much hospital stuff… but I’m starting at Viet Duc hospital on Tuesday, and I will start treating this more like an elective than a jolly again! Being a lady of leisure is so much fun though!

Day Nine

Really sorry, but this post is also going to be a medical one! I’m really getting into things at the hospital, and it’s taking up a lot more of my time… so there isn’t much else for me to write about! I’ll keep it quite brief today though.

For those of you who think I’m out here on a jolly, you’ll be pleased to hear that I was in the hospital from 8.30am – 5pm today!! This morning, I was in with Dr Hoi in the IVF department together with Emma and Matilda (Anna is still not well). We started out watching some ultrasound scans to assess patient’s follicle sizes after gonadotrophin stimulation. We also looked at sperm samples under the microscope, and washed sperm ready for IUI… Then we observed some IUI procedures (IntraUterine Inseminations). It was good to see all of those things, but we didn’t want to spend all morning doing that, so we decided to go back to labour ward.

On the labour ward, Dr Lien seems to have taken us under her wing… She went through a patient’s medical notes with us, showing us where everything is recorded in the notes, such as past medical history, examination results. It was really useful, and it was fun using sign language and diagrams to figure out the corresponding Vietnamese and English words for certain things… I think it will really help, because now we know where to look in the notes for specific information, so even if we can’t understand what’s going on, we can at least use the notes to figure out the basic plot. All the staff on the labour ward have gotten used to us, and are all really welcoming. It was slightly quieter on labour ward today, so we had plenty of time to chat to everyone… my Vietnamese-English phrasebook, and my Oxford Handbook of Clinical Specialties both helped to break the ice between everyone… One of the senior doctors was trying to persuade me to marry one of the registrars! I think they all find my half-Chinese looks quite interesting out here. They all say that I look a little bit Vietnamese, but different (Same Same, but Different!!!)… Anyway, everyone was laughing and joking around, and it was a really fun atmosphere. (And don’t worry Will, I told the doctor that I can’t marry him!)

In addition to all the laughing and joking, we also saw two deliveries today. One of the newborns was premature (35 weeks)… In England, 35 weeks wouldn’t be a very big deal, but here it is. One of the doctor’s told us that the prognosis is very poor out here for babies born under 33 weeks because they aren’t equiped for it. We decided to follow the little baby down to the baby unit, and one of the paediatricians showed us around the unit. They actually had a 28-weeker down there, who seemed to be doing quite well… he had been given surfactant and was having NG feeds. There was also a baby nursery down there, which is where they keep babies who were delivered by Caesarean while their Mum’s recover. It was like the nurseries that you see in old films… in the UK, babies are always kept with their Mum’s these days. Although I think the babies probably should have been with their Mummies, it was so nice to wander around the nursery and coo at the babies… Emma, Matilda and I were all very soppy and broody! Here is a photo in the baby unit:

In one of my previous posts, I discussed how common Caesarean’s are here in Hanoi. Today, Dr Lien explained that the women here are very tiny, but their babies seems to be getting bigger, and this is one of the reasons why Caesarean rates are so high. Today, one of the women labouring (who ended up being sent for Caesarean), was so tiny, she weighed less that me and she was carrying a full-term baby!! I’m really trying to be conscious of the fact that I don’t want to criticise the things I see out here without fully understanding why things are the way they are… I definately do not know best. However, I’m also not really willing to assist with things that I disagree with. One example: I’m a bit concerned about getting too involved with labouring women, because if I’m asked to do an episiotomy and I don’t fully agree with why the woman is having an episiotomy, I don’t think I could go ahead and actually perform one. It’s really tough, because I want to get hands on, but I don’t want to do things that make me feel uncomfortable, or that I disagree with. Oh well, I think they’re quite happy for me to get involved as little or as much as I feel comfortable. So I’ll see what happens tomorrow… All I know today, is that I really enjoyed my time in the hospital, and I feel really happy with my decision to come to Vietnam.

Day Eight

Those of you who dislike my medical posts… stop reading! This is all about obstetrics, and all about babies!!! 

I saw three little Vietnamese babies being born today! Two girls and a boy! I didn’t deliver the babies, I was just observing today to see how they do things over here… and the labour ward is very different to the West Middlesex Maternity Unit back in London! If you’ve read my previous posts, the labour ward is quite similar to the clinics that I’ve seen here – no pivacy, and lightning fast! I think the general rule of thumb seems to be that most women have caesarean’s, but if you are allowed to have a vaginal delivery, then you will automatically have an episiotomy, push, push, baby born, move to post-natal ward, change the bedsheet, next woman please!

All three women this morning were cut, and I think that only one of the women would have been cut if she was in the UK (and all three would have been consulted properly about it beforehand, whereas here communication is kept to a minimum). However, I don’t want to start to appear as if I’m criticising their methods. I just want to portray how it is and how much things differ over here.

Anyway, baby number one was a little girl who was born quickly and easily… The pain threshold of Vietnamese women seems to differ to that of British women, because not a sound came out of the lady during the entire labour and delivery! She just knuckled down, pushed, and that was it. The baby girl was straight away taken to be weighed and wrapped up and put onto a table top (no skin-to-skin contact with Mummy – in fact Mummy didn’t seem to have a chance to even look at the baby, and she didn’t seem to expect to hold or see the baby in the delivery room. I think the practice over here is to wait until you reach the post-natal ward). Emma, Matilda and I were able to coo over the baby while the Mum was being stitched up. Here is a photo of baby number one (I asked the Mum’s permission of course):

Anyway, shortly after baby number one, the other woman labouring in the room delivered, (yes, two women labour and deliver in one room, no screens or curtains, and the door to the room is a sliding glass door (left open), so the rest of the pre-labour ward and post-labour ward can see in too). The midwives and staff were getting to know us better and let us examine the lady, and use the pinnard stethoscope (never used one before because they’ve been replaced by hand-held dopplers in England, so that was cool!). 

Here is a photo of Matilda and Emma in an empty room so that you can get an idea of what the labour ward looks like, it’s a bit out of focus (sorry Will!), but you’ll get the idea.

After that, we moved to another room with two other labouring women. One woman was being monitored by CTG because of fetal distress. This lady seemed to be a lot more vocal, which was a relief, because it looked like it hurt like hell, and I would have been really shocked if she had stayed silent! She had a pretty massive episiotomy, and it took a lot longer for her to deliver (it was a big baby). The baby was very limp and blue when he was delivered. The midwife used suction, and rubbed the baby with the towel, and after a few seconds he made some noises and moved a little bit. No Paed’s doctors were present, and Matilda, Emma and I were left with the baby and some oxygen (they didn’t have oxygen face masks, just an oxygen tube, so we held it in front of the baby’s face wafting oxygen towards him). After being wrapped up and under a lamp for a few minutes, his colour improved and he was making spontaneous movements… After fifteen minutes or so, a midwife came in, and took the baby to be with Mum.

For lunch I took Matilda and Emma to Quan An Ngon, and it was just as yummy the second time around. We had Spring Rolls, pork and noodles wrapped in rice paper, banh ghoi (like a friend puff filled with meat, noodles and veggies), and a seafood noodles. I was so full after that! Here’s a picture of us all at Quan An Ngon:

In the afternoon, Emma and Matilda went to study. Anna isn’t well, so she was sleeping for most of the afternoon. As for me, I watched a disturbing amount of Grey’s Anatomy!! I know that I’m in Hanoi, but I was just feeling tired and lazy, and Grey’s Anatomy is so addictive! I did make it out of my room for dinner though… Wandered over to the north east part of the Old Quarter for some dinner with Emma and Matilda. Now I’m feeling stuffed for the second time today!

Really good day though!! And I can’t believe I saw three babies being delivered… In London, the midwives really made us put in the hours in order to watch the deliveries. Here, women are delivering every five seconds, and there’s no keeping the students out when the doors are made of glass, and left wide open! I think on the next labour ward session, we’ll be able to get more hands on.

Until tomorrow…

Day Five

Today my post is going to have a bit of medicine-chat to start with, but lots of non-medic stuff too!

I’m feeling really happy today! The day has gone very well, right from beginning to end. I woke up at 7am, got dressed, had a speedy breakfast, and got to the hospital for 7.45am to meet Dr Hoi (a doctor who speaks wonderful English because he spent a few years training in the States). Dr Hoi, myself and the Swedish students all chatted for about 10 minutes in the courtyard of the hospital, and it felt so good to be able to communicate properly. We all had so many questions about the hospital, the Vietnamese healthcare system, Obs & Gynae practices in Vietnam (e.g. local views on abortion, Vietnam’s 2-child policy, how much healthcare costs)… So we were all firing questions at poor Dr Hoi, who had to stop us after 10 minutes because his clinic was starting. We went with him to the ultrasound clinic. It was such a good morning, and we continued asking our many questions about Vietnamese healthcare practices.

I am still shocked by the lack of privacy in Vietnamese hospitals! These women were havng trans-vaginal ultrasounds behind a frosted-glass screen, with three other women queuing, and one woman next-in-line stood by the bedside getting undressed. I also continue to be shocked by the speed of clinics… Dr Hoi saw between 40-50 patients this morning! Phenomenal! The other thing that shocked me was that ultrasounds were being performed for reasons that wouldn’t warrant an ultrasound in England. After seeing so many unnecessary scans, I asked Dr Hoi why these women were being scanned. He explained that during pregnancy, all women have a scan every 4 weeks here!! Every 4 weeks! In England you get 2 scans (one at ~12weeks, and an anomaly scan at ~20 weeks), and only if there is a good clinical reason do you get scanned more regularly. However, here the women are paying for their scans (60,000 dong – not very expensive, but still).

We also got onto the topic of treatment costs, and what happens to those who can’t pay! Patients pay for their healthcare, and if they can’t afford it, there is a seperate section of the hospital (At the O&G hospital this separate section is called the A Block) where they receive subsidised treatment. (An ultrasound scan for example is only 30,000 dong in the A Block – but I’m going to check out the A Block on Monday to see how things differ over there!)

Here is a photo of me, Anna and Emma at the hospital:

Anyway, enough medicine for today… Time to get onto another favourite topic of mine, FOOD!!!

As I mentioned in my blog yesterday, I’ve been hoping to start meeting more people! So, I decided to try something new… The New Hanoian is a website for expats new to Hanoi. On the website, I saw a post from a woman called Annett who was looking for people who work near her to go for lunch with. I checked out the address of her office, and it’s only 2 streets away from the hospital… so I messaged her a few days ago and said I would be happy to meet her for lunch, and we spoke on the phone, set it all up, and met today! I went to Pacific Place Building to meet her at midday… and guess what?! It turns out she works for PriceWaterhouseCoopers, which is the same company that Will works for! We went to a great upmarket food court called Quan An Ngon. It serves up typical Vietnamese street dishes, but cooked in a clean environment, and eaten at nice tables in an open air courtyard. We shared our food, and had these great wrap-your-own rice paper pork and noodle rolls, spring rolls and crispy fish noodle soup, yum! Annett was really nice, and it was interesting to find out what Hanoi-life is like for someone living here more permanently. She’s been here for a few months, and is out here on a 3 year contract. I think we’re going to meet there for lunch again on Tuesday. 

Well, after lunch, I went to the bank to change some more money before the weekend, and then met the Swedish girls at Hoan Kiem lake for some ’studying’! We all took along medical books (they took O&G because they have an exam coming up, I took Surgical Talk…) But the whole studying thing didn’t really materialise, we just chatted, sunbathed, and fended off booksellers and postcard sellers!!

In the afternoon I went back to my hotel for a bit to do some laundry. I washed all my hospital clothes, and some other things, and it’s all drying out on my balcony! (I bought a travel clothes line before I came out here, great buy! It is made up of two pieces of elastic wrapped around each other, so you don’t need any pegs, you just push the clothes through the two bits of elastic!)

This evening, to celebrate Matilda’s birthday (yesterday), we went out to a fancy restaurant called Au Lac. It’s a Vietnamese restaurant in a beautiful colonial French villa. We sat out on the terrace, and felt very proper!

 

We had wine… and spring rolls, seabass in orange citrus sauce, sauteed beef in lemon grass and chilli, tofu and vegetables in clay pot, prawns in coconut (literally 6 prawns sat in a coconut shell) and steamed rice. Then for dessert, we had banana fritters with caramel… MMmmm. The bill came to 200,000 dong, which seems sky high when I think in dong, but no doubt Will will helpfully provide the conversion to pounds for me and explain that I spend as much in Wagamama’s in London or something! Since we were feeling so lavish with our money, we splashed out and got a taxi home!!

Had a really lovely day!