“A mind that is stretched by a new experience can never go back to its old dimensions”
~Oliver Wendell Holmes Jr.
As I pass the halfway point in our elective at Cho Ray Hospital, this quote is starting to ring true for me. I feel so comfortable here in Ho Chi Minh city, and medical school back in Vermont feels like the distant past rather than a mere month ago. After so many months in the classroom this experience, while certainly not easy, is reviving my excitement and commitment to becoming an influential physician.
Because Vietnam is a very safe and relatively affordable country, we had the opportunity to explore and even travel to the north for five days last weekend. These experiences have been absolutely stunning and amazing. I have traveled quite a bit throughout my life because of my parent’s heritage and my own desire to explore. Each time my telescoped picture of the world grows a little larger. It is crazy how we live our lives focused on such a small set of values and priorities. Particularly with something as consuming as medical school it is easy to lose touch with the world. For the past year I essentially lived only along the axis between my apartment and UVM’s campus. I enjoyed myself and was successful in school, but I recognize how closed off and caught up in the details I was!
Travel – particularly Global Heath – truly opens one’s perspective. When I think about my relationship to the rest of the world I find myself humbled, connected, and motivated. I feel tiny, but also I have met so many friendly people who I can find commonalities with, even if that shared ground is just a smile. Growing up I often struggled with communication skills and shyness, but experiences like coming here have helped me grow into being able to make connections and express myself. Seeing a different culture has taught me about things that work and things that don’t- both in the United States and in Vietnam. While I understand that many of the issues our countries face are huge and complex, I still feel a motivation to help in some way, even if that contribution is small.
There is a stark contrast between the picture we see in the hospital and the one seen by so many people who come through this country without understanding what is going on behind the scenes of the glitzy and bustling tourist industry. Because Cho Ray is the major government hospital of the South of Vietnam, they are the catch-all for all patients who cannot be helped at the provincial hospitals. Because prescriptions are not needed at the pharmacy, the pharmacist has replaced the doctor as the first line of treatment in the healthcare system. Because patients try to self-medicate first, they come to the hospital in a much more progressed state.
Given these reasons, the majority of cases we see in tropical medicine are shockingly severe. The mental images I have of these sick people will likely be burned into my memory for the foreseeable future. Watching and learning from these hurting patients is difficult, especially with the language barrier preventing me from expressing much of the empathy I feel. Finances are a barrier for many, as are staff and resource shortages in the hospital. The doctors who teach us are smart and fully dedicated, but there is only so much a brilliant mind can do in patient care. I cannot imagine bearing the burden of witnessing so much death and despair every single day.
Our global health elective is unique because we get the chance to see both the beautiful and the less glamorous side of this place. It is difficult to process at times. There is still so much to experience and to learn here, I am not sure I will feel ready to go home when the time comes. This rotation has provided me with a special opportunity to grow, and I am not done with that growth yet.