Tuesday, July 14, 2009

Playing with Tigers @ Tiger Kingdom

One of the coolest things about Thailand is all the native creatures… that neither the US nor Australia has. Some creatures include the ELEPHANT… which can be commonly seen walking down the street.

Another is the elusive (yet very fearsome) TIGER!

So one day after work, a bunch of the volunteers and I went to go see these tigers up close at this tourist attraction called Tiger Kingdom, where some 50+ caged tigers can be seen.

Well… we paid something like $10 USD and we were allowed to step inside the cage with the tigers and take photos with them… AHH, pretty crazy, right?!?

It was absolutely 100% the most terrifying thing I’ve ever done! The tigers are right there… only 2 feet away… and they’re walking around and fighting/playing with each other… All the handlers say not to worry about it, but every time one of the tigers got up and started walking towards me, I freaked… complete adrenaline rush… SOOOO SCARY!

The good thing is we can out alive… no tiger attacks! And we got some great pics!

I petted a koala in Australia... now I'm petting a tiger in Thailand... HAHA!

Group photo of some of the volunteers and I

Handlers trying to calm a tiger down as it jumped onto the table... eeek.

Pretty scary eyes

Tiger in a cage

On the prowl

Another group photo

Tiger Kingdom also had lion cubs... Simba?

His stare is not that welcoming

Petting tigers...

...is DANGEROUS!

Umm yeah... you won't see me lying on any tigers any time soon... haha.

This is the closest I got...

This handler was CRAZY... he was like kissing the tigers... WHAT?

Friday, July 3, 2009

WEEK 1: PEDIATRICS

I just finished my first week at McCormick Hospital in PEDIATRICS, under the guidance of Dr. Kamol. It turned out to be an amazing week filled with medical terminology, procedures/techniques used for examining patients, information about diseases/sicknesses, healthcare issues in Thailand, etc. Most importantly, I got A TON of first-hand experience.

I spent most of my week shadowing Dr. Kamol in the pediatric clinic and the nursery/general wards. A typical day included diagnosing patients for half the day at the clinic and then visiting them later in the wards.

Despite only being a week, I got to see a wide array of illnesses affecting children: herpes, anemia, dengue hemorrhagic fever, jaundice, URIs, fever, tonsillitis (TONS of tonsillitis), gastroenteritis, laryngitis, bronchitis, roseola infantum, bronchiolitis, epilepsy, asthma, etc, etc. And I learned a lot about each illness from Dr. Kamol. He taught me what symptoms to look for, what caused them, and how they are treated… I have tons and tons of notes from all the information he gave me.

Dr. Kamol even let me physically examine patients in the clinic. When patients would come into his office and tell him their symptoms, he would let me check their breathing (stethoscope), check their throats, and check their ears (otoscope). And sometimes while we were in the wards, Dr. Kamol would tell me to go to patients' rooms and check up on them BY MYSELF… either to examine their breathing, check their skin for poor circulation (a symptom of dengue fever), etc, etc… And that took me completely out of my comfort zone (in a good way, though). I mean I don’t even speak Thai, yet I went to patients' rooms, greeted them and their family, and then examined them.

And that is what most surprises me about this medical internship in Thailand… Thai people are not concerned with privacy like Americans. They don’t ask tons of questions or demand answers. They simply respect doctors and healthcare professionals, so they never questioned who I was or what I was doing… Nor did they mind it… they just let me examine the patients without any complaint. Some even smiled and called me, “Mr. Adam.”

By far, however, my favorite part of this week was getting to go to the nursery ward to see the newborns. On Thursday, 2 babies were born (one at midnight and one at 7 am)… So Dr. Kamol and I went to give each baby a full examination to ensure that everything was okay and normal with them. And I got to do a full examination on one of the babies, even though he was only 4 hours old!

For the examination, we…

  • Checked the baby’s hip movement
  • Listened to his heart to ensure there were no heart murmurs
  • Checked his TSH (thyroid stimulating hormone) levels
  • Checked his reflexes (Tonic Neck Reflex)
  • Examined his genitalia (ensured the presence of the penis, the 2 testicles, and the anus)
  • Checked/felt the anterior & posterior fontanels (soft spots) in his head to ensure they were normal
  • ETC

Another interesting event during my time in the nursery ward was a baby that had been born in the mountains about 2 days ago… His mother belonged to a Thai hill-tribe, so she was unable to make it to the hospital in time to give birth. She ended up giving birth at home and cutting the umbilical cord with a bamboo sheet. Well, the baby caught Clostridium tetani (tetanus) from the bamboo, so he came to McCormick for treatment. I just thought it was interesting because I had just learned in depth about Clostridium tetani in my Microbiology class at UWA in Australia… and now I was seeing it first-hand… It was one of those times when you apply all the science stuff you learn in class to the stuff you actually want to do as a career….

This week was also just a great opportunity to build relationships with the patients. I saw many patients come in on Monday, receive treatment, and then come back 2-3 days later to check-in on how they were doing. And most of them remembered me. Plus, it was pretty cool when Dr. Kamol said that I had the personality to be a great doctor one day… YEAH!

Ultimately, I’m just ecstatic that I got this opportunity to come to Thailand and to do this internship. I’ve gained so much insight into what kind of doctor I want to be and medical knowledge that will prepare me for a career in healthcare… and it’s only the 1st week! Pediatrics is definitely something I found an interest in, and I cannot wait to see what the next three weeks will be like…

Next Week - Internal medicine

Week 3 – Surgery

Week 4 - Tropical Skin Diseases

Hopefully, I will gain as much knowledge/first-hand experience as I got this week. I’ll keep you posted though via my blog. Here are just a couple of pictures from my time in pediatrics this week… I didn’t take very many pics because I didn’t want to appear unprofessional in any manner... I also didn’t want to be disrespectful to any patients. Instead I just took pics of pictures/diagrams on the hospital walls… haha!

Inside the pediatrics clinic @ McCormick Hospital

This is just a picture from a poster on the wall just outside the clinic... It's not a "real" patient, but it's a good representation of just how cute Thai babies are... haha.

Pediatric Clinic... in both English and Thai

Play area for kids in the wards

Again, not an actual picture of a patient... I stole this one off of ELI's facebook page... but again, it's a pretty cute kid.

Me just sitting and waiting for the day to begin...

One of the many wards we visited

Outside the clinic... a playground for kids

Dr. Kamol's office

A view from where I sit most days as patients come in and out

Baby waiting to be seen...

NURSERY WARD!

The 2 newborns... not the best picture, but oh well...

Nurses

Me after a HOT day at work... YUCK. There isn't AC in the hospital... just fans, and it really doesn't fight off the humidity!!

Another Thai baby on a hospital diagram

Bassinet for a newborn

Information about My Medical Internship

I received my schedule for the next 4 weeks during my internship, which are as follows:

Week 1 – Pediatrics
Week 2 – Internal Medicine
Week 3 – Surgery
Week 4 – Tropical Skin Diseases

And I’m absolutely ECSTATIC with what I was given. In my application, I told them that I was interested in interning in a wide array of different departments within the hospital because I thought having knowledge in many areas of medicine would be most beneficial to me, especially if I try to become a General Practitioner (GP) in the future…

Well, I got it! Each week I will be shadowing doctors within these departments and learning as much as I can about them. For the first 3 weeks, I will be at McCormick Hospital, but for the final week, I will be at McKeane Hospital.

According my information packet, interns will be paired with a full-time Thai doctor and work five days a week (Mon – Fri) 8:00am – 4:00pm. In special cases, interns may work on weekends and evenings. Interns will shadow the Thai doctor in their normal, daily routines and assist with professional responsibilities.

A little info on McCormick Hospital… McCormick is well known as being the first hospital in northern Thailand. It originally opened in 1889, and the father of King Bhumibol (the current king of Thailand) did his residency training at McCormick Hospital many decades ago. Currently McCormick Hospital has roughly 780 employees. A total of 41 doctors, 7 dentists, 10 pharmacists and 214 nurses currently work there full-time. McCormick is a private Christian hospital, founded by Presbyterian Missionaries.

I don’t know too much about McKeane Hospital yet (I haven’t been there), but here are some pictures I took during my first week @ McCormick.

McCormick - Private Christian Hospital (see the cross above)

This is how I look most days... blue polo with khakis (they want us to dress nice)

Front of the hospital

Entrance... both in Thai and English

Picture of Jesus (it is a Christian hospital)

OPD (Out-Patient Department) or the front of the hospital...

"Doctors Dining Hall" - where we get to eat lunch with the doctors everyday

Chapel Hall - service is held every morning @ 7 AM

Another mural of Jesus... YAY.

Exploring Chiang Mai for the First Time...

For my first weekend in Thailand, I had VOLUNTEER ORIENTATION. It was pretty cool… just a time for us to learn a bunch of helpful stuff about Thailand before we actually begin volunteering at the hospital on Monday.

We learned a lot about Thai culture, like how to greet “wai” people – by putting your hands together and raising them to your forehead as you bow.

We also learned a bunch of helpful vocabulary/phrases, such as:

“SAWADEE KRAP” – “Hello” (Male form)
“SAWADEE KAH” – “Hello” (Female form)

Finally, we got a city tour of Chiang Mai, which was spectacular! We saw tons of temples and markets.

Overall, the orientation was great. I learned a ton of valuable information/tools that will definitely help me as I try to navigate myself around Chiang Mai for the next couple weeks. Plus it also gave me an opportunity to explore all the wonderful things Thailand has to offer… Here are just a couple of pics of all the cool & interesting things during my first weekend in Chiang Mai.


Atop of Chiang Mai @ a temple "wat" on the mountainside

Exploring temples...

Temple with TONS of golden Buddha images (not real gold)

HUGE temple ruins...

Traditional Thai dancing @ the cultural center

Buddha image in the temple gardens

Street market... or as we call them in NM, "flea markets"

HUGE 50 ft Buddha statue

3-story street market

Another temple

Elephant statue

These are the taxi cabs we have to take everyday to/from the hospital (there is no bus system in Chiang Mai). They are called "Song-taows," which literally means "two rows" because they have 2 rows of seats in the back (see picture below). It's pretty cheap to ride one (about $0.60 USD each way to/from the hospital), but you always have to barter with the driver, which can be a hassle...

The back of the taxi cab "song taow" - 2 rows of seats

A view of all Chiang Mai... well only some of Chiang Mai (it just rained, so the fog/clouds blocked most of the city)

50 ft Buddha statue

Temple where Buddha's bones are "believed" to be buried

Exploring an underground temple

It just rained... so you can see a little rainbow over the city

Gate leading to the city

Another statue... looks Hindu to me...?

Yep, I'm definitely in Chiang Mai...

MONKS - They're everywhere! Most are novices (boys training to become monks), but it's still pretty cool because you can go up and talk to them... They're always eager to practice their English

Baht - Thailand's currency. This 1500 baht is probably equal to $40 USD.

Mural of the King of Thailand... Pictures/images of him are EVERYWHERE... calendars, billboards, flags, etc. He's a very respected man.

Temple ruins

Alter @ the temple

Golden dragon

Temple

Tons and tons and tons of motor bikes fill the streets of Thailand... the motor bike to car ratio must be at least 10:1.