If I were to redefine the term "crazy," it would encompass all that happened yesterday at clinic.
We started heading to Ba Tri (a rural district in Ben Tre) at around 7AM. I only had four hours of sleep the night before, and I could barely move my body. The sun was also less forgiving today, the morning heat burning through the pores in my skin. We arrived at a new school and started setting up. There were fewer people, but it was still as chaotic as I remembered. The new school itself was much smaller than the first one.
At first, we started on crowd control and the rush began. To clarify, crowd control is the team responsible for leading patients in and out of the different stations and making sure the clinic is running smoothly and efficiently. I have come to appreciate the value of teamwork. Medicine is and has never been a one-man job. I’m glad to say that we all work well together and crowd control became more manageable. Every one is passionate and willing to work extra to make sure that the patients are all checked. Today I have realized that in full. I was exhausted, but my team members--who were just as tired as I were—lessened the load. Having to keep track of all the patients is beyond stressful, but I can tell that we knew how tantamount our jobs were.
While waiting for primary care to finish, I had a chance to sit down and talk to a lot of the older patients: “Do you get checked up a lot? And where do you go?”
In reply, almost all have said that they hardly visit the doctors for check-ups, and when they do, they go to a bigger hospital. The trip is strenuous as most do not have easy access to transportation. Although buses are cheap, they are usually jam-packed and take a long time. Going to the city itself for a hospital check-up requires at least three days, and maybe longer if the check-up requires any type of follow-up. Many said that the doctors at their local health commune were not communicative, and they were scared to visit the doctors for a simple check-up. They would only go as a last resort, for a dire emergency.
I hear these same stories and answers often. But I finally witnessed how diabolical this cycle can be. Dr. Sim, a doctor in primary care, asked me to look after a patient. He was an older man in his fifties or sixties and had been waiting to be seen for the first half of the day. Dr. Sim told me that this man was at high risk for a stroke and he had to go to the hospital immediately after receiving his medicine pills. She told me to make sure that he went to the hospital.
If I can explain how heartbreaking it was for me to explain this to him, and see the look on his already tired face. He looked completely lost and confused by my words and did not want to believe that something was wrong. His eyes were watery and red, and I could feel him growing smaller and smaller with my words. I told him that he needed to go to the hospital immediately, and he only replied: “But… but... I don’t have any money” and grabbed my hand, searching for some reassurance. I sat him down and told him everything will be okay and that we will arrange transportation for him. He insisted on saving the money and getting a motorbike (xe om taxi) instead, but this was not possible because the heat would have catalyzed an immediate stroke.
We needed to get a taxi, but he kept refusing and insisted that he would just call his son to take him home and that he did not need to go to the hospital. These defiant words weren’t from denial, but from fear of being burdensome to his family, and for fear that something might really perhaps be wrong. Later on, his wife finally came and our logistic manager arranged proper transportation for him.
I wonder how he is now. I can only hope that they were able to help him at the larger hospital and that he continues his treatment. I can only hope.
After a short lunch break, the girls and I were sent to shadow Gynecology. Dr. Ho has been utilizing visual inspection exam to detect signs of cervical cancer in women. An acetic acid solution is rubbed onto the cervix and inspection is done at the transformations for any signs of cancer development.
Little did I know that I would not just be shadowing. Gynecology was non-stop work, and we had to set up and assist the doctors. We were also able to see a biopsy and the freezing of cysts near the cervix. I could only imagine how painful the exams must have been for the women. We worked to a point where I thought that I would pass out. It was in these moments that I could only imagine how tired the Gynecology team (Dr. Ho, Dr. Thao, Dr. Fabe, and Veronica) must have been. They had there since the morning and were constantly seeing patients. Despite the exhaustion, they all exuded warmth and sincerity towards each patient—making sure everyone had a good experience.
Dr. Thao also showed me how to ask for a woman’s gynecology history—which was really helpful. I learned a lot by asking these women simple history questions. For instance, I spoke to a woman in her seventies who was still working in the fields. She has had seven children throughout her whole life—and who are all grown up—but she still works. I told her to exercise more, and she told me she does all the time by working in the rice fields. Vietnamese women work hard. On top of helping their husbands support the family financially, they are responsible for taking care of the children and running the home.
Yesterday was the most intense day so far. And even though we worked non-stop for a grueling twelve hours, I learned a lot and am so grateful for this opportunity. It is so rewarding even through the exhaustion. I am learning so much.