mo'c mo'l

this week has seemed crazy long so i (and poo) were way happy when it was friday. btw, poo is a machine. she works the entire day post-call (call=staying overnight at the hospital and answering calls on id patients and sleeping little, if at all) and then still goes out partying at night. it is really ridiculous. anyway, yesterday was one of those crazy days for her.

in the morning, i joined her in ID clinic (mostly HIV+ patients). one dude had a CD4 of less than 10 and we examined his chest films (patients carry around their medical records with them here). it was pretty cool (but sad); we saw textbook PCP, then a CXR after treatment with the PCP resolved but another new nodule forming (the pt had complained of chest pain in the area as well), and now they're thinking he could have Nocardia or something; they need to bronch him to try and get sputum to stain and culture. He can't start ARV treatment yet and he is sad. I hope he doesn't die before he can start. Also, I saw this pt that was being transferred from another hospital with cryptococcal meningitis. he was stiff as a board and unconscious. i was surprised more people weren't freaking out (his family kinda was) but most of the staff around were like um...let's see if we can find an open bed on our ward. he really looked like badness (fun term that medical ppl use to connotate exactly that..badness). ill check on him next week after he starts his amphotericin B.

after ID clinic, we had khao soi (yummy noodles with this spicy soup - kinda like curry, but a northern thai specialty) to celebrate the end of the short course and the Japanese docs' stay. I got relegated to the 'adult' table (go figure, even though im the youngest kid) and ended up talking to this japanese doc who came to supervise the other docs (he's an md/phd and has a really funny body habitus - basically, he has a huge paunch but small arms and big legs and a kinda smallish head and he is balding). he is nice and tries to make jokes but it's funny because sometimes they don't make sense and then the thai doctors are like what? and then laugh awkwardly. im actually really surprised at how bad the japanese docs english was. anyway, we had an interesting conversation about female physicians (he said that Japanese female physicians were discouraged to continue working as a physician after marriage and asked about the situation in the US), University of Michigan Med (I forgot that there was a Japanese health clinic run by the family doc Michael Watters (i don't remember his name) at UMMS), the medical education system in US, and American college life. the cool head ICU doc was also there and said he was nervous about this presentation he was scheduled to do in the US in the fall. apparently his presentation was one of fifteen picked to compete for this international research award and he's nervous about his english (although it's really pretty good), so i offered to help him go over his slides and listen to his talk. I'll also investigate potential projects with him. :) Poo says he has much power in the hospital, and he's really cool.

At the lunch, I ate crazy amounts of food, including yummy thai fruit (longan!) and this ridiculously yummy ice cream sandwich. Ice cream sandwiches here are actually like real sandwiches - sweet bread with ice cream in the middle. It's actually really good, and there are people who make homemade ice cream and sell it on the street in hot dog buns (seriously) or hamburger buns. You can also add toppings to it, but the toppings are things like corn and beans. It's actually pretty yummy (I know it sounds gross, like bananas and cheese...but that's actually yummy too! Chris and I ate it unknowingly in Brazil).

in the afternoon, i went to a peds id lecture with ben (sadly for ben, the slides were all in english but they all talked in thai). a bunch of peds fellows/attendings gave short presentations on their research re: the immune response to HIV+ children who receive different types of vaccines (Hepatitis, Japanese Encephalitis, MMR, etc). There was also a review of immunology, and i forgot how much i enjoyed that sequence. perhaps i should investigate peds projects as well.

i am totally impressed by how much literature people read here (including residents). it's also all in english, which is their second language, but there's tons of journal clubs and just informal reading all around. i need to start reading more, as usual.

in the evening, we went out with this japanese docs again to this really awesome indoor/outdoor cafe/bar/restaurant named mo'c mo'l (short for monkey club and moon lover). it's open but covered (so you dont get rained on), there's raft-walkways between the cafe and the restaurant/bar part, live music, and fish and frogs in the pond they've constructed...think tropical garden). there was tons of food, as usual, and rotating thai bands that sang both english classics and thai songs. dr kuanchai (young id doc, poo's boss, and totally awesome dude all around) was rocking out to some of the music. the japanese docs all got drunk on beer and bacardi blueberry/vanilla liquer. kinda hilarious, but also kinda fun. after mo'c mo'l, poo, nui, ben, and i went to the original monkey club near where ben lives for more food and a fleeting moment of clubbing (mostly it was us going in to the club area to try and find poo's friends) most clubs here are packed, there's a thai band playing covers of current hit thai music, and people stand around their tables (or carts) and kinda dance and sing along. ben was dragged into the melee and said he was afraid. it was good times, anyway, but i turned in right when i got home.

on the agenda for the rest of the day: 2.5 hr spa treatment (body wrap, massage, and facial) at chiang mai oasis spa and maybe lara's husband's art opening at a local thai gallery in the evening. i havent been that productive since waking up, but did hand-wash all of my underwear (cost for laundry is per piece, so i think it's a waste to throw in underwear) and caught up on email.

hey, people, if you're reading, comment so i know this isn't all going into a black void!!