Women's work

Yesterday was a good day even though I spent half of it hacking up a lung (I can’t imagine having smoker’s cough…I hate coughing!!) I didn’t do much in the morning but then got my act together and went to RIHES (the research institute where I work), had a long chat with L about various things, including birth control. A lot of women here don’t really know anything about birth control (even health professionals) because it’s kinda skimmed over in school and also because it’s culturally not acceptable to talk about stuff related to sex/family planning if you’re not married. Engaged doesn’t count. In lots of trials, women who are HIV+ have to agree to use some form of contraception, and we were talking about how it wasn’t really okay to say, ‘just buy anything and take it’ without proper counseling. Oral contraceptive pills are all over the counter here (as is most medicine…I saw Keflex for sale yesterday when I went to pick up azithromycin for my freaking amoxicillin-resistant strain of strep) and it comes with instructions, but I’m sure most people don’t read the insert.

The first time I had this conversation with L, I happened to get my period and not have anything on me, so I went downstairs to ask these two secretaries/admin personnel if they had a pad (tampons are also not popular here – I wonder if people think you lose your virginity if you use a tampon?) I could use. They did, but somehow the topic of birth control came up. One of the secretaries had heard it could help in the treatment of acne but she was scared to take it. Another told a story of her friend who started taking OCP’s before her marriage and got dizzy and nauseous. They had a ton of questions about it and felt comfortable asking me as a Thai-American, medical person, and also because I was married. I was thinking to myself, we should just do a private seminar for all these single women who want to know about this but don’t feel they’re in a position to ask about it because they’re not married (and likely not sexually active, as “good” and/or educated women). There are actually a great number of single career women here – I think a lot of them felt as if they had to decide between a career/education and a family (and/or sex life). Since they’ve made the career decision, they are celibate and they don’t date (or not to my knowledge anyway), which is sad. I’m not sure if this is their own choice or if Thai men are just too intimidated to date someone who is highly independent and educated (probably a bit of both). Sometimes I bring up the topic of sex/birth control but only if I know the women well (and never if men are around with a group of women) – I know the topic is taboo but want people to know that they can approach me if they want to know something and that I’m comfortable about talking about my own experiences/sharing my knowledge.

My Swattie friend Libby who’s on a Fogarty in India is actually trying to look at a similar issue (but from a different perspective) among HIV+ women in India. She states that there is a lot of social pressure for women to bear children there and wants to examine HIV+ women’s views on having children, family planning, etc. I think that that’s a super interesting question and wonder about possibly asking women (since we see a lot of them in the HIV clinic here) about their reproductive intentions, especially the younger women who don’t have any children yet and are often single or in a relationship (some of them are in serodiscordant relationships as well). With the MTCT (mother-to-child-transmission) rate being super low (<5%) style=""> (more on this later – I can’t believe I never finished my paper on that at WHO)

Anyway, back to my day yesterday. While waiting for Poo in the ID fellow room, I was able to write a five-page research proposal on the retrospective chart review we’re doing to compare cryptococcosis in immunocompromised vs immunocompetent patients. It was good to be productive again and also reminded me of college, where I would just sit down and write a paper and then print it out when it was done an hour a two later. Poo was impressed, but it wasn’t anything too difficult. After I was done writing, Poo and I hung out while waiting for P’Nui (Poo’s fiancée) to pick us up. He was late getting off of work, so we ended up chatting while Poo played Diner Dash (a heavily addictive game if you want to check it out). Poo tried to tell me I was an inspiration to her in Thai but I didn’t understand the word she was using. Luckily, she was able to translate it into conversational Thai (‘someone who makes someone feel like they can do more, and better’) as well as English. She said that previously she didn’t make a lot of plans or goals for herself in her life but after meeting me, she started thinking about what she wanted to do and where she wanted to go. It was really sweet! I’m happy that I can be a mentor to people regardless of where they are at in their lives. One thing I’ve learned for sure though is that you can make tons of plans, but sometimes life just has a different road map altogether for you – you definitely have to take things as they come. I think the best part about planning is being prepared for opportunities as they arise though…I’ve been lucky, sure, but I’ve also been prepared. I told Poo about a conversation I had with former Swarthmore IC director Anna Marie (does anyone reading this remember her?). She was generally useless, but I remember having this conversation with her when I was a first-year or a sophomore about thinking about where I wanted to be in five or ten years and thinking about my CV and what I wanted it to look like (or what I needed to do in order to get where I wanted to go). I’ve remembered that conversation until this day, and have really thought about long-term things I want to accomplish or things I’m interested in but haven’t had the chance to do yet (and how to go about getting $$ to fund me to do such things J ) So far, it’s worked pretty well. That being said, I don’t think life should be about your CV at all, but I think it’s your life experiences that can really make up your CV – what issues you choose to work on, who you choose to work with, how you choose to make a difference (even in your daily life). Even though I don’t have the most kickass boards scores (or grades in med school, for that matter), I’m happy about what I’ve accomplished in medical school, not just as a student, but as an activist (and a daughter, wife, and friend). In the long run, it really is true that no one remembers what your GPA looks like (even five years down the road)…thank god I don’t want to match in urology though. I wonder what my priorities would be then ;)