Beer Lao Scooter

What is wrong with this picture? At the recent elephant festival, we found the Beer Lao booth promoting their special festival brand beer--Lane Xang (Million Elephants--name of the former Kingdom in what is present-day Laos). They were having a raffle and it looked like the grand prize was this Lane Xang Beer scooter. Alcohol plays a large role in the Lao culture and being unable to perform emergency surgery because you are drunk or driving while intoxicated is not shameful or unaccepted. During Jon and Rose's visit, Jon gave an excellent grand rounds about the physical and societal effects of alcohol including trauma, fetal alcohol syndrome and professionalism in the medical community. I have found myself in some uncomfortable and unsafe situations due to the lack of societal understanding of drunk driving. I once was riding with someone I thought had drank more than he should have and listened as he told me about his long time physician friend who had died in an alcohol-related crash that week. There seemed to be no understanding that this could happen to him (or innocent others), too.

I have noticed some signs around town placed by the Beer Lao company discussing responsible use of alcohol, but they are not wide-spread and I doubt they are effective. The government has a significant financial stake in Beer Lao which is a conflict for public health issues. The no smoking campaigns have taken off in the hospitals. We will see how long it takes for responsible use of alcohol to be aggressively promoted.

Reanimation Unit

Entrance to the adult intensive care unit at Mahosot hospital. Somehow I suspect the outcomes aren't as good as this sign makes it sound. Animation is a pretty complex task that is not easily re-done.

It's a bird; It's a plane; It's SuperMom!

I have to admit I was a little nervous about my mom coming to SE Asia for a month for her first real travel in the developing world. How would she do with the food, accomodations, heat, TOILETS? Well, I was very impressed with how well she did. It seemed that everywhere we went there were tall steps, hills, boats or other general obstacles and she did quite well. Other than the heat stroke I almost induced for her walking from the few blocks between the Grand Palace and Wat Pho in Bangkok, there were no major catastrophes. I think she is an adventure traveler at heart, but just didn't know it before. Way to go, Mom!

Residents just wanna have fun

Dr. Xaykesone (2nd year, Chief resident) and Interns Drs. Chilapah, Kongpath, Panivone (back) , Sisomphone and Phonepaedith take a break from dancing.



One thing that I am adjusting to about the Lao culture is there is always an opportunity for a celebration. A bacci for a new house, welcome home, farewell, etc. Even weddings which are common times of celebrations around the world, get celebrated with more enthusiasm here. Nothing like throwing a party for you and your 1000 closest friends. Not only are your friends and family invited but the friends, coworkers and other random people your parents and grandparents know. So it was for the wedding party I went to last week with the residents. The groom was the son of one of the leaders and "founding fathers" of the internal medicine residency program. None of us knew the bride or the groom, but the majority of the IM residents and teachers came for the night of dinner and dancing. Although a very different style of dancing than anything I have previously experienced, it is kind of fun in its own slow, hands off way. I have also recently discovered the passion the Lao have for line dancing. Who would have guessed? The residents said they will teach me the various dances before Lao New Year so that I can fit it. I also need to get some fancier clothing and less sensible shoes to really fit in. I will choose to not fit in when it comes to drinking too much and then driving home. It is hard work to keep the glass from getting filled with alcohol but I am learning little tricks along the way. Unfortunately I will be on vacation for the next wedding which is for someone I actually know, but I am sure there will be many more occasions to celebrate.

One of these things is not like the other

Health Frontiers IM graduates and now teachers at Mittaphab at the gala dinner to celebrate the 20th Anniversary of Mittaphab hospital. (left to right) Drs. Veluvanh, Christine, Manichanh, Chanmaly.


Ever felt like you were different than everyone else? Well, here, I am. Not only is my skin whiter, my dress size bigger and my clothes not so beautiful, but I have the biggest problem with red eyes. It is a recurring problem that when photographed with people with dark eyes, my blue eyes produce a red eye effect so much more pronounced than the others in the photo. It makes me look possessed or something. I dislike that red-eye feature on the cameras, but maybe I should turn it on.

The Meaning of LIfe

I went to a funeral yesterday. It was unlike any funeral I have ever been to before. Not only was it held in one of the three Evangelical church buildings in Laos, but very few people in the room had ever met the departed. This was a service for a 71 year old American man who had been a pilot in Laos in the 60s and 70s and then returned to the country in the mid 90s. He was orphaned after his mother died and his stepmother killed his father. He left the care of his older brother when he was about 10 years old before joining the Marines at age 17. He married once, had no children and was separated from his wife before she died of cancer 15 years ago. He failed at several business attempts and had no meaningful relationships. He was a self-described recluse. His only friend was the owner of the Scandinavian Bakery where he helped set up the outside tables and chairs every morning in exchange for an omelet. It was this Swede who looked after him (and paid the hospital bill, I think) while he was dying a painful death of renal cell cancer metastatic to the bones. I met this man only once on the day he was admitted to the hospital. The residents tried to tell me his story, but even after talking to him in our native language, I was confused. Before I really delved into it too much, he was transferred to a private room in the ICU where he stayed for the next several weeks. I never made it back to see him before he died last Friday. The owner of the bakery asked the International Church community to visit the patient while he was out of town for a few days. Two men from the church went to see the man regularly for the next two weeks and they were the ones who arranged the funeral service for him. They had known him for only two weeks, during much of which he was on powerful narcotics.
What is there to say at a funeral for a man with no family, no friends no one to grieve and no clear religious preferences? As I sat and listened to the recounting of this sad story, I wondered if he had any regrets. Would he do things the same way again? I started to write that his life seemed to have little impact, but then I guess it has had an impact on me. It showed me that it is relationships that make life remarkable. I do not know the meaning of life, but it seems that if pleas have to be made to gather a handful of people to attend ones funeral, that is not it.

Western influences

During my recent trip to Bangkok, I was amazed by the Western influence in this city. I spent quite a bit of time studying in a shopping mall where Ronald McDonald greeted visitors with a wai (Asian respectful greeting) and this Christmas display from Starbucks lured visitors inside. Then I went to one of the many large shopping malls where Christmas lights were glowing and Christmas music was playing and throngs of people ate at McDonalds, Sizzler and Burger King. It was before Thanksgiving in America, but since Thanksgiving is not celebrated in Thailand, the"not before Thanksgiving" rule doesn't apply. I was thinking of the irony of listening to songs about snow and the birth of Christ in a tropical, Buddhist country. Then I thought just how sad it was that Christmas is so secularized. It is even celebrated with gift giving in the Communist country with significant Buddhist influence where I currently live. When I commented to my housemates about how strange it seemed, I was told "Christine, Christmas is a secular holiday." Huh? Maybe that is what the world has made it, but it is not a secular holiday. So, I am getting ready to start my Christmas music and I will strive to remember the reason for the season.