A Cracked Door: Global Health Rotation at Cho Ray Hospital

Let me preface this post with noting that Cho Ray hospital delivers a very high standard of care to its patients despite somewhat limited resources. The doctors and medical students in the Pulmonary department have taught and challenged us with a generosity that overwhelms me. And every upsetting moment that has caught me off guard, whether inside the hospital or outside, has been balanced two fold with a moment of kindness or humor. For instance, a few days ago we saw a kitten crossing the street a few feet away from us literally explode as it was run over by a bus. Ten minutes later we saw a toothless old man giggling uncontrollably as he rode his reclining bicycle backwards down the same street, with his wife chasing after him. I don’t mean for this to be another stereotypical emotional reaction to the sometimes devastating facts of life in another country. Because it does not do justice to my whole experience here. That being said, this past week held a few emotionally tough moments that I simply needed to write about to make sense of.

We met a Vietnamese woman living in the United States who had flown immediately to Ho Chi Minh City to be with her mother when she learned she was in the hospital. Given her knowledge of English, she was the only family member in the pulmonary department with whom we could easily communicate. She expressed her distress over watching her mother deteriorate in such a crowded facility where there are sometimes two patients to a bed, family members scattered across the floors, and minimal sanitation. After growing accustomed to American hospitals, Cho Ray was a frightening contrast for her, especially with her mother’s life at stake.

Sympathizing with her came naturally for two reasons. Firstly, I’ve known several people, including my mother, who have been in similar situations: getting a dreaded phone call in the middle of the night from halfway around the world, frantically booking an expensive last minute flight, sitting on a plane for 24-48 hours praying that your parent will still be alive by the time you get there, only to face the real battle upon arrival. Secondly, we are in a hospital full to the brim with stories we can only catch glimpses into. We watch shoeless old women carry food and belongings up eight flights of stairs in the heat of the afternoon with love and worry in their eyes.

We watch family members sit at their loved one’s bedside tending to them as if they were a fragile child – fanning them, feeding them water spoon by spoon, even ventilating them with an Ambu bag when there aren’t enough ventilators to go around. They remain ever vigilant – the patient’s advocate, nurse, caretaker, all the while sleeping on mats in stairwells and hallways. More than the patients, more than the doctors and nurses, these family members are the real heroes. Thuy was the cracked door into their world I had been looking for.

We checked in with Thuy almost every day. She was even staying at the same hotel as us. As we continued speaking, it grew apparent that she felt that American doctors and students delivered a higher quality of care – a delicate situation for us to handle. We certainly did not want to overstep any boundaries or propagate this false notion, especially while we were guests at the hospital. Thuy frequently asked us to take a second look at her mother. While our faculty mentor was with us in the department, she was able to examine Thuy’s mother and reassure the family that the doctors at Cho Ray were doing everything that she would have done.

Last week, however, only we medical students were in Pulmonary. Thuy continued to come to us with similar requests. Although I explained to her that I was only a first year medical student, and couldn’t treat her mother or give her medical advice, I’m not sure she completely understood n the midst of her desperation to get the best possible care for her mother. “Please save my mom,” she begged shakily through her tears. All I could do was sheepishly repeat that I was only a medical student.

One morning, as we were sitting at the doctor’s station a few feet from Thuy’s mother’s bed, her mother began to code. We looked on from our seats as Thuy stumbled out of the medical team’s way, sobbing. A few doctors and several nurses surrounded the patient’s bed, most of them just watching. Although I desperately wanted to help, there was not much I could do medically – and the bedside was already crowded with bystanders. If anything, as a foreigner, I would just be adding to the spectacle.

In that moment, I felt embarrassed to be wearing my white coat. In wearing it, I was parading around giving patients and families the false impression that I could help them. I worried that my idling in times of crisis made it seem like I didn’t care, or couldn’t be bothered to help when in reality, my insides were churning. The extreme frustration I felt that afternoon forced me to reflect on several things. I cannot wait to progress with my training in the coming years, and become a doctor who could have actually helped in that moment. To earn the right to wear a white coat and back it up with skill. I also want to show compassion for patients in a more effective way. This was the first time I had watched someone die while standing beside their family, and my first instinct was to tense up and over think my every gesture. Although I comforted Thuy afterwards, it felt like too little too late.

With time, I hope to more meaningfully navigate my place in delicate situations such as this one. Although I may not be able to provide direct medical care or advice for now, I will certainly strive to offer valuable emotional support. I look forward to growing through these experiences, and allowing them to shape me into a more compassionate doctor in the future.