Be pissed off. Then, be the change.

Highlight of the post: Be pissed off.  Be very pissed off when something is fundamentally wrong and it hurts people.  Then change it so you're less pissed off.

Holy heck ya'll.  I stepped foot inside a hospital in Vietnam.  I truly realize I'm in a 3rd world country.  This is a picture I stole from the internet, but this is exactly what its like.  8 beds a room.  Sometimes 2 patients per bed.  No handwashing between patients.  Doctors examined wounds without gloves and moved onto different patients.  I was in the same room as active TB and lots of other things that we normally use negative air pressure rooms for.  For every patient there are at least 2-3 family members. One nurse per room sometimes.  Your family member is your own nurse.  There is just simply no personnel, time, resources, or hope. Oh, but wait, there is one thing.  If you have wads of cash, you can tip your MD or nursing staff for extra care or to get your sheets changed.  Honestly, if hell had a look, a hospital room here would be it.

Imagine the level of bacterial resistance.  When antibiotics can be just bought anywhere for any little infection or indication, that's a bad sign.  When people don't wash hands, that's a bad sign.  Excuse: we don't have time.

I'm upset.  Upset that I can't change the culture here.

On the last day of the week here at the hospital, presented a clinical case retrospectively.  We talked about all the things that pharmacists could've intervened on and they just say very helpless things.  Then we present on Clinical Pharmacy in the US and they have this look like "these girls are so far off".  But really.  The US Clinical Pharmacy was where they were 30 years ago.  It's doable.  We're proof.  At the end I did my inspiration soap box talk, "you can make the difference if your department works together to start little initiatives i.e. all use hand sanitizers on the floor, get out on the floor and be available, start tracking your interventions."  I wish I was more inspirational because again, excuse: we're not there yet.  Yes, I know, but how will you ever freaking get there with this attitude?  If you're scared to offend your physician colleagues, you're wrong because when I was on the floor with my UCSD friends, they bombarded us with questions!  They want a pharmacist brain.  They'll demand it when they know how much you know!  Do it for the patients, do it for your education, for you.

The pharmacy school impressed me but the system in general is disappointing.  There is a 1.5 hour nap at lunch in the office and somehow, "there is no time" is an excuse.

Benchmarking: if you haven't heard of it, it can be a really good thing.  I.e. hotels didn't always used to have complimentary soap.  But one did, then other ones had to do it to stay on the same level.  Then came along complimentary breakfast.  Then wifi and HBO.  End result: the experience you and I, the consumers get to experience in hotels.

In the context of hospitals, your consumers are your patients.  If ya'll start using hand sanitizer, other people will see.  Physicians will see you do it.  Then patients will wonder why they don't do it too.  End result: best patient care.

All that said, it was an extremely learning experience.  We are very grateful for the opportunity to learn about a different side of things from the pharmacists here.  We just wish we could do more.  Next week, we'll go to a different hospital.  I want to be less shocked but I never want to stop being shocked.  Things like this should always piss one off.

So take away point: please don't stop being mad at things that are not right.  It's okay to complain as long as you do something about it.  I hope to successfully deploy this therapeutic drug monitoring program for Vancomycin at the next hospital and expand the scope of the pharmacist.  Be the change you want to see in the world.
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On the lighter side of things, the photoblog portion.

Wednesday was a national holiday, visited grandpa's grave with the entire family.

Then we visited a temple where Uncle 4 bought a 10 birds for me to free.  I'm praying really hard for the same 3 things: 1) for world pleace, 2) for those I love to be healthy and happy (5 minutes of imagery of each specific prayer for each person here) 3) for the strength to be who I want to be.

The Phamily that really misses Daniel. 

 I talked to someone really close to me about what he wants to do with his body when he's gone.  Cremate/burial.  VN/US.  And I am shocked at the response.  I have to give you some background on our culture.  You get buried in one piece or else your spirit will be stuck or something or another.  Well, this person's answer blew me away because I'm like what?!  He told me that he may decide to donate his body to science.  Jaw. Dropped.  What type of psycho progressive thinking is this?  Yes, I did learn anatomy dissecting cadavers and many people have made the sacrifice so we can advance in science etc. But I never thought this.  He said, "what you did, the schooling you went through, made me seriously consider this."  One of the reasons what this man is so loved and respected by me and others around him.  So logical, full of integrity, fair, and honorable.

Went to a legit amusement park called Dai Nam via bus an hour away from Saigon.  In this picture, you see a duck feeding fish!

This is also part of Dai Nam.  I'm with the leading lady of my life.  The woman that has the hardest job in the world.  She is all that I am.  All that I could ever wish to become.  Mommy.  Too often this trip is Mommy followed by, where is this? how do you do this? etc etc etc.  I'm completely useless.

Can I just talk for one second about another conversation I had?
Daddy said, "Your mom and I did two best most amazing things for you and Daniel..."
Me: "What? Take us to all these countries?  Like 40 of them?  Guide us through life and school?"
Daddy: "1) I love your mom. 2) Your mom loves me.

Lovebirds in DaiNam.  My parents dating life is more lively than mine at the moment.

This is terribly amazing.  Chris, our relationship benchmark is as such. :)

Just another picture at Dainam.

 Friday, we went out to my beach condo for the weekend which is in Vung Tau, approximately 2 hours away by bus.  The four of us had a legit time with seafood and all that.  Totally warm waters.

Missed you Dan!

Missed you Fatcat!

Vietnamese culture = hours as garden coffee shops that have wicked trees like these.  Bunch of the family today.

Obligatory kitten picture from a crazy cat lady :)  My uncles baby.

So when it rains here it pours.  For 45 minutes.  So hard that bubbles come up from the ground.  And storeshop awnings break.  And then the streets flood and I have to wade across the street to get home.

Vince, this portion of the blog is dedicated to you once again.  I just wanted to officially document that you owe me boba for eating 4 silkworms!

My friends, I leave you today with another quote: 

 If we could change ourselves, the tendencies in the world would also change.  As a man changes his own nature, so does the attitude of the world change towards him.  [...] A wonderful thing it is and the source of our happiness. We need not wait to see what others do.

[From VOL 13, Ch 153, General Knowledge About Health, Page 241, Printed in the Indian Opinion on 9/8/1913 from The Collected Works of M. K. Gandhi, published by The Publications Division, New Delhi, India.]

Namaste, I'll be back sooner than you think!  Officially the halfway mark! <3

Maria, Nick, I'm just testing if you guys are reading this. :)