I've been terrible at blogging!

Highlight of the week: Worst and best of both worlds.

I'm learning that I don't fit in here.  Not a terrible thing, it's not like I'm planning to live here, but its an interesting identity to have. A guest lecturer from America told me that in a room full of Asians, he could pick me out easily.  Of all 100 people or so, me.  "Why?" I ask. "Your demeanor, the way you dress, everything."  Not sure how to take that but sure, I stand out.  I'm used to it.  Next.  

When I walk along the riverbank at night for exercise, people whisper and gossip.  When I speak English, it is said that I'm being uppity.  When I speak Vietnamese, it is said that I'm a foreigner.  Yes, I'm totally American, but no, I'm not blond and blue eyed.  I'm so out of place, even the way I walk is telling that I'm not from Vietnam.

When I lecture, I use my hands, I ask questions, I beg for participation, I try to engage.  They don't even know what to do with me.  I think I'm hilarious and so do Kare and Thu but I don't know if they're too shy to laugh or if they don't get my jokes?!

Best of both worlds is that I'm looking in from the outside so I'm removed enough, but inside enough to be in the know and to care.  This place is beautiful.  The hustle and bustle of city life.  The calmness at the end of the day when everyone realizes they've survived yet another one and couples enjoy each other's innocent company and the cool breeze along the riverbanks.  Makes me wonder, will I learn to enjoy the little things like a cool breeze along the riverbanks more when I get home?  I spent 4 years in San Diego and I've been to the beach way less times than I wish I did.  Why didn't I go?  I was busy doing things, making things move, elevating the field, forging relationships.  Is that right?  I'm always seeking to do things with more intention and this may just be the push I needed.  I've never stopped to think of why I haven't been to the beach much ever before?  This trip is changing me, it is changing my paradigm.  

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Another note: you guys.  Everyday is a near-death experience.  Everywhere you go.  But here especially.  Remember when I was being all dramatic about my totebag (filled with other totebags) was snatched?  

Look at this:  "Police in Ho Chi Minh City have arrested four thieves after they chopped off the right arm of a 28-year-old woman in an attempt to steal her SH scooter"

http://tuoitrenews.vn/society/4589/woman%E2%80%99s-arm-chopped-off-by-thieves

What the hell man.  I mean the scooter costs like $8K. Come on.

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It's been a week since I last blogged.  Too much has happened.  Don't even know how to account for it.  Lets just go through my pictures.  Photoblog!

So my first impression of clinical pharmacy education in Vietnam: I'm impressed.  They learn things we learn in therapeutics.  Like delve deep into mechanisms of action and molecular explanations as well as SOAP each disease state as well as the big picture.  HOWEVER, the system fails them.  Clinical Pharmacy in Vietnam is where it was in the states 30 years ago.  Pharmacists are not respected as a healthcare team member and are not consulted on what they're educated on.  Much progress is to be made in this country to elevate the profession.  FURTHER, options are quite limited  i.e: Parkinsons.  We went over all treatment options but the conclusion of the case was that: "most of the time you'll see Levadopa/Benzamide because that's all we got".

When I say mechanism of action, I mean it.  They go into CYP and stuff and how PPI like omeprazole will decrease efficacy of clopidogrel, but then it's also incorporated into this lecture to not confront physicians regarding this because essentially you must "pick your battles".  I mean that's true anywhere, but it's unfortunate that this dynamic is reinforced in class.  My Rx for this: interdisciplinary CEs, professional school core classes...etc...

Food!  Bun Rieu Oc!  I'm obsessed with this.  Kare actually got this and I copied here thereafter.  At this point I've had this dish 3 times. :)  

We had an extended lunch so guess what we opted to do?  We each got our nails done. :)  50,000VND = $2.50 for finger and toes painted!  Megs this is for you girl.

All this is the same day guys.  Went to a talk on Asthma at the Institute of Health.  Did some networking and learned that they learn exactly we learn.  Step therapy etc.  Long day. 530pm home.

 Day 5: Project day.  Spent the entire day laboring over how to translate my lecture on diabetes into Vietnamese!  So I'm fluent in Vietnamese, I really am, but I barely know some of these technical words in English.  Back in the states, we were asked to present in English.  No big deal.  Can do that with my eyes closed.  Diabetes?  I got this!  But at the end of day 4, we were told that on day 6, it is recommended that we present in Vietnamese.  So I spent the day rehearsing/practicing (which I never ever do under any circumstances) and using google translate (which I also never do).

Day 6: Collectively, we presented on the curriculum and pharmacy system in the States.  So well received.  Where pharmacy now in the states is a snapshot of what will hopefully be achieved in these pharmacy student's lifetime and I hope we were engaging and inspirational enough.  I kept going back to the ROLE OF THE PHARMACIST.  I hope I guilt-tripped some of them into it.  Fiduciary responsibility etc... (Ching are you reading this? I used the world fuduciary)

So Kare, Thu and I divided up Hep C, Pneumonia, and Diabetes respectively.  Go figure.  For non pharmacy friends, I want to go into the type of pharmacy called ambulatory care pharmacy. Which essentially is when a patient comes in to see a specialist (i.e. diabetes specialist) for intensive management of their chronic disease states.  Usually it's when a patient is so out of control where physicians say, "I'm not going to tinker with all the meds etc...Defer to pharmacist for 6 months and send them back to me when they're better".  I'm motivated to do this because I've been in a dialysis unit (where your kidneys fail and you rely on a machine to filter your blood for 4 hours at a time 3 times a week).  2/3s is caused by daibetes, 1/3 hypertension.  Most preventable.  So if you're my patient. nononononono. You will not get dialysis.  If I have to walk you through a unit to make sure you gain control of your life, I freakin will.

Day 6: Me lecturing about diabetes.  In Vietnamese!

Ya'll, lecturing to this crowd was difficult for me.  1) not in my native language. 2) culture shock! there's a sense of respect to just sit and listen and not interact much with the lecturer.  I found it very hard to engage regardless of how much encouragement I gave them!

Handmade gift from a student we helped.  Mine is the green one!

 Cute story: we helped edit a student's personal statement, academic statement, etc.... for her application to pursue graduate studies beyond her pharmacy degree abroad and we whipped her stuff into shape.  So as a small token of appreciation, we have these precious keepsakes!

Quan Ngon.  High end Vietnamese restaurant walking distance from school.  Turns out, we're walking distance from huge sightseeing touristy places!  Jackpot!  Because.... that's exactly what I freakin am!

This is a carved out coconut with ice cream in it! <3  Thu looks happy.  

One of the sightseeing places.  Notre-Dame of Saigon

Post office turned tourist site.  I may have written 2 postcards to two special people.  If you want one, PM me your address and I'll spend a buck on you!  I'm planning to go there once a week!  For those of you that don't know, every week, I write a letter of thanks to someone I appreciate.  Want me to write one to you with a wicked picture of Vietnam in the front? :)

My grandma, she totally can walk but not super long distances.  This weekend, we took her to the condo, 40 minute from where she lives and in the evening, by the Saigon river, it's nice and cool and we walked her around for an hour or so.  Change of venue for her.  Relaxing weekend for us.  Got a haircut.  Forgot to take pictures.  I suck. :)

 Week 2: Almost caught up.  Dr. Joseph Bertino a PharmD from upstate NY was gracious enough to volunteer his time to lecture at the school of pharmacy on antibiotic stewardship which is in great need here and is up and coming.  Delved into PK/PD and TDM.  It's just so great to meet other people from back home that feel ya!  Lovely gentleman, will be in touch.  Lectured 2 days straight.

Quan Nem: what we had for lunch.  No regrets.  http://www.travelfish.org/blogs/vietnam/2012/11/29/review-quan-nem-ho-chi-minh-city/

Tomorrow is a holiday.  I will be visiting my grandfather and great grandparents grave to pay my respects.  Will update again later.  It'll take you about a week to read this anyway. Chris, I expect you to read this faster. :)  I miss you all back home and can't wait to get back to spend time with the rest of the people I love--Dan, I'm talking about you man.  I get to spend a few months in San Jose with you! <3  Fatcat, you're out of luck.  Too far.  Just wait for Dan to come to LA.

Leaving you all with a quote: There are only two days in the year that nothing can be done. One is called yesterday and the other is called tomorrow, so today is the right day to love, believe, do and mostly live. -Dalai Lama