PRACTICE PRACTICE PRACTICE

"I feel as if I know so little about medical practice" is a statement I find myself often making to the young doctors at Mercy Medical Center.  They look at me as if I have lost my mind, apparently the wrinkles on my face and hands give away my years of practice.  After this conversation from time to time I will talk for several minutes about the diagnosis at hand and turn around in an attempt to seek out the person who was giving the advice before I realize the words came from me.

In the practice of medicine with the ever changing environment of new studies, new medicines, and new ways of approaching old topics, I feel as if I am on the verge of beginning to understand the entire scope of what practice entails but then an event will take place putting into perspective something I have thought of for a long time.  As I have opportunity to mentor young physicians in Cambodia, I've come to realize knowing much information is important, but as important or maybe even more important is the use of the knowledge.  Helping the young doctors develop a compassionate approach to a patient will help the doctor as well as the patients because as the doctor and patient build a trusting relationship,  credibility is added to the advice given.  The patient begins to open up to the doctor about the previously unspoken concerns and questions. and  as trust deepens between the two, the doctor's medical knowledge coupled with a good history and physical exam leads to a better outcome.  I can only hope to have a small impact on the young doctors by beginning to instill in them a desire to serve their patients.  Knowledge yes, but I hope to encourage them to begin with the patient and not the textbook.

DUSTED DUSTY PUFF

The dusty puff virtually reach dust storm proportions on the road in Chin State.  Our medical team gathered in two twenty year old 12 passenger vans loaded with medicine and luggage.  Even though traveling the roads on the right usually place the driver on the left our van's driver sat behind the wheel on the right facing a majorly cracked windshield.  Having looked up the distance on an internet map I determined the trip was about 90 miles through the mountains.  However, most report about the time indicated the trip took about 6 hours.  We began the trip on a reasonably paved road.  On previous visits we traveled a very short distance on the road to look over the city standing by several monuments thanking God for a safe trip and invoking God's blessing on the ensuing trip.  No other place have been in the world where the vehicles stop allow the road at the beginning and end of a journey raising the expectation of an arduous journey.  A couple hours down the road the pavement gave way to an earthened road on which each vehicle generated several pounds of dust and dirt which was flung into the air creating a dust storm.  You can imagine where the dust settled.  As we traveled to about 7000 feet we stopped and a giant cross inscripted with Matthew 11:28.  Then we continued on the up and down switch back road for another several hours with no evidence of fueling stations.  So when the announcement came for a fuel stop I got out to take pictures of two young ladies holding a fuel topped with a filter into which they poured fuel from a two gallon bucket.  Upon our return we spent two hours waiting for a truck stalled in the middle of the road with a broken axle.  The road was narrow so that no other vehicles could pass.

We stayed in a barebones cabin with a flush toilet with nightly freezing weather without heat.  Daytime warmed to temperatures allowing  one to dress in fairly light clothes. 

At the church the congregation joyfully greeted us, since in time past they would travel on foot and bus up to 2 or three days to visit us.  We felt encouraged by our acceptance and they express appreciation by honoring  us with two chickens and several pounds of rice.  We are grateful to God for the gifts that he gives us to encourage the church in Myanmar