Paper Tiger

July 28, 2011 § Leave a comment

After a month of traveling through Vietnam, we are finally home.

The trip was full of unforgettable memories, stories, personal revelations, and most importantly, adventures. A month ago, we packed our bags and left the States after finishing our first year of medical school. We were so exhausted from finals that we all slept for 12 of the 14 hours it took to fly from Los Angeles to Taipei. An international flight never felt so brief.

We came back refreshed, with new perspectives and new ideas for the future. Some of us even found closure in rediscovering our personal history.

This trip was my second to Vietnam. The first time, in 2007, was two of the most emotionally charged months of my life. During that time, I discovered my true passion in life, came to a decisive conclusion about what to do with my future, and fell in love before leaving the country. My first trip was filled with adventure, but I wasn’t ready to leave when the time came. It was hard to let go of the children I worked with. It was hard to let go of something I cared about so much at such an uncertain time. The death of Thay Hung remains a vivid memory, one that I will continue to cherish and nurture for many years to come as I practice treating my patients with the kindness and compassion he passed onto me. It was difficult for me to leave because I’d rebuilt a life for myself in Vietnam, one filled with purpose and love. I left without any real sense of closure with the promise to return.

What did I learn this time? Well, I found the kind of closure that allows me to sleep at night, a partial solution to years of insomnia I’ve had. I allowed an old wound to heal, as well as a relatively fresh one. The scars of the past are finally beginning to fade.

Just as importantly, the last month gave me time to decompress after the first year of medical school. Change is stressful, especially when you move 400 miles away from all your friends, into a new culture and a new profession that you don’t necessarily fit into. To be honest, I don’t think my personality type belongs in medicine for a number of reasons, but I love what I do, and I don’t do it for respect or money, but because I like to help people. I do it for my patients.

I do it for an older gentleman I met several months ago at mobile clinic: a recent immigrant from Vietnam with no health insurance, no job, and no English. I do it for the old woman I met that same day, who was having neurological symptoms but couldn’t find anyone she could explain them to. I do it for the many older women I meet, who come to this country searching for prosperity and end up sharing a room with a friend in Garden Grove, away from the family, friends, and familiarity of Vietnam.  These women are like my mother, these men are like my father. These children are my sisters and my cousins, their children are my nieces and my nephew. Had my family never had the opportunities and education made available to them after the war, we would have ended up in the same position.

That alone is motivation enough for me to chase the dreams that I believe in.

Secondly, I came to an important revelation about my transition into adulthood. I finally admitted to myself that seven months ago, I was getting ready to propose in an attempt to save a relationship that ultimately failed. I’m no good at failing, and when I do, I overanalyze my mistakes. The revelation I came to was that my American upbringing once again clashed with my cultural values. While American men often prolong their teenage years long into adulthood, idolizing a playboy lifestyle as a mark of masculinity, Vietnamese men are largely defined by their ability to start and raise a family. Nearly everyone I met asked me if I was married or at the very least engaged.

While my Bay Area education has taught me to value gender equality and ethnic pluralism, I have been raised in cultures, both American and Vietnamese, that mark the male identity with irresponsibility and oppression. Caught between cultures, education, and experience, I realize that my sociocultural identity must be defined on its own terms. My world is colored in shades of gray.

By reconciling these conflicting ideologies, I finally developed the confidence and maturity to know deep inside that I have not turned into my father. He was a good physician, but a difficult, abusive parent and a terrible spouse. I have, in many ways, become the opposite (but hopefully, still a good physician).

In the last seven months, I’ve emotionally grown into my role as adult, and perhaps to an extent my role a man, even if that means redefining what either of those things really mean. I realize now that I have a precedence to set for my family, my mentees, and most importantly, my community. I have too big of a responsibility to them to waste my mid-twenties drinking and partying like a frat boy. Someone once told me that in order to lead, you have to walk your own path, and occasionally, you have to walk that path with swagger. After so many years, I am finally ready to walk that path, swagger and all, come hell or high water, because it is an essential part of who I am.

Posted by Dave

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Glimpses of a Beautiful Life

July 19, 2011 § 1 Comment

We are heading back to the states today. A great month, a long month, a fun month – but we’re ready to go back!

This blog, email, and Skype has been great for telling all of you at home about my trip, but there is one person that I really wish I had a chance to come home and tell my experiences to: my grandma. She passed away recently, and it has been one of the hardest things I’ve had to go through. I wish I was coming home to her right now; she would have been so joyful to hear my slightly better Vietnamese, see me in my ao dai, and eat the snacks and goodies I would’ve brought home to her.

I made plans to go to Vietnam this summer right when I started medical school, long before my Ba Ngoai (maternal grandmother) passed away this past March. I don’t remember exactly if I told her about going on this trip, but I know she’s been watching over me this whole time and making sure I am safe, sound, and definitely well-fed, as she had done for me my entire life. I didn’t get sick; I didn’t get hit by any motorbikes; I didn’t get my bag snatched; I didn’t get any food poisoning; and, I even gained a few pounds. Ba was watching over me very carefully and made sure this trip would be a memorable one.

This trip has been a memorable one not only for the medicine, but for the learning experiences. The journey I made from Hanoi to Saigon was sort of like the one she made in her life here in Vietnam, growing up in Hanoi and then moving down towards the South. With each leg of the trip, I couldn’t help but think of her and imagine her life here before moving to the US. Everything reminded me of her, and these past four weeks have made me understand a lot about her life, her traditional values, and her unique, quirky little ways.

Family:
I’ve grown up extremely close to my family (immediate and extended), and I’ve never quite understood why we always did everything together and always had a bajillion family parties and obligations when I was growing up. As a 24 year old, I didn’t get why my mom still cuts my fruit for me and why my dad worries about every detail. After seeing the family structure in Vietnam, I get it now. The family unit is central to Vietnamese culture. You grow up under the care of your parents and grandparents, you live with your parents until marriage, and you are taken care of by your parents way beyond that point, until they are dependent on you as they get older. Depending on the family, you, your parents, your siblings, your significant others, and all your children may all even live in the same house.

Ba Ngoai was all about this family unit, going from house to house to spend time with, cook for, and care for her children and grandchildren. The closeness I have my family stems from her love and her prioritizing of family before anything else. I felt this family love throughout my time here; my extended family in Vietnam treated Dave and me as their children, making it a priority for us to be happy and fed.

Education:
There is little concept of the self-made man, or the “American Dream” here in Vietnam. You either are born into a family with money to provide for you, or you get yourself educated to make a decent living. It’s really difficult to move up in this society. Every time i went to visit Ba Ngoai, she always always always told me to nho hoc doi, which means remember, study hard. I always laughed especially when she said boys were not allowed- school is the priority. Here in Vietnam, I’ve come to understand school is the means to a better life, especially if you started with nothing.

For example, we met a young doctor at Hospital 108, only a year older than us, who came from a very poor town in Central Vietnam. He was doing a fellowship in a very difficult field, Interventional Radiology, before going to the hospital he was placed to work at in Da Nang. Just to get into medical school, he placed in the top 10% of his class and has had to prove himself over and over just to get by. He lives alone in Da Nang, works 12 hour days, and sleeps in the hospital with no A/C, making only $200 USD a month. He barely gets to see his family as they live far away in the poor mountain regions. I asked him how he manages this difficult lifestyle, and he told me that it’s his duty; otherwise he’d be in the poor town, living meagerly, and not being able to provide for his family.

We complain a lot about the rigorous hours of studying, but it’s a means to a stable life. I’m just gonna have to suck it up and keep going on this long, but worthwhile, road.

Closure:
Ba Ngoai, I saw you in the church you were baptized and grew up in. You were kneeling and saying the rosary for all your family. I saw you in the pediatric unit at the hospital, sitting with your sick grandchild fanning her as she cried of a fever. I saw you in the ba ba outfit, sitting in the street shop and selling the goods to make money to feed your children. I saw you in the yellow xoi (sticky rice) that you used to make that I loved so much. I saw you with every dish of cut fruit pushed my way, even when I was really full- remembering that last bag of oranges that you pushed me to bring back to UCI before you passed. I saw you eating corn on the cob in the particular way you do, row by row, each time I passed a corn vendor on the street. I saw you at the Reunification Palace, a memorial of the war, thinking of the stressful journey you took uprooting your entire life and coming to the strange, unfamiliar US for a better lifestyle. You gave up everything you loved to come to America for your kids and grandkids, and I am living a blessed life because of that.

Ba Ngoai, I miss you. This trip has given me a little more closure to your beautiful life. Although I know you’re gone, I know you’re always with me. Thank you for taking care of me along this journey, giving me little glimpses into how your life was here, and helping me to understand more about my Vietnamese culture, my family, and myself. Rest in Peace.

PS. Thank you to my parents, Larry Gold, Van Le, Bac Si Dung and 108 Hospital, and Dave for organizing this great experience and bearing with (the sometimes difficult) me along this journey.

Posted by Cassidy

The Cave

July 18, 2011 § Leave a comment

I am of two minds about Vietnam.

The first is that I’m a foreigner, an American hiding among expatriates in Saigon. I acknowledge that parts of me will never be fully Vietnamese and that coming from a dual culture means that true assimilation into both cultures is impossible. There are aspects of Vietnamese culture that escape me. It is in Vietnam that my personal history and culture collide; can a young person truly be Vietnamese if they have full independence from their family?

In Vietnam, a young man who lives independently, far away from his mother and his long departed father is considered to be a tragedy. Vietnamese linger at home long into adulthood and sometimes beyond marriage, taking care of each other as part of a familial-communal structure that extends back many generations. The Confucian-Vietnamese family structure is everything here; you listen to your elders, your parents, and oblige your older cousins and siblings. Losing that structure means becoming an orphan.

In America, my independence and success is celebrated, lauded as part of the American dream. The fact that a publicly educated young man with little family support and no parents can become a physician is a sign that the American dream is still very much alive. It is alive in me and each of my cousins back home, the children of refugee parents who are becoming doctors, pharmacists, lawyers, actors, and businesspeople. I am, regardless, extremely proud of my education and grateful for the opportunities that could only be offered to immigrants in America.

My solution is to stay close to the Vietnamese community. In brief, you give what you get, and the community has provided me with the structure and motivation to succeed in life. Other Vietnamese families seem to like adopting me. The first year of medical school taught me that without the community, I become depressed and irritable, disconnected by the unhealthy work ethic that is inherent to medicine. My solution has been to stay connected through my community work, which gives me a sense of family when I miss my father or when I miss  Vietnamese holidays simply because I am unaware of them.

The second mindset I have about Vietnam is: I get the sense that Vietnam needs me, almost as much as I need Vietnam. It is here that I can leverage my education, business savvy, and technology knowhow to influence the development of the country. There are times that I am treated as more of a countryman than a foreigner. Doctors, patients, children and street vendors have all reminded me that Vietnam is aware of its own poverty and its future truly lies in the hands of Vietnamese from abroad, who have the money, education and influence to change the direction of Vietnam. Life in America simply isn’t as good for Vietnamese from abroad.

It is true. My community work in America will prevent me from obtaining great wealth, which for the most part, I’m fine with as long as I have a roof over my head and food on my plate (because there were times I had neither). I don’t think of it as much of a sacrifice, because I know that people in Vietnam live on much, much less. As a future primary care physician in the US, I know that I will make less money than most of my peers. I will have to pay high malpractice insurance rates, follow the legal limitations of whichever bureaucracy I end up working for, and eventually, I will get sued by a patient for unforeseen reasons. After 11 years of education, from college to medical school to residency, I will owe at least a quarter million dollars in loans. The only way to escape this trap, it seems, is to work for a private insurance company such as Kaiser, which will offer me more legal protection, benefits, and a higher salary than the public sector.

I am forced, it seems, to choose between public and private practice. I feel it would be a grave injustice if, as a publicly educated child of immigrant parents who found success in America, I left to work in the private sector. In America, I feel that I can make a bigger difference by working in the community.

But what about Vietnam? The hospital I worked with here has only one lawyer and there are only a few pages of medical law applied to the whole country. True, I won’t be paid as well as in America, but the lifestyle here will be better for me. The quality of care is not as high as in the States, but I’ll be able to help many, many more people. With the power and influence of an American physician, I have a chance to affect the public health outcomes of millions of people. It occurred to me that I could seamlessly integrate public health and community health into my practice here, a fact that I constantly have to defend and fight for in the highly privatized and flawed American healthcare system.

Several months ago, while waiting for an elevator in the California’s State Capitol, I was told by a member of the California Medical Association, “Good luck!” in lobbying for statewide universal healthcare. He was being a dick. He was there to lobby against the same bill, and it was clear that day that there was very little a group of poor medical students could do against the wealth and lobbying power of the CMA.

In Vietnam, the government is starting to listen to NGOs, the CDC, and the World Health Organization. Public health education is being implemented – having been here four years ago, I can attest that while the government is still corrupt, the country is developing at a rapid rate and its healthcare system is beginning to change for the better. Despite doctors not making as much money, they treat more patients with fewer liabilities and a cost accessible to even the poorest of Vietnamese.

In Vietnam, I hear stories about foreign nurses and physicians who implemented vaccines that saved millions upon millions of lives. Something as simple as a Vitamin K shot can prevent hemorrhagic disease of the newborn by allowing stable clots to form despite a malnourished pregnancy (this has been done, and indeed, it was implemented by a Vietnamese-American physician who saved millions of lives).

The next big challenge? It should be possible to implement a Hepatitis B vaccine. It would be extremely expensive, but considering that at least 20% and up to 40% of the population has Hepatitis B, and up to 70-80% will develop cancerous tumor growth in their lifetime, it would be worth it. The effects are readily tangible and the cause is more than worth fighting for.

At the same time, I have a community of orphans here who need me, perhaps as much as I feel I need them. They ask when “Chu Loc” will return. This time, I was reintroduced as “Dr. Dave”.

I realize now, towards the end of my second trip to Vietnam, that the country will play an important part in my future and I hope I can do the same in return. I don’t plan on moving here permanently, probably not even for the longterm, because I miss the basic sanitation and creature comforts of America. It is possible, however, to come here and work for a few months out of the year, after I get my doctorate and pay off all my debts in 15 years or so. After all, Vietnam is the place that made me decide to become a physician. Ironically, it was also where my American dream was conceived and where it continues to develop and morph into bigger, better plans.

Posted by Dave

Whirlwind

July 15, 2011 § Leave a comment

Four cities. Five days.
It’s been hard to get a chance to update with all the activity, but here’s a quick recap of the last few jam-packed traveling days.

Da Nang:
Leaving Hanoi was bittersweet, but it was time to go. We hopped on a quick flight down to the city of Da Nang, one of the up-and-coming cities in Vietnam with its many luxury resorts and beautiful white sand beaches. We checked into our hotel, Sandy Beach, where we were grateful to find some of the things we’ve been missing: a nice shower, clean sheets, and a place to relax. There was an incident with a gecko where my fears got the best of me…(see above)

Hoi An:
We only had a half day in this small city, so we tried to make the most of our time. Hoi An is of the most beautiful in the country, as it is known for its mix of French, Chinese, and Japanese architecture, its picturesque setting along the river, and its fabrics and tailoring. First item on the agenda was finding fabrics. Dave got a couple pairs of perfect CF pants tailor made, while I went searching through at least 20 stores for fabric for an ao dai, the traditional Vietnamese dress. After this frantic search, we were able to finally enjoy ourselves and stroll the city. Hoi An is even prettier at night, as lanterns light up the bridges along the river. We sat down at one of Dave’s favorite restaurants, Mango Rooms, and took in the beauty of this quaint little city.

Hue:
After a 6am sunrise swim at the resort, we ventured to Hue, the former imperial capital of Vietnam. We visited Doi Nam, an imperial complex where centuries of emperors lived and ruled. Most of the complex is undergoing restoration, but you can really appreciate the beauty of the imperial architecture juxtaposed next to beautiful ponds and trees. We also visited Thien Mu Pagoda and the Mausoleum of Tu Duc, both very stunning sights. The only downside of the day was the intense heat – almost 40°C (over 100°F).

Buon Ma Thuot (aka Ban Me Thuot):
Every person we’ve met here has asked us, “Gia dinh que tu dau?” which translates into, where do your family roots come from. This question is an important part of every Vietnamese family’s cultural history. My dad grew up in Ban Me Thuot, a city in the central highlands of Vietnam and the country’s coffee capital (a point Dave was very excited about). It was natural for me to go visit, as I have an aunt who has a family and a business in the city. I got to see some of my ancestors’ graves, the house where my dad grew up, and spent some time with cousins I had never met – seeing these things helped me get a sense of my dad’s family and their history.

We got to climb scary bridges, ride elephants, drink lots of coffee, visit ethnic village houses, and sing karaoke. Dave and I got to get a feel for some local life as well as we got to ride (and practice driving!) motorbikes. I also used the fabric I got from Hoi An to make two ao dai, which will be worn for Tet or a special occasion.

Only have five more days left! Off to a very busy couple of days in the biggest, craziest, most hectic cities in Vietnam: Saigon. Hope we make it out alive…

Posted by Cassidy

Golden Moments

July 12, 2011 § Leave a comment

Traveling together gives new opportunities to realize how dorky your classmates actually are. Translations, mistranslations, and mishaps happen all the time around us because of what we assume of others and what they assume of us. The most important thing we’ve learned to do is enjoy these golden moments for the laughter they bring us.

The following is a series of random quotations and hilarious moments that had us laughing (or crying).

At the hotel…

CV:      [runs into fence on way out] S#@&!
CV:      [runs into fence on way in] TWICE, WHY!? S#@$!

While eating fruit…

CV:     You’re going to have to be a woman and cut the fruit for me.
DT:     Okay, you wash it and I’ll cut it.

(Later)

DT:     … Want another slice?
CV:     I’m an independent woman, I don’t need a man to cut my fruit for me!
DT:     >.<

After the beach…

DT:     [rinsing sand off legs with a coconut ladle]
CV:     [holds out leg]
DT:     Wash your own damn feet, woman!

Buying sightseeing tickets in Hue…
(in Vietnamese)

DT:             2 adult tickets please.
Vendor:     For Vietnamese or for foreigners?
DT:             Vietnamese.
CV:             Vietnamese.
Vendor:     [points at Cassidy] You’re a foreigner! That’ll be 55.000 VND.
CV:             No, I’m Vietnamese!
Vendor:     No, you’re not! Nice try.

DT:             Okay, okay! [hands over 110.000 VND]
Vendor:     [hands DT back 25.000 VND]
DT:             [confused]

Vendor:     Sir, your ticket is 35.000 VND. Her ticket is 55.000 VND because she is a foreigner.
CV:             >.<
DT:             [bursts out laughing on way in]

Getting rid of geckos in the hotel room…

DT:     I don’t want to kill it! It’s okay, they’re harmless.
CV:     They’re going to crawl into my mouth while I’m sleeping like in Parent Trap!
DT:     Only to lay eggs…
CV:     [look of horror]
DT:     [spends the next 30 minutes taking apart hotel room to search for runaway gecko]

In the rain…

DT:     [unsuccessfully closes umbrella, which pops open four or five more times.]
CV:     [bursts out laughing while watching DT fight with umbrella]
DT:     [yelling at umbrella as he sets it down, fully closed]

Posted by Dave

Peanut Butter Jelly Time

July 11, 2011 § 1 Comment

After three weeks in Hanoi, I believe we ate, saw, and bought everything that Hanoi had to offer. We walked up and down every street in the city center at least twice, circled Ho Hoan Kiem at least a dozen times by foot or taxi, and even began to look like the locals -Nguyen and Dave, that is. (I’ve been told multiple times that I look like a nguoi lai (mixed blood) or nguoi Tay/Duc (French/German blood). Starting to take offense to this – I’m full Viet!)

Three weeks came and went quite quickly, but we were ready to move on from this great experience at 108 Hospital. We have been treated so well by the hospital, by our relatives, and by the people of Hanoi. Nguyen went home back to California for her sister’s wedding, while Dave and I were very excited to begin our ten days of travel down south to see the rest of the country.

As much as we are enjoying this experience, there’s really no place like home and its many comforts that we tend to take for granted. Three weeks has made us a little homesick, and we concocted a list of what we cannot wait to get back to after our travels. It also shows how different life is here.

What we miss about the USA (in no particular order):

  1. Two-ply, soft toilet paper
  2. Cheese
  3. Seatbelts
  4. Clean, non-polluted air (yes, this is coming from an LA girl)
  5. Purified tap water
  6. Mexican food in every form
  7. The gym
  8. Mindless, trashy television
  9. Trash cans
  10. Gender equality
  11. Silence
  12. Martial arts – a la Dave
  13. Peanut butter and jelly sandwiches
  14. Obeying of traffic laws and crosswalks
  15. Paper towels and hand soap
  16. Memory foam and soft pillows
  17. Cafe Med Chocolate Muffin – a la Dave
  18. Broccoli
  19. Waffles
  20. The concept of lining up and waiting your turn
  21. Google Maps and Yelp
  22. Granola
  23. The same prices on food/drink regardless of whether you’re a tourist or not
  24. And of course, our family and friends

America. Nothing like it. It’s the land of the free and of the awesome.

Sidenote: For the 4th of July, we dressed up in our red, white, and blue, went to an American bar in Hanoi, and feasted on beer, burgers, fries, nachos, and apple pie while listening to some Springsteen. God Bless the USA 🙂

Posted by Cassidy

Sunrise in Da Nang

July 10, 2011 § Leave a comment

20110711-055702.jpg

After three weeks in Ha Noi, we left the city to travel through the rest of the country. We said our goodbyes to Chi Xuan, Thay Dung, and the hospital’s director before heading off to the airport. They’ve been incredibly generous in showing us around and connecting us with everything we could possibly ask for.

And so Part II of our adventure begins: Hue, Da Nang, Hoi An, Buon Ma Thuot, Sai Gon, and My Tho. After a brief flight to Da Nang and checking into our hotel, the Sandy Beach Resort, we spent the day wandering my favorite city in Vietnam, Hoi An.

This morning, this is what we woke up to from a beautiful beachfront room.

Posted by Dave