Eastern Thoughts

Make a difference Continued

2009-03-29T11:52:00.004+08:00

Thank you to those that have called me out for not continuing to post my daily "Make a difference." It can get away from you if you do not take the time to write things down daily. I also must admit that my focus has waxed and waned throughout this time period. It is hard to stay motivated to make a difference in others lives. I think this is especially true when you are not taking time to focus on God. At Bible study this past week, I was challenged to spend daily time in prayer. The study had me verbally admit to the reasons why I don't pray. For me it was not wanting to have to face God with the repetitive sin that is in my life. My head tells me that He already knows and that He loves anyway, but my heart wants to ignore the sin, thus not pray.

But enough on that topic. Here is the update on my make a difference. To some, even myself, it may seem like a list of common things, things I "aught" to do. But I feel I must start somewhere, and this is where I have started.

Day 6 - Kim served me, I had just finished finals, (at 11:23 pm Friday night) and she allowed me to relax during the day

Day 7 - Called and wished my grandfather Happy Birthday, Ella and I sang to him.

Day 8 - Took Luci to the Doctor for her regular check up, so Kim could stay at home and watch a friend's kids.

Day 9 - Took care of the girls while Kim got her hair done.

Day 10 - Took care of the girls while Kim worked on "Earn While You Learn" for the pregnancy center.

Day 11 - Partook in Global TB Day activities on Capital Hill, took care the girls while Kim had mom's night out.

Day 12 - Picked up my brother-in-law and sister-in-law from the airport.

Day 13 - Did our taxes, God made a difference, We don't own near as much as I thought we would.

Day 14 - Spent time building relationships with my brother-in-law and sister-in-law while in DC

Day 15 - Ran at my wife's running pace (she is pregnant, so it was a little slower than my usual pace).

Day 16 - Called to wish my dad a happy birthday. His day was rough, he had a friend/employee pass away

Day 17 - Put the recycling out (made a difference in the environment!)

Day 18 - Helped an undergraduate student with her term paper

Day 19 - Kim served me, she took care of the girls while I participated in advocacy training for universal health care coverage.

Day 20 - Encouraged Ella during her ballet recital

I am half way there and I already feel that I have gotten laxed in my mind set. I have seen how others have remembered Mrs Glass and it challenges me to keep going on this adventure, to look for the "out of the way" difference I can make in others each day. Also, to keep God at the center of this and not me. (This is much easier said than done!)

Make a Difference Update

2009-03-13T23:40:00.004+08:00

At my wife's suggestion, I am going to update my blog weekly with the list of Make a Difference from the prior week. Here is the rest of this week's list.

Day 4
Gave a Friend a ride and was a listening ear
Day 5
Took care of the girls while Kim volunteered at the Pregnancy center

Make a difference Challenge

2009-03-12T01:57:00.003+08:00

Some Background

This week has been finals week, and I have found myself with my head glued to a computer screen writing and studying. In the mist of this I realized that I am being so self-indulged, spending almost any time I have had away from family, friends, and my faith. This school year has been great, learning health from a completely different perspective compared to clinical medicine. But I find myself missing the opportunity to meet people in their time of need and "make a difference."

Recently I watched the movie Fireproof. In it, the main character takes a 40 day challenge to love his wife. Each day adds a new way to display his love. After getting some feedback on a facebook status this week, I have decided to make a 40-day "Make a Difference" challenge.

What It Entails
Making a difference can be small or large. It can be showing love to your wife or family. It can be picking up litter on the street or giving the random compliment. The key is that it is intentional. Everyday purposefully making a difference!

Some days it may be me that needs a difference made, but as often as possible it will be others. My intention is to keep an updated list of the ways I made a difference here, not to boast in pride, but to have others keep me accountable. Secondly, I hope to pass on my challenge! Note what today's "Make a Difference" is and pass it on!

Will you take the Challenge? Let me know. Let others know.

Day 1
Gave Kim a back massage and brushed her hair before bed.
Day 2
Took care of the kids while Kim worked on Earn While You Learn program for our local Crisis Pregnancy Center
Day 3
Challenged others to Make a Difference
Day 4 ....

Man, I got a great wife!!

2008-07-24T02:38:00.003+08:00

So, I have been engulfed in studying, for Hopkins MPH, Hopkins Preventive Medicine Residency, and Family Medicine Board review. I feel like I am in medical school again with the amount of my time dedicated to studying/classroom work. I come home spend a few hours with Kim and the girls, and then more studying. She is supporting me with such an amazing attitude. I have had such little time for one-on-one time for Kim and I. Yet each day she seem to show me respect/love in a different way. I can't say it enough, that God is Good and he blessed me with an amazing wife.

Graduation and the trip East

2008-06-29T20:26:00.007+08:00

Traveling east again, this time not to China, but to Baltimore - The next 2 years will be on the East Coast, who would have thought. Johns Hopkins here I come!! The Van ride here was a little crazy, but I don't want to steal Kim's thunder on this one, check her blog out for more details. I can't believe that my time in Glasgow is up. I have actually completed my family medicine residency!!! I will miss all those I have grown to love in Glasgow! Below are some pictures from the event.

2008-05-01T10:45:00.004+08:00

11 hour days, plus studying in the evenings x6 days, ulgg. This is my jumping off point for studying for my Family Medicine Board Exam. I will be taking it toward the beginning of August. It is good that I am doing this with a couple of my residency buddies, Ryan and Rob. They help me stay focused. Only a couple of more months of this residency and then off to Baltimore, wow time flies!!

My Trip West, (unfortunately, without Kim)

2008-04-27T11:59:00.002+08:00

Towards the beginning of April I presented a poster at Global Health Education Consortium Conference. While in Sacramento, I took a couple of small road trips, one to San Fransisco and the other to Lake Tahoe. Kim had the digital camera, but I did buy a disposable one. Here are some of the pics from San Fran. Kim helped me add effects to make them look much cooler. Sadly , Kim and the girls did not go with me. After our time in China it was just more than our budget could handle.

The Golden Gate

Alcatraz

A picture from the widow of a trolley.

Mennonite Communitiy

2008-03-26T10:39:00.004+08:00

Kim reminds me that it has been a while since I have placed a new blog. So I thought I would mention my experience today. I had the opportunity to be apart of medical education and see patients in a local Mennonite Community. This community is a very conservative order of Mennoite, no running water, no electricity, no zippers, no photos etc. Each month a group of Western Kentucky University Nursing students, University of Louisville Physicians and retired local physicians give a medical lecture/discussion time and see patients from the community. I grew up having Amish as neighbors, so it brought back memories of my childhood watching them from a far as they harvest the corn in the field across from our house. I recall a few occasions that we actually went inside one of their homes, but not in much detail.

I spoke on seasonal allergies, with a few questions about food allergies. The intelligence of their questions were great. They wanted to know western medicines as well as herbal/natural treatments. I enjoyed my time immensely. I hope I have an opportunity to go back before I leave for Baltimore. I had an interesting discussion with one of the men. I mentioned that I was in China last month for 5 weeks and he became excited and began asking me questions about my time there. When I told him I was in Macau, he knew before I could even speak that it was a former Portuguese colony and the oldest European Colony in China. This completely caught me off guard. Most people I have talked to have never heard of Macau, let alone know the facts he so quickly rattled off. Come to find out he is a convert to the Mennonite faith. He used to be involved with international business.

How amazing to go from a completely different culture half a world a way one month and visit another completely different culture 30min down the road!!

Check out this link to learn more about Mennonites and how worldwide spread the faith is!

Getting Back to Business

2008-03-06T02:01:00.002+08:00

I think I am finally getting over jet lag. Although, I still get tired in the afternoon and want to take a nap. I have been blessed with having sometime this week to get caught up on all the paper work and messages that have occurred since I was gone. I will start seeing patients tomorrow. These past couple of days have given me a chance to spend a little extra time with my girls (Kim, Ella, and Lucy) and spend a some time in reflection about the last 5 weeks. People have asked me, "Was it worth it?" "Any interesting medical cases?" "Are you happy to be back?" "What is the thing you missed most about America?" "What was the food like?"

It is hard to know where to start. How do you sum up 5 weeks in just a couple of sentences. Yes I am glad to be back, but yet I miss the relationships started. I see these next few years as a critical time for Hope Medical and Macau with opportunities. Because of the continued boom in the casino industry, Macau is in the Christian sense, "Ripe for the harvest." Parts of me want to stay and be apart of it. Yet other parts of me realize that Hope Medical has two more doctors joining their team later this year and currently my skills do not fill any particular needs gap in the team. I can't say God is not calling my family to Macau, but I can say not now. I will keep tabs on the happenings there and see what happens after my time at Johns Hopkins.

In the mean time, I must gear myself up for the remaining 4 blocks of rotations that finish up my Family Medicine Residency and get prepared for my time in Baltimore.

We are finaly home

2008-03-03T16:31:00.004+08:00

Well, after a 13 hour plane flight from Hong Kong to Chicago, a 2.5 hour layover, 1 hour on the plane to Columbus while waiting for repairs to the toilet and 1 hour actual flight to Columbus, we arrived on the ground. Kim, Lucy and I were reunited with Ella and our extended families. We slept the night and part of the day at my parent's house before making the 6.5 hour drive to home in Glasgow. We arrived here just before 1AM. Luckily our bodies still feel like we are on Macau, China time, so staying awake to drive was no problem. Now I must ready myself for work this week. The stress of planning for the next stage in our life journey in Baltimore begins. Thanks for following my trip, it is a one I will never forget. I look forward to seeing how God uses the experiences Kim and I had in the future. I will try to keep my blog going. The frequency of the posts may slow down. Thanks for all your prayers. I hope to catch up with many of you in person and share more about the medial and Christian work I did in Macau.

Lastly, during my trip I spent some time with other ex-pats, a couple of whom were from New Zealand. They introduced me to rugby and the Super 14 league. I even signed up for fantasy rugby. Check it out. The last 2 weeks I have done pretty well for not knowing much about the sport.

A gift for Lucy

2008-02-29T12:48:00.005+08:00

The staff, as a sending off present, got Lucy a bee outfit and bunny slippers. She looked so cute in the bee suit. The staff all got pictures with her . She managed to smile rather well with each of them. Afterward she fell asleep in Kim's arms right away. We have truly enjoyed our time here and will miss all the our new friends.

Time Winding Down Here, But Still Trying New Foods

2008-02-26T22:30:00.004+08:00

Yesterday Kim helped pass out Bibles to tourist at a local attraction. We had lunch with the team doing the Bible distribution. And yet again I got the chance to try new foods. Including one that I will never try in America..... chicken feet. I have heard through Kim that many of you enjoy my pictures of the interesting food I have tried, so here is one more.

Visa Extended!

2008-02-25T17:57:00.002+08:00

So I found out today that they did extend my visa until after I leave this Saturday. Thank you for all your prayers. It is hard to believe that I am leaving in less than 1 week. It has been so good to be here. I have met so many great people and learned so much about the Chinese culture and medical issues. It will be hard to leave, but I do really miss Ella and can't wait to see her.

Enjoying Time with Family

2008-02-25T11:54:00.004+08:00

This weekend has been mostly rainy or gray skies. But it did not stop us from enjoy spending time together and seeing some of the sites. When it rained on Saturday, we went to the Venetian. It is a Casino, convention center and shopping complex. When they finish construction it will also have a wave pool. We spent 2-3 hours there and only saw about 1/3 of the complex. If you have read Kim's blog you have realized how much of a hit Lucy is here. All the women want to hold her and at one of the local restaurants a waitress fed Lucy her first taste of white rice.

From my time in Hong Kong

2008-02-23T10:12:00.008+08:00

Here are some of the pictures of my time in Hong Kong. It is so different than Macau. The buildings are much taller and more modern. It has less of an European influence to the architecture.

Inside the Temple dedicated to the god of war and literature, the haze is from the incense burning.

Meat anyone? It is from the local butcher.

From The Peak. The Hong Kong skyline is amazing!

Kim and Lucy are here!

2008-02-22T16:33:00.002+08:00

Well after many hours on the plane and about 45 minutes looking for me, Kim, Lucy and I met up in the Hong Kong airport. Lucy did rather well on the plane, she slept for 6 hours straight. Kim was blessed by having three empty seats next to her (the only ones on the plane) God is Good!! Kim and I met up at the pay phones. We were both trying to call the Morgans to see if they had heard from either one of us. But before I figured out the phone number, I spotted Kim. Thankfully Kim was not too stressed. I enjoyed the time before picking up Kim by exploring Hong Kong for the day. I will put some pictures up tomorrow. Today I went down to the immigration office to apply for an extension of my tourist visa. I was only given 30 days upon arrival and hoped that by visiting Mainland China and Hong Kong they would extend this, but no such luck. I will find out on Monday if they will give me a 6 day extension. The adventures never end!! The good thing is that now they include Kim and Lucy!!

Patient Care

2008-02-21T09:55:00.002+08:00

One of the patient care aspects that has surprised me is that I have had a fare percent of the patients I have seen want to come back and see me for their next visit and make me their doctor. For the quick follow up visits, I have actually done this for a few patients. One actually brought his friend into see me. The others I have had to say with disappointment that I am only visiting and they will have to follow up with one of the other doctors. I am also surprised with the amount of prenatal care done here. The clinic doctors do not delivery, so I assumed this would be a small part of the practice. But because there is only one hospital that does OB here, many immigrant works and westerner do most prenatal care here and then decided if they are going to go back to their home country to deliver, deliver in Hong Kong, or stay here in Macau.

PS I just got word that Kim did make it on the plane flying from Chicago to Hong Kong. I am getting ready to leave to meet her in Hong Kong!!! YEAH!

Interesting Resource

2008-02-20T18:09:00.002+08:00

For anyone interested in getting a Chinese background to their culture and how it relates to medicine check out this site from NYU. Not only does it give cultural info, but helps teach you basic Mandarin or Cantonese, especially language needed to conduct a medical interview. I have added it to my list of interesting sites as well.

Excited to See Kim and Lucy, Just Not Yet

2008-02-20T10:14:00.003+08:00

So Kim was supposed to leave on Tuesday, but when she got to the airport, she waited ...waited...and the plane never arrived. There were mechanical problems and she was not able to make her connection in Chicago. Instead of seeing her today, I will have to wait and she will try it again tomorrow. At least she is able to stay with my parents and see Ella for one more night. The sun is shining so bright here today, it makes it hard to go to the clinic when I was supposed to be off to pick up Kim. Well hopefully tomorrow I will see her and Lucy.

2008-02-19T09:21:00.002+08:00

One of the components of Hope Medical is a palliative care team. Most of the work is done by social workers, some nursing and some doctors. Many participants are prior patients of Hope Medical Clinic, but some are through connections in the community. The government hospital just opened a cancer/palliative care unit. While Kennis, a social workers, was visiting one of our patients in the hospital, she met the boy below in the black baseball cap. He has a spinal tumor. He was all alone at the time, and she started talking with him. She found out that his birthday was coming , he was going to turn 19. His mother works nights and his father works days. So he does not get a chance to see them much. Kennis decided to throw him a birthday party. I was honored to be able to come along. She brought cake, and cookies. One of the residents, Eddie, came and played guitar and some of the people in Kennis's church came to help celebrate. A few of the nurses from the Hospital joined and even one of the doctors. You could tell that he really appreciated it. Please pray for him, because he was told that the radiation and chemo treatments were not controlling the cancer, and surgery will be needed. I am not sure of his faith, pray for that as well.

The one in the black baseball cap is the birthday boy, the one next to him is his roommate in the hospital, he has cancer too.
Kennis is the one with short hair on the right in the back. The other girls in the picture are his sister and her friends.

This is a picture of the church members, Eddie who played guitar for us, and Kennis, who organized the party.

Teaching Moment

2008-02-18T09:02:00.003+08:00

One of the medical opportunities that I did not expected to have here is precepting other resident physicians. For those of you not in the medical field, a preceptor is a more senior doctor that serves as a teacher/adviser to the younger resident physicians. usually the residents will see the patient in the room, then present the patient's history and physical exam findings to the preceptor. This gives the resident physician an opportunity to ask questions and learn about possible treatment options and possible diagnoses. This is true in the United States as well as here.

Now with that background. Last week I was precepting with one of the 1st year residents. She wanted me to come look at her patient's throat. Earlier in the week another resident had diagnosed her with strep throat. She did not get better, so she returned to the clinic. I looked at the back of the throat and saw what looked like oral thrush. (yeast infection in the mouth) I was able to discuss with the resident about potential causes of oral thrush in an adult. She obtained further history and found out that the patient had been taking an inhaled steroid for her asthma. If you do not rinse your mouth out after using an inhaled steroid a person can get oral thrush. Some of the younger residents did not know this and I was able to show them the thrush and discuss the appropriate treatment. It energizes me to see others be so excited about learning, especially when I am the one teaching.

My First Hot Pot and So Far So Good

2008-02-15T11:09:00.007+08:00

So last night a number of the single people in the clinic went out to dinner for "hot pot" in celebration of Valentine's Day. Myself and Dr. Kwan were invited along since our wives were not here with us. In case you are like me and have never experienced Hot Pot, it is when you order meats and vegetables from the menu, they come to your table raw and you cook them yourself in a boiling pot of soup in front you. The key is to make sure the meats are completely cooked as to not get diarrhea from ecoli infection. I had a great time. Unfortunately, my camera ran out of battery early in the evening, so some of the most interesting foods I ate I did not get pictures of, but these will give you the idea. I had beef, lamb, pork cut thinly as seen on the plates below. I had fish, shrimp, and lamb make into balls. I had cow stomach. I had many types of vegetables of which there is not an equivalent found in the U.S. The great thing is that it has been over 12 hours since ingesting the food and no diarrhea or stomach cramps yet!!

This was the name of the restaurant. It is a restaurant chain.

This the different types of meat, pork, beef, and lamb

The elements of fish balls, what you do is take a clump of the fish meat and plop it into the boiling soup in front of you.

You can some what see the pots in the picture, but the meat goes in your own personal Hot Pot. The Key is to make sure it is fully cooked before you eat it.Yes this is Cow Stomach. It does not have much taste, just very rubbery.

Born in the Year of the Horse

2008-02-14T18:14:00.003+08:00

I found out that I was born in the Chinese Year of the Horse. Just for fun I looked up the characteristics of the horse on the internet. This is what I found:

Horses are hardworking people who are generally well liked and admired. As well as working hard, they play hard.

Horses are independent, and are well known for their individuality. They intuitively gravitate towards tasks to which they are well suited. This, together with their hard working nature invariably leads to success.

The horse is a strong masculine sign, and both male and female horses are fairly laid back and easy going, while at the same time being direct. Asked for an opinion, the horse will give it, and where factual matters are concerned, the horse is a good source of reliable information.

The horse is a placid person; however, if their passions are brought to the boil, the result is not easily forgotten - wild horses are hard to calm down. In the home the horse is a steady partner, although they are likely to give as much attention to their work as to their families. Horses easily fall in love, but there are many passing relationships before a long-term partner is found.

Oddly enough, this description matches me rather well.

Question about Antibiotics

2008-02-14T16:22:00.002+08:00

In my last posting, one of my family left a question regarding the use or misuse of antibiotics here in Macau, I thought others would enjoy my response as well. This was her comment, "Question for you: There is so much in public health here about washing hands and the use (overuse) of anti-bacterial products. How does China deal with this? Do they promote the use of all these anti-bacterial products? Do they have the same resistent bugs that we face due to the use of anti-biotics?"

My response: In Macau and Hong Kong I have seen advertising on tv and on street signs that stress the importance of taking antibiotics only when a doctor prescribes them and to finish the complete course of antibiotics when they are prescribed. Here it is not necessary to have a doctor prescription to get most of the drugs from a pharmacy on the street. Only narcotics and addictive types of drugs are restricted. The problem is that some pharmacies have been known to either dilute the medication or switch the medication with a cheaper version or a substance that is not even close to the original drug. So most doctor offices have a pharmacy within the office. This provides more trust to the quality of drugs given. The mind set towards taking antibiotics is worse here than in the States. They feel that they should be better in 2-3 days from any illness after seeing the doctor. So if they do not feel better they go back to the doctor, if they feel better, they stop the medicines. As far as anti-bacterial creams/form/gels they are not really used here. Although more people wear medical masks. Some of the doctors here say this is left over from the SARS epidemic.

So far MRSA has not been seen wide spread in the community as it is becoming in the U.S. I am not in the hospital setting, so they may have hospital acquired MRSA and other resistant bacteria present.

Clinic work

2008-02-12T13:21:00.000+08:00

Patient load in the clinic has picked up now that the main part of the Chinese New Year is over. The actual new year celebration lasts 2 weeks, but gradually the city is coming back to life and more shops are re-opening. Yesterday the clinic saw just over 100 patients. We are on track to see about this many again today. This afternoon is dedicated to lectures for the residents. A couple of the attending physicians cover the clinic during this time. I will be team teaching suture technique today. Peter Kwan, who is on faculty with Herman Memorial Family Medicine Residency in Houston, is the other facilitator. We are using pork of some kind. The residents assure me that none of it will go to waste after we are done. They plan on removing the suture and taking the pork home for dinner.

Church on Sunday

2008-02-11T18:55:00.000+08:00

Currently, I am reading Hudson Taylor’s Spiritual Secrets. It is an amazing account of his life and work in China. It has really spurred me on to pray for the people of Asia even more. At Church on Sunday, I met a rather new believer named Jeevan. He is a security guard at one of the casinos here. He is originally from Nepal. The casino business is bringing in workers from many parts of Asia. Macau is becoming very fertile ground for the harvest. Lift up the current workers that they would be strengthened and encouraged during the next 5-10 years as more and more Asians come to Macau for work in the casinos. Just as Jeevan, may they be inspired to return to their home countries and share their new truth with their family and neighbors.

Fishing across the border

2008-02-11T16:10:00.000+08:00

A number of the staff at Hope Medical visited the Place family in Zhuhai, just across the Macau/China border. We took the children fishing at a local pond. Zhuhai is different from Macau. The streets are much wider and it has wide sidewalks. The city is not land locked by the sea like Macau, so at the edge of the city are fishing ponds and vegetable farms. After fishing, I went to a Chinese spa and had a foot massage. For 1 hour it was 50 patakas, which is about $8 US. It was intense, okay sometimes it actually hurt, but in the end my feet were much more relaxed.

The Old Border Gate. Now it is much bigger.

Ben is a ENT resident at one of the hospitals in Macau, he is engaged to Cynthia, one of Hope's residents. No one had luck catching the fish with poles. Some of Dr. Place's children netted a number of fish.

Don't worry, I did not eat any of the fish that were caught.

Along the pond were fields of vegetables. Here is their "automatic" watering system.

New Year Dinner

2008-02-08T13:18:00.000+08:00

I was honored to be invited to the home of Candy's parents for a tradition New Years Meal and family celebration. (Candy is Eddie's girlfriend who is one of the resident physicians at Hope) I was the first foreigner who has visited their home. They spoke some English, but most of our communication came through Eddie and Candy translating. I had a great time and was filled to the brim with good home cooked food. I learned a lot about the history and types of Chinese tea. Her family was very gracious to me. I learned a few New Year sayings in Cantonese. They appreciated my effort and I appreciated their grace in my poor pronunciation. Below are some pictures from the night.

From Left to right, me, Candy's Mother, Candy's Father, Candy, Eddie is taking the picture

Cucumber dish with mushrooms. It is very difficult to make. And very difficult to eat with chopsticks if you are only moderately practiced with them.

Spicy Pork with Celery, My favorite dish of the evening

Glutenous Rice with peanut and sesame seed filling. Served warm as the dessert. It is tradition to eat this with your family on New Years Day.

A Few Pulbic Health Topics

2008-02-08T10:49:00.001+08:00

As many of you know, I have an interest in Public Health. So I have been mindful of the different ways that Macau informs the public on health matters. When I get back I will have share in more detail the different formats that I encountered, but here are a few pictures. The first is an example of how exercise is promoted. In most of the parks there are at least 3-4 exercise machines. The last two pictures are of a poster advertising ways to avoid getting and spreading avian bird flu. These are posted in public areas around the city.

Lion and Dragon Dance

2008-02-07T13:04:00.001+08:00

There have been many activities to celebrate the Lunar New Year. Here are some pictures from the Lion and Dragon dance.

Happy New Year's Eve

2008-02-06T13:03:00.000+08:00

Today is the last day of the Chinese Lunar Year. Follow this link to see some of the activities planned for the City of Macau. Click here to learn more info on the Chinese Lunar New Year. I will try to get some good pictures to share with you all as I visit the different celebrations. Currently we are finishing the year of the pig and we are entering into the year of the rat.

It may not look like it, but I am doing Medical work too

2008-02-06T12:39:00.001+08:00

I realize that a majority of my blog has focused more on the extracurricular activities and experiences. I have been doing medical work as well, really. The clinic in general has not been as busy as I expected. Part of it is that there is enough staff to see their current patient load. The other issue is that it is bad luck to be sick near/the beginning of the new year. We did have a rather busy day on Monday, we saw just over 100 patients. On average the clinic sees roughly 60 pt's per day. The numbers for this January were up 25% from this time last year. The leadership here feels that with the continuing boom of the casino industry the patient load will only increase. Majority of the illnesses here are similar to that of the States. I have seen alot of URI, acute bronchitis, flu, and ear infections. Conditions like T.B. are much higher in our differential here, we have placed a number of ppd's. (a way to test for tuberculosis) None have come back positive yet, but I am sure we will have at least one case before I leave. About 25% of their patient population is dealing with chronic illnesses. Again, similar to the U.S., hypertension, Diabetes, and high cholesterol being the main three.

Below is a picture from one of the parks. I thought this was an interesting way of leaving your mark in the world. (graffiti that is)

Weekend Explorations

2008-02-05T11:03:00.001+08:00

Over the weekend there were days of opposites. Saturday was very dreary and it rained all day long. It stopped briefly at night, and I did do some exploring. But when I awoke to get ready for church on Sunday, the sun was out!!! This was the first time the sun has broken through the clouds since I have been here. It not only physically warmed my body, but also emotionally warmed my spirit. After church one of the team members took a few of us to a shrine dedicated to The Sea Goddess. Once I got back to the flat I explored the Fort that was at the very top of my hill. It was used by the Portuguese to defend Macau. It was constructed in the early 1600's. The remains of St. Paul's cathedral can be seen near by as well. I have many more pictures from these adventures, but will have to share them with you in person, so I don't overwhelm this blog entry. Directly below is St. Paul Cathedral. Kim is excited to see this site, so I have saved exploring it in detail until she arrives.

This is Monte Fort. It only had to be used in defense of the City once, - against the British. And it was successful in repelling the English charge. Now is it a Museum.

This is the Goddess of the Sea, Mazu (click to learn more),

Above is a view from the statue site. It is land that was reclaimed from swamps. They are converting it into Asia's largest strip of Casinos. It will rival Las Vegas in size and stature. Below is the Chinese Temple celebrating the Goddess of the Sea.

Friday Night out with my new Chinese friends

2008-02-04T12:14:00.001+08:00

Below are some pictures from my evening with some of my new Chinese friends. They took me to one of their favorite local restaurants. I told them to pick out their favorite dishes and I would give them a try. I said, "As long as you are willing to eat it, so am I." Along with the pictured food below they had hot wings and fried bread. These were no different than what is in the states, so I did not take any pictures of them. And no I did not get any diarrhea or stomach cramps. I had a great time experiencing the local culture. Eddie promised me that we would play some basketball before I leave. I look forward to it!

This is Eddie and his girlfriend Candy, he is a second year resident.

This is Inson, he is a fourth year resident.

This is Tim, he is a first year resident

The up close and personal look at colon noodle soup. Yes this is pig intestine. Really not bad as long as you can get past it mentally.

Oyster pizza? Well it is not quite pizza, but it is a flat bread with oysters and cheese. Not bad when is it warm, kind of rubbery when cold

1000 year egg. Cultural myth has it that the egg was originally made with horse urine. This is what my Chinese friends told me before I ate it. But since then I have investigated it on the internet and found this to be just a myth. If you are interested in Learning more about the 1000 yr egg follow the link to wikipedia

Winter Storms in China

2008-02-04T10:25:00.000+08:00

Some of you have been asking about the big snows that have been going on in China. I am far enough south that I have not seen snow. Thanks goodness, because it is has been cold enough for me as it is. The bad thing for the mainland Chinese people is that this is at the beginning of their new year travel. I have heard reports that somewhere between 200,000 - 600,000 people were stranded at one train station trying to get home to their families. Most of the factory workers migrate from many miles away. The New Year holiday is the only time they get off all year. So imagine being stuck in a city many hundred of miles away from your family during a holiday time that is as big as our Thanksgiving, Christmas, and New Years combined. Not so fun.

Need a CT?

2008-02-01T17:42:00.000+08:00

Here in Macau you can just walk into a Radiology clinic and get what ever type of test you want as long as you are willing to pay for it. I came across one of these clinic during a walking explorations(some people may have called it getting lost, but not me.)

Letter in the mail

2008-02-01T12:50:00.000+08:00

Kim told me that I got a letter in the mail from Johns Hopkins yesterday. I have been accepted to the school of public health. Some of you may already know, but I am applying to Preventive Medicine Residencies, so that I can get my masters of public health. It is good that I have been accepted to Johns Hopkins school of public health, but I also need to be accepted to the Preventive Medicine Residency. I should hear from them towards the end of the month. I have already been accepted to Emory's Preventive Medicine Residency. So I have to decided which opportunity is better. From the interview process, Johns Hopkins' education would be better. But their salary is rather low and even with working part time on the side I would have to take out more loans or find another way of paying for living expenses in Baltimore. Keep this process in your prayers, as Kim and I try to discern God's will for our family.

Dinner at the Humphries

2008-02-01T10:43:00.000+08:00

Last night I had dinner at Dr. Humphries' flat. He has two boys, ages 5 and 3. They are 21 months apart just like my girls are. Because of the cold weather they had not been outside to play much this past week. So needless to say they were a little wound up. It reminded me of how my brothers and I must have been growing up, full of energy. His wife made American style chili and baked potatoes. After dinner we all played Cranium together. The staff finds if funny that there is another Dr. Humphries here, we have to remind them that I am singular and the other doctor is plural. Interesting enough, Dr. Humphries has a brother named Mark.

People of Hope Medical

2008-01-31T15:31:00.001+08:00

I barrowed this picture from Dr. Place's webblog. It has most of the doctors from the clinic in it. Some of the Chinese people are recent graduates of the program, the others are current residents or staff. I have placed a link to his blog in my list of interesting web sites. The 3 western doctors present in the picture are from left to right, Dr. Chris Place, Dr. Matt Humphries, and Dr. Keith Morgan. The other American physician not present is Dr. Dean Sides.

Chicken and Green Peppers

2008-01-31T15:05:00.000+08:00

So I realized that I thought to take the picture after I ate my meal, but word to the wise, be careful of a dish that has 3-4 times as many red hot peppers as pieces of chicken. The menu at E.S. Kimo (pronounced Eskimo) was in both Chinese and English. I think something must have been lost in the translation to English, because even though the name of the dish included green peppers, none were to be found when the plate came to my table. After two bites of chicken my lips were tingling. I am sure the locals in the restaurant had to be laughing inside a bit to see a westerner sweat like I did.

The Hill to My Flat

2008-01-31T10:49:00.001+08:00

So I have learned that I do not stay in an apartment, but a flat. It reminds me of watching British t.v. My wife reminded me that I promised to show a picture of the hill to the Baptist Mission Compound where my flat is located. Below is a picture only half way up the hill. An old Portuguese fort is actually at the very top. The compound is just below the fort. The other picture is the view from just outside the gate of the Mission Compound.

Hope Clinic

2008-01-31T10:37:00.001+08:00

This is the building where Hope Medical Clinic, down town office, is located. Their office is most of the 1st floor.

The time change…

2008-01-30T10:56:00.002+08:00

I did not realize how much the time change would affect me. During my traveling day, I was up for more than 24 hours. Obviously I was tired when I went to bed that night, but it just felt like being post an on-call shift during normal residency routine. I slept well and woke up for church the next day feeling mostly rested. But since that time I have had trouble waking up early in the morning and needing to go to sleep early at night. It is somewhat frustrating to wake up at 4-5 AM and not being able to fall back asleep. I imagine that I will just be getting used to this by the time I leave to go back to Kentucky.

Drug rep, Macau style

2008-01-30T10:56:00.001+08:00

Yesterday was a day of lecture for the Chinese resident doctors. The last lecture was a Gardasil representative. I found it very interesting; because back in Glasgow, at my residency, I listened to the Gardasil representative give the United States version of this talk. In Macau, the rep focused much more on how agencies like the FDA, EU Health Council, and other international organizations have supported it. They focused how multiple other governments have placed it as part of the national immunization programs. The cost of the vaccine is similar to in the U.S., thus making it rather expensive for the average person here to afford. The vaccine rep even brought food and pens, just like they do in the U.S. For those of you with medical interests, I will bring the vaccine product promotional material back with me for viewing.

A bit on Hope Medical

2008-01-30T10:52:00.000+08:00

It is a clinic set up on the main peninsula of Macau. It has been a presence here for more than 20 years. Within the past month, a second clinic has opened on the island of Taipa. Currently, four American physicians serve as faculty, and another physician is preparing to join them later in the fall. The residency is a four year process after graduation from medical school. It is not required, but medical school in China lacks clinical hands on experience compared to U.S. education. The model is more of a “watch the expert and copy,” no questions asked. There also are a higher number of medical school graduates than post-graduate training programs. The Hope Medical program has 6 residents in total, divided throughout the different years. So far I have had the opportunity to both see patients and precept patients with the Chinese resident doctors.

A few picts

2008-01-29T10:04:00.000+08:00

I found it funny that Lebron James was being used in Nike ads even here.

Below are some photos of preparations for the Chinese New Year.

I could not sleep yesterday morning, I went out sight seeing around the city. This is the first hospital set up by the Portuguese.

Two Days into things...

2008-01-28T12:01:00.000+08:00

Things are colder here than I thought. I knew that it was going to be in the 40-50's range, but I did not think that the buildings mostly do not have indoor heat. So it is almost as cold inside as out. I find that I am drinking lots of hot tea and coffee to keep warm. Being that I have been living in a rural community for the past 2 years, the big city wow's me every time I walk out of the compound. The buildings are so tall, they are so close and people every where. The store signs are a mixture of Chinese characters, Portuguese, and English languages. The architecture is a combination of old European and new Asian styles. The streets are beginning to be decorated for the Chinese New Year. It is the Year of the Rat.

Yesterday I went to a church call Oasis. It is an international church with members from over 10 countries. This is alot since there were only about 30-40 people there. Today I woke up early and could not fall back to sleep. So finally I stopped trying to sleep and got up around 6:30 AM. I got around and hit the streets to explore the city. Every thing was closed for the most part. I am finding that the city is "late to bed, late to rise". I took some pictures, but have not loaded them onto my computer yet, I will post them in my next blog.

By the way, my luggage did make it!!! The only problem was with my cream of wheat. I brought it for hot, cheap breakfasts. Note to self ,put the box of cream of wheat in a zip lock bag when traveling. Only about 1/3 to 1/2 a cup spilled out into the suit case, but it was enough to make a minor mess.

Thanks again for all the comments, it is great to keep in touch with so many all at one time.

I am here!!!, Well in Hong Kong that is.

2008-01-26T20:01:00.000+08:00

Well after a day of traveling I have arrived. Thank you to all that prayed for a safe flight. I am currently in Hong Kong airport waiting for the sea shuttle to Macau. My connection in Chicago was tight, I made it, but I am not sure my luggage did. The sea shuttle actually gets your bags for you and you go through customs in Macau. So as I sit here I have no idea if my luggage was on the plane with me.

Oh, by the way it was my birthday today. (Jan 25) The funny thing is, when a got on the plane in Chicago, I changed my watch over to Hong Kong time, and it was already Jan 26, so my birthday went fast. Kim had made me a great birthday card to read while on the plane. While on b-day notes, Happy birthday goes out to my mom ( Jan 26). We won't mention her age.

Thanks for all the responses to my blog thus far. It is very encouraging to know others are thinking and praying for me!!

The days are counting fast!!

2008-01-22T11:21:00.000+08:00

It is Monday night and I leave on Friday morning. It seems the past 3 weeks have gone by so quickly. I have had a couple of interviews and a medical lecture to prepare since starting the New Year. These things have kept my mind from being completely focused on my China trip.

This past weekend my parents came down to celebrate my mother's and I's birthdays. Kim and I also were prayed over at church. It is good to know that others will be praying for us and thinking about us while we are in China.

I think the hardest part of about the trip, aside from the long travel and being in another country, is the potential time spent alone. Since Kim and Lucy are not joining me until the last 10 days of the trip, I will have a number nights by myself. My hope is that God will use this time to grow me, and that I will take time to listen to God.

11 Days and Counting

2008-01-15T13:49:00.000+08:00

So, trip time is quickly approaching. Check back here for updates and information on my trip.