(apologies for the delay in posting)
This week is Kristina’s final week, and marks my half-way
point of my Thailand immersion. I’d just like to say she has been a
wonderful travel companion: kind, supportive, energetic, curious, and
fun. It’s been a wonderful month acclimating/assimilating into Thai
culture with her and she will certainly be missed!
We both prepared discussions this week that supplanted the
fellow’s monthly lectures. Kristina talked about medicine and the media.
She focused on how providers can better navigate this relationship and
underscored the importance of doing so. She also gave instructions on how to
speak to the media with about 10 recommended rules to follow. I gave a case
presentation on lamivudine toxicity causing rhabdomyolysis with a short
discussion about the differential for rhabdo afterwards. Then I gave a thorough
review of HAART medication side effects in the major drug classes. In
preparation for the discussion we had to buy a thumbdrive. We had an encounter
with a saleswoman that just again underscores the generosity of the Thai
people. She owns a small store at the corner of our soi (road/street), and
sells several knick-knacks, but apparently not thumb drives. She has seen us
walking back and forth daily and recognized us when we asked. She went to
the back of the store and brought her own thumb drive and said we could use it
as long as we needed! We were just overcome with her kindness. We couldn’t
take hers, but now always say hello to her as we pass her corner.
Additionally, we were invited to be a part of a
multidisciplinary international discussion panel for a course given by One
Health at a satellite campus of Chaing Mai University. The night before we met
with Deb Olson, Will Hueston, and other representatives from the group, to
discuss the details of our role and the program. The panel of which we would be
apart had representatives from nursing, medical research, agricultural
industry, and physicians (us). The topic of the discussion was antibiotic
resistance, the obstacles to overcome it, the risks of not doing so, and ways
of troubleshooting and improving the issue. The panelists were convened to
share their experience and give more insight to the people in the course on the
topic and also practice in facilitating a panel discussion. Panelists were
questioned by members of the class and then participated in several exercises
to detail the problem further in small groups. The individual from the research
field was German, and he had some fantastic insight into the problem in
terms of monitoring and control of antibiotic use. IT was a pleasure to be involved
with the course and contribute to the One Health movement.
On rounds this week we saw a patient with SX linked
Hypogammaglobulinemia leading to a cardiac abscess and grade I heart block
who had negative blood cultures. We also saw aeromonas peritonitis and two
cases of penicillosis!
