Global Pulmonary Health Scholars
Grady Creek, M.D.
In the spring of 2016 I was given the opportunity to travel to Vietnam as part of the LSU International Pulmonary Exchange Program.
My visit to Vietnam started in Ho Chi Minh City where I was hosted by the Pulmonary Department at Cho Ray Hospital. For this segment of my visit, I was joined by our fellowship director, Dr. Stephen Kantrow. We began each day with teaching rounds with the residents in the pulmonary ward. Each resident would present his patient to the group. We would review the patient’s radiograph and discuss the diagnostic dilemmas. I was impressed by the thoroughness of the diagnostic workup that each patient had received as well as the residents’ knowledge of evidence-based practice. There was no shortage of interesting patients to see at this busy tertiary care hospital.
After a week in Ho Chi Minh City, I ventured to the northern capital city of Hanoi. There I visited Bach Mai Hospital for a symposium on lung cancer that had been arranged for my visit. Fascinating epidemiologic differences in lung cancer exist between Caucasian and Asian populations. Pulmonologists in Vietnam are participating in exciting research into the genetic determinants of lung cancer among the people of Vietnam. This visit was a unique personal opportunity to review our knowledge of these differences and discuss future avenues for research.
Overall, I was struck by how similar healthcare delivery in Vietnam was to America, but there were several distinct differences that are worth noting. For me, the most interesting difference was the role of the family in the patients’ care. Each hospitalized patient was assigned one family member who attended to his personal needs. This family member assisted with medication administration, bathing, and discussing the plan of care each day with the physician. Each designated family member wore a yellow vest so he could be easily recognized by medical staff. There are several benefits to utilizing family members in this manner. First, it defrays the cost of healthcare by sharing the responsibilities of patient care between paid nursing staff and the family. Second, it gives the family a chance to contribute to the recovery of their loved one in a tangible way. I frequently encounter family members at the bedside of my patients in New Orleans who have a desire to help, but within our healthcare system they are afforded no opportunity to assist in the provision of personal care. While the resources available within our system are immense, I can’t help but wonder, “Are we asking too little of the family?”
While my visit to Vietnam was both exciting and thought provoking, it was the generosity of the people I met that made the most lasting impression on me. I was honored by kindness and hospitality throughout my visit. I want to thank Drs. Vu and Ngoc at Cho Ray Hospital, and Drs. Giap and Viet at Bach Mai Hospital for giving me the unique opportunity to experience pulmonary medicine in their corner of the world.
Jonathan M. Richards, M.D.
The opportunity to participate in an international exchange program during fellowship was, without a doubt, the "Lagniappe" in my training experience at LSU. As you know, I traveled to Izmir, Turkey during the month of April, 2013. As I had never traveled to a part of the world so different than mine in language, topography, architecture, culture and religion, it was something that I shall not soon forget.
The kind physicians of Ege University welcomed me with open arms and were more than delighted to have me as an honorary member of their team during that month. Even ancillary, non-english speaking nurses and aids recognized the familiar purple and gold patch on my white coat and gave a thumbs up or a smile saying "Ohhh... LSU!" -Hugs and cheek kisses were also frequent. Questions about Drs. Ali and Kantrow and former fellows, Drs. Patterson, Morrison, and Aventura were common, as they had preceded me on my journey in prior consecutive years.
The gratitude from the patients was something that I did not expect. People traveled in some cases for days by bus or train, only to wait in a crowded waiting rooms for as much as twelve hours to see the doctors at the "Chest Hospital." They were patient, grateful, and excited to know that an "American Doctor" was part of their healthcare delivery team. Despite a system that seemed so much less advanced than ours in the United States, doctors and patients seemed to always make the best of the limited resources available to them, and this was refreshing.
Upon return to the US and repeatedly on the job interview trail last year, the comment that came up again and again was "So tell us about your experience in Turkey..." The question was frequently revisited in more relaxed settings after the formal interview was complete. And in settings such as national conferences and society meetings, I was surprised to learn that very few other fellowships have an opportunity such as ours. After sharing my experience with fellows and program directors from other areas of the country, many of them were inspired to initiate similar pursuits.
Experiencing differences in healthcare delivery, the impact of cultural differences on the practice of medicine, and the successes and failures of the government-run Turkish healthcare system gave me perspective that few other young physicians at my level of training possessed. As such, my hope is that the section of Pulmonary and Critical Care Medicine and LSU School of Medicine will be able to continue this wonderful, distinguishing part of fellowship training. It sets our program and our fellows apart from other training experiences in a unique way. I hope it will continue to enrich and inspire young physicians and encourage professional growth, as it did for me. I am forever grateful to Dr. Juzar Ali for laying the foundation for this exchange. I am also grateful for Dr. Stephen Kantrow, who with Dr. Ali continue to work tirelessly to afford this opportunity, and additional new opportunities, to the fellows of the LSU Pulmonary and Critical Care Fellowship.
The impressions and understanding gained from my experiences in Turkey will forever be a part of me, and of my practice of medicine. Even now, as I watch and read news about conflict and war over differences of language, culture, and religion I am reminded of what I may have previously known, but never experienced prior to my journey to Turkey: At the end of the day "We" humans are all the same people. "We" value the same things. "We" value our families, cultural practices, our safety and, importantly our health.
Richard Morrison MD, FCCP
The LSU International Pulmonary Exchange Program provided me with a very unique and valuable cultural experience. I was able to share clinical cases, present literature to faculty and residents and improve my interpersonal communication skills. Also the exposure to a socialized healthcare system provided me with knowledge in systems based practice allowing me to compare the American healthcare system to other parts of the world. I was treated with respect and was given many opportunities to perform practiced based medicine as we cared for our patients.
Likewise, the faculty at EGE University had many positive comments about their experience with our program in New Orleans. I completed the fellowship in 2011, but often think about my experience in Izmir Turkey. I continue to maintain communication with my friends and colleagues that I established during my journey to Western Turkey. I am thankful to LSU for my experience and hope to return to Izmir someday with my family.