More Firsts

These past several days have held yet more milestones for my trip. On Tuesday I got to observe my first surgeries, which was quite an experience. I scrubbed in with Dr. Huan, and watched as he prepared the anesthetics for two patients. Each operating room (OR) has two beds, and it’s standard for there to be two operations occurring simultaneously. The first was a woman who was having two large staples removed from her ankle. The second was a young boy, probably about 9, who was having two pins removed from his elbow. Both of them seemed like relatively simple and benign operations compared to what I’ve seen since.

The most intense surgery I’ve seen so far has been the removal of an approximately 16 inch rod from a man’s femur. They had to open his left hip using a cauterizing electric knife (which created a less than pleasant smell in the OR), and then literally use a mallet and chisel to get access to the top of the rod and pull it out. All the while, the man only has a spinal block and partial sedation, so he is aware of the hammering and shaking of his body, even if he can’t feel or see the operation. It’s pretty crazy to watch.

Watching my first nerve block, where anesthetic is injected around a major nerve to numb an extremity, definitely rekindled my old aversion to needles, but as I saw more, they quickly got easier to watch. The surgeries themselves though didn’t bother me at all. Between surgeries, Dr. Huan would explain to me more about the OR and the procedures, and I would help him learn the English medical terms for things by drawing and writing on the operating table covers. Despite the serious nature of the work, the doctors still manage to keep a warm sense of humor amidst the professional environment, telling jokes between procedures and helping put the patients at ease. I think my favorite part of their OR, however, has got to be the music. During all the surgeries so far, they’ve been playing one of Dr. Huan’s CDs that is basically full of the equivalent of Vietnamese Barry Manilow. I almost laughed out loud when they first started playing it, and it definitely gives a rather farcical character to the whole situation.

 On a somewhat related note, Dr. Huan also invited me to my first evening of karaoke this week. It was for his friend’s birthday, and so I got to meet several more locals, a couple of which even started attending my English class at the hospital. We spent the evening in the small acoustic prison of our modest karaoke room singing, eating cake, and bonding over our shared audacity to butcher such great classics as “Tiny Dancer” and even “We are the World”. It was fantastic. And considering the total fee was less than $2, I’d challenge anyone to find a more economic way to entertain eight people for three hours.

That said, we did give ourselves a run for our money today when we spent the day picnicking in the park. They’ve got a great park here surrounding a lake with the coolest playgrounds for kids I’ve ever seen, but which would never fly in the states out of liability concerns. (For instance, they have a not-quite-horizontal wheel about 8 ft. in diameter elevated a few feet off the ground, which seemed to have the express purpose of having kids spin it by running around on it until it was going fast enough that they would fall off. What could go wrong?) Anyway, several members of our karaoke group spent the day there hanging out, which definitely gave me some more perspective into Vietnamese culture. Some things, like a few of us taking shots at playing guitar, and Dr. Huan getting his palm read, could have been just like anywhere else. But then there were things I would never have expected to see, like our group of early to late twenty-somethings being enthralled by hangman for a good hour and a half, or learning how to Cha Cha and Tango lakeside to the downloaded ringtones on one of the guy’s cell phones. We also played (for lack of better title) pick-a-random-dare-out-of-a-hat. The dares—which were all found universally hilarious—consisted of such provocative commands as “pinch the person next to you”, “sing a song”, and, the one I chose, “put a leaf on your head”. The most baffling to me though had to be, “say what a bee would say when it comes home from work.” No, it was not a translation error; I inquired earnestly. Rather, it was more or less a challenge to come up with the best pun you could involving bees, work and a stereotypical domestic lifestyle. “Honey, I’m home,” was of course the obvious cop out response.  I couldn’t make this stuff up if I tried. We had a great time though, and I sincerely doubt this is the last you’ll be hearing of these guys.

Don’t Eat the “Ox Muscle”

            My first week here has absolutely flown by, and I am happy to report that on the whole things have been going extremely well, though there was a bit of a hiccup when my reservation for a bed on the overnight train from Hanoi to Da Nang fell through. As a result I wound up in a crowded “soft-seat” compartment for the 15 hr, overnight journey. Fortunately, however, with the amply reclining seats, I still managed to sleep through the vast majority of the trip, but still awoke in time to see the impressive surf along the shoreline from the night’s storm as we pulled into Da Nang.

            On arrival at the hospital, I was quite impressed by the guestroom they are renting me for a very affordable $5 per night. It’s well furnished, has high ceilings, a refrigerator, AC, cable TV (which is universally free in Vietnam, and a good bit of which is in English), and even an extra bed, which is currently occupied by my guitar, but which could easily accommodate any of you who are interested in visiting between now and February. An ether net cable and a washing machine are just down the hall, and I even have my own small balcony. My only real complaints are a slightly leaking roof (likely from the typhoon that hit a couple months ago), and a slightly temperamental toilet, which has been easy enough to fix however.

            My gustatory adventures started my very first night here, and before I go into the story, now would be a good time for me to suggest saving this tale for a time when you can afford to lose your appetite. That said, there is a makeshift cafeteria for the staff below me in this building, and as I was digging into my dinner of pho bo, I was invited to join a group of guys sitting nearby by one of the orthopedic technicians who spoke English. The technician, Nguyen (“Wyn”), explained to me that the man in the wheelchair to my right, Binh, who looked rather like a Vietnamese Steve Buschemi, was getting braces for his legs the next day so he could finally walk again, and was treating everyone to drinks and hors d'oeuvres to celebrate. We started with a round of Tiger beer, the local cheap brew of choice, followed by some rice wine served out of old soda bottles. The cloudy liquid could no doubt be used to sterilize the hospital’s surgical equipment in a pinch, and in accordance with the old adage, my chest has become notably hairier since. I offered to buy a round for everyone, but Nguyen told me that Binh insisted that this was his treat, and that “as I long as I kept drinking, he could keep pouring.”
            It was about this time when they brought out the first appetizers, and Nguyen asked me if I had ever tried “ox muscle”. I had not, and so Nguyen picked up one of the fleshy coils on the platter and dipped it into a mild looking sauce before setting it on my plate. Not wanting to appear rude, closed-minded or weak-stomached, I popped the morsel into my mouth despite its unappealing appearance, and immediately regretted the decision. Before I could even appreciate the texture of the “muscle” which fell somewhere between stale calamari and cartilage, my nostrils and taste buds were assailed by the devastatingly pungent sauce, which in retrospect was probably equal parts salt, concentrated fish extract and ammonium carbonate (the active ingredient in smelling salts used to revive the unconscious). Through sheer force of will, I smiled/grimaced to indicate how much I was enjoying it, as I did my best to not audibly gag. The real kicker though was about a minute into chewing it when I noticed that the other pieces still had bits of black stubble sticking out of them where they hadn’t been totally shaved. Remember kids, it’s ok to say “no”, even if everyone else is doing it—which is exactly what I did the following night when I was offered the chance to try a partially developed, hardboiled duck egg. This delicacy is what you get when you give a fertilized egg a few weeks head start on becoming a duckling before cracking it open. It’s pretty grim—I’ll just leave it at that.

            Most of the food, however, has been more than palatable, and you can eat for about a dollar a meal if you want to. There are lots of great restaurants around here with very nice chicken, noodle and rice dishes. Vietnamese seafood is also supposed to be fantastic, but I’m still trying to get a handle on what is safe before I eat too much of it. Banh Mi, a customizable sandwich on a small baguette, is a popular meal here that is quickly becoming a staple of mine. And if I get desperate, there are even a few ex-pat friendly eateries that serve pizza, burgers and the like. One of which called Bread of Life is particularly cool because it is staffed exclusively by deaf Vietnamese citizens to help them find employment. There is also a shopping center here, called Big C, that has just about everything you could ever need—think Safeway meets Target—which has been really convenient for getting snacks and little things for my room like bath mats and power strips. It’s also nice because they have fixed prices, and so far it seems like I get charged about twice as much as the locals for most things that don’t have a price tag. They are incredibly uptight about their security though. Any backpacks or bags you bring into the store are literally put into heat sealed plastic bags so you can’t hide anything in them, and even the employees are frisked by security when they leave the main store area to go to the bathroom.

            I definitely stick out stick out on the street being blond and about 8 inches taller than most people. As a result I get a lot of curious looks from the locals, and I can’t find shoes less than three sizes too small. A lot of the plastic patio furniture used by local restaurants is also what we would consider kids’ size in the US, and so I always wind up laughing at myself when I awkwardly sit down to eat. Most people can’t speak English, but they are still usually very friendly and helpful. Kids, adolescents, and sometimes even adults will say “hello” to me on the street, and they usually get quite a kick out of it when I say hello back. One girl at Big C was even bold enough to shout “I love you!” up the escalator to me triggering a chorus of giggling from her friends.

            I also have my own motorcycle for getting around town—ok fine, it’s more of a motor scooter that probably tops out at about 40 mph (the speedometer is broken)—but it’s still a lot of fun to get around on. In Vietnam it seems like these are how virtually everyone gets around, and when you combine that with the fact that only about every fifth intersection has a stop light you can get quite a rush just cruising around town. I’ve also been very lucky to have been put in touch with Uyen, the local guide who rented me my motorbike. He is a very likeable and honest father of four, who has already been extremely helpful in familiarizing me with the city and helping me get essential supplies for my stay here. If any of you consider coming to Da Nang, I would wholeheartedly recommend getting in touch with him.

            So far I’m still getting to know the ins and outs of the hospital, and meeting new doctors and physical therapists (PTs). Up to this point I’ve spent the most time with Dr. Huan, a short, upbeat anesthesiologist, and Dr. Vu, a more relaxed orthopedic surgeon who shares my appreciation for a certain videogame I used to play a lot in high school. Many of the staff speak English well enough to have a conversation with, and most of them are very glad to have a chance to learn from a native speaker so we set up a daily English class that anyone in the hospital can attend. So far there are about eight people attending regularly, and it will likely grow as the word gets out. It’s been really interesting speaking so much with people who only know the basics of the language. It makes you realize how much you can simplify your speech and still convey the same essential meaning, but also how much we take the subtleties of English for granted, things like the differences between “family” versus “relatives”, “to like to fish” versus “to like going fishing”, and “to be no longer working” versus “being retired”. Despite the virtually identical technical meanings, each of these words and phrases still conjures a rather different idea in your mind, and it has been interesting to see both how that subtlety gets lost and trying to teach it in our class. The other day I was trying to explain all the ways you can use “cute” for instance, which made me realize just how much we take the versatility of the word for granted. Another time I was trying to teach the meaning of “literal”, but I think I only had limited success. 

            There is another volunteer staying here as well named Durga. She is a PT taking a couple weeks away from her family in Atlanta to work in the hospital’s rehabilitation clinic and to teach the latest physical therapy techniques. This weekend the two of us took a short ride down the coast to see Marble Mountain, a grouping of giant marble monoliths overlooking the coastline. The natural beauty of the mountains is something to behold on its own, but what is really spectacular about the place are the ornate pagodas and ancient statues hidden throughout the caves, which have eroded into the marble over time. The incense burned throughout the caves catches the light that beams through the natural openings in ceilings, and combined with the droplets of water dripping throughout the caves, it creates an ambiance that is just spectacular. At the base of the mountain are dozens of stone carving workshops that create some truly impressive sculptures and jewelry out of the local marble. Unfortunately, the views from the mountaintop reveal the hardships of the local communities. Despite the beautiful ocean vistas, the surrounding developing areas create a juxtaposition of great cultural wealth and economic poverty that seems regrettably common in the area. 

Peru Vol. 4

8/22/09 10:30pm:

            So we’ve gotten back into a bit of a groove after changing our plans around. Unfortunately that groove includes waking up 5 am to do our bio-inventories—but hey, what’s good science if not mundane, repetitive tasks at uncomfortable hours? At least that’s the one time of day it’s cool out. When it was bad a few days ago I was still sweating, at rest, until about midnight.

            Our time in Puerto has also given a chance to get more of the local color. For instance we wound up being coerced into sharing several beers with a nice, but very aggressive, Peruvian woman, who then proceeded to show us rather racy pictures of her daughter, an adolescent professional dancer (who was present at the time) on her cell phone. Alex had mentioned the warnings he’d gotten in the past about the girls here latching on to guys as a ticket out of Puerto Maldonado, which is the Peruvian equivalent of a small, agricultural city in the US, but this was the first time I’d seen it in action. Alex says I just haven’t been in the right bars on a Saturday yet.

8/26/09 6:13pm: Obelisco

            This afternoon we went to the Obelisco, a cool observation tower in the center of town and arguably Puerto’s biggest tourist destination. It’s about 70 ft tall, which as far as observation towers go isn’t remarkable, but it is easily the tallest building in Puerto by 30 ft. At the top of the obelisk you get an interesting perspective of how limited the town is. At street level the town feels like more or less like any other in the developing world, but from the tower you realize the entire developed area fits neatly into a square a few kilometers in diameter with well defined edges that abruptly transition into dense rainforest. You also don’t think of it from the ground, but the Amazon basin appears incredibly flat once you’re far enough above the canopy, almost to an unnatural degree. Joel accurately commented it seemed a lot like we were inside a game of Sim City.  We got there just at sunset too, and the clouds were incredibly diverse along the sky line, creating an incredibly beautiful and dynamic scene as the colors shifted with time.

            While we were up there we also saw a local marathon, or at least some sort of street race. It was confusing at first though because they hadn’t blocked off the streets. Our only initial hint was a motorcycle policeman with his lights and siren going, but only driving about 10 km/hr. At first we thought it was Peru’s slowest car chase, but then we saw the runners behind him. The whole time we were up there though, about 30 min, we probably only saw a maximum of 20 runners, which made us wonder why they did it at all. But then again, despite the police escorts, traffic just weaved between the runners the whole time, so I guess it really wasn’t much of a burden on the public. The guy in had last place had to feel a little embarrassed though considering the race had created enough congestion to stack up a couple dozen cars and moto-taxis behind him.

            It also turns out we may have missed the chance to get to know an up and coming Peruvian star. Before we went to the Obelisco, we cruised through the market to pick up some maracuyás and platanitos, and while we were there we casually cruised through the DVD section. As we were about to leave, I took one last look at one of the booths, and to my astonishment, found a Peruvian dance movie with none other than the racy picture of the girl we met at the bar on the cover.

            Tomorrow we head out to the Sachavacayoc Center for a few days to meet up with the other Stanford students and the Fauna Forever team working there. I haven’t been there yet, but I’ve heard good things about it and I’m looking forward to going.

8/29/09 6:45pm: Sachavacayoc

            Our time here at Sacha has been absolutely fantastic, and it’s hard to believe it’s over already. Compared with the other lodges it’s a lot simpler. There aren’t any tourists so we have the whole station to ourselves and our relationship with the staff is much less strained because of it. The food is good, the beds are comfortable and the company is good. Alex’s brother Ian and his friend Kelsey are here studying dung beetles (which I’ll simply say involves some rather unsavory practices to bait the traps), and the most of the Herpetology team is still here. There’s even a guitar here, and I’ve managed to relearn the first half of “Green Sleeves”, which I had learned just before I left.

            The wildlife here has also apparently been great with people seeing tapirs, herds of peccary and the Herp team even catching a rainbow boa. We haven’t had much time to get out, but on the walks I’ve been on we’ve seen some great tarantulas and wolf spiders almost the size of your hand, white caiman, a coral snake and a tamandua, which is basically a really cute, small anteater that whistles and climbs around in trees. There are also these small beetles that have glowing, neon green spots behind their heads, which glow bright orange when they fly, and when you hold them, they snap themselves as a defense mechanism that makes it feel like you’re being shocked.

            Yesterday we also got to take an overnight trip to Lake Sachavacayoc. It was about a 5 km hike to the lake where they have a thatched, open-air platform on with pads to sleep on and ropes to hang mosquito nets from. Joel and I got there at just before sunset, and we took one of the old, wooden canoes out from the dock to meet up with the other group members who were already on the lake watching the sunset. Needless to say, the sunset was gorgeous, and in total our group probably took a couple hundred photos of it.

This was in large part because of Joel’s recent discovery of a photography technique called High Dynamic Range (HDR), where you take three pictures of something at various exposures. Then you apply software that takes out the underexposed portions of the properly exposed picture—say the dark, backlit trees in the sunset—and replaces them with the corresponding portions from overexposed picture–in this case, the adequately lit trees from the overexposed sunset picture. The result is a more vibrant picture that much better captures what it was like to actually be there. This is because a camera can’t capture in a single photograph the same range of color and contrast as the human eye. You can also take things even further by tweaking the software to make the pictures have an absolutely stunning, surreal quality to them. Unfortunately when applied to people, however, it just highlights all your flaws and basically predicts what you would look like in 20 years if you dedicated yourself to a career sweeping chimneys around Chernobyl.  Definitely a technique worth looking into though, if you’re into photography.

We stayed out on the lake well after sunset and enjoyed the stars and the moonlight on the lake. Our expectations weren’t very high, but Joel tried taking some long exposure shots, as in 5-30 seconds, with the camera resting on the boat, while I tried as hard as I could to lie perfectly still. Surprisingly, they actually turned out remarkably well and in one of the 30 second exposures I’m virtually completely illuminated by the moon. It was also surprising how much red you could still pick up in the sky when you left the shutter open so long—or at least so Joel told me. Since the boat was slightly rocking, the picture also has a cool a contrast between me who was in focus rocking with the camera, and the sky which became slightly blurred. It was incredible how still the lake was though since it had virtually no flow in or out. This is actually fairly common though for oxbow lakes, which are old sections of river, named for their shape, that have broken off as the river has slowly changed course.

            The next morning we woke up at 5 am so we could eat our breakfast of crackers, bread, marmalade and manjar (i.e. caramel made from condensed milk) as we watched the sunrise. For those of you who have tried to wake me up in the morning, it will be no surprise to you that I was the last one down to the docks, and that I pointed out repeatedly that we had at least another half hour before you could actually see the sun above the tree line. It, in fact, took about 50 min. Never the less, it was quite beautiful, and afterwards we took the two canoes around the lake before napping again and then walking back to Sacha.

            Once we were back, the group decided to take a swim in the quebrada, which, unlike the lake, was relatively caiman-free. It had been higher before we came, and people had been jumping in off the bridge, a drop of about 25 ft.  It was much too low when we got there though, but we still had a great time crawling up the rapids, tossing around the frisbee and sharing a couple beers as we tried (with only moderate success) to avoid dashing ourselves on the jagged rocks hidden below the exceptionally murky water.

9/1/09 10:35pm:

We’ve just said goodbye to Joel and Jane who left today. To send them off last night we took one last stroll through the plaza near our hostel. There is a really cool landscape painter who works in the plaza at night, and what’s really impressive is that he only uses spray paint. He has a myriad of different techniques using sponges, newspaper, cardboard and a razor, and it is truly remarkable how precisely he can fade, smudge and blot the paint around the canvas. And just to make it even more of a show, he routinely lights his paints and canvas on fire to dry the paint faster.

Shortly after watching the painter we were looking at a couple comedians, one of who was in drag, who had gathered quite a crowd around them lip-syncing. Within a minute one of them sees Alex and Joel wearing their somewhat conspicuous Peruvian soccer jerseys and drags first Alex, and then also Joel, into the circle. My Spanish wasn’t good enough to follow exactly what he was saying, but Jane translated for us as best she could. The performers weren’t particularly clever, and most of the humor was simply derived from a couple gringos being put on the spot, with a dash of lewd humor to keep Alex and Joel uncomfortable. All things considered Alex and Joel handled it very well, and escaped relatively unscathed, though Alex now gives the crowds a comfortable berth when we walk through the plaza.

Alex’s mom, Pat, is also here now and we’ve been hanging out in her room at Cabana Quinta as much as we can since it has AC. She’s also a pathologist so naturally we got around to talking about all the diseases we can get here and we’ve come to the conclusion we almost definitely have giardia. The symptoms have been very mild for me and only lasted a couple days a while back, so I may have already cleared it, but I could just be asymptomatic. Alex has had it worse, and one of the members of the Herp team was also diagnosed with it though so it’s pretty likely we all got it somewhere. We looked up the recommended treatments on the CDC website and then visited a pharmacy here to see if we could find anything. We actually got really lucky and they had our top choice, Nitazoxanide, since it didn’t have any mentioned side effects and it was really cheap too. We also met a guy who had been bitten a bat at one of the research stations and now had to get the rabies vaccine series, which is apparently brutal and takes a week, so we definitely felt like we got off easy. However, we did discover our meds did, in fact, have the side effect of turning your urine an alarmingly dark, neon yellow.

9/5/09 5:38 pm

            And thus our great trip is coming to a close. We’ve just gotten back from TRC where we saw those of the team that were still here and got one last hurrah in the jungle. The boat ride up was absolutely spectacular. While it was still light we saw an entire family of half a dozen Capybara, but we had gotten a late start and so later we wound up driving straight into another particularly beautiful sunset on the river. And as if this weren’t enough, as the light from the sunset faded, the almost full moon was rising in the sky to our left as an enormous lightning storm started flashing behind us. It was far enough away that we couldn’t hear the thunder, but it must have been several miles wide, and the strikes were absolutely incessant, brilliantly lighting up the hazy thunderheads every second or two. Eventually another storm cropped up in front us, and our boat was surrounded on all four sides by the moon glinting off the river, the dimming glow of the sunset and the luminous bursts from the storms.

            Once we got off the boat, however, we had the herculean task of hauling 12 people’s backpacks and equipment the mile or so to the lodge (which was built so far back to avoid the sand flies near the river which carry leishmaniasis, a flesh eating parasite that is exceptionally difficult to treat) with a single cart. The result was (in retrospect) a rather comical scene of us strapped with bags on every limb trying to keep the equipment from falling off the cart as we hauled it was best we could through the jungle.

            Fortunately the food this time around at TRC was far better than last time. Perhaps they were better prepared for us this time, or now they simply weren’t running out of food, but it made things much more pleasant. Plus they let us eat in the dining area with the tourists, and even made cakes for Dennis’s and then Alex’s consecutive birthdays. My present to Alex was a Spanish pocket guide to diseases of the digestive track.

            It was sad to leave the rest of the team at TRC. By now it’s happened quite a few times in my life, but it still gives me quite a peculiar feeling to realize I’ll likely never see these people I’ve become friends with again. I’m glad to be going home though. There are certain things I’ve simply been away from for too long: hot showers, dry air, meals that don’t get half their caloric value from white rice. The trip has certainly been spectacular though, and I certainly hope to come back one day.