Aieeee....

Tonight we ventured to Lumpini Stadium, one of the 2 venues in Bangkok where Thai boxing occurs--supposedly the one w/better views regardless of ticket prices, to see Muay Thai (Thai kickboxing). The night starts at 6:30 and lasts almost 5hrs w/7 match-ups and each contest consisting of 5 3min rounds. Needless to say we arrived just in time for the main fight of the night, and bought the "cheap" tickets, which were standing room only in the upper level. We were the only non-Thai's in that section and all around us people were actively betting on different rounds vs different match-ups (not really sure but there was alot of point screaming and signalling numbers to people--one guy had at least 10 cell phones attached to his belt and each one had an earpiece which was cliped to the collar of his shirt), lots of money was being freely exchanged as we stood up there w/the degenerates. If I couldn't see the fight, then I could always tell when it was getting good, b/c suddenly everyone would be standing, yelling and signalling their bets--I was not able to discern the signals to take part.

The fighting was more skill than anything, it was much less brutal or bloody when compared to regular boxing; however we did witness one guy essentially punch-out a guy's knee and thus ended the fight early. But the fights would almost always start very slow for the first 2 rounds then starting in round 3 it would start getting good and usually by round 5 the winner was already determined and pointless. It was a fascinating night watching both the Thai population and seeing a huge part of Thai culture.

Ahhh...the flying rats

Pigeons, I've learned, are all around the world; only apparently in some countries they are not nearly as obese as those in New York. In fact, the pigeons in Thailand look kind of scrawny...and today I saw why. While I was eating my lunch on a bench in one of the outside courtyards of Siriraj hospital, I realized that Thai's don't eat alot of bread and then I saw a family of 3 feeding them tofu. I guess the tofu keeps the flying rats slightly thinner than the bread at home.

Bangkok touring...

Today marked the last full weekend I am spending in Bangkok and to honor this day I took the express ferry up to Dusit (part of Bangkok that resembles many European cities) and visited the Vimanmek Palace--a palace made entirely of golden teak in the Victorian style. The palace was originally built in another location in Thailand for the royal family and brought to Bangkok by King Rama V. The mansion is gorgeous and contained artifacts from all over the world--now a collection of the possesions of many different kings and queens. The area that the mansion resides is a green oasis among the concrete and smog of Bangkok.

Following the mansion, Chris and I made our way back down the Chao Phrya River on the express ferry to the start of the sky train and took the sky train to the Suan Lum Night Bazaar (where we will be revisiting on Tuesday for Mai Thai) and found the Traditional Thai Puppet Theater (otherwise known as the Joe Louis Theater) and saw a traditional Thai puppet show re-enacting the Birth of Ganesha done by professional Thai dancers. It was really impressive. There were 3 dancers to control each puppet and their movements and facial expressions reflected those of the puppet. The music and story telling (in Thai) was all performed live.

After the puppet show ended, we grabbed a cab and went to a really nice dinner where the food was good and restaurant had a great ambience. Then...the rains came right as we were leaving and hailing a cab. Rainy season has started...early nonetheless.

River Kwae

Today with Pluk and Aom we ventured to the Kanchanaburi Province and the River Kwae, where thousands of WWII POW's died while building both the Death Railway and the Bridge over the River Kwae. The most impressive and memorable part of today was seeing how the community continues to reverently honor those who died. Several cemetaries were donated by Thailand for the burial of the POW soldiers from the Netherlands, Austrailia, UK, America etc., and over 7,000 soldiers are buried in these immaculately kept cemetaries. The bridge still stands and was rebuilt after it was bombed during the war and a train continues to take tourists across the bridge (eventhough it is easily walked).

We had a great lunch, that included lots of seafood (Tom yam gung soup with giant river prawns and a large river fish), then hired a boat to take the four of us up the river to see the scenery along the River Kwae--this was by far my favorite part of the day.

On the way back, we stopped off at the Phra Pathom Chedi--which was closed but could walk around it-- and wandered through the local food stall market that sets up in front of the temple. As we wandered by the carts, Pluk and Aom would ask if we had ever tried something--be it fruit or some cooked thing--and when the answer was no (as it usually was) they decided we needed to try it & bought several. Everything we had while wondering--& I couldn't tell you the name of any of it--was wonderful. Then we went to one of the outdoor restaurants for the "official" dinner--for which they ordered the equivalent of shark fin soup apparently which was a syrup consistency soup containing different parts of the bamboo, coagulated pigs blood and fish stomach--needless to say I didn't really like the taste before I knew what was in it, but it really only made it worse when they were describing the contents while I was trying to eat it. We finished the evening of a great day with chocolate ice cream (thai toppings of note are corn soup, corn, pumpkin, and a few other things that I have no clue--very strange to eat them mixed w/ice cream...I think I like my sprinkles, berries and chocolate chips).

The perfect day...

Yesterday was the perfect day...I went to work for 2 hours, then ran into Jessica on the way out of the hospital and we wandered through the market beside the hospital to find lunch. Bought a lunch of bubble tea, pork & sticky rice eaten with my fingers like the Thai's. Grabbed Maly when she was done and sat with her during lunch. Then Maly and I went on an adventure to find the train station that was very close to the hospital...during which we spoke to no less than 3 military/policemen who all directed us in the general area by pointing b/c they didn't speak English, at one point we ended up on the other side of the tracks & had to turn around. We finally found it, and as a reward I went for a 2hr Thai Massage.

Then for dinner all of us ventured into the Middle Eastern section of Bangkok and had a fabulous feast of falafel, hummous, lamb, yogurt, tabouli...you get the picture. While we were there we were surrounded by signs written in arabic, not Thai, and the population within that area was entirely Middle Eastern...it was almost like we were in a different city. After dinner we walked a few blocks over to the club "BedSupperClub" and had a couple of drinks and watched many tourists/expats dance...there were 2 couples who deserve mention: one couple was attempting to two-step to techno/80's music, and the other was just dancing very poorly but the guy was wearing a patch-work button-up shirt and the girl was donning a hideous floral patch-work-looking shirt. I don't think I've done them justice in this blog, but you can use your imagination.

Night markets of Bangkok

Monday night, Chris, Jessica, Maly and I ventured to the PatPong night market full of knock-offs and apparently sex shows. As we walked down the crowded isles, we had a small, and sometimes large, laminated paper advertising "Pussy" and "show" listed as the price shoved into our faces. Our sexes did not matter these people were very aggressive, sometimes following us halfway down the isle. The best response of all was when Maly replied "no thank you, I have one" and kept walking. As far as the shopping goes, they had knock offs of all varieties and qualities with very high starting prices, intense bargaining skills were required & usually the vendor won--so we did not buy. I realized that if I ever wanted to start buying knock-offs, NYC Chinatown is as good a place as any.

Genetics

So, on Monday I started Genetics. The docs are nice and all speak English very well and I have seen many children with both inborn errors of metabolism (inability to tolerate nml quantities of essential amino acids--the building blocks of proteins--and can go into a major metabolic crisis when they get sick & go into a coma if severe enough) and musculoskeletal deformities. In fact today we had birth defects clinic where we saw many children with abnormal arms/fingers, lobster-like hands, extra-digits, etc. And during this clinic, the head attending was discussing with all these parents surgical correction, but majority of them had no interest in it. I've actually seen 2 children with birth defects who were the product of failed abortions in the past 3days. Well, that is genetics.

Of note as I am writing this, I am looking out of my window at rain blowing sideways, lightening crashing all around and palm trees trying to lie flat on the ground from all of the wind.

oh...koh samui

So when we left on Friday for Koh Samui, I pictured a nice relaxing weekend on the beach...however, with all the different things we fit into 2days, it did not happen. On Saturday morning we awoke early in order to take a boat tour of Ang Thong National Marine Park, during which we swam, snorkeled, went kayaking around one of the 80+ islands that compose the park, and climbed over a mountain to see breathtaking views of the park and the emerald lagoon inside the mountain. While staring into the lagoon, I could see huge sea urchins, a sea snake laying on a rock, and various types of fish swiming in the undisturbed water. That day it was rainy and sprinkled on and off, but the beauty of the area was undeniable.

Then on Sunday, Chris really wanted to do a tourist safari into the interior of Koh Samui, so once again I was up and ready to go before 8am. They picked us up and took us to their site where we went on a brief elephant ride--yes, it was very bumpy, but now I can say that I did it. From the vantage point the elephant climbed to, we were able to see a good part of the jungle that is the interior of Koh Samui. After the elephant ride, we witnessed an elephant show where a 7yo elephant and a 4yo elephant played the harmonica, crossed their legs, walked on 2legs, made 3 soccer goals--beating the volunteer goalie--and made a basket in basketball net. It was followed by a demonstration of how they use monkeys to harvest coconuts and a Mai Thai demonstration. After all of that, we were taken by a jeep to a river where we canoed a short distance into the river, of course I was not paddling and they ran me into a tree at one point--I think the guide could have used some more training. And finally, 3 1/2hrs after starting this very touristy adventure, we finally got to Na Muang Falls and hiked a short distance through the jungle to the beautiful waterfall. It was that 1/2hr that made me willing to participate in this endeavor. Finally, we were taken back to the hotel and I spent the rest of the afternoon wandering on the beach and getting a Thai Massage before returing to Bangkok.

If I ever return to Koh Samui, I will spend the time lounging on the beautiful beaches with the backdrop of jungle, ignoring the massive amount of development that is occuring b/t the beach and the jungle. All in all, it was a good weekend and I am glad that we went, but I think that I needed another day to fully experience Koh Samui.

A Confession...

For all those out there who will jump for joy...don't expect this at home. It took me going half way around the world and 3 Thai's to show me how good seafood can be. We went to a local Thai restaurant near the hospital tonight with Pluk, Aom, & Pom (NICU fellow, 3rd year peds resident, & 1st year peds resident) and I let them order whatever was good on the menu...so they ordered river fish, squid, fried shrimp and 2 other things that I have no clue what they were...and it was all delicious (there was no seafood/tarter sauce involved--alot of citrus flavors & spicy basil & peppers). Confession made & I love you all.

Of note--I tried sushi here again--& I'm still not a fan.

Ohmmmm....

Yesterday we visited the Grand Place and Wat Phra Kaeo. The buildings of the Wat are astounding with the amount of ornate detail that was put into building each of these buildings. Pictures don't do it any justice. Housed within the Wat Phra Kaeo is the emerald buddha which is only about 60cm high and sits upon probably 20foot (or more) gold shrine and it is considered the most sacred Buddha within Thailand. (sorry, no pictures allowed in the temple). We could look at all of the buildings, but all of the side temples were closed to the public.

After the Wat we wandered over to the Grand Palace (now there for looks & hx--no one lives there), which we looked at the outside, but there was no entry allowed and part of the grounds were closed for a ceremony. Lots of hype..little disappointed.

Oh, the beautiful beach...

On Monday, we discovered the Eastern bus terminal of Bangkok, otherwise known as Echami Station, and took the 4hr bus ride in an airconditioned bus to Ban Phe. While we were in route, water suddenly started pouring out of one of the ac vents onto an unsuspecting rider. He attempted to get the attention of someone who worked for the bus company w/o any success and therefore spent the entire remainder of the ride bouncing from seat to seat when other riders would get on or off (the seats were assigned & the bus practically full). Upon arrival to Ban Phe, Chris and I caught the ferry to Koh Samet.

Once on Koh Samet we took a songthaew (a pick-up truck w/benches in the bed of the truck for passengers) to our hotel. Only problem is that for Songkran--songthaew's & foreigners are sitting ducks and we were soaked by the time we reached the hotel--my white skirt and non-waterproof bag did not enjoy this. After finally getting to our hotel bungalow on the beach & drying off, it was smooth relaxation. Walking on the beach, drinking coconut milk & eating coconut directly from the coconut that was opened while I watched, and getting a 1hr thai massage on the beach--who could have asked for more.

Monday night we ate at a restaurant sitting on the beach while watching a fire show at the restaurant immediately adjacent, it was pretty impressive, but the child involved in the show did drop his fire wand putting it out during his only solo. And of course I ate grilled pork ribs and pad thai for dinner--& it was good. Tuesday was more of lying under an umbrella on the beach & swimming in the water, then back to Bangkok--this bus ride uneventful & much more rapid.

Thank God for Secret Platinum

Current daytime temperatures are 38-40degrees celsius (for Brad & Matt), and today Narongs picked us up at 8am and drove us to Ayutthaya which is about 80km north of Bangkok. We traveled from one ancient temple to another, walking around in the searing sun (and yes I am wearing my sunscreen), & climbing up the steep stairs of the different temples. By 10am we were dripping.

Ayutthaya was the ancient capital of Thailand until the Burmese attacked, destroyed & burned the temples and city grounds. What was not destroyed by the Burmese, the Thai's took the heads of most of the remaining Buddha's and sold them for money. The large towers/ upside-down cones are known in Thailand as Chedi's (pronounced "jetty").

At Wat ChaiWattanaram, we climbed up the chedi's very steep steps & once I got to the top I was terrified. The view was beautiful, but I could not go anywhere near the edge. In order to climb down I sat on the top step like Sophie would and clinged to the side concrete wall as I took each step one by one--right foot first. (We all know how graceful I am in NY on stairs). Anyway, I survived, and the remainder of the temples were all gorgeous.

Songkran

The Thai New Year officially started tonight with an opening ceremony at Wat Arun (but unfortunately that ceremony was by invite only & somehow I was left off the list). Festivities started today. As is the tradition, the buddhist observers pour water over the hands of the elder monks while they recieve blessings from the monk for the new year. Over many years this has progressed to water gun fights on Kao San Rd in the Bangalamphu area of Bangkok. Essentially, Thai's and many, many foreigners run around with buckets of flour mixed with water & try to smear as many faces as possible and high powered waterguns shooting anybody they see. It is impossible to just observe this phenomena and stay dry (trust me I tried & ended up getting buckets & buckets of water dumped over my head--granted it was a really hot day and initially felt good, but it became a little excessive).

New People!!!

On Friday, I finally met some pediatric residents who weren't afraid to use their English and weren't excruciatingly shy. One of the people is a 2nd year NICU fellow who will be coming to NY to do a rotation at Columbia for the month of May; his name is Narongs or Pluk. He claimed me and took Chris & I with him and the rest of the NICU team to go to lunch & we proceded to have a feast of Thai food (& I tried everything that was put in front of me--but I don't think any of it had seafood in it) with many different small dishes including the infamous Spicy Papaya salad--after that I felt like I should have gotten a nap.

Then, when Chris & I were on our way out for the evening we met 2 girls who are 4th year Medical students at Downstate who are doing rotations at Siriraj for 6 weeks. Jessica & Maly actually live across the hallway from me. Not that I am not enjoying Chris' company exclusively, but it was nice to talk to some other people who were from home and who had been there a little longer than me. We went & found dinner on Sukhamvit & during dinner a man walked up with a baby elephant selling sugarcane to feed the elephant. Of course Chris failed to bargain and bought 4 bags to feed the elephant. Elephants are quick to grab sugar cane out of your hands if you're not paying attention. We then proceded to try to go to a club in Bangkok--we ended up at a very obviously non-thai club full of foreigners that closed at 12am (apparently all clubs close early in Bangkok). While the club was not really what we were looking for, it was absolutely fabulous people watching.

I'm Huggable...

Today, two things happened of note. One is while I was standing in the massive waiting room talking to Chris while waiting to start clinic probably an 11yo female walked up to me and said in pretty good english "How are you today? I am Nah", gave me a hug and ran away. She completely ignored Chris who was standing beside me. Now realize, I've never seen this girl before and probably never will again. It reminds me why I love kids--if an adult ever did this to me I would probably slap them, etc.

The second one is we found the giant shopping complex in Bangkok called Siam Square--it is a conglomerate of 3 large multilevel buildings full of high end shops surrounded by streets and streets of smaller shops in addition to a bazaar type area. The food in that area, not too grand, but we did stay away from the Outback, McDonalds, Pizza Hut, Swansens, and Au Bon Pain that was very prominent.

Getting there we took a cab, no problems--they used the meter. Coming home, not so clear. We hailed at least 6cabs, all refused to use the meter quoting "traffic" and charged us about 2x the initial price off the meter. Once we got back to the area we are staying in, we realized that cabbies probably don't like to come over to our side of town b/c they have no clue how to get around. We showed several the map & they acted completely clueless--the one that did take us home looked utterly lost when we got out of the cab. Oh well lesson learned--will probably take cab to a well known area close by and then take the bus from there from now on.

Just another day...

So, last night's food adventure was much more successful in a tourist part of town where the menu was in english (in fact there was not one word in Thai on the menu, but to our credit there were several Thai's in the restaurant). The food was really good, and I tried something called Miang which is an appetizer where you get a plate with dried coconut, chilies, nuts, some fruit (and if you eat dried shrimp--then dried shrimp) and lime almost diced and pile it onto some kind of leaf and eat it kind of like a taco. And Singha, was a recognized word. Both of these things made for a happy, but still jet lagged, girl.

Another day at the hospital, only today I actually got to examine 2 patients, and to be honest the pimping is getting more and more prominent. The attending is now starting to include me in the discussions on the care of the consult patients that we are actively getting daily. I have to say that my weakness regarding the kidney, sorry Dr. Schact, is showing. But I am reading, so hopefully it should get better, and I am learning alot.

First day at Siriraj Hospital

So, today I finally went to work. Janjira, an "international ambassador", met Chris and I at the apartment and walked us to the hospital which surprisingly was only a 15min walk. During that walk, we competed with motorcycles for walking room both on the sidewalks and edge of the road in addition to almost getting hit by several of them (come to think of it I'm really surprised that there aren't more in NYC given their ability to weave in & out of traffic).

When we got to the hospital, Siriraj is a massive hospital complex with many buildings and dormatories for the doctors. The heart center has its own building, pediatrics is in at least 2 9+ floor buildings, of which some floors have AC while others get fans--I haven't figured out yet what determines which building a patient gets admitted to or even what floor. I started on Nephrology and we have patients on all different floors and in both buildings. The cases I saw today are things I've always read about but rarely seen at either NYU or Emory. They have patients with all different stages of lupus nephritis, some well controlled on medications while others are recieving hemodialysis on a regular basis; while I know these exist in the US, I just haven't seen it much.

I am working with one resident by the name Plernpiss who is really shy and not very comfortable with the little English that she does speak, but she seems really sweet & fortunately/unfortunately being forced to speak english for me. I am also working with 2 attendings (whose names for the life of me I cannot remember, despite being told them multiple times today & they weren't long names either). Anyway, they all seem very nice and happy to have me, they even ordered lunch for me & attempted to teach me the basic thai on how to order water and say chicken. I think that I am going to have to spend some time on the Thai language or I've realized I will never know what I am eating unless it is Pad Thai & there is so much more out there.

PS--for those who are interested my typical day is: rounds with Plernpiss and attending in the morning, lunch, then teaching by the attending in the afternoon or clinic. On Thursday mornings I will get to go round with Toxicology, while everyone else is in gen peds clinic--not translating for me.

Chakri Day

Today was national holiday, Chakri Day--when I asked the significance of the day all I got in return was "It's a Buddhist Holiday". As a result of the holiday, I did not start work. Instead, I had the opportunity to explore part of the city. After breakfast Chris & I took one of the local buses to the other side of the river where most of the city lies. We planned on exploring the Bangalamphu area; however, we ended up in a tuktuk with plans to visit many of the city's Buddha's since all of the temples were open for free for the day. While this sounds very benign, especially since the government was sponsoring a pro-tuktuk day by setting the price for taking one at 20bhat, it wasn't. We ended up going to the Temple of the Lucky Buddha, then spent probably 45min traveling to a suit shop where we were supposed to look around for 15min so that the driver could get free gas. We did not really have anything to look at since it was a very expensive custom made suit shop (& there were no suits to look at), so we left w/in 5min & apparently he didn't qualify to get his gas. He then took us to the Temple of the Standing Buddha...seemed ok at this point; however, when we left that temple we spent well over an hour going to a tourist agency which was trying to sell a package weekend for the Thai New Year (next weekend), then he took us to a jewlry shop--refusing to take us to any more temples until we went in--well apparently we didn' t stay there long enough either. Finally we refused to go to anymore shops & he got upset until Chris offered to pay 200x the original price for him to take us back to where he picked us up at. While the first hour was entertaining, I have to say riding in tuktuks is very hot, dirty, and you get to inhale all of the exhaust of the traffic (for those who don't know what a tuktuk is--it is basically a motor bike w/a covered seating area that is still open to the elements--picture above).

Once we finally escaped we climbed to the top of the Golden Mount and had some great views of the city.

Tonight we went to a local place near where we live for dinner, when we sat down, we realized that neither one of us remembered the phrase book & no one spoke english. They handed us a menu where the first page said "Welcome", and that was the last English that we saw. We ended up ordering by pointing at things, and it was a miracle that we got something close to what we ordered for the main course. Other things, we just gave up on.

Oh the animals...

Upon waking this morning in Bangkok, a rooster was crowing outside my apartment sometime around 6:30am--fyi I did not have to wake-up that early. I go to look outside and see multiple stray cats, one was sunning itself ontop of the roof of a nearby building. Dogs are running rampant around the city, chasing after guys on bikes who obviously are carrying food or just lying around the sidewalks not paying any attention to people who pass-by without food. All in all this really isn't very different from other large metropolises--except the rooster & hopefully I will learn to sleep through him.

Included are some pictures I took from my balcony this morning.

We Arrived!!!

After 17 1/2 hours on a plane while listening to 2 large snoring men around me, Chris and I walked off the plane into a modern airport, made it through immigration w/o any questions asked and finally found our driver that had been arranged prior to our arrival--never mind they never informed us how to find him or the company before we left New York. Upon stepping outside, it was 90% humidity and 90+ degrees, luckily the van was air-conditioned, as was my apartment. We are staying in an area on the west bank of the Chao Phraya River near the hospital; and with the exception of other non-Thai's in the building, it is a very Thai area.