 |
| Bassett neurologist Michael Miller says Vietnam's pediatric hospitals should focus less on technology, and more on old-fashioned physical exams. Here, Miller examines a boy during a week-long humanitarian mission in March 2011. |
ON CALL FOR CARE IN VIETNAM
Back to basics for Bassett neurologist in Southeast Asia
--Trang Ho, special correspondent
Source: Columbia Magazine March 2011
and the Columbia University College of Physicians and Surgeons website.
Confused, in pain, and unable to walk, a 14-year-old girl rides piggyback on her much smaller mother, who is carrying her to see Dr. Michael Miller.
For them, it is a godsend that the clinical professor of neurology from Columbia University’s College of Physicians and Surgeons and the Bassett Healthcare Network happens to be volunteering at Nhi Dong Hospital 1 in Ho Chi Minh City this week through the Project Vietnam Foundation, a non-profit that provides pediatric care to the country’s underserved populations.
Bassett neurologist Michael Miller says Vietnam's pediatric hospitals should focus less on technology, and more on old-fashioned physical exams. Here, Miller examines a boy during a week-long humanitarian mission in March 2011.
Doctors at Vietnam’s 1,200-bed national pediatric facility couldn’t diagnose the girl’s problem, even after doing an MRI scan and observing her for 10 days. But experienced eyes and ears managed to discover what had eluded technology.
After spending a half an hour with the girl – more time than any other doctor at Nhi Dong could spare – Miller diagnoses her with Brown-Sequard Syndrome. Unfortunately, the rare form of paralysis, caused by an injury to the spinal cord, can’t be cured. But Miller recommends physical therapy that could dramatically improve her quality of life.
After doing rounds with Nhi Dong’s doctors and teaching them about neurological treatments in the U.S., Miller recommends that the hospital adopt simple procedures like Apgar scores, an easy way to assess newborn health, and head circumference measurements. Such tasks merely require time – not expensive technology – yet could dramatically improve quality of care.
“They think technology is going to be the answer to their problems when really, getting a full history and doing a thorough physical exam is the most important thing,” Miller says.
Aside from providing goodwill, Miller wanted a chance to see, first-hand, diseases eradicated long ago in the Western world, such as polio, tetanus and botulism. Things he has only seen in textbooks. “This is like practicing neurology in Paris in the 1840s or London in the 1890s or New York in the 1930s,” he says. “There’s much to learn.”
Even though he had to pay for his own airfare and lodging to volunteer in Vietnam, Miller is willing to do it again. He is surprised at how much fun he’s having, even though he can’t understand the language.
“I simply find the people joyful and charming,” he says. “They’ve been very open and kind.” For those interested in donating to the Project Vietnam Foundation, even money for little things, like hand sanitizer in all the hospital rooms to prevent the spread of disease, can reap big benefits.
“It’s amazing how far a little bit money can go here,” Miller says. “People are doing wonderful things with a pittance.”
Wow! Gurl, you should be talking about your man more often!
ReplyDeleteSusanna,
ReplyDeleteI am more secretive than you are! I'll tell him you said so...
How proud you must be of your husband's work! and what a family of achievers you all are.
ReplyDeleteIf you poked your head in the playroom right now and saw all those gamers and Black Adder watchers going full tilt, you might not be so sure!
ReplyDeleteYes, I am proud of him. He came from a blue collar background and worked his way on his own through a trade degree, a B. S., an M. S., and an M. D. And he has chosen to be a salaried academic doc, which I also admire.
It is a thing he has in common with my father, who was a sharecropper's child in the Depression and became a Professor of Analytical Chemistry.
I'm glad you have a good guy.
ReplyDeleteMe, too.
ReplyDeleteI love reading about good people. The more I read, the more I realized that revelations here were making me so happy. I hope Michael had a very nice Father's Day indeed!
ReplyDeleteWhat a smashing fellow.
Thank you for posting this up and sharing with us, Marly.
He did, I believe. Our children were pretty good about it! They arranged for a lunch from Danny's, our little gourmet shop, and then Rebecca and I (with some help from Nate and Campbell, a visitor) made a dinner that Rebecca picked out--moussaka with a Greek spinach-tomato-rice dish. Since we didn't start until Rebecca got home from work, we served up dinner at 11 p.m. But that just made it a little more Greek!
ReplyDeleteGood for Michael! (My brother Ben is a family doctor in Montana --)
ReplyDeleteRE: "'They think technology is going to be the answer to their problems when really, getting a full history and doing a thorough physical exam is the most important thing,” Miller says.'" --This could be said of American health-care, too--allowed no more than 15-min visits with each patient by their Hospital-owned clinics, doctors spend much of that time looking at the computer screen rather than the person.
Blimey, and he cooks dinner. If you made those you you could sell'em you know...
ReplyDeleteLucy,
ReplyDeleteI did give birth to two of the male species, but I don't think they come that way! It takes an awfully long swath of life to make one... They'd be hideously expensive.
Mary,
Well, I know that's not how Mike sees his patients, since neurology is a hands-on kind of discipline... and a lot of his procedures take a great deal of time. In fact, I have never had what you describe happen at our clinic. But new federal government regulations and systems coming on line will demand a lot more computer input from doctors--a mistake, in my mind, but so is much coming from that direction to doctors.
In defense of the 15-minute return visit: there are plenty of patients who don't need more than a few minutes on a return visit. If you gave every patient a visit the length of an initial visit, you would be wasting time--better to have the patients who need it return again in a longer slot.
And, of course, one thing about going to Vietnam is that nobody is wasting your time trying to get unjustified disability or being a high-demand person with a headache or faking a disorder. It's all genuine; it's all need and meaningful and often desperate.
The above is my own observation from knowing a lot of doctors for more than twenty years. It's not a doctor's statement.
What a great thing to do! Great message, too! I am sure that a lot of patients would benefit from more time with the doctor - not just in Vietnam.
ReplyDeleteClare,
ReplyDeleteAgain, this is my own opinion from being in the presence of a lot of doctors for many years.
One thing that I've noticed is that there's a lot of difference regionally, according to culture ways. For example, in one place we lived there seemed to be much more courtesy to the doctor (no late or dirty patients, for example) and there were always genuine problems. In another, there was a good bit of discourtesy and a lot of time-wasting. I won't identify the regions but put everything in past tense...
But when you go to a place of need, you eliminate all of that sort of time-wasting.
My observation as a hanger-on in the medical world is that in priviliged society, there's a lot of people who who want either to get rid of the working life they hate (i. e. get disability) or else are so needy and lonely that they want to talktalktalk. That's a ruthless way to put it, but after some years floating about a hospital milieu, I believe it to be true.
Going to a place like Vietnam, doctors find that everything that happens all day is meaningful. They are giving a gift with love and it is received with love and gratitude. Such days are inspiring and renewing.