Helping the Needy. The Reason for Play For A Cause.

Congratulations, once again, to Roger and Casa do Caminho, Brasil. What an exciting final. Two previous winners going to a tiebreaker to determine who repeats. As follow up, here is the receipt for the donations this year - $200!!! Thank you to everyone who played and donated. Here's to next year!

Villanova! What a game!

Congratulations, Roger and Casa do Caminho. What an amazing tournament! Came down to a tiebreaker on points scored in the championship game, and by FIVE POINTS, Roger beat Dennis.

Every year a new charity wins, which is one of the best parts of this thing. I can't wait to see who and what charity wins next year!

Thank you everyone who made this a success. 15 people this year, plus one generous benefactor, equals $250 dollars raised for the winning charity. I'm very proud of everyone.

Maybe next year I can actually win this thing...

Cincinnati Got Robbed

So, today is a poster day for why BETTING ON MARCH MADNESS IS STUPID.

Also, I'm never going to win my own charity pool.

Michigan State... huhuhuhu 😭😭😭😭

But, the real question is this: Did Cincinnati actually lose???

If you didn't watch, Cincinnati was down 76-78 when a player dunked the ball at the end of regulation. It originally counted (tying the game 78-78) but the referees watched replays and eventually waved off the basket. 

However, here are the official rules about shooting a basketball for NCAA Men's Basketball:

Section 33. Goal
Art. 1. A goal shall be made when:
a. A live ball that is not a throw-in enters the basket from above and
remains in or passes through; or
b. A free throw enters the basket from above and remains in or passes through.
Art. 2. Whether the game clock is running or stopped shall have no influence on the counting of a goal.

Section 71. Try for Goal/Act of Shooting
Art. 1. A try for field goal is an attempt by a player to score two or three points by throwing or tapping the ball into his or her basket.
...
Art. 3. The try shall start when the player begins the motion that habitually precedes the release of the ball on a try. The ball does not need to leave the player’s hand. The arm might be held so that the player cannot throw; however, he or she may be making an attempt.
Art. 4. A try shall end when the throw is successful, when it is certain the throw is unsuccessful, when the thrown ball touches the floor or when the ball becomes dead.
Art. 5. A dunk attempt is a try.

Section 4. Basket
Art. 1. Each basket consists of an 18-inch ring, its flange and braces, and appended net through which players attempt to throw or tap the ball.

Section 5. Basket Interference
Art. 1. The ball shall be considered to be within the basket when any part of the ball is below the cylinder and the level of the ring.

It looks to me like the dunk was good, because 1. A dunk is a try, 2. a try ends when it is successful, 3. success is when a live ball enters the basket and remains in, and 4. that happens when any part of the ball is below the cylinder and the level of the ring -- regardless of whether he had let go or not. Cincinnati got robbed.

NRG Stadium Sucks the Energy out of Basketball

VERY interesting given that the Final Four will be at NRG stadium next year.

Watching the Elite Eight there a few years back, I can attest, it's a horrible venue to watch basketball, and, putting myself in players' shoes, I would hate to play there.

The backdrop is all black, but it's shades of black based on shadows and curtains, which makes it hard to tell how far away is the basket. There is also a ledge around the raised court that just screams accident to someone sliding off the sides.

See Ken Pomeroy's data on three pointers.

Never Bet Against Michigan State

If the tournament this year has taught me anything, it's reminded me to NEVER bet against Michigan State, and that truly anything can happen.

Yet again, Tom Izzo has taken a Michigan State team with a middling record, and had them peak at the right time - "overperforming" in the tournament and making the Sweet 16 for something like 7 out of 8 years.

This will be Michigan State's fourth straight appearance in the Sweet 16 and its 11th since 2000.

 To see the second point, one needs look no further than #5 Utah. If Utah makes the finals (granted, that's a long shot), and Michigan State defeats Oklahoma, then my son, currently DEAD LAST in our 16-bracket pool, will win the whole thing - even if Kentucky wins the tournament (whom over half of pools picked to do so). Crazy.

So, watch the games tonight. A loss by Gonzaga or Duke weeds a lot of brackets out. Fun times.

March Madness Underway

Congrats to all who joined the pool this year. Looks like we will be down from last year - some attrition due to babies born recently, etc., but well over $100 will be raised regardless. And that's wonderful.

The first round (I don't count the First Four as a separate round) has proven NOT to disappoint. Gone our the "traditional" 5-12 upsets and now we have 4-13 upsets! Hopefully, that killed my bracket just as much as anyone else. And the ONE guy who actually got the entire first round correct.... crazy! (not in our pool)

Here is the current leaderboard:

As always, your's truly is NOT on the list. But, most of the 16 brackets in the pool are very close together - anything can happen over the next few days - especially if the officials keep blowing calls at the end of games or giving technicals to coaches for no reason.

I also enjoy seeing the variety of charities chosen this year. Every year I learn about wonderful groups doing good work that's woefully unrecognized. Polaris and Camp Spike and Wave are only two examples this year.

If you haven't chosen a charity, pick one now and change the name of your bracket (or tell me). Watch the games. May the best bracket win!

March Madness Charity Pool 2015 is Here!!

Play. Win. Give.


It's that time again!! Come join the annual March Madness charity pool where people choose a charity to play for and the winning charity gets the pot. Some of you remember playing last year (Congratulations, Baton Rouge Child Advocacy Center).


No knowledge necessary. You can donate online or come visit me in Houston. I'd love to have y'all join, have some fun, and help out a worthy cause.

If you'd like to join, this is what to do:1. Go to http://games.espn.go.com/tournament-challenge-bracket/2015/en/ and join/login

2. Create a bracket (named for your charity).

3. Join the group "TBE Play For A Cause 2015"
4. Donate $10 per bracket via the paypal link at http://thebleedingear.blogspot.com/p/tbe-play-for-cause.html or somehow send it to me.
5. Selection Sunday is March 15, 2015
6. Fill out the bracket between March 16-18, 2015.
6. Watch the games starting March 19, 2015 and root for your teams!


The winner's charity gets all the cash, and you are entered into ESPN's $10,000 prize pool also!!


Let's have some fun, and help others in the process. 

Abuse, the NFL, and Due Process

Recently, you can't go anywhere, read or watch anything, and not hear about the National Football League and its abuse scandal. Ray Rice knocking out his then-fiancé. Greg Hardy beating up a woman. Adrian Peterson accused of child abuse by disciplining with a switch.

Somehow, this has turned into a societal referendum on discipline - spanking, specifically - and safety nets for abused partners.

This has made the American people into experts on abuse lately. The cynic in me says "This is wonderful," because, in my four years of taking care of abused children that came to the hospital, we were ALWAYS woefully understaffed with people that could properly tell abuse from non-abuse, and do a good forensic exam, or forensic interview.

The civic organizations we worked with for psychiatric care for patients and parents, the police and state who prosecuted perpetrators, were always horribly underfunded.

I see roughly one patient per week in the ICU with serious injury (or death) from physical abuse. But now, we have almost an entire nation who can accurately perform a forensic interview and examination via the internet. No more CPS write-ups, forensic exams, brain death exams, worrying about serum sodiums or intracranial pressures, getting ophthalmology to come in late at night, etc., etc.

The reality is, we have no increase in experts, on another example of America's penchant for self-righteous indignation without education. I am all for the discussion, when people take the time to educate on the situation, American Academy of Pediatrics recommendations, etc.

But most people don't.

And as a doctor who sees this at least once a week, we must do our job to prove that what we see came from actions alleged. If we jump to conclusions, we do the child a disservice. I've seen more than one child come in with bruises consistent with abuse only to find underlying bleeding issues no readily apparent on a routine CBC.

So if people in positions to report or make decisions are going to highlight this, let them truly become educated too. It's better for the child and future children.

Secondly, I have serious concerns about our society over the last 1-2 weeks. "Innocent until proven guilty," must apply in ALL scenarios in this country, or we end up in the same situation the NFL is currently in - creating arbitrary punishments for crimes not properly vetted.

How many people have been exonerated from death row sentences by DNA evidence? Or new evidence? Or findings of police misconduct?

As much as we may feel certain that Ray Rice knocked out his wife, or Adrian Peterson abused his child, we must let the system play like it's supposed to.

Holding second grand juries is scary - because it's almost double jeopardy that our constitution forbids. If you are a strict constitutionalist, you should definitely oppose Adrian Peterson being tried again. Can we suspend or fire everyone in America when a crime is alleged? There are many spurious allegations out there, or ones done in good faith that still end up being wrong.

No, as much as it might hurt us to be patient, in a case like this we MUST be patient and not crucify the alleged perpetrator until the system runs its course so that the system is infallible, and justice without caveat can be served for the child and safeguarded for the next child. Otherwise, we're all just a modern mob with torches storming to Frankenstein's castle.

Finally, as an organization, the NFL has made a huge mistake with Ray Rice. In his case, the system has played out, he was convicted and given a sentence for a first time offender. Then, the NFL made it's suspension. Yes, it was woefully too lenient (IMHO), but when the video came out, you can't, as an organization, go back and produce arbitrary punishment again. That's where Goodell has major problems. he's just made his justice system COMPLETELY arbitrary. No, the NFL must stick with the punishment it doled, take egg on the face for doing it wrong, and set something correct up for the future.

My concern is not the child defended - yes! let's do that. CPS can take Peterson's child out of the home. We have a court system. Heck, it's here in Houston that it's happening. BUT, if America "educates" itself without true knowledge, then we are worse off than before. I'm glad people are talking, but the media needs to talk correctly. And due process must be observed or the next child isn't protected.

Apprenticeship in America

Recently, Cathay Pacific instituted a program titled "I Can Fly," which hopes to give juniors and seniors in high school 8 weeks of direct experience to aviation. Not flying, but aviation - learning about everything from passenger sales to airports, cargo to catering. This is a Canadian program, partnering Toronto with Cathay Pacific.

America lost it's apprenticeship culture years ago. Sure, we all read of our Founding Fathers learning watchmaking, or silver smithing, or printing at the hands of someone else. But by the end of World War II, America's government-subsidized public high school network was robust enough to provide basic education. People graduated, applied, and got jobs. Then they received on-the-job training.

As the economy developed and higher education became more important, that model persisted. Now, some companies are going back to Europe to study their apprenticeship systems. The hope is that large companies, like Siemens in Germany, can help counterparts in the USA close a gap where 4 million jobs sit unfilled although 10 million people are unemployed.

The problem is, this hasn't extended to one sector of the economy gravely hit by this labor shortage - health care. Physician training, specifically, is woefully inefficient - a byproduct of this stage-by-stage top-down, myopic, it's-always-been-done-this-way approach. Since the Flexner report in 1910 (see pdf), American medical education time has been seen as an empty cardboard box to be filled with whatever is possible until the timer dings. As medical knowledge advances, we try to shove more and more into the box faster and faster, without stepping back and reimagining the box itself, or the method of pouring.

"Then I wised up and got out while I still could."

It is time for a serious look at the ACGME, AAMC, and LCME - the accreditation bodies of American medical education. They are bloated dinosaurs that do not move fast enough to deal with the times. With expected shortages of up to 52K physicians by 2025, it's past time to look at other ways of educating future medical professionals.

We need to shorten medical education by at least 2 years. We need to decrease debt incurred by physicians in training. We need to change the culture to make medicine more family friendly. We need to increase responsibility given trainees to help them progress to self-sufficiency faster.

Perhaps we could learn something from Cathay Pacific. We should at least look.

2014 TBE Play For A Cause Winner: Baton Rouge Children's Advocacy Center!!

I'm incredibly sorry for the long delayed post. Congratulations to all who played in the TBE March Madness pool this year. It was a great tournament that hinged on an Elite Eight game. If Arizona had beaten Wisconsin, many possibilities would have remained alive. However, Wisconsin won, and that sealed the deal for Dr. Z and the BRCAC. Congrats!!

Below is the press release.

***Dated: May 9, 2014***

Congratulations to Dr. Zeretzke and the Baton Rouge Children’s Adovocacy Center!

The Bleeding Ear’s Play For a Cause March Madness charity pool (“TBE Play For a Cause”) was started in 2008 as a way to funnel a good time into good deeds. Two years earlier, while volunteering at an orphanage in Vietnam, I saw how much $100 – a relatively small amount in America – could do for needy children.

That first year we raised $100 for Heifer International. Every year we’ve had an increase in players, money, fun, and watched some excellent tournaments. This year we have raised $260 for the Baton Rouge Children’s Advocacy Center. Congratulations to all involved.

The Baton Rouge Children’s Advocacy Center (BRCAC) is a non-profit organization whose mission is to “lessen the trauma experienced by child victims when abuse allegations are investigated, and to provide support during any subsequent proceedings within the criminal justice system.”

The BRCAC:

•Protects children who have been sexually and/ or physically abused and helps prevent further abuse.
•Provides therapeutic counseling during the time of disclosure and thereafter.
•Maintains and reconstitutes a healthy family by healing the scars of abuse
•Enhances community safety by preventing the perpetration of sexual/physical abuse.
•Coordinates the prosecution of the criminal cases

In 2013, BRCAC served 312 children who were sexually abused, physically abused, or had witnessed a severe crime.

We cannot be more proud to help support the Baton Rouge Children’s Advocacy Center.

Thanks,
The Bleeding Ear

Largest donation in the history of TBE Play For A Cause

Winner! 2013 TBE Play For A Cause!

Well, March Madness is far over, and the payments have finally come, so let's give credit where credit is due: congratulations to Julie and her charity, the Ovarian Cancer National Alliance!

Unlike last year, the battle royale lasted until the championship game. Julie and James, long hovering in the middle of the pack, rose slowly and steadily as people's championship picks were eliminated. In the Final Four, James' wife was eliminated when Syracuse bit the bullet. The championship game featured Marc for Michigan and Julie/James for Louisville.

The game was exciting, as Louisville mounted a fierce comeback at the end of the first half to make a game of it, and pulled away just enough in the second half to seal the deal. BUT, that only eliminated Marc. We had to go to the tiebreaker - absolute value of game score guessed vs actual game score - to find out if James or Julie would be the winner. With an absolute value of 12 vs 18, the Ovarian Cancer National Alliance won the day.

 The best part about everything is the $200 raised for ovarian cancer research and awareness. Together we all had fun and pooled resources to give a gift that can truly make a difference.

DIY: Idle Air Control Valve

Someone once said, "when you're poor, your save money and pay for it in time. When you're rich, you'll save time and pay for it in money."

Well I'm poor.

Lately my 1994 Honda Accord (4 door LX 4 cylinder) has been idling low - I mean really low - somewhere around 300-400 RPM. Besides the incredible shakes that make you think it will die at any minute, it has started dying as I back out of parking spaces. This problem happened when the engine is warm - starting in the morning with a cold engine got a decent response until the radiator fan came on.

Unable to pay for someone to diagnose and fix this for me, I scoured the internet. I found this post on Honda-Tech.com. People smarter than I had ran into the same problem.

**Now, sometimes all you need to do is turn the idle control screw on top of the throttle body and adjust the idle speed, but I figured my problem was deeper than that given my car's 260K + miles.

This post described how to clean your Idle Air Control Valve (IACV) which adjusts the amount of air let into the engine (if I understand it correctly). A clean IACV gives you better idling RPM and more fuel efficiency.
I'm not going to recreate the excellent "How-To" on Honda-Tech.com, but I will give you some thoughts.

There it is waaayyy in the back

A closer view

On opening the hood, I spotted the IACV well in the back. This made it incredibly difficult to get to - especially from someone like myself who's passably good with tools but not even remotely experienced with cars.

Yes, that's a battery

First, I disconnected the battery because 1. electricity runs through the IACV and you need to reset it after cleaning it, and 2. I don't want to die.

Darn black tube in my way

Ah! Much better!

 Second, I had to take the top off the air filter and disconnect the intake manifold.  I tried for too long to disconnect the IACV without doing that, and I couldn't reach it. It's WAY too crowded and small back there. Taking that big black tube out of the way made it MUCH easier.

Soiled shut

Once I got it off, I easily saw how right I was about the etiology of my problem.

After

Before

 I bought IACV cleaner from Autozone (although I've read that Carburetor cleaner would work fine .. don't know if there's even a difference) and this is what it looked like afterward (O-ring removed during cleaning so it wouldn't get damaged. Don't forget to put it back in!).







After putting it back in, I almost didn't check the radiator fluid. The resevoir was almost dry, because of the lost fluid from the tubes that run through the IACV. Topped it off after another trip to Autozone, and it's idling at 750 RPM like a champ!

The whole experience was awesome, because I realized I can fix a car without breaking it more, I saved tons of money, and it reminded me again how similar car repair is to surgery - without the malignant residency to go through...

Congratulations ASPCA!

This post is rather late in coming, but I would be remiss if I didn't acknowledge the results of our last "TBE Play For a Cause" March Madness pool.

Congratulations, Andres, and the ASPCA. They sealed the deal after the Elite 8, when UNC went down. Once the Final Four was set, nobody could up end them.

I asked Andres what made him play for the ASPCA this year. A love of pets? A soft spot for those less fortunate or unable to care for themselves?

"No," he replied. "I saw an advertisement on the ESPN website as I went to register."

Well, whatever your motivations, people and animals everywhere are thankful to all who played, and those who played are in awe with his great prognosticating skill. Until next year!

They will bark your name for years to come, Andres!

Vietnamese Communal Street Culture

A typical small street in Saigon with mom-and-pop shops

One of the amazing parts of Vietnamese culture is the "night scene." As in many societies - perhaps because of a lack of air conditioning and lighting - people typically take to the streets in the evenings and then retire early. In Vietnam this daily routine is codified as arising one or two hours before sunrise, starting to work about 6 - 7 am (sunrise), taking a siesta in the middle of the day, returning home about 5 - 6 pm, and hitting the streets. Because of the now "stable" electricity (rolling blackouts are the subject of another day), people often stay out past dark, but in general, the country goes to sleep about 9 or 10 pm.

Saigon stays out a little later than the rest, maybe due to the expatriate influence, greater electric stability, westernization - who knows. Anecdotally, the majority of people in the city still go to sleep at 9 or 10 pm like the rest of the country, but their are enough people in the city that a vibrant culture from 10 to midnight still exists.

A "hẻm" (small alley) during the day where most people live 

This street scene is enhanced by the communal nature of Vietnamese family culture and the living proximity of people in the country. Vietnamese society, like most Asian societies, live in large family structures. Typically three or four generations in a household. This creates a large network of closely related people to interact with on a nightly basis. Also, it manifests itself in gastronomical ways: family dinners are usually social affairs where many dishes are placed in the center of the table for people to share as they talk and joke.

Vietnam has a population density of 280 people per square kilometer, according to the World Health Organization. Ho Chi Minh City has an even higher population density - 9450 in 2006 - and according to Vietnamese research, the inner city (old Saigon) has approximately 30,000 people per square meter!*

The same alley alive around dusk as everyone comes home 

*In comparison, the United States of America's density of 34 people/sq. km, and the two most dense cities - Washington D.C. and Los Angeles - have densities of 3886 and 2750, respectively.

What all this close living does is create not only a "night scene" as thought of in America - clubs, bars, restaurants, etc. - but a small community "night scene" with local alleys (hẻm) alive with children running and playing, women gossiping, families and friends eating, and old men drinking coffee or beer and playing chess. These "micro-communities" are the true social structure of Saigon, and any visitor would be remiss to not experience it.

Vince and Linh

Travel blogs are nothing new, but I do enjoy perusing ones dealing with Vietnam to see other people's perspectives on my second (third?) home. In this case, the travel blog happens to include a good friend of mine, fellow white-boy-speaks-Vietnamese, adopter of Viet culture, Vince and his girlfriend Linh. So, if you want a fresh, biased-only-by-America, virgin view of Vietnam, this is for you. I'm too old and jaded now...

Check out http://vinceandlinhinvietnam.wordpress.com/ and tell them hi from me!

Lang Co Clinic

Three days of working in a rural clinic went by like a whirlwind. This is incredibly different than my previous medical experiences in Hanoi and Ho Chi Minh City (HCMC), but, it really is about what I expected. The disparity in care (and life) is amazing here. Some stats from a Vietnam News article I read yesterday:

1. HCMC accounts from 21% of the nation's GDP (this is an improvement, I think, because it used to be 75%. Now Hanoi and Da Nang have grown tremendously, siphoning this off) including 44% of tourism dollars.
2. Average income is 2.4 times higher in HCMC than the rest of the country.
3. The city has an average economic growth rate of 11% over the last 25 years - 1.5 times the national average.

What does all this mean? It means if you live outside of HCMC (and definitely outside of it plus Hanoi and Da Nang) you are markedly poorer than the rest of the country. It logically follows that your health care will also suffer, since all the major hospitals are in HCMC or Hanoi, and you will have little if any ability to travel for medical services.

Consequently, clinic saw both run-of-the-mill malnutrition and parasites (probably 80-90% of cases) mixed with really interesting cases that had little to know previous medical follow-up.

In the three days I was in Lang Co, I saw an average of 40 patients per day. One young boy, about 2 years old, came in with his mother who complained about a large lump behind his left knee. On examination, I noticed he had a rather large (7cm by 5cm), non-tender, immovable, solid mass behind the right knee. Nothing noticeable on the left. Mother stated that the mass had been there since at least 3 months of age, and had gotten bigger as he had grown. A local physician had seen the child early in the course, performed no tests, and said it was totally normal.*

*(aside: this is common in Vietnam, where medical tools are scarce and money to pay for them more so - to do almost no tests, except an ultrasound of the abdomen which is done for everyone regardless of chief complaint because ultrasounds are so prevalent - and not explain to the patient anything. Although, in America we explain everything and the patient never hears or understands what we say, so perhaps that is just universal...)

So, I ordered some xrays of the bilateral knees and femurs and told the mother to return the next day. Early the next morning, in she walks with xrays in hand, showing growths on both femurs (left markedly greater than right). Luckily, one of the other physicians on the team, Mark, is an orthopedic surgeon, so I walked next door to get a specialist consult. He had the child walk, looked at the xrays, then declared it was most likely an osteochondroma - a benign tumor of the bone. It's monitored through periodic xrays and removed if it impacts function (walking in his case) or grows rapidly (small chance of becoming malignant).

Mother went away happily knowing a diagnosis, and knowing what to look for, and I moved on to the next patient - more worms.

In all, I saw probably three or four cyanotic heart lesions, a previously undiagnosed brain mass, juvenile idiopathic arthritis, hodgkins lymphoma not receiving treatment because of no money, cleft lip, and - jewel of the diagnosis crown - Russell-Silver Syndrome (stories for another day). Sleep was welcome each night. It's amazing how much good you can do with so little.

My First Clinic

Lang Co is a small hamlet between Da Nang and Hue.

This month I have two different medical experiences designed to let me see the disparities of care between rural and urban Vietnam. For four days at the beginning of the rotation,i will work in a small rural clinic in Lang Co, Vietnam with an organization called Vets With A Mission. They are a nonprofit organization that provides medical missions to Vietnam with a Christian background.

Today was my first day in the clinic. VWAM had their in country representative contact local leaders who sent flyers ands invitations out ahead of time to residents advertising them that we would be providing free medical care over four days. Of course the prospect of American physicians and free care is incredibly popular, and we saw 153 patients between four doctors: family practice, orthopedic surgery, chiropractor, and myself ( pediatrics).

A typical house in rural Vietnam near Lang Co

A clinic like this provides unique challenges. Many parents being their children just because we are American, even though their children have already seen doctors and received medications. Usually the normal Vietnamese doctor takes the week of because we make crowded and siphon patients. We also see children incredibly sick, who have not received care because their families cannot afford it.

The rural clinic where we practiced

Today was a "get the hang of it day," so I only saw 29 patients. Most children came for two reasons: inadequate weight gain and horribly rotten teeth. The chief complaint was " my child is a lazy eater." I am very good now at explaining that milk is not healthy in Vietnam when they mix sugar with it. This causes cavities, which cause pain, which leads to decreased eating and poor weight gain.

The communist government provides free care "in theory," but in practice those doctors are not respected, wait times are so long, that people don't see them. They go instead to private physicians, but often do not have the money to buy the medicines prescribed. So, in practice the Vietnamese have a very capitalistic health care system with two tiers, similar to the USA system, and very low access for the poor.

The waiting area on the morning of day 1

The flight over

Korean airlines is the best airline in the world. I hear that Singapore Airlines is wonderful also, but Korean Air is top dog. My wife says I love them because the stewardesses are hot. She is correct ( they employ incredibly good looking people), but that is not all. What sets them apart from the rest is their customer service.

Flying over this time was as enjoyable an experience as 37 hours of travel can be. I had an aisle seat near the rear of the plane and received prompt service for all my needs. More to the point, a few rows ahead sat two families with small children about the ages of my two. One family was just a mother and the kids, and I couldn't help remember my wife's ordeal with bringing our two to Vietnam just two sort months earlier, and how it was made light by the helpful staff.

Many times I saw a steward or stewardess sit with the children while mother stretched her legs or use the restroom. Nobody complained when the toddler got tired and cried. Instead, they immediately brought games, things to help the child sleep, and offered in any way possible to help the young mother in her defensive efforts.

Consequently, thirteen hours later, an entire plane unloaded happily, and with sanity and hearing intact.

Years ago, when taking my son as a baby, Korean Airlines helped us with formula after an idiotic Vietnamese official read a poorly translated copy of international flight requirements. Then, when his bad parents let him fall out of the bassinet, they helped us get to see a physician in the airport to make sure he was OK and not have to worry about flight arrangements.

So yes, Korean Airlines is the best airline in the world ... and it doesn't hurt that they're pretty too.

In-N-Out Burger and LAX

There are few things in life as amazing as a hamburger from In-N-Out. Anyone who has lived in California understands what I'm talking about. I think they secretly put drugs in the burgers because how else could they be so addictive? Seriously, part of the draw is the fresh - almost HEALTHY - taste of their burgers, and another part is the secret menu. It's so secret that even the menu posted online doesn't have everything that they actually offer. Each time I go, i invariably learn something new on the menu.

Well, when I booked my ticket to Vietnam, i realized that I would have about five hours at LAX before boarding my flight for Korea. This had me wonder on Facebook if it was possible to grab some delicious grub while waiting. Thanks to my friend Daniel, who pointed me to a forum about this exact subject, i realized I'm not the first ( and surely not the last) to think these same thoughts.

It looks like there's actually a pretty established way to get there. Following these tips, i walked about 25 minutes with my carry-on, to reach In-N-Out. On arrival, i found the line out the door, and the line of cars out the parking lot. Seems everybody loves In-N-Out. A little ahead of me in line was a middle aged Hispanic woman with a suitcase - i want even the only airport denizen there! LOL.

Of course the food was delicious, and I couldn't have asked for a better finals meal in America. I hear In-N-Out has finally reached Texas. Perhaps I'll be so lucky as to one day see it in Louisiana. We can only hope...

Tam biet,

Global Health Vietnam: An Overview

I have had this blog for quite some time, and have written extensively about my experiences in vie team. However, this trip marks another first: the first time i am an actual physician and responsible for treating people here. As a third-year pediatric resident, i have had many "firsts" medically over the last two years. Now i am the first resident from my program, Our Lady of the Lake Children's Hospital (OLOL), to do an international elective.

I set this rotation up in collaboration with my boss, Dr. Roberta Vicari, with the hope of establishing a perpetuating global health experience that helps those less fortunate, develops resident medical skills and empathy, and furthers the mission of OLOL.

So, over the next five weeks, i hope to blog various posts about my experience. Perhaps we will all learn about the Vietnamese, their culture, and their medical care together. I look forward to sharing this time with you, and maybe next time our roles will be reversed. Feel free to comment, question, or pontificate on my posts. Social collaboration is key!

Tam biet!