Gene's Joint

Leaving Taipei today

So much for relaxing. Three full days of being in the hospital watching surgeries and seeing patients, going to the National Palace museum, shopping for ceramics at the old town in Yingge, seeing friends, family dinners, clubbing, drinking and shopping. I also got to see some good Taiwanese friends who have moved back to Taipei recently, Charles and Kathy who have a new three year old and Steve who is finishing up a PhD in Chemistry at Qinghua. Unfortunately they all tell me that I am getting fat. I figure I’m just making some extra reserves for the cold weather at Dartmouth. Haha

Keigo left this morning for Japan. I think he had a good time which is great. I also leave Taipei today for San Francisco. Four days and then I’m off to Africa.

Great Eats in Taipei

OLDIES BUT GOODIES
1) Din Tai Fung (Yung Kang Jie) – Go on 9-10am on Saturdays and Sundays for their famous “Tang Bao” Soup Dumplings. Some of the best dumplings you’ve ever had wrapped in a very thin dumpling skin, each filled with soup. The tang bao are gently placed in a broth based soup where they osmotically soak up more goodness before you finally finish them off.

2) No Name Beef Noodles (Heng Yang Rd/Tao Yuan Jie) – This place has no sign, no name, no menu, only the best Taiwanese beef noodles you’ve ever had. Just go there and ask for “hong shao niu rou mien” and you get a steaming bowl of hand pulled noodles in a spicy hot beef soup with generous pieces of beef and tendon cooked tender.

3) Fei Qian Wu (Zhong Shan Bei Rd Sec 1 181 Alley No. 13-2, closed Mondays) – If you like Unagi rice, this place is as good as any in Japan. Traditional Japanese style restaurant with wooden benches, fast service and excellent unagi rice. Great place for a quick dinner with friends or family.

4) Sheng Ji Dan Dan Noodles (Chang Chun road near the intersection with Dun Hua, go up Chang Chun on the Hong Kuo building side) – My favorite lunch place in Taipei. Tender dan dan noodles with a creamy spicy peanut sauce, a bowl of hong yiu chao shou (wontons in spicy red oil) and an Apple Sidra soda really hit the spot!

THE NEW STUFF
1) SuHang (Jin Nan Rd Sec 1 No. 2-1 2nd Fl, phone 0223963186) – One of the best Shanghainese style places I’ve been to. Excellent roast pork in steamed buns, shanghainese dumplings, rice with greens. Ask for the dou shu dish (I hear its their best).

Pictures from home!

The lights of Taipei’s Xinyi district from Taipei 101 (the tallest building in Taipei – for now . . .)

One of my favorite pieces at the National Palace musum. Its a piece of Jade whose natural colors were shaped by the artist into a very convincing piece of pork . . . mmmmmm

Keigo, invading someone’s privacy in Yingge?

My family at my grandparents’ house. I hope to see them again soon.

Happy Birthday Saya! :)

AP nijyusan sai no tanjyoubi desuyo!

Taiwanese Medicine – a manufacturing approach to health care

Its amazing how well run this place is. Computerized IT systems that allow the doctor to see a patient’s charts, previous diagnoses and office visit notes, imaging and meds all from a smart computer terminal that recognizes and authenticates (via a smart card reader) the user. This as well as the efficiency with which these HMO doctors see their patients results in an average consult time of 10-20 minutes per patient. In some cases, the patients we saw today were in and out in less than 5.

Contrast this with UCSF where the pain management doctor I shadowed sometimes took 30-50 minutes with each patient and you start to see how the bills can add up.

I would be interested to see how a third party public health group rates the care at Chang Gung Hospital in Taiwan. Without much experience to go by, I would say that from what I have seen so far, it is accessible (all Taiwanese are able to go to any hospital), efficient without sacrificing quality, and cost effective for the patient. Maybe the manufacturing mentality that has served Taiwan so well in making semiconductors CAN indeed be applied to health care?

Neurosurgery or Seeing patients?

After two days of observing in both the OR and the outpatient clinic at Chang Gung Hospital in Linkou, I think I have a better idea of what area of medicine I want to pursue. Between spending 3-4 hours
operating on a immobilized BODY that is barely breathing versus seeing and interacting with a living breathing PERSON with real economic, social and medical problems, I prefer the latter. It seems more real to me somehow. The problems and the human contact are aspects of medicine that I like more. Perhaps some area of medicine in which I see patients most of the time and spent 1/4 or 1/5 of my time on procedures may also be good.

I’m finally in Taipei!

Whew! No matter what I say about being a global citizen, not having a home, etc, there’s nothing better after a long trip than to be in familiar surroundings.

My parents picked me up at the airport yesterday after 24hrs of flying and layovers. A hot bowl of wonton soup, fresh Taiwan pineapples and a hot shower later, I felt completely relaxed.

Its good to be home . . .

On the vital role of stability

Is Paul Kagame, the President of Rwanda a saviour, a murderer or both?

Kagame was the leader of the Rwandan rebel army in exile that finally ended the Hutu led genocide and secured the country. According to Deo, he even executed his own troops for seeking revenge against the Hutus and prevented a reverse genocide. However, the Rwandan army, under the guise of protecting displaced Tutsi refugees in the Congo from the Interhamwe (Hutu militia), has also taken control over the diamond and precious mineral assets of the Congo which has subsequently led to the displacement of more refugees, continued violence and instability in the region.

I do not blame Kagame, as the leader of his people, he must do what he can to feed them and maintain stability in his country as it tries to recover from the genocide. But the reality is that even heroes must be pragmatic, lives must be sacrificed for stability.

The prerequisite for microfinance or any type of intervention for that matter really comes down to stability. Without it, any type of intervention would be an exercise in futility.

Deciding which Med School

This weekend, I attended Visiting Days at Dartmouth Med School. I met with incoming and current students, faculty and administrators and even looked at some properties to buy.

Today, as I depart DMS (I am now in Narita in transit on my way home for two weeks), I have decided to attend DMS. I suppose you could say that they sold me on the school but part of me also feels like it was forgone conclusion. This school really fits me well.

Its appropriate then that I explained the Chinese word ‘yuan’ or fate/destiny to Deo this weekend as we were sitting down to a meal together. Is it fate that the first student host I contacted was busy that weekend and I got to live with and get to know Deo back in October? Was it Yuan that I interviewed with the Chairman of the Admissions Committee who recognized my achievements in business instead of holding my non-medical background against me? Was it fate that I had a great conversation this weekend with the former Dean of DMS who incidentally was stationed in Taiwan in 1955 as an Army doc and urges me to get involved in US-China affairs?

I don’t suppose it always works out this way for all pre-meds, but somehow I think choosing DMS was yuan fen.

Rwanda and the Heart of Darkness

Deo and I talked today about Rwanda today. Deogratias is a first year student at DMS who I met last year when I came to interview. He escaped from the genocide in Rwanda 1994, lived in refugee camps and came to the US and has been involved in public health fighting AIDs in Africa since then. We have become fast friends and he is one of the big reasons I am coming to DMS.

We talked about the war and its aftermath. Deo showed me a Nightline special about the aftermath of Rwanda now playing itself out in the Congo where people have been dying at a rate of 0.5 million a year from ongoing fighting, disease and lack of food. The final episode in the series talked about coltan, the precious conductive metal used in cell phones that has led to SEVEN different guerilla armies fighting in the Congo displacing millions of refugees. The commentary about the Congo, the diamond and coltan minerals feeding the rich while starving the poor really makes you sick.

Watching this made it apparent to me that it is critical to come up with solutions to counteract both the poverty and disease that are killing people. We gotta get working on implementing microfinance in these areas . . .

Some websites about the ongoing conflict and the DVD . . .

Congo War and the Role of Coltan

NIGHTLINE: HEART OF DARKNESS SERIES DVD