January 30th
After getting in to the plane from Wichita on the 29th of January at 6am, came to Thailand on 30th of
January at 2am. The transits were through Chicago and Narita, Japan. Flight was smooth and there were
no delays until Japan. The flight to Japan to Bangkok was delayed about 2h but it did not add much
conflicts to my schedule because Thailand was my final destination.
After going through immigration and baggage claim, I asked from an airport employee for
directions to get a taxi. Although she did not understand English, she used Google translator to help me
and she directed me to a counter where I can get a ticket to a meter taxi. I got a ticket for a meter taxi.
He took me to the apartment for total of 500 BHT and it was about 65Km. Then I got the apartment. It
was a good one with A/C and a bed with a closet and a cabinet fixed to the wall. Many mosquitos were
there in the wall but it was a familiar experience for me as I am originally from Sri Lanka. After having a
bath with cold water without soap, I went to bed at around 4am with an intention to wake up around
10am in the same morning and go for shopping, money exchange as well as to visit the site where I have
to report on Monday morning.
January 31st
Woke up around 8am and went to visit Bangkok. Got a phone sim card and exchanged the USD to BTH.
Did visit Siriraj hospital to be familiar with the place that I have to be on the 2nd of Feb. After visiting
Siriraj hospital, I ate street noodles for breakfast and then head back towards downtown to visit temples
and monuments. Took a taxi to go to downtown. In downtown went to visit some shopping malls as
well. Textiles were very cheap compared to the US and other goods were somewhat cheap as well. Then
took a three wheeler (tak-tak) towards the temples and visited the Golden Buddha and some parks as
well. I was accompanied by my classmate Mariam and we did not forget to get a river boat ride. The
river boat ride was operated as a medium of public transportation and we took it to travel about 3Km
along the river to visit several temples. During this journey, coconuts, Mangustin, traditional Thai dishes
also traveled with us to satisfy our thirst and hunger respectively. Around 6pm we came back to the
apartment with sweaty cloths and tired selves. Took a shower and had dinner. Then went to bed.
February 1st
Today we went to visit one of my apartment mate’s friend. He is a person from Thailand but travels to
the US very frequently. He owns restaurants in the US and some food industries in Thailand. He
prepared us a delicious meal (fried rice and authentic noodles with curry). After having that meal, we
went to the Sunday market in Bangkok. It was a huge market with textile, furniture, lather bags, food
and many other items sold inside small boutiques. After spending about 4h shopping we returned back
to the apartment to have the dinner and be ready for our first day of hospital work on the following day.
February 2nd
Today was the first day in the hospital. Around 7:45am we went to the international affairs building to
meet Mrs. Korboon. She then asked us to sign some documents and gave us a tour to the places that we
will be working during this week. My friend Mariam went to the OB/GYN building and I went to the
hematology building. During the morning session I shadowed a doctor with the medical students. There
were about eight inpatients with leukemia, and multiple myeloma on chemotherapy regimen. They
were not isolated from each other and there were no contact precautions implemented. Some patients
were on antifungals to treat pulmonary Aspergillosis due to chemotherapy induced neutropenia but the
entire floor had open windows and it was not under any air conditioning. After the rounding’s with my
attending, I went to the library to read and then had lunch as this was my free time. At 1:30 pm there
was a symposium by visiting doctors from MD Anderson Cancer Center in the USA about treatment
strategies and bone marrow transplantation in liquid tumors. It went until 6pm and it was a fantastic
lecture series where they introduce all the novel agents in this area of medicine. Then had dinner on the
way home and went to bed.
February 3rd
Today the entire day was spent at the hematology outpatient clinic. The clinic was a big air conditioned
hall where chairs are aligned in rows for waiting patients. There were close to 150 patients at a time
who were waiting for their appointment. Doctors are seated in the corner of the room. When a doctor
becomes free, the nurse hand over a paper file to the doctor and the doctor call the patients name.
Then the patient comes and sits in front of the doctor. Then the doctor asks questions from Thai and
goes through his or her labs and prescribed medicine, labs or imaging if appropriate. Each doctor spends
about 15 min total with patients and with their paper work and a doctor will see about 30 patients per
day.
Most of the patients were leukemic patients and many were on chemotherapy as outpatients.
After spending the 1sta half of the day, I went for lunch. The second half of the day was spent reviewing
bone marrow biopsy and pathology slides with doctors and fellows. It was an interesting experience as I
did not have any clinical training in liquid tumor management during my 3rd and 4th year. I got a chance
to look through microscopes and listen to the lectures done by the doctors for fellows. At around 6pm
me and my friend Mariam went to eat from the hospital cafeteria and then went to our apartments.
February 4th
Today was a good day. I went to see the inpatients at about 8am. Rounded on 10 patients and all of
them had leukemia’s and were on chemotherapy. Some were on antibiotics and antifungals due to
chemotherapy induced neutropenia. Then, ate lunch with the medical students in Thailand. They were
very nice and they bought me lunch. It was Khao Soi with is the traditional food in north Thailand. It
consists with noodles covered with curry made with traditional herbs, coconut milk and pork. It was very
delicious. Then went to noon conference and leaned about ARDS and ECMO. Although the lecture was
in Thai, the PP slides were on English. Hence I understood the content. I was done around 2pm. Then we
went to see the Chinatown in Bangkok. It was a road decorated with Chinese arts and there were lots of
small shops beside the road which were selling food. Noodles, sea food, fried deserts, kebab, BBQ
seafood, juices, etc were plentiful on those small shops. We are some of them. After spending about 2h,
headed back to the apartment and got detergent and water on the way back.
February 5th
Today I had Thalassemia clinic after inpatient rounding. During the inpatient rounding, I rounded on
leukemic patients with CML, Burkett, AML, ALL and MM. Then after the rounding, I shadowed a doctor
in the thalassemia clinic. Thailand has large number of thalassemia cases and 40-50% of that is
HgbE/Beta thalassemia. After seeing about 10 patients, I and the doctor went for lunch. She bought me
traditional Thai dish. In the afternoon I participated in the journal club where they present about using
Ruxolitinib in Polycythemia Vera and infections in multiple myeloma. It was a good educational session.
Then I went to see the museum in the evening. It was a historic museum about Siriraj hospital and the
area. Got free admission because of my affiliation with the hospital. That was a great experience.
Although the commentaries were in Thai, I enjoyed the sceneries. Then came to the apartment to wash
my cloths and had dinner.
February 6th
Today was a good day. In the morning I had a lecture about bone marrow transplantation in multiple
myeloma patients. Then rounded on patients who were on chemotherapy regiments due to
liquid malignancies. After finishing rounding, attended the coagulation clinic where I saw cases of Von
Willebrand factor deficiencies, hemophilia, etc. The professor was very good and I learned a lot about
diagnosis criteria of coagulopathies in Thailand. After having lunch, my attending, Dr. Weerapat gave a
lecture just for me and another visiting doctor about acute leukemia and its treatments. They ask me to
do a presentation on a topic I like in the following week as well. After the lecture I went to participate in
the International Multiple Myeloma conference in the intercontinental hotel in Bangkok. It was a very
educational conference were new methods of treatments and management of multiple myeloma was
discussed. They gave my dinner at the hotel and then came to the apartment around 10pm.
February 7th
Today I went to get some money changed and visited the MBK shopping mall. It was a 5 story building
with many shops full of textiles, food, electronics, ceramics, ornaments, etc. After that, I visited the Kao
San road. This is a road which is about 0.5 miles full of shops and food venders. After visiting there,
came to the apparent by walking and a boat ride aided me to cross the river
February 8th
Today I went to see the ancient city called Ayutthaya. It was situated about 80Km from Bangkok. I and
my friend Mariam took the train in the morning to Ayutthaya which was about 15 Baht per person. It took
about 2 h to get there. After getting there, we had out lunch (fried rice) and rented two bicycles (40Baht
each) and rode to see the ancient monuments. These monuments were built in 1374 AD and most of
them were Buddhist statutes. It was a nice town which has a great historic significance. We rode our
bicycle around the town and visited many places which resembles an old civilization to a certain extend.
Then around 5pm we return our bicycles and took the train back to Bangkok. It was very crowded as
today was Sunday and many people return to Bangkok for work on Sunday afternoon. The train ride took
about 2.5h and we enjoyed that as well as it was a standing train ride for entire time. People were very
friendly on our way to and from Bangkok as well as in Ayutthaya. We had dinner form the street near out
apartment and met another lady from Nepal who is staying in our apartment complex. She is a
pathologist by training and has come here for a training program at Siriraj hospital for 3 months. After
talking with her for about 20 min, we went to our apartment and called it a good day.
February 9th
In the morning I attended to the ward rounding. It was good because I rounded in a new ward. There
were about 20 patients who have liquid tumors and many were on chemotherapy. Although the rounding
happens on Thai language, some medical students came to me and explain the cases in English which
was very helpful. After that I had grand rounds in the afternoon. Grand rounds were little different than
in the US. The residents, fellows as well as the attending physicians gather in a room. Then the residents
or fellows present the case. After that entire team goes and inspect the patient. Then they re-gather in
the room and discuss the case further. There were two cases. One is about amyloidosis and the other
was about TTP and SLE. It was a good learning session and I asked some question from the attending
physicians as well. After the grand rounds, had dinner from the hospital cafeteria and headed home after
calling today a good day.
February 10th
Today in the morning I went on ward rounds with the team. Saw about 15 leukemia patients. Although
the rounds was conducted in Thai, some medical students translated those to me in English which was
very helpful. After the ward rounds, went to the hematology clinic. I was shadowing a doctor in the clinic
and saw about 10 patients with hematologic malignancies and pathologies. I saw a case with paroxysmal
nocturnal hemoglobin urea, which is a rare disease in the US, and learned about it with respect to the
management and clinical course of the disease. The drug of choice for this disease is Eculizumab but in
Thailand this drug is not available and the patient was managed with steroids. He was very anemic with
Hgb was around 6.5. Although I felt bad about the patient, I was grateful and thankful in giving me this
opportunity to learn about this disease. After the clinic I went to have lunch with the doctors. Then from
1 to 4pm I worked on my research that I am doing in the USA and then went to see bone marrow
biopsies. It was a good learning experience because I learned the basics of reading bone marrows to
diagnose hematologic malignancies. After reviewing bone marrow biopsies, went home and grabbed
dinner on the way home. Hence I could say that today was a great day with lots of new educational
experiences.
February 11 and 12th
I did ward rounds in the morning on leukemia patients with the team of residents as our attending was
late. It was a good leaning session as I was exposed to a case with hemophagocytic lymphohistiocytosis.
I leaned about the diagnosis criteria of this disease. After an hour or so I had a 1.5 hr break until my
presentation. I did some work on my research during that time and went for my presentation on
Neutropenic fever in the era of bacterial resistance. There were about 15 residents, three physicians and
two nurses as my audience. It did the presentation well and they were happy with the information. In
the afternoon there was the internal medicine conference but it was in Thai language. Hence my
attending told me to take the afternoon off today. I came home after eating my lunch from the street
and packed my luggage to go to Chiang Mai as a trip. I and my friend were going to Chiang Mai and Pai
for 4 nights as a trip in Thailand and today we are going to start the first day. It is a town in North
Thailand situated about 800Km away from Bangkok. We were going to travel by the train. We took the
train at 6pm and it was in the 3rd class category. This train was consistent with normal ordinary seats
without air conditioning. We went to the train station around 5pm and purchased the tickets. We got
the train at 10PM as all the other trains were full. Since we had about 5h to do nothing, we sat in the
railway station and just chat for about 5h. The train came at 10PM. We got two seats in the second class
compartment. We reached Chiang Mai at around 1PM. The train ride was comfortable. The seats were
good and you can recline the seats so that you can have a short nap. The meals should be purchased in
the train or you can bring your own meals. During the train ride landscape started to change. It change
from the flat land to mountains in about 300Km. We could see the paddy cultivation and many other
varieties of cultivation as well. Chiang Mai was the final destination of the train. After reaching Chiang
Mai, we took a taxi to the guest house we booked. We put our bags in our rooms and then went to see
the temple on top of the mountain in Chiang Mai. On our way we met two other medical students from
Yale and another person from Italy who shared the taxi with us to the temple. The taxi took us to the
top of the mountain and to the temple. It was a nice view but could not see the entire breath due to the
fog. Some people attribute the fog to the prolusion. After spending about 1.5h in the temple we came
back by the taxi. Then all of us visited the night market which is open from 5pm to 12am. There were
shops and bars in a street which was full of lights in different colors. There we ate Khao Soi which is a
traditional food in north Thailand. After spending out time at the night market, we came to our rooms
around 10am.
February 13th
Today was a great day. My classmate went to see an elephant sanctuary and I did not join to that as I
had seen enough elephants in my life. I went to see a garden which was called a Bhubing garden. This
situated on a top of the mountain and it is about 4km from the ground level. I had to take a taxi to it and
the entrance fee was 50 BHT. The garden was very beautiful with full of roses, orchids, jasmines and all
other variety of flowers. There are some palaces in this garden where kings and queens, prince and
princes have stayed in past (in around 1950 to 1990s). The architecture of the buildings and the
landscape of the garden were somewhat unique as well. I spent about 6h in the garden and then
decided to walk down the hill for about 4Km until I reach a place where I can get a taxi to the Chiangmai
city for a cheaper prize. This was a great decision. I walked under the shade of trees down the road.
Sometimes I went inside the forest to see some waterfalls as well. It took me about an hour or so to
walk and then I had a fresh fruit shake before getting the taxi to the town. Taxi came to the town after
an hour or so. Then came to the room at around 5pm and my classmate also came to the guesthouse at
that time. Then we rested for an hour and went to eat dinner with the friends that we met yesterday.
Came back around 10pm. We just walked in streets and some did shopping as well.
February 14th
Today we went from Chiangmai to Pai from a van. It took us about 4h. Pai is a small town compared to
Chiangmai and it is surrounded by mountains hence it has got the eye of many tourists. We arrived at
Pai about 5pm after going through hilly roads with lots of bends. Then we found a bungalow to stay. We
got a friend from Italy who joined us in our trip. The bungalow is made with bamboo and it was very
close to nature. We had huts to stay with small mattresses to sleep. After keeping our stuff in the hut,
we went to walk in the streets. Ate dinner in the streets and then went street viewing further. Returned
to the bungalow around 11pm and went to sleep as we had plan to explore Pai tomorrow early morning.
February 15th
Today we started our day around 9am. Me and my class mate Mariam and the guy from Italy made out
team. We rented two motor bikes 100 BHT each from a renting office nearby. Then, we started our
journey to see the beauty of Pai. First we went to see a waterfall. It was a beautiful waterfall and the
nature’s beauty was well depicted by the waterfall. After spending about 1h seeing the beauty of the
waterfall, we drove to see Pai Canyon. This is a land spill were canyons have been made by natural land
split. We walked through the canyon for a certain distance. It was little we slippery as it is made with
sand and dust. After spending about 1h there continue our journey on the motor bike and the next stop
was for lunch. Ate pat Thai and fried rice for lunch and then went to visit the memorial bridge which was
built by Japanese forces to transport weapons, in second world war time when they fought against
Myanmar. After that we head to another peak of a mountain to see a temple. The view was
breathtaking as this temple is built on top of a mountain. We could see the entire bed of mountains
surrounding this temple. After observing its beauty, we head back to another scenic point which was
also built on top of a mountain. This was another breath taking view. In this view point there was a
garden which had a land scape closely resemble china. They offered us herbal tea and bananas for 20
BHT. Surrounding this garden was a bed of mountains which could be viewed slightly blue due to the
covering of fog accompanied by the sunset. We spent about 1.5h observing the nature’s beauty and
then head to the Chines village. This was a small village which was decorated according to the chines
tradition. As it was late in the afternoon, not much people were here. We walked in this village for about
1h and then headed back to the bungalow and had a wash. After been clean with cold water, we went
to return the bikes. Then had dinner from the street and headed back to get a good night sleep as we
were little tired due to the long but interesting and adventures day that we had.
February 16th
Today we went to Soppong to see the second largest cave in Thailand called The Lod Cave. We left Pai
around 7am and went to Soppong by a van. It was a 1.5 h drive. After reaching to Soppong around
8:30am we went to visit the cave. It was about 500 Bht per person and this included a raft to travel and
a guide. It was very beautiful and resembles the nature’s beauty in its true sense. There was a small river
which travels across the cave and we had the chance to go inside the cave from a raft. Then after
travelling about 100m, we came off the raft to visit inside the cave. The cave is consistent with lots of
calcium and its minerals. The water consistently drops from the roof of the cave and this water has
many minerals where majority is calcium. Then this calcium deposit on the cave forming huge tower like
structures which sometimes run from the roof of the cave to the floor of the cave, from floor of the cave
and rises half way towards the roof or from roof of the cave descends half way towards the floor. It
forms different structures during this formation which sometimes resembled a crocodile, a dragon, a
human head and a frog. These crystal depositions form many different patterns on the surface and
many resemble corals in the sea. We walked inside the cave for about 1h with the aid of a guide and a
kerosene lamp as it was pitch black inside. Intermittently we used the raft to ravel from one place to
another inside the cave. There were many bats hanging on the roof with plenty of bat droppings on the
floor. In a part of the cave there were some coffins and according to our guide these were there for a
long time and did not know how they came to this cave.
After this wonderful adventure we came back from Soppong to Pai from the same van. Then ate
lunch at Pai and took another van to Chiangmai as we have a train booking to go to Bangkok at 5:30pm
today. We came to Chiangmai around 3:30pm. Sat in the train station for about 2h and got to the train
at 5:30. We were in the second class compartment in the train with seats which can be reclined a little.
Chiangmai to Bangkok was a 13h ride and came to Bangkok around 8:30am on Tuesday.
February 17th
We reached Bangkok around 9am in the morning. Had a little bit of sleep in the train but was tired when
came out from the train. Then we took a taxi to our apartment. Today, we decided to rest as tomorrow
we have to start a new rotation. I was allocated to Gastroenterology service starting tomorrow. Had a
wash and worked on my research the entire day. Went to the street to grab some lunch but did not
have dinner as the lunch was quite enough to fulfill both meals. After working on my research went to
bed at night and looked forward for the new rotation.
February 18th
Today was the first day of my GI rotation. It was very interesting. In the morning I shadowed the head of
the GI department in his clinic. He was a great teacher. He explained every case in English and taught
the pathophysiology and treatment strategies for hepatitis management and hepatocellular carcinoma
management. I also saw a patient with Budd-Chiari syndrome which is a very rare disease in the US. The
clinic was a hall where patients were seated and the names were called in an order. Then the patient
come and sits in front of the doctor and the patient-physician interaction begins. Since most of his
patients were seen by the fellows and residents, when a patient comes to meet him, a resident or a
fellow will accompany the patient and present the case to the head of the GI department. Then he
oversees the treatment plan which was derived by the resident or the fellow and corrects the plan if it
needs to be corrected. I was with two other 4th year medical students and they were helpful for me as
well in explaining the logistics. Then I ate lunch with my classmate Mariam and went to a lecture. It was
a 2h lecture about liver transplant. Although the lecture was in Thai, the slides were in English hence I
could follow the lecture throughout. It was about 4pm when the lecture was over. Then I and the two
medical students went forward rounding with a GI fellow and a resident. It was a very educational
rounding session as the fellow started to pimp me through out. For most questions I did answer well but
sometimes when she asked about the guide lines of managing patients I struggled because I do not have
a specialized knowledge about GI as the fellows. Anyway it was very valuable because after that she
explained the answers to her questions. Around 7pm I went to meet Mariam and another doctor from
Nepal called Anju in the library and we went to have dinner together. Then we headed back to the
apartment. The Nepali doctor is also staying at out apartment complex so we all walked back to the
apartment and called it a day.
February 19th
Today is the chines New Year day. Streets were decorated with chines symbols and shops were closed. I
went to the hospital at 7:30 am and attended to morning report. It was held by the head of the
department. They did it in English just because I was there and it was very nice of them to do that. Then
I went to observe an ERCP. It was a great experience because it was a difficult case. It took about 4h to
complete. First the doctor could not find the ampulla. Then it was difficult to get the probe in. After that
the stent was too long to put so they have to get another stent. It was a good learning experience for
me as I saw many different ERCP techniques used in this session to complete the procedure successfully
as it was a very difficult patient. After finishing this, I went to have lunch with the medical students.
Following lunch we had a lecture about portal hypertension and they also did some question practice
with the residents. These lectures were in Thai and some of the lecture slides were in Thai too. But since
most of the lecture slides were in English I kept up with the pace. After the lecture I did ward rounding
with a fellow, resident and two medical students. After finishing that I, Mariam and another doctor from
Nepal went to see the China town which was bout 5Km away from our apartment. It was a street
decorated with chines symbols for the new year. The queen of Thailand went on a parade and I saw her
as well. The street was heavily populated with street markets, shoppers and people how came to see
the Chinatown. We ate dinner over there and walked a little. At the time we went there the parades
were over. So we decided to come back to the apartment by bus. We ate again from a street market on
the way home and call it a day as it was 10:30pm by the time we came home.
February 20th
Today was a slow day as I finished the ward rounding around 10am and was done for the day. The
residents and physicians had a special meeting which there was going to attend hence the afternoon
activities including lectures and procedures were cancelled. After finishing my rounds, went to the
library and worked on my research as well as read some papers about hepatitis B in Thailand. Then went
for lunch and came back to the apartment for an afternoon nap. There was a girl from University of
Colorado staying at our apartment complex who was doing her ENT rotation at Siriraj as well. I, Mariam
and she went for dinner with another doctor from Myanmar who is doing a fellowship in pathology at
Siriraj hospital. We ate noodles in a restaurant near the river and the sight was great as we saw the river
and the sailing boats while we were eating. Then I came back. Mariam and the student from Colorado
had plans to go out toning to see the night life but I wanted to stay in my room as I needed to Skype
with my family. Therefore they went out and I called it a day after coming to my room.
February 21st
Today was a slow day. Woke around 9am and then I and my classmate went to visit some shopping
malls by bus. The bust ticket was 9BHT and we reached the shopping mall called Central Pratunam after
a 20min ride. Then we did some window shopping and just walked through the stores. For lunch we ate
Sushi from a restaurant. Since we were board, we decided to watch a movie and went to see ‘Unbroken’
in a theater. The movie was very nice and it is the one and only time we watched a movie in Thailand.
After the movie, we walked back to our apartment. It was a bout 4Km walk and was nice since we could
see the Saturday night streets. We ate from a street for our dinner and came to our apartment around
9pm.
February 22nd
Today was a shopping day as it was the last Sunday in Thailand. I and my classmate went to the
weekend market in Bangkok which called Chathuchak. It is a huge market with more than 5000 stoles
with many different items in sale. Rage is varying from animals, ornaments, textiles to food. I bought
gifts to my teachers, doctors as well as my parents and friends in the US. We shopped for about 4-5h in
the market and came to the apartment by bus. After keeping our stuff in our rooms went to have dinner
with the Nepalese doctor in out apartment complex. Came to the apartment again around 10:30pm and
watched the cricket world cup highlights of the match, Sri Lanka Vs Afghanistan. Went to bed after
watching the highlights as tomorrow I have morning rounds around 8am.
February 23rd
Today was a strange day. In the morning I was scheduled to attend grand rounds and conferences but
they wall were postponed due to a special meeting. This meeting is for the special doctors at Siriraj
hospital for making plans to treat the Thailand King who is hospitalized these days due to
cardiopulmonary and GI complications and he is debilitated due to old age as well. These postponed
meetings were then rescheduled in the afternoon. One was the journal club where three papers were
presented in Thai but the slides were in English. I barely was able to keep up with the pace in this
meeting. It was great in content as it was new treatment strategies in lower GI bleeding. Following that
there was an x-ray conference. Here the residents projected an image of XR or CT scans of the abdomen
and explain the image from Thai. Unfortunately I could not keep up with the pace in this meeting as I did
not have any context to rely upon. Following this meeting where I paced out for about 40min, there was
grand rounds. This is done little differently than in the US where a team with students, residents, fellows
and two doctors will go to the bed side of the patient and the residents will present the case. This is
always an unknown and a difficult case. Then the doctors will question the residents at the bed side of
the patient and then the residents will answer as much as they can. Then attending’s will correct them
and teach them afterwards. After that they will establish a plan for the patent together. Unfortunately
this was also done in Thai language. There were some medical students who tried to translate the
content to English but they were not successful at all times. But because I had some content, I barely
kept up with it. After the grand rounds I completed a ward round with an attending physician and
finished the hospital work around 5pm.
Then I wanted to buy a wallet for my father. I went with my class mate and the Nepalese doctor
to a shopping complex called MBK. It was a large shopping mall with lost s of stores and floors. I found
the wallet which I wanted but could not buy it as the shop was closed. So I may go tomorrow to buy it.
We had dinner near the mall and then headed back to the apartment around 10pm by a taxi. Since I had
to go early to the hospital tomorrow, I called it a day and went to bed after doing some research work in
my room.
February 24th
Today was a good day. In the morning I had rounding with the residents and the fellows at 7:30am.
There we rounded on patients who had GI issues and most of them had liver pathologies. Following the
rounds, I and another two medical students went to motility clinic. Here most patients came with
complains of gastric and GI mortality issues such as fecal incontinence, gastroparesis and swallowing
problems. It was a nice educational session because the professor explained all the cases in English for
me. After the clinic I went to eat Khoa Soi with my classmate Mariam. This is a tradition food in northern
Thailand and it is so far my favorite food which I had since coming here. After lunch, I went to the
outpatient clinic where many liver cases were seen. I observed a paracentesis as well. It was around
4:30pm when I got finished with the outpatient clinic. Following the clinic, the residents and the
medical students including me had a lecture for 3h about pancreatitis. It was the best lecture that I had
on this topic so far in my medical career. The professor was such a gentlemen and a great teacher. He
conducted the lecture in English just because of me and explained the facts very well. He covered
everything with respect to diagnosis, management and treatment in a level of a GI fellow about acute
pancreatitis, acute recurrent pancreatitis and chronic pancreatitis. It was a phenomenal lecture and I
learned a lot about up- to- date treatment strategies. Around 8pm I went to have dinner with Mariam
and the Nepalese doctor. After having dinner, I headed back to my room. Had a wash and submitted my
rank order list. As I have to wake up early tomorrow for morning rounds, I went to bed and called it a
day.
February 25th
I went to the hospital at 7:30am for morning rounds with the residents and fellows. Saw about 8 patents
with cirrhosis and hepatocellular carcinoma. Following the morning rounds, attended to the outpatient
clinic with the head of the GI department. It was a great educational session as he explained every case
in English. He went through how to manage hepatitis infection, how to diagnoses such infections and
the pathophysiology behind the infection and the drug resistance. Further, in this clinic I saw patients
with Wilson’s disease, auto immune hepatitis and primary biliary cirrhosis as well. This session was a
great learning session. After that I went to have lunch with the medical students around 2pm.
Today I and my classmate Mariam were invited to a dinner by a relative of Mariam. Since we
had to go there by bus, I went to my apartment little early and did some laundry. I and Mariam then
headed to his house and on the way we visited the MBK shopping complex to get a wallet to my father.
We took a bus and then the train to get to his house. This house was not a residential house but it was
built by him only for dining for his family. He is a very wealthy person in Thailand and a gentleman as
well at the same time. He gave a traditional Thai dinner for us with Pat Thai, roast duct curry and
chicken curry with fish cake. It was great and we had a good time. Around 9pm he asked his driver to
drop us at our apartment. Came to the apartment and did some work on my research. I went to bed
around 12am as I have to go to the hospital tomorrow early morning.
February 26th
Today I did two good things which made me happy and made my day a pleasant one. I went to the
hospital around 7:30am. As I have mentioned above, it is a 15 min walk to the hospital from the
apartment. When I reached the hospital grounds, I decided to get a Nescafe for me before going to the
ward rounds. I went to the cafeteria and bought a Nescafe and a pastry for breakfast. There I saw a
Buddhist monk standing among the crowd to obtain his breakfast. In Buddhist countries such as
Thailand, monks walk to people and in the streets and people give food for them as a respect and
worship them. There were several people donating food for him and in return he gave good blessings for
them. I purchased a vegetarian pastry and gave it to the monk and he gave me good blessings. This
made me so happy and with a smiling face I went to start my ward rounds. When I went to start my
ward rounds, the fellow and the resident were there. After about 5 min in to the rounds, the fellow
came to me and told that she has to cover the entire building and another building today hence she
does not have time to explain the cases in English and told me it is better if I can take off today in the
rounds so that the process will be quick. I understood their rational and it won’t be any benefit for me if
no one explains me the case in English. Therefore I went to the library and worked on my research. I
made a power point on my research and did some reading as well. Today was the cricket match
between Sri Lanka Vs. Bangladesh in Cricket world cup 2015. Since had free time, I watched the score of
the match as well. Then I went to eat Khoa Soi with Mariam and the Nepalese doctor. After lunch, I had
two lectures in the afternoon. One was about gastric mortality disorders and constipation and this was
in English which was really helpful. The other lecture was about upper GI bleeding and this was in Thai.
Since the slides were in English, I could keep up with it. Following this, there was a case presentation
about acute recurrent pancreatitis by a medical student and I attended to this as well. Then it was
around 5:30pm and I started to walk in the ‘Wanglung’ market.
I walked along the streets where lots of venders were selling food items. Purchased some
snakes, fish cakes (like a pancake made with fish and deep fried), and a sweet roti and walked towards
my apartment. On the way, I found a person who is selling some sweets such as cashew nuts and
candies. He was neatly dressed with a shirt and a short but he had some congenital anomalies in her
legs. He could barely walk and had hearing aids. Although his hands had contractures throughout, he
carried the candy station on his hands. I saw great determination and courage in this person’s eye. I
could not pass this person without helping. I rolled a 20 Baht note and placed in his hands. He then was
the happiest human on earth. He smiled very innocently and talked to me in Thai. Although I did not
understand what he was saying, I am sure he was thankful for the money I gave though it was not that
much. Then I came to my apartment.
Since I had to leave Thailand early in the morning on Saturday, I started to pack my stuff. Then
watched the highlights of the cricket match and ate dinner with Mariam and the Nepalese doctor and
went to bed.
February 27th
Today is my last day in Thailand. I was off from the hospital duties today because my attending gave me
my last day off. I slept until 10am today and then went to see the grand palace at 1am. This trip was
arranged by the hospital. I went to the international affairs building at 1pm for the tour. I, Mariam, the
Nepalese doctor, four chines medical students who were visiting Siriraj hospital, one Indonesian medical
student, another student from university of Colorado also visiting the hospital and two staff members
composed our team. We then headed towards the grand palace. It is situated about 2Km from the
hospital but opposite the river. So we cross the river by boat and then walked towards the palace. We
got a special guide and special permission to visit the kings dining area due to Siriraj affiliation that we
carried. The grand palace was built by the king Rama the 9th and it was full of Buddhist ‘sthupa’,
Buddhist statues and Buddhist architecture. Many foreigners and locals had come to see the palace.
Further we got free admission due to Siririaj affiliation as well. After taking pictures with the great
architecture of the buildings and the landscape in the background, we went to see the kings dining area.
It was a special privilege that we got today. It is a big hall with lots of decorations and appeared majestic
with respect to the design. Small tables and chairs were arranged so that kings and queens can sit
around and chat before the feast. Pictures of the past kings and queens were on the wall. After visiting
there, we went to see another museum in grand palace which explained how it was build and the
materials like wood, ceramic and concrete which were used to build the palace were on exhibits.
Following this visit to grand palace, the team got scattered. I, Mariam and the Nepalese doctor stayed
together and we went to see the reclining Buddha ‘Wat Pho temple’ which was about 10 min walk from
the grand palace.
This was a huge monument of reclining Buddha which was long about 50m and height was
about 35m. Painted in gold, it looked very majestic and glorious. After visiting there, I visited some other
Buddhist statues in the same premises but Mariam stayed with the Nepalese doctor as she was not
feeling well. Following that we took the boat to cross the river and started to head home as I have to
pack my suite cases as well. On the way I and the Nepalese doctor (Anju) had fried rice on the street
while Mariam went directly to the apartment as she felt tired. I brought her fried rice to the apartment.
She felt fine after having a wash and relaxing a bit. She might have got tired as it was a warm humid day.
Tomorrow my flight is at 8:40am and I and Mariam are leaving to the airport at 4am (in about
5.5h from now). Now I have to pack my stuff and get ready. This will be my last post in my blog about
trip to Thailand. I have enjoyed it very much and it was a great experience overall. I felt that I am very
fortunate to see the culture, society, medicine and happiness of people in Thailand and I want to thank
you everybody in giving me this opportunity. This experience will surely act as a catalyst in shaping me
as a competent doctor and I will use this divers experience wisely to serve the needs of my patients in
the US. Again, thank you very much for all in the US and in Thailand in helping me to make this trip an
educational and enjoyable one. I would love to give help in return to anyone who needs it.
Take care
Jithma Abeykoon