Reflection: Ian Macomber

            Thailand has been a wonderful once in a lifetime opportunity.  For that, I am forever thankful I was given this opportunity.  I am incredibly grateful to all the people that made this trip a reality.  Upon reflecting on this experience there were three parts that I will take home with me.  I first loved meeting all the different healthcare professionals in each of the hospitals, I found the food to be better than I could have ever anticipated and I saw and did way more than I ever thought possible.  It was an absolute pleasure to go on the APPE rotation to Thailand. 

Picture of myself at the elephant hospital

            Looking back at the trip, I thoroughly enjoyed interacting with the Thai pharmacy students, pharmacist, nurses, doctors, and other medical support staff members.  One of the hospitals I enjoyed going to was the first hospital that Desiree, Natalie, and myself went to was Ramathibodi Hospital in Bangkok.  There we met with the head of the clinical pharmacy department who was an absolute sweetheart.  She was incredibly personable and friendly.  We were joined by two students who stated their English was really bad but I believe they spoke very good English.  It was fun hearing about their experiences and interests after school.  It was there I really started to get the sense there are a few universal characteristics of a pharmacist and patient care is always number one.  Every hospital was the same in that regard, they always focused on patient care.  I was impressed by how incredibly respectful and incredibly knowledgeable each pharmacist was about their specific topic.  This is an experience that I couldn’t even fathom receiving in the United States.  I don’t even think it would be possible outside of a large city to visit all the hospitals that we did.  We went to more hospitals here than I have ever been to in the U.S.A.  The next thing looking back on the trip that I really enjoyed and relished was the Thai cuisine.

            The food… the food, it was so delightful.  The Thai are incredible cooks and the food is just the freshest.  I am incredibly thankful that there was a cooking class with this rotation because I definitely want to use some of the recipes back home.  We also learned about how the Thai combines sweet, spicy, sour and savory together in a perfect blend to make their food one of a kind.  The food was never too spicy because unlike the US the Thai aren’t looking to declare war against your taste buds and digestive system.  The spice added to the flavor but doesn’t overpower it.  One cultural event I thoroughly doing was looking to find tasty food.  I loved walking to a street market and finding a stall to grab some food from.  It was cheap, tasty and so flavorful.  I will not get used to the US and how much food costs.  In Thailand, it is a fraction of the cost but infinitely more flavorful. 

            Another aspect about the food I found it interesting how the traditional Thai medicine considers food as an option in treating patients and I can see why.  They cook with so many herbs and spices.  I feel that in the US food doesn’t have the same respect that it does here.  I could be wrong but I just feel like there is more of an emphasis on the meal.  I also learned so much about traditional Thai and Chinese medicine that I would not have been able to experience otherwise.  Often in the US traditional medicine is viewed with ambivalence at best of disdain and distrust at worst, here the hospitals all allow traditional healers into their hospital.  Before arriving here, I didn’t know that these healers spend many hours learning about their subject and follow a similar format to treating their patients as many Western doctors do.  I know more about the subjects though I am by no means an expert.  I have a healthy appreciation for their work and expertise.  I was also happy to hear that the healers in TTCM also were willing to refer a patient to a westernized doctor if it was something they couldn’t treat.  There were a great many experiences that I thoroughly enjoyed as well.    

            In Thailand, I have done many things that I have not had the opportunity to do in the US.  I was able to see many facilities that treat diseases that I have only read in textbooks and learn about a healthcare system completely different from our own.  Maine isn’t in the tropics, as we are acutely aware during this time of the year, so we do not see the same diseases with the same prevalence as Thailand.  The healthcare system is quite different as it is an open system where access is more important than safety because the country doesn’t have enough pharmacists and doctors.  This is different from the closed system that the US has where safety is more important than access because we have a larger pool of doctors.  I had the pleasure to participate in traditional Chinese medicines practices like cupping which felt great though looked a lot worse than it felt.  I thoroughly enjoyed the personal experiences that help us to further meet and speak with our fellow students across the world. 

            We were given the opportunity to speak with pharmacy students from Thailand and Indonesia as well as Chinese student who were not associated with the medical field.  In the international exchange, I met many smart and young pharmacy students who were able to talk about our respective healthcare systems and how do we improve them.  I am grateful that we were given the opportunity to meet with other students.  Lastly, a cultural event the was a delight to participate and one of my favorite cultural events was the elephant hospital just outside of Chiang Mai.  I learned so much about the elephants.  I was thrilled to play catch with such a large, gentle giant.  There is so much more than we did that I couldn’t even fathom doing back home in the US.

            This trip, maybe every trip for that matter, is like a Thai massage.  The first time it is weird.  You walk into a place you don’t know and you don’t quite understand what everyone is saying to you but that doesn’t matter because through hand gestures you are able to get where you need to go.  Once you start there is no turning back.  Some things may feel funny like having your calf muscle tickle the bone underneath(still at a loss of words to explain how it felt that is the closest I can get).  Other parts of the massage may feel painful like when you have a small Thai man pushing his elbow into your back forcefully. And at other times you may feel slightly uncomfortable because of the massage goes very close to a more intimate area that you weren’t expecting it to.  But in the end, you realize you survive and you feel much better for having the experience.  Sometimes it was not what you were expecting but life is made more enjoyable by the unexpected. 

            At times this rotation was very difficult, but with the help of every one of the professors and preceptors, I was able to complete the rotation.  I appreciate their knowledge, expertise, and compassion.  I especially want to thank Dr. Krebs, Noi, Dr. Choi, Dr. Warren and our drivers Nue and Burd.  Everyone was wicked nice and I can see why Thailand is called the land of smiles.

Thank you for reading, I hope you all have the opportunity to travel and see things you have never seen before.  I leave you with the sunset here on Koh Samet

-IM