Getting Back to Brass Tacks: Chiropractic in VN

The first time I laid eyes on my chiropractic staff, I didn’t realize that this would be our first meeting.  The boss lady had called me at 2 pm and told me to meet her at the clinic at 3 pm.  I was sitting in a coffee shop overlooking Hoan Kiem Lake, eating a sandwich.  I was wearing flip flops, shorts, and a t-shirt.  I think my legs were pretty hairy too, and all scabbed up from mosquito bites.  I finished my sammy and jumped in a cab.

I sauntered through the clinic gate at 2:55 and was met by the clinic 24 hour security guard.  I asked for the boss with her name and a shrug, and he led me back to the courtyard.  As I rounded the corner, I was met with applause from a U shaped group of twenty-something year olds.  Whoa.  “The doctor!” my boss proudly exclaimed, and the clapping continued.  The day before had been my first effort to learn a vietnamese sentence.  I started out strong: “I don’t . . . .I . . . . don’t . . . . .”  Hmmm.  I looked down at my fingers.  Must be stage fright.  “Ummmmmmm. I don’t . . . . speak . . . . . . Vietnamese” I managed to get out in their language.  As I think I’ve said before, if you don’t get it perfect, they still won’t understand you, even after all the effort.  “Who here speaks English?” I asked in English.  I was met with stares.  The girl next to me turned to me and said, “We are very happy to meet you and very excited to work with you.”  My boss turned to the crowd.  “Can you understand her English!?” she barked in English.  She was met with unsure nods.  She dismissed the class and led me away.  I wondered what they could possibly think of me, a fellow asian of about the same age, looking like any traveling backpacker coming off of the street.  

I have been training “the kids” for about five days now.  I went through my prepared material in the first two days, and wondered how I was ever going to be able to keep them busy for ten days.  I was actually pretty nervous about not having enough material by the end of the second day.  I basically gave my standard chiropractic health talk that I would give to any patient, but in this case left a lot of time to make sure nothing was lost in translation.  They need to know what I am doing and why I am doing it so that the clinic can run as smooth as possible and so they can explain chiropractic themselves.  They eagerly ate up their anatomy lesson and memorized which organs and systems are being affected by the nerves exiting each vertebra.  If they didn’t know the function of an organ, it turned into a lesson on organ function.  If they couldn’t grasp the sympathetic nervous system, I took the time and patience to explain it to them until a light bulb would go off and then the Vietnamese would be flying across the room and other faces would light up too.  I started to feel really proud of my little students.

The morning of the third day, I looked on amazon.com hoping specifically for “Chicken Soup for the Chiropractic Soul” but willing to settle for any inspirational stories about chiropractic for the kindle.  There happened to be one, and I downloaded it just before I had to run out the door to catch my motorcycle ride to work.  I figured, worse come to worse, I can read in English and my translator can translate.  The boss stresses that learning english is just as important as any chiropractic information they get.  Only two translators understand me at 90%.  The other two understand at about 65-75%.  So this requires a lot of repeating and slowing down.  They enjoyed the chiropractic story so much.  As the published stories usually end in a miracle, there was much clapping and looks of surprise.  I decided I would try to tell them about a miracle every day.  Apparently, for most people, the first few days was just noise coming out of my mouth, but they are beginning to catch on.

For the last couple of days, I have just been winging it.  Since they did so well with learning where the nerves go, I spent a day teaching them about dermatomes (areas of skin innervated by a single nerve root) and how to test for problems.  After that, I figured I might as well teach them which muscles are supplied by the spinal nerves, and how to test muscle strength for each level of the spine.  This morning I said, tell me everything you know about Cervical vertebra number five.  Their reply: “It affects the throat and lower neck muscles, you test the dermatomes of the outer part of the arm, and you muscle test shoulder abduction and elbow flexion.”  My little angels!  Today they learned the process for taking a case history (OPQRST, PC).  Then I acted like the patient and made them ask me questions.  In this way, I have a code word for a series of questions I want them to ask, and I don’t have to waste the time on translation because they know what to ask.

The thing I stress the most is that chiropractic brings hope to life.  In the spirit of my great chiropractic mentors, I show inspirational youtube videos like my buddy Peter Kevorkian, and repeat some of the great Kevin Donka stories.  It brings tears to their eyes, as they have never imagined that they could be part of something that will have such a big impact on the world around them.  It brings tears to my eyes too.  

I spend a lot of time writing on the board, because they understand better when they can see it.  I draw pictures.  Yesterday I thought I had better learn their names.  They are named after actual “things” here.  We have two Victories, two Waters, a Mountain, a Cherry Blossom, a “such as or the same” (this one wrinkled her nose at her name’s meaning), a Flower, two Rivers, a Forest, a Happy, an Advantage, a Hero and a Sunny, just to name a few.  I learned 27 Vietnamese names in ten minutes, and they were so happy when I went through the list the first time with no mistakes.  Of course, musical chairs would tarnish me big time. 

And my pronunciation is never perfect.  They love to correct me.  I ask them to teach me new words every day.  I say it, and I get 27 answers back with an encouraging nod for me to try again.  They beam at me.  They tell me they love me and adore me.  One of them has volunteered to bring me back and forth to work every day.  They invite me home and bring me food and take me grocery shopping.  They asked where I live, and after telling them, they said, “Your street is named after Heroine.”  “No way!” I exclaimed, wondering if I lived in the ghetto.  I mimed sticking a needle in to my arm.  “Heroine?”  We all broke out into laughter.  “Heroine is girl Hero, and your street named after famous vietnamese heroine who is 16 year olds.”  Well laugh out loud.  Even though some are older than me, they are my kids, and I am happy to be around them every day.

I am working my butt off over here.  I told my boss I would be happy to be in charge of new doctor recruitment.  I know when I looked at the position, I had my doubts because the emails in English made me question if anyone would even be able to communicate with me.  The applications have been pouring in, and every question is important and must be answered.  It is, however, a lot of effort to put out for someone who might not come.  On my third day of training, I was called up to the bosses office to receive the news that the other doctor who was supposed to be back next week decided not to come.  This basically means that I am now solely in charge of the chiropractic direction of this three million dollar clinic.  I get to chose the protocols on everything.  I get to shape the impression of chiropractic in this town of six million in Vietnam.  The  cool thing is that when I ask my staff, what does chiropractic focus on?  They say, “The nervous system.”  What travels from the brain to the body by way of the nervous system?  “Signals.”  What do the signals carry?  “Information.”  What disrupts the flow of information?  “Subslushation.”  If you think Americans have a hard time with ‘subluxation,’ come over here.  I feel really glad that the philosophy that I learned at Sherman goes over with admiration, but most importantly, without argument.  In America, some patients find chiropractic to be absolutely amazing.  Here, they all do.  It is really really really cool.


The Clinic and Staff: