Jan 16, 2013

Family Medicine at Tzu Chi General Hospital Dalin Branch

I have to apologize for the delay of this post. I completed this rotation at the end of December but it took me 2 weeks largely because my mind had been totally shut down after my Step 1. The hospital at Dalin is Tzu Chi Foundation's second hospital. True to our nature of building big things at small places, Dalin itself is a sleepy little town which felt like it's been left behind after 1970.
The first day I was there, there were no taxis at the train station when I arrived at 7 pm. I hauled my luggage and walked 15 minutes in near-total darkness to the tallest structure at Dalin township and was told by the security guard, the first human being in a 5-mile radius, that the dorm is another 10 minutes away.
After I have settled I wrote to Steve describing this place "something like the motel in Hitchcock's Psycho." The only thing missing would be a schizophrenic slashing a knife while I'm showering.
Over the course of the following month the people of Dalin would prove again and again, that the largest of hearts live in the smallest of places.

As family practitioners at Dalin work with a huge network of community leaders, social workers, nurse practitioners, and physicians from other specialties, we were given full exposure to all the spokes of their work during our month there. We enjoyed all the trips to nearby townships and villages, lectures and talks on various NGOs working in different fields, and participated in hospice ward meetings (which were always full of food and fruits given by patients' families).

I benefited the most from talking to several nurse practitioners who specialises in patient education. As our Dalin branch names itself a health promoting hospital, education on food and lifestyle modification as well as medication compliance is a paramount issue for many patients with chronic diseases. The many educators I met were more than eager to share their experiences dealing with stubborn patients, stressing repeatedly that health behaviour modification is a long-term goal with step-by-step approaches. For example, if we simply shower a first-timer with all the importance of avoiding sweets, they will probably land on deaf ears and the patient would possibly never return because we just cut him off his very essence of life. One would prefer to establish a solid relationship with the diabetic first before gradually cutting down his sugar intake, teaspoon-by-teaspoon monthly. You gain a friend, the patient lives better.
In retrospect, I am very grateful I did not switch my courses to gain more time for my Step 1. It was time to take a break out of Hualien and Dalin simply bedazzled us with their warmth and sincerity. In fact, I think I was able to study better thanks to a new environment and pleasant daytime work.
I felt sad leaving Dalin on my last day, heading down south for a major exam but missing a train that day. It renewed my faith in how doctoring could be happy instead of burdensome, and reminded me that people, not diseases, is at the core of every patient seeking medical care.