Day 1, or token white girl goes to cinic

I show up to clinic at 8 am like I was told last week. I climb five flights of a staircase lined with bodies in various degrees of wakefulness. The clinic waiting room is already super crowded. I walk past the reception into the clinic area; it already smells like products of conception. I walk up to the nurse sitting in the hallway, and ask for her boss. The nurse scurries away, then returns and drags me to a different doctor-looking person, presumably understanding English. Now, this is my fault because I entirely should have anticipated what followed.
I am asked who I am. I am a doctor, from America, I spoke with your boss…..of course I don’t remember her name, and she told me to come here today…and it is today. Another (male) doctor is summoned, they take out cell phones, start calling people, then I am dragged into the back of the clinic, where another doctor is summoned. The three of them proceed to have a conversation, the third doctor does not seem pleased. I am escorted back to room one. What is the purpose of your trip? I am here to work and to observe. More conversation; the entire staff is now out, staring at this spectacle, ie me. eventually, I am escorted back into a locker room. You can change your clothes. Do you mean into surgery clothes? No just white coat. Oh, I certainly don’t need a locker room for that. I put on my white coat and we walk back into the clinic room. You will observe me examine patients? Sure, that’s all I ask.
The clinic room is about 8x20, separated in the middle by a large column, with US and blood draw area in the back, separated by a plastic half-wall. There is a desk on one side, another on the other, plastic fold out chairs behind the desk. The two doctors sit behind the desk, they pull a chair for me and make me sit in it. The patients come in randomly. There are plastic stools (about 5) lining the wall, which is where they wait. Each patient carries her own chart—paper with handwritten notes on history, payment stubs, number in line (DMV style)—all handwritten and stapled together. There is a nurse who sits at the side of the desk and takes the charts from women's hands and places them in the corner of the desk, from which they are taken. This whole clinic operation, the clinic itself, functions like triage: women are seen for terminations, for consultations with questions of weirdo bleeding, for procedure follow up. They enter the room, whenever, and line the walls sitting or standing until their chart is pulled from the pile. There is no privacy, there is no HIPAA. Conversations, counseling, discussions of medical histories happen outloud, with everyone listening.
Doctors take the chart, calls the name of the patient, who then moves to the chair across the desk. Ultrasounds are reviewed, notes are scribbled and labs are recommended, after which the doctor pulls some sheet of paper, writes her orders and passes it along to the nurse, who fills the rest (patient’s name, birth year) and explains to patient where to go. Cross-conversations happen all the time: doctors are talking this way, while the nurse is talking about something with a different person sitting at the desk that way. Everyone's paper is stamped—tehre are about 5 different stamps on the desk--blue and red—and the nurse staples all of it together.
I feel like I’m on display, sitting at this desk with everyone walking in (or passing by, for that matter) staring confusingly at me. yes I stand out, I am aware. The room is crowded. At one point I counted 12 patients just hanging out along the wall, waiting to be called. This is including 2 doctors, 1 nurse, big ole’ me, and about 7 different nurses and ultrasound techs hanging out behind the desk waiting on patients. Everything is in Vietnamese. The young doctor, who is a resident (confirmed later, she has 6 more months left of residency) intermittently explains things about patients, but they are too busy and I feel bad taking their time. I piece information together largely by ultrasounds, figure out what patient are here based on grainy and poorly taken pictures (I would have made my residents redo the ultrasound). Super tiny early pregnancy, tiny slightly older pregnancy, thin uterine stripes of follow up. A 68 year old diabetic woman shows up because she has had an IUD for the last 20 years and wants it out. (This is way big to do about nothing, if you ask me), but she is sent to the lab for blood sugar check and then likely hospital…because she is 68. Another woman walks out of ultrasound crying: she has an embryonic demise--fetus with no heart beat. Another woman has thyroid cancer and is undergoing chemotherapy—freshly keloid scar across her neck, shut voice—her 18 week fetus has no heartbeat. One woman is turned away: she is 23 weeks, Vietnam allows termination up to 22. Patients who are admitted to the hospital get a blue chart; procedure charts are green, both are started at the desk. It is hard to tell if patients are being counseled—medical versus surgical termination—or just told what is happening. It is all in Vietnamese.
By 11a my doctor friend gets up and disappear, two more patients to see. Then, she comes back to tell me that she is working the night shift and because of that gets to go home half day to rest. If I’d like, she’ll take me to lunch. We walk outside. Do you eat Vietnamese food. Yes, but no meat, no fish, no street food. Oh, you’re vegetarian---dumbfounded look. Do you eat bread? Yes, but I’d prefer not to. She takes me to a ‘nicer’ looking café. After scrolling through the menu, together, nothing is vegetable friendly other than a pot of vegetables, so a waitress is summoned. She suggest french fries… umm, maybe I’ll just have thing yogurt thing. My companion orders the same, I think, because she feels bad. As it turns out I basically order dessert: soupy yogurt with crushed ice, whipped cream, pieces of strawberry on the bottom. My companion fears I will be hungry; I fear SHE will be hungry. We talk shop, medical practice while eating. Then head out, I thank her for her help and company, and then realize—I’ve just eaten ice. Shit!
So one redeeming doctor things I did today was help talk to this young Spanish girl who is traveling through southeast asia and just found out she was pregnant. she is too early in the pregnancy, and the ultrasound could not see the pregnancy. So I have to explain to her that we cannot do her abortion until we see the pregnancy in the uterus, until we make sure it is normal, otherwise, it can be somewhere else and not normal, and that would require a whole different set of meds. She is on a visa which expires, she has plans to travel the country before she leaves, she is now sobbing. I try to tell her not to worry. That if she can change her plans, she should come back in one week and we’ll take care of her then. Then, I ask her where she is going. It’s ok, if something happens, we’ll take care of you in Thailand. I hand her my email address and tell her to email me with questions. I tell her not to worry. I hope she feels better. I mainly feel bad because I can see myself, ten years ago in my travel days, suddenly being pregnant in a foreign country. I would have flown directly home, and I admire her for the courage to walk into a mess of a clinic, in a foreign country to take care of a very unintended mistimed pregnancy.