Today we finally started our first rotation in Taiwan! We begun our day by attending the Internal Medicine Department's morning meeting. It was such an interesting experience and we were able to learn so much in just one hour! Not only did we get to walk through a real-life case study with the doctors, it also helped prepare us with case presentation for our future rotations in the US. I was surprised that even with only one year of medical education, although we did not know some of the specific clinical terms, we were able to understand almost all of the pathophysiology and differential reasoning behind the case and it was great to be able to utilize what we learned in classroom to real-life situation.
At 9 o'clock, Mickey and I went to the TCM department to officially start our rotation. This morning, we had the privilege of studying with Dr. 謝抒玲. Dr. Hsieh specializes in weight loss clinic and begun the rotation with a demonstration of acupuncture on a patient. It was interesting to see how fast and efficient she was at needling and finding the acupuncture points. Unlike the osteopathic points that we are familiar with, it seems like the TCM points relies little on palpation of landmarks. Dr. Hsieh taught us that the points are often measured relative to each other with the Chinese unit 寸, which is often approximated with 1/3 of the patients' finger length. She also added that although many acupuncture points, called 穴道 in Chinese, are fixed and have specific names and corresponding effect/function like 陰陵泉 and 足三里, many of them are fluid and dynamic, depend on the patient's body and do not have a specific name. These points are called 阿是穴 and are often effective acupuncture points that are not found on literature and specific only to each patient.
After the demonstration, we spend the rest of the morning observing Dr. Hsieh doing outpatient consultations. The first thing we noticed was how fast she went through each returning patient, with each patient encounter average about 5 minutes. However, for the first time patients, Dr. Hsieh will group several of them together and give a quick patient education: including explanation of food nutrition (avoiding fried food, starch, sugar...etc), possible adverse effects (palpitation, constipation, insomnia, thirst, dehydration...etc) with the Chinese medicine (made with several different Chinese herbs, has appetite reduction effect), followup in one week (to check for any adverse effect/reaction with the Chinese medicine)...etc. She also helps the patients set a healthy weight goal by BMI calculation. One striking difference we noticed between Dr. Hsieh and US physicians was her attitude toward patient. She seemed to be a firm believer of the paternal approach to patient interaction, often speaking to the patients in an authoritative way. However, even though it may seem strange and too forceful to us Americans, all the patients seemed to be responding well to her style, probably due to the traditional Chinese view toward physicians.
One other interesting thing we noticed was the general hospitality of the Taiwanese people. Just yesterday, the TIHTC staffs brought us around to attend the Dragon boat race in celebration of the holiday 端午節. Since it was a national holiday, the staffs could have stayed at home and avoid the 34C temperature outside, instead, they were there with us at noon time when the sun was the harshest just to give us the unique experience. In addition, after the race, they even treated us to a delicious meal of ShabuShabu! And today, even before meeting us, Dr. Hsieh brought us each a cup of latte, probably in anticipation to our jet-lag! It was so sweet of her! In addition, she even gave us her cell phone number in the end when she found out that we wouldn't have more rotation with her (she is only at Taipei hospital Tuesday mornings). Kind acts like these said so much about the Taiwanese people and had really touched our hearts.
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