We arrived in Hanoi today from Luang Prabang. We’re in a completely different environment! Luang Prabang in Laos is a small, sleepy hill town with a population of 100,000 known for Buddhist temples, beautiful scenery, and refreshing mountain climate. The recently built Lao-Chinese provincial hospital is clean, spacious, and – at least while we were there – decidedly uncrowded. The airport is tiny and can only accommodate small planes. We only saw props (and not too many of those).
Hanoi on the other hand is now a sprawling metropolis of over 6 million people. The airport is modern and expansive. The streets are congested rivers of humanity with potential catastrophe everywhere. At least now motorcycle helmets (“insurance hats” is a direct translation) have become mandatory.
After checking in to our hotel, I took a taxi to the National Conference Center located clear on the other side of town. I will be performing a live angioplasty/stent case tomorrow and there was a meeting to select and assign the cases. That’s definitely a meeting that one doesn’t want to miss unless one relishes the idea of doing something crazy and difficult with a lot of cardiologists watching. The NCC, a brand new gigantic and beautiful complex which cost over $268 million US, is yet another symbol of the new Vietnam.
I found the meeting room and was warmly greeted by my dear friends Tuan and Thai. I’ve worked with both since my first trip back in 1997 and in fact Tuan and I were part of the team (along with Dr. John Douglas from Emory) that placed the 1st stent in Vietnam that year. Tuan and I share many special memories. Since 1997 we’ve travelled throughout Vietnam lecturing and performing coronary procedures. Tuan has been over to the US many times for conferences. He stayed with us a few years ago and visited Eisenhower. And he was with me when I got stranded in Washington, DC on 9/11. I remember Tuan, a survivor of the 1972 bombing of Hanoi, bringing quite a different perspective to that day as we stood by our hotel window watching the smoke rise from the Pentagon. I was with him in 2000 when his daughter was born (actually we were working together in Hue as she was being born in Hanoi). He even named her Anh which is the name of my oldest daughter. Tuan today is recognized as one of the leading interventionalists in southeast Asia and is a regular on the international lecture circuit. Thai is Tuan’s second; he is loyal, reliable, and a skilled interventionalist in his own right.
I was very happy to see another familiar face in the room. Aaron Kugelmass, MD is the head of the cardiac cath lab at Henry Ford in Detroit. Ari and I shared an apartment my first year at Harvard Medical. We were both intent on saving money and decided, rather than a room in Vanderbilt Hall which was the medical dorm, to rent a place in Mission Hills, an incredibly dangerous place a short walk from the medical campus.
Tuan presented the clinical history and angiograms of about 10 patients. All appeared extremely challenging, some prohibitively so. I was happy to have Ari, who has always been as blunt as he is bright, looking over these cases with me. Anyway, I somehow ended up with an elderly man with 2 out 3 coronary arteries (the LAD and circumflex) completely occluded and the sole remaining vessel (RCA) compromised by a critical lesion. To make matters even worse, this last vessel looks like a total minefield: extremely tortuous, filled with plaque with multiple significant lesions, and moderately calcified. As it turns out, the patient is somewhat of a VIP with important political connections. Tuan assigned me this case. Evidently they had requested me because of my long history of clinical work at Vietnam Heart Institute over the years. I have to say this case is a lousy reward. Not at all the kind that anyone would want to tackle in front of a panel of experts and a crowd of conference attendees...
