Building walls and Building Connections

My cab yesterday had a scooter bump into the door and get knocked over. No one was hurt and damage if any was little to the car or scooter. It did shake me up. It is a constant juggling of cars and bikes and scooters each into each other's lanes. Right now, 15 floors up, I can hear the constant rumble of horn blowing. I saw a little bit of a temper with the latest dustup but usually with all the horn blowing and aggressive driving for position there is a remarkable sangfroid. This is something I want to cultivate or; Binh Tinh in Vietnamese.

I spent time this morning working with the Cancer Report on Breast Cancer and treatment. Mostly straight forward modified radical mastectomy. Breast conservation is not a prominent issue here and I think that that is appropriate for the time being. We also discussed issues of screening. One of the things I am trying to help with is thinking about the psycho-social barriers. So why a woman would wait till the cancer has grown through the breast tissue and is an ulcer before coming to the doctor? We need to understand the reasons that she did not come earlier; while education may be part, the roots in psychology is much deeper. Later we went to see a patient that has a bad tumor not responding to radiation and now getting a first dose of chemo. He always looks so happy, vui ve, and the fellows are concerned that we not cause problems by negatively affecting his optimism. I countered that while he is optimistic, that anyone with a problem like this would realize that things were not going as planned. I complimented him on his positive outlook and then asked a few questions about how he manages stress and worrying about illness which I am sure he does. For a moment his mask fell and we all saw a glimpse of the terror behind. I told him that we did not need to talk more now but that if there are questions or worries that come to him that we could talk next week. I know, this sounds like such a small issue but it led to much discussion and request for more education on communications.

I am also interested in construction. Many houses are about 10 meters wide and maybe 20 meters deep and then as many as 6 stories tall. The first floor may be a business or dwelling depending on the street. All around I see the most beautiful hand made brick. Brick has been made in Hanoi and Red river delta for probably 2000 years. This kind of artesian brick would cost a pretty penny in the USA. The floor and then pillars and beams are made rebar with re-enforced concrete is poured into forms. The construction goes up one floor at time this way. The squares are then filled in with the brick and the whole will be plastered inside and out to cover-up the beautiful brick. Since the lots seem so small the only way to expand is up. The highest such house that I have seen is 6 stories and 4 stories is not uncommon at all. I wonder how tall you can go with formed concrete post and beam construction with what appears to be concrete floors at least on the first few floors and then wood thereafter. Maybe one of our engineer friends can comment. I will try to post a few construction pictures soon.