The air is so thick and filled with vapor that fine droplets of yet-to-be-evaporated sweat are visible on my forearms refusing to be borne off into the air. We drive through the sometimes paved, narrow and uneven roads, plastic bags and bags and more bags of trash strewn on the edges of the roadway like strata of rock you would see at the Grand Canyon. There are nearly continuously heard beeps from car and motorcycle horns not tooted from some angry road rager but more to announce ones’s presence. Whether heeded or effective; who knows. The road we are presently on has a nearly completely worn away dashed white line running its length but it is only for suggestion as taxi drivers and motorcyclists travel on both sides when possible to advance their position. They return to their side at the last moment just barely avoiding collision with oncoming traffic which doesn’t slow for one second. Expressionless faces grace the myriads of helmeted-motorcyclists who outnumber car drivers by at least 10:1. They drive with a casual confidence as if they are the only ones on the road, with little regard to the narrowness of the street, the potholes and puddles and wandering dogs and chickens, leave alone the multitude of other motorcyclists. Yet there seems to be some mutual respect among them; a sense of cooperation and joint respect for road usage, that they yield to each other at the very last minute and accidents are avoided. I saw one very heavily-burdened motorcycle with a father steering the machine, then the mother held tightly around the waist from her back by what couldn’t have been more than a 2 yr old child and finally a 10 year old at the rear of that poor motorcycle. And they looked straight ahead without a care or sense of standing out. And it appeared that they didn’t stand out as no one else besides myself thought the sight unusual.

In the hospital, there are areas of fine marble wall that border bathrooms with leaking rusty faucets or sinks that have no water at all. It seems like so many contradictions. Then again this hospital is run on donations and construction occurs piecemeal and continuously. Surgical patients are awake having been anesthetized by spinal anesthesia and they gaze at me at the head of the operating room table, to the sound of hammers and clanging metal in the not to distant areas of the hospital undergoing construction. There is no wastage of anything here. Anesthesia circuits are washed and hang out to air dry like someone’s Saturday afternoon laundry. Shared midazolam and fentanyl from case to case; a practice that would never work in the states, happens here as daily usual and customary practice. When our operation was over, we transferred our ever-grateful  patient to her gurney for transfer to the recovery room. That same gurney would have been thrown out to the recycle heap at home. The wheels on her gurney were so worn that the expected round and smooth ride of the wheel was replaced by the clackity clackity sound resembling the sound of train wheels you hear while at the crossing gate. You would think the wheel had an irregular hexagonal or octagonal shape to it. Yet the smiling patients don’t complain one bit. When we arrive to the communal recovery room, 20 pairs of eyes rubberneck to see the patient return from whence it left just 2 hours earlier, alive and well. The recovery room has the buzz of many fans that make ones existence there just tolerable. Luckily for us, the operating rooms are air conditioned with air directly from outdoors that is unfiltered. Not good for orthopedic cases for sure but I’m thankful. Without that AC operating would be most miserable.

Like a mother finally delivering, the heavy mugginess has birthed a downpour with thunder and lightning. The rain brings out the pungent sweet odor of decaying garbage. We travel in the open-aired tuk-tuk; basically a motor scooter with a rickshaw-like carriage attached by a 5th wheel apparatus. The tuk tuk reminds me of the autopia at Disneyland as the motor makes the same putt putt sound. It has no windows and offers essentially no protection in the event of a collision. No seatbelts are provided so you need to hold on tight to the thin bars. I suppose the closest American equivalent would be the little golf cart vehicle the janitor at your high school used to move about campus. The fresh rain spares us from the dust and odors that would have for certain assaulted our eyes, noses and mouths, but the price we pay is the splash of water on our pant legs as we pass through the puddles of water.

Then in an instant we pass from this 3rd world almost ghetto-like scene to a first rate modern mall that would shame even the Mall of America. The cleanliness here would embarrass the Ritz Carlton. There is relaxing background music to encourage shoppers to open their wallets, and high-end clothing, baggage, jewelry and tech stores, all well staffed by young, informed neat and polite salespeople. All Asian fares abound and the fragrance of ginger and other eastern spices reward your nose for suffering the garbage smell on the way to the mall.
Who shops here? Who built this place that seems so out of place from the Cambodia I have seen? All the people I have seen so far seem far too poor and certainly not dressed well enough to present themselves here. There must be some elite population hidden from me that comes here, but for sure the common man doesn’t come here.
We finally settle down for some Japanese food where my hosts inform me that this mall was chosen for dinner tonight in order to give me the choice of where to dine since heretofore we have dined at places they assumed weren’t appealing to me. I reassured them that where we had eaten before were just fine establishments but they nevertheless gave me the honor. I ordered some beef udon; basically a beef and noodle soup. No waiters except to bring water. We ordered by computer at the table and our food travelled to us by a miniature rail system that encircled the entire restaurant at table level; no doubt passing through the kitchen. Our food was quickly delivered, stopping precisely at our table and not spilling anything.
After dining, we had about half an hour to walk around before our tuk-tuk was to meet us for our trip back to the hotel. I kept a keen eye open for small things to buy or even postcards, but there was nothing I thought appropriate for you all. That’s all for now. Love you all very much. Dad.

Today is Friday. My last day here in this strange and different country on the opposite side of the globe. We ate breakfast, checked out of the hotel, rounded on patients and now we are off to the Killing Field Museum. This place seems to be the knee jerk response to the visitor’s request to visit local sites. Don’t misunderstand me; I really want to see the museum, but part of me is saddened that the Cambodians show this as their premier attraction. Is it because there is nothing else worth showing us or is it because they want to impress upon visitors the terrible atrocity this people experienced due to PolPot from 1975-79. Over a quarter of their population was exterminated. There are no old people here. The median age is 24, which means half the population is younger than 24 and half is older than 24. During the reign of the Khmer Rouge, all the intellectuals, politicians and business people; essentially everyone except the peasantry were murdered and the people were moved out of the cities to the countryside to be re-educated to PolPot’s version of agrarian socialism. That’s  why this poor country is struggling to pull itself up from that social and genocidal disaster. Many of the young Family Medicine residents lost grandparents, parents, uncles and aunts.

Our driver is lost. We break out our google maps and direct him how to get to the museum. Beep beep. The street turns into just one lane as an outdoor market and shoppers pour onto the road.