Watching surgeon reinforces faith that doctors care

Using a miniature version of a crochet hook, Dr. Vasana Cheanvechai carefully stripped the varicose veins in the back of the calves of a patient. To her medical intern, it looked like the vascular surgeon was pulling spaghetti out in inch-long pieces.

Varicose veins, she said, are not just cosmetic. Waitresses, bartenders, hairdressers, dealers -- all those who stand for hours -- can feel great pain by the end of the day.

This patient stands a lot for his job and, at the end of his day, his legs feel like they are burning. This procedure should help.

(The intern learned veins shrivel up quickly, so there is little bleeding. Despite that, the intern got lightheaded.)

Tonight, most of the 14 medical interns who participated in the Clark County Medical Society's Mini-Internship Program will discuss their experiences after spending a morning or afternoon with a physician this week. Legislators, judges, educators and others were invited to participate. (My question: Was I the only wimp to get woozy and need to sit? Hey, the room was warm.)

For four hours Monday, I followed Dr. Cheanvechai (or Dr. C as her patients call her), observing her with 17 patients. She looked at ulcers and wounds, kneeled to gently stroke legs to feel veins and patiently answered questions. Surgery was arranged, treatment advice offered, options explained.

In the exam room, the doctor was calm and empathetic.

In the hallway, she juggled three students from Touro University, her certified nurse assistant, her receptionist, her billing person and me -- all while rushing between three exam rooms. Four to five patients an hour are scheduled. Some need just a few moments; others take longer.

It was an eye-opener to see what goes on outside the exam room when a patient is inside. Where are the X-rays for one patient? Where are test results from another doctor for another patient? Does this treatment need to be coordinated with another doctor treating illnesses such as cancer or diabetes?

If Cheanvechai doesn't have the necessary materials for review, the patient's visit might be wasted. So the students and staff scrambled to get the latest information, if it's not already there.

As the afternoon wore on and patients backed up in the waiting room, there was more stress outside the exam rooms, but never inside.

Cheanvechai, 42, has worked in Las Vegas for four years and is one of only six board-certified vascular surgeons in Clark County. She worked previously in Chicago, Miami and Baltimore. She was born in the United States, but her parents are from Thailand.

She chose vascular surgery because it's a field that's relatively clean and delicate.

"I actually develop a relationship with a patient," she said. "When they become my patient, I tell them: 'I'm going to know you for the rest of your life.' "

Pausing to write orders after each exam, she also quizzed the three students -- Alyssa Kroska-Wilhelm, Adam Ferguson and Kelly Heck. She always has students because she likes to teach. "My goal is not to make them a surgeon, but teach them to be able to recognize if the problem is serious and what the treatment should be."

She is concerned about the speed with which the health care overhaul is moving and wishes there could be more time to know what the House and Senate bills actually do.

"We need changes in both bills, but the biggest problem is the rush," Cheanvechai said.

That's a refrain we'll be hearing a lot over the next few weeks.

She hoped to prove with this internship that, while Las Vegas has more than its share of bad doctors, there are good and caring doctors here.

I already knew that. Now I know one more.

Jane Ann Morrison's column appears Monday, Thursday and Saturday. E-mail her at Jane@reviewjournal.com or call (702) 383-0275. She also blogs at lvrj.com/blogs/morrison.