Endless Knots

A start-up for "liquid gold"

Last weekend, Boston Globe's Sunday Magazine ran "The Story of My Start-up," a feature on five interesting start-ups in the area. Thrilled to see my friend Naomi Bar-Yam's Mother's Milk Bank of New England as one of them. Fascinating undertaking, she's got. When her first son was born at "only 4.5 pounds...he was in the NICU. Another mom didn't have enough milk, and I was the only mom with extra, so I shared. Then, about seven years ago, my dad was very sick. There had been anecdotal evidence that mother's milk can be palliative for cancer. I thought I would arrange for a milk bank to send him some, but I discovered there were none in New England. The first milk bank in the US was in Boston; it was downright embarrassing that there wasn't one [now]."

Determined to right the situation, Naomi is changing all that. Purpose of the Milk Bank is "to provide donor human milk to newborns in need by: collecting, pasteurizing, and dispensing donor human milk; educating the medical and general communities about indications for, benefits and use of donors human milk; and contributing to furthering our knowledge of donors human milk through research."

Human milk is often called "liquid gold" because of its color (gold tinged) and "the value of the irreproducible nutrients, antibodies, and growth factors babies receive with each nursing. Numerous studies prove the nutritional and immunologic qualities of human milk and support its use as a preventive treatment for many diseases," according to the Mother's Milk Bank site.

FYI. there's an interesting conversatioon going on at World Hall, where policy issues related to breastfeeding are being discussed in an open forum. Weigh in with your views on what actions employers, Congress, insurers, CDC and even the JHACO (Joint Commission on Accreditation of Healthcare Organizations) should take to promote and protect breastfeeding and breastfeeders.

I encourage all my young nursing mother-friends to donate. A little bit of pumping goes a long way. Bravo, Naomi. I wish this had been around when I was nursing.

Medical researchers to play nice in Boston

Kay Lazar's piece in this morning's Boston Globe is another worth the click: "Harvard medical researchers to pool work." For access to hundreds of millions in NIH grants over the next five years, the mano a mano among Harvard Medical School affiliated hospitals also will have to give sway to a new martial art: cooperation. Grant criteria mandate that fierce competitors work together on specific projects, forming always-on "communities of practice"  that cross organizational boundaries. The purpose of the arrangement is to "shorten the time it takes to turn discovery into treatment." Harvard Medical School hands out the allowances. NB: The grants represent only a portion of NIH research dollars available to the institutions but still it's a great start in putting our best medical minds together here in Boston:

There will be matchmakers to introduce scientists who have never met because they have been hunkered in their isolated research labs. A massive, centralized database will give Harvard's researchers instant access to one another's work.

..."There has always been a disincentive to collaborate," said Dr. Lee Nadler, codirector of Harvard's new Clinical and Translational Science Center, which will link researchers and allocate Harvard's grant money..

"If we succeed in doing what we are trying to do, then it will become far easier for studies that relate to specific diseases to be carried out for the maximum benefit of patients," he said. "We also will be training people to carry out this type of collaborative research in the future."

Last year, Johns Hopkins University was awarded one of the new grants from NIH in an earlier round of funding, and leaders there have since found collaboration to be a strong learning experience.

 

What disease is a cousin of yours?

Fascinating article in today's NY Times, "Redefining disease, genes and all," with a chart called "Mapping the human diseaseome" that looks a lot like OrgScope, which I've posted about here, here, and here (search "OrgScope" on right for full listing).

Gene research is causing medicine to reclassify. Turns out that seemingly unrelated diseases share some number of genes. Definitely worth reading and definitely worth playing with the map in which Albert-Laszlo Barabasi, author of Linked: How Everything Is Connected to Everything Else, has had a hand. The map assigns a color to each disease and a size to its "wafer," indicating how many genes that disease contains. Then it draws lines to other diseases that share genes with it. Implications are far-reaching and possibly even paradigm changing for how we treat disease. From the article:

Duchenne muscular dystrophy may not seem to have much in common with heart attacks. One is a rare inherited disease that primarily strikes boys. The other is a common cause of death in both men and women. To Atul J. Butte, they are surprisingly similar.

Dr. Butte, an assistant professor of medicine at Stanford, is among a growing band of researchers trying to redefine how diseases are classified — by looking not at their symptoms or physiological measurements, but at their genetic underpinnings. It turns out that a similar set of genes is active in boys with Duchenne and adults who have heart attacks.

"Feeling Numb" - Ars Medica

"Feeling Numb," my essay about MS in Ars Medica, Vol 4, No 1.

Download ars_medica_feeling_numb.pdf

With thanks to Allison Crawford, Ian MacKenzie, and Liz Konigshaus of Ars Medica.

Contact Ars Medica.

Running away

I happened to be at Logan Airport today where there were an inordinately large number of very thin people in sweats and running shoes, many of whom were limping. Why? The Boston Marathon, run yesterday under sunny skies, a race we've watched nearly every year for as long as I can remember. The wheelchair competitors always make me cry, none more so than Team Hoyt, the father-son team, with the father, Dick, now 65, pushing his son, Rick, now 45 and with cerebral palsy for the 25th time this year. 26.2 miles, Heartbreak Hill, and people screaming support all along the route. Inspiring.

Yoga, blessed yoga

I agree. There's nothing like it. See CNN's "Yoga's appeal broadening to disability community:"

...[l]ongtime instructor Karen O'Donnell Clarke says the limitations could have a number of sources: multiple sclerosis (which she has), a sports injury, fibromyalgia or even a sedentary lifestyle. Post-surgical conditions, Parkinson's disease, stroke and arthritis may also cause some impairment. "Pretty much if you name a health condition, yoga can help with it," she says.

"A geek doctor takes a 2.0 approach..."

My profile of John Halamka, CIO at Beth Israel Deaconess Medical Center and its affiliates (plus a ratttthhher famous medical school), is up at TheStandard.com as "A geek doctor takes a 2.0 approach to healthcare technology." Thanks, John, for the easy interview and help with fact-checking.

Ice and pain

It's been pretty cold, snowy, rainy, and icy here in Boston of late, leaving a lot of the dreaded sheet of slipperiness in odd patches around town. I fell last night and though I didn't hurt myself at all it does prompt me to post this note, reminding everyone to keep their eyes open. I slipped in my driveway in the dark. I hadn't come far enough in to set off the motion detector.

That said, my very close friend did take a terrible spill during an ice hockey game last Saturday, resulting in a broken femur, surgery, and a lot of pain. He fell when a player on the opposing team "checked" him, which is not supposed to happen in Saturday morning play among adults of a certain age. So it's dangerous, this ice. Be careful and make sure, if you're a hockey player, that the rules have been spoken and acknowledged by all before play begins.

Vote for my favorite medical blog

I keep few secrets especially when it comes to my enthusiasms. As I've mentioned in articles I've written in the past year - including one about my fave blogs, I'm a subscriber to/regular reader of Paul Levy's blog, Running A Hospital. What's so great about it? Self-quoting:

Running a Hospital, the blog of the CEO of a large American medical centre, is informative about health care, as well as funny and controversial, and even includes the occasional recipe.

Turns out Medgadget, "an independent on-line journal covering the latest medical gadgets and technologies, discoveries in medical science, and the progress of the digital revolution in the healthcare industry," is runningacontest, ooops, running a contest. So I'm voting for Paul's blog in two categories: Best Medical Blog and Best Medical Policies/Ethics.

Contests aside, it's hard enough to run anything these days but what sets Paul's blog apart is that he's not afraid to expose what's going wrong inside his hospital - as well as in health care - and he's not a johnny-one-note. My favorite all-time post of his and the one that got me hooked? "Blackberry Cold Turkey," in which he simply gave his up (I haven't). Take a look at his blog and vote with me.

Public service announcement: Wash your hands

Flu outbreak in three Boston hospitals prompts the reminder to wash our hands over at Running a Hospital. I've been doing the twice-through "Happy Birthday" while washing my hands since seeing a sign in a client's bathroom.  In all their bathrooms. Sing it twice, the signs say, above a drawing of hands washing. What I've noticed: next person to the sink washes her hands longer, which causes person after her to do the same. What's the antonym to contagious? This is it.

Chicken Soup for the Cold (but better warm)

A member of the Peanut Gallery (and loyal reader) popped up last night with the observation that this blog has been very work-y of late. Let’s fix that right now.

Chicken Soup. I’ve been all about the elixir with no known rival for some days now due to a certain unwelcome visitor (cough, sneeze, Neti Pot, repeat). Sadly, this morning I had to part with my delicious concoction and take off for climes better known for their barbecue than Mama’s go-to remedy.

Here then, my recipe, evolved from my mother’s, as certain ingredients have become less available since the days when we went to the Farmers Market, a building of its own in rural Pottstown, Pennsylvania, to buy our chickens, eggs, vegetables, and French crullers that have no rival.

Assume, by the way, that all ingredients are organic. Jump page for the recipe.

"The studio of my mind"

She lived for thirteen years after tests confirmed ovarian cancer, which she intuited long before that.  She opened her sealed orders early, knew she was meant to dance, which she did until two days before she died on April 6, 2007.

Last night, two hundred members of Dorothy Hershkowitz's family celebrated her life. Sweet nibbles to welcome guests and then the curtain.

A forty-minute film that Dorothy narrates, a dance biography, with Dorothy looking to the filmmaker, Lynn Bikofsky, and talking to us. Dance has been her "best friend," she says (at her funeral last April, the cantor recalled her saying that dance was her "conversation with God"). When things have been difficult, which they often were (we remember), she goes to her studio or at least "the studio of my mind." Dance is where she works out life, realizes emotion, travels through space. We see clips of her as a very young dancer, and, remarkably, pieces of her major early works, Kaddish, which she choreographed and performed shortly after her father's death (I made seafood lasagna for the cast party), and Monday Morning Quarterback, inspired by an incident where she had to step over a drunk in a subway turnstile. She is still dancing at the end of the film: she had to repeat a take 30 times, 30, when she performs in the halls, not the auditorium, of Dana Farber Cancer Institute, because people keep walking into frame, the background narration a lab technician saying "some people enjoy this test, find it relaxing," as Dorothy throws her body, just a few months before her death, from wall to wall with the knocks of the MRI. And then her teaching one of her last classes, frail, close to the end, her arms floating like no others, and the camera rests on her smile, her very beautiful smile.

People speak, beginning with the cantor, Lorel Zar-Kessler, and then many others. Poems, anecdotes, quotes from letters, a cello concert, cards, and emails Dorothy wrote, Dorothy-aware of death coming soon, her son, Alexander Bohn, recalling that she danced when she put away groceries, her students, her best friend in junior high, her cousin, all recalling a Dorothy the others recognized, and the brave tall man who said Dorothy was his icon of hope after his wife's ovarian cancer diagnosis because D had already lived seven years, (and, as it turned out, did live four years more after his wife died). Surely, as her husband, Dave Evans, has said, her incredibly strong body, all those years of movement, extended her life.

And then they danced, 15 of her students, in a piece choreographed by Joanie Block to "Smile."

Dave said the last words. Gratitude to all, composed and dignified, and very lovingly he tells of two things Dorothy said, the first a few moments after they met: "She poured out her love, meaning Alexander and Jonathan, her sons;" and her last, to the effect of: "No one should go hungry - there is no reason for that."

And then we all sang "You gotta have heart," words on the jump page here.

Repeating what I wrote when she died: Dance on, Dorothy.

A nice article in the Newton, Mass, newspaper where Dorothy lived.

Meet Jeffrey Walker

I've blogged before about the special gifts that come uninvited to speakers. People, strangers, all perfect in their own ways, say outrageously nice things, tell you their stories, say they know you from some chapter in your life where their characters may not have been as well-portrayed to you.

So it was that when Jeffrey Walker introduced himself at the Enterprise 2.0 conference this past June, said he knew us from when we consulted to Index Systems, a long-gone but then high-end consultancy based in Cambridge, Mass, I, reading his nametag, exuberantly replied, "We have to talk!"

Jeffrey is President of Atlassian Software, the Australian company that makes Confluence, a sleek wiki product that simplifies collaboration. We were introduced to Confluence through a client using our virtual team methodology; within days, that company's clever engineers had adapted our People-Purpose-Links-Time model to their wiki.

As things worked out, it took a few months before we scheduled our call but, during that time, Jeffrey sent an insightful note about his views of the conference with a good list of +/- (I was on the Advisory Board), invited me to be "LinkedIn" to him, and observed that I hadn't joined Facebook (corrected as of 48 hours ago). This morning I received his acknowledgment as his "friend" on Facebook (if you haven't joined, this could sound ridiculously hokey but there is something very compelling here, still to be understood by moi)...and so I checked out his "wall." There I noticed a number of notes where people were wishing him a speedy recovery and such...which caused me to click through to his blog where I discovered that Jeffrey has been blogging about his cancer, an arcane form, his recent surgery following what appeared to be a recurrence (fortunately benign), and the tremendous energy he has brought to recovery, i.e. just post-op, he asked the nurses where the hospital gym was, they looked at him as if he were mad, and long-short, he ended up with a treadmill in his hospital room.

Jeffrey is also a painter and a jazz musician. He lists Coltrane's "A Love Supreme" as his fave all-time album, which gives us common cause right there, and, business interests aside, I am very happy to have made his acquaintance. You will be too.

PS: His blog, radiowalker, is must-reading for those interested in Web 2.0.

Yoga: Rx for MS?

When I began my first real job as a reporter for my hometown daily, The Pottstown (Pa) Mercury, I had two regular assignments: writing up weddings and writing up obituaries. Both were compiled from forms - in the case of the former, the family filled out the details, including the description of the bride's and bridesmaids' dresses; for the latter, the funeral director would come into the newspaper, stand at the counter, and go over the details with me. The result of this early training is that I always read the obits first - and, on Sundays, I never skip the weddings in The New York Times.

Thus today I read the Boston Globe obituary of Janet Marzilli, who died of complications of Multiple Sclerosis (MS). I did not know Ms. Marzilli but I do have MS. Like so many others I've met over the years with the disease, she, according to the obit, developed many coping mechanisms, including starting a group for others with MS (ATOMS - the Association to Overcome Multiple Sclerosis). And, notably, she lived for 43 years post-diagnosis and gave birth to five children.

For anyone reading who has MS or who knows anyone else with MS, I offer this: Do yoga. I cannot claim it as a cure, for I continue to have episodes many years after my original one, but I can attest to its efficacy in reducing my symptoms. About a month ago, all the telltale signs of an episode descended - extreme fatigue, numbness in my back, legs, and feet, "banding," the sensation of terrible tightness, in my calves. Sometimes when this has happened, I've soldiered on, doing my best to ignore it. But, as I've grown up, I've come to understand that this is not the wisest approach.

This time I decided to pay attention to what I know works: laying low, meaning a lot of time in bed (ah, wireless computing) and increasing my yoga practice significantly. Significantly. For the past month, I've pushed myself to do at least an hour of yoga a day. While I cannot say my symptoms are gone, I can say that I feel immeasurably better than I did a month ago. Stronger, more energetic, and happier - and for those who know the symptoms, decreased banding, less tingling, and a whole lot less pain.

If you've never tried yoga, don't be put off by photos of people who can turn themselves intro pretzels. Even a motion so slight as bending your neck, reaching your chin toward your chest, done slowly, consciously, without strain, is a form of yoga. You can do it right now. Right here at the screen. Don't push - and, please: If you have MS, avoid the craze called "hot yoga." Heat exacerbates symptoms.

The five-minute headstand

Drawing from Yoga.net.au

A friend who's new to yoga asked this: "What happens in a five-minute headstand?" Coincidentally, I'd asked myself the same question the previous day during the four minutes I managed to hold headstand.

Minute 1: As slowly as you can, measure and place perfect triangle with forearms, interlace fingers, place top of head on floor, walk toes toward body until feet naturally lift, bend knees, raise torso, straighten legs, roll pelvis under, extend spine, distribute weight evenly along forearms, watch every little wobble.

Minute 2: Remember you're supposed to be using abs, notice clenched jaw, drooping shoulder, scrunched forehead, circulation stopping in gripping hands. Let all those go then realize you're wobbling again.

Minute 3: Pull up through spine (though you're upside down). Oh, remember to breathe. Calmly, slowly, inhale, exhale and for one very sublime moment you are completely relaxed, just resting, no effort. At which point...

Minute 4: Wobble wobble, weight rolls from elbows to sides of hands (and back), legs very anxious to come down, control, control, use the abs, very slowly bend knees, even more slowly straighten legs, very lightly touch toes to ground...and you are down.

Newsday: "Bellevue hospital makes move from medicine to manuscripts"

Brush off all your short stories, poems, essays, novels, and memoirs about illness, writer friends. Turns out Monique Doyle Spencer's having secured a hospital as her publisher may be a trend.

New York's Bellevue Hospital, at 271 the oldest such institution in America--and one associated with madness--now doubles as a publisher, including of fiction no less. The hospital has launched its own imprint, Bellevue Literary Press, according to Jennifer Peltz's piece in today's Newsday. So on I googled and found  "Unexpected Brand Name for Books: Bellevue" by Julie Bosman in the March 1, 2007, New York Times. Four books came out last Spring; four more are due this fall:

The Bellevue Literary Press sprung from the Bellevue Literary Review, a journal that was founded in 2000. Dr. [Jerome] Lowenstein, the journal’s nonfiction editor, recruited private donors to finance the imprint, raising at least $500,000 to be doled out over a four-year period. The imprint operates on a relatively shoestring budget, paying its authors advances that are usually less than $5,000, [Erika] Goldman, [the imprint’s editorial director] said.

“The types of books we’re publishing are books that we’re proud of, but they’re not commercially oriented books,” she said. “We don’t have any illusions about making a fortune. We’re in it for love and art.”

Take a look at Bellevue Literary Review ("We invite submissions of previously unpublished works of fiction, nonfiction, and poetry that touch upon relationships to the human body, illness, health and healing," says its website.") and wish me luck. With a few keystrokes, I just submitted "Feeling Numb," an essay about multiple sclerosis.

PS to Richard Selzer fans: He's judge of this year's nonfiction contest, deadline already passed.

My weekly post on Roland Merullo's Boston Globe column

I guess I should just set a timer reminding me to post. Every Monday for the past however many, the supremely talented Roland Merullo has had a worth-reading column in The Boston Globe. Today's "No burgers, but still nifty," has those laugh-out-loud moments that Roland is famous for (but, when you read some of his books, be prepared for the ones that leave you in a weeping heap, e.g. In Revere, In Those Days' readers: remember the toast?). Roland has an eye for the absurd, in this case, foreign tourists who don't appreciate the food in Italy, to which I say, are these people actually humans?

And...I have to praise another friend's column in The Globe from yesterday, "Drive Calmly," by Monique Spencer Doyle. Here she manages to capture what most of us are thinking - when those humongous SUVs, with the drivers on cell phones, cut in front but just before a bicyclist narrowly misses flying over your windshield. OK, she didn't mention either of these but I find myself screaming more than I like at the  people in the very large vehicles with phones tucked under their chins - and possibly smoking - while cutting me off. AAARRRRGGHHH. Monique is hands-down one of the funniest writers on earth. Any writer who can leave readers in stitches about breast cancer -- and still nail one truth after another -- is one-of-a-kind. As I've said before, if you know anyone with any cancer - or any life-threatening illness - or know anyone who has, does, or might (which would be everyone), buy multiple copies of "The Courage Muscle: A Chicken's Guide to  Living with Breast Cancer." Proceeds go to the cancer gift shop in the hospital where she was treated (and which published her book).

Jimmy Fund Telethon today

Just received this from Ron Currie Jr., whose father, Ron Sr., is being treated at Dana Farber Cancer Institute in Boston. Today's the day they're raising money for The Jimmy Fund, which I learned about when a beautiful young man whom I love dearly was diagnosed with cancer at the age of three. Here's Ron's note:

Today is the annual radio telethon to raise money for the Jimmy Fund at Dana Farber Cancer Institute in Boston. This is a big event here in New England, esp. among Red Sox fans, as the club has been affiliated with the Jimmy Fund since 1948. My father is being treated at Dana Farber, so I've seen firsthand the really incredible work they do there. I know you hear that all the time but it's really true, especially in their work with children and emphasis on family. So consider skipping the mochaccino today and kicking that ten bucks over to the Jimmy Fund instead.

 

www.jimmyfund.org

Holding the pose

About a month ago, a young friend with whom I've practiced yoga many times, told me she'd just done "breakthrough yoga." I wondered what she meant specifically but understood from experience without her answering. A yoga session where you feel "back," where you're limber, aligned, in balance, at peace with your body. How had she gotten there this time, I asked?

"Holding the pose," she said. "Things happen when you hold the pose." She went on to say that she'd been holding headstand and shoulder-stand for five minutes each, forward bend for ten, twenty minutes of Sun Salutation. If you've done any of these postures, you can appreciate what these lengths of time mean. If you've never done yoga, try this: Lean forward, trying to touch your finger tips to your toes. Now stay there for ten minutes. That's what forward bend is (also done seated and with infinite variations).

So the next time I did yoga, I got out a digital clock, moved it to various spots so that I could see it (just try looking at a clock in headstand), and held and held and held. Things do happen when you hold the pose. Awareness of tight muscles that soften, gripping that loosens, leaning more to one side than the other that rights itself. Things happen and suddenly you're considerably more straight, palpably more relaxed, stronger, more centered. This is why I love yoga.

Yoga postures -- asanas in the lexicon -- are challenging. Even "corpse" pose -- where all you do is lie in a relaxed state on the floor -- is a challenge when done properly. Same is true for most challenges. The longer you stay with them, the more you learn, the more resistance gives way.

I offer this to all who are trying things that seem impossible or just plain difficult. Hold the pose and things happen.

NIMH Outstanding Resident for 2007 - James Murrough!

Huge cheers and high-fives to James Murrough, who's been named a National Institute of Mental Health Outstanding Resident for 2007. The notice to his colleagues at Mount Sinai Hospital, where he is a PG-3 resident, reads: "This is a highly competitive and prestigious resident award, and to be chosen reflects a tremendous effort and dedication to the science of psychiatry on James’ part."

James, a graduate of Emory University and Tufts Medical School, also celebrates his 30th birthday today, a day we here at Endless Knots remember in great detail as he is our one and only nephew. Proud and thrilled for you, as always, James, shown here with his cousins at a significant family event a few years back.

"I walk because I miss my mom"

Amanda Lipnack, who walked the Susan G. Komen Breast Cancer 3-Day last weekend, writes about what she learned clocking 42 miles on foot in sweltering heat.

...I also learned to honour my body and be proud of what it can do and not be ashamed of what it can't do. I couldn't walk 60 miles this weekend but I could walk 42 and that, quite frankly, is amazing. There was a time in my life when walking up a flight of stairs was a challenge and this weekend I walked up miles and miles of stairs. Up big hills and down big hills -- over fields and roads and rivers and through the pain, I kept walking. I have fought against my body for so much of life but it felt very good to honour myself and be true.

I wish such an experience on the world around me. I wish that everyone can let the noise around them disappear and focus on what is in front of them. I wish that everyone can live life as it is meant to be lived, fully and strongly. I walked behind people this weekend with signs on their back that said "I walk because I miss my mom". How can we let ourselves forget that in a moment the things in front of us that we cherish can be gone so we need to embrace and honour them in the moment.

Breast Cancer 3-Day

In a few minutes, I leave to drive my niece, Amanda Lipnack, to the start of the Breast Cancer 3-Day, a 60-mile walk through eastern Massachusetts, to raise money for research and awareness about breast cancer. The walk takes place on different weekends in different locations around the country, beginning with this one here in New England. You can join me in making a donation here. Principal beneficiary of the walk: "Eighty-five percent of the net proceeds from the Breast Cancer 3-Day benefits Susan G. Komen for the Cure, the world’s largest and most progressive grassroots network fighting to end breast cancer." I'm very proud of Amanda - and hoping she won't be too hot as it's sweltering, even at 5 am.

After dropping Amanda off: There were hundreds and hundreds of cars, all politely following instructions, leaving off thousands of walkers. As I drove away, I thought of the women I know who've had breast cancer--three very close to me who died (my grandmother, Rae, my aunt, Frances, and my high-school roommate Robin) and my friends who were treated and doing fine (PH, JB, and MDS)--and then I thought of the thousands of women (and some men) whose families and friends were walking for them. These walks and rides and swims are powerful networks of support, love, and concern--and very good engines for raising funds for research. I hope everyone reading makes a donation now, while it's fresh in your mind.

Two thumbs-up for this hospital

Next time I need a hospital, I'm booking a flight. A young woman I've had occasion to meet sadly needed to see a doctor while on Koh Samui, an island off the coast of Thailand, where she was engaged in deep studies of the culinary arts. There, a doctor's visit usually involves a hospital. Take a look at her description and should you have the need, be sure to dress up.

Here's a picture of the Out-paient Dept at the Hospital, along with its description:

Our OPD with 10 examination rooms serves as an OPD for all of our specialist doctors. The waiting area is cozy, comfortable and homelike. Complimentary refreshments are available in the unit. For non-Thai speaking customers we provide a one-stop service within the OPD area.