Confessions, recorded in bed with my wife, November 6, 2026
Part III of a trilogy
By Omar Nabil Metwally, MD
Friday, November 6, 2026
I. Ground Rules
Before we started, I asked my wife for her consent to record. She gave it, with conditions.
“I consent to you recording my ideas,” said An Hien, “and you can only use them to make a funny story. Not to hurt anyone or ruin anyone’s reputation. Not for dark content. Just for pure laugh.”
“You’re very Vietnamese,” I said. “You set the ground rules.”
“To protect myself. I don’t want anyone to distort my pure thought. Independence, freedom, happiness. And respect.”
“Can we begin the session?”
“Yeah. That was a great start.”
Everything that follows is within the ground rules. Mostly.
II. The Mastermind
It begins, ends, and continues with the Mastermind.
I walked up to the woman at the reception desk to pay for the MRI. Ouch. Ouch. Ouch. It is electricity, shooting down my legs into the sole of my right foot.
“What are we talking about?”
“The Mastermind.”
“Why is it so hard to talk about the Mastermind? I keep stumbling on the Mastermind.”
“Because the Mastermind has infinite power. You have to show respect to keep moving.”
Yes. With respect, then.
The imaging center has two locations. I usually go to the one in Royal Oak. It is very beautiful. It has marble, and it feels like the Middle East. I have never been to Syria, but that is how I imagine Syria. You are transported in time and space.
This time, for the first time, I went to the Dearborn location. It is also beautiful, right in the heart of the Arab medical community, one of the last bastions of independent private practice. And I recognized the woman at the desk from Royal Oak.
“Didn’t I see you at the other location?”
“Yes, I work here and there,” she said. “Here, let me show you a picture of the Mastermind.”
I knew that face. I had seen him at my first imaging study. I had taken him for a man the owner was doing a favor. In my head I gave him a whole life: a refugee, just trying to feed his family. The kind of man you want to tip after the service. Life has been hard on you, sir. Here.
I had even asked him: “Are you a doctor? A technician?”
“Yes,” he said. “I’m a doctor.”
And I thought, sure. The last time he practiced was decades ago, in a completely different era of his country’s history. He is probably working part-time at a car wash.
Lo and behold. He is the Mastermind.
It runs in the family. When An Hien dropped me off at the emergency department at Michigan, she pulled up to the entrance and thought she had to tip the wheelchair guy.
III. Chú
Which reminded me of Chú.
My wife is Vietnamese, and we lived in Vietnam for a year, in her parents’ home. Across the street was a vegetarian restaurant. Out front was Chú.
In Vietnam there are a lot of these men: porters, security guards, a little like bouncers, in uniform. Scrawny, but not someone you want to mess with. The uncle who has had a really hard life.
“He came on a motorcycle, like everybody else,” said An Hien. “Sometimes a bicycle.”
“He looked poor.”
“He looked poor.”
He was always the first one there. He opened the shutter. He was the last one to leave. All day he parked people’s bikes. If it rained and you stepped out, he was holding an umbrella over you. He sat outside the whole time. You could tell he had gotten a lot of sun his whole life. We tipped him here and there, and he always appreciated the small tip. I practiced my Vietnamese with him. He really helped me.
“Tell them about when you first came,” said An Hien.
Ah, yes. My first lesson in Vietnamese privacy law. In my first month there I practiced yoga every morning in front of the window. Natural hot yoga: no heater required, you just close the window. In my underwear, dripping sweat. Then a cold shower, then vegetarian food from across the street, then hanging out with Chú. I got to know the chefs on the top floor of the restaurant really well. It took me a month to realize what their shy, mischievous, embarrassed gazes meant.
After a year, the restaurant closed. The owners were not happy that the kitchen had cut the quality and quantity of the food. They said it was unethical to do that to customers. They would rather close than serve less.
We asked Chú what he would do next.
“Oh, I’ll just go work at a vaccination center,” he said. “My daughter owns it.”
That was surprising. Then he dropped another bomb.
“My daughter is also the owner of this restaurant. I have been a vegetarian for forty years. When she had the idea for a vegetarian restaurant, I told her I would invest. Fifty percent. She is the owner, and I am the investor.”
He was the Mastermind.
IV. The Shopping Cart
I told the Mastermind in Dearborn something, too. I have spinal stenosis. In medical school, decades ago, the textbook sign was pain that is relieved by leaning forward on a shopping cart.
I don’t lean on shopping carts. I have a great wife. Thanks to her, it has been years since I have been inside a grocery store. An Hien is always the one who does the groceries.
But I have been doubled over on the floor for months, trying to get relief. It is not a shopping cart. It is the same mechanism in the spine. The textbook was right. I just needed a floor.
V. Warm Congee
Later, in bed again. The pain was bad.
“Focus on the good thing in Vietnam,” said An Hien.
So here is the good thing in Vietnam.
When I was having a flare of eosinophilic esophagitis, though I didn’t know that yet, I lost so much weight. Then my throat closed up and I couldn’t swallow. That is when I knew I needed help. I went to Vinmec.
We had an appointment. We checked in. The whole day took four hours, and it was four hours of what would take months, if not years, here.
First, the internist, who ordered comprehensive labs, including parasite testing and things a primary care doctor here would never order. Next stop, gastroenterology: I spoke with the chair of the department himself, and he recommended an EGD. While I waited for the procedure, they suggested I go pay, to save time. Things happened in parallel, not in sequence with a six-month gap between each step.
Then the EGD. When I woke up from the anesthesia, they brought me warm congee.
“Warm congee,” said An Hien. “Yes.”
Then the results, explained right away, face to face, by the chair of gastroenterology. Eosinophilic esophagitis, diagnosed according to international guidelines, with the pathology to show it. This is what you need for treatment. Next stop, the pharmacy, where everything was already in the system and waiting: a nice bag, professionally packed, with three months of medication. Then follow-up on Zalo, which is the WhatsApp of Vietnam, and a patient portal that actually works.
The whole thing cost about $260. They gave me all the images.
I once had an EGD here, too. I’m not even going to talk about that.
“Focus on the good thing in Vietnam.”
Right. The brain MRI, for my migraines. We walked in. The neurologist was Canadian-trained, with perfect English and excellent bedside manner. I got the MRI on the spot, discussed the results, and walked out with the CD. And she made herself available afterward.
At the public hospital where our daughter was born, the prices for everything are posted on a big sign outside, before you even reach the entrance. You can read from across the street what a visit, a procedure, or a medication will cost. The OB ultrasound, with a better machine than most clinics here and a radiologist who does nothing else all day, cost about four dollars. They handed us the printouts and the videos on the spot.
It is right on the beach. You look out the window during labor and think you are in Hawaii. People take off their shoes before they enter the clinical areas, the way you would in someone’s home.
Healthcare and education. If you don’t have those two things, you don’t have a foundation, and you can’t build a house without a foundation. I love a lot about this country. I love having a yard. I love the local farms, the produce, the green, the space. I love the seasons. But that is where the conversation starts and ends.
VI. A Wimp
I had so many encounters with the healthcare system in Vietnam. So many times, I thought I was going to die.
The time yellow pus was coming out of my eye. Dengue. Food poisoning from seafood, which was not the restaurant’s fault at all, they were so sweet. I was hugging the toilet.
“Your body,” said An Hien.
“I’m a wimp.”
“Yeah.”
“That’s why Vietnam won the war.”
“Yeah, yeah, yeah.”
VII. Keep Going
That is the problem with being married to a Vietnamese woman. You have to keep fighting. It does not matter that your spinal cord is shooting electric bolts down your legs. You have to get up. You have a daughter and a wife. The dog is barking. Keep going. Keep going.
I understand why Vietnam won. I know that better than anybody in the world.