Since I've been up since before 5am due to this lovely jet lag, I thought I'd post an update about how things are going back in the states. Some of my reactions since returning:

~It's so calm here! Where are all the people? And animals? And cars?
~It's SO QUIET. I can hear crickets in the morning. Unreal.
~It's so clean.
~Why did I ever worry about crossing the street?
~When you go back in time, jet lag is horrendous. I think this is payback for having almost no issues going to India
~Flying while sick with a head cold is absolutely no fun.
~It's so weird seeing everyone wear shorts here.
~We have so much food! India has fast-food too, but it seems like whenever we went out for a quick meal we just ended up at a little hole-in-the-wall place that probably had better food than a nice restaurant. But here, there are so many choices!
~I miss Indian food!

The Last Week:

Our program ended and now it was time for a week of travel! Abby’s plans changed last-minute and then Maddy, who had been having abdomen pain for a while, ended up in the hospital with such severe pain that she was diagnosed with kidney stones. Although Maddy was better by the time we were ready to travel, we all agreed last-minute it wouldn’t do her any good to go off travelling after such a hectic few days. I didn’t want to sit around in Bangalore, so I headed off to Kerala by myself. I took an overnight bus on Sunday night and arrived in Fort Cochin early Monday morning. I spent the night at this awesome homestay called Dream Catcher Homestay, and dropped my stuff off there before going exploring. I walked around, bought some souvenirs, had banana pancakes for lunch (they were weird), dipped my toes in the Arabian Sea, and got lost and walked ten times as far as I ever wanted to walk. That evening I had dinner with these three crazy Australian medical students who, go figure, were staying right next to me! They were doing rotations in Chennai but it was clear they were much more focused on travelling than actually doing medicine. It was also funny because even though we could understand each other’s English, it was apparent that there are still so many cultural differences….they asked me about wearing “thongs” in the hospital and I was really confused until I realized they were actually talking about flip-flops!

The next day, I went on a backwater tour that the man in charge of the homestay organized. Not the same as Alleppey, but nonetheless interesting. I was with this random, but nice, group of people. We started out on a houseboat-type boat and in addition to being on the water, stopped to see coconut fibers being made into rope and cement from clam shells and coal. After lunch we switched into smaller boats- basically just wooden canoes, which was really relaxing. That night I left on an overnight bus from Fort Cochin, arrived in Mangalore early morning, and immediately caught a bus to Madikeri, where I met Maddy.

Madikeri is in the Coorg region, and it was so nice to see some green for a change! I arrived around mid-morning, and almost immediately after getting there, the people at our homestay (called Alpen Glow; it was awesome. If you ever go to Coorg, stay there!) took us to an Indian wedding where we basically just showed up to take a picture with the bride and groom and eat lunch! Still, it was pretty awesome! The people who own the homestay also own the local newspaper, so they seemed to know just about every person in attendance.

That afternoon, Maddy and I headed a couple km out of town to see Abbi Falls, a pretty magnificent waterfall only made better by the mist and rain. We also walked around town, bought a couple souvenirs, and had a light dinner. Madiker, by the way, is this cute little town and it was really neat to see something smaller after living in such a big city for so long.

The next day (Thursday) there was a strike. Apparently it’s because the government wants to protect the wilderness around Madikeri but the people want more factories for work. They were protesting by not running any local transportation, which we thought was almost supporting the people they were striking against. But anyways, because of this we were basically stuck in town the entire day, which was unfortunate. We managed to get out, though, by going with the owners to their brother’s coffee estate in the morning and then walking to see these old castle-type ruins afterwards.

Friday, our last day in Madikeri, was most definitely the highlight of the week. We left early morning and started by going to the Dubare elephant camp, where we were able to see the elephants bathe, eat, and most exciting of all, we got to ride an elephant!! One goal of coming to India: accomplished! Next, we headed to this deer park where there were unfortunately not any deer, but we did have a nice walk through some woods. After that we headed to the Namdroling Monastery, which was incredible. Not only was it so ornate, but much bigger than I had anticipated. Unfortunately we were unable to actually sit/meditate because the monks were in prayer, but did get to walk around and observe their various activities. Apparently all these Tibetans are refugees from China, and they have formed nine different camps in this area. We had this awesome auto driver who showed us some different sights around the Monastery and finally dropped us off at the first camp for lunch and shopping. After we had had our fill of walking around the cute little village, we headed back to Madikeri (and actually much earlier than we had anticipated).

That evening (last night), we took an overnight bus to Bangalore. It was actually sad to leave because the owners were so nice. They were so accommodating and actually gave Maddy and I gifts as we were leaving…. We had been commenting (to ourselves) on how much we liked the stainless steel plates/silverware sets they use, and the lady gave us each a small plate with some snacks for the bus ride…so incredibly thoughtful and something I can’t imagine happening in the states! How often do people you’re paying to stay with give you gifts when you leave? Probably not often.

We arrived this morning in Bangalore by bus at the ungodly hour of 5am. It was still dark, we knew nothing would be open, and there was no way we wanted to be on the streets, so we crashed at the train station where we had been dropped off. Because all the seats were taken, we spent several very uncomfortable hours on the floor attempting to sleep, people watching, getting weird looks, and glaring at the creepers giving us weird looks. Finally we wandered into a small restaurant to find something to eat and get coffee. We ended up talking to this guy from Holland who’s traveling alone for 6 months, which luckily killed some more time. He asked advice for what to do in Bangalore and surprisingly we didn’t have that much, but I guess that’s good because it means we’ve actually lived here and not just been tourists. We finally left at the more respectable hour 9am and arrived at Mathyoo just in time for breakfast!

Maddy is here for a couple more days and I just finished packing up all my stuff for my flight home tonight…

Kerala backwaters

Our boat

Backwaters

Fort Cochin

Coast of India!

Abbi Falls

Chinese Fishing Nets

Monastery

Monks during prayer time

Days 48, 49 & 50
(7/6-7/8)

The last couple of days have been a whirlwind of good-byes. It all started on Friday, my last day at the hospital. I spent the morning in OT and went out with a bang seeing some pretty cool procedures! The most exciting one was an umbilical hernia- basically this guy had a mass of tissue coming up from his abdominal wall, into and out of his belly button (you could see this big lump of tissue right where his belly button would be). The doctors went in laproscopically and basically just pulled the tissue out from his belly button into his abdominal cavity (which was filled with gas so they could easily work). It took a lot longer than expected, though, because the mass was so big that it wouldn’t fit through the laproscopic holes, so the doctor had to take it out in pieces. Finally, they put mesh over where the hernia was so it won’t come back- and took at least an hour longer than was expected.

After the surgery finished, it was time to say good-bye. I went around to the different units to say bye to the various doctors and nurses I’ve met. It was very bitter sweet; I’m glad it’s done but at the same time, I’ll miss seeing everyone everyday. And besides, how do you even say bye to people in all honesty you may never see again in your life? I mostly got a lot of “best wishes for your future,” so I guess that’s how. The nurses are who I spent the majority of my time with, and I’m going to miss their personality and questions and tours around the units (not to mention the IRC team and everything they did)- so if you guys ever read this, thanks for a great six weeks!

Yesterday (Saturday) was spent running a ton of errands: to the phone store to fix a slight problem, mailing postcards, sending a box of clothes/souvenirs home (Sam), and to the bookstore because we’ve all run out of things to read, which could be bad during 24 hours of travel! That evening we had a final get-together/thank-you party for everyone we’ve worked with the past month and a half. It was actually really nice to talk to everyone and thank them one last time (although once again, there were more good-byes, including Laura's friend who I really enjoyed talking to; she's going into public health and doing an internship here dealing with maternal/fetal health). I also wore a sari (borrowed from Laura), which was awesome!

Today was full of more good-byes. Yoshi left early this morning, as did the Rajasthan group. I’m leaving tonight, and more people are leaving tomorrow as well. It’s exciting to be heading out for a week (or two) of travel, but also weird leaving Bangalore-our home for the last two months- and everyone we’ve spent so much time with. But I’m definitely looking forward to the next week and seeing other areas of India!

Me, Navee, Maddy

Day 47:

Today and tomorrow I’ll be in the operating theatre again. I really enjoy being in the OT; not only is surgery interesting in the first place, but there’s always something new going on! I arrived and walked in on the tail end of a complete mastectomy. Then I got to observe the removal of hardened tissue from a woman’s uterus and her selective fertilization (basically her tubes were tied). Finally I got to observe part of an abdominal operation where I believe the man had some sort of rectal cancer, had part of his large intestine and/or bowel removed, and the doctors were connecting everything again. I had to leave early, which was unfortunate because there was an entire day of surgeries planned. I did have a good reason, though, because Mr. Ramesh and the IRC team wanted to take Cathy and I out to lunch. We went to this really nice North Indian place and had a huge lunch of really yummy food.

Tonight we had a big group meeting about checking out of Mathyoo, plans for this weekend, and advice for travelling. Hard to believe tomorrow is the last day of work!

Day 46:

Today I shadowed a Pediatrician on the OPD unit. I’ve met the doctor before and he’s the one who let me give vaccinations yesterday, so it was interesting to observe office visits after seeing him in other areas of the hospital. It was also nice because his hours ended early, so I got a free afternoon. 

View from the bus stop

The type of bus I take to work

Days 44 & 45
(7/2/12 & 7/3/12)

Yesterday I was on the oncology unit, and specifically where they give chemotherapy treatments. Even though these patients are sick and have terrible diseases, it was a relatively calm unit. Once the nurse set up all the IV’s with the drugs, there was basically nothing else to do, other than general maintenance here and there. So basically it was boring for me. Luckily one of the patients (and his sister) spoke English, and we ended up talking. I also talked with one of the nurses for a while. We actually talked about some more personal topics, such as marriage and jobs and hopes for the future (mostly hers).

It’s interesting because people always think that everyone across the world is so different and foreign. But that’s not true at all. Even though we speak different languages, wear different clothes, worship different gods…beneath all that everyone has the same hopes and dreams for their futures, their careers, and their family. And I bet the world would be a much more peaceful place if people would just realize that!

It’s also interesting because I was talking to this nurse about arranged marriages and how the woman is submissive to her husband. She told me that she didn’t have any expectations for her future spouse, and that she didn’t have problems with obeying him (and in regards to clothing, wearing what he wanted would keep away unnecessary attention). We always think we’re doing good by trying to make all these social changes, but it makes you wonder about the validity of our efforts if the people we’re attempting to help don’t think there’s a problem in the first place?

Today was a whole different adventure. I’m realizing more and more that what I thought was a completely organized six-week internship is not quite that organized. The medical director had told me I should shadow the ENT in OPD, so I showed up at 10am expecting to do just that. Expect the doctor doesn’t come in until 4pm. So then I had to figure out what to do with myself for six hours.

After wandering around a little, talking with some nurses, and touring the ambulance (it’s actually very nice, called the ACLS Ambulance, equipped to handle all sorts of emergencies), I ended up asking one of the pediatricians I had met before if I could shadow him. Apparently Tuesday is unlucky for some reason so he really didn’t have any appointments, but he was going to OB to give vaccinations so I followed him there. It actually worked out really well because he let me give some of the vaccinations! All the babies are required to receive polio, TB (I believe) and Hep B, and I helped give the Hep B shots. They’re called IM (intramuscular), so the nurses and doctor not only showed me how to give the vaccination, but also how to load it, including getting the medicine in the syringe and then changing to a smaller needle. Pretty cool stuff!

After several hours in OB, I finally headed over to the ENT’s office. I hadn’t realized it before, but I already knew the ENT. I’ve seen him around the hospital multiple times before- in casualty for a couple biopsies, in the operating theater- and he’s always really great about explaining what he’s doing and also allowing me to participate/view/help whenever possible. Of course, it being Tuesday, he had almost no patients as well. But he did see one patient; it was a post-op follow-up from surgery to remove cancer from the tongue and lymph nodes. The patient was there to have the staples from surgery removed, and the doctor let me try (and I ended up removing most of them)! Unfortunately that was the extent of his appointments, but he did tell me I could come back tomorrow and see some more.

Days 42 & 43:
(6/30/12 & 7/1/12)

This past weekend was the last free weekend before all our programs end and we head out of Bangalore. Most of the students had to stay back and work, but Sam and I decided to head out of town while we still had the chance. We left on an overnight bus from Bangalore at 11pm, and arrived at Hampi the next morning at around 7am. Basically all we knew when we got there was that Hampi is known for its ruins, but boy were we in for a surprise because it was so awesome!

Before going exploring, we headed off to find the B&B, called Gallery Guest House, where we were staying to drop off our stuff… it was basically this little family-owned place, and I’m pretty sure we were the first foreigners to stay there! But it was actually really nice, had great food, and affordable. What we also didn’t realize was that first you have to cross this river and then go at least a couple kilometers on the other side before reaching the place. But it turned out to be really nice because we were out of the way of the other foreigners and got to see some local villages.

After dropping our stuff off, we walked back into town, stopping to take tons of pictures along the way, and basically spent the afternoon walking around all the ruins (and there were SO many). It was so nice to be out of the city and surrounded by palm trees, rice paddies, rock formations, water buffalo, monkeys, and green! We stupidly forgot to put on sunscreen and got some pretty bad sunburns, so later that evening we went back to the B&B and slept and read in hammocks in the nice breeze for a couple hours.

On Sunday, we slept in late, ate breakfast, lazed around on the hammocks for a couple more hours, and then walked into town. We thought about going on a rickshaw guide of some of the farther-out temples but decided against it. Instead we spent the day walking around, sitting by the river, talking….basically we just had a really nice relaxing weekend which is what I think we both needed!

We took another overnight bus back to Bangalore- it left at 8pm, we rolled into the bus station at around 6:30, got back to Mathyoo around 7, and both left for a full day of work around 9! Needless to say we’re both going to bed early tonight!

Also a final note about Hampi: we both felt like we stood out much more as foreigners. For example, we were buying water (after a long day in the sun) at a roadside place and this guy comes up and says “your faces look horrible.” But his eye was swollen shut, so it’s not like he could even talk! But we definitely weren’t sad to get away from the whistling, obnoxious staring, and heckling (although the kids who tried to talk to us in English were cute).

Just your average cow walking up the stairs

Lakshmi, the temple elephant

Our home away from home

Life doesn't get much better than this!

View of Hampi from across the river

Eating the remains of our mango

Rice paddies

Sunset over the river

Some of the many temples

Day 41:

I’m back early from work after spending the morning in the Operating Theater. I’d seen surgeries before in the US and knew that I liked being in the OR setting, so it was great to be back in that environment again! I first got to watch two c-sections which was really incredible! I’ve seen births before (both here and in the states) but it never ceases to amaze me each time! Then we got to watch a varicose vein surgery, and we saw how the vein is actually removed. Pretty cool, and made even better because the doctors were really good about explaining the process, how the problem occurs, what you do to fix it, and what exactly they were doing. Finally, we got to watch a biopsy get taken from a man’s throat tumor. This was actually the same doctor who I assisted a couple days ago with a biopsy in casualty, so it was nice to see him again, and to see a more in-depth procedure.

Tonight we’re headed off to Hampi for a weekend out of the city before the craziness of the final week of work!

Epidural

c-section

Healthy baby boy!

Finishing up

Day 40:

Today we played hooky from work and went on a day-long trip with CSIM. We first went to this place called Navadarshanam, an organic farm compound just outside of Karnataka. There are only a couple people that actually live on the property but a lot of people from the surrounding villages work there too, and it was interesting to hear about their farming, solar powered electricity, and organic food. We listened to a short talk by one of the men there, and then were able to explore a little on our own. We also had this really awesome natural, home-cooked lunch!

After leaving Navadarshanam, we drove to the Narayana Hrudayalay Heart Hospital, which is a place that Navee wanted to visit. It’s a huge hospital (1000 beds) and is known for its world-leading cardiac specialists and care. We were given a short tour of the Pediatric Intensive Care Unit and Telemedicine Center, where doctors are able to conference with patients/doctors at other hospitals all over the country. The pediatric center was especially moving; it’s hard to see all those little babies and kids lying there hooked up to ventilators and all sorts of other tubes/wires. We then went to a little talk by another hospital staff member. It was actually annoying because while I’m sure many of the doctors have well-meaning intentions, this man was basically preaching about how the hospital is ranked #2 in the world and that the surgeons can “replace a heart valve in fourteen minutes,” rather than talking about quality of care and success rates. But overall, it was still a really great visit. If I had more time here, I think it would be interesting to visit such an advanced hospital such as this- definitely a much different experience than RMH.

Finally we went out to dinner and had a really great meal of paneer, daal, roti, rice, and chocolate cake for Laura’s birthday!

One of the buildings at the farm

Yummy lunch!

On our walk

Village on our way to the farm

Temple just outside of the hospital
It had four different rooms; one each for Hindus, Muslims, Christians, and Sieks
Pretty cool...this would never happen in the US!

Day 39:

We spent the entire day on the wards. The wards are comprised of several different sections but on our section, there were about 30 patients. The patients come to the wards for a variety of reasons, but mostly after being released from ICU, for chemo, or from getting admitted after visiting casualty. As a result, none of the patients are really critical care, meaning there wasn’t a whole lot to do. It was interesting because there were two residents on the unit, yet I felt like all they did the entire day was write notes in charts and occasionally check on patients. Granted it wasn’t like the patients really needed a ton of care, but I just think it would be boring to write orders/notes all day. Nevertheless, we did get to round with the physician we shadowed yesterday, and I even got to write the notes in the chart as he dictated them to me- pretty cool that he felt comfortable enough allowing me to do that!

I think there comes a point when you’re on a unit that you realize there is absolutely nothing you can participate in, so you’re just better off trying to connect with the patients and learn that way. The other kid left early for an “appointment,” although I think that was just his excuse because he was bored out of his mind and wanted to leave. So while I was alone, I ended up talking to these two sisters... such feisty but sweet women. One of the woman’s husband was in the hospital for a foot wound-turned-blood-infection, and we ended up talking for a long time….about school, what my parents did, religion, their kids, how I don’t know Kannada. Apparently one of the sons lived in San Diego and while they said they’d never been to America, they told me they would visit when I got married! It’s funny, but once the conservation covers where you’re from, your schooling, and your family, it always, without fail, turns to whether or not you are married. They also insisted in giving me a bindi, which I immediately took off after leaving the hospital. Not only was I a white foreigner wearing a bindi, but it was red (which I think means you’re married), only adding to the staring and questioning looks. But anyways, they were super nice and so fun to talk with!

Day 38:

Today was a little bit of a bummer day at the hospital. The medical director told us yesterday that we should go to the lab both yesterday and today, but there really was not enough to do for two full days (let alone one full day) and we would have just been in the way. So we spent a good chunk of the morning waiting to ask the “sir” where we should go. We ended up in OPD again but with an internist. It was actually interesting because we went on rounds with this physician, watching him examine several patients with Dengue Fever (apparently there are multiple cases of this in Bangalore right now) and listening to him question a resident about the effects of diabetes. The physician also gave us a little lecture about how it’s necessary to do a thorough examination and history when you first meet a patient. I think he thought we were medical students because he even told us the best book to buy that would explain this! Unfortunately, though, the physician was done at RMH very early in the afternoon (he works at another hospital in the evening)…..so we spent a large chunk of the afternoon waiting once again to see the medical director about the rest of this week. Luckily he said we can be on the wards the rest of the week, so thankfully we won’t have to bug him anymore!

Day 37:

Today we were in Casualty once again. We were actually supposed to be in the lab, but when we got there this morning, they gave us a brief tour and told us we could come back after 4 when the doctor would arrive. So we decided to spend the day in Casualty, where we would hopefully be guaranteed to see some interesting cases….and we did! We saw a cast come off, many IV’s get put in and blood drawn, a failed endoscopy (we actually got kicked out of the room because the patient wasn’t cooperating and the doctor was getting angry), a colonoscopy. We also got an impromptu lesson in X-ray reading and how to spot fractures in an examination. This specific patient had completely fractured her femur near its head and after showing us how to interpret the x-ray, the doctor then showed us how the patient’s shortened and externally rotated leg indicated this fracture. After the other kid left, I was observing a bronchioscope and was actually able to assist a little! I was really only helping get the biopsied tissue into the container, but still, it’s better than nothing!

Finally, we had a death on the unit, which most definitely dampened everyone’s mood. The patient was brought in in cardiac arrest and without a carotid pulse, which apparently means it’s not even possible to shock the patient to bring them back. The nurses quickly started CPR, but their efforts didn’t last very long. Although it was hard to see, it wasn’t that much of a surprise, as she basically came in with a look of death about her. But even so, it’s pretty hear-breaking to see all the family members crying both at the patient’s bedside and outside the unit.

After Casualty, I headed over to the lab to see if anything was going on. It’s was small, but interesting to see everyone at work. I watched one of the lab techs working with samples for a little, and then watched another tech dissect a variety of biopsy samples, which was really interesting! She had actually spent one year of high school in Cleveland and an internship at Johns Hopkins, so it was fun to talk about that. 

Days 35 & 36
(6/23 & 6/24)

We spent yesterday afternoon at the Lalbagh Botanical Gardens. It’s a 240-acre garden with a variety of paths, trees & flowers, and a lake. It’s also right in the middle of the city. Amanda and I spent our entire time there looking for the elusive aquarium. We found several maps that all showed the building (but never our location) so we basically just spent a lot of time wandering aimlessly, but we did manage to see the majority of the park over the course of our wanderings, which was nice. I think half the city was there (and the majority of them couples) and while that’s not necessarily my idea of a nice relaxing afternoon in nature, it was nice to see some green!

Today we went to the opening of the Autism Resource Library at the hospital. We (Lilly and GSE kids) carried some of the books over in our luggage so the Rotary club wanted to thank us, although I don’t think we actually did enough to deserve all the recognition at the meeting. After lots of required formalities and networking (as Cathy told us to do), we had lunch. This was probably the best part of the day and unfortunately we had eaten breakfast, because there was a ton of food. They served a traditional South Indian meal on leaves and said they were going to challenge us with a silverware-less meal. They did give all us foreigners spoons, and I am proud to say none of us actually used them!

Tonight we just hung out together and Sam made a really good daal dish.

Small temple on top of the hill

Tired puppies

Lunch
Only part of the food, and trust me, it tasted much better than it looks!

Days 33 & 34
(6/21 & 6/22)

I spent both Thursday and Friday in the ER, or Casualty as it’s called here. While other units are nice, they are always the same type of case or treatment; but in Casualty, it’s constantly changing. I know a lot of times this type of unit is highly stressful, but I also think it would be nice to be constantly challenging yourself with different types of cases. For example, in the span of two days, I was able to see several people come in with fevers; a young boy needed a dressing change for a head wound; several accidents that required sutures; a bronchioscope to investigate a tumor; a diabetic woman with hypoglycemia brought in by ambulance; a woman with cellulitis (infection of the soft tissue). Keeps you constantly on your toes, that’s for sure!

I’m definitely finding out that a big part of the experience is who you’re working with. Luckily the nurses and doctors have all been nice, but I found it to be especially fun in Casualty. The doctors seemed more involved in care and the nurses were a riot! It’s funny because when I first came in they (nurses) were a little reserved and we didn’t talk that much. But then all of a sudden it’s like a switch is flipped; everyone started joking around more and they decided to give me a tour of the unit (keep in mind I had been there several hours already and it only has about 10 beds, so I’d pretty much seen it anyways)! And of course all the questions begin too: where do you stay? Are you alone? Did you eat breakfast? Have you had lunch? Are you in MBBS (India’s medical school)? How does it work in America? What’s this called in America? But overall it was a great experience! I’m supposed to be on a different unit Monday but when the nurses found out I’d spent three days on OPD but only two with them, they told me I had to come back Monday, so we’ll see!

Thursday I unfortunately had to leave early to go to a CSIM event with the GSE kids. They have weekly speakers and this week one of the speakers was a doctor who started a rural hospital and school in Mysore. It was interesting because when I asked him about incorporating traditional medicine with allopathic medicine, he answered that they just want to alleviate pain and suffering, whatever method that may be. It sounds like they really try to incorporate all types of medicine in order to best help the patients and their beliefs. I really wasn’t expecting this answer because the doctors at RMH view traditional medicine as a real hindrance; patients will use traditional medicine, not really be helped, and then come to the hospital even sicker and expecting a cure. I guess it makes sense to incorporate and be mindful of all types of medicine, but I really emphasize with the doctors who are expected to save the world. But in the end, I guess it’s just about giving patients all their options and then letting them choose.

Friday night, Laura brought in one of her friends to speak about his work with art in under-privileged communities, which was really interesting.

Days 31 and 32:
6/19 & 6/20

Today and yesterday were both spent on the outpatient unit. It’s interesting because the doctor sees mostly elderly patients and even though she’s providing treatment and advice, most of the appointments end up being counseling sessions. Patients are stubborn and won’t exercise to lessen the effects of their diabetes. Or they live alone and spend all day thinking about what would happen if their cancer from five years ago returned, instead of finding activities to occupy their mind. And so the doctor spend the majority of the appointment hearing about their lives, their complaints, and trying to counsel them to listen or fix things in their life. Definitely interesting, although I think I would prefer something with a little more variety.

We didn’t have to be at work until noon today, so I decided to see whether I could visit the disability school associated with the hospital (they’re both funded by Rotary). I could, and spent several hours with the Autism unit observing their outdoor exercise/play time and then classroom time. The school has about 150 kids, all with a variety of physical and mental disabilities and varied ages.

Also, a short note about doing internships: do not bring your little sister to work just because she’s 15, kindasortofmaybe wants to be a doctor but really thinks she wants to be a vet. It’s just awkward for everyone involved. I may or may not have had experience with this awkwardness today (and no, it was not my sister because she’s in the states and wants to be an actress!!).

Day 30:

Today we were on the OPD (outpatient) unit. I didn’t realize RMH offered so many specialties, but there was a board listing them all- probably at least 15 different types. However, being such a small hospital, I think each specialty only has one or two rooms each. The doctor we were shadowing, for example, had one room with a desk for herself, chairs for the patients, and an examining table with a curtain. This doctor was a general practitioner specializing in diabetes care. We basically just sat in the room and listened to her talk with patients for three hours. It was interesting, but being here definitely emphasizes the language barrier once again. I feel like I’m in my own world for the majority of the appointment just kind of zoning out, until either the patient speaks a little English or the doctor would explain what was going on. It was also interesting because I felt like the patients I saw today were much more put together- dressed nicer, maybe cleaner, less hardened by work- than past patients I’ve seen. I’m not really sure why this would be the case, but it was interesting to notice. I’ll have to try to ask again.

Tonight we made ourselves a paneer dish with roti, with mangoes for dessert!! We also tried and failed at opening a coconut, although found some pretty hilarious videos in the process of trying to figure out how to eat one!

Days 28 & 29:
(6/16 & 6/17)

This weekend was pretty relaxing and I spent a lot of time just doing nothing, which was nice. Today was great because I was able to meet up with one of Anna’s friends from her trip to Delhi….it truly is a small world! We rode the metro (my first time, one of the cleanest parts of the city I think!) on the way to Corner House, an awesome little ice cream place! Other than that, it was just nice to talk to get to know her better.

Also Happy Father’s Day to the best dad ever!! I wish I could be there to celebrate, but I hope you have a great day! J

Day 27:
(6/15/12)

Yesterday was another great day in OB! I got to watch all the babies get baths and vaccinations. So adorable (baths, not vaccines)!! I also got to watch another birth right after I arrived! Later in the afternoon, I went with the nurses to this lecture about cleanliness in the hospital. From what I understand they have these classes every Tuesday and Thursday for all units of the hospital…but it was Friday, so I think this one was an exception. Kind of boring, but still interesting to learn about the procedures. And we got food, which was a bonus! I stayed at the hospital a little later hoping I might get to see one final birth, but the mom was not progressing fast enough, it was going to be at least a couple more hours, and it was getting late, so I left.

Nursery
But not actually equipped to handle high-risk babies. The isolates are only used for warming.

Labor and Delivery room
Moms are transferred here once in active labor and stay a couple hours after delivering before being transferred back to the ward.

Day 26:

Today was an awesome day, and definitely made up for the lack of business in ICU! I was on the OB unit, and it was CRAZY!! The kid who crashed my internship got kicked off the unit because the women didn’t want him observing, so I had the whole day to myself without anyone tagging along! At first I felt a little out of place because the unit didn’t seem prepared to have interns/observers at all. The doctors were preoccupied with all the patients, and told me repeatedly they were sorry they didn’t have time to explain anything. So instead, I just wandered around the ward talking to the patients. I eventually ended up rocking this adorable two-day-old baby girl to sleep while talking to her mom and grandma. They were so nice! And they actually let me participate in this little traditional ceremony (or rather, told me that I was going to do this without any choice). There was a little bit of a language barrier, but apparently it’s customary to let newborns suck on sugar water (off your finger) so that they’ll like you, and I guess I was the first to do this for the baby! A pretty big honor, if you ask me! They also told me that I needed to give them baby name ideas by tomorrow, so if anyone has any let me know! Ha

After all the baby cuteness, I decided to try and watch some procedures, and ended up getting to watch the anesthesiologist place several epidurals. It’s done almost exactly the same in India and the US, but still cool to see!

And finally, the highlight of the day, I got to watch a baby being born! I was literally standing right next to the mom and got to watch everything, something that would never happen in the states! C-sections are neat, but natural births are even better! Sure makes you appreciate life, although after seeing all that pain (and an episiotomy), watching a birth would make anyone not want to ever have kids. It’s probably good most patients don’t actually know what goes on during procedures (like during the eye surgery or a birth) because guaranteed nobody would ever follow through!! I have to say though, births in India are a very lonely affair. From what I observed, once moms receive epidurals (or are far enough along) they’re transferred out of the main ward into a delivery room. However, they are there all alone. This particular mom labored by herself for at least an hour or hour and a half while the nurses just did their work all around her. And even when it came time to actually give birth, it was just the doctors and nurses. No mom, no husband, no relatives. That’s actually true for the main ward as well. Most of the women had a female relative with them, but there just isn’t room for entire families to visit. Another thing is that the OB ward is almost entirely female-dominated (as in, all the doctors and nurses are women), which is a nice change from the very male-dominated wards in the rest of the hospital, and which could be why most of the husbands weren’t even present.

Such an adorable baby!

Proud grandma

Happy momma

Day 25:

Today was another long day on the unit. There was practically nothing going on all day, which is great for the patients but really dull for us when we want to see stuff! It was nice, though, when the woman doctor I mentioned yesterday arrived. It’s amazing how some people are just natural teachers…one of the patients was having irregular heart rates and she was looking at the monitor, which led to an impromptu lesson about heart rates and pulse ox’s. Basically you know there are arrhythmias if the peaks on both the pulse and oxygen saturation don’t line up, and above all machines only aid in care, and you as the doctor are ultimately the one who needs to understand and be able to interpret the science behind the machine. It’s interesting because I never would’ve thought to ask about the machine because I know its general function; however, once she started explaining, I ended up asking a lot more questions! This doctor also helped us interpret an x-ray (it showed fluid in the lungs) and explained deep vein thrombosis (the reason why people wear those really tight socks after surgery). So it ended up being a decent afternoon, and we’re onto OB tomorrow!

Dinner at Moledina's on Monday

ICU

X-ray machine

Days 23 & 24:
(6/11, 6/12)

The first part of the week we’ve spent in the ICU unit, and it has been much different than I expected. The unit is extremely small- only 8 beds- and is much less busy compared to US hospitals. Yesterday there were two patients in the unit and then they both got moved to the wards. And then today there were two more patients and a third arrived late in the afternoon. The unit is eerily quiet, and the machines don’t really even make noise, which is also different from what I remember from the states. Since RMH is a pretty small hospital, it doesn’t get many major traumas, so the ICU’s main source of patients is surgery. The first 24-30 hours after surgery are the most critical, and all patients are required to spend those hours in ICU being closely monitored before being moved to the wards.

Our time in ICU has actually been pretty boring. At least from what I’ve seen, most of the work is just maintaining the patients’ condition. One of the doctors told me she thinks ICU is one of the easiest fields because it’s common sense and just about regaining and maintaining homeostasis- what’s wrong, what’s causing the problem, and what can be done to fix it? So far that has been nothing more than monitoring airways, extubating, taking blood pressure, cleaning wounds, and setting up IV’s. This stuff is so basic that I don’t even have that many questions, making it hard to connect with the nurses/doctors and difficult to know what to ask them. I would never wish sickness upon someone, but I guess in some way I do wish there would be a little more action on the unit. But such is the ebb and flow of a hospital; last week it was crazy, this week is quiet, and probably it’ll be crazy again next week.

Aside from the long boring days, I did have a really nice chat with one of the women doctors this morning. We ended up talking about the unequal gender ratios in India and how infanticide is a now-illegal but still very common practice. We were also talking about how many times doctors in villages are seen and treated as God, but that in hospitals it is different; in hospitals, patients expect to be cured when in all reality mistakes do happen. Homeopathic medicine is also an issue because while it is usually harmless and can supplement actual care, many homeopathic-trained people also practice allopathic medicine (without actual training), leading to a whole range of problems. Patients then find their way back to allopathic doctors, expect to be cured, and get angry when there are issues. Finally, we talked about how a lot of times in India doctors may withhold information or make certain decisions for the patients, but that the doctors in ICU (and this doctor specifically) are making a concerted effort to give patients and their families all information available, and then allow them to make treatment decisions based on that information. This doctor shared a quote, and we both agreed it is the way doctors should handle themselves:

“From inability to let well alone; from too much zeal for the new and contempt for what is old; from putting knowledge before wisdom, science before art, and cleverness before common sense; from treating patients as cases, and from making the cure of the disease more grievous than the endurance of the same, Good Lord, deliver us.”

~Sir Robert Hutchison

Day 22:

Today we woke up and went to a talk about economics and businesses Laura set up through someone she knows from study abroad. I didn’t really have enough background information to actually understand everything, but it was still interesting! We spent the afternoon out shopping for various gifts and work clothes. Tonight, we had a really great dinner. It was Matt’s birthday, and some of the girls made a really great dinner and dessert!

More blood pressure!

Cows literally have right-of-way all the time!