Farewell

The four weeks experience in India has been completed. I have just arrived back from India. There is so much that I have experienced and wanted to document, but every time I try to blog I somehow always manage to leave out something. I am still amazed at how advance CMC is and the equipments provided at the hospital despite the condition of the surrounding environment. The doctors and medical students are so well read and very hardworking. During grand rounds, the attendings ask very intricate questions and seem to always be interested in what year did a certain medication regimen begin, etc. I do miss the rickshaw rides. They were quite an adrenaline rush but I will not miss the littering. Throwing water bottles, candy wrappers, plastic cups, and everything and anything else is almost second nature for the elders and children. It is so hard to find a trash can around the city that I can almost understand why littering is so prominent. I will most definitely miss tea time. Everyday at exactly 10:30am, all work stops and all the doctors have their tea/coffee break. Then around 4pm there is another tea break; this one is not as consistent. Even during the nurse/doctors’ runs to the villages at 10:30am we stop by a coffee shop to grab some tea/coffee. I will not be able to have a meal for $1 anymore. Breakfast would be at most 50 cents and lunch maybe 75 cents if I wanted to splurge. Yet somehow I ended up spending much more than I intended to. Maybe it was the “foreigners pay 750 rupees and only 20 rupees for Indian residents.” However, the traveling to Mamallapuram, Kanchipuram, Bangalore, Delhi, and Agra were well worth the trip. The Taj Mahal is breathtaking and the Lotus Temple is amazing! I’ll miss the Indian spices they were delicious, but goodbye to my heartburns now that I’m back in the U.S.

Delhi

I'm in Delhi now, the capital of India! Tomorrow I'll finally get to see the infamous Taj Mahal. Although, the bus ride will depart Delhi at 6:30am and arrive back in Delhi at 10:30pm! I hope the ride will be enjoyable....or at least comfortable. It is crazy here! There are so many people here.
This past weekend I stayed in Bangalore and experienced my first banana leaf meal. So I finally caved in and learned to use my fingers and scope up pieces of rice without utensils. First, I had to sit on the floor then wash my banana leaf with some bottled water and then the meal was placed on top of the banana leaf. It's quite a challenge trying to scope up rice and pack it into a ball before bringing the fingers to your mouth! With many eyes on me from the others around me and a pile of rice outside the banana leaf that managed to escape between my fingers....I finished the meal in about 20 minutes! No problems with the GI so far!

Bangalore

CMC was an incredible experience! I saw/experienced things I probably wouldn't have had a chance to see in the U.S. It's amazing how similar and yet different medicine is practiced across the world. Now, I am in Bangalore visiting my medical school roommate and her relatives. It was a 4 hour train ride from Vellore.
Today I got my eyebrows threaded for the first time ever! Quite different and a lot faster than plucking. The coffee in India tastes wonderful! There is an international coffee festival this weekend in Bangalore. On Tuesday, I am traveling to Delhi to see the capital of India. Then hopefully the Taj Mahal in Agra before I leave India for Houston. These past few weeks have flown by! I cannot believe I'm leaving India in less than one week.

Infectious Disease

Wow, I am almost done with my rotation here at CMC. Yesterday was outpatient clinic and it was quite interesting. The doctor had studied in the U.S. and did a fellowship at MD Anderson in Houston. His English was great and it was interesting in how he practices medicine here compared to the other doctors here. He respects his patients very much and treats each one with dignity and will praise every patient that walks into his room. Although, it quickly became chaotic when he had 4 patients in his room at one time! He had one sitting in the room across his room and three other patients in his room. I was suppose to interview one, Codi another, and a medical student from CMC see the 4th patient. In addition, each patient brought along a close family/friend. I interviewed about 4 patients that only spoke Hindi and well...understood a couple of English words here and there. I realized after my first patient that the only way to succeed was to use one word sentences/questions. For example...pill (along with a hand motion imitating taking a pill), hurt (pointing to certain areas of the body), job, etc. Asking "do you take any medications, or does it hurt anywhere" will not get me anywhere! The only response I will receive is either a puzzled look on their faces or they start saying a bunch of stuff I completely don't understand. This epiphany only occurred after I had realized that they spoke to me the same way. For example when I step into a shop, they say "come" and that's it or "bye" and walk away. It's been a quite interesting experience.
Today during ward rounds, I saw gangrenous toes due to SLE, Raynaud's phenomenon at different stages, a great clinical example of rebound tenderness, and numerous cardiac murmurs. I've noticed that many of the patients have rheumatic heart diseases or have been treated with tuberculosis....I just hope I don't end up having positive PPD's once I leave India.

The Pool

This weekend was nice and relaxing. It was almost an escape from reality......the pool by the CMC college campus. With palm trees, a blue swimming pool, western toilets, pizza with cheese, french fries, coke, and grass, real grass, was a nice escape from the dirt roads and the honking of the cars, motorcycles, mopeds, rickshaws, bicycles, and buses! Codi and I spent the entire day at the pool on Sunday along with some other international students we met the previous night at a hotel roof top restaurant. One is a Urologist attending starting up this fall in Baltimore. Another two were doing research here in Vellore, one from Sweden and the other from Denmark. Then there are two girls doing their endocrinology fellowship elective at the CMC hospital. There were a bunch of other international students there too. So this week we start I&D, infectious disease.

Leprosy Clinic

Today was leprosy clinic. Yes, it's a Saturday and we had to show up at 7:30am but it was definitely worth it! I've always seen leprosy on TV or in the books but to see it in person is stunning. I did not realize how debilating it was and I saw all stages of leprosy. I meet a newly diagnosed leprosy female in her late 20s. She had the hypopigmented patches/macules on her face and arms. Then I saw another male with hypothenar atrophy and missing digits. Another patients had ulcerated his entire plantar surface of his right foot and yet he walked around as if nothing was there. Thankfully, there are multiple drugs for this disease and quite curable! This afternoon, there's suppose to be some festival right in front of the CMC hospital. We might even visit the one and only tourist spot in Vellore....the FORT! :)

CHAD

So much has happened since my last blog. I've been at CHAD, a community health and development secondary hospital out in the rurals. That is the reason why I have not had a chance to update my blog. The computer there takes forever to start up. To get to a website would take 2 mins! So, here's a review of what happened this past week.

Monday:
Orientation at CHAD and learned about the history of CMC. It's a great story. So a brief synopsis would be a lady named Ida Scudder, who is a daughter of a medical missionary, was born in India. She is an American who one day witnessed the death of three pregnant women while in labor during one night near Vellore, because no female doctors were available to help with the deliveries. Ida's dad was a doctor but he was not able to assist because he was a male. So she went back to the U.S. and studied to become a doctor. She came back to Vellore and started a one room clinic at her house that eventually expanded into CMC hospital. She was a huge advocate of community health and traveling to villages to help people. So now CMC sees over 5,000 outpatients and 3,000 inpatients a day! This is a very brief discription of CMC's history but there's a more complete story online.

Tuesday:
Checked out the L&D, pediatrics, geriatrics, ICU, ER, and general wards at the CHAD hospital. I saw leprechaunism, a congenital syndrome, which I have not ever seen/heard of before. I have a great picture but until I figure out how to upload pictures onto this blog.....maybe later. So apparently there is a lot of consanguineous marriages within the villages and many autosomal recessive traits show up.

Wednesday:
Nurse's Run, where we do home visits. This was exhausting! We visited a total of about 16 homes and 6 villages. We walked to each house and did mostly prenatal and postnatal checkups. We saw some hypertensive individuals and a handful of well baby exams. Unfortunately, most of the babies were malnourished and one was a 2 months old term baby girl, but only weighed about 5 pounds! The mom was feeding her cow milk and the baby had diarrhea and just looked aweful! The nurse referred the baby to the hospital and supposedly there will be a van to pick the patient up the next day. Some of the houses were made out of sticks/cow dung and some were made out of concrete and bricks. There was a huge variety of living quarters. Some villages had a well!

Thursday:
Doctor's Run, where we travel in a mobile clinic and go to 4 different posts. The patients would arrive at the post and we would see patients either in the van or outside the van at a table set up. I loved this experience! So two doctors would run this. One doctor is outside at the table taking blood pressures and doing baby exams, hypertensive/diabetes checkups and some geriatrics/psychiatric conditions. Another doctor would be in the van doing prenatal checkups. The back part of the van were two nurses giving immunizations to the babies and dispensing medications. We left at 8:30am and didn't get back until 6pm!

Friday:
Today, was our day to recuperate! Wow, what an exhausting week! We went to a traveling agent to help us organize our trip for our last week in India. So far we have a train ticket to get to Bangalore and a plane ticket from Delhi back to Chennai on March 2nd to catch our flight back to Houston, home! Ro, my roommate back in San Antonio, is in Bangalore with her relatives so I'll get to see her finally!! Now, off to the ER at CMC hospital to explore some more.